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A Study on Tonsillectomy of the Elemeniary School Children in Busan Area (도시(都市) 국민학생(國民學生)의 편도선(扁桃腺) 절제율(切除率) 및 학부모(學父母)의 인식도(認識度))

  • Kim, Kyung Hee;Park, Jae Yong
    • Journal of the Korean Society of School Health
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    • v.4 no.2
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    • pp.78-89
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    • 1991
  • In order to understand how the parents who have the children of elementary school actually recognising their children's tonsillectomy, and then, analyze its motivation, and how many children was treated tonsillectomy in our country, we hereby analyzed and intended for 3,882 of the children of elementary school in Susan area from 1st grade to the 6 years grade by the questionnaire through the parents of students. The viewpoint about the requirement of tonsil in the human body, the only 25.1 percent had responded: absolutely necessary. The respondents who responded absolutely necessary were highly ranked according to the urban, medium urban and then outskirt area. The advisory person who whishes, to be tonsillectomised was physicians 76.2 percent of the highest point. Operation had performed mostly the age of 6 year and had appeared the questionnaire through 6-9 year old, and they utilized their operational period was at the time of summer vacation of August 31.5 percent and winter vacation of December and January 16.7 percent respectively, and place of implementation was accounted for 87.0 Opercent at the hospitals and the motivation of tonsillectomy had motivated during one had been medical examination and advisory of the physician was appeared highest rate of 51.9 percent. In the case who's symptom of the cold and high fever somewhat improved was appeared as 79.6 percent and the other hand, 5.6 percent of them have responded not knowing they got better. The case that otitis media or chronic nasal inflammation had restored was 13.0 percent respectively, but 18.5 percent had responded their ailment was not knowing their improvement so well that ailed before operation. The sequela by aftermath of the tonsillectomy, seeing collectively, it appeared 16.7 percent of the person was responded they had sequela and the idea of operational result, 90.7 percent responded they had favoured their operation, and 3.7 percent regret their carelessness. As above mentioned, it is advisable to be operated by the degree of its symptoms and there is any complication existed or in case of absolutely necessary case.

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A Study on Hypertension Management of Community Health Practitioner Posts (보건진료소 고혈압 관리사업의 실태)

  • Kwon, Myung-Soon
    • Journal of agricultural medicine and community health
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    • v.28 no.2
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    • pp.155-169
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    • 2003
  • Objectives: The purpose of this study is to provide data for the improvement of hypertension management of community health practitioner posts through the study on hypertension management in community health practitioner posts. Methods: A questionnaire was mailed to 700 community health practitioners and 205 of them responded during the period from March 13, 2003 to May 13. The survey results were analyzed using SPSS program, version 11. Results: The results are as follows; 1. There are two major activities in a hypertension prevention project for community: health education and early detection. About 57% of community health care practitioners perform a health education for community people four times a year. The 64.5% of them used the materials for health education provided from a community health center and 22.1% of them performed a post-evaluation. The main method of early detection of hypertension was measurement of blood pressure of person to visit, which was 96.1%. Other methods included home visiting(89.3%), a referral from community hospitals and other resources(49.1%), health promotion events(39.5%), and a review of medical records(35.7%). 2. For the registration and management of patients with hypertension, about 36% of community health centers used a special form and more than 50% of them have registered patients who were managed by other health care institutions in the community. A computerized program was used for the management of patients with hypertension in 68.5% of them. More than 60% of them responded that it was used for report, treatment, and follow-up of patients with hypertension.

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A Study of Nurses' Knowledges on Gestational Diabetes Mellitus (일부 간호사의 임신성 당뇨병에 대한 지식정도)

