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The Effects of Near Miss and Accident Prevention Activities and the Culture of Patient Safety Management for the Patient Safety (Near Miss 사고 예방 활동과 환자안전관리 문화형성이 환자안전에 미치는 영향)

  • Chang, Ho-Suk;Lee, Gui-Won
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.138-144
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    • 2010
  • Purpose: Despite the rapidly changing healthcare environment, healthcare organizations have recognized the importance of patient safety management. But patient safety management has the problem of the lack of participation of members due to the process of focusing on the follow-up service and punishment. The department of nuclear medicine in Uijeongbu St. Mary's Hospital started this research to reduce the near miss and prevent patient safety accidents by both initiating the participatory near-miss-proof activities as an advance management and constructing a system without disadvantages of reporting. In addition, this research aims to establish a differentiated patient safety management system in the department of nuclear medicine. Materials and Methods: 1. Colleting cases of team members' past and present near miss and accidents(First data collection). 2. Quantifying the cases of near miss and accidents after identifying the degree of importance and urgency through surveys(Second data collection). 3. Quantifying cases and indentifying important points of contact through data analysis. 4. Making and standardizing a manual for important points of contact, and initiating participatory activities to prevent errors. 5. Activating web-based community for establishing the report system of near miss. 6. Estimating the result of before and after activities through surveys and focus group interviews. Results: 1) Quantified safety accidents and near miss in the department of nuclear medicine. About 50 near misses a month and one safety accident a year. 2) Establishing improvement measurements based on quantified data. About 11 participatory activities, the improvement of process, a manual for standardization. 3) Creating a system of safety culture and high participation rate of team members. Constructing a report system, making a check list and a slogan for safety culture, and establishing assessment index. 4) Activating communities for sharing the information of cases of near misses and accidents. 5) As the result of activities, the rate of near miss occurrence declined by 50% and the safety accident did not happen. Conclusion: The best service in the department of nuclear medicine is to provide patients with safety-guaranteed high-quality examination and cure. This research started from the question, 'what is the most faithful-to-the-basics way to provide the best service for patients?' and team members' common answer for this question was building a system with participation of all members. Building a system through the participatory improvement activities for preventing near miss and creating safety culture resulted in the 50% decline of near miss occurrence and no accident. This is a meaningful result from the perspective of advance management for patient safety. Moreover, this research paved the way for creating a culture to report and admit near miss or accidents by establishing a report system with no disadvantage of reporting. The system which sticks to the basics is the best service for patients and will form a patient safety culture system, which will lead to the customer satisfaction. Therefore, all members of the department of nuclear medicine will develop a differentiated patient safety culture with stabilizing the established system.

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A Study on Need Assessment in Health Promotion Programs for Developing Nursing Centers - Breast Self Examination- (간호센타 개발을 위한 건강증진 프로그램 요구사정 연구-유방자가검진 프로그램을 중심으로-)

  • Park, In-Hyae;Kang, Hae-Young;Lee, Jeong-Hee;Ryu, Hyun-Sook
    • Research in Community and Public Health Nursing
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    • v.11 no.1
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    • pp.21-36
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    • 2000
  • The purpose of this study was to assess the needs of breast self examination education (BSEE) programs for developing nursing centers. A first, we reviewed the literature of activity and management-related factors of nursing centers: and, second. we used a questionnaire to discover the degree of knowledge, attitude, and practice on breast cancer, as well as an individual's intention to participate BSEE program. 1. Reviewing the literatures of nursing center activities. Nursing centers which were administered by a professional nurse are an ideal site for faculty and student practices. With the use of nursing models of health. professional nurses in nursing centers diagnose and treat human responses to potential and actual health problems and offer holistic, client-centered health service. In nursing centers professional nursing services include health education, health promotion, and health-related research. A nursing center is comprised of the advisory and exacutive commitee; the advisory commitee serves consultants and links community needs to the nursing center, while the director of the exacutive commitee identifies the potential resources to generate funds, support, and facilitate the activities of staffs in a nursing center. Nursing centers mobilize various financal resources for reimbursement of services from college and insurance companies, collect minimum service fees from the client, and further collect fees for providing programs to community groups, this also includes membership fees, and donations. The services provided by nursing centers focus on services related to primary prevention, health maintenance & health promotion, direct nursing care for acute & chronic diseases, and holistic care for actual and potential health problems. The client satisfaction for the services was high. Students also showed positive reponses for their clinical experiences and independent working conditions. 2. The degree of knowledge, attitudes, and practices for breast cancer. and an individual's intention to participate in the BSEE program. The subjects of this study were 308 females in K-city in the Republic of Korea. Data were collected using a self-administered questionnaire. The mean age of the respondents was 35.0 years old. Those who already participated in the BSEE were 64.9%, and those who had support and encouragement to practice BSE from significant others were 25.1 %. Clients intent to participate in the BSEE were 37.0%. The mean score of knowledge(2.4 out of 5 points) and practices(1.8 out of 5 points) for breast cancer were quite low, but the mean score of attitudes was relatively positive04.5 out of 20 point) for breast cancer. Those who already had BSEE showed significantly high scores in knowledge(t=6.48, p<0.01), attitudes (t=10.54, p<0.01). and practices(t=57.07, p<0.001) for breast cancer than those who had not participated in the BSEE. In all age groups no intention to participate in the BSEE was higher than who the intention to participate. These findings suggest some strategies should be developed to increase the awareness of breast cancer's early detection.

