• The Journal of the Korea Contents Association
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• v.8 no.4
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• pp.237-246
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• 2008

The purpose of this study was to develop relaxation training contents for middle and high school archery players with considering the ecological validity of social, cultural, and sports environment in Korean but also examine the effect of developing relaxation training contents through case study approach and interviews. The relaxation training contents was based on previous researches about relaxation program. In addition, in order to develop the program 3 archery experts and 2 sport psychologists had meetings. The relaxation training contents categorized as orientation, breathing regulation, progressive relaxation training, cognitive restructuring, meditation, heart rate biofeedback training, autogenic training, behavior therapy, self regulation. The experimental group were 6 male Korean national archery substitute players, who were selected in 2007. The effects was examined on competitive state anxiety inventory-2, heart rates, archery score and interviews. As the result of applying the developed program of this study on the field, competitive state anxiety, somatic state anxiety and heart rate were decreased. In the interviews athletes told that they were relaxed psychologically and physically. This result demonstrated the relaxation training program were effective.

• Journal of Oral Medicine and Pain
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• v.37 no.4
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• pp.221-225
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• 2012

Disc dislocation without reduction, as known as closed lock, is a clinical condition in which the disc is dislocated from the condyle and does not return to normal position during condylar movement When the condition of disc dislocation without reduction is acute, the initial therapy should include an attempt to reduce or recapture the disc by manual manipulation. When patients report a history of being locked for 1 week or less, manual manipulation is usually successful. In patients with a longer history, success rate tends to decrease rapidly. If the disc has been successfully recaptured, placing an anterior positioning appliance is recommended to prevent clenching on the posterior teeth, which would likely redislocated the disc. But it is hard to make an appliance immediately in the clinic because it takes too much time. And making an appliance using self-curing acrylic resin is not very popular because of its discomfort by odor and working time. Also, if the patient has resin allergy or is under orthodontic treatment, or if it is impossible to control behavior of the patient, it has been restricted to make an appliance immediately. Therefore, to supplement this disadvantages, we tried to confirm about successful short term use of temporary anterior positioning splint made by using putty impression material after manual manipulation in this study.

• Journal of Home Health Care Nursing
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• v.3
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• pp.86-97
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• 1996

The traditonal inpatient acute hospital setting is organized primarily for the intensive management of disease, but not well-suited for continuity of care for the chronically ill patients after being discharged from hospital. For the planning of the continuity of care, firstly, it is necessary to assess the home care needs of the discharged pateints in the context of the nursing diagnosis. Therefore, this study is designed to identify the home nursing care need trajectory of the patients with chronic illness after discharged from one of the the General Hospitals in Seoul, Korea. The subjects are the patients with chronic illness such as stroke, musculoskeletal disease, hypertension, cancer etc., in average age of 52. 2 years old. The findings of this study are as follows : 1) The limitaion of ADL has been constantly facing to the subjects and has not been changed 4 weeks after being discharged. And the sense of with-drawal was getting worse at 4th weeks than the 1st week after being discharged. 2) The lists of the patient's problems are the impairment of mobility, elimination pattern, inactivity, impairment of skin integrity, ineffective airway clearance, and potential anxiety, self concept deficit, ineffective family coing, etc. Those problems were diminished in quantity at the first week after discharged, but at the 4th week, those problems were getting worse. 3) The need of specialized nursing care such as tube feeding, ostomy care, $O_2$ inhalation, IV therapy, teaching and exercise are considered as the most consisting problems facing to the subjects. 4) In general, the chronically ill patients and their caregivers have not been adapted well even at the 4th weeks after being discharged. 5) Considering those findings, the basic care for patients should be given and the trainging for process of the adaptation after discharged should be encouraged prior being discharged from hostital. For this suggestion, the systematic discharge planning should be carried and the hospital based home nursing model should be implemented at the general hospital for the chronically ill patients.

• Korean Journal of Clinical Pharmacy
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• v.22 no.4
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• pp.356-366
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• 2012

