• 대한감각통합치료학회지
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• 제19권1호
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• pp.39-53
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• 2021

목적 : 체계적 문헌고찰을 통해 섭식장애가 있는 아동의 질환에 따른 연하장애를 증상별로 세분화하고 증상에 따른 치료방법을 알아보고자 한다. 연구방법 : 데이터베이스는 PubMed, Medline, CINAHL을 통해 검색하였다. PRISMA, PICOS를 이용하여 연구를 선정하고 체계적 고찰을 시행하였다. 최종적으로 연구에 사용한 문헌은 총 13개로 연구의 질적수준, 질환군, 평가도구, 중재방법, 중재 후 효과에 대해서 분석하였다. 결과 : 총 13편의 연구를 분석한 결과 섭식장애가 있는 아동의 질환군은 자폐스펙트럼장애(Autism Spectrum Disorder; ASD)는 6편(46.15%), 뇌성마비(Cerebral Palsy; CP)는 7편(53.85%)으로 나타났다. 섭식장애 중재를 받은 아동의 연령대는 ASD는 2-8세, CP는 12개월-18세까지로 확인하였다. 평가영역에서 ASD는 행동평가, CP는 구강과 삼킴기능 평가영역이 가장 많았다. 중재방법에서 ASD는 행동수정이 가장 많았고, CP는 구강감각운동, 음식질감조절, 전기자극치료가 각각 동일한 빈도로 적용된 것으로 나타났다. 중재 후 치료효과에서는 모두 효과가 있었다. 결론 : 본 연구에서 섭식장애가 있는 아동의 질환군, 적용되는 평가도구, 중재방법을 고찰을 통해 알아보았다. 본 연구가 질환에 따른 평가와 중재 선택 시 임상가들이 시행착오를 거치지 않고 효율적인 섭식장애 중재를 적용할 수 있는 프로토콜 개발을 하는데 기초자료로 활용될 수 있을 것으로 기대한다.

• 대한두개안면성형외과학회지
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• 제24권3호
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• pp.111-116
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• 2023

Background: In Indonesia, the prevalence of cleft lip and palate increased from 0.08% to 0.12% between 2013 and 2018. Children with cleft deformities typically undergo staged surgery. However, the coronavirus disease 2019 (COVID-19) pandemic has had negative impacts on the healthcare sector, including the suspension of elective procedures; this has raised concerns about the safety of performing surgery and the functional consequences of delaying treatment, the latter of which is associated with poor prognosis. The purpose of this study was to report the characteristics of clefts treated by the Bandung Cleft Lip and Palate Center team during the pandemic period. Methods: This brief comparative study based on a chart review was conducted at the Bandung Cleft Lip and Palate Center. We statistically evaluated data from all patients treated between September 2018 and August 2021. Frequency analysis was performed to analyze the average number of each procedure by age before and during the COVID-19 pandemic. Results: Data from 18-month periods before (n= 460) and during (n= 423) the pandemic were compared. Cheiloplasty procedures were examined (pre-pandemic, n= 230; pandemic, n= 248); before the pandemic, 86.1% were performed according to the treatment protocol (patient < 1 year old), and this proportion non-significantly dropped to 80.6% during the pandemic (p= 0.904). Palatoplasty procedures were also compared (pre-pandemic, n= 160; pandemic, n= 139); the treatment protocol (patient 0.5-2 years old) was followed for 65.5% of procedures before the pandemic and 75.5% during the pandemic (p= 0.509). Additionally, 70 (mean age, 7.94 years) revision and other procedures were performed before the pandemic and 36 (mean age, 8.52 years) during the pandemic. Conclusion: The cleft procedures performed at the Bandung Cleft Lip and Palate Center did not significantly change during the COVID-19 pandemic.

