• Title/Summary/Keyword: 중재인 확인

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The Effects of Job Stress of Nurses Working in the General Hospitals on Their Turnover Intention -Mediating Effects Organizational Commitment- (종합병원 간호사의 직무스트레스가 이직의도에 미치는 영향 -조직몰입의 매개효과-)

  • Kim, Gyeong-Suk;Cho, In-Sook
    • Journal of the Korean Applied Science and Technology
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    • v.36 no.2
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    • pp.656-667
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    • 2019
  • This study is a descriptive research to grasp the effects of job stress on turnover intention and to confirm the mediating effect of organizational commitment according to the extent of job stress, organizational commitment and turnover intention in the relations between job stress and Turnover Intention of nurses working in general hospitals. Method: The subjects of this study were 199 nurses are working in general hospitals, that have more than 200 beds and less than 400 beds, located in Gwangju. I surveyed them using a structured questionnaire for collecting data from Sep. 01, 2017 to Sep. 20, 2017. The collected data were analyzed by the frequency, the percentage, t-test, ANOVA, Scheffe's Test, Pearson's Correlation Coefficient, Multiple Regression Analysis and Sobel Results: In the first step, job stress as an independent variable had a statistically significant effect on organizational commitment(${\beta}=-.321$, p<.001). In the second step, job stress, an independent variable, also had an important effect on turnover intention as a dependent variable(${\beta}=.389$, p<.001). Job stress and organizational commitment were meaningful predictor variables of turnover intention in the third step. The explanatory power of two variables was 45.5%. The value ${\beta}$ of job stress in the third step was .203(p<.001) which was smaller than its value ${\beta}$,.389(p<.001), in the second step. That meant organizational commitment had the mediating effect on turnover intention. The Sobel Test was conducted to verify the significance of the extent of the mediating effects of organizational commitment. The test result was that the value Z was -3.694 and the mediating effect of organizational commitment was significant on the relation between job stress and turnover intention(p<.002). Conclusion: this study is expected be useful to find ways to reduce subjects' turnover intention by decreasing their job stress, increasing their organizational commitment and developing intervention programs as basic data.

Incidence and Procedure-Related Risk Factors of Delirium in Patients Admitted to an Intensive Care Unit (중환자실 입원 환자의 섬망 발생과 처치 관련 위험인자)

  • Ahn, Jee Seon;Oh, Jooyoung;Park, Jaesub;Kim, Jae-Jin;Park, Jin Young
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.1
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    • pp.35-41
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    • 2019
  • Objectives : Although delirium is a common complication among patients hospitalized in intensive care units(ICUs), little is known about the roles that diagnostic and therapeutic procedures play in its development. This study investigates the procedure-related risk factors of delirium in ICU patients. Methods : All the consecutive patients admitted to the ICU between June 2016 and May 2017 were routinely evaluated for delirium by psychiatrists. In total, 1156 patients met the inclusion criteria and were retrospectively analyzed. A multiple logistic regression analysis was conducted to investigate independent risk factors of delirium development while adjusting for other characteristics. Results : The age, Acute Physiology and Chronic Health Evaluation (APACHE II) score, proportion of patients who had undergone an operation, and proportion of patients who were foley catheterized, mechanically ventilated, and physically restrained were higher in the delirium group. The multiple logistic regression analysis confirmed that the use of restraint was an independent risk factor of delirium (odds ratio : 10.006 ; 95% confidence interval : 6.120-16.360 ; p<0.001). The patient factors independently associated with delirium were an advanced age and a higher APACHE II score. The incidence of delirium was 15.3%. Conclusions : There is a high prevalence of delirium influenced by potentially harmful procedures in patients in ICU settings. The use of physical restraint had the strongest association with the development of delirium. These findings advocate the need to target procedure-related risk factors such as the use of restraints as preventive intervention measures for ICU delirium.

