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The Effects of Mouth Care with Sterile Normal Saline on Chemotherapy-induced Stomatits (멸균생리식염수를 이용한 구강 간호가 항암요법을 받는 환자의 구내염 발생에 미치는 영향)

  • 박혜자;신혜숙
    • Journal of Korean Academy of Nursing
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    • v.25 no.1
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    • pp.5-16
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    • 1995
  • The effects of the mouth care using cool sterile normal saline on oral stomatitis were investigated in 59 patients on chemotherapy. The subjects were divided into two groups, one was experimental group(N=31) in which the subjects were provided mouth care 4 times a day (after meals, before bedtime)with cool normal saline, the other was the control group(N=28), The Oral Assessment Guide(OAG) which it includes eight items(voice, swallowing, lips, tongue, salivation, oral mucous membrane, gingiva & teeth) was used to assess oral status six times(once in the Prechernotherapy Period, and on the third, 5th, 7th, 10th & 14th day postchemotherapy). The means of the total scores at each time were analyzed by repeated ANOVA The results are as follows : 1. The incidence of stomatitis was higher in the control group than in experimental group. The incidence of third grade stomatitis characterized by bleeding, sore, infection & severe pain was 3.3% in the experimental group, and while 21.4% in the control group(p=0.01). 2. The number of stomatitis sites which were occurred in the experimental group were significantly lower than in the control group(p=0.046). 3. The grade of stomatitis(mean of total score) for patients in the control group was significantly higher than for patients in the experimental group (p=0.005). 4. In the control group, voice change increased in the period between the seventh and tenth day after chemotherapy (p=0.04). 5. In the control group, swallowing difficulty was mest severe in the period between seventh and tenth day(p=0.05), and decreased by the fourteenth day(p=0.01). 6. Changes in the lips gradually increased after chemotherapy in the control group(p=0.0025), while they were significantly lower in the experimental group(p=0.0002). 7. The increment of tongue changes started on the third day after chemotherapy reached a peak on the tenth day and decreased by the fourteenth day in both groups(p=0.0016). 8. Driness of the mouth reached a peak on the seventh day after chemotherapy in the control group (p=0.05). 9. The degree of oral mucositis was significantly higher in the control group than in the experimental group(p=0.02) . In the control group, the mucosal change started three days after chemotherapy and reached a peak on the tenth day(p=0.03). 10. Changes in the gingia were significantly higher in the control group(p=0.03). In control group, the degree of gingivitis reached a peak on the tenth day. In conclusion, meuth care with normal saline four times a day could reduce the incidence and grade of stomatitis. Stomatitis was shown to begin on the third day after chemetherapy, reach a peak on the tenth day and be reduced by fourteenth day.

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Comparison of Oral Hygiene Effects between 0.1% Chlorhexidine and Normal Saline on the Incidence of Oral Pathogens (0.1% 클로르헥시딘을 이용한 구강간호와 생리식염수를 이용한 구강간호의 구강내 병원균 발생빈도 비교)

  • Lee, Eun-Nam;Park, Hee-Sook;Kim, Soo-Mi;Park, Mi-Ja;Lee, Young-Jin;Jang, Mi-Ra;An, Hyang-Nam;Ju, Hyeon-Ok
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.13 no.3
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    • pp.351-358
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    • 2006
  • Purpose: The purpose of this study was to compare the effects of oral hygiene with 0.1% chlorhexidine or with normal saline on the incidence of pathogens in the oral cavity of patients in Intensive Care Units (ICU). Method: A quasi experimental design with non-equivalent control group and non-synchronized design was used. For the study 46 patients were recruited from a university hospital (24 for the experimental group, 22 for the control group). patients in the experimental group received mouth care with 0.1% chlorhexidine gluconate and those in the control group received mouth care with normal saline twice a day for 7 days in a row. Oral samples were taken for bacterial cultures on admission day, the 4th day and the 7th day for both groups. Results: The incidence of oral pathogens decreased in the experimental group, and increased in the control group. There was no significant difference in the incidence of oral pathogens between the two groups. However oral hygiene using 0.1% chlorhexidine gluconate decreased the incidence of oral pathogens significantly for patients who already had pathogenic bacteria in their mouths on the admission day. Conclusion: The results suggest that mouth care with 0.1% chlorhexidine is effective for decreasing the incidence of oral infection for ICU patients who have oral infections.

