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Recent outcome of extremely low birth weight infants - The use of CRIB(clinical risk index for babies) II score for analyzing the survival rate - (초극소 저출생 체중아의 최근 치료 성적 - CRIB(clinical risk index for babies) II 점수를 이용한 생존율 분석 -)

  • Kim, Do-Hyeon;Shim, So-Yeon;Kim, Jae-Ri;Shin, Seung-Han;Kim, Eun Sun;Joung, Kyoung-Eun;Kim, Sang Duk;Lee, Jin A;Choi, Chang Won;Kim, Ee-Kyung;Kim, Han-Suk;Kim, Beyong Il;Choi, Jung-Hwan
    • Clinical and Experimental Pediatrics
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    • v.49 no.9
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    • pp.952-958
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    • 2006
  • Purpose : The survival rate of infants weighing less than 1,000 g at birth(extremely low birth weight infants, ELBWI) has increased due to recent advances in perinatal and neonatal intensive care. The purpose of this study was to evaluate the survival rates of ELBWI born at Seoul National University Hospital during the last six years. Methods : A total of 99 infants were divided into three groups(period I: 2000 to 2001, period II: 2002 to 2003, period III : 2004 to 2005) based on date of birth. We compared the survival rate of ELBWI over the three periods, using CRIB II score for adjustment for clinical severity. Results : Overall survival rate of ELBWI was 74.7 percent. The survival rate of ELBWI increased over the three periods(period I: 60.7 percent, period II : 73.3 percent, period III : 85.3 percent). The threshold of viability(defined as survival of at least 50 percent of infants) was 25 weeks of gestation and 600 g at birth. The birth weight-specific survival rates increased considerably over the three periods for infants <750 g at birth(period I: 10 percent, period II: 46.2 percent, period III : 70.6 percent). The survival rates of ELBWI over the three periods increased much remarkably after adjustment for clinical severity by CRIB II score. Conclusion : In our institution, survival rates of ELBWI during the last six years continued to improve, particularly for infants weighing <750 g at birth. This increase in survival rates was not associated with the clinical severity of ELBWI.

Status of Mixed Grain Diet by People with Diabetes in Jeollabuk-do and Sensory Evaluation of Different Composition of Mixed Grains (전라북도 지역 당뇨환자의 잡곡밥 섭취 실태 및 혼합비를 달리한 잡곡밥의 관능검사)

  • Jung, Eun-Sun;Shin, Dong-Hwa;Doo, Jae-Kyun;Chae, Soo-Wan;Kim, Young-Soo;Park, Young-Min
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.39 no.7
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    • pp.1049-1055
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    • 2010
  • This study investigated the status of mixed grain diet by 68 people with diabetes living in Jeollabuk-do and performed sensory evaluation of different composition of mixed grains to improve the sensory characteristics based on the investigation. BMI of all subjects were measured and found that 61.7% were overweight. 94.1% of them ate mixed grains and females ate more mixed grains than males (p<0.05). Most males and females answered that they ate mixed grains for their health. Females added more mixed grains than males (p<0.01). More females (47.1%) than males said they would continue to eat mixed grains (p<0.05). 59% of them said they had eaten mixed grains for more than 3 years. 46.0% of them said they purchased mixed grains at a small mart near their houses. The mostly added grain to rice was black soybean (76.5%). RMGD-50 is composed of six mixed grains excluding nonglutinous rice and has the mixing rate of 50%. RMGD-40 has the mixing rate of 40%. Sensory evaluation was performed and RMGD-50 got lower score ($3.33{\pm}0.68$, $3.50{\pm}0.81$) than RMGD-40 in the appearances and color. RMGD-40 with Control 1 that includes more glutinous grains and Control 2 that is polished rice were compared. RMGD-40 got lower score than Control 1 in its appearances, smell and color, although there wasn't a meaningful difference. For the people with diabetes who are accustomed to mixed grains, the polished rice got the lowest score in moisture amount, gumminess and overall taste ($3.26{\pm}0.82$, $3.48{\pm}0.85$, $3.19{\pm}0.70$). It showed meaningful difference from RMGD-40 and Control 1 (p<0.01). Consequently people with diabetes preferred mixed grains that include more glutinous grains that have lower mixed ratio. So it is necessary to educate the people with diabetes about eating grains for better blood sugar management. Continual study and development of mixed grains that can help people with diabetes to control their blood sugar are necessary.

