• Journal of Korean Orthopaedic Sports Medicine
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• v.8 no.1
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• pp.39-45
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• 2009

Purpose: We intended to classify the pattern and to seek the cause of fractures and/or dislocations related to middle and high school Taekwondo athletes in competition and try to get the ways for preventing them. Materials and Methods: We studied 50 fractures and dislocations of the athletes in competition, which were surveyed in 2005-2007 national middle and high school Taekwondo tournament annually. We analyzed the type and the cause of the injury, performed survey at postinjury l year in 32 cases, sought proper treatments and methods for prevention. Results: The 26 cases (52%) of foot fracture, 15 cases (30%) of hand fracture and 9 cases (18%) of forearm fracture are occurred in this study. The 9 cases (28%) of satisfaction in treatment, 15 cases (47%) of average and 8 cases (25%) of dissatisfaction are surveyed in the 32 cases. The causes of dissatisfaction are lack of rest (7 cases), excessive training (5 cases), immoderate participation of match (6 cases) and the others. The athletes were returned to the match before complete recovery in 21 cases (67%). Conclusion: The causes of fractures and dislocations in middle and high school Taekwondo athletes were stroke on upper and lower extremities and high-speed hyperflexion injury that was occurred during spraining of great toe on the floor. We consider that the athletes need the development of effective protector, improvement of equipment in stadium and enough rest and education.

• Journal of Korean Academy of Nursing
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• v.24 no.3
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• pp.389-412
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• 1994

This study was done to investigate stress and coping methods of mothers with brain disease children. The subjects for this study were obtained by taking a sample of mothers with brain disease children hospitalized in neurosurgery ward of K medical center in Seoul from Nov. 20, 1992 to Mar. 10, 1993. The collected date were analized by S.P.S.S. program(frequency, percentage, mean, t-test, ANOVA, Pearson Correlation). The results of the study were as follow. 1. The mean of the degree of mothers' stress was 3.681. Of the stress categories, illness treatment (4.216) was highest, and the next were in order of ill-ness status and prognosis(4.154) , family relation-ships and personal roles(3.202), interpersonal relationships(2.916). 2. The mean of the degree of mothers' coping method was 2.930. Of the coping method categories, communication with medical team or parents in similar situations(3.332) was highest, and the next were in or-der of family cooperation and optimistic thought about the situation(3.241), reforcement of self esteem and maintenance of psychological stability(2.538). 3. There was not seen a stastically significant correlation between stress factors and coping methods of mothers. But with categories, the higher the stress to illness status and prognosis was, the hight coping methods' degree of communication with medical team or parents in similar situations was shown a positive correlation, if not high (r=.2776, P=.046) . And the higher the stress to illness treatment was, the higher coping methods' degree of communication with medical team or parents in simial situations was shown a positive correlation, if not high (r=.2727, P=.049). 4. With the difference of stress according to mothers' general characteristics, religion and monthly income shew a statically significant difference. The mothers' group who have a religion shew the higher degree of stress(t=-3.17, P=.003), The group who get the most income shew highest degree of stress (F=.4693, P=.0156). With the difference of coping according to mothers' general characteristics, the most support-ing person, satisfaction with husbands and mothers' own health status shew a statistically significant difference. The group who get the most support from parents-in-law(F=3.7508, P=.013), the group who are much satisfied with husband(F=3.589, P=.016), and the group whose health status are good(F=3.3675, P=.046), shew the highest coping degree. 5. There were no significant difference in degree of stress and coping by children's characteristics The significance of the study will be concluded as follows. 1. Investigating the stress factors, which mothers are perceiving, it will be utilized as the basic materials of nursing plan so as to reduce the stress of mothers. 2. In searching for the ways of mothers' more helpful coping methods, it shows the necessity of the active nursing intervention for the mothers in the process of coping with their stress. That is, the nurse should serve the earnest nursing as counselor, supporter, educator, and information - provider. 3. Recogning mothers as well as children with brain disease as a client, the nurse will be able to help the mother, who is taking care of the children, cope with the stress situation well, and to make a contribution to the recovery, rehabilitation, and health of the children and to the enhancement of the family' health.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.151-158
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• 1996

