• Asian Pacific Journal of Cancer Prevention
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• 제15권1호
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• pp.455-460
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• 2014

Background: The purpose of the present study was to determine geographic clustering of breast cancer incidence in Kanagawa Prefecture, using cancer registry data. The study also aimed at examining the association between socio-economic factors and any identified cluster. Materials and Methods: Incidence data were collected for women who were first diagnosed with breast cancer during the period from January to December 2006 in Kanagawa. The data consisted of 2,326 incidence cases extracted from the total of 34,323 Kanagawa Cancer Registration data issued in 2011. To adjust for differences in age distribution, the standardized mortality ratio (SMR) and the standardized incidence ratio (SIR) of breast cancer were calculated for each of 56 municipalities (e.g., city, special ward, town, and village) in Kanagawa by an indirect method using Kanagawa female population data. Spatial scan statistics were used to detect any area of elevated risk as a cluster for breast cancer deaths and/or incidences. The Student t-test was performed to examine differences in socio-economic variables, viz, persons per household, total fertility rate, age at first marriage for women, and marriage rate, between cluster and other regions. Results: There was a statistically significant cluster of breast cancer incidence (p=0.001) composed of 11 municipalities in southeastern area of Kanagawa Prefecture, whose SIR was 35 percent higher than that of the remainder of Kanagawa Prefecture. In this cluster, average value of age at first-marriage for women was significantly higher than in the rest of Kanagawa (p=0.017). No statistically significant clusters of breast cancer deaths were detected (p=0.53). Conclusions: There was a statistically significant cluster of high breast cancer incidence in southeastern area of Kanagawa Prefecture. It was suggested that the cluster region was related to the tendency to marry later. This study methodology will be helpful in the analysis of geographical disparities in cancer deaths and incidence.

• Journal of Nutrition and Health
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• 제31권1호
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• pp.36-45
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• 1998

Dietary and other factors affecting bone density of 32 Korean healthy college women aged 19-23 years were assessed. Data for food and nutrient intake was obtained by a semiquantitiative food frequency questionnaire. Serum samples were anlayzed for total Ca, P, Ca++, PTH, calcitonin and 25-hydroxycholecalciferol , (25-OH-Vit D3) and BMDs of lumbar spine(L2-L4), femoral neck(FN), ward's triangle (WT) and trochanter(TR) were measured by an XR-series X-ray bone densitometer. Relationships between the factors and BMDs were analyzed by stepwise multiple regression analysis and Pearson's correlation coefficient(r). The results are summarized as follows. Mean daily intake of energy(86.1%), Ca(74.3%), vitamin A (53.75), Fe(49.75) and vitamin B$_2$(86.6%) were lower while other notrients incuding P(126%) were higher than the Korean RDA. The BMDs of lumbar spines and femurs ranged from 0.73g/$\textrm{cm}^2$ to 1.23g/$\textrm{cm}^2$and 0.48g/$\textrm{cm}^2$ to 1.04g/$\textrm{cm}^2$, respectively. Both protein and P intakes were inversely associated with serum total Ca. Furthermore, Ca intake as well as Ca/P ratio (Ca/P) were inversely associated with serum ionized Ca(Ca++) concentration. The intakes of protein P and Ca , however, were not significantly associated with the BMDs measured in this study. There were little association between BMDs and alcoholic beverage or caffeine consumption. The only significant association detected was a positive relationship between caffeine consumption and BMD of WT. It seemed to be noticeable that BMDs of L2-L$_4$, FN and WT were significantly inversely associated with serum P concentration. However, there was no significant association between BMDs and the levels of total Ca to Ca++ in serum. Body weight was positively associated with BMD of lumbar spine and BMI was also positively associated with BMDs of FN and WT. The subjects who had an early menarche appeared to have higher BMDs than those who had had a late mearche. According to stepwise multiple regression analysis. Menarche and BMI were stronger determinants of BMDs in the young women than was diet. P intake appeared to be a more potent dietary determinant than Ca intake. The three factors, menarche, BMI , and P intake , additionally accounted for 24% and 378% of the variance in BMDs of FN and L$_2$-L$_4$, respectively. Further investigation is necessary to determine the factors needed to increase serum P level which negatively affects. BMD in young Korean college women.