Development of cardiopulmonary resuscitation nursing education program of web-based instruction (웹 기반의 심폐소생술 간호교육 프로그램 개발)

  • Sin, Hae-Won;Hong, Hae-Sook
    • Journal of Korean Biological Nursing Science
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    • v.4 no.1
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    • pp.25-39
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    • 2002
  • The purpose of this study is to develop and evaluate a web-based instruction Program(WBI) to help nurses improving their knowledge and skill of cardiopulmonary resuscitation. Using the model of web-based instruction(WBI) program designed by Rhu(1999), this study was carried out during February-April 2002 in five different steps; analysis, design, data collection and reconstruction, programming and publishing, and evaluation. The results of the study were as follows; 1) The goal of this program was focused on improving accuracy of knowledge and skills of cardiopulmonary resuscitation. The program texts consists of the concepts and importances of cardiopulmonary resuscitation(CPR), basic life support(BLS), advanced cardiac life support(ACLS), treatment of CPR, nursing care after CPR treatment. And in the file making step, photographs, drawings and image files were collected and edited by web-editor(Namo), scanner and Adobe photoshop program. Then, the files were modified and posted on the web by file transfer protocol(FTP). Finally, the program was demonstrated and once again revised by the result, and then completed. 2) For the evaluation of the program, 36 nurses who in K university hospital located in D city, and related questionnaire were distributed to them as well. Higher scores were given by the nurses in its learning contents with $4.2{\pm}.67$, and in its structuring and interaction of the program with $4.0{\pm}.79$, and also in its satisfactory of the program with $4.2{\pm}.58$ respectively. In conclusion, if the contents of this WBI educational program upgrade further based upon analysis and applying of the results the program evaluation, it is considered as an effective tool to implement for continuing education as life-long educational system for nurse.

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A Study of the Attitudes of Nursing Students toward Their Clinical Affiliation in a Mental Hospital (정신과간호 실습에 대한 간호 학생들의 태도 조사연구)

  • 김소야자
    • Journal of Korean Academy of Nursing
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    • v.3 no.3
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    • pp.15-26
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    • 1973
  • (Directed by Professor Hong, Shin Yong) Today, over seventy five Percent of the schools of nursing in Korea Provide a psychiatric experience in the basic curriculum. The psychiatric presents numerous major problems of adjustment to the student. The importance of positive attitudes toward the nursing care of psychiatric patients is recognized by the nursing profession. The purpose of this study was to determine the expressed attitudes of fifty-three nursing students toward their psychiatric affiliation. An attempt, also, was made to determine what implications these attitudes revealed relative to future program planning for students during the psychiatric nursing affiliation. A questionnaire, a Korean translation of the "psychiatric Nursing Attitude Questionnaire" by Milder Elizabeth Fletcher, was administered to fifty-three nursing students from three schools of nursing in Seoul, Who had completed a four-week psychiatric affiliation in a large mental hospital during Mar. 19, 1973 to May 19, 1973. The questionnaire of 100 statements was administered in the following way: (1) Part 1, Preconceptions. was. given in individual conferences with each subject, during the first few days of their affiliation, and again during the final week of the affiliation. The responses to Part Ⅰ were oral. (2) Part Ⅱ , Expectations, Part Ⅱ, Personal Relations, Part Ⅳ, Personal Feelings, and Part V , Attitudes and Activities of Patients were given to all of the subjects in a group meeting during the second week of the affiliation, and again. during the fourth week at the termination of the affiliation. Responses to Parts B, B, n, and f, wire written. Each of the 100 statements of the questionnaire was considered to be either Positive or Negative. A favorable response was assigned the Positive value of land an unfavorable response was assigned the Negative value of O. The coefficient of correlation was computed between the two sets of scores for the fifty-three nursing students., The mean score, the standard deviation, and the differences in the means on each of the five parts of the questionnaire were computed and the relationships calculated by a t-test. The results. of the study were as follows: 1. There was no significant correlation between the two sets of scores for the fifty-three nursing students during the four-week psychiatric affiliation. (r=573) 2. There was no significant difference in the mean scores between the first and final tests for any of the five parts of the questionnaire. 3. The Part.1, Preconceptions, data indicated nursing students enter the psychiatric affiliation with certain attitudes and preconceptions toward tile psychiatric affiliation which affect their psychiatric nursing experience, 4. The Part Ⅰ, Expectations, data indicated inappropriate expectations of students related to lack of experience, Lack of pre-psychiatric affiliation orientation, lack of social understanding, and feelings of insecurity. 5. The Part Ⅲ, Personal relations, data indicated some students have negative attitudes in personal relations with normal people in respect to psychological security and social responsibilities. 6. The Part Ⅳ, Personal feelings, data indicated nursing students have psychological insecurity & inappropriateness. 7. The Part Ⅴ, Attitudes and activities of patients, data indicated nursing students have negative attitudes of fear and frustration due to the psychotic behavior of certain patients in certain situations. 8. The data indicated preconceptions are predominate in unfavorable attitudes of students toward psychiatric nursing affiliation. Further researches indicated in the following areas: 1. Because of the limited number of students in this study, similar studies should be performed with larger groups for further validation of the results. 2. Because of the findings concerning the influence of the opinions of people in close contact with the students, similar studies of the attitudes of the staff in nursing schools, attitudes of graduate nurses and attitudes of the public should be done to determine weakness and strengths of present programs.