Background: Buprenorphine, a new synthetic thebaine derivative, is a partial agonist of the opioid $\mu$-receptor with high receptor affinity, great lipid solubility, and slow rate of opiate receptor association and dissociation. Continuous epidural infusion of opioid can possibly produced undesirable effects, such as respiratory depression, pruritus, etc, in spite of effective postoperative analgesia. Methods: The present study was undertaken to compare the analgesic properties and side effects of continuous epidural infusion of buprenorphine combined with bupivacaine, and morphine combined with bupivacaine in 90 patients following elective gynecologic lower abdominal surgery. At the end of surgery, the initial bolus doses were 3 mg morphine (M group), 0.15 mg buprenorphine (0.15B group), 0.3 mg buprenorphine (0.3B group) combined with 0.25% bupivacaine 10ml, and subsequent continuous infusion doses were 6 mg morphine plus 0.125% bupivacine 100 ml (M group) and 0.6mg buprenorphine plus 0.125% bupivacaine 100 ml (0.15B, 0.3B, group) during 48 hours. The assessment of analgesic efficacy and side effects were made at arrival of recovery room, 1 hr, 4 hr, 8 hr, 24 hr, 36 hr, and 48 hr after the epidural injection. Results: The pain score during 48 hours was significantly higher in the 0.15B group than in the M group and 0.3B group (P<0.05), and the number of patients requiring additional analgesics was significantly higher in the 0.15B group than in the M group and 0.3B group (P<0.05). Signs of respiratory depression were not noted, and the incidence of pruritus, nausea, and vomiting was slightly lower in the 0.15B group and 0.3B group than in the M group, and the incidence of sedation and urinary retention was similar in three group. The subjective rating of satisfaction was better in the 0.3B group than in the M group and 0.15B group (P<0.05). Conclusion: The above results suggest that continuous epidural infusion of buprenorphine combined with low-dose bupivacaine is an advisable method of postoperative analgesia.

• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.127-135
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• 1984

Personal and social characteristics, disease status, reason of delay of receiving drug from City Health Center and knowledge and attitude on the pulmonary tuberculosis were compared between the faithful group in treatment and the unfaithful group among the patients for pulmonary tuberculosis registered in a City Health Center in order to analyze the factors which influenced the faithfulness to treatment. Record as well as interview survey was done toward all patients of 247 who were registered and being cared during over 6 months in a City Health Center from April 1, 1982 to March 31, 1983, and results were as follows; 1. There was no statistically significant difference in sex and age distribution between the faithful group in treatment and the unfaithful group. 2. There was no statistically significant difference in marital status distribution between the faithful group and unfaithful group in treatment. 3. The lower education group comprised higher proportion than the higher education group among the faithful group in treatment. 4. The proportion of the emlployed was higher than unemlpoyed among the unfaithful group in treatment. 5. The proportion of mild case was higher than severe case among the unfaithful group in treatment. 6. As for the onset of delay of receiving drug, 'less than 3 month after starting treatment' was 59.5% among the unfaithful group in treatment. 7. The reasons of delay of receiving drug were 'no time' (42.2%). 'being away from home' (25.0%), 'being sick' (13.8%), and 'forgot the appointed date' (12.0%). 8. There was no statistically significant difference in the knowledge on the communicability of the tuberculosis between the faithful groups in treatment and the unfaithful group. 9. There was no statistically significant difference in the knowlege on B.C.G. as vaccination drug of tuberculosis between the faithful group and the unfaithful group in treatment. 10. There was no statistically significant difference in the satisfaction on the treatment of health center between the group of faithful and unfaithful in treatment. 11. There was no statistically significant difference in the belief on the complete recovery of tuberculosis between the faithful group and the unfaithful group in treatment. 12. The rate of consulting on tuberculosis treatment with life partner was higher among the faithful group in treatment than the unfaithful group.