• Journal of Nutrition and Health
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• 제51권2호
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• pp.132-139
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• 2018

본 연구는 일반병동에 입원하여 3일 이상 경장영양을 시행한 성인 환자 95명을 대상으로 영양집중지원팀의 중재 효과를 평가하기 위해 영양중재를 받은 중재군과 받지 못한 군으로 분류하여 열량 및 단백질 지원율과 생화학적 지표를 비교 분석 하였다. 연구결과를 통해 환자의 입원초기부터 적절한 영양관리를 계획하고, 영양집중지원팀의 영양중재로 체계적인 관리를 실시하면 환자의 영양상태가 개선되는 것을 확인할 수 있었다. 결론적으로 영양불량 문제가 있는 환자에게 영양집중지원팀의 중재를 받아 문제를 개선할 수 있도록 절차를 마련한다면, 이는 환자의 임상적 치료에 긍정적인 영향을 줄 것으로 생각된다. 본 연구는 국내에서 경장영양을 시행한 일반병동 환자를 대상으로 영양집중 지원팀의 중재 효과에 대한 초기 연구이며, 집중영양치료료 수가 신설 이후 진행된 연구다. 추후 일반병동 환자를 대상으로 영양집중지원팀의 중재효과에 대한 연구가 다양하게 시행된다면 의료진의 관심이 증대 될 것이고, 나아가 영양집중지원팀의 중재를 통해 진료의 질을 높일 수 있을 것이다.

• 대한방사선치료학회지
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• 제1권1호
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• pp.70-78
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• 1985

The intrauterine irradiation is essential to achieve adequate tumor dose to centeral tumor mass in radio therapy for uterine malignancy. The complications of pelvic organ are known to be directly related to radiation dose and physical parameters. The comparison study of currently using 2 systems was undertaken. The simulation films and medical records of 135 patients who was treated with intrauterine irradiation at one of general hospitals in Busan and Seoul between Jan. 1983 and June 1983, were critically analized and physical parameters of low dose rate system and remote controlled high dose rate system were measured. The physical parameters include distances between lateral walls of vaginal fornices, longitudinal and lateral angles of tandem to the body axis, the distance from the external os of uterine cervix to the central axis of ovoids, the radiation dose ratio to rectum and bladder to reference point A. Followings were summary of study results: 1. In distances between lateral walls of vaginal fornices the low dose rate system showed wide distribution and relatively larger distances. In low dose rate system 5.0-5.9 cm was $55.89\%$ 6.0-6.9 cm: $23.53\%$, 4.0-4.9cm: $10.29\%$, 3.0-3.9cm: $10.29\%$, and in high dose rate system 5.0-5.9cm was $80.59\%$, 4.0-4.9cm: $17.91\%$, $6.0\~6.9\;cm:\;1.5\%$. 2. In lateral angulation of tandem to body axis, the low does system revealed mid position (the position along body axis) $64.7\%$, Lt. deviation $19.13\%$ and Rt. deviation $16.17\%$. However the high dose rate system revealed mid position $49.26\%$ Lt. deviation $40.29\%$ and Rt. deviation $10.45\%$. 3. In longitudinal angulation of tandem to body axis the mid position was $11.77\%$ and anterior angulation $88.23\%$ in low dose rate system but in high dose rate system the mid position was $1.56\%$ and anterior angulation $98.44\%$. 4. Down ward displacement of ovoids below external os was only $2.94\%$ in low dose rate system and $67.69\%$ in high dose rate system. 5. The radiation dose ration to rectum to reference point A was $102.70\%$ in high dose rate system and $70.09\%$ in low dose rate system. The dose ratio to bladder to reference point A was $78.14\%$ in high dose rate system and $75.32\%$ in low dose rate system.