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The Optimal Pulse Oxygen Saturation in Very Low Birth Weight or Very Preterm Infants (극소 저체중 출생아에서 경피적 산소포화도의 적정 범위)

  • You, Sun-Young;Kang, Hye-Jin;Kim, Min-Jung;Chang, Mea-Young
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.320-327
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    • 2011
  • Purpose: To determine the effect of changing practice guidelines designed to avoid hyperoxia or hypoxia in very low birth weight or very preterm infants. Methods: We analyzed a database of <1,500 g birth weight or <32 weeks of gestation infants who were born and admitted to the neonatal intensive care unit of Chungnam National University Hospital from January 2007 to July 2010. First, we defined the relationship between arterial partial pressure of oxygen ($PaO_2$) and pulse oxygen saturation ($SpO_2$). When we evaluated 96 pairs of $PaO_2$ and $SpO_2$ measurements, oxygen saturation was 90-94% at a $PaO_2$ of 43-79 mmHg on the oxyhemoglobin dissociation curve, according to pulse oximetry. Based on this observation, a change in practice was instituted in August 2008 with the objective of avoiding hypoxia and hyperoxia in preterm infants with targeting a $SpO_2$ 90-94% (period II). Before the change in practice, high alarms for $SpO_2$ were set at 100% and low alarms at 95% (period I). Results: Sixty-eight infants the met enrollment criteria and 38 (56%) were born during period II, after the change in $SpO_2$ targets. Demographic characteristics, except gender, were similar between the infants born in both periods. After correcting for the effect of confounding factors, the rates for mortality, severe retinopathy of prematurity, and IVH attended to be lower than those for infants in period II. No difference in the rate of patent ductus arteriosus needed to treat was observed. Conclusion: A change in the practice guidelines aimed at avoiding low oxygen saturation and hyperoxia did not increase neonatal complication rates and showed promising results, suggesting decreased mortality and improvements in short term morbidity. It is still unclear what range of oxygen saturation is appropriate for very preterm infants but the more careful saturation targeting guideline should be considered to prevent hypoxemic events and hyperoxia.

Clinical characteristics of severe meconium aspiration syndrome (중증 태변흡입증후군의 임상적 특성)

  • Choi, Chang Won;Kim, Beyong Il;Lee, Hyun Ju;Joung, Kyoung Eun;Shim, Gyu Hong;Lim, In Suk;Lee, Jin-A;Kim, Ee-Kyung;Kim, Han-Suk;Choi, Jung-Hwan
    • Clinical and Experimental Pediatrics
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    • v.51 no.7
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    • pp.713-721
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    • 2008
  • Purpose : This study aims to describe the clinical characteristics of severe meconium aspiration syndrome (MAS) which required mechanical ventilation over 48 h and to delineate the progress of respiratory failure and radiographic findings in severe MAS. Methods : Twelve infants admitted to the Neonatal Intensive Care Unit (NICU) of the Seoul National University Bundang Hospital diagnosed with severe MAS from January 2004 to July 2007 were analyzed retrospectively. Results : The presence of persistent pulmonary hypertension of the newborn (PPHN) is the only independently significant risk factor for a longer hospital stay and longer duration of mechanical ventilation. Surfactant replacement therapy (SRT) was not randomized but only performed in infants with radiographic findings for respiratory distress syndrome (RDS). In the presence of radiographic findings for RDS, the duration of high-frequency oscillatory ventilation was significantly longer. PPHN developed in 8 infants (75%). The PPHN group had a significantly longer duration of mechanical ventilation. All infants who received SRT showed radiographic improvement within 12 h, but there was no significant change in the severity score during the same period. Infants without the PPHN complications showed significant decrease in the severity score within 12 h after SRT, whereas infants with PPHN complications did not. Conclusion : The clinical course of severe MAS differed significantly depending on the development of PPHN. SRT conferred radiographic improvement in infants who showed radiographic findings for RDS, but did not influence the clinical course of MAS significantly.

