• Title/Summary/Keyword: intervention of state

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The Effect of Supportive Nursing Care on Depression, Mood and Satisfaction in Military Patients with Low Back Pain (지지간호가 군 요통환자의 우울ㆍ기분ㆍ만족에 미치는 영향)

  • 김정아
    • Journal of Korean Academy of Nursing
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    • v.20 no.3
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    • pp.324-340
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    • 1990
  • Support has always been considered an important nursing concept. However, there is no agreement among nurse researchers as to a conceptual definition of supportive nursing or meaningful supportive behaviors. Clarification of the concept, support in nursing, is necessary to promote communication among nurses on nursing behaviors that are effective in providing support and on understanding the relevant properties and charcteristics of the concept, supportive nursing care. The objectives of the study were : 1. to analyse the concept, support in nursing, in order to provide a definition of supportive nursing care, and 2. to operationalize the definition of supportive nursing care and use it as an experimental nursing intervention for patients with low back pain. The first part of the study used the concept analysis approach developed by Walker and Avant(1983) to define the concept of supportive nursing care. The properties of supportive nursing care, defined by this analysis, included perception of supportive need, reciprocal interaction(Transaction), listening, providing empathy and information related to health, and confirmation of the patient's verbal and non - verbal response. The second part, the experimental part of the study, was done using King's(1970) Interpersonal Theory for Nursing. The concept, supportive nursing care, as defined in the concept analysis was operationalized and used as the experimental intervention. The experiment tested the effectiveness of the independent variable, supportive nursing care on the dependent variables, depression, mood and patient satisfaction, in the patients with low back pain in army hospitals. The instruments used to measure the dependent variables were Zung's(1965) Self- Rating Depression Scale, Ryman and Colleagues'(1974) Mood Questionnaire and LaMonica and Colleagues'(1986) Patient Satisfaction Scale. The experimental design used for this study was a Solomon 4 group experimental design. This design has the strength of allowing for observation of the main effects of supportive nursing care and pretesting, and for observation of the interaction effects of pretesting and supportive nursing care. The design includes one experimental group and three control groups. The Subjects of this study were 150 young male patients with low back pain on Neuro - Surgical Wards in three general army hospitals. There were 35 in the experimental group, 39 in the pre - posttest control group, 36 in the treatment - posttest control group and 40 in the posttest only control group. Supportive nursing care, as operationalized by the researcher according to the concept analysis, was given to the patients in the experimental group and the treatment -posttest control group, individually for 30 minute sessions, every other day for 5 days. Data collection was done using a questionnaire. The data were collected in a pretest one week before the supportive nursing care sessions, a posttest immediately after the sessions and follow- up test one week later. Hypotheses testing was done using 2×2 factorial analysis of variance and Meta analysis(Stouffer's Z method). The results of this study are summarized as follows : 1. Hypothesis Ⅰ, “There will be a difference on depression level between the patients with low back pain who receive supportive nursing care and those who do not receive supportive nursing care”, was supported (F=8.49, p<.05). 2. Hypothesis Ⅱ, “There will be a difference on mood level between the patients with low back pain who receive supportive nursing care and those who to not receive supportive nursing care”, was supported (Z meta=2.17, p<.05). 3. Hypothesis Ⅲ, “There will be a difference on satisfaction level between the patients with low back pain who receive supportive nursing care and those who do not receive supportive nursing care”, was supported (F=13.67, p<.05). 4. ANOVA, done to examine the interaction effect of history and maturation, showed no significant difference on the dependent variables between the observations of the pretest scores of the experimental group, the pretest scores of the pre- posttest control group and the posttest score of the posttest only control group. 5. To test for continuing effect of supportive nursing care, paired t-test was done to compare the scores for the dependent variables at the posttest and at the one week later follow-up test. No significant difference on the scores for the dependent variables was found between the posttest scores and the follow-up test scores for the two groups that received supportive nursing care, the experimental group and the treatment-posttest control group. In conclusion, it was found that in the case of young soldiers with low back pain in army hospitals, their depression level was decreased, their mood state was changed positively and their satisfaction level was increased by receiving supportive nursing care. Further, the effectiveness of the supportive nursing care lasted for at least one week in this study. The significance of this study to nursing is in the analysis of the concept of supportive nursing care and the demonstration of the effectiveness of supportive nursing care as an intervention within the limits of the study.