  • Choi, Euy-Soon;Oh, Jeong-Ah;Park, Chai-Soon
    • Women's Health Nursing
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    • v.7 no.4
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    • pp.419-431
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    • 2001
  • The purpose of this study was to provide the correct knowledge on GDM(Gestational Diabetes Mellitus) to nurses for effective care of pregnant women with GDM by investigating the knowledge of nurses about GDM. The subjects of this study were 557 nurses who work at six general hospitals in Seoul and Gyung-Gi province of Korea. The data were collected from November, 2000 to December, 2000, using a 30-item knowledge questionnaire about GDM consisted of eight areas developed by Choi et al. (2000): characteristics and diagnosis, influence on pregnancy, goal and method of management, diet therapy, exercise therapy, insulin therapy, hypoglycemia and hyperglycemia and postpartum care of GDM. The data were analyzed by SAS program for t-test, ANOVA and Scheffe test. The results were as follows: 1. The mean score of knowledge on GDM was 23.18. 2. There were significant differences according to age(p= 0.002), education background (p= 0.045). working period(p= 0.000), working unit(p= 0000), working experience of obstetric and gynecologic (OS & GY) units(p= 0.000), experience of pregnancy (p=0.003) and experience of delivery (p=0.014) in GDM knowledge. 3. The level of each area on GDM knowledge was as follows; 1) Area of characteristics and diagnosis of GDM The mean score of this area was 0.79. Nurses' knowledges were significantly different by age(p=0.003), marital status (p=0.018), working period(p=0.002) working unit(p=0.007), working experience of OB & GY units(p=0.005), experience of pregnancy(p=0.034) and experience of delivery(p=0.033). 2) Area of influence on pregnancy The mean score of this area was 0.93. Nurses' knowledges were significantly different by age(p=0.006), working unit (p=0.000) and working experience of OB & GY units(p= 0.000). 3) Area of goal and method of management The mean score of this area was 0.70. Nurses' knowledges were significantly different by age(p=0.004), region(p=0.006), education background(p=0.013), marital status(p=0.007), working period(p=0.000), working unit(p=0.011), working experience of OB & GY units(p=0.002), experience of pregnancy(p=0.025) and experience of delivery(p=0.043). 4) Area of diet therapy. The mean score of this area was 0.74. Nurses' knowledges were significantly different by age(p=0.002), region(p=0.011), marital status (p=0.001). working period (p=0.007). working unit(p=0.002), working experience of OB & GY units(p=0.001), experience of pregnancy(p=0.001), experience of delivery(p=0.011) and diabetes patients in family members(p=0.032). 5) Area of exercise therapy. The mean score of this area was 0.83. There were not significant differences in all general characteristics. 6) Area of insulin therapy The mean score of this area was 0.61. Nurses' knowledges were significant differences by age (p=0.024), marital status (p=0.048), working period(p=0.027), working unit(p=0.002), working experience of OB & GY units(p=0.000), experience of pregnancy (p=0.047) and experience of delivery(p=0.040). 7) Area of hypoglycemia and hyperglycemia. The mean score of this area was 0.83. Nurses' knowledges were significantly different by marital status (p=0.027), working period(p=0.001). experience of pregnancy(p=0.020) and experience of delivery(p=0.010). 8) Area of postpartum care The mean score of this area was 0.69. Nurses' knowledges were significantly different by working unit(p=0.000), working experience of OB & GY units (p=0.000) and working experience of medical unit(p=0.047). The results of this study are suggested that nurses might be taught systemically and individually about GDM so that they can become more proficient in detecting and preventing GDM, and therefore they will feel confident to teach GDM to women.

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A Study on the Effects of the Institutional Pressure on the Process of Implementation and Appropriation of System: M-EMRS in Hospital Organization (시스템의 도입과 전유 과정에 영향을 미치는 제도적 압력에 관한 연구: 병원조직의 모바일 전자의무기록 시스템을 대상으로)

  • Lee, Zoon-Ky;Shin, Ho-Kyoung;Choi, Hee-Jae
    • Asia pacific journal of information systems
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    • v.19 no.2
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    • pp.95-116
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    • 2009
  • Increasingly the institutional theory has been an important theoretical view of decision making process and IT adoption in many academic researches. This study used the institutional theory as a lens through which we can understand the factors that enable the effective appropriation of advanced information technology. It posits that mimetic, coercive, and normative pressures existing in an institutionalized environment could influence the participation of top managers or decision makers and the involvement of users toward an effective use of IT in their tasks. Since the introduction of IT, organizational members have been using IT in their daily tasks, creating and recreating rules and resources according to their own methods and needs. That is to say, the adaptation process of the IT and outcomes are different among organizations. The previous studies on a diverse use of IT refer to the appropriation of technology from the social technology view. Users appropriate IT through not only technology itself, but also in terms of how they use it or how they make the social practice in their use of it. In this study, the concepts of institutional pressure, appropriation, participation of decision makers, and involvement of users toward the appropriation are explored in the context of the appropriation of the mobile electronic medical record system (M-EMRS) in particularly a hospital setting. Based on the conceptual definition of institutional pressure, participation and involvement, operational measures are reconstructed. Furthermore, the concept of appropriation is measured in the aspect of three sub-constructs-consensus on appropriation, faithful appropriation, and attitude of use. Grounded in the relevant theories to appropriation of IT, we developed a research framework in which the effects of institutional pressure, participation and involvement on the appropriation of IT are analyzed. Within this theoretical framework, we formulated several hypotheses. We developed a second order institutional pressure and appropriation construct. After establishing its validity and reliability, we tested the hypotheses with empirical data from 101 users in 3 hospitals which had adopted and used the M-EMRS. We examined the mediating effect of the participation of decision makers and the involvement of users on the appropriation and empirically validated their relationships. The results show that the mimetic, coercive, and normative institutional pressure has an effect on the participation of decision makers and the involvement of users in the appropriation of IT while the participation of decision makers and the involvement of users have an effect on the appropriation of IT. The results also suggest that the institutional pressure and the participation of decision makers influence the involvement of users toward an appropriation of IT. Our results emphasize the mediating effect of the institutional pressure on the appropriation of IT. Namely, the higher degree of the participation of decision makers and the involvement of users, the more effective appropriation users will represent. These results provide strong support for institutional-based variables as predictors of appropriation. These findings also indicate that organizations should focus on the role of participation of decision makers and the involvement of users for the purpose of effective appropriation, and these are the practical implications of our study. The theoretical contribution of this study is lies in the integrated model of the effect of institutional pressure on the appropriation of IT. The results are consistent with the institutional theory and support previous studies on adaptive structuration theory.

