• Journal of Korean Academic Society of Home Health Care Nursing
• /
• v.6
• /
• pp.5-18
• /
• 1999

This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.

• The Korean Journal of Rehabilitation Nursing
• /
• v.4 no.2
• /
• pp.137-145
• /
• 2001

This study examined and identified the relationship between the level of hope and self-care agency in hemodialysis patients. The purpose of the study was to reveal that hope is an essential factor to enhance self-care agency and to prepare the basic materials to help nurse the patients. The subjects for this study consisted of 108 persons who undergoing hemodialysis from 2 hospital, 2 hemodialysis center in Pusan, Korea. The degree of hope was measured by the questionnaire that has been developed by Miller. The self-care agency was measured by the questionnaire that has been developed by Kearney B.Y & Fleisher B.J. The collected data were analyzed by descriptive statistics and t-test. one-way ANOVA and Pearson's Correlation Coefficient with SPSS WIN program. Results were obtained as follows: 1) The mean scores of hope were $131.77{\pm}25.77$(range 67-195). The rate of hope classified said that the lowest hope was 2.8% and low hope was 27.8%. 2) The mean scores of self-care agency were $143.78{\pm}23.63$(range 74-187). The degree of self-care agency classified said that the rate of self-care agency deficiency was 0.9% and low self-care agency was 12.0%. 3) The hope was significantly related to self-care agency. That is, the higher the hope score was， the higher the level of self-care agency score(r=0.668，p=0.001) was. In this result, there were hemodialysis patients who have very low hope score and self-care agency score. In this cases self-care agency can be increased by encouraging the patients to be more hopeful. Conclusively nurses should access the degree of hope and self-care agency of hemodialysis patients individually and apply the hope therapy in order that the patient have higher hope than before.

• Korean Journal of Adult Nursing
• /
• v.21 no.5
• /
• pp.529-537
• /
• 2009

Purpose: The purpose of this study was to investigate the correlation of sexual satisfaction and daily stress in breast cancer patients. Methods: Data was collected through self-administered questionnaires and analyzed by descriptive statistics, t-test, ANOVA and Pearson's correlation. Data survey was conducted with 500 conveniently selected breast cancer patients who visited the out patient department in 5 university hospitals in Seoul, Gyung-gi and Gang-won province. Results: The sexual satisfaction of breast cancer patients score was 31.34 and there were significant sexual satisfaction differences by age, education level, menopause and sexual activity frequency. Sexual satisfaction was negatively related with daily stress (r = -.177) especially personal stress (r = -.155), economic stress (r = -.138), stress of self (r = -.181), family stress (r = -.154) and stress about leisure (r = -.139). Conclusion: These findings are expected to make a contribution to creation of ideal sexual rehabilitation nursing interventions for breast cancer patients care nurse. Furthermore continuous and customized education and counseling programs can contribute to promote healthy sexual life for breast cancer patients.

• Research in Community and Public Health Nursing
• /
• v.24 no.2
• /
• pp.245-254
• /
• 2013

Purpose: This study was conducted to investigate factors influencing suicidal ideation in people with mental disorder. Methods: The subjects were 176 people with mental disorder from community mental health centers, social rehabilitation facilities, and university hospital psychiatric outpatient departments. The instruments used included a suicidal ideation questionnaire, a self-esteem scale, a spiritual well-being scale, a family support scale, and a professional support scale. Data were analyzed with t-test, one-way ANOVA, Pearson's correlation coefficient, and hierarchical regression analysis. Results: Suicidal ideation was influenced by age, history of suicidal attempts, and existential spiritual well-being. This study shows that suicidal ideation has negative correlation with existential spiritual well-being, self-esteem, family support, and age. Existential spiritual well-being, history of suicidal attempts, and age accounted for 30% regarding suicidal ideation in people with mental disorder. Conclusion: The lower existential spiritual well-being and age, the higher suicidal ideation. And also suicidal ideation was higher in people who had attempted suicide than in those who had not. Based on the outcomes of this study, it is necessary to design an intervention program that emphasizes existential spiritual well-being in order to decrease suicidal ideation in young people with mental disorder.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.11
• /
• pp.4831-4836
• /
• 2016

