• Women's Health Nursing
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• v.6 no.2
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• pp.234-257
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• 2000

At present in the medical care, the study and effort for producing health service to consider efficiency, effectiveness, and quality are urgently called for because of the difficulty in the keen competition according to the inter- nationalization and opening, the operation in the medical institution service testing system, the change in the medical policy of KDRGs, and the lack of the health care cost increasing rate. As an alternative, the case management for the new management system is introduced in the U.S., and the Critical Pathway that is the method designing the contents of activity and its result has been developed and applied in order to anticipate and manage the patient-outcome for the realization of the cost-effective case-management. Thus, this study intended to analyze the effectiveness to obtain by developing the Critical Pathway presented as the method to improve the quality-betterment and cost effectiveness through the continuous and consistent patient management for the hysterectomy patient and applying it to the real practice. As a study method, this author formed a conceptual framework through considering five Critical Pathway used in the current U.S. and three Critical Pathway presented in the literature to develop the Critical Pathway for the hysterectomy patient, and made out the preliminary Critical Pathway through reviewing the old chart. This author made the verified the validity of the expert group about the developed Critical Pathway, and to confirm the possibility of practice application, completed and settled the final Critical Pathway after using the Critical Pathway to the hysterectomy patient from March 1st to 15th, 1997. Finally, to analyze the application-effect of the developed Critical Pathway, this author offered health care service applying the Critical Pathway to the hysterectomy patient from April 15th to August 31th, 1997. The guide for the Critical Pathway was carried out in advance by outpatient setting nurse for outpatient setting visit before the operation, and after hospitalization the primary nurse monitored the execution degree on the every duty. After discharge this author surveyed the complication through phone visiting, and one month after discharge surveyed the patient's reaction about the offered service when outpatient setting visit and analyzed the result. The source for health care cost was obtained by the statistics about the hospital charge which was offered by the General Business Department. The results were as follows. 1. It was decided that the vertical line of the Critical Pathway was made up of eight items such as monitoring/assessment, treatment, line/drains, activity, medication, lab test, diet, patient teaching, and the horizontal line of the Critical Pathway was made up of from hospitalization to discharge. 2. After the analysis of service contents through reviewing the old chart, it was decided that the horizontal line of the preliminary Critical Pathway was made up of from hopitalization to fourth postoperative day, and the vertical line of it was divided into eight items which were the contents to occur with the time frame of the horizontal line. 3. After the verifying the validity of the expert group about the preliminary Critical Pathway, the horizontal line was amended from hopitalization to third postoperative day, and taking their consensus, some contents of the horizontal line was amended and deleted. 4. From March 1st to 15th, 1997, to confirm the clinical suitability, this author offered eight hysterectomy patients the medical service through the Critical Pathway. The result was that three of them could be discharged at the expected discharge day, and the others later than that day. Supplementing the preliminary Critical Pathway through analyzing the cause of that delay- case, this author developed the final Critical Pathway. 5. There were no significant differences between the experimental and the control group in the incidence of complication(P > 0.05). 6. The 92.4% of experimental group was satisfied with the Critical Pathway service. 7. The length of hospital stay of the experimental group offered with the Critical Pathway service was 4.6 days and there was a significant difference that it was 1.3 days shorter than that of the control group(t=-29.514, P=0.000). 8. There wsa a significant difference that the mean medical charge per one patient of the experimental group offered the Critical Pathway service was cheaper \124,150 than that of the control group(t=-9.826, P=0.000). 9. The result that the author assumed and analyzed hospital income with the rate of turning bed was assumed that the increase of hospital income was \63,245,072 for that study, and the income increase was expected with \68,704,864 for a year. The result that this author applied the Critical Pathway to the hysterectomy patient have no differences in the incidence of complication, high satisfaction with that service, and the length of hospital stay decreased in the experimental group, and the mean hospital charge per one patient decreased, but hospital income increased. Suggestions for further study and nursing practice are as follows. 1. The study to apply the Critical Pathway for a year, verify the validity, and measure the effect repeatedly is needed. 2. To apply and manage the Critical Pathway effectively, the study to computerize it is needed. 3. The study to develop hospital-based Critical Pathway about other diseases or procedure, and measure the effect is needed.