A clinical study of child bacterial meningitis in Daejeon and Chungcheong area : 2001-2005 (대전·충청 지역의 소아 세균성 수막염에 대한 임상적 연구 : 2001-2005)

  • Lee, Yong Joo;Lee, Soo Jin;Park, Ho Jin;Lee, Young Hyuk;Kang, So Young;Kim, Young Chang;Lee, In Kyu;Lee, Kyung Yeon;Lee, Keon Su;Kim, Won Seop
    • Clinical and Experimental Pediatrics
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    • v.50 no.2
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    • pp.157-162
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    • 2007
  • Purpose : The purpose of this study was to analyze the epidemiology, causative organism, clinical manifestation and prognosis of bacterial meningitis for children after the introduction of Haemophilus influenzae type b (Hib) vaccine in Daejeon and Chungcheong area. Methods : We analyzed retrospectively 53 medical records who had been diagnosed with bacterial meningitis at 10 general or university hospitals in Daejeon and Chungcheong area. All patients aged 1 month-14 years admitted between January 2001 through December 2005. Results : During the 5-year study period, 40 of all cases were positive for bacterial growth. Of the 40 cases that were CSF culture-proven bacterial meningitis, Streptococcus peumoniae was the most common bacteria for 17 (32.1%) of all cases, followed by H. influenzae for 10 (18.9%), Neisseria meningitidis for 3 (5.7%). In this study, the most common clinical manifestation is fever, accompanied by all cases. CSF leukocyte count was more than $100/mm^3$ in 45 (84.1%) cases. CSF glucose concentration was less than 50 mg/dL in 42 (79.2%) cases and protein concentration was more than 45 mg/dL in 49 (92.5%) cases. 45 of all cases made a recovery after treatment and were discharged. Most common complication after treatment is subdural effusion (19.0%) and hearing disturbance (9.4%). Conclusion : The most common organism of culture-proven bacterial meningitis in the children beyond neonatal period was S. pneumoniae. Continued surveillance studies were demanded to know the altered incidence of bacterial meningitis, because we expect the incidence of S. pneumoniae meninigitis will be on the decrease after more active innoculation of pneumococcal protein conjugate vaccine.

An analysis of one-year experience of pediatric observation unit: The first report in Korea (소아 관찰병실 운영에 대한 분석)