• Journal of Korean Academy of Nursing Administration
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• v.9 no.3
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• pp.337-352
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• 2003

Purpose: The purpose of this study is to analyse research trends related to the evaluation of quality of nursing, thereby obtaining basic data relating to the identification of current situation of instrument development of quality of nursing, and of future research orientation and to the development of performance index of nursing organization. Method: The data were collected from June to December, 2002 through the review of total of 32 research papers which had evaluated quality of nursing among published papers in Korea from 1976 to August 2002. The analysis was done in terms of research period, the periodicals in which research papers were published, domains and the approaches of evaluation of nursing quality. The content analysis of lowest-level items amounting was performed using NIC developed by McCloskey & Bulecheck(1998) and consequential indices of quality of nursing developed by Chi(1995). Results: Twenty-three of 32 papers(71.8%) turned out to be published after 1995, indicating surging interest in the evaluation of quality of nursing from the mid 1990s. Also, ten of 12 research papers dealing with subjects' diseases were published after 1995. In content analysis of lowest-level items of the process-oriented evaluation of quality of nursing, the highest nursing intervention was patient education about procedure and treatment; followed in descending order by patient education about disease process, strengthening of communication, managing environment, infection control, admission care, defecation and urination care. In content analysis of lowest-level items of the outcome-oriented evaluation of quality of nursing, items of physical and psychological state, of patient and family satisfaction, of knowledge and home care, of change of patients' state, of addressing nursing issues, and of patient recovery were the outcome indicators in more than 60 percent research papers. Conclusion: The findings provided the foundation for their effective use in nursing practice with comparing and presenting various core evaluation items representing process and outcome domains.

• Korean Journal of Psychosomatic Medicine
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• v.11 no.2
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• pp.196-204
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• 2003

Objectives: It is known that sedative hypnotics would make cross tolerance with alcohol and deteriorate quality of sleep in alcoholics. Light therapy is effective non-pharmacological intervention for sleep disturbance in circadian phase disorders, jet-lag, shift-work and age-related sleep disorders. Authors would investigate the effects of morning light therapy on sleep of patients with alcohol dependence during recovery state without withdrawal symptoms. Methods: 13 patients with alcohol dependence who have not any alcohol withdrawal symptom were recruited. Light therapy during 1 hour in the morning had been administered by 2500 Lux light box through serial 3 days. Sleep state of subjects were assessed by sleep log and the subjective satisfaction at sleep was by 100 mm visual analogue scale. Sleepiness, depressive mood, anxiety were evaluated by 100mm visual analogue scale at 8 AM, 2 PM and 8 PM. For assessment of performance ability that would be associated with sleepiness and vigilance, trail making test A, B and digit symbol substitution test were performed by two times on base line and 4th day. Univariate repeated-measures ANOVAs were performed for each measures except performance tests which were analysed by paired t-test. Results: Sleep latency and sleep efficiency were significantly improved with light therapy and satisfaction at sleep was. There was no significant difference in sleepiness at 2 PM with light therapy but sleepiness at 8 AM significantly decreased and at 8 PM increased. The time to complete Trail making test and digit symbol substitution test were significantly shortened at 4th day compared with baseline. Fatigue at 8 AM were not significantly changed with light therapy but at 2 PM and 8 PM significantly decreased. Depressive mood and anxiety were not significantly changed with light therapy. Conclusion: Although this study had some limitations, it showed that light therapy would be effective modality on sleep disturbance of patients with alcohol dependence who have recovered from alcohol withdrawal symptoms. It is proposed that short term light therapy could be used clinically for alcoholics with insomnia. In the future, long term controlled studies using more objective tools for sleep are required to further investigate the effect of light therapy in alcoholics.