The study aimed to find out to what degree suicidal thoughts and associated factors affect the suicide risk of advanced cancer patients. The frequency of suicidal thoughts among patients with cancer, especially in the advanced stages, is about 3 times greater than the adult average in South Korea. We recruited 457 participants with four types of cancers (colon, breast, cervical, and lung) using stratified sampling. Data collection was carried out through one-on-one interviews by trained nurses using a structured questionnaire. Advanced cancer patients with high, vs. low, levels of anxiety and pain had a higher suicide risk. In contrast, having one's spouse as the primary care provider was associated with a low suicide risk. Overall, the three factors of anxiety, pain, and the primary caregiver being one's spouse explained 17.2% of the variance in suicide risk. In conclusion, we derived influencing factors of suicide risk using a sample of patients with various types of advanced cancer. The results provide systematic baseline data for preparing nurse-led interventions to prevent suicidal thoughts and suicide attempts among advanced cancer patients.

• Journal of East-West Nursing Research
• /
• v.1 no.1
• /
• pp.22-39
• /
• 1997

Purpose: The purpose of this study is to evaluate the effect of rehabilitation education on the reduction of the stress of family members who have patients suffering from stroke and to find a new way to nurse the patients and their family. Subjects & Methods: The subjects were sixty-one family members with the patients who had been hospotalized in K hospital of oriental medicine from september the 9th, 1996 to september the fourteen, 1996. This study was performed by simulated control group pretest-posttest design; pretest was done on the control group through a questionnaire, counselling and observation while posttest was done on the experimental group 1-2 days after systemic rehabilitation education. To teach the patients and their family, the amended version of a book written by Lee Hae-jin was used as a tool for systemic rehabilitation education. As a method to estimate ADL score, modified Kang's method was applied and ADL score was measured by well-trained technician. As for the tool to estimate the degree of family stress, Choi's method adjusted to this study was applied. In the analysis of the data, social property of the patient and the characteristic of the disease were surveyed in $X^2$ examination to confirm the consistency between the experimental group and the control group. The diffrence in the degree of the stress, which is a dependent factor, was examined by t-test. The difference in ADL score between the experimental group and the control group was examined by t-test. The difference in the degree of the stress according to the general feature of the family with stroke patient, social property of the patients and the characteristic of the disease were surveyed by F examination. The difference in family stress according to the degree of ADL was surveyed by F examination. RESULTS: 1. After hypothetically-examined systemic rehabilitation education, the total of the score of family stress surveyed in 34 items of three domains was compared between the experimental group and the control group. There was no statistically significant difference between two groups; mean score of experimental group=2.28, that of control group=2.93(t=.17, df=59, p=. 66). 2. In the survey on family stress in 34 items, the items over mean score 3.0 were firstly the anxiety of possible disability and relapse of the disease and secondly to watch the patient's suffering without doing anything in the domain of the change of the disease and the difficulty in caring. And the items of the lowest stress with less than mean 2.0 score were little chance to meet the relative and friends, inconsistent treatment and attitude of the medical workers and the change of the attitude of the relative due to the patient orderly in the domain of social and personal relation and the responsibility as the family. The items which showed the difference between two groups were aggravation of neighboring patient(t=3.36, df= 59, p=.001) and the possibility of patient's death(t=2.19, df=58.38, p=.033) in the domain of the change of the disease and the difficulty in caring. 3. In the study on the stress difference according to general features of the family with the stroke patient, the score of family stress with the occupation was higher with mean 2.49 than that of the family stress without occupation with mean 2.16, but there was no significant difference. (F=5.21, df=1/59, p=.026). 4. In the study on the stress difference according to social property of the patient and the characteristic of the disease, there was significant difference in the age of the patients (F=2.98, df=3/57, p=.039). These results show that even if there is no statistically significant difference between two groups, sixteen of the experimental group are less than 3.0 in ADL score(standard 6 score)while eight of the control group are less than 3.0 and that ten of the experimental group are in the year range of 39-49 while four of the control group are in the year range of 39-49 which showed significant difference in family stress. These imply that there is a possibility that the experimental group have serious and fundamental stress resulting in high pretest stress compared with the control group. It might be due to the characteristic of simulated control group pretest-posttest design that the psychologic-supportive effect by the education was not observed. On the basis of these results, the followings are suggested. 1) A study on the nursing-mediated method to reduce the stress in the items which are not resolved by rehabilitation education, a study on nursing according to the patient's age and a study on the supportive nursing toward the family with occupation are required. 2) More than two times consecutive nursing-mediated rehabilitation education to measure the family stress is required. 3) Comprehensive and multilateral systemic education program including the instruction on western-eastern medicine, physical therapy, exercise and diet through collaboration of the experts in each field is required. 4) Family stress at home as well as in the hospital needs to be estimated and home rehabilitation and home-nursing needs to be continued.