A study of quality of working life to dental hygienist's (치과위생사의 근로생활의 질(QWL)에 관한 연구)

  • Oh, Hye-Seung;Kim, Eun-Hee
    • Journal of Korean society of Dental Hygiene
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    • v.10 no.2
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    • pp.375-392
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    • 2010
  • Objectives : Dental hygienist's work satisfaction and stress affect the overall quality of work life(QWL). Therefore, this research is intended to suggest fundamental data to improve QWL by finding out characteristics of each work satisfaction and stress element. To this end, a total of 327 dental hygienists working at general hospitals, university hospitals, dental hospitals and dental clinics across Seoul, Gyeonggi and Incheon were surveyed. Results of survey are as follows. Methods : The collected data were analyzed by using an SPSS 12.0 statistical program, obtaining the following results. The collected data conducted a questionnaire survey for 327 dental hygienists who work at the hospitals, university hospitals, dental hospitals, and dental clinics located at Seoul, Gyeonggi-do, and Incheon district from January until March, 2009, and drew the conclusions as follows. Result : 1. Demographic characteristics, income from 1.5 to 1.99 million were the whole lot, more than 2 million to less than 1.5 million was similar. Marital status Married Unmarried higher than the atheist religion, Christianity, Catholicism, Buddhism, and other, respectively. Classification by level of education in the college graduate, university graduate, graduate diploma, respectively. 2. Are working in a job-related characteristics of dentistry, dental hospital, general and university hospital, respectively. The making in position, Mount, contractor, responsible, senior, was an intern in the order. The five-day workweek whether working at night and is not going to care whether the conduct was similar. Classification of working hours and 8 hours, 8 hours, 8 hours or less orderly, and total of less than 1-3 years of clinical experience, 5 years, less than one year, less than 3-5 years, respectively. 3. There comes out a significant difference according to age, income, position, gross clinical experience, and whether to put night shift into practice in job stability in terms of the quality subsequent to general characteristics(p<.05). 4. There comes out a significant difference according to marital status, one's place of work, position, whether to put a five-day workweek into practice in work environment and benefits package in terms of the quality subsequent to general characteristics (p<.05). 5. There comes out a significant difference according to age, marital status, income, position, and gross clinical experience in education & training and benefits packages in terms of the quality subsequent to general characteristics(p<.05). 6. There comes out a significant difference according to whether to put night medical treatment into practice in social usefulness in terms of the quality subsequent to general characteristics(p<.05). 7. There comes out a significant difference according to marital status, income, one's place of work, gross clinical experience, work hours, and whether to put a five-day workweek into practice in leisure activity in terms of the quality subsequent to general characteristics(p<.05). 8. There comes out a significant difference according to income, one's place of work, and position in wage level in terms of the quality subsequent to general characteristics(p<.05). 9. There was no significant difference in all items related to human relations and free communication in terms of the quality subsequent to general characteristics(p>.05). Conclusions : It is necessary to analyze factors related to work satisfaction and stress in order to improve dental hygienist's quality of work life. Hospitals must support them systematically and institutionally and related organizations must conduct practical research.

A Study on Sexual Function of Women with Coronary Artery Disease (관상동맥질환 여성의 성기능에 관한 연구)