• Journal of Korean Academy of Nursing
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• v.24 no.4
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• pp.545-556
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• 1994

Medical insurance and health care delivery system enabled Korean people to get the necessary medical service, but it caused increased needs for medical service, and resulted in the occurence of some problems such as a lack of manpower and medical facilities. In order to solve these problems, many countries, which already had medical insurance system had developed home care system and it has been regarded effective both in reducing costs and in increasing the rates of turnover of bed. Recently, Korea has included home nursing care in its health care delivery system, and some models of the hospital based home nursing care had been tried and its effects had been evaluated. So, author tried to run a home nursing care for the Cesarean section mothers and evaluate Its effects both in the mother's health and costs. This study was designed as a Quasi-experimental study. Subjects were thirty mothers who got Cesarean section operation in hospital in Seoul. Experimental group consisted of 15 volunteers, and control group were selected by means of matching technique. Data were gathered from February 1st to March 26th by two assistants who were trained by author. Experimental group were discharged on the 4th day after their operation, and got nursing care and assessment about their home three times on the 5th, 6th, and 7th day. Control group stayed in the hospital until 7th day as usual and were checked on the same day as above mentioned To evaluate the state of physiological recovery, vital signs, H.O.F, presence of edema in the legs, bathing, appetite, sleep, presence of pain or discomfort in the breasts, amount of lochia, color of lochia, defecation urination. To compare incidence of complication in experimental group with that in control group, specific assessment was done such variables as smell of lochia, presence of inflammation of operation wound, dizziness, and presence of immobilization in the extremities. The activities of daily living were checked Satisfaction of nursing were checked To calculate costs, author asked subjects to specify expenditure including hospital charge, traffic enpenses, and food expenses. The results were as fellows. 1. On effectiveness of home nursing careThere were n significant differences between experimental and control group in incidence of abnormal symptoms and any complication. The number of taking a bath [POD #5 P=0.001, #6 P=0.0003, #7 P=0.001] and the degree of appetite [POD #5 P=0.03, #6 P=0.02, #7 P=0.013] were significantly higher in experimental group than in control group. Contrary to author's expectation, the degree of the activities of daily living in experimental group was not higher than that of control group. All of the experimental group said they were satisfied with the home nursing care. 2. Cost analysis 1) Hospital charge of experimental group was lower than that of control group. ［P=0.009］ By taking home nursing care, average period of hospitalization was shortened to 3.1 days, and family members could save 22.8 hours. Total amount of money saved by early discharge was 3,443,093 Won. It is estimated that total amount of money saved by early discharge in a year will be 40,398,956 Won. 2) Home nursing care charge of 15 mothers was 1,781,633 Won. It is estimated that total amount of money Saved by it in a year Will be 20,904,493 Won. It was lower altogether than hospital charge of the three days which is 5th, 6th, 7th day of operation. The average cost of single home visit was calculated 10,940 Won. It took 87 minutes per round and it costed 1,017.3 Won. The average hour of home care was 39.0 minutes. 3) It is expected that early discharge can bring forth the increase of hospital income. On the condition that the rate of running bed is 100%, the expected increase of hospital income will be 202,374, 026 Won in a year. Suggestions for further study and nursing practice are as follows : 1. For the welfare of patients and the increased rates of running bed, home nursing care system should be included in the hospital nursing care system. 2. Studies to test effect of home nursing care on the patients with other diseases are needed. 3. Establishment of law on the practice of home nursing care is strongly recommended.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.1
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• pp.79-88
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• 2002