• Acute and Critical Care
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• v.33 no.4
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• pp.260-268
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• 2018

Background: The purpose of this study was to evaluate the clinical application of modified Burns Wean Assessment Program (m-BWAP) scoring at first spontaneous breathing trial (SBT) as a predictor of successful liberation from mechanical ventilation (MV) in patients with endotracheal intubation. Methods: Patients requiring MV for more than 72 hours and undergoing more than one SBT in a medical intensive care unit (ICU) were prospectively enrolled over a 3-year period. The m-BWAP score at first SBT was obtained by a critical care nursing practitioner. Results: A total of 103 subjects were included in this study. Their median age was 69 years (range, 22 to 87 years) and 72 subjects (69.9%) were male. The median duration from admission to first SBT was 5 days (range, 3 to 26 days), and the rate of final successful liberation from MV was 84.5% (n=87). In the total group of patients, the successful liberation from MV group at first SBT (n=65) had significantly higher m-BWAP scores than did the unsuccessful group (median, 60; range, 43 to 80 vs. median, 53; range, 33 to 70; P<0.001). Also, the area under the m-BWAP curve for predicting successful liberation of MV was 0.748 (95% confidence interval, 0.650 to 0.847), while the cutoff value based on Youden's index was 53 (sensitivity, 76%; specificity, 64%). Conclusions: The present data show that the m-BWAP score represents a good predictor of weaning success in patients with an endotracheal tube in place at first SBT.

• Journal of muscle and joint health
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• v.21 no.2
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• pp.135-144
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• 2014

Purpose: The purpose of this study was to analyze and clarify the concept of shift work maladaptation syndrome and to facilitate development of interventions for the shift work adaptation. Methods: This study used Walker and Avant's concept analysis process. Results: Shift work maladaptation syndrome can be defined as the following attributes: 1) destruction of the circadian rhythm, 2) existence of a threshold, 3) individual characteristics (year of career, type of personality, and type of coping) 4) somatization, and 5) negative emotional conditions. The antecedents of shift work maladaptation syndrome consist of counterclockwise shift work, irregular shift cycle, night work which is breaking circadian rhythm, and lifestyle changing. The consequences as a result of shift work maladaptation syndrome are deterioration of health (gastrointestinal, neuro-psychic, cardiovascular function), reduction of social relationships, and turnover or resign. Conclusion: The results of this study can be useful as the foundation of shift work adaptation implementation.

• Korean Journal of Exercise Nutrition
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• v.25 no.4
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• pp.17-23
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• 2021

[Purpose] This study aimed to investigate the effect of education based on the health belief model on the physical activity of the staff of the University of Medical Sciences. [Methods] This semi-experimental study was conducted on 130 university staff aged 25-50 years from the Hamadan University of Medical Sciences. Inclusion criteria were having at least 1 year of work experience, lack of acute and chronic physical and mental illnesses, and not using drugs that affect physical activity. The samples were randomly divided into two groups. The experimental group received three training sessions based on the health belief model. Before and 2 months after training, the control and experimental groups were evaluated via the following questionnaires: (1) demographic information questionnaire, (2) Health Belief Model Questionnaire, and (3) International Physical Activity Questionnaire. Finally, data were analyzed statistically. [Results] The training process resulted in a significant increase in the mean scores of the health belief model constructs in the experimental group, but changes in the control group were not significant. Self-efficacy was the strongest predictor of physical activity. [Conclusion] The health belief model is a useful model for improving individuals' understanding of the benefits of physical activity.

• Journal of the Korean Society of School Health
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• v.13 no.1
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• pp.63-84
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• 2000