  • Kim, Choon Shim;So, Hyang Sook
    • Korean Journal of Adult Nursing
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    • v.12 no.1
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    • pp.99-111
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    • 2000
  • The purpose of this study was to identify risk factors related to sexual function of women with coronary artery disease, and to determine the predictors of sexual function. The study design, a descriptive correlational study, was done through structural questionnaire and interview. A total of 50 subjects from C University Hospital at Kwang-ju city who have undergone coronary angiography at department of cardiology were observed and interviewed from Feb. 22, 1999 to March. 23, 1999. The number of affected vessels, the level of total serum cholesterol, and the ejection fraction of 2-D echo cardiography were analyzed to evaluate the severity of coronary artery disease. And also type A behavior pattern, health behavior, Brief Index of Sexual Functioning for Women (BISF-W) were measured. The data obtained were analyzed using percentage, mean and standard deviation, t-test, ANOVA, Pearson's correlation coefficient, and stepwise multiple regression analysis via SPSS PC+. The results of this study were as follows: 1. The mean age of the subjects were 58.1 and 72.0% of those have been married over 30 years. Seventy two percentage were unemployed and monthly family income of 56.6% was less than 1,000,000 won (approximately $ 840). Eighty percent were in their postmenopausal state, and the frequency of sexual intercourse of 84.0% were two to three times per month. 2. The scores of type A behavior pattern were from 16 to 38(mean 24.94) and health behavior ranged from 21 to 43(mean 31.2). Abstinence from smoking, alcohol, and caffeine were best compliant factors and weight control and exercise were least abided ones. The result of 2D-ECHO EF showed that the half of the subjects were abnormal, and 24% had more than 240mg/dl of total serum cholesterol. The coronary angiography showed that 64% of the subjects had more than one affected vessels. 3. The predictors to explain the factor score of 'orgasm' were number of health examination, the pre- or post-menopausal state, protestant, number of coronary vessel affected, level of serum total cholesterol, and comorbid group of hypertension and diabetes, and it's total variance accounted for 52.4%. The predictors to explain the factor score of 'sexual activity' were comorbid group of hypertension and diabetes and type A behavior pattern, which accounted for 22.4% of total variance. The predictors to explain the factor score of 'sexual satisfaction' were type A behavior pattern, no religion, exercise, level of serum total cholesterol, and pre or post menopausal state, which accounted for 52.1%. The predictors to explain the factor score of 'sexual desire' were the period of marriage, type A behavior, employment or unemployment, and weight control, which accounted for 43.2%. The predictors to explain the factor score of 'external force of sexual functioning' were physical overload and exercise, which accounted for 41.1%. The predictors to explain the factor score of 'sexual activity' were family monthly income, catholics, and exercise, and which accounted for 35.4%. Above results lead us to some consensus that sexual function of women with coronary artery disease is related to various factors including vasogenic factors such as total serum cholesterol level, number of coronary vessel affected, an endocrinal factor such as menopausal state, and type A behavior pattern as a sociopshychological factor. And also health behaviors such as fitness care, overwork, weight control, and emotional tension are contributed to sexual function.

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A Study of the Effect, Safety and Saving Expense by Reusing Hemodialyzer (재사용(再使用) 투석기(透析器)의 효과(效果) ${\cdot}$ 안정성(安定性) 및 비용절감(費用節減)에 관한 연구(硏究))

  • Jung, Ha-Chung
    • Journal of Korean Academy of Nursing Administration
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    • v.3 no.1
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    • pp.93-106
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    • 1997
  • By the increase of the rate of existence of the hemodialyzing patients, they were required the long run treatment. Regardless of medical insurance expansion, hemodialyzing cost much expenses so that hospital has been considering the reuse of hemodialyzer and flowing euqipments along with the diverse study and progress of the ways of hemodialyzing and medical instruments. This study was aimed to provide the basic materials regarding the reuse of hemodialyzer which is used for the patients of chronic renal disease. The reusing program in the artificial kidney center of K hospital has been used for this study from 50 patients aften one year result from Sep. 1995 through Aug. 1996. Automatic equipment of DRS-4 made by Seratronic Co., was used as the equipment and it was retreated with the function test simultaneously. Compliaction and confirmation of the infection were by the records of the hemodialysis of the patients. SPSS was used for the analysis of the materials by computerization. The character of the patients and the rate of removal was by mistake and percentage, function test and rate of complication by Ftest(ANOVA) and the rate of complication per items by ${\chi}^2$ and Ftest. As the post test the Duncan's test was used for the statistically significant different variables in the standard of p<.05 after Ftest. The followings are the summary of the result : 1) In the function test of the new hemodialyzer and the reused one, and in all of CA110 and CF15.11, the dialyzer ultrafiltration coeffient(KUf) was appeared to have been higher in the reusing groups than the first use ones. This has been the normal limit showing no troubles with them. 2) In the function test of the new and reused hemodialyzer, in all of CA110 and CF15.11, the total blood volume was appeared to have been the less value in the reuse groups than the new ones. This was the price within 80% of the first price that both showed possible for use. 3) The result of reuse hemodialyzer of CA110 was $29.48{\pm}7.83$ in average in the test of leak test while $17.3{\pm}7.96$ in reuse of CF15.11. The normal limit of <60 was the leak test result. So both of the hemodialyzer was normal for reuse. 4) The rate of removal of Blood Urea Nitrogen(BUN) was 72.25% in CA110 hemodialyzer by reusing 16-20 times as the highest rate showing the better result in the reuse hemodialyzer, while in CF15.11 hemodialyzer showed 71.16% by highest rate in the first use by the highest rate with no difference from the reuse. 5) The rate of removal of serum creatinine of CA110 was 64.08% by highest rate in reuse of 1-5 times by showing better result in reuse hemodialyzer. While in CF15.11 66.47% the highest by reuse of 16-20 times showing no difference from each other. 6) No patients were admitted or precribed by antibiotics in relation with reuse dialyzer and no reports were shown about hepatitis $B{\cdot}C$. AIDS in fection. 7) Of the total 248 episods of complication due to the hemodialyzing, 86 by first use, 73 by 1-5 times, 35 by 6-10 times, 35 by 11-15 times and 19 by 16-20 times have been shown which have had no significant difference between the groups. 8) In the comparison of the expense for the hemodialyzer, there was the effect of saving 11,597.6 Won between the first and reuse hemodialyzer. And by decreasing the extracted materials, they did the great role of disposing the waste matters.