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A Comparative Analysis of Childcare Expansion and Social Investment in Sweden, France, Germany, the UK, Japan and South Korea (스웨덴, 프랑스, 독일, 영국, 일본, 한국의 아동 돌봄 체제와 사회투자에 대한 비교 연구)

  • An, Mi-Young
    • 한국사회정책
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    • v.20 no.2
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    • pp.169-193
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    • 2013
  • This paper examines how a social investment approach can be applied in a comparative analysis of childcare arrangements. We compared changes in Sweden, France, Germany, the UK, Japan and Korea during the 2000s, focusing on four dimensions of social investment: activation, gender equality, quality of care, and the degree of state's intervention in the family. We considered leave systems and the number of children enrolled in formal care and education facilities as indicators for labour market activation. For gender equality, women's position in employment is considered with respect to labour market participation rates, proportion of permanent employment, and wage-sex ratio. Quality of care concerns child-to-staff ratio and care provided with government quality control. The state's intervention was measured as social spending on families as proportions of GDP and total social spending. Our analysis provides empirical evidence that Sweden and France are pioneers in this arena and that the UK, Germany, Korea, and Japan are path-shifters in their care paradigms, albeit to varying degrees. Is the social investment approach an adequate paradigm for care? In a normative sense, this approach has potential. However, the following issues remain unaddressed: gender equality should be achieved through an expansion in good-quality jobs, fathers should be encouraged to take on childcare duties, and families should have universal access to good-quality childcare services controlled by the government.

Womans experience of Risk Situation on the High-Risk Pregnancy (여성의 고위험 임신에 대한 경험)

  • Kim, Kyung-Won;Lee, Kyung-Hye
    • Women's Health Nursing
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    • v.4 no.1
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    • pp.161-178
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    • 1998
  • In spite of the great progress of the theory and skill of the Nursing Care & Medical area in relation to pregnancy, nurses in clinics face up to many challenges in maternity nursing care areas. The reason is that the mobility and mortality of mothers was sharply decreased and the unknown high-risk diseases of pregnancy woman in the past is made public. That's why it is difficult to meet the pregnancy woman in natural process from pregnancy to delivery in recently. Admission rooms are filled with high-risk pregnancy women. As a matter of fact, we have done nursing care into the surface symptoms and diseases of high-risk pregnancy women so far. We have been indifferent to a long period hospitalization, separation from family, and conflict of repeated examination. Therefore, it is widely spread to understand the emotional conflict experienced by high-risk pregnancy women and to need for nursing intervention to bring up about emotional support and the ability of perception in psychological crisis. Although the pregnancy woman judged in high-risk should carry out normal task of pregnancy, she have to be confronted with secondary risk situation. The health of self & fetus threatened by the risk situation could be decreased through care plan, but psychological stress increases. Therefore, the pregnancy brings into non-control state. It is important to ask that what the hospitalized pregnancy women in high-risk think of themselves status. Because misunderstanding or serious anxiety of themselves status put into mother and fetus in danger. And adaptation mode makes all the difference. I would like to consider how nurses could deal with this high-risk circumstances in the position of pregnancy woman on the basis of the above fact. This study uses phenomenological method to suggest the basis material for nurses to do nursing intervention in view of pregnancy woman. Because this method understands the nature of true life of pregnancy woman throughly. The phenomenological method is the sources to describe or explain affluently the process generated in confirmation areas and environment and is the application for readers to understand and recognize clinic reality and then apply this method to reasoning study place or other places. Specifically, the phenomenon study method, one of the phenomenological method, is applied. The use of that method is to describe and generalize the experience in environment exactly. The study of this study is as follows : Among 187 descriptive stamens from 8 study participants are classified into 42 theme cluster at the stage of the first analysis. Those theme is categorized into 8 sub-subjects such as anxiety of uncertainty, foreknowledge about risk circumstance, will power about overcome, unsettled feeling about hospital, relief, optimistic thought, family support, and indifferences. At the last stage of analysis, those things are categorized into 3 subjects. When high-risk pregnancy woman foretell the situation, they feel unsettlement about uncertainty and untrust feeling about hospital. But they are ease with family support and hospital support. On the other hand, they express indifferent 3-way structure response to the situation having will of overcome and exceeding optimistic thought. In those statements, the experience by pregnancy woman shows 3 respect subjects. 1. They are anxious of this situation and are in desperation and don't recognize their role to be carried out 2. They think of this situation as normal process of pregnancy and are not concerned that this can give themselves and fetus fatal damage. 3. The pregnancy women will never confront this situation. This study shows the pregnancy woman has anxiety and optimistic relief about the situation, and ignores and optimistic relief about the situation, and ignores many things. Therefore, nurses in clinic should give pregnancy woman knowledge and information about the high-risk and help them to deal with the situation spontaneously. High-risk pregnancy woman should have the care plan in respect of the right perception. And the nurse know that their support help out pregnancy woman overcome the crisis in this respect of the special nursing intervention.