Primary school is regarded as an important period when many health-related behaviors and life-styles begin to be formed. Acquiring them through school heath education has a strong influence on the health promotion of not only the family but also the community. Primary school health education in Korea has a systematic flaw in that health-related subjects are divided and taught under various subjects in primary school. In order to develop a proper school health curriculum, it is essential to assess what is currently being taught. In this study the current health education of the 6th grade primary curriculum was investigated to improve school health education. The purpose of this study is to identify the health education contents and time in textbooks of the 6th grade primary school curriculum. In this study, the textbooks & teacher's teaching manuals of the 6th grade curriculum were analyzed with a health instruction framework for Korean schools developed by the Korean Nurse Association & Korean School Health Education Association in 1993 and health care framework for health education curriculum presented by Kim in 1991. The results are as follows ; 1) Health education hours of the curriculum are 206 hours, about 34.3 hours a year. 2) The contents of health education were divided into nine subjects at primary schools. Organizing principles of learning experience(eg, integrity, sequence and continuity) were not considered sufficiently. The physical education & natural science subjects include a lot of health education contents. 3) The major content areas are community & environmental health areas and daily healthy life areas. 4) The major areas at each grade level are daily healthy concerns and safety & first-aid 5) The remarkable contrast to the 5th primary school curriculum are that environmental health is offered to the first grade step by step, and that drug use & abuse and mental health education are included in the 6th primary school curriculum. 6) The main contents of health education in 1st, 2nd. and 3rd grade curricula consist of treatment & recovery health functions. Those of the 4th grade curriculum consist of treatment & recovery health functions, and daily healthy life functions. Those of the 5th grade consist of growth & development functions. Those of the 6th grade consist of treatment & recovery health, growth & development functions. Most health care functions belong to physical health care. The results above suggest that we put together the divided contents of health education and manage them on the basis of systematic integration.

• Korean Journal of Health Education and Promotion
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• v.20 no.1
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• pp.91-109
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• 2003

The importance of repeat screening for stomach cancer is well known to decrease deaths from stomach cancer. This study was aimed at assessing practice behaviors and to identify related factors in the aspects of demographic factors, health status and cancer risk recognition, attitude to cancer screening, health behaviors, and inhibiting or facilitating factors to stomach cancer screening in an urban area. Data was collected through self-administered questionnaires from 403 people aged 40 to 69 years from April 23th to May 15th, 2002. Practice behaviors were classified as : "ever" or "never", and "repeat" or "not repeat" grouped based on a recent 5 year screening history. The results were as follows: 1. Among the 403 subjects: "the ever group" was 23.8% and "the repeat group" was 4.0%, The rates of screening were 20.5% for men, 27.8% for those women, and 27.3% for aged 40-49, 24.5% for those aged 50-59, 19.0% for those aged 60-69. The rates of repeat screening were 4.0% for men, 4.1% for women, and 2.9% for those aged 40-49, 6.3% for aged 50-59, 2.5% for those aged 60-69. 2. The main factors associated with adherence to gastric cancer screening were education(post high school vs below : OR=2.44), previous cancer screening(yes vs no : OR=2.61), belief in personal health(no vs yes : OR=2.72), health status(unhealthy vs healthy : OR=3.40), possibility of cancer compared to others(low vs not low : OR=2.56), and regular exercise(yes vs no : OR=2.94). The main factor associated with adherence to gastric cancer repeat screening was other cancer screening(yes vs no : OR=6.33). Consequently, there is a need to change the recognition of the importance and necessity of stomach cancer screening in healthy conditions through health education, and to perform multiple screening tests each visit.

• Journal of Korean Academy of Nursing
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• v.4 no.3
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• pp.1-12
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• 1974

It is the purpose of this study to determine an effective method of communication between teachers and students. This study was done by using the theory, methods and tools of transactional analysis as developed by Borne and Harris. In order to achieve this objective: First; The teacher and student communication process is to be used, noting the student's reaction when the teacher uses "Adult" and "Parent" stimulus. Second; The effectiveness of the reaction toward the "Adult" and "Parent" stimulus is to be determined with these objectives in mind. The problems of this research study are as follows; What influence on the response of the student is brought about by the method of communication used by the teacher? 1) When the teacher uses the "Parent" Stimulus method what response of the student is shown? 2) When the teacher uses the "Adult" Stimulus method what response of the student is shown? 3) What method of communication helps to promote the student′s growth? In order to determine the answers to these questions data was collected from 40 first year students at a school of nursing in Inchon. These students were divided into two groups and the unstandardized interview technique was used to interview each student for ten minutes. A tape recording was made of each interview and the nonverbal communication was recorded by process recording immediately following each interview. The recorded material obtained from the two groups was analysed and then the Borne and Harris transactional analysis method was used in analysing the writer of this thesis undertook. Hypothesis 1. When the teacher used the "Parent" stimulus the student′s response was more frequently "Child" than "Adult", the results showed a significant difference of P〈0.001. Hypothesis 2. When the teacher used the "Adult" Stimulus the student′s response was more frequently of "Adult" than "Child", the results showed a significant difference of P〈0.001, The following conclusions are drawn from this study: 1) There is an indication that the teachers use of "Parent" stimulus communication is not an effective method to increase the growth of the student. 3) Since the teachers use of "Adult" stimulus resulted in an increase in the "Adult" response of the student there is ah indication that use of an effective communication method can help the student to develop. The writer of this research paper suggests for further study the following; 1) A comparison of the differences in response to the giving of both "Adult" and "Parent" stimulus to the same Students. 2) A comparison of the differences in student response to the communication method according to the student′s grade, age, sex and level in school.