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Microbiological Quality Evaluation for Implementation of a HACCP System in Day-Care Center Foodservice Operations I. Focus on Heating Process and After-Heating Process (보육시설급식소의 HACCP시스템 적용을 위한 미생물적 품질평가 I. 가열조리 및 가열조리후 처리 공정을 중심으로)

  • 민지혜;이연경
    • Journal of Nutrition and Health
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    • v.37 no.8
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    • pp.712-721
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    • 2004
  • The objective of this study was to evaluate the microbiological quality of heating and after-heating processed foods for implementation of a HACCP system in day-care center foodservice operations. The evaluating points were microbial assessment and temperature of foods during receiving, cooking, and serving in heating process. In non-heating process, in addition to monitoring microbial assessment of food during preparation, cooking, and serving steps, the microbial populations of employees' hands and utensils and serving temperature were also evaluated. Microbiological quality was assessed using 3M Petrifilm$^{TM}$ to measure total plate count and coliforms for foods and utensils and Staphylococcus aureus for hands in five Gumi day-care centers. Microbiological quality assessment for foods and utensils is summarized as follows. Microbiological quality of the heating processed foods was satisfactory for cooking and serving steps. The internal temperature of food was above 74$^{\circ}C$. However, temperature control before the serving step was not achieved due to inappropriate time management between the cooking and serving steps. In the after-heating process, the total plate counts of boiled mungbean sprouts salad, blanched spinach salad, com vegetable salad were below the standard at the serving step. The majority of samples showed that coliforms exceeded the norm, which is thought to be the result of the cross-contamination from utensils. These results suggest that it is essential to educate employees on the importance of hand washing and of avoiding cross-contamination by using clean, sanitized equipment to serve food in the after-heating process. Establishing Sanitation Standard Operating Procedures (SSOPs) is an essential part of any HACCP system in day-care center foodservice operations.

Factors Relating to the Quality of Care for Nursing Home Residents in Korea: Using the Delphi Method

  • Shin, Juh Hyun;Kim, Eun Mee;Lee, Ji Yeon
    • Journal of Korean Academy of Nursing
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    • v.49 no.6
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    • pp.783-794
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    • 2019
  • Purpose: This study identified factors related to the quality of care in nursing homes, and elicited consensus opinions from experts on nursing homes. Methods: A Delphi questionnaire was developed based on a review of the literature using the keywords "nursing homes," "workforce," and "quality of care." A total of two Delphi surveys were conducted with 14 experts. The important and urgent factors related to the quality of care for nursing home residents emerged. Results: A consensus was achieved on the important and urgent factors relating to the quality of care. The related factors were grouped into four sections: Organizational Characteristics, Staffing Characteristics, the Long-Term Care Market and Legal and Policy Issues, and Nursing Processes. In total, 23 items were important factors and 26 items were urgent factors relating to the quality of care. In addition, the unanimous advocacy by the experts for increased hours per resident day for registered nurses (RNs, 41 minutes 59 seconds) was much higher than the current hours per resident day of RNs in Korea. Conclusion: To provide optimal care for residents in nursing homes in Korea, the mandatory and essential placement of RNs with professional knowledge and skills is paramount.

Using Tobit Regression Analysis to Further Understand the Association of Youth Alcohol Problems with Depression and Parental Factors among Korean Adolescent Females

  • Delva, Jorge;Grogan-Kaylor, Andrew;Steinhoff, Emily;Shin, Dong-Eok;Siefert, Kristine
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.2
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    • pp.145-149
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    • 2007
  • Objectives : This study characterized the extent to which youth depressive symptoms, parental alcohol problems, and parental drinking account for differences in alcohol-related problems among a large sample of adolescent females. Methods : The stratified sample consists of 2077 adolescent females from twelve female-only high schools located in a large metropolitan city in the Republic of Korea. Students completed a questionnaire about alcohol use and alcohol problems, their parents' alcohol problems, and a number of risk and protective factors. Data were analyzed using tobit regression analyses to better characterize the associations among variables. Results : Almost two-thirds of students who consume alcohol had experienced at least one to two alcohol-related problems in their lives and 54.6% reported at least one current symptom of depression, with nearly one-third reporting two depressive symptoms. Two-thirds of the students indicated that at least one parent had an alcohol-related problem, and that approximately 29% had experienced several problems. Results of tobit regression analyses indicate that youth alcohol-related problems are positively associated with depressive symptoms (p<0.01) and parent drinking problems (p<0.05). Parental drinking is no longer significant when the variable parental attention is added to the model. Decomposition of the tobit parameters shows that for every unit of increase in depressive symptoms and in parent drinking problems, the probability of a youth experiencing alcohol problems increases by 6% and 1%, respectively. For every unit of increase in parental attention, the probability of youth experiencing drinking problems decreases by 5%. Conclusions : This study presents evidence that alcohol-related problems and depressive symptoms are highly prevalent among adolescent females. Although a comprehensive public health approach is needed to address drinking and mental health problems, different interventions are needed to target factors associated with initiation of alcohol problems and those associated with increased alcohol problems among those who already began experiencing such problems.