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A Study on the Change of AIDS Knowledge and Sexual Behavior among Middle and High School Students through AIDS Prevention Education (중고등학생의 에이즈 예방교육(豫防敎育)을 통한 에이즈 지식(知識)과 성의식(性意識) 변화(變化)에 관(關)한 연구(硏究))

  • Kwon, Kwan-Woo;Lee, Kyoung-Mu;Kim, Joung-Soon
    • Journal of the Korean Society of School Health
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    • v.12 no.1
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    • pp.109-129
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    • 1999
  • AIDS is worldwide problem. It has threatens societies and is potentially a big problem among youth. UNAIDS has warned that collective global responses are necessary; with half of the newly infected being children and young people in 1998, educating youth below age 24 is essential. Because of both their unexpected, strong sexual activities and an easjer tendency to change their behavior than adults, UNAIDS emphasizes the importance of prevention education for youth. In Korea, 4 cases of HIV infection have officially been reported among high school students. Considering the potential seriousness of HIV infection among youth, the Korean AntiAIDS Federation (KAAF) began an education programme for Korean youth (middle & high school pupils) as one intervention method in 1993. The purpose of this study is to evaluate the impact of the education programs performed and to develop a better programme. The intervention method used in this study was mainly a lecture in a big or small auditorium or through broadcasting systems using audio-visual teaching aids. The period of this survey was from Nov. 10 to Dec. 26. in 1998. The subjects surveyed were 792 pupils who were sampled from 12 different middle and high schools in Seoul by a two-stage cluster sampling. Self-recording the structured questionnaire was used for data collection. Data were analyzed by using a paired t-test to compare the knowledge difference before and after the interrention method. A chi-square test to compare the consciousness difference between pre-post-education results was used, and an ANOVA was ased to compare the knowledge difference among the selected groups. Major results of this study are summarized as follows: (1) AIDS knowledge significantly changed after AIDS prevention education. (2) The direct lecture in a big or small auditorium is more effective than an indirect lecture through a broadcasting system or through audio-visual teaching aids. (3) Those who had not seen obscene materials (e.g. pornography films, magazines etc.) acguired much more knowledge than others after AIDS prevention education. (4) Those who had no girlfriend/or boyfriend acquired much more knowledge than the others after AIDS prevention education. (5) As to the attitudes toward chastity, more girls than boys and students who had not seen obscene materials rather than those who already had were liable to support the state ment: "all should remain chase" and their consciousness on "being chaste" changed much more than that of others after intervention. (6) As to the individual evaluation of lectures, 23.1% shows "very good", 44.1% "good", 26.9% "normar" '-' thus, the positive evaluation was to 94.2%. The negative response was 5.8%. (7) As to the desire for AIDS education sponsored by KAAF in the future, more than 90.5% showed a positive reaction. (8) As to the educators in future education methods, pupils wanted lecturers from outside their schood. (9) Students from vocational high schools have seen obscene materials much more than other groups and the percentage of those who had a girlfriend/or boyfriend was higher than that of the others as wello. (10) 90% of those who watched obscene materials responded that they experienced these materials while at middle school and 100% before reaching the second grade of high school. (11) The number of boys who have experienced obscene materials is twice as many as that of girls. (12) The percentage of boys who have a girlfriend is much higher than the percentage of girls who have a boyfriend. (13) Among those who have friends of the opposite sex, 11.1% say that they hare had sexual contact and 20.8% hare experienced kissing and caressing.