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The Effects of Clinical Application of a Nursing Diagnosis Protocol (간호진단 프로토콜(Protocol)의 임상적용 효과에 관한 연구)

  • 이향련;조미영;조결자;김윤희;김귀분;김광주;문희자;박신애;강현숙
    • Journal of Korean Academy of Nursing
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    • v.19 no.1
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    • pp.40-62
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    • 1989
  • This study was conducted to measure the effects of clinical application of a Nursing Diagnosis Protocol. The dependent variables were the degree of patient's satisfaction and the degree of nurse's satisfaction with the nursing activity. Analysis of the effect of the use of the nursing diagnosis protocol was based on the nursing record. The subjects for this study were 61 nurses(experimental group 31, control group 30) and 155 patients (experimental group 55, control group 100) on four internal medicine wards in K University Hospital in Seoul. Data collection was done from August to October 12,1988. The results obtained in this study can be summarized as follows, 1, Effect of the clinical application of the nursing diagnosis protocol. 1) The first hypothesis ; “nurses who use the nursing diagnosis protocol will have higher degrees of satisfaction than those who use traditional methods” was rejected (t=.54, df=58, p=.59). 2) The second hypothesis ; “patients nursed by nurses using the nursing diagnosis protocol will have higher degrees of satisfaction than those nursed with traditional methods” was supported(t=1.93, df=154, p=.05). 3) The third hypothisis : Major hypothesis ; “the nursing records of the experimental group, who used the nursing diagnosis protocol, will be more detailed than those of the control group” was supported (t=6.40, df=79.90, p=.000). (1) The first subhypothesis ; “The recorded data collection of the experimental group will be more detailed than that of the control group” was rejected (t=1.79, df=118, p=.07). (2) The second subhypothesis ; “The recorded patient's problem statement of the experimental group will be more detailed than that of the control group”, was supported. (3) The third subhypothesis ; “The nursing record of the experimental group will be more convenient for implementation than that of the control group” was supported. 2. Factors related to the nurse's degree of satisfaction with protocol. 1) No general characteristics(age, religion, education level, duty career, present duty career) were related to the nurse's degree of satisfaction. 2) Variables related to the nurse's degree of satisfaction were “satisfaction as a nurse” and “consider nursing as lifelong job” (t=-2.6, df=13.22, p=.02, t=2.41, df=23.85, p=.02). 3. Factors related to the patient's degree of satisfaction. 1) General characteristics related to the patient's degree of satisfaction with nurses using the protocol were age, educational level, and being married.(F=5.17, df=3/153, p=.00, t= -2.39, df=154, p=,01, f=5.91, df=2/153, p=.00) 2) The variables previous hospitalization, duration of hospitalization, the hospital unit presence of a relative, medical insurance, or medical diagnosis were not related to the patient's degree of satisfaction. 1. The experimental group's nursing record was more detailed than the control group's record with regard to the physical and psychological state of the patients. As noted above, the experimental group nurses, who use a nursing diagnosis had protocol were less satisfied than the control group who used traditional methods of the recording, but experimental group patients had a higher degree of satisfaction than the control group patients. The nursing records of experimental group, using the nursing, diagnosis protocol was more detailed than that of the control group. If the nursing diagnosis protocol is used in clinical nursing practice, the quality of nursing care may be improved.

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