• 한국식품위생안전성학회지
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• 제28권1호
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• pp.69-74
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• 2013

본 연구는 식초절임 무의 HACCP (Hazard Analysis Critical Control Point)시스템 구축을 위하여 생물학적 위해요소분석을 위한 목적으로 2012년 2월 1일~6월 31일까지 약 150일 동안 수행하였다. 일반적인 식초절임 무 제조업체의 제조공정을 참고로 하여 공정도를 작성하였으며, 식초절임 무의 원료 농산물(무), 용수, 첨가물과 포장재료에 입고, 보관, 정선, 세척, 표피제거, 절단, 선별, 충진, 내포장, 금속검출, 외포장, 보관 및 출하공정에 대하여 작성하였다. 원료 무의 세척 전, 세척 후의 Coliform group, Staphylococcus aureus, Salmonella spp., Bacillus cereus, Listeria Monocytogenes, E. coli O157:H7, Clostridium perfringens, Yeast 와 Mold를 측정한 결과 Bacillus cereus는 세척 전 $5.00{\times}10$ CFU/g이었으나, 세척 후 검출되지 않았으며, Yeast 와 Mold 는 세척 전 $3.80{\times}10^2$ CFU/g, 세척 후 10 CFU/g로 감소되었으며 나머지 병원성균은 검출되지 않았다. 조미액의 pH(2~5)별 미생물의 변화를 시험한 결과 모든 균이 검출되지 않은 pH 3~4를 조미액의 pH로 결정하였다. 작업장별 공중낙하균 (일반세균수, 대장균, 진균수) 시험결과 내포장실, 조미액가공실, 세척실, 보관실의 미생물수는 10 CFU/Plate, 2 CFU/Plate, 60 CFU/Plate 그리고 20 CFU/Plate 가 검출되었다. 종사자 손바닥 시험결과 일반세균수 346 $CFU/Cm^2$, 대장균군 23 $CFU/Cm^2$로 높게 나타나 개인위생관리에 대한 교육 및 훈련이 요구 되었다. 제조설비 및 기구의 표면오염도를 검사한 결과 모든 시료에서 대장균군은 검출되지 않았고, 일반세균은 PP Packing machin과 Siuping machine (PE Bulk)에서 가장 많은 $4.2{\times}10^3CFU/Cm^2$, $2.6{\times}10^3CFU/Cm^2$ 검출되었다. 위의 위해분석 결과 병원성미생물을 예방, 감소 또는 제거할 수 있는 조미액 가공 공정이 CCP-B (Biological)로 관리되어야 하고, 한계기준은 pH 3~4로 결정하였다. 따라서 전통한과생산에의 HACCP 모델 적용을 위한 미생물학적 위해도 평가에서와 같이 조미액 가공 공정의 관리기준 및 이탈시 조치방법, 검증방법, 교육 훈련과 기록관리 등 철저한 HACCP 관리계획이 필요할 것으로 생각된다.

• Journal of Preventive Medicine and Public Health
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• 제5권1호
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• pp.97-104
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• 1972

For the purpose of ascertaining the status of physical growth and health status of the University Students, an intensive survey was conducted by the authors towards a total of 1,250 (Male 792, Female 458) who passed the written entrance examination at the Kyung Hee University in 1972. The items included the measurements on physical growth, various physical and nutritional indices, status of visual distourbance, dental status and tuberculosis. The findings and results cad be summarized as follows; 1. Physical Growth and Develspment. i) The average of body height by anthropometric was $169.39{\pm}5.05cm$ in male and $157.45{\pm}4.43cm$ in female. ii) The averages of body weight by sex were $59.42{\pm}6.47Kg\;and\;51.81{\pm}5.21Kg$, respectively. iii) The averages of chest-girth were $87.18{\pm}5.30cm\;and\;80.51{\pm}4.53cm$. iv) The averages of sitting-height were $92.21{\pm}2.79cm\;and\;86.28{\pm}2.57cm$. In all cases the male measurements were higher than female. 2. Various ludices about Physical Growth and Development; i) Relative body weights by sex were 35.08 and 32.91, relative chestgirth 51.47 and 51.13, and relative sitting-height 54.43, 54.79, respectively. ii) Rohrer index was 1.222 in males and 1.327 in females, Kaup index 2.071 and 2.089, Verveck index 86.54 and 84.04, and Pelidisi index 91.15 and 93.08, respectively 3. Status of visual distourbance The vision of the students under 0.8 with Landolt's testing chart was 45.4% in left eye and 46.6% in right eye(male: 44.4% and 45.7%, female: 47.2% and 48.0%), while under 0.6 in both visions was 41.0% and 40.5% (male: 40.8% and 40.7%, female: 41.5% and 40.2%), respectively. 4. Dental Status Out of total 19.4% (male 19.2%, female 19.6%) had gingivitis, the female incidence rate of gingivitis was higher than male. Average number of teeth in each subject was 29.6 teeth: male had 29.9 teeth and female had 29.1 teeth. The caries rate was 78.9%(male 75.6%, female 84.5%), the female caries rate was higher than male. Total filing per subject was 35.6% (male 34.0%, female 37.1%), female incidence was higher shan male. The average number of i) Caries per tooth rate was 8.5% in male and 9.2% in female, ii) Missing per tooth rate was 0.3% and 0.2%, iii) Filling per tooth rate was 3.9% and 4.2%. in all cases, the female incidences were higher than the male. The average number of D.M.F. was 3.8 teeth in male and 4.0 teeth in female, female was higher than male. The average rate of D.M.F. was 12.7% in male and 13.7% in female, female was higher than male. 5. Pulmonary infiltration Among the total, 53 students were diagnosed as pulmonary infiltration (tuberculosis), of whom 51 were minimal cases, one were moderately advanced case and one were far advanced case.