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A Study on Factors Influencing The State of Adaptation of The Hemiplegic Patients (편마비 환자의 퇴원후 적응상태와 관련요인에 대한 분석적 연구)

  • 서문자
    • Journal of Korean Academy of Nursing
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    • v.20 no.1
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    • pp.88-117
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    • 1990
  • The purposes of this study are to delineate a profile of the state of a stroke patient's adaptation at 3 months after hospitalization and to explore the relationship between the level of adaptation and the variables which influence the adaptation of hemiplegic patients. To these ends, theoretical framework was derived basically from the stress adaptation model. The basic assumption underlying the level of adaptation is influenced by the presenting focal, contextual and residual stimuli. This group of stimuli is further operationalized and represented by a perception of stress. which is the perceived effect of the disability and by the mediating variables such as sociodemographic factors as an external conditioning variables and perceived social support and hardiness personality characteristics as an internal intervening variables. The dependent varibales in this study is the level of physical, psychological and social adaptation and is hypothesized to be a function of the interaction between 3 sets of variables namely, the perceived disability effect, external conditioning variables and internal intevening varibles. A total of fourty three subjects from 3 general hospitals in Seoul were observed and interviewed with the aid of 7 structured instruments. The data were collected twice on each subject : first at the pre-discharge period arid at 3 months post-discharge from hospital for the second time. The study was carried out for the period from February to August, 1988. The instruments used for the study include 4 existing scales and 3 scales developed by the researcher for this study. They are : 1) The ADL dependency scale and the scale of the clinical physical functions for the assessment of physical adaptation. 2) the SDS(self report of depression) to measure the level of psychological adaptation. 3) The scale for the amount of social activities for the measurement of the level of social adaptation. 4) The scale for the perceived effect of disability for the measurement of the focal stimuli. 5) The health related hardiness scale and the perceived interpersonal support self evaluation list(ISEL) for the measurement of the hardiness personality character and the perceived social support. The data obtained were analyzed using percentage, oneway ANOVA, Pearson coefficients correlation and stepwise multiple regression. The findings provide valuable information about the present level of physical adaptation at 3 months after discharge. The patient revealed a decreased ADL dependency and lowered limitation of physical function as compared with pre - discharge state. Psycholcgically, the average degree of depression at follow up was within normal range of depression. Socially, the amount of social activities was very low. The one way ANOVA and the correlational analysis revealed the relationship between the 3 sets of variables and the adaptation level as follows : 1) The perceived disability effect was related to the degree of the depression and the amount of social activities but was not related to the physical adaptation. 2) Among the sociodemographic variables, sex and education were related to the difference of ADL dependency and the change of physical function. These factors indicate that women more than men and educated more than the less educated were found more independent. The education was also related to the degree of depression suggesting that the higher the educational level, the more well adapted the patients were both physically and psychologically. Age, marital status and job state were not found to be related to the patient's adaptation level. 3) Among the internal intervening variables, the health related hardiness characteristic was related to the differences of ADL dependency, physical functions and the social activities, indicating that the higher the hardiness character the higher the level of physical and social adaptation. 4) The perceived social support, another internal intervening variable, was related to the degree of depression and the social activities. This data suggest that the higher the perception of social support, the better adapted the patients were psychogically and socially. In summarizing the results of the correlational analysis, the level of physical adaptation was influenced by sex, the years of education and the hardiness character. The level of psychological adaptation was influenced by the years of education, the perceived disability effect and the perceived social support. And the level of social adaptation was influenced by the perceived disability effect, the hardiness character and the perceived social support. The stepwise multiple regression analysis shows findings as follows : 1) The most important factor to explain the difference of ADL dependency was sex, indicating females were more independent than males. 2) The most important factor to explain the difference of physical function and the degree of depression was the patient's education level. 3) The strongest explaining factor for the amount of social activities was perceived self esteem(one of the subconcepts of perceived social support). Thus the most important factors influencing the level of adaptation were found to be sex, education, the hardiness character and self esteem. From the above findings, the significance of this study can be delineated as follows : 1) Corroboration of the assumed relationship between the various variables and the adaptation level as suggested in the conceptual model. 2) Support for the feasibility of the cognitive approach for nursing intervention such as hardness character training, counselling and teaching for self-care in the chronic patients.