Evaluation of Musculoskeletal Disease Risk Assessment and User Satisfaction in Accordance With Using Front-Entry Sitting Toilet for Wheelchair Users (휠체어 사용자의 전면진입착석 화장실 사용에 따른 근골격계질환 위험성 및 만족도 평가)

  • Park, Je-Mo;Hwang, Do-Yeon;Kim, Hee-Dong;Chung, Hyun-Ae;Jung, Hwa-Shik
    • Korean Journal of Occupational Therapy
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    • v.26 no.4
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    • pp.73-84
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    • 2018
  • Objective : The purpose of this study was to promote R&D of toilet design for the disabled by evaluating the Front-entry sitting toilet applied it to actual wheelchair users to examine the possibility of their application as a toilet that is low physical demanding and high satisfaction. Methods : Forty wheelchair users were asked to demonstrate using Front-entry sitting toilet after collecting the general characteristics and their current wheelchair usage information. Musculoskeletal disease risk assessment and user satisfaction were evaluated throughout Rapid Entire Body Assessment(REBA), Quebec Evaluation of Satisfaction with assistive Technology 2.0(QUEST) and subjective opinion questionnaire. Results : Statistical result showed that REBA scores($3.18{\pm}.38$) of Front-Entry Sitting Toilet were significantly lower(z=-5.930, p<.05) than the conventional toilet($6.53{\pm}1.15$). Overall, user satisfaction ratings were high with detailed scores were high in order of durability($4.48{\pm}.62$), safety($4.38{\pm}.63$), necessity($4.33{\pm}.73$) and universal ($4.6{\pm}.61$). Subjective opinion survey showed most were 'it was convenient to not have to rotate(30.8%).' Conclusion : This study found that Front-entry sitting toilet was highly likely to reduce the risk of musculoskeletal disorders and users' satisfactions were high. Through this study, we hope to expand the scope of occupational therapists and contribute to the physical, mental and social health in the daily activities of the people by applying various approaches.

Nutritional status and related parental factors according to the breakfast frequency of elementary school students: based on the 2013~2015 Korea National Health and Nutrition Examination Survey (초등학생의 아침식사 빈도에 따른 영양상태와 부모 관련요인 분석 : 2013 ~ 2015년 국민건강영양조사 자료를 활용하여)

  • Yu, So Young;Yang, Yoon Jung
    • Journal of Nutrition and Health
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    • v.52 no.1
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    • pp.73-89
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    • 2019
  • Purpose: This study was conducted to identify the dietary life and nutritional status of Korean elementary school students according to breakfast frequency and to clarify the relationship between breakfast frequency of elementary school students and parental dietary and social environmental factors. Methods: This study used data from the 2013 ~ 2015 Korea National Health and Nutrition Examination Survey (KNHANES VI). The subjects were 1,325 elementary school students aged 6 to 11 years old. Subjects were categorized into two groups: a skipping breakfast group (ate breakfast 0 ~ 4 times per week), eating breakfast group (ate breakfast 5 ~ 7 times per week) by sex and grade (lower grade: 1st ~ 3rd/upper grade: 4 th ~ 6 th). Results: Among upper grade boys and girls, the skipping breakfast group had a higher rate of childhood obesity than the eating breakfast group. In lower grade boys, the mothers of the skipping breakfast group had higher rates of economic activity and eating breakfast alone without family members than the mothers of the eating breakfast group. For lower grade boys and girls and upper grade boys, the skipping breakfast group had a higher rate of parents who did not eat breakfast than the eating breakfast group. The energy intake of the breakfast consumed by all subjects was less than 25% of the Estimated Energy Requirements (EER). Moreover, for upper grade boys and girls, the skipping breakfast group had a higher rate of subjects whose daily intake was below the Estimated Average Requirement (EAR) for iron than the eating breakfast group. Conclusion: Breakfast frequency of elementary school students was related to childhood obesity. The frequency of eating breakfast among elementary school students was related to the dietary life factors of parents such as breakfast frequency and dietary condition. Intake for breakfast was less than 25% of the EER, while the skipping breakfast group had a higher rate of subjects whose daily intake was below the EAR for iron than the eating breakfast group. Therefore, it is necessary to consider diverse forms of policy support such as opening nutrition education programs for parents and practicing morning meals at school for elementary school students to provide regular and balanced breakfasts.