• 대한불안의학회지
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• 제15권2호
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• pp.61-67
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• 2019

Objective : This study aimed to investigate the general process from the symptom onset to the psychiatric treatment in Korean panic patients and the effect of improved public awareness on it. Methods : This study has a retrospective design. The subjects were the new patients with panic disorder who visited the psychiatric outpatient clinic in twelve university-affiliated hospitals all across Korea. The medical chart was reviewed retrospectively and the data were collected including chief complaints of symptoms, recent stressors, the time to visit the psychiatric outpatient clinic, and visit of other departments and diagnostic approaches for their symptoms. Results : A total of 814 participants were included in the study. The most common department other than psychiatry the panic patients visited were cardiology (28.3%), general internal medicine (16.0%) and neurology (11.4%). The most frequently used diagnostic tests were a echocardiography (17.9%), 24-hour Holter monitoring (11.2%), and brain MRI (8.2%). Only 37.3% of participants visited psychiatric clinic directly. About 80% of participants visited psychiatric department within 1 year after their first panic symptoms and it took $13.8{\pm}13.7weeks$ on average. Comparing before and after 2012, the number of participants increased who visit directly the psychiatric clinic without visiting other departments (p=0.002) and without visiting emergency room (p<0.001). Conclusions : Our results suggest that a substantial number of patients visit departments other than psychiatry when they experience first panic symptoms. However, most patients begin psychiatric treatment within 1 year after their first symptoms and the number of patient are increasing who visit psychiatric department directly without visiting other departments.

• Clinical and Experimental Pediatrics
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• 제49권5호
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• pp.482-488
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• 2006