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Predictive Factors of Health promotion behaviors of Industrial Shift Workers (산업장 교대근무 근로자의 건강증진행위 예측요인)

  • Kim, Young-Mi
    • Korean Journal of Occupational Health Nursing
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    • v.11 no.1
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    • pp.13-30
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    • 2002
  • Industrial shift workers feels suffer mental stresses which are caused by unfamiliar day sleep, noisy environment, sleeping disorder by bright light, unusual contacts with family, difficulty in meeting with friends or having formal social meetings and other social limitations such as the use of transportation. Such stresses influence health of the workers negatively. Thus the health promotion policy for shift workers should be made considering the workers' ways of living and shift work specially. This study attempted to provide basic information for development of the health promotion program for industrial shift workers by examining predictive factors influencing health promotion behaviors of those workers. In designing the study, three power generation plants located in Pusan and south Kyungsang province were randomly selected and therefrom 280 workers at central control, boiler and turbine rooms and environmental chemistry parts whose processes require shift works were sampled as subjects of the study. Data were collected two times from September 17 to October 8, 1999 using questionnaires with helps of safety and health managers of the plants. The questionnaires were distributed through mails or direct visits. Means for the study included the measurement tool of health promotion behavior provided by Park(1995), the tool of self-efficacy measurement by Suh(1995), the tool of internal locus of control measurement by Oh(1987), the measurement tool of perceived health state by Park(1995) and the tool of social support measurement by Paek(1995). The collected data were analyzed using SPSS program. Controlling factors of the subjects were evaluated in terms of frequency and percentage ratio Perceived factors and health promotion behaviors of the subjects were done so in terms of mean and standard deviation, and average mark and standard deviation, respectively. Relations between controlling and perceived factors were analyzed using t-test and ANOVA and those between perceived factors and the performance of health promotion behaviors, using Pearson's Correlation Coefficient. The performance of health promotion behaviors was tested using t-test, ANOVA and post multi-comparison (Scheffe test). Predictive factors of health promotion behavior were examined through the Stepwise Multiple Regression Analysis. Results of the study are summarized as follows. 1. The performance of health promotion behaviors by the subjects was evaluated as having the value of mean, $161.27{\pm}26.73$ points(min.:60, max.:240) and average mark, $2.68{\pm}0.44$ points(min.:1, max.:4). When the performance was analyzed according to related aspects, it showed the highest level in harmonious relation with average mark, $3.15{\pm}.56$ points, followed by hygienic life($3.03{\pm}.55$), self-realization ($2.84{\pm}.55$), emotional support($2.73{\pm}.61$), regular meals($2.71{\pm}.76$), self-control($2.62{\pm}.63$), health diet($2.62{\pm}.56$), rest and sleep($2.60{\pm}.59$), exercise and activity($2.53{\pm}.57$), diet control($2.52{\pm}.56$) and special health management($2.06{\pm}.65$). 2. In relations between perceived factors of the subjects(self-efficacy, internal locus of control, perceived health state) and the performance of health promotion behaviors, the performance was found having significantly pure relations with self-efficacy (r=.524, P=.000), internal locus of control (r=.225, P=.000) and perceived health state(r=.244, P=.000). The higher each evaluated point of the three factors was, the higher the performance was in level. 3. When relations between the controlling factors(demography-based social, health-related, job-related and human relations characteristics) and the performance of health promotion behaviors were analyzed, the performance showed significant differences according to marital status (t=2.09, P= .03), religion(F=3.93, P= .00) and participation in religious activities (F=8.10, P= .00) out of demography-based characteristics, medical examination results (F=7.20, P= .00) and methods of the collection of health knowledge and information(F=3.41, P= .01) and methods of desired health education(F=3.41, P= .01) out of health-related characteristics, detrimental factors perception(F=4.49, P= .01) and job satisfaction(F=8.41, P= .00) out of job-related characteristics and social support(F=14.69, P= .00) out of human relations characteristics. 4. The factor which is a variable predicting best the performance of health promotion behaviors by the subjects was the self-efficacy accounting for 27.4% of the prediction, followed by participation in religious activities, social support, job satisfaction, received health state and internal locus of control in order all of which totally account for 41.0%. In conclusion, the predictive factor which most influence the performance of health promotion behaviors by shift workers was self-efficacy. To promote the sense, therefore, it is necessary to develop the nursing intervention program considering predictive factors as variables identified in this study. Further industrial nurses should play their roles actively to help shift workers increase their capability of self-management of health.