Background: Chemotherapy-induced peripheral neuropathy (CIPN) involving sensory and motor nerve damage or dysfunction is a common and serious clinical problem that affects many patients receiving cancer treatment. This condition may pose challenges for the clinician to diagnose and manage, particularly in patients with coexisting conditions or disorders that involve the peripheral nervous system. Many chemotherapeutic agents used today are associated with the development of serious and dose-limiting CIPN that can adversely affect the administration of planned therapy and can impair quality of life by interference with the patients' activities of daily living. The most important clinical objective in the evaluation of patients with CIPN is to determine their level of functional impairment involving activities of daily living. These findings are used to make medical decisions to continue, modify, delay, or stop treatment. The most commonly reported drugs to cause CIPN include taxanes, platinum agents, vinca alkaloids, thalidomide, and bortezomib. We aimed to determine PN incidence during cisplatin, carboplatin and oxaliplatin administration. Methods: We collected data from 125 patients who received at least one cycle of cisplatin, carboplatin or oxaliplatin. They completed a self-reported questionnaire and items related to their disease and peripheral neuropathy. The investigators filled in part of items about disease and treatment. Patient Neurotoxicity Qeustionnaire developed by Bionumerik company were applied for PN assessment. Results: The incidences of sensory neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 23%, 56% and 50%. The incidences of motor neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 18%, 42% and 19%. The incidences of severe neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 13%, 28% and 14%. The incidences of PN were associated with cumulative dose but not age, gender and concurrent illness. 19.2% of the patients (24/125) were prescribed with gabapentin, nortriptyline or gabapentin plus nortriptyline to reduce these peripheral symptoms and 75% of the patients answered the drug were effective. Conclusion: Incidence of PN after cisplatin or oxaliplatin administration is cumulative dose-related. Physician-based assessments under-reported the incidence and severity of CIPN. To overcome this limitation, diagnostic tools specifically designed to assess peripheral neuropathy severity associated with chemotherapy must be developed.

• Korean Journal of Clinical Pharmacy
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• v.22 no.3
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• pp.239-250
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• 2012

In recent years, national health insurance(NHI) coverage had been expanded gradually for cancer as a severe disease requiring high level of medical expenditure, to reduce patient's financial burden. But, subjective burdens level for out-of-pocket(OOP) money expense are still considerable owing to high medical cost and decent numbers of services not covered by benefit plan. This study aimed to investigate OOP medical expenditures and identify factors influencing subjective financial burden in cancer patients. A 28-items questionnaire for self-reporting by responders was designed to satisfy study goal and finalized following by one pilot study and experts' verification process. Subjects were enrolled during July to October 2010 through regular meetings organized by five patient or patient-advocacy groups had acknowledged the study purpose. Subjects who aged 20 or more, have histories of cancer diagnosis and anticancer drug use, and voluntarily agreed to participate in this study were recruited. Total 107 subjects included in the analysis have cancer lesions in breast, colon, kidney, liver or stomach at the stages from I to IV. Approximately 73% of them has passed less than 5 years since cancer diagnosis. For the OOP medical expenditure regarding cancer, less 6 million won was in 31%, 6-15 million won in 35% and more than 15 million won in 28% of responders, and more than half responders(58%) felt financial burden subjectively. 63% of responders had subscribed commercial insurances, resulting in money receipts of more than 10 million won since cancer diagnoses in 76% of responders. Logistic regression results showed significant differences in subjective OOP financial burden level depending on gender, household income level, benefit type, commercial insurance money receipt degree, year cancer diagnosed, cancer lesion, therapy type, duration of anticancer drug use, drug listing in national formulary, total OOP medical expenditure and total OOP anticancer drug expense. They had mixed feelings both wishes to expand NHI coverage to reduce financial burden(70%) and no willingness to increase premium(59%). This result suggested that NHI might direct future strategies to reduce absolute total OOP medical cost and expand benefit plan coverage in higher burden groups in particular.

• Child Health Nursing Research
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• v.19 no.3
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• pp.177-186
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• 2013

Purpose: The purpose of this study was to identify the predictors influencing on resilience in adolescents with cancer. Methods: The participants consisted of 107 parents and 107 adolescents who aged ten and eighteen diagnosed with cancer more than six months and currently receiving outpatient treatment or further management after off-therapy. Data was collected using self-report questionnaires and analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation, and multiple regression. Results: Resilience was significantly different by religion (t=2.472, p=.045) and number of cancer treatment regimens (F=3.155, p=.047). Family problem-solving communication was also significant by number of cancer treatment regimens (F=3.582, p=.031). The higher social support showed the stronger family hardiness and the better family problem-solving communication. In addition, a positive relationship was found between Family Hardiness Index (FHI) (r=.193, p=.046), Family Problem Solving Communication (FPSC) (r=.226, p=.019) and resilience of adolescents with cancer. FPSC (${\beta}$=.356, p=.045) and religion (${\beta}$=.441, p=.002) were predictive factors at ages 10-12, FHI (${\beta}$=.509, p=.029) and FPSC (${\beta}$=.503, p=.037) were predictive factors at ages 13-15 on resilience of adolescents with cancer that explained 16.0% and 24.3% respectively. Conclusion: The findings suggest that nursing interventions should focus on enhancing family resilience and resilience of adolescents with cancer.