• 한국산학기술학회논문지
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• 제18권5호
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• pp.160-168
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• 2017

본 연구는 중소병원에 근무하는 간호사들의 의료기관인증제 인식, 직무스트레스, 조직몰입과 이직의도를 파악하고 이 요인들이 이직의도에 미치는 영향을 확인하고자 시도되었다. 연구 대상은 경기도에 소재한 500병상 이하의 의료기관에 근무하는 간호사 202명이었다. 자료수집을 위한 설문조사는 2015년 12월 1일부터 2016년 3월 30일까지 최근 인증평가를 실시한 5곳의 중소병원에 연구자가 직접 방문하여 기관의 승인 후 간호사들에게 설문조사를 하는 방법으로 실시하였다. 연구결과 중소병원 간호사의 이직의도에 유의한 영향을 주는 일반적 특성은 연령(F=4.68, p<.001), 결혼상태(F=3.92, p<.001), 부서유형(F=3.23, p<.008)이었다. 간호사의 이직의도와 의료기관인증제 인식(r=-.46, p<.001), 조직몰입과는 음의 관계(r=-.35, p<.001), 직무스트레스와는 양의 관계(r=.21, p=.002)로 나타났다. 회귀분석 결과 중소병원 간호사의 이직의도에 유의한 영향을 미친 변수는 조직몰입, 근무유형, 직무스트레스가 유의하였으며 전체 22.0%의 설명력을 가졌다. 본 연구 결과를 통해 의료기관 인증제를 실시하는 중소병원 간호사의 이직의도를 낮추기 위해서 중소병원 관계자는 간호사가 직무에 몰입할 수 있는 환경과 제도적 개선에 힘써야 할 것으로 보이며 직무스트레스의 경감을 위한 방안을 마련해야 할 것이다. 또한 근무유형별 이직의도에 차이가 있는 것으로 나타났으므로 특수파트, 병동, 외래 등의 근무유형별로 차별화된 접근이 필요할 것으로 사료된다.

• 한국산학기술학회논문지
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• 제19권4호
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• pp.293-300
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• 2018

본 연구는 간호대학생의 직무 유형을 통해서 경력개발을 위한 교육요구는 무엇인지 알아보기 위한 목적으로 실행하였다. 연구목적의 달성을 위하여 먼저 부산 경남 지역에 있는 K 대학과 P 대학의 간호대학생 146명을 대상으로 커리어앵커 질문지를 이용하여 직무 유형을 분석하였다. 그리고 직무 유형 중에서 상위 유형의 경향성을 보이는 간호대학생 28명을 선별하여 4개의 팀으로 나누어 맵을 작성하였고, 작성된 맵의 내용을 기반으로 초점집단인터뷰를 했다. 이는 간호대학생의 실제적 목소리를 통해 경력개발을 위한 교육요구에 대해서 알아보기 위해서이다. 그 결과 첫째, 간호대학생의 커리어앵커 유형은 라이프스타일과 안전 보장이 가장 높게 나타났고, 가장 낮은 커리어앵커 유형은 순수한 도전과 관리적 역량이었다. 둘째, 경력개발을 위한 교육요구는 크게 4개의 영역, 전공역량, 실무역량, 인성역량, 자원관리역량으로 범주화하였다. 전공역량은 간호 전문지식 및 기술, 실무역량은 병동 업무처리, 의사소통, 위기대처능력, 인성역량은 협력, 책임인식, 자원관리역량은 시간 관리 능력, 스트레스 관리능력이다. 본 연구의 결과는 향후 간호대학생의 경력개발을 위한 교육적 기초자료로 활용할 수 있다는 점에서 의의가 있다. 아울러 간호실무 개선을 위한 교육과정개발에 적용할 수 있을 것으로 기대한다.

• 동서간호학연구지
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• 제11권1호
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• pp.33-41
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• 2005

