• Journal of Korean Academy of Nursing
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• v.24 no.4
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• pp.696-705
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• 1994

This study was done to provide a basis for home health care management for women following Cesarean delivery. Furthermore it was initiated as an possible application of home health care in the future. In this study, client selection criteria was developed by the researcher and assessment tools for home health care, recording system and problem oriented recording system were revised from Jun's(1993) methods. The selection criteria tool for home health care for women who had a Cesarean delivery was structured and consisted of five areas : physical status, functional status, psychological-emetional status, educational needs status and environmental status. The structured assessment tool consisted of general items, obstetric history, past medical history, methods of feeding, medications taken before ad-mission, laboratory results, discharge instructions, discharge medications, family tree, economic status, environmental status, a map, health assessment of women and their newborns. The visit note consisted of the date : nursing problems : nursing process including initial assessment : nursing goals : visit plan : health status of the postpartum women and their newborn : nursing diagnoses : nursing implementation evaluation : summary : next visit plan and revision. The problem oriented recording system consisted of the date, problem numbers, nursing diagnoses, problem appearance date, problem resolution date. The results of the research are as follows : The seven cases having had a Cesarean delivery were discharged on an average on the 5th day after the Cesarean birth. The total number of home visits was 13. According to Cordon's functional health patterns the total possible nursing diagnoses was 34 diagnoses for the methers and their newborns. Among the 34 diagnoses, there were 13 diagnoses in the health perception /management pattern, 7 in the psychosocial health perception / management pattern, 8 in the psychosocial self-perception, 2 in the nutrition / metabolism pattern of physical function, 2 in the knowledge deficit of newborn management, anxiety related to newborn management, knowledge deficit related to disease process of new-born, anxiety related to disease process of newborn anxiety related to prognosis of baby's condition, knowledge deficit related to newborn jaundice each appeared once. The changes in the number of nursing diagnoses was related to not the number of visits but to the number of nursing diagnoses decreasing. The con-tent of the home health care was categorized ac-cording to assessment, direct care, counseling, education, family care. The recommendation based on the results of this research are Home health care nurses for Cesarean postpartum women and their neonates requires comprehensive knowledge of pregnancy, delivery, and the postpartum period and of the neonate so that they can provide appropriate care and holistic views. Most of cases terminated after the second visit, this outcome may be related to the subjects being discharged on the 5th day after delivery. Therefore, study done with earlier discharge after delivery may have different outcome. It is very hard to assess psychological aspects that need follow-up and to develop communication channels.

• Child Health Nursing Research
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• v.4 no.2
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• pp.159-176
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• 1998

In effort to conduct comparative study on the caregiving environment of Neonatal Intensive Care Unit(NICU) in both U. S and Korea, this study was been conducted first in the U.S. Purpose : The purpose of this study is to identify the physical environment and direct caregiving practices to lowbirth weight infants in NICU in the US. It also aims to examine the NICU outcome status and behavioral reponses of lowbirth weight infants. Methods : A study design using descriptive and inferential statistics was been conducted through an observational, field method. A sample of 15 preform infants admitted to NICU were recruited for the study. The subjects were those with birth weight between 1,000 gm to 1,500 gm, born at the gestation period of 27 to 33 weeks, and without any chromosomal or other genetic anomalies, major congenital infections, or maternal illness. Thirty minutes observation(three times of ten minutes of continuous observation)of the infant's behavior and physiological status, and an four-hour observation of the physical environment and direct care giving procedures were been conducted on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. The data to be collected were in four areas : the demograghic characteristics of the infants, the physical environment and care giving procedures, the frequency of the infant's designated behavior and physiological response, and NICU outcome variables. A descriptive analysis and Kruskal-Wallis, Pearson r were been applied according to variable characteristics. Results : 1. Mother's mean age was 29.47. The sample consisted of 6 males and 9 females. Mean gestational ages were 29.17 weeks. Mean birth weight was 1236.33g. Mean Apgar scores at one minute were 6.6, and 7.8 at five minutes. 2. The location for the incubator was in the distance from the light, X-ray screens and nursing station, in proximity to side-lamp, telephone and faucet on the third day after birth. The location for the incubator was in the distance from the light and radio on the tenth day and in proximity to nursing station on the day of dischage from the NICU or at 34weeks postconception. 3. Nesting was the most applying aids to the infants. And foot roll, shielding and plastic frame were frequently using by nurses for facilitating well modulated restful posture. 4. There were statistically significant changes in the patterns of physical environment included locating the infant's incubator and bedding, specific aids to self regulation on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. 5. Statistically significant changes were not appeared in the patterns of direct caregiving procedure to the infants included stress inducing or reducing manipulations on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. 6. The stress response of the infants in NICU were significantly reduced as the infants grow older. 7. There were not statistically significant correlation between the physical envronment and the stress responses of the infants in NICU. 8. There were statistically significant correlation between the direct caregiving procedure to the infants and the stress response of the infants in NICU in the second and third observation on the day three. 9. Average weight gain per day from birth to discharge was 38.73g, number of days in the hospital was 42.60, number of days before bottle feeding was 3.6. Postconception age starting bottle feed ing was 31/sup +5/ weeks. Number of days on mechanical ventilator was average 7.64, 11.42 was an average number of days of oxygen need. Conclusion : It, thus, appears that to minimize the sensorymotor stimulation for the low birthweight preterm infant in NICU, manipulation of care giving practices to the babies whatever the stress inducing or reducing procedures, have to be limited in the immediate early stage after birth. And it needed to be reexamine to identify the appropriate and specific physical environment and the patterns of direct caregiving to the low birthweight preform infant as the infants grow older in NICU.