• Korean Journal of Cleft Lip And Palate
• /
• v.15 no.2
• /
• pp.69-82
• /
• 2012

Our Team Approach consists of following five stages; (1) Peri-natal care until lip repair After ultrasound diagnosis, some obstetricians recommend the mother with CL/P fetus to undergo prenatal counseling in our CLP clinic. On the day the CL/P baby was born, our oral surgeon, nurse, and pedodontist visit the maternity clinic, and take counseling and take impression for a feeding plate. The cheiloplasty is performed in three months old. (2) From lip repair to palatal repair At one year of age, Otorhinolaryngologist checks middle-ear disease. Palatoplasty is carried out at 1.5 - 2 years old. (3) In deciduous and early mixed dentitions Speech is the most important issue in social life for the CL/P subjects, therefore the training of velopharyngeal function is essential. Orthodontist monitors dentofacial development from 5 years of age. In the case of severe maxillary under-growth or severe collapse, maxillary protractor or lateral expansion is indicative, respectively. In early mixed dentition, upper central incisor on the cleft area erupts with some torsion, and then the traumatic occlusion with tooth torsion must be corrected. (4) In mixed dentition Right before the eruption of upper canines, secondary bone grafting is performed. One year prior to the operation, maxillary fan-type expansion is carried out to correct the collapse of maxillary segments. Following the surgical operation, the erupted canine will be moved into the transplanted bone to avoid alveolar resorption. (5) In permanent dentition Final tooth alignment is carried out after eruption of second molars. Some cases may require orthognathic surgery after physical maturation. Prosthetic oral rehabilitation including the dental-implant is carried out after age eighteen.

• The Korean Journal of Rehabilitation Nursing
• /
• v.9 no.1
• /
• pp.15-24
• /
• 2006

Purpose: This study was to explore the cognitive function of Korean-Chinese stroke patient in China. Method: The study sample was 100 who were possible to communicate and agreed. The data were collected from one Brain's hospital at Yanji in China and by trained nurse from December 12, 2005 to April 28, 2006. The measurement tools were Digit span, Trail making, and MMSE-K. The data were analysed by SPSS Win 11.5 using frequency, t-test, ANOVA, and Pearson's correlation coefficients. Results: The mean score of DSF was 5.07, 3.42 of DSB, 161.37 of TMA, 229.28 of TMB, 22.64 of MMSE-K. There was a significant difference in DSF (F=6.35, p=.001), DSB (F=6.10, p=.001), TMA (F=3.53, p=.018), TMB (F=3.26, p=.025), MMSE-K score (F=12.97, p=.000) according to age, and DSF (F=6.67, p=.000), DSB (F=6.01, p=.000), TMA (F=5.82, p=.001), TMB (F=6.23, p=.001), and MMSE-K score (F=13.02, p=.000) according to educational level, and DSF (F=5.35, p=.006), DSB (F=3.16, p=.047), TMA (F=3.30, p=.041), TMB (F=3.42, p=.037), and MMSE-K score (F=4.95, p=.009) according to duration of disease, and DSB (F=3.54, p=.018), and MMSE-K (F=6.05, p=.001) according to frequencies of hospitalization. There was high correlation between DSF and DSB (r=.581, p=.000), TMA and TMB (r=.936, p=.000), MMSE-K and DSF (r=.579, p=.000), MMSE-K and DSB (r=.591, p=.000), DSF and TMA (r=.727, p=.000), and DSF and TMB (r=.721, p=.000). Conclusion: The cognitive evaluation score of Korean-Chinese stroke patients in China was in normal limit. The age, educational level, duration of disease and income were significant demographic characteristic affecting cognitive function. Further study need to compare the cognitive function of Korean-Chinese stoke patients in China and stoke patients in Korea.