Extraction of An Improvement Plan of Day Care Center's Interior Environment Design Reflecting Persona Characteristics -The case of Jounno Ward Silver Center- (페르소나 특성을 반영한 데이케어센터 실내환경디자인 개선방안 도출 - 종로 구립 실버센터의 사례를 중심으로 -)

  • Lee, Jin-Woo;Nam, Kyung-Sook
    • Korean Institute of Interior Design Journal
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    • v.24 no.1
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    • pp.43-53
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    • 2015
  • As part of alternative of elderly problems in the future super-aging society, this study aims to extract an improvement plan of interior environment design of Seoul-type day care centers to expand in future by observing day care centers as medical and healing environments, from the perspective of user experience. For this study, after selecting major activity areas of representative cases of Seoul-type day care centers, user behaviors in the space were observed and 4 seniors of baby-boom generation who are potential uses were chosen as personas by reflecting characteristics of healthy elderly, physical aging, mental aging and infirm elderly, from the perspective of user experience. Based on previous studies on healing environments, these characteristics and demands of personas were classified into environmental aspects, physical aspects and mental aspects to extract an improvement plan. The study results are as follows. First, interior environment design reflecting persona characteristics helps the elderly adapt to the environment and provides a comfortable environment like home for stability, treatment and recovery of memory. Second, interior environment design reflecting persona characteristics helps psychological healing through light entering the large windows and natural environment elements. Third, for interior environment design reflecting persona characteristics, finish materials with bright and soft colors should be used to change the images of facilities positively. Fourth, spatial composition should be remedied through division of space and built-in furniture depending on the needs of users for loitering of extra time and programs.

Analysis of Hospital Services for Elderly Inpatients (노인 입원환자 병원서비스 분석)

  • Chang, Hyun Sook
    • Quality Improvement in Health Care
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    • v.7 no.1
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    • pp.18-31
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    • 2000
  • Background : This study is to identify the inappropriate hospital services for elderly inpatients over 65 years in general hospital with acute care functioning. Consequently elderly inpatient care and the management of long-term care facilities are key issues for current government health policy. Method : The survey was conducted for two months for all inpatients over 65 in 7 general hospitals, 6 work sampling days randomly selected. In each survey day, the subjective judgement by medical staff on the degree of acute care needs and by nursing unit manager on hospital services of each inpatients was also conducted. Result : The total number of cases collected are 2,541 elderly inpatients, according to subjective judgements by medical staff on inpatient condition. However 46.8% of cases are turned out to be non-acute care group. The frequency of medical services provided to non-acute group are 2~3 vital sign checks per day 78.2%, IV injection 40.1%, antibiotics medication 20.2%. Conclusion : Lots of elderly patients' who are staving in acute hospitals, at present need to be transferred to long-term care facilities. However, there was been shortage of long-term care facilities. It is expected to identify the need of elderly inpatients and therefore, to provide cost-effective, appropriate and good quality health services to elderly inpatients depending on their needs.

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An Analysis on Nursing Activity in Oriental Hospital (한방근무 간호사의 업무분석)