목 적 : 신생아의 첫 태변 및 초뇨 배출 시간은 건강 상태의 양호한 정도를 나타내는 표지이다. 첫 태변 배출 시간과 초뇨 배출 시간에 영향을 미칠 수 있는 여러 인자들에 대해 조사하고 이를 비교 평가 분석함으로써 그 임상적 의의를 비교 관찰하였다. 방 법 : 2004년 11월부터 2005년 4월까지 본원에서 분만된 재태 연령 34주 이상의 신생아 1,221명을 대상으로 하였다. 모체의 인구학적 변수(모체 연령, 분만력, 분만 방법, 양수의 태변 착색 여부, 그리고 모체 당뇨 여부)와 영아의 변수(성별, Apgar 점수, 재태 연령, 출생 체중, 첫 24시간 동안의 수유 유형, 첫 수유 시 연령, 출생 후 12시간까지 수유 횟수, 퇴원 시 연령, 첫 번째 배뇨 시 연령, 첫 번째 태변 배출 시 연령)에 따른 태변 배출 및 초뇨 배출 시간을 비교 분석하였다. 결 과 : 본 연구에서, 58.8%가 12시간 이전에, 95.3%가 24시간 이전에, 99.8%가 36시간 이전에 초뇨가 배출되었다. 그리고 68.3%가 12시간 이전에, 95.8%가 24시간 이전에, 98.3%가 36시간 이전에 태변이 배출되었다. 미숙아와 만삭아를 비교하였을 때 초뇨 배출시 연령은 각각 $6.5{\pm}5.8$시간, $12.1{\pm}6.6$시간이었고(P=0.000), 첫 태변 배출시 연령은 각각 $20.7{\pm}13.5$시간, $10.0{\pm}6.3$시간(P=0.000)으로 미숙아의 경우에 초뇨가 더 빨리 배출되고 태변이 더 늦게 배출되는 경향을 나타냈다. 수유를 빨리 시작한 경우에 초뇨나 첫 태변 배출 시간이 통계학적으로 유의하게 더 빨랐다. 출생 후 첫 12시간 동안의 수유 횟수는 초뇨 배출 시간과는 큰 상관이 없었다(P=0.778). 수유 횟수가 많을수록 24시간 이내에 첫 태변을 배출한 영아가 더 많았으며 이는 통계학적으로 유의하였다(P=0.000). 분만 방법(질식 분만, 수술 분만), Apgar 점수, 출산력, 성별, 수유 유형, 모체 당뇨 여부 등은 초뇨 배출 및 첫 태변 배출시 연령과는 통계학적으로 유의성은 없었다. 결 론 : 재태 연령, 출생 체중, 초기 수유 시작 시간이 초뇨 및 첫 태변 배출 시간과 연관성이 있는 것으로 보여지며, 초뇨 및 태변 배출의 지연을 보일 경우 동반되는 이상 증상의 유무에 대한 면밀한 관찰 외에도 상기 요소들에 대한 사항을 고려하여 성급하고 불필요한 임상 검사 및 치료는 피해야 할 것으로 사료된다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제9권1호
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• pp.13-25
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• 1998

본 논문에서는 부모학대의 주이유가 무엇보다도 가족내 역동과 정신병리에 있다고 생각되어, 부모학대를 주소로 입원한 청소년들을 대상으로 임상적인 소견과 병력을 심도 있게 알아보고, 그 저변에 있는 정신병리와 가족역동, 특히 모자관계를 중심으로 알아보았다. 국립서울정신병원내의 1987년부터 1997년까지 입원한 환자중 부모에게 신체 공격 또는 신체적 위해를 가하겠다는 언어적, 비언어적인 위협을 가한 환자중 정신증, 기질적인 뇌질환, 자폐아, 정신지체아동을 제외한 21명 환자의 면담과 병록지 검토를 통하여 대상 청소년들에 대한 고찰을 하였다. 부모학대로 입원한 21명의 환자중 남자 14명, 여자 7명으로 진단은 품행장애, 경계선 인격장애가 가장 많았으며, 평균 연령은 10대 중반이었다. 가족역동과 발달병리상 4개의 소집단으로 나눌 수 있었다. 1) 어머니와의 공생적인 관계군；(1) 어머니와 공생적인 관계에서 분리되지 않은 상태로 청소년 시기를 맞이하였고, 아버지의 정서적. 실제적 부재상태에서 어머니의 가정내 유일한 남자인 환자에 대한 과도한 밀착이 두드러졌다. 제2차 분리개별화시기인 청소년을 맞이하여 어머니와의 갈등적 관계에서 오는 내적 긴장감과 분노를 표현함과 동시에 나름대로 분리를 획득하고자하는 시도로서 어머니를 향한 신체적 공격을 이해할 수 있겠다. (2) 이 환자들은 탄생 이후부터 중한 질환과 발육부진으로 부모의 과잉보호로 공생적 관계에 머물며 유아적인 전지전능감, 힘에 대한 환상의 비현실적인 감각을 제대로 처리하지 못하고 현실적응을 못하고 부모에게 과도하게 의존하고, 자신의 요구가 충족되지 않으면 쉽게 과격행동으로 표출하였다. 2) 경계선 인격장애군：이들은 양육상의 적절한 모성의 결핍과 부모자체의 성격상의 문제와 미숙함으로 의존성이 조장되고 분리가 방해받아 발달상 재접근시기에 머물고 있었다. 제2차 분리개별화시기인 청소년기를 맞이하여 의존과 독립에 관한 그들의 위기 갈등이 되살아나고, 이 갈등의 표현으로 부모학대가 일어났다. 3) 품행장애군：이들은 부모와 기본적인 애착관계를 형성하지 못하였고, 부모의 존재는 이들에게 단지 자신의 필요 충족의 대상이었다. 환자 자신의 전지전능한 요구가 충족되지 못하고 갈등 상황에 빠졌을 때 공격성과 충동 조절 능력의 결여 상태에서 부모를 향한 폭력을 행사하게 된 것으로 이해된다.