• Progress in Medical Physics
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• v.25 no.1
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• pp.8-14
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• 2014

The amounts of radioactive wastes to be disposed in the medical institute have been increased due to development of radiation diagnosis and therapy rapidly. They are produced mostly by the very short lived radioisotopes such as $^{18}F$ used in PET/CT, $^{99m}Tc$, $^{123}I$, $^{125}I$ and $^{201}Tl$, etc. IAEA proposed a criteria for the clearance level of waste which depends on the individual ($10{\mu}Sv/y$) and collective dose (1 man-Sv/y), and concentration of each nuclide (IAEA Safety Series No 111-P-1.1, 1992 and IAEA RS-G-1.7, 2004). Radioactive wastes of $^{18}F$, $^{99m}Tc$, $^{123}I$, $^{125}I$ and $^{201}TI$ in the several types of container like Marinelli beaker, vial and plastic, were collected to measure the concentration of the waste of each nuclide in accordance with IAEA criteria. The measurement method and procedure of determining specific activity of the wastes using gamma emitters like MCA, gamma counter and beta emitters were developed. For the efficiency calibration of the detectors, CRM (certified reference material) which has the same dimension and shape was provided by Korea Research Institute of Standards and Science (KRISS). Correction factor of the radioactivity decay was calculated based on the measurement results, and the consideration of mutual relation with theoretical equation. The result of this study will be proposed as ISO standard.

• Journal of the Korean Society of Radiology
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• v.11 no.4
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• pp.289-295
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• 2017

In general, a number of studies have been conducted on factors affecting breast cancer development, but systematic investigations of risk factors are rare. The purpose of this study was to investigate the factors involved in breast cancer screening before breast ultrasound diagnosis and the risk factors associated with breast cancer screening by ultrasound. Self-administered questionnaire was performed on 417 patients who underwent breast ultrasonography and classified as benign and malignant. Breast cancer was associated with age, BMI, and type of medication(p<0.05). Multivariate analysis showed that the odds ratio was 4.93 times higher in the 50s compared to the less than 50s, 2.43 times higher in the obese group than in the normal group, 0.14 times and 0.16 times lower in hormonal replacement therapy(p<0.05). Therefore, as age increases, periodical examination of health and appropriate weight management are needed. So this study is expected to provide basic data for identification of risk factors affecting breast cancer development.

• Women's Health Nursing
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• v.5 no.1
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• pp.133-145
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• 1999

The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

• Management & Information Systems Review
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• v.23
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• pp.75-97
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• 2007

In the meantime hospital system of Korea has institutionally performed its errand in stable circumstance, however the system now faces with new environment of change of customer's satisfaction, of regime, deepening of competition, and opening market. Under the rapidly and complicatedly changing circumstance, the hospital system is required to promote getting a dominant position in the competition, enhancing outcome, creating value added, and customer satisfaction in both internally and externally likewise other organizations, as they continuously introduce a knowledge management and originate, accumulate, and put the knowledge to practical use. This organization capacity of knowledge management involves a process of management that requires great change of all organizations and individuals and it is brought up through four steps which are Initiation, Propagation, Integration, and Networking. The main factors of successful knowledge management are intension of the chief executive officer(CEO), organizational culture, appraisal and compensation of work, knowledge controlling system, and organizational structure, and each of these five stage has got different characteristic. To be successful by introducing knowledge management, hospital organization should be based on these premises. Not only CEO or the director of a hospital, but also the constituent members should be fully aware of knowledge, the characteristic of knowledge management, and successful factors of this operation. Should understand step-by-step characteristic of knowledge management, therefore able to analyse a situation of specific hospital and see which step corresponds to that hospital. By analysing, constituents should make up for the weak points and ready to move on to next step. CEO or the director of a hospital should be aware of knowledge management as a strategic factor which is able to get a dominant position in the rapidly changing environment, and also it should be firm in the director's intention to introduce the knowledge management into the hospital. By continuously carrying out education and training constituent members, the director of a hospital should promote their interest and participation in knowledge management, and build an organization culture that ultimately creates, accumulates, shares, and put the knowledge to practical use. The hospital organization needs to systematize an institution of objective compensation that corresponds to objective appraisal of knowledge management outcome. The hospital ought to build knowledge controlling system in stages, in order to take the initiative in rapidly changing environment. By considering the characteristic of hospital system, it is required to change the organizational structure into self-managing team which is a sort of horizontal structure that allows members to make decisions and take the responsibility by themselves. The limitation of this study is experimental study. Positive investigation about successful factors of hospital knowledge management and characteristic of each steps is expected with following study.