The Effect of Exercise Intensity on Changes in Neuronal Nitric Oxide Synthase Expression in the Hippocampus and Cerebral Cortex of Obese Mice (고지방식이로 유도된 비만 마우스의 해마 및 대뇌피질에서 운동강도에 따른 nNOS 발현의 변화)

  • Baek, Kyung-Wan
    • Journal of Life Science
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    • v.29 no.1
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    • pp.18-28
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    • 2019
  • Recent studies reported that obesity upregulated the expression of neuronal nitric oxide synthase (nNOS) and regulated particular behavior patterns in animal models. They also reported that ameliorated the increase in nNOS expression and decreased depression and anxiolytic effects. Thus, exercise seems to be an effective strategy for improving brain function by downregulating nNOS. However, the immune response differs greatly, depending on the exercise intensity. The aim of the present study was to investigate differences in brain nNOS expression in obese C57BL/6 mice that performed exercise of different intensities. Obesity was induced in 6-wks-old mice (n=35) by feeding a 60%-fat diet for 6-wks. A control (CON) group (n=14) was fed a normal diet. At the end of the induction 6-wks period of obesity, seven animals in the CON group and obesity-induced group were sacrificed to confirm obesity induction (preliminary experiments and confirmation of visceral fat accumulation). The remaining animals were then used in an 8-wks exercise intervention. Other than the CON (n=7), the obesity-induced animals were divided into the following groups: high-fat diet (HFD, n=7), HFD-low intensity (HFD-LI, n=7, 12 m/min for 75 min), HFD-moderate intensity (HFD-MI, n=7, 15 m/min for 60 min), and HFD-high intensity (HFD-HI, n=7, 18 m/min for 50 min). The exercise was performed on an animal treadmill. The expression of the nNOS protein in the hippocampus was significantly higher in the HFD group as compared with that in the CON group (p<0.01). However, there was no difference in the hippocampal expression of the nNOS protein in the other exercise groups as compared with that in the CON group. In contrast, nNOS expression in the HFD-HI group was significantly lower than that in the HFD-LI group (p<0.05). The expression of phosphorylated Akt (pAkt) was significantly higher in all the exercise groups as compared with that in the CON and HFD groups. There was no difference in the expression of pAkt in the cerebral cortex among groups, and the expression of pAkt in the cerebellum was significantly higher in the HFD-HI group as compared with that in the CON group (p<0.05). There were also no between-group differences in pAkt expression in the cerebellum among the various exercise groups. In conclusion, nNOS seems to be overexpressed in response to obesity, and it appears to be downregulated by exercise. Relatively high-intensity exercise may be effective in improving brain function by downregulating nNOS.

Changes in Occupational Therapy Students' Occupational Balance and Quality of Life in Epidemic of COVID-19 (COVID-19 유행으로 인한 작업치료(학)과 학생들의 작업균형과 삶의 질 변화)

  • Lee, Hyang-sook;Han, Gyeong-ju;Park, In-yeong;Hwang, Eun-bi;Chae, Hyun-ah;Noh, Chong-su;Cha, Jung-jin
    • The Journal of Korean society of community based occupational therapy
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    • v.11 no.1
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    • pp.11-22
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    • 2021
  • Objective : The purpose of this study was to investigate the changes in occupational balance and quality of life caused by COVID-19 in occupational therapy students. Methods : From May 27 to June 26, 2020, questionnaires were distributed to a total of 35 universities among 62 occupational therapy departments nationwide. General characteristics, COVID-19 related characteristics, OBQ and WHOQOL-BREF were used to evaluate and analyze occupational balance and quality of life. The SPSS/PC 24.0 program was used to analyze frequency analysis, crossover analysis, chi-square test, independent t-test, analysis of variance, and Pearson correlation analysis. Results : There were significant differences in school system(years), class, life pattern, quality of life, personal and public schedule depending on whether they are interested in occupational balance. There were significant differences in occupational balance(OBQ) and quality of life(WHOQOL-BREF), 'Hobby', 'new hobbies after COVID-19', 'life patterns', 'use of public transportation', 'maintenance of occupational balance', and 'quality of life'. There was a significant positive correlation occupational balance and quality of life. Conclusion : This study showed that the more people who have changed their lives due to COVID-19 are interested in work balance, and the better they maintain their work balance and emotional well-being, the higher the work balance and quality of life, and the positive correlation between work balance and quality of life was confirmed. This will be the basis for studies related to intervention strategies that can improve occupational balance and quality of life in a time when social isolation is easy due to the COVID-19 epidemic.