• Pediatric Infection and Vaccine
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• 제23권3호
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• pp.172-179
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• 2016

목적: Bacillus cereus 는 암환자들에서 기회감염을 일으킬 수 있다. 2013년에서 2014년 기간 동안 삼성서울병원 소아 암 병동에서 B. cereus 균혈증의 급격한 증가가 관찰되었다. 이에 증가된 B. cereus 균혈증에 대해 분자역학적 연구를 시행하였다. 방법: 2001년 1월부터 2014년 6월까지의 기간 동안 B. cereus 균혈증이 발생한 소아 암 환자들을 확인하였다. 이번 연구에서 B. cereus 균혈증은, 오염여부와는 상관없이, 혈액배양검사에서 적어도 한번 이상 B. cereus 가 확인된 경우로 정의하였다. 획득 가능한 균주들에 대해 multilocus sequence typing (MLST) 분석을 시행하였고, 후향적 챠트 리뷰를 실시하였다. 결과: 연구 기간 동안 총 19명의 B. cereus 균혈증 환자가 확인되었다. 그러나, 2013년도에는 B. cereus 균혈증 환자가 급격하게 증가하였다. 또한, 응급실 공사 중이던 2013년 7월의 1주, 2013년 10월의 한주 동안 각각 3명의 환자가 발생하였다. 그러나 MLST 분석상 일정한 패턴이 없는, 다양한 sequence types (STs)들로 확인되었다. 2013년 이전의 5개의 균주들의 ST는 ST18, ST26, ST177, ST147-like type, ST219-like type이었고, 2013년도의 균주들의 ST는 ST18, ST73, ST90, ST427, ST784, ST34-like type, ST130-like type으로 확인되었다. 고찰: MLST 분석상 B. cereus 균주들의 다양한 ST 분포가 확인되었다. 이번 연구에서 단일 ST의 B. cereus 에 의한 균혈증 발생의 가능성은 낮아보인다.

• 대한간호학회지
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• 제29권4호
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• pp.929-939
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• 1999

The purpose of this study was to identify knowledge of universal precautions and its performance in practice. The research was conducted from November 2 to 30, 1998. A total 515 student nurses ; 249 from a baccalaureate nursing college and 266 from second and third year of a 3-year community nursing college were surveyed. The results are as following : 1. The average score for universal precautions knowledge was 270.41$\pm$19.43/300(range 150-300). The results showed that 99.2% of students avoid injury from used needles, 98.6% answered that they always wash their hands if they had contact with the patient's blood and they always dispose of used needles in special collectors (97.7%) for needles. But, 39.2% responsed that they dispose of used needles after recapping them. 2. The average score for universal precautions knowledge of the senior students in the 4-year college was the highest (277.65$\pm$13.99). 3. The average score for the performance of universal precautions knowledge was 53.18 $\pm$5.91(range 14-70). The items : ‘I cautiously avoid injury from the used needles’(4.92$\pm$0.33), ‘I always wash my hands if there has been contact with the patient's blood’(4.91$\pm$0.34), and ‘I always disposed of used needles in the appropriate collector’(4.89$\pm$0.42) showed the highest performance. However ‘I always dispose of used needles after recapping them’(2.19$\pm$1.39) and ‘I always use protection goggles when in danger of contamination’(2.19$\pm$1.20) showed low performance level. 4. The highest average score for universal precautions performance was shown among the second year students in 3-year nursing college (54.19$\pm$6.92) between the groups. It showed that the level of the universal precautions performance was higher for those who had education on university precautions prior to performance of the universal precautions than for those without any prior education. 5. The percentage of students who reported the experience of direct contact with patients' blood and/or body fluids was 42.30%. The experience of direct contact with blood and/or body fluids of the educational group was significantly higher than those were not educated. 6. The most frequent cause of the direct contact was ‘needle pricking and/or skin cut’(63.04%). The most frequent substance with which the students contact was ‘blood’(59.85%). The majority of the sample had answered that the mode of contamination was ‘unknown’(63.54%). The majority of the sample answered that strategies used after contamination included ‘washing with soap’(33.61%). Reviewing the chart of patients or asking other health professionals(28.85%). 7. The number of students who had the experience of a needle stick and/or skin cut was 145(28.16%). The clinical practice places where the incidents occurred were mainly in the internal medicine unit (45.07%) and the surgical unit (31.92%) followed by the intensive care unit and the emergency unit in order. The experience of a needle stick and/or skin cut happened during on intra-muscular injection 47.34% and intravenous injection 21.81%. The causes of the needle stick and/or skin cut were ‘putting the needle cap back on 77(35.81%)’. The number of students who took an appropriate post management blood test and/or vaccination was 27(18.62%). 8. The Pearson Correlation Coefficient between the knowledge of universal precautions and performance of universal precautions in practice showed a positive correlation.

