• 간호행정학회지
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• 제1권1호
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• pp.65-78
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• 1995

This is a quasi-experimental research to test the effect of using a nursing care scale. This study identified the effects of using a nursing care scale influencing on the nursing performance and job satisfaction. The subjects consisted of 63 staff nurses in 8 medical and surgical units of one hospital affiliated to university hospital in Seoul, and assigned to experimental and control group conveniently. The data were collected in September and December, 1992. The evaluation of the nursing performance were measured by the instrument from a nursing care scale of one univerrsity hospital and job satisfaction was measured by Stamp's Scale (1978). The data were analyzed by percentage distribution, 2-test, Mann-Whitney U Wilcoxon Rank Sum W test, ANCOVA and T-test. The summarized results were as follows : 1. The nursing performance of the experimental group showed markedly increase about 13 areas of nursing care. However no significant difference in the nursing performance between the two groups was found. 2. There was a significant difference in the nursing performance between the experimental and the control group about 7 areas of nursing records(W=22.0, P<.05). 3. After using a nursing scale, there was a significant difference in the nursing performance about nursing care and nursing records between the experimental and the control group(W=25.0, P<.05). Comparing before using a nursing scale with after, there was no significant difference in the nursing performance between two groups. 4. There was no significant difference in job satisfaction between the experimental and the control group. The main reasons for there being no defference in two groups could be the small size sample and the procedure of intervention. Further comparative study is needed using more strictly controlled procedure of intervention.

• 대한간호학회지
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• 제16권3호
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• pp.11-21
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• 1986

The purposes of this study were to clarify whether the health belief model could explain the women's adoption of sterilization and to find the factors which influence the adoption of sterilization. To achieve these purpose, 35 women, who visited the family planning hospital to undergo an surgical operation for sterilization, were selected and named the group of adoption. Also, 36 women, who have the same demographic characteristics as the group of adoption, and have no sterilization among the married women, were selected and named the group of non-adoption. The measuring instruments used in this study were made by the researchers on the basis of the results of the review of the related literatures. The validity of these instruments was examined by one professor majoring in nursing and two family plmanning practioners. The reliability was proven by calculation of Cronbach's α with data of the group of adoption. The data was analyzed by t-test, X²-test, and ANOVA using Computer SAS system. The results were following: 1. Health belief model could be said to explain whether women accept the sterilization or not, because the degrees of susceptibility and severity for future pregnancy and the degree of benefit or adoption of sterilization in the group of ad-option are higher than those of the group of non-adoption. 2. Influence of demographic variables on health belief variables was as follows. With advancing ages, degree of susceptibility increased in the group of adoption, and the higher the number of artificial abortion increased, the higher degree of barrier increased in the group of non-adoption. Suggestions for further studies and application to the nursing practice are as follows 1. If one wants to educate the non-adoption women, one would be better to give such information as to increase the perception of susceptibility, severity and benefit. 2. New instrument to measure the perceived barrier which includes such items as fear on well-ness of the existing children, objection of husband and postoperative complication, is needed. 3. A study to find the change of perception on health belief variables is needed, after education to increase the level of perceived susceptibility and severity on the future pregnancy, and benefit on sterilization is given.

• Archives of Plastic Surgery
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• 제41권5호
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• pp.505-512
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• 2014

Background Laryngeal allotransplantation (LA) is a technique involving transplantation of a deceased donor's larynx into a recipient, and it may be substituted for conventional laryngeal reconstruction. There are widely different views on LA, as the recipient is administered continuous, potentially life-threatening, immunosuppressive therapy for a functional or aesthetic result, which is not directly related to life extension. The purpose of this study was to analyze the difference in risk acceptance and expectations of LA between four population groups. Methods A survey was performed to examine patients' risk acceptance and expectations of LA. The survey included 287 subjects in total (general public, n=100; kidney transplant recipients, n=53; post-laryngectomy patients, n=34; doctors, n=100), using a Korean translated version of the louisville instrument for transplantation (LIFT) questionnaire. Results All four groups responded differently at various levels of their perception in risk acceptance and expectations. The kidney transplant recipients reported the highest risk acceptance and expectations, and the doctor group the lowest. Conclusions This study examined the disparate perception between specific population groups of the risks and benefits of using LA for the promotion of the quality of life. By addressing the information gaps about LA in the different populations that have been highlighted from this survey, we suggest that LA can become a more viable alternative to classical surgery with resultant improved quality of life for patients.