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The Effects of Aroma Self Massage in Hands on Pain, Depressive Mood and Anxiety in Breast Cancer Patients (유방암 환자의 통증, 우울 및 불안 증상 조절에 아로마 자가 치료의 효과)

  • Sohn, Keun-Joo;Kim, Myung-Ja;Lee, June-Young;Lee, Jae-Bok;Kim, Su-Hyun;Kim, Jong-A;Jung, Hoe-Hyun;Choi, Seung-Wan;Choi, Youn-Seon
    • Journal of Hospice and Palliative Care
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    • v.8 no.1
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    • pp.18-29
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    • 2005
  • Purpose: Aroma therapy is one modality of alternative medicine. It was well known to have an analgesic, antidepressive and anxiolytic effects. This study is designed to investigate the effect of aroma self hand massage on vital signs, pain, depression, anxiety and stress in breast cancer patients. Methods: 32 female patient over 20 years old were divided into two groups by a non-blinded randomized controlled method. Patient in the aroma group (n=15) massaged their hands twice a day using aroma oil by themselves in their home for 2 weeks. However, those in control group (n=17) had not received my intervention during the study periods. Pain intensity, state anxiety, depression and stress of subjects were evaluated three times (0, 1, 3 weeks) using Visual Analogue Scale (VAS, $0{\sim}10cm$), State Trait Anxiety Inventory (STAI), Beck Depression Inventory Scales (BDIS), Brief Encounter Psychosocial Instrument (BEPSI revised edition). Also the change of patients' accompanying symptoms after aroma massage were analyzed using a structured questionnaire. Results: Pain Intensity decreased in the aroma group compared with control group (VAS changes $-0.83{\pm}1.01\;vs\;0.38{\pm}0.86$, P=0.005). The numbers of accompanying symptoms (P=0.044), depression score (P=0.001) and anxiety score (P=0.008) were significantly decreased in the aroma group, while in control group they increased after 2 weeks. However, the stress score showed no significant changes in both groups ($0.05{\pm}0.85\;vs\;0.04{\pm}0.20$, P=0.1519). The depression, anxiety and stress score showed negative correlation with compliance of aroma massage, but statistically no significant. The systolic blood pressure was a little increased in aroma group ($4.53{\pm}14.43\;vs\;0.0{\pm}7.22$, P=0.026), but was not significant clinically. Patients in the aroma group complained of several symptoms such as headache (20%), paresthesia (6.75%) and nausea (6.7%). However, there were no drop-out patients for those side effects. Conclusion: Aroma self massage during two weeks in breast cancer patients alleviates the pain intensity, depression and anxiety significantly.

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A Theory Construction on the Care Experience for Spouses of Patients with Chronic Illness (만성질환자 배우자의 돌봄 경험에 대한 이론 구축)