  • Lee, Jee Young;Choi, Ui-Yoon;Lee, Soo Young;Lee, Ji-Young;Lee, Byong Chan;Hwang, Hui Sung;Mok, Hye Rin;Jeong, Dae Chul;Chung, Seung Yun;Kang, Jin Han
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.622-628
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    • 2007
  • Purpose : While pediatric observation units (POU) have become a common practice in hospitals throughout developed countries, there has been no report about POUs in Korea so far. The aims of this study were to analyze our one-year's experience of the POU and to decide which disease entities are suitable for the POU. Methods : All children admitted from March 2006 to February 2007 to the POU at the Department of Pediatrics in Our Lady of Mercy Hospital were included in this study. Data were collected from retrospective reviews of their medical records. Results : There were a total of 1,076 POU admissions. Median age of patients was 2.4 years and median length of hospital stay 14.0 hours. The most common diagnoses were gastroenteritis (42.7%), pharyngotonsillitis (19.1%), bronchiolitis (7.8%), pneumonia (5.5%) and febrile seizure (5.2%). Overall, 7.5% of the POU patients required subsequent inpatient admissions due to hospital stays of longer than 48 hours. The disease entities that were most likely to require inpatient admission were pneumonia (17.0%), febrile seizure (12.5%) and asthma (11.5%). Diseases that allowed successful discharge from the POU were gastroenteritis (4.6%), upper respiratory tract infection (5.8%), such as otitis media and pharygnotonsillitis and seizure disorder (6.4%). Compared with the previous year when the POU was not in operation, there was a statistically significant reduction in the average length of hospital stays (from 4.69 to 3.75 days), as well as a rise in the bed turnover rate (from 78.8 to 98.2 patients/bed). Conclusion : Our study shows that the POU is efficient for the management of children with certain acute illnesses. Based on this study, we suggest that the POU be used as a new modality which links between the outpatient, inpatient, and emergency departments in the field of pediatrics in Korea.

Adenoviral Lower Respiratory Tract Infections in Children; Serotypes and Clinical Characteristics (소아의 아데노바이러스 하기도 감염증: 혈청형 및 임상상)

  • Shin, Seon Hee;Lee, Hoan Jong;Yoon, Hae Sun
    • Pediatric Infection and Vaccine
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    • v.9 no.2
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    • pp.182-192
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    • 2002
  • Purpose : This study was performed to characterize the epidemiologic and clinical features of acute adenoviral lower respiratory tract infections(LRTIs). Methods : Virological analysis was done from respiratory specimens obtained from patients with LRTIs hospitalized to other hospitals and referred to the Department of Pediatrics, Seoul National University Children's Hospital(SNUCH) from June 1998 to July 2000. Viral diagnosis was made by isolation of viruses employing HEp-2 cell culture and indirect immunofluorescent staining with monoclonal antibodies. Serotypes of adenoviruses were determined by neutralization test using antiserum for types 1, 2, 3, 4, 5, 6, 7 and 11. Medical records of children admitted to the SNUCH were reviewed retrospectively. Results : Adenovirus was isolated from 118(9.0%) of 1,305 children with LRTIs. Serotypes were 3(39.0%), 7(16.9%), 1(11.0%), 2(7.6%), 4(7.6%), 6(5.9%), 11(2.5%), and 5(0.8%) and 10 strains(8.5%) were not neutralized by antisera included in the study. Infections by type 3 and type 7 occurred in outbreaks. Male to female ratio was 1.0:0.9 and mean age was 1.95 years. The clinical diagnoses were pneumonia(83%), acute tracheobronchitis(12%) and bronchiolitis(5%). Associated symptoms, signs and abnormal laboratory findings included cough(100%), sputum(73.5%), fever(54.2%), rale(59.3%), wheezing(34%), anemia(35%) and leukopenia(15.8%). Mortality was in 13.5%. Residual radiologic sequelae was identified in 32.6% of the patients followed. Conclusion : These data confirms that adenovirus may cause severe lower respiratory tract diseases, and infections by type 3 and 7 may occured in outbreaks.

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Systemic Candida Infection in Very Low Birth Weight Infants : Epidemiological Features Over 5 Years (극소 저체중 출생아에서 전신성 칸디다 감염 : 5년간의 역학적 특성)

  • Lee, Seung-Woo;Lee, Jeong-Eun;Lee, Ju-Young;Lee, Hyun-Seung;Lee, Jung-Hyun;Sung, In-Kyung
    • Neonatal Medicine
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    • v.16 no.2
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    • pp.190-196
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    • 2009
  • Purpose: Candida infection has increased in neonatal intensive care units (NICU). However, recent reports on systemic candida infections in preterm newborns are rare in Korea. The aim of this study was to examine the epidemiological features of systemic candida infection in very low birth weight infants (VLBW) over the past five years. Methods: We retrospectively reviewed the medical records of 19 patients with systemic candida infections in VLBW that were admitted to the neonatal intensive care units of three hospitals affiliated with the College of Medicine, The Catholic University of Korea from January 2004 to December 2008. We analyzed the birth weight, gestational age, age at diagnosis, risk factors, co-morbidity, antifungal treatment, and mortality rates among the 19 patients. Results: Systemic candida infections occurred in 19 cases (4.7%) among the VLBW infants. The mean birth weight and gestational age were 959.0$\pm$255.9 g and 26.7$\pm$2.1 weeks. The isolated Candida species were C. albicans (4), C. parapsilosis (9), C. glabrata (2), C. famata (2), and unkown subspecies (2). Most patients had various associated risk factors, including a central venous catheter, broad spectrum antibiotics, parenteral nutrition, intravenous lipid emulsion, endotracheal intubation and $H_2$ blocker therapy. There was no significant difference in the risk factors between newborns that survived and those that died with regard to the systemic candida infection, except for gestational age. Nine (47.4%) out of 19 patients with a candida infection died and four cases (21.2%) were directly related to the candida infection. Conclusion: The prevalence of systemic candida infection is increasing in VLBW infants. The majority of Candida species has shifted to C. non-albicans, especially C. parapsilosis. Because of the high mortality associated with candida infection in the NICU, prophylaxis and early treatment based on epidemiological features is necessary.