• Journal of the Korean Society of Food Culture
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• v.20 no.1
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• pp.1-14
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• 2005

This study was conducted to develop and evaluate food menus after investigating eating behaviors and food preferences of preschool children. Parents of the preschool children In 2 Gumi City day-care centers completed questionnaires in July 2003, which were used to assess eating behaviors and food preferences of their preschool children. Analysis of the questionnaires led to the development of the menus. Menus (n=10) were developed for five different categories (two menus were developed for each category) including general menu, unbalanced menu, anemia menu, obese menu, and traditional menu. The preschool children(n=656) evaluated the menus as they were provided with each them throughout October 2003. The five score scale method was used to evaluate taste, smell, looks, texture and general preference of each menu. Results in eating behaviors showed that 70.7% of preschool children had unbalanced eating behaviors. No gender based differences in eating behaviors were found, but in regard to food preferences boys tended to prefer carbonated drinks more than girls. Results indicated that among all menus, fruit ranked highest $(3.97{\pm}0.65)$ for food preference, and vegetables ranked lowest for food preference $(2.46{\pm}0.68)$. Food preference in regard to cooking process indicated the highest preference was for fried foods $(3.80{\pm}0.68)$ and the lowest preference was for raw vegetables $(2.61{\pm}1.27)$ and namul $(2.85{\pm}1.13)$. Preference for taste ranked the highest $(4.30{\pm}0.91)$ but preference for looks recorded the lowest $(3.95{\pm}0.89)$. Of all the foods in the menus, steamed tofu rated the highest for individual food item preference, while tuna sesame leaf rice rated the lowest preference. Statistical analysis of interrelationships among food taste, smell, looks, texture and general preference were significant (p<0.0l). Results from this study suggest that various factors including food taste, smell, looks, and texture influence the food preferences of preschool children. Therefore, it is concluded that by developing a variety of appetizing menus for use at home and in day-care centers, containing varied food items and cooking methods, preschool children will be encouraged to increase their food preferences and to establish appropriate eating behaviors.

• Korean Journal of Human Ecology
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• v.19 no.1
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• pp.203-214
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• 2010