Efficacy of Preliminary Magnetic Resonance Imaging Measurement in Ultrasonography-Guided L4 Selective Nerve Root Block (초음파 유도하 요추 4번 선택적 신경근 차단술 시 자기공명영상 계측의 유용성)

  • Shim, Dae Moo;Kweon, Seok Hyun;Cho, Hyung Gyu;Yu, Hyun Kyu;Lim, Kyeong Hoon
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.3
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    • pp.229-236
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    • 2020
  • Purpose: This study examined the utility of preliminary magnetic resonance imaging (MRI) measurements in the ultrasound-guided L4 selective nerve root block. Materials and Methods: As a retrospective study, 71 patients, who met the criteria for outpatient visits from March 2016 to December 2017, were included. From March 2016 to February 2017, 31 patients who underwent an L4 nerve root block without MRI were classified as group A, and 40 patients who underwent an L4 nerve root block through MRI measurements from March 2017 to December 2017 were classified as group B. Group A was injected under ultrasound-guidance through the pararadicular approach without a pre-interventional MRI evaluation, and group B was injected under ultrasound-guidance according to the preliminary MRI measurements. The results were assessed using the numeric rating scale scores before, three hours, and two, six, and 12 weeks after the procedure. Results: At three hours after the procedure, the proportion of patients better than good results were 51.6% in group A and 67.5% in group B. At two weeks after the procedure, the proportion of patients with better than good results were 48.4% and 70.0% in groups A and B, respectively; 58.1% and 62.5% of patient of groups A and B, respectively, showed better than good results after six weeks. In 12 weeks after the procedure, the results of group A and B were 67.7% and 62.5%, respectively. At three hours and two weeks after the procedure, group B showed significant symptom improvement than group A (p<0.05). The procedures were repeated 2.8 and 1.7 times in groups A and B, respectively, between two and six weeks for satisfactory pain relief (p<0.05). Conclusion: A pre-interventional MRI evaluation might improve pain relief within the initial two weeks after ultrasound-guided L4 selective nerve root block by improving the success rate of the procedure.

The Effect of the Shift Work on Drinking and the Mediating Effect of Sleep (교대근무가 음주에 미치는 영향 및 수면의 매개효과)

  • Jeong, Heeju;Kong, Ji-Sook;Kim, Mi Kyung;Kim, Seok Hyeon
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.111-120
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    • 2021
  • Objectives : Shift work has been known to cause various health problems by making it difficult for humans to adapt to their natural circadian rhythms. In particular, shift workers tend to complain of sleep difficulties associated with work schedules, and sometimes use alcohol as a self-medication to induce sleep. To date, no clear mechanism has been identified regarding the link between shift work and sleep, between shift work and drinking. This study aims to confirm the relationship between shift work and sleep, and to analyze whether the change in sleep caused by shift work causes drinking. Methods : This study included 11360 people (5704 men and 5656 women) among the Korean National Health and Nutrition Survey data in 2014, 2016 and 2018. The work type between 6am-6pm was defined as day work, and other work types were defined as shift work. Using logistic regression analysis, the relationship between shift work and sleep quality, shift work and high risk drinking, drinking amount at 1 time, drinking frequency were analyzed. In addition, we analyzed whether sleep mediates the relationship between shift work and drinking using mediated analysis. Results : Shift work showed a significant negative relationship with sleep quality in men and women (male OR=1.37, 95% CI 1.11-1.70, female OR=1.26, 95% CI=1.05-1.50). There was no significant relationship between shift work and alcohol in the case of men, but in the case of women, there was a significant positive relationship between shift work and the number of alcohol consumption (OR=1.34, 95% CI=1.04-1.72). When mediation analysis was conducted, it was found that women's sleep quality partially mediated the relationship between shift work and the frequency of drinking. Conclusions : The results of this study suggest that shift work causes sleep difficulties, and in the case of women, drinking can be induced through the partial mediating effect of sleep. Considering that women are more likely to choose drinking as a coping method for sleep problems, more active interventions for female shift workers are needed.