• 대한간호
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• 제34권5호
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• pp.52-67
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• 1996

As home care in developing and becoming part of the health care delivery system in Korea, it is necessary to examine the use of nursing diagnoses and related nursing interventions with a view to increasing the standardization of nursing recording. This study was done to examine the nursing diagnosis and related nursing interventions used in home care. Data were collected using a chart review of the nursing notes written for the home care given to 38 patients who had pulmonary diseases or traumatic brain or spinal cord injuries and who had received home care as part of a demonstration home care project in a college of Nursing in Seoul. Early on in the project discussions as to format and use to nursing diagnosis was done and a tool was developed based on Gordon's eleven functional catergories with the addition of categories to cover family and environment. This tool was used in the data collection. Data included nursing diagnosis, etiologies and interventions. Real numbers and percentages were used in the analysis. The results show that the most frequently used diagnoses were in the category of physical function (75.6%), followed by the category of emotional and social function (21.8%). The least frequently used category was the one for family and environment (2.6%). The order of the frequency of recorded nursing interventions was the same, 82.3% for physical function, 16.2% of emotional and social function and 1.5% for family and environment. Under the category of physical functioning the most frequently used nursing diagnoses were related to mobility (62.2%), nutrition (23.6%) and elimination (11.9%). The frequencies of nursing interventions for these three diagnostic categories were 69.8%, 16.0% and 10.8% respectively. For emotional and social functioning, the most frequently used diagnoses were for cognition-perception (37.1%), self-perception (30.6%) and perception of health (23.7%). The ordering of the frequency of nursing interventions varied slightly. The most frequently used interventions were for the category of self-perception (31.7%) followed by cognition-perception (24.1%) and perception of health (22.9%). Looking at individual diagnoses, it was found that within the categroy of physical functioning, the most frequently used diagnosis was "impaired physical mobility" (29.5%) and this diagnosis involved 43.9% of the interventions. This was followed by "ineffective breathing pattern" (19.4%) with 17.7% of interventions, and "alteration in nutrition, less than body requirements" (11.2%) with 8.1% of the interventions. For the emotional social category, noncompliance was the most frequently used nursing diagnosis (18.2%) with 19.2% of the interventions. This was followed by "anxiety" (13.4%) with 13.6% of the interventions and by "knowledge deficit" (13.4%) but with only 5.5% of the interventions. The other diagnoses and interventions did not follow this pattern of frequency. Although there were a large number of diagnostic and intervention events, the number of actual diagnoses and interventions used were relatively small ranging from six interventions for "knowledge deficit" to 40 interventions for "imparied physical mobility". From this it can be concluded that the results of this study could be used as basic data for the development of standardized charts with respect to nursing diagnosis and interventions for clients with pulmonary disease and clients with traumatic brain or spinal cord injuries. Interventions that were direct care activities (1178) were much more frequent that education (430), and assessment and observation (148). There were also few diagnoses or interventions related to the family and the environment. This suggests two areas that need to be developed in home care and that need to be considered in the development of standardized records for use in home care.