This study was conducted to identify the effect of meridian acupressure on defecation of patients with post spinal operation. The nonequivalent control group posttest only design was used. The data were obtained from 77 post spinal operative patients, 34 in the experimental 43 in control group in Y Hospital, Seoul, Korea. The neurosurgical unit A and B ward, assigned by matched sample by the name of operation such as laminectomy and posterior lumbar interbody fusion are performed. Meridian acupressure meant the method that an examiner presses response points distributed in the pass of energy vessel. In this study, meridian acupressure program was performed on as points in order of Hegue (LI-4), Zhigou (TE-6), Zusanli (S-36), Shangjuxu (S-37), Xiajuxu (S-39), Tianshu (S-25), Taichong (L-3) which was known to be related to large intestine. Data were collected from 1, July 2003 to 1, September 2003. Meridian acupressure program was carried out for 20 minutes 4 hours after operation twice daily. In order to evaluate the effect of meridian acupressure intervention, they were asked time of bowel recovery, gas passing, and defecation though questionnaire method. Data were analyzed by the SPSS/ WIN 11.0 program. The results of this study were summarized as follows; 1. Homogeneity tests of general characteristics and operation related characteristics of the experimental group and the control group were performed. General characteristics included age, sex, defecation habit, eating pattern, fluid intake, life style, activity, usage of laxative and etc. 2. Hypotheses were verification as follows; 1) Recovery of bowel sound of the experimental group who received meridian acupressure intervention was faster than that of the control group after spinal operation (t=-6.770,P=.000). 2) Time of gas passing of the experimental group who received meridian acupressure program was faster than that of the control group after spinal operation (t=-8.003, P=.000). 3) Time to defecation of the experimental group who received meridian acupressure program was faster than that of the control group after spinal operation (t=-9.026, P=.000). 4) Abdominal discomfort due to defecation of the experimental group who received meridian acupressure program was lesser than that of the control group after spinal operation (t=-3.431, P=.001). From these results, meridian acupressure intervention was effective for recovery of bowel sound, reduce time to gas passing, time to defecation and lessen abdominal discomfort due to defecation on post spinal operative patients. And therefore this intervention can probably considered on clinical practice.

• 대한간호학회지
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• 제6권1호
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• pp.72-79
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• 1976

Contemper nursing literature place much importance on human- centered and individualized care. Nursing research has related stress during hospitalization of adolescent patients to adaptation to a new environment, isolation from friends, limitation due to illness, over protection of parents and communication with member of the medical team. The investigator conducted this study in the hope that an understanding of adolescents responses to hospitalization, their perceptions, the kinds and levels of stress, and the relationships between stressors and individual characteristics would contribute to the improvement of adolescent patient care. The objective of the study was to obtain informations related to the adolescents psychological stress experience during hospitalization, specifically stress from interpersonal relationships and communication, isolation from the family, social or economic problems, illness and from the treatment environment and nursing care. An interview schedule adopted from Holmes and Rahe's Social Readjustment Rating Scale and selected items from Voicer's instrument on stress-producing events was used with 120 adolescent inpatients aged 13 to 18 years three general hospitals in Seoul during Aug. 10, to Sep. 30, 1975. 1. The sample consisted of 66 male and 54 female patients. Sixty-six percent were late adolescents, aged 16 to 18 years: 4% were early adolescents, aged 13 to 15 years. The primary cause for hospitalization was for orthopedic problems (35.8%). More than half of these (54.4%) were due to injury or accident. 2. Stress eclated to illness revealed the highest score (4.97), followed by stress related to treatment environment and nursing care (4.34) , isolation from family and social or economic problems (4.01) and interpersonal relationships and communication (3.96). 3. The perceived indifference of doctors and nurses was a serious cause of stress (mean=4.83). Fellow patients and visitors caused least stress (mean=2.06). 4. Discontinuation of education or unemployment were major stressful events (mean=4.71). Least stressful was isolation from the family (mean=3.47). 5. More than 94% of the respondents expressed fears related to body image (mean=4.97) 6. Within the category of treatment environment and nursing care, items related to restrictions because of treatment, discomfort because of treatment, inadequate explanation from nurses about procedures were rated as severe stress events (mean=4.6). Items related to the ward environment and to having a relative stay with them were seen by the group as less serious events (mean=3.7). 7. Stress related to interpersonal relationships and communication was correlated positively with female patients and those preferring passive activities. (P〈0.05) 8. Stress related to family problems was positively related to female and early adolescent patients (P< 0.05). Stress related to social problems was positively , elated to students and those preferring active pursuits (P< 0.05). 9. There were no correlation between the high stress related to disease and any of the characteristic items. (P> 0.05) 10. Stress related to treatment environment and nursing care was positively related of early adolescent and female and student patients. (P< 0.05) This group of hospitalized adolescents reported high level of stress related to treatment environment and nursing care, due to lack of consideration of normal growth and development and individual characteristics. The findings have important implications for the planning of effective, individualized, comprehensive nursing care of adolescents during hospitalization.