  • Choi, Kyung-Sook;Eun, Young
    • Journal of Korean Academy of Nursing
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    • v.30 no.1
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    • pp.122-136
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    • 2000
  • Chronic illness requiring attention and management during a long period of time puts great burden onto patients, their family and society. For patients with chronic illnesses, providing social support is the most important, and the fundamental support comes from their spouses. Amount and quality of support from spouses seems to differentiated according to the sex of patients. Female patients tend to believe that their spouses are not very supportive. Therefore, the researchers assessed the burden of husbands of female arthritis patients to discover the factors that result in greater burden. Also, they developed a theoretical model of husbands′ care for their wives through a qualitative research into husbands′ experience. Method 1: The study material was 650 female arthritis patients registered in an arthritis clinic. The questionnaire about the disease experience of female arthritis patients and the burden of husbands were sent. Returned questionnaires numbered 210(32.3%) and 27 were excluded because of inadequate answers. The remaining 183 questionnaires were analyzed. The mean age of the patients was 51 years and the mean age of spouses was 55 years. The mean marital period was 28 years. The average duration since diagnosis was 9.1 years. Education level was varied from primary school to graduate school, and average income/month was 1,517,300 won. Method 2: Initial questionnaire studies on the burden of husbands were performed. Among 183 responding husbands, 23 consented to participate for a qualitative research. Data was obtained by direct and telephone interviews. The mean age of participants was 58 years, and the educational level and socioeconomic status also varied. Result: 1. Husbands′ burden: The average burden was 57.68 with a range of 6-96. 2. Burden and general characteristics: The husband′s burden correlated with the age of the patients, numbers in the family, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and the husband′s understanding of the level of severity. 3. Linear correlation analysis on burden: The husbands′ burden is explained in 22.5% by husband′s recognition of level of severity and husbands′ age. 4. There were four patterns of the burden on husbands: both objectve burden and subjective burden were high(pattern I), both of objectve burden and subjective burden were low(pattern II), objective burden was high but subjective burden was low(pattern III), objective burden was low but subjective burden was high(pattern IV). The pattern was correlated with the family income, educational level of the patients and their husbands, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and husband′s understanding of level of severity. 5. The core category of the caring experience of the husbands with arthritis patients was "companionship". The causal factor was the patients′ experience due to symptoms : physical disfigurement, pain, immobility, limitation of house chores, and limitation of social activities. Contextural factors are husbands′ identification of housework and husbands′ concern about the disease. The mediating factors are economic problems, fear of aging, feeling of limitation and family support. The strategy for interaction is mind control and how to solve emotional stress. The "companionship" resulted from caring activities, participation of household activities, helping patients′ to coping with emotional experience. 6. Companionship is established through the process of entering intervention, and caring state of mind. Entering intervention is the phase of participation of therapy and involvement of houseworks. The caring phase consists of decision on therapy, providing therapy, providing direct care, and taking over the household role of wife. Through caring phase, the changing phase set a stage in which husbands consolidate the relationship with their wives, and are reminded of the meaning of marriage. As a result, in changing phase, husbands′ companionship is enhanced. In conclusion, nursing care of chronic illnesses should include a family member especially the spouse. All information on disease shoud be provided to patients and whole family member. Strong support should also be provided to overcome difficulties in taking over role of other sex. Then the quality of life of patients and families will be much improved.

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The Political-Economic of Capitalism and its Effects on Spatial Dynamics (도시공간의 변화에 내재한 정치${\cdot}$경제적 논리의 규명-서울시 도심재개발을 대상으로-)

  • Park, Sun-Mee
    • Journal of the Korean Geographical Society
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    • v.28 no.3
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    • pp.213-226
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    • 1993
  • In Korea, the urban studies of geography have mainly dealt with such a series of research as system of urban place and internal structure of urban area. The existing studies have been carried out with ecological approach. Ecologists, now a days, regard organiation and transfor-mation of the urban space as the process of invasion, succession, and segregation. However it is more proper that cities should be considered not as fragmantary objects, as some ecologists insist, but as synthetic ones in social structure. This research, with adopting a case of the renewasl of central area in Seoul, tried to make it clear that the formation and transition of the city is a product of social structure and examined polical and economic logic which exists in variation of urban space in detail. The results of this study are as follows; Urban renewal of central area is closely related with production and reproduction in capitalist society. In urban center, as business activities had increased since 1973 due to decen-tralization of production process, the necessity of reorganizing the land use in existing central area accordingly increased. The urban renewal program of central area in Seoul was inrroduced under such situation. The urban renewal of central area reflecting the capital logic has changed the central area with six hundred year's tradition. From the urban renewal of central area, not only was the central area, which traditionally had been mixed with various fun-ctions, simplified into the unitary area of busi-ness, but also physical landscape changed. As the land lot in renewal area expanded into regular shape, buildings became larger and taller. The program tremendously raised the price of related area. Aiming at these profits caused by the raised price, a great number of capitalists participated in the program. And as the benefit ratio of the manufacture sector continuously dropped with the economic recession, the pro-gram was carried out much more vigorously. That was because the idle capital accumulated during the recession was invested in property sector and was self-proliferated. The urban renewal raised the land value of central area and drove out the people living in this area. The people moved into the whole parts of the city resulting diffused squatter settlements. And the urban changes in central area were results of the policy of municipal authorities, who supported and systematized the changes lawfully and administratively, as well as reali-zation of capital logic. Due to the renewal policies of central area in Seoul, much more renewals by the only capitalists were carried out than those by the people themselves living in that area. The integration of land ownership in the law of urban renewal shows the reason of that. Moreover, the law allows the third deve-loper to participate in the tasks and admits the land expropriation rights. The municipal autho-rities guaranteed the profitability of the tasks through finacial aid, tax benifit, and relaxation of regulations for construction. As examined above, the changes in the land use of urban space have been led not by the ecological process of development of the city itself, but by the restructuring of capitalism and the intervention of the government authorities.