This study will examine the current condition of outdoor play in child care centers and the overall perception of teachers on outdoor play in regards to its related programs and children's reaction to them. Through examining such issues, this study will provide the basic data that can be applied in planning appropriate outdoor play activities, programs and environments. For the study, we surveyed teachers and directors of child care centers using a structured questionnaire. The objects of the survey were 22 child care centers in Daejeon and Seoul, who agreed to conduct the survey. The survey was conducted from August 1 to September 30 2006; 220 copies were distributed, and 188 copies were collected. The results of the study can be summarized as follows: 1) The number of outdoor plays per week were on average 1~2 in most cases, although teachers believed the play should be done everyday. Outdoor play time was mostly 21~30 minutes, while teachers thought 31~40 minutes as appropriate. Children's reaction scored the highest when they played outdoors for 30 minutes every day with their teachers involved in the play. As a result, we have concluded that the appropriate outdoor play should be conducted everyday for 30~40 minutes. 2) Outdoor play was mostly conducted as part of the overall educational plan rather than a separate plan. Since outdoor play affects children's development as much as indoor play, there is a need for development of a specific and separate plan for various outdoor play programs. 3) The outdoor play program that was most often conducted was equipment play and sand play. This indicated the monolithic nature of the outdoor program. Given the fact that children enjoy outdoor plays a lot (M=4.71), various programs including adventure play, sensitive play, and carpenter play should be developed. 4) In outdoor play, the teacher's role included supervising and interacting with children. According to the survey, teachers had a good understanding of the importance on safety and supervising issues in outdoor plays. However they seemed to overlook the importance of having better programs and improving teacher's participation to the play. Despite the importance of outdoor play to children's development, the result shows that teachers have tendencies to limit and obstruct outdoor plays by emphasizing supervising and safety issues instead. 5) Children's safety should not be the only consideration for outdoor plays; teachers ought to better understand that children's development can be maximized by the play. Furthermore, there should be emphasis placed on the program development and teacher's participation; teacher's participation should actively encourage the interactions between a child and a teacher, as well as among children.

• Health Policy and Management
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• v.3 no.1
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• pp.1-24
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• 1993

This study is designed to find clues to make a plan for efficient hospital bed utilization. Author has tried to estimate the level of appropriateness and to find out factors affecting intra-hospital variation of inappropriate bed utilization using modified Appropriateness Evaluation Protocol of which criteria are based on service intensity and patients' conditions. Systematic random sampling was done from the population of inpatients during one month in on university hospital. Data were collected by concurrent and retrospective medical record review and analysed by multiple logistic regression. In medical services, 83.5% of admission reveals appropriate and the level of inappropriate admission shows significant differences by patients' residence, type of department admitted to, admission 개\ulcorner, and length of stay. In surgical services, 97.3% and 34.7% are appropriate in location and timing of surgery respectively. Inappropriate timing of surgery differs significantly depending on patients' age, type of department admitted to, admission route, and length of stay. Sixty two percent of hospital days shows appropriate and the level of inappropriateness show marked differences by patients'age, type of services, admission routes, part of the month, part of the stay, and length of stay. Inappropriate hospital days are due to inappropriate level of care, premature admission, improper scheduling of diagnostic or therapeutic procedures, and problems in scheduling surgery in sequence. In conclusion, substantially high proportion of inappropriate hospital bed utilization was confirmed. To reduce it, it is necessary to develop alternative services with which can replace inpatient services, and to introduce utilization management system which may include internal peer review.

• Health Policy and Management
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• v.15 no.3
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• pp.94-113
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• 2005

The purpose of this study was to determine the level of appropriateness in hospital stays and factors influencing inappropriate hospital stays. The study was conducted at fifteen general care units in a tertiary university hospital. Appropriateness of hospital stay was assessed using Appropriateness Evaluation Protocol by trained head nurses. The total of 447 patient records were reviewed. Among them, 352 patient data were included in the final data set. A unit of observation was patient day. A rate of appropriate hospital stay was calculated per patient as a unit of analysis. Multiple regression analysis was performed to determine the factors affecting inappropriate hospital stay. The eighty-three percent (2030/2651) of hospital stays were evaluated as appropriate. There were significant differences in appropriateness of hospital stay according to patient's age, type of health insurance, medical specialty, and length of stay(p<0.05). In the multiple regression analysis, medical speciality was the most significant factor to predict the inappropriate hospital stay. The study showed a substantial proportion of hospital stay was found to inappropriate. Level of appropriateness was significantly different from medical specialty. Interdepartmental approach should be required to coordinate and improve appropriate resource utilization.