ICU nurses' ethical attitudes about DNR (중환자실 간호사들의 DNR에 대한 윤리적 태도)

  • Yu, Eun-Yeong;Yang, Yu-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.4
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    • pp.2691-2703
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    • 2015
  • This research aims to provide basic materials for assisting DNR patient cares by understanding ICU nurses' awareness and ethical attitude regarding DNR. A total of 154 results were analyzed which were collected from Aug. 1st to Sep. 5th in 2014 by surveying nurses working in ICU (from 1 advanced general hospital in G metropolitan city and other general hospitals of more than 700 beds in Cheolla provinces). (1) For the decision attitudes of DNR, there were both consent and objection. Consent for the patient's opinion of rejecting further treatment and life extension despite of bad prognosis. And objection for no conducting DNR in the case of the patient's wish, treatment requested by the guardian, and CPR for the patient who has no chance. (2) Objection for artificial respirator and other treatment requested by the patient's family and the entrance of guardians into ICU. Consent for the passive use of artificial respirator by the doctor and the decrease of basic care to stabilize patients physically and mentally. No specific opinion for treatment not following aseptic techniques. Objection for frequent reports to primary care physician requested by the family. (3) Acknowledging less interest by the doctor, while supporting the health care team in the case of the guardian's complaint, objection for the DNR decision mede by the primary care physician. Objection for the DNR decision by the guideline. Objection or neutrality for straightforward explanation to the patient of bad prognosis. Objection for straightforward explanation of the patient's status (even near to death) to the patient him/herself or the guardian. In conclusion, the subject of DNR is the patient and the patient's opinion should be fully reflected. The conflict arising from the scope of medical practice and decision processes should be minimized. The standard and guideline for DNR decision is required for the ethical decision making for the patient along with agreements based on full explanations.

A Study on Factors Affecting Emotional Labor of Clinical Dental Hygienists (임상치과위생사들의 감정노동에 영향을 미치는 요인)

  • Lee, Myeong-Ju;Kim, Young Nam;Lee, So-Young
    • Journal of dental hygiene science
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    • v.15 no.2
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    • pp.113-118
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    • 2015
  • This study was conducted to develop a plan for emotional labor of clinical dental hygienists by understanding the factors affecting their emotional labor. Self-administered questionnaires were distributed to 293 dental hygienists who worked in dental hospitals and clinics located in Busan and Gyeongsangnam-do from June to September in 2013. The questionnaire items used in this study consisted of 5 items of general characteristics, 2 items of characteristics related to turnover, and 9 items of emotional labor. t-test, ANOVA, and multiple regression analysis were performed using the SPSS Statistics ver. 17.0 for Windows program for data analysis. The average level of the study subjects was $69.85{\pm}12.82$. With regard to the emotional labor according to the general characteristics, the frequency of emotional expressions (p<0.037) showed significant differences in the marital status. The workplace showed significant differences in the frequency of emotional expressions (p<0.001), attentiveness of emotional expressions (p<0.002), emotional dissonance (p<0.032), and total (p<0.001). The turnover intentions showed significant differences in the frequency of emotional expressions (p<0.001), attentiveness of emotional expressions (p<0.001), emotional dissonance (p<0.001), and total (p<0.001). As a factor affecting emotional labor, turnover intention (p<0.001) and workplace (p<0.001) had an effect on emotional labor. The results showed that turnover intention and workplace were associated with the emotional labor of dental hygienists. There is a need to develop an emotional education program to make it possible to effectively manage emotional labor of dental hygienists for providing high-quality medical services of dental institutions.