  • Kang, Hyun Sook;Cho, Kyoul Ja;Kim, Kwang Joo;Kim, Kwuy Bun;Cho, Mi Young;Suh, Yeon Ok;Shin, Hye Sook;Jeon, Eun Young;Chung, Sook Ja;Lee, Hei Jin
    • The Korean Nurse
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    • v.33 no.5
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    • pp.63-75
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    • 1995
  • The need of oriental nursing role is recently increasing. The implication of this trend is enormous not only for the need of independent of independent oriental nursing intervention. Hence, this study was designed to describe the characteristics of oriental nursing activity and identify the meaning of nursing activity in oriental hospital. A total of 24 nurses were selected by convenience sampling from eight units at one oriental hospital. A total of 168 data were collected using minute-by-minute recording during nurse s work shift. The data were analyzed using nova and scheffe method as post-hoc test The results of this study are as follows; 1. the category of nursing activity in oriental hospital 74.4% of nursing activity was the patient-oriented nursing care. The nursing activity included others (18.28%), the function-oriented nursing care (7.07%), and staff-oriented care (0.2%). 29.1 % of the patient-oriented nursing care was the direct care, and 24. 5 % of the patient-oriented nursing care was the indirect care. There was a lack of patient education and the communication patient. 2. Nursing activity in oriental hospital by characteristics 1) Nursing activity by unit For patient-oriented nursing care, there was a statistically significant difference among 8 units. In the critical care unit, the patient-oriented nursing care was mostly performed. For function-oriented nursing care, there was statistically significant difference among 8 units. In the physical therapy unit, the function-oriented nursing care was mostly performed. 2) Nursing activity in oriental hospital For all kinds of nursing activity, there was a statistically significant difference between shifts. In night shift patient-oriented nursing care, function-oriented nursing care, and other kinds of nursing care was mostly performed. Patient-oriented nursing care included indirect care, treatment set management, and the breaktime. In day shift, staff-oriented nursing care was performed. 3) Nursing activity in oriental hospital For all kinds of nursing activity, there was not a statistically significant difference by day. The day has not impact on nursing activity. 3. the meaning of activity in oriental hospital The results of this study show that the patient-oriented care was vital check, input! output check, medication, bedsore prevention, nasogastric feeding, oral care, catheterization care, perinatal care, nursing care associated with acupuncture and moxacautery, observation (fever, sweating), heat and cold application communication with patent and family, and patient room management In conclusion, two issues associated with the findings of the research appeated to be involved in the difficulty of nursing activity in hospital. The first issue was the nursing care in oriental hospital provided by nurses who have a limited understading of the principles of oriental medicine. The second issue was the deficiency of systematic guideling for oriental nursing activity. The findings suggest the need to develop the systematic guideline for oriental nursing activity. The need of continuing education for nurses who work in the oriental hospital, and the need of nursing education including oriental nursing are critical.

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Study on the Effect of Organizational Culture of Child Care Facilities on Child Care with Respect for Young Children's Rights (보육시설의 조직문화가 영유아권리존중 보육에 미치는 영향 연구)

  • Kim, Min-Jung
    • The Journal of the Korea Contents Association
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    • v.18 no.12
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    • pp.595-610
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    • 2018
  • It is becoming common that the lack of child care due to changes in social structure and family function should be serviced at society and at the national level. Interest in child care services in child care facilities also increased. The purpose of this study is to examine the effect of organizational culture on child care respect for young children's rights that is needed to improve the quality of child care services. The questionnaire was administered to 340 day care teachers working in day care facilities and statistical analysis was performed using SPSS 22.0 statistical program. An analysis of the impact of organizational culture on child care among infants and toddlers showed that development culture, rational culture, collective culture, and hierarchical culture, which are sub-factors of organizational culture, have statistically significant on day -to-day respect, and child- first interests. The degree of influence was shown in the order of development culture, hierarchical culture, and rational culture. In particular, the influence of group culture is very low, which has been proven to differ depending on the type of organizational culture. These results show that the organizational culture of child care facilities affects child care respect for young children's rights. In the end, we suggested the theoretical and practical implications of this study, presented limitations and future research directions.

Development of a Korean Senile Dementia Management Model (한국형 치매환자 관리모형 개발)

  • Kim, Jung-Soon;Park, Nam-Hee;Kim, Myoung-Soo
    • Research in Community and Public Health Nursing
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    • v.15 no.3
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    • pp.450-459
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    • 2004
  • Purpose: The purpose of this study is to grasp the welfare service for the demented people staying at home and the service that caregivers want to use. Therefore, we are going to develop a Korean senile dementia-care management model. Method; It analyzed the data of 185 demented people and caregivers, who registered in 16 public dementia care centers in B city since June 2002. Results: 1) The types of services used by the aged people with dementia staying at home were, in the order of frequency of use, the day-care center(26.5%), and home-help service (21.6%). 2). The types of services according to the degree of dementia were as follows; mild cases: home care service (5.4%), moderate cases: day-care service (40.0%) and severe cases: day-care service (26.0%). 3). The caregivers who want to use senile welfare institutions accounted for 23.3%, and the major reason they could not use the institutions was due to their economic situation. 4) The Korean senile dementia care management system must be excuted, considering caregivers' economic state and severity of dementia. Since the system was actively operated, many small sized welfare service institutions showed development. Conclusion: The welfare services appropriate to the severity of dementia should be provided. With the model developed in this study, the dementia management requires sufficient care and should be achieved to reduce the caregivers burden.

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