• 대한두개안면성형외과학회지
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• 제17권2호
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• pp.68-76
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• 2016

Background: In scalp allotransplantation, the scalp from a brain-dead donor, including hair, is transferred to a recipient with scalp defects. Opinions differ on the appropriateness of scalp allotransplantation. In order to maintain graft function and cosmetic outcomes, scalp transplantation recipients would need to receive lifelong immunosuppression treatments. The risks of this immunosuppression have to be balanced against the fact that receiving a scalp allotransplant does not extend lifespan or restore a physical function. Therefore, the present study aimed to investigate risk acceptance and expectations regarding scalp allotransplantation in different populations. Methods: A questionnaire survey study was conducted. A total of 300 subjects participated; survey was conducted amongst the general public (n=100), kidney transplantation recipients (n=50), a group of patient who required scalp reconstruction due to tumor or trauma (n=50), and physicians (n=100). The survey was modified by using the Korean version of the Louisville instrument for transplantation questionnaire. Results: Risk acceptance and expectations for scalp transplantation varied widely across the groups. Kidney transplantation recipients revealed the highest risk acceptance and expectations, whereas the physicians were most resistant to the risks of scalp transplantation. Conclusion: Our study demonstrates that, in specific groups, scalp allotransplantation and the need for immunosuppression carries an acceptable risk despite the lack of lifeextending benefits. Our results suggest that scalp allotransplantation can be an acceptable alternative to existing scalp reconstruction surgeries in patients with pre-existing need for immunosuppression.

• 임상간호연구
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• 제18권2호
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• pp.296-306
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• 2012

Purpose: This study was done to compare the physical injury, emotional response and unplanned self-removal of medical devices in patients with physical restraints and patients not restrained. Methods: Eighty patients admitted to the intensive care unit (ICU) of a university hospital in Seoul participated in this study. Forty patients made up each group and the group not restrained was matched with the restraint group for age and history of smoking and alcohol consumption. Data on occurrence of physical injury, intensity of anxiety, stage of agitation and unplanned self-removal of medical devices were collected by observation and medical chart review using a structured instrument. Statistical processing of collected data was done with the SPSS WIN 17.0 program. Results: The physically restrained group experienced more physical injuries and recorded significantly higher levels of anxiety and agitation than the unrestrained group. However, there were no significant differences between the groups in occurrence of unplanned self-removal of medical devices. Conclusion: Results indicate a need for critical care nurses to carefully monitor physical injuries and emotional responses of physically restrained patients and to develop nursing interventions to prevent adverse effects associated with restraint use. There is also a need to develop patient safety guidelines when using physical restraints.

• Archives of Plastic Surgery
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• 제47권1호
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• pp.33-41
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• 2020

Background Closed-suction drains are widely used in expander-based breast reconstruction. These drains are typically removed using a volume-based criterion. The drainage volume affects the hospital stay length and the recovery time. However, few studies have analyzed the factors that influence drainage volume after expander-based breast reconstruction. Methods We retrospectively analyzed data regarding daily drainage from patients who underwent expander-based breast reconstruction between April 2014 and January 2018 (159 patients, 176 expanders). Patient and operative factors were analyzed regarding their influence on total drainage volume and drain placement duration using univariate and multivariate analyses and analysis of variance. Results The mean total drainage volume was 1,210.77±611.44 mL. Univariate analysis showed correlations between total drainage volume and age (B=19.825, P<0.001), body weight (B=17.758, P<0.001), body mass index (B=51.817, P<0.001), and specimen weight (B=1.590, P<0.001). Diabetes history (P<0.001), expander type (P<0.001), and the surgical instrument used (P<0.001) also strongly influenced total drainage. The acellular dermal matrix type used did not affect total drainage (P=0.626). In the multivariate analysis, age (B=11.907, P=0.004), specimen weight (B=0.927, P<0.001), and expander type (B=593.728, P<0.001) were significant predictors of total drainage. Conclusions Our findings suggest that the total drainage and the duration of drain placement needed after expander-based breast reconstruction can be predicted using preoperative and intraoperative data. Patient age, specimen weight, and expander type are important predictors of drainage volume. Older patients, heavier specimens, and use of the Mentor rather than the Allergan expander corresponded to a greater total drainage volume and a longer duration of drain placement.

• 대한두개안면성형외과학회지
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• 제20권5호
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• pp.284-288
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• 2019

Background: Closed reduction of nasal fracture with various instrument is performed to treat nasal fracture. Depending on the type of nasal fracture and the situation in which it is being operated, the surgeon will determine the surgical tool. The objective of this study was to investigate whether a periosteal elevator (PE) was a proper device to perform closed reduction for patients with simple nasal fractures. Methods: From March 2018 to December 2018, 50 cases of simple nasal bone fracture underwent closed reduction performed by a single surgeon. These patients were divided into two groups randomly: nasal bone reduction was performed using only PE (freer) and nasal bone reduction was performed using Walsham, Asch forcep, and Boies elevator (non-freer, non-PE). Results: The paranasal sinus computed tomography was performed on patients before and after operation to carry out an accurate measurement of reduction distance at the same level. According to the results, the interaction between instruments and fracture types had a significant influence on reduction distance (p = 0.021). To be specific, reduction distance was significantly (p= 0.004) increased by 2.157 mm when PE was used to treat patients with partial displacement compared to that when non-PEs were used. Conclusion: Closed reduction using PE and other elevator is generally an effective treatment for nasal fracture. In partial-displacement type of simple nasal fracture, closed reduction using PE can have considerable success in comparison with using classic instruments.