• Journal of Korean society of Dental Hygiene
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• v.22 no.5
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• pp.425-435
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• 2022

Objectives: This study aimed to examine the opinions of registered dental hygienists (RDH) and dental hygiene students (DHS), professionals who can practice visiting oral health care (VOHC), and the demand for specialized training courses of RDH for VOHC. Methods: Using a Google online survey, 125 RDH and 106 DHS personnel were surveyed on their perception of VOHC and the operation of special training courses. Results: RDH (97.6%) and DHS (96.1%) agreed that they needed VOHC for older people. Moreover, the qualification course for specialized training for VOHC was considered necessary. Regarding the appropriate curriculum, RDH preferred training programs comprising 2-hours classes over 6 months and 15 weeks and so on, and DHS preferred 3 hours classes over 6 months and 15 weeks and so on. Regarding the desired working type, the RDH preferred the half-day system, whereas the DHS preferred the alternate-day system. The Korean Dental Hygienists Association was intended for human resource development. They agreed that continuing education was necessary when working as a visiting RDH, and many responded that they would participate if a specialized training course was opened. Conclusions: RDH and DHS have a high level of awareness of the importance and necessity of VOHC, and consider a specialized training qualification course necessary for efficient VOHC.

• Journal of Korean Academy of Nursing
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• v.17 no.1
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• pp.52-63
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• 1987

Il-primigravidas who visited antenatal clinic and their husbands were taught lamaze childbirth education by the investigator in the third trimester of pregnancy. Lamaze childbirth educational course consisted of six weekly class totaling twelve hours of instruction. A questionnaire was adminstered to subjects for the evaluation of Lamaze educational Program. 21-questions were rated on a Likert-type scale containing five responses and subjects described the advantages, the disadvantage, and the difficulties of lamaze childbirth education course. The results of the study were as follows; 1. The core contents of lamaze childbirth educational Program were Process of labor, anatomy and physiology of the female body, the care of newborn, maternal-infant attachment, breathing patterns to be used at the appropriate stage of labor, techniques for conscious relaxation of muscles during labor and delivery, and exercise to limber and prepare the body for the work of labor and delivery. All couples understood the above core contents very well and there were not significant differences between the understanding scores of wives and those of husbands (p>0.05). 2. 81.8% of couples Practiced breathing pattern to be used at the appropriate stages of labor one or three times a day and 72.7% of couples practiced conscious relaxation of muscles one or three times a day. 3. The contents of Lamaze childbirth educational program were easy for the couples to understand, and the total length, the amounts and the structures of 6-classes were appropriate. 4. Lamaze childbirth educational program was very useful, necessary, interesting, and successful to achieve the couples' objectives. 5. The couples expressed that they had positive attitude and high self-esteem, and reduced their anxiety on the pregnancy and labor.

• Clinical and Experimental Pediatrics
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• v.58 no.4
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• pp.154-157
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• 2015

Plastibell is one of the three most common devices used for neonatal circumcision in the United States, with a complication rate as low as 1.8%. The Plastibell circumcision device is commonly used under local anesthesia for religious circumcision in male neonates, because of cosmetic reasons and ease of use. Occasionally, instead of falling off, the device may get buried under the skin along the shaft of the penis, thereby obstructing the normal flow of urine. Furthermore, the foreskin of neonates is highly vascularized, and hence, hemorrhage and infection are possible when the skin is cut. Necrosis of penile skin, followed by urethral obstruction and renal failure, is a serious surgical mishap requiring immediate corrective surgery and medical attention. We report a case of fulminant urosepsis, acute renal failure, and pyelonephritis in a 4-day-old male neonate secondary to impaction of a Plastibell circumcision device. Immediate medical management was initiated with fluid resuscitation and mechanical ventilation; thereby correcting life threatening complications. Pediatricians and Emergency Department physicians should be cognizant of the complications from Plastibell circumcision device in order to institute appropriate and timely management in neonates.

• The Journal of the Convergence on Culture Technology
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• v.6 no.1
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• pp.403-411
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• 2020

The purpose of this study is to explore the construct system and revision emphasis of curriculum for early childhood education and care in japan revised in 2017. First, the construct system of the revised early childcare curriculum and kindergarten curriculum of the three institutions in 2017 is different. However, it is more specific according to its characteristics, and the revision focus is given in the same direction. Second, The revised emphasis of the curriculum establish itself with three qualities and abilities that must be nurtured through infancy and clarifies ten childhood images. Also, Emphasis is placed on the establishment of curriculum and management to implement these. Expert review is needed to ensure that the content presented in childhood images is appropriate and does not emphasize the establishment of curriculum and management without ensuring teacher autonomy.