Purpose: In this prospective, randomized study, we compared the results of early motion versus conventional immobilization after the arthroscopic Bankart repair. Materilal and Methods : We performed an arthroscopic Bankart repair using suture anchors in 62 patients with traumatic anterior shoulder instability and randomized them into two groups; Group 1 (n=28; mean age, 28 years) underwent three-week of immobilization and conventional rehabilitation program, while Group 2 (n=34; mean age, 29 years) underwent an accelerated rehabilitation program with staged range of motion and strengthening exercises starting from the immediate postoperative day. Selected patients were non-athletes with a classic Bankart lesion and a robust labrum. Analysis of outcome included pain scores (6-week and follow-up: 31(9 months), range of motion, return to activity, recurrence, patients’ satisfaction with each program, and shoulder scores (ASES, UCLA, and Rowe). Results : The recurrent rate was not different between the two groups (2 anterior apprehension from each group) (p=0.842). Patients with accelerated rehabilitation resumed functional range-of-motion faster and returned earlier to the functional level of activity (p<0.05). Accelerated rehabilitation decreased postoperative pain and more patients were satisfied with this program (p<0.05). No differences were found between the two groups at the follow-up with regards to the shoulder scores, return to activity, pain score, and the range-of-motion. Conclusions : Early mobilization after arthroscopic Bankart repair does not increase the recurrence rate in selected patients. Although the final outcomes are similar in both groups, the accelerated rehabilitation program promotes functional recovery and reduces postoperative pain, which enables patients an early institution of desired activities.

• Journal of Oral Medicine and Pain
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• v.31 no.4
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• pp.283-296
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• 2006

Along with the development of scientific technologies, health care has been growing remarkably, and as the social life quality improves with increasing interest in health, the demand for medical service is rapidly increasing. However, medical accident and medical dispute also are rapidly increasing due to various factors such as, increasing sense of people's right, lack of understanding in the nature of medical practice, over expectation on medical technique, commercialize medical supply system, moral degeneracy and unawareness of medical jurisprudence by doctors, widespread trend of mutual distrust, and lack of systematized device for solution of medical dispute. This study analysed 30 cases of civil suit in the year between 1994 to 2004, which were selected among the medical dispute cases in dental field with the judgement collected from organizations related to dentistry and department of oral medicine, Yonsei university dental hospital. The following results were drawn from the analyses: 1. The distribution of year showed rapid increase of medical dispute after the year 2000. 2. In the types of medical dispute, suit associated with tooth extraction took 36.7% of all. 3. As for the cause of medical dispute, uncomfortable feeling and dissatisfaction with the treatment showed 36.7%, death and permanent damage showed 16.7% each. 4. Winning the suit, compulsory mediation and recommendation for settlement took 60.0% of judgement result for the plaintiff. 5. For the type of medical organization in relation to medical dispute, 60.0% was found to be the private dental clinics, and 30.0% was university dental hospitals. 6. For the level of trial, dispute that progressed above 2 or 3 trials was of 30.0%. 7. For the amount of claim for damage, the claim amounting between 50 million to 100 million won was of 36.7%, and that of more than 100 million won was 13.3%, and in case of the judgement amount, the amount ranging from 10 million to 30 million won was of 40.0%, and that of more than 100 million won was of 6.7%. 8. For the number of dentist involved in the suit, 26.7% was of 2 or more dentists. 9. For the amount of time spent until the judgement, 46.7% took 11 to 20 months, and 36.7% took 21 to 30 months. 10. For medical malpractice, 46.7% was judged to be guilty, and 70% of the cases had undergone medical judgement or verification of the case by specialists during the process of the suit. 11. In the lost cases of doctors(18 cases), 72.2% was due to violence of carefulness in practice and 16.7% was due to missing of explanation to patient. Medical disputes occurring in the field of dentistry are usually of relatively less risky cases. Hence, the importance of explanation to patient is emphasized, and since the levels of patient satisfaction are subjective, improvement of the relationship between the patient and the dentist and recovery of autonomy within the group dentist are essential in addition to the reduction of technical malpractice. Moreover, management measure against the medical dispute should be set up through complement of the current doctors and hospitals medical malpractice insurance which is being conducted irrationally, and establishment of system in which education as well as consultation for medical disputes lead by the group of dental clinicians and academic scholars are accessible.