• Archives of Plastic Surgery
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• 제50권6호
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• pp.627-634
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• 2023

In recent decades, a number of simulation models for microsurgical training have been published. The human placenta has received extensive validation in microneurosurgery and is a useful instrument to facilitate learning in microvascular repair techniques as an alternative to using live animals. This study uses a straightforward, step-by-step procedure for instructing the creation of simulators with dynamic flow to characterize the placental vascular tree and assess its relevance for plastic surgery departments. Measurements of the placental vasculature and morphological characterization of 18 placentas were made. After the model was used in a basic microsurgery training laboratory session, a survey was given to nine plastic surgery residents, two microsurgeons, and one hand surgeon. In all divisions, venous diameters were larger than arterial diameters, with minimum diameters of 0.8 and 0.6 mm, respectively. The majority of the participants considered that the model faithfully reproduces a real microsurgical scenario; the consistency of the vessels and their dissection are similar in in vivo tissue. Furthermore, all the participants considered that this model could improve their surgical technique and would propose it for microsurgical training. As some of the model's disadvantages, an abundantly thick adventitia, a thin tunica media, and higher adherence to the underlying tissue were identified. The color-perfused placenta is an excellent tool for microsurgical training in plastic surgery. It can faithfully reproduce a microsurgical scenario, offering an abundance of vasculature with varying sizes similar to tissue in vivo, enhancing technical proficiency, and lowering patient error.

• 한국산학기술학회논문지
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• 제17권6호
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• pp.750-758
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• 2016

일반적으로 시스템을 강성체로 설계할 경우 시스템의 구조적 안정성을 확보할 수 있으나 유리잔을 잡거나 작은 수술용 도구로 사용하는 등의 사용용도에 따라 활용성이 제한될 수 있다. 이러한 문제를 해결하기 위하여 유연한 재질을 사용하여 강성조절이 가능한 메커니즘에 대한 연구가 다양하게 이루어져 왔다. 기존에 연구했던 강성체와 연성체의 연속구조로 이루어진 모델에 텐던을 삽입한 구조를 이용한 가변강성 메커니즘을 통하여 가변강성 구조체에 대한 가능성을 확인하였다. 그러나 필요로 하는 가변강성을 충족하기 위한 구조체의 설계 변수에 대한 연구가 필요하였다. 따라서 본 연구에서는 가변강성 메커니즘의 다양한 변수 변화에 따른 강성변화 실험을 통해 강성의 경향성을 파악하고자 하였다. 실험 결과 지름이 클수록 강성은 증가하며 강성의 증가폭 또한 늘어난다. 또한 연성체 길이가 짧을수록 강성이 증가하며 텐던을 당겨 연성체를 압착할 경우 강성값은 비선형적으로 증가하였다. 동일 조건에서 연성체 길이변화에 따른 강성 증가폭과 강성체의 길이 변화에 따른 강성 증가폭을 비교하였을 때 연성체 길이 변화가 강성체 길이 변화 보다 강성값 변화에 영향을 미친다는 것을 확인하였다. 또한, 해석값이 실험값에 비하여 정확성은 낮지만, 가변강성의 경향성을 확인하기 위하여 해석적인 방법을 통한 강성을 예측해보았다. 이러한 변수변화 실험 결과는 필요로 하는 강성값을 충족하는 가변강성 메커니즘 설계에 활용할 수 있을 것이다.

• Journal of Chest Surgery
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• 제32권5호
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• pp.465-470
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• 1999

배경: 안면부 다한증 환자들은 수장부, 액와부 다한증 환자들 못지 않게 대인관계에 매우 어려움을 보이고 있다. 적절한 치료가 없었으나 최근 교감신경차단술을 시행하여 좋은 결과를 얻고 있다. 안면부 다한증에 대해 흉강경을 이용한 흉부 교감신경절제술은 하부 성상교감신경절을 절제하는 것으로 알려져 있으나 호너증후군과 같은 합병증의 우려 때문에 잘 시행되고 있지 않았다. 본 병원에서는 최근 6년간 수장부, 액와부 다한증 치료 경험에서 안면부 다한증도 제2흉부 교감신경절 절단만으로 충분할 것으로 판단되어 시술을 하였고, 만족할 만한 결과를 얻었다. 대상 및 방법: 서울대학교병원 흉부외과학 교실에서는 1997년 6월부터 1998년 5월까지 연속적으로 38명의 안면부 다한증 환자들에서 2 mm 기구를 이용하여 양측성 제2흉부 교감신경절단술을 시행하였다. 결과: 수술직후 전례에서 안면부 발한이 소실되었다. 합병증으로 수술후 다섯명(13.2%)에서 흉관 삽입이 필요 하였는데, 3명은 불완전한 폐의 재팽창 때문에, 나머지 2명은 심한 폐유착을 박리한후 생긴 혈흉 때문이었다. 예측되는 합병증인 호너증후군, 상완신경총 손상 등은 없었다. 모든 환자가 수술후 평균 1.7$\pm$0.9일에 퇴원하였다. 결론: 안면부 다한증에서 적절한 교감신경 절단 부위는 제2흉부 교감신경절이며, 하부 성상교감신경절을 절단하지 않음으로서 호너 증후군등의 합병증 발생을 예방할 수 있다. 아울러 미세한 2 mm 흉강경 기구를 이용한 수술이 가능하며 결과도 매우 좋다.