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Clinical review of Typhoid Fever Patients (장티브스에 관한 임상적 관찰)

  • 최정신
    • Journal of Korean Academy of Nursing
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    • v.6 no.1
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    • pp.60-71
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    • 1976
  • The author reviewed the medical records of 96 typhoid fever patients who were diagnosed, admitted, and treated at Sea grave Memorial Hospital from January 1 , 1973 through August 31, 1975. Diagnosis was determined by clinical observation, aerology and bacteriology, eighty patients were treated medically, the remaining 16 patients required surgical intervention. The following results were obtained: 1) The age distribution of the patients revealed that 33.3% wert between 10 and 19 years old 21.9% were between 20 and 29, and 19.8% were between 30 and 39. The majority of patients were from these more active age groups. Male to female sex ratio was 1.3 : 1 2) Seasonal distribution was observed. Most illness occurred in the summer and autumn month 5. 3) 84. 3%of the patients came from farm families. 4) Duration between onset and admission averaged 16.0 days. The group without compilations was admitted after an average of 15. 1 days; The group with complications was ad-matted after an average of 19.4 days. 5) Methods of treatment before admission were as follows: 10.4% at medical clinics, 61, 5% at pharmacies (antibiotics 47.9%, other. drugs 13.5%), 7.3% by herb medications, 20.8% had no treatment. 6) Main clinical symptoms were as follows: fever 93.8%, headache 47.9%, abdominal pain 47.9%, chills 38.5%, cough 36.5%, general weakness 26.0%, nausea e vomiting 24.0% and generalized pain 21.9%. 7) Temperature of patients on admission: 22.9% were 39f or more, 67.6% were between 37℃ and 38℃, and 9.4% were 37℃ or less. 8) Occurrence of intensional bleeding after onset of disease averaged 9.3 days; perforation occurred at an average of 19. 1 days. 9) Interval between onset of major complication and surgical intervention averaged 2.8 days. 10) Among the 68 patients who underwent the bacteriological test the positive rate was 44.1% (30). The positive ,ales to, each separate culture method were as follows: 20.4% in the blood culture, 40.4% in the stool culture and 6.7% in the urine culture. Among these bacteriological positive patients 15 patients had a negative results or less than 160 titer of vidal reaction. 11) The initial vidal test of the total group showed a counts of 160 titer or more in 60.4% and less than 160 titer in 39.6%, 12) W. B. C. Counts in the uncomplicated group indicated that 32.5% were 6,000/㎣ or less, 47.5% were between 6,000 and 10,000, arid 20.0% were 10,000/㎣ or more. In the complicated group, 37.6% were 6,000/㎣ or less, 25,0% were 6,000-10,000/㎣ and 37.6% were 10,000/㎣ or more. 13) Duration of hospital stay of the patients averaged 6.4 days in the uncomplicated group and 12.7 days in the complicated group. 14) Subdiaphragmatic free air simple X-ray was found in 91.7% of the perforated cases. 15) Duration of antibiotic therapy until an febrile state was attained averaged 4.8 days in the uncomplicated group and 6.5 days in the complicated group. 16) Operative procedures were as follows: one layer simple closure of their perforation with or without debasement in 56.3%, drainage only in 6.3%, small bowel resection with primary anastomosis in 18.8% , externalization in 6.3%, cholecystectomy in 6.3%, The clinical findings of this study suggest the following recommendations. According to Top's report; 1% of typhoid fever patients treated with chlorarnphenicol and 2% of patients treated with other drugs become chronic carriers. Therefore, importance should be given to the strict control of these carriers. Immunization, improvement of sanitation and living standards are all needed for the prevention and treatment of disease, but a more serious problem is a lack of knowledge on the part of patients and their families. Thus it is most urgent to enlighten the citizens about the transmission and hygiene related to contagious disease. Legal restriction of sale of antibiotics at drug stores without a physician's prescription is an urgent matter for public health administrators. An even more important nursing responsibility is the reemphasis on health education both in the clinical setting and in the home.

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