Grounded Theory Analysis on the Experience of Women from the Provinces Settling in Seoul (지방출신 여성들의 서울정착 경험에 대한 근거이론적 분석)

  • Yoonjung An;Yunseo Iem
    • Korean Journal of Culture and Social Issue
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    • v.24 no.2
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    • pp.273-300
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    • 2018
  • In order to analyze the experience of women from the provinces settling in Seoul, the current study conducts in-depth interviews on seven women who are working in Seoul after coming up to Seoul to attend and graduate from university. The results of the interview were analyzed using grounded theory methodology, under which the open coding extracted one hundred ten concepts, twenty-one sub-categories, and eleven categories encompassing them all. Causal condition is 'difficulty of settling in Seoul' and contextual conditions are 'intensification of psychological anxiety', 'reduction in quality of life', and 'continuation of economic instability'. The central phenomenon is 'dilemma of continuing life in Seoul' and intervening condition is 'diagnosis of ten years after coming up to Seoul'. Action/interaction strategies are 'changes in personal life', 'securing economic abilities through a stable job', and 'finding ways to participate in the society', while the result was 'choosing whether to continue living in Seoul'. The paradigm of experience of women from the provinces settling in Seoul proceed from coming up to Seoul for university to becoming independent, adapting to life in the city, experiencing growth and failures, facing challenge and searching for solutions, and conducting self-evaluation and making new choices. The participants reported that they were aware of differences and experienced anxieties as a stranger in Seoul even after living in the city for ten years; the problems they face have become more complex and diverse since when they were in university, and while they launched a career and making money, the gap between them and their peers from Seoul has not closed. The women also express desperation that they may need to leave Seoul to find alternatives to problems caused by accumulated stress and social problems that cannot be solved by an individual. In conclusion, the current study confirmed that efforts by individuals can only have limited effects in helping women from the provinces to settle in Seoul, indicating that detailed policy plans are required to solve social issues in the overall Korean society.

Weight loss effects of Bariatric Surgery after nutrition education in extremely obese patients (고도비만환자에서 베리아트릭 수술 (Bariatric Surgery) 후 영양교육이 체중감량에 미치는 효과)

  • Jeong, Eun-Ha;Lee, Hong-Chan;Yim, Jung-Eun
    • Journal of Nutrition and Health
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    • v.48 no.1
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    • pp.30-45
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    • 2015
  • Purpose: This study was planned to determine the characteristics of extremely obese patients during Bariatric surgery and to evaluate how the difference in the number of postsurgical personal nutritional educations they received affected the weight loss. Methods: This is a retrospective study on the basis of the medical records of extremely obese patients for 15 months after receiving gastric banding. A total of 60 people were selected as the study subjects and they were divided into the Less Educated Group and the More Educated Group according to the average number of personal nutritional educations they received. We investigated both groups to determine the general characteristic, health related lifestyle habits, obesity related complications and symptoms in possession, and eating habits before their surgery, the body composition measurement result, obesity determination indices at 1, 3, 6, 9, 12, and 15 months before and after their surgery, and the biochemical parameters at 6 months before and after their surgery. Results: Body fat and weight showed rapid reduction until 6 months after the surgery, but thereafter reduced slowly depending on the result of body composition measurement. Regarding body fat and weight, the More Educated Group, who received nutrition education more often, showed significantly lower levels than the Less Educated Group at 15 months after surgery. Regarding BMI and degree of obesity, the More Educated Group showed significantly lower levels than the Less Educated Group at 15 months after surgery. Here, we were assured that BMI is reversely proportional to the number of personal nutritional educations at 15 months, which is more outstanding after surgery than before surgery. Conclusion: Long-term nutritional education is a key factor for the extremely obese patient in maintaining the effects of Bariatric surgery on weight and body fat reduction onwards. In the next stage, considering the characteristics of the study subjects, adoption of individual nutrition education is recommended for postsurgical prospective arbitration of obesity in order to monitor blood pressure, obesity related complications, symptoms in possession, and how eating habits and health related life habits change, and to judge the actual effect of the nutritional education method at the same time.