• 간호행정학회지
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• 제3권1호
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• pp.37-50
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• 1997

The purpose of this study was to identify the gap between need-level and demonstration-level in nursing managerial competencies. In addition, the study proposes solutions to narrow this gap. The results of this study are as follows : 1) The mean score for need-level of each item was 4.0, and for demonstration-level, 3.5. This indicates that military hospital head nurses demonstrate a higher level of managerial competencies than the moderate level on all items. But items which were related to resource/ cost/ information managament, staff development management and professionalism management got relatively low ratings in the need-level. 2) The mean score for need-level of each category was 4.14, and for demonstration-level, 3.53. Categories on the individual dimension got a higher rating than categories on the group or organization dimension in both need-level and demonstration level. 3) The gap between need-level and demonstration-level appeared in all items(p<.05) and categories(p<.001). Although the gap was relatively low, it indicates that it is essential to plan a developmemt program for all nursing management competencies for military hospital head nurses. 4) There were significant differences in the gap between need-level and demonstration-level according to specific characteristics of the subjects. The gap did not appear in many categories on the individual dimension where the number of nursing staff was more than 10, a major grade, ICU head nurse or for head nurses having a long career. 5) Need-level and demonstration-level showed a difference according to specific characteristics of the subjects, because need-level and demonstration-level were higher where the number of nursing staff was more than 10, a major grade, and for ICU or Medical ward head nurses. The categories which showed need-level difference and demonstration-level differences according to specific characteristics of the subjects existed almostly completely in the group and organization dimension. Gap-level differences according to the number of hospital bed existed in only two categories. 6) The general causes of the gap were indicated to be 'Knowledge/ skill/ experience deficit', 'Limitation of rules and systems/ Inappropriate organizational environment' for most items, categories, and dimensions. The results of this study indicate that extensive competency developing strategies must be developed, because a gap was found in all items and categories. Specially, there is a need to concentrate attention on competencies in the group and organizational dimension which had a wider gap level. And it is important to take an individual approach according to the cause for each gap. In order to produce effective competency developing strategies, top managers must have sinsights into the importance of nursing staff development and nursing officer's efforts to develop themselves must be achieved. Further multi-dimensional(education, personnel-policy, nursing/ organizational environment) solutions to the gap must be developed and utilized.

• 대한치과교정학회지
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• 제11권2호
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• pp.85-100
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• 1981

Serial lateral cephalometric radiographs of 40 Korean children(25 males, 15 females) ranging in age from 6 to 13 years were studied by means of computer morphometrics and statistical analysis. As a result of this study, the following conclusions can be made: 1. In both sexes, the mean growth patterns of the face were very stable and the growth directions of the face were more prominent both forward and down-ward away from the cranial base(S-N). 2. In the mandible, the rotation and the 'wave-like' manner of migration were observed. 3. The size of the lateral faces in males was larger than females at 6 and 13 years of age, and the forms of the lateral faces in males were slightly more squares than females at 13 years of age. 4. The sex differences and practical means in the growth increments and growth rates during 7 years of the growth period were as follows: (1) In the total face, there was a significant sex difference in the growth increments(males $26.21cm^2$, females $23.24cm^2$) and growth rates(males $42.02\%$, females $39.28\%$). (2) In the facial surface 1, there was a significant sex difference in the growth increments(males $21.30cm^2$, females $19.19cm^2$) but there was no significant sex difference in the growth rates(males $41.35\%$, females $39.10\%$). (3) In the anterior total facial height(N-Ne), there was no significant sex difference in the growth increments(males 18.23mm, females 17.45mm) and the growth rates(males $18.44\%$, females $18.19\%$). (4) In the posterior total facial height(S-Go), there was a significant sex difference in the growth increments(males 14.61mm, females 12.98mm) but there was no significant sex difference in the growth rates(males $23.78\%$, females $22.25\%$). 5. The percentages of anterior upper facial height to anterior total facial height in both sexes were very stable in spite of the age increase. 6. The percentage of total facial height to standing height was reduced by the age increase, and the reduced rate of anterior total facial height(males $13.26\%$, females $13.75\%$) was larger than the posterior total facial height(males $9.95\%$, females $11.70\%$). 7. The correlations of lateral facial surfaces to the standing height and the weight were higher in males than females, but the level of correlation in males was in the moderate range.