• Journal of Korean society of Dental Hygiene
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• v.16 no.2
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• pp.185-193
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• 2016

Objectives: The purpose of the study was to examine the recognition and satisfaction of dental care customers after 1 year national health insurance coverage of dental scaling. Methods: A self-reported questionnaire was completed by 477 dental care customers in Gyeongbuk, Busan, Yangsan, and Gyeonggido from July 18 to September 30, 2014 after receiving informed consents. The questionnaire consisted of general characteristics of the subjects(5 items), subjective awareness of oral health(4 items), recognition of scaling(5 items), and recognition and satisfaction of scaling health insurance(5 items). Data were analyzed using SPSS version 20.0 program. Results: Those who recognized the national health insurance coverage of dental scaling accounted for 80.1 percent and 47.2 percent of them got the health insurance coverage via media advertisements. Those who received the scaling service by health insurance coverage accounted for 73.8% and 66.2% of them were very satisfied with the service. Among the customers, 91.8% were satisfied with scaling health allotment. There was a statistical significance between scaling health insurance and subjective oral condition recognition(p<0.01). Through the health insurance coverage scaling service, the oral health in Korea will improve much. Conclusions: The expansion of health insurance coverage of scaling service will provide the universal oral health care for all people. Owing to low cost service, people will actively try to come in contact with public health service in the future.

• Journal of Industrial Convergence
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• v.21 no.8
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• pp.119-127
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• 2023

This study was conducted to investigate the structural relationship between depression, self-esteem, and social withdrawal that affect academic helplessness in adolescents. The study sample was 2,265 first-year students of high school in the fourth year (2021) data from the Korean Children and Youth Panel Survey 2018. In this study, data were analyzed by a structural equation model based on the partial least squares method using SmartPLS 3.0. Results indicated that depression and social withdrawal had a significant positive effect on adolescents' academic helplessness, and self-esteem had a significant negative effect. In addition, social withdrawal had a significant positive mediating effect on the relationship between depression and academic helplessness. Therefore, it is required strategies that consider the relationship between depression, self-esteem, and social withdrawal to approach adolescents' academic helplessness.

• The Korean Journal of Rehabilitation Nursing
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• v.5 no.1
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• pp.7-17
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• 2002

The purpose of this study was to investigate the effect of taping therapy on activities of daily livings (ADL), hand function and range of motion in poststroke-hemiplegic patients. Sample were selected from 20 poststroke-hemiplegic patients at public health center in the period from September 5 to November 21, 2001. The research design was one group pretest-posttest design. The hemiplegia period of the participants was from one year to five years. The pretest and posttest included measuring activity of daily livings(ADL), instrumental activity of daily livings(IADL), hand function, range of motion, quality of life. In this research design, a treatment were to expose taping therapy who were received self-help management program. This self-help management program was composed of five sessions and each session had health education on stroke, diet, risk factor, ROM exercise and recreation. 20 patients were treated with kinesio taping(Nippon Sigmax Co., Ltd., Benefact(r), width 50mm). Tapes were applied to the Deltoid, Supraspinatus, Infraspinatus, Brachioradialis with paralyzed upper extremity. The taping therapy was performed once a week for 5 weeks. SPSS Win 8.0 was used for the data analysis. The results of this study were as follows: 1) The score of BADL was increased from 30.5 to 33.95 after program, and that was statistically significant(p=.019). 2) The score of IADL was increased from 11.6 to 12.75 after program, but that was statistically insignificant(p=.161). 3) The score of hand function was increased from 17 to 20.35 after program, and that was statistically significant(p=.026). 4) The shoulder's ROM(p=.000) and wrist's ROM(p= .004) were significantly increased. According to the results of this study, taping therapy is effective for improving ADL, hand function, ROM, quality of life. However, this study found no significant differences in IADL. Consequently, these findings showed that the taping therapy was effective in improvement of physical aspects(BADL, hand function, upper extremity's ROM) in poststroke-hemiplegic patients.