• Journal of muscle and joint health
• /
• v.23 no.3
• /
• pp.197-205
• /
• 2016

Purpose: The purpose of this study was to conduct a comparison analysis on requirements of online continuing education requirements according to practical experience of nurses at small and medium-sized hospitals. Methods: Data had been collected with 236 nurses from May to June, 2015. The data were analyzed with the use of SPSS. Results: Among them, 45.8% participated in online continuing education. Nurses in beginning level required musculoskeletal diseases (20.9%), care for injuries and stomas (5.8%), and surgical disease and operation care (4.7%). Competent nurses required musculoskeletal diseases (19.7%), cerebrovascular diseases (9.9%), emergency care and CPR (8.5%), and medical nursing (8.5%). Skillful nurses required cerebrovascular diseases (13.9%), care for internal diseases (8.9%), and rehabilitation care (8.9%). Among the educational contents of diseases, the items that were significantly different according to practical experience were operation management ($x^2$=23.92, p<.001) and drug care ($x^2$=7.85, p=.020). Among continuing education methods, the items that were significantly different were video ($x^2$=16.81, p<.001), webtoon ($x^2$=8.96, p=.011), and test ($x^2$=10.56, p=.005). Among continuing education evaluation methods, the items that were significantly different were multiple-choices ($x^2$=9.43, p=.009) and OX ($x^2$=6.47, p=.039) based quizzes. Conclusion: Based on the study results, it is necessary to develop a differentiated continuing education program according to practical experience of nurses.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.10
• /
• pp.4401-4408
• /
• 2015

Background: Cancer is a primary source of concern in Thailand and other countries around the world, including the Asian-Pacific region. Evidence supports that an important contributing cause of cancer and other chronic illnesses such as stroke, diabetes, and hypertension is excessive alcohol consumption. Studies conducted in Thailand reveal a worrisome rise in the number of new and regular drinkers in communities. Therefore, actions for primary, secondary and tertiary prevention of problem drinking are necessary. In recent years nurses in North East Thailand have been developing and implementing the Khon Kaen Family Health Nursing model to embed disease prevention in communities through the actions of family health nurses and local family health leaders. Aim: The aim of this qualitative research was to better understand the experiences of the local family health leaders using this model and to synthesize lessons learned. Materials and Methods: As part of a participatory action research approach involving analysis of focus group discussions and individual interviews, the experiences of 45 family health leaders were synthesized. Results: Four main themes were identified, namely: i) Family first: role modeling beginning at the personal and family level. ii) Local leverage: using village community forums to reduce alcohol drinking. iii) Gentle growth: making the first step and treading gently; and iv) Respect, Redemption, Rehabilitation: valuing the person to re-integrate them in the village society. Conclusions: As alcohol consumption in the village declined significantly following the prevention program, these findings illuminate how low-tech integrated prevention approaches may be very useful, particularly in rural communities. The lessons learned may have relevance not only in Thailand but in other countries seeking to prevent and mitigate behavior that conduces to diseases such as cancer.