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A Study of Home Care Needs of Patients at Discharge and Effects of Home Care -Centered on Patients Discharged from a Rural General Hospilal- (퇴원환자의 가정간호요구와 가정간호사업의 효과 분석 - 일 종합병원을 중심으로)

  • Choi, Yun Soon;Kim, Dai Hyun;Storey, Margaret;Kim, Cho Ja;Kang, Kyu Sook
    • The Korean Nurse
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    • v.31 no.4
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    • pp.77-99
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    • 1992
  • The study was carried out at W. hospital, an affiliated hospital of Y university, involved a total of 163 patients who were discharged from the hospital between May 1990 und March 199J. Data collection was twice, just prior to discharge and a minimum of three months post discharge. Thirty patients who lived within a hour travel time of the hospital received home care during the three months post discharge. Nursing diagnoses and nursing interventions For these patients were analyzed in this study. The results of the study are summarized as follows : 1. Discharge needs for the subjects of the study were analyzed using Gordon's eleven Functional categories and it was found that 48.3% of the total sample had identified nursing needs. Of these, the needs most frequently identified were in the categories of sexuality, 79.3 %, health perception, 68.2 % self concept, 62.5 %, and sleep and rest 62.5 %. Looking ut j he nursing diagnosis that were made for the 30 patients receiving home care, the following diagnoses were the most frequently given; alteration in sexual pattern 79.3%, alterations in health maintenance, 72.6%, alteration in comfort, 68.0%, depression, 64.0%, noncompliance with diet therapy, 6.3.7%, alteration in self concept, 55.6%, and alteration in sleep pattern, 53%. 2. In looking at the effects of home nursing care as demonstrated by changes in the functional categories over the three month period, it was Found that of the 11 functional categories, the need level for health perception, nutrition, activity and self concept decreased slightly over the three month period. On the average sleep patterns improved, but restfulness was slightly less and bowel elimination patterns improved but satisfaction with urinary elimination was slightly less. On the other hand, role enactment, sexuality, stress management and spirituality decreased slightly. The only results that were statistically significant at the 0.05 level were improvement. in digestion and decrease in pain. No statistically significant changes were found in ability related to ADL, the total ADL Score at discharge was $19.78{\pm}8.234, and after 3 months $19.01{\pm}8.12$. Considering that a majority of the patients were over 60 years of age and that many had brain or spinal cord injuries, the fact that their ADL ability did nor deteriorate after discharge can be interpreted as related to a positive impact by the home health care nurses. Similarly there was a slight be not statistically significant decrease in the quality of life scores between the two lest times(l47.83 at discharge and 113.02 at the three month period). Again, when the chronic nature of thee problems facing these patients is considered this maintenance of quality of life can be interpreted as a positive impact by the home health care nurses. 3. One of the home care nursing activities was diagnosis. For this activity it was found that for nine functional health categories(sexuality and spirituality excepted) there were 20 nursing diagnoses. The most frequent were noncompliance, alteration in skin integrity both actual and potential, and impaired physical mobility in that order. 4. Delivery of home health care by the home health nurses included the following nursing activities; assessment, patient education, demonstration of care activities, counselling, direct care to the patient and referrals. Direct care included changing dressings, bladder irrigations, changing Foley catheters, measurement of residual urine, perineal care, position change, back care, oral hygiene, exercise and massage of motion exercises, cleansing enemas, tracheostomy suctioning and tracheostomy care, care of dentures, applications of heat and other similar nursing activities. In conclusion almost 50% of (he sample indicated a need for continued nursing care at the time of discharge and for the patients in the sample who received home care there was a slight decrease in nursing needs but while the patients had chronic and debilitation problems there was ill decrease in ADL abilities or in quality of life. Further study needs Lo be done La increase the reliability and validity of the tool that was used to measure home health care needs. It is also recommended that study by done using a randomized sampling with a control group to compare patients who receive home care with those who do not.

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Perceptions of Body Shape and Weight Control in Individuals Consuming Weight-Control or Functional Health Foods (체중조절용 조제식품과 다이어트 건강기능식품 섭취자의 체형 및 체중조절 인식에 관한 연구)

  • Lee, Hyo-Jin;Won, Hye-Suk;Kwak, Jin-Sook;Kim, Mi-Kyung;Kwon, O-Ran
    • Journal of Nutrition and Health
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    • v.44 no.3
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    • pp.243-254
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    • 2011
  • The purpose of this study was to investigate the general characteristics, body shape, and perceptions of weight control in individuals consuming functional health foods and weight-control foods. The survey was conducted between April 15 and June 17, 2010 among 199 (57 males and 142 females; age range, 25-45 years) in Seoul and Gyeonggi-do, who experienced eating functional health foods or weight control foods during the past year (June 2009 to June 2010). The subjects were divided into a weight-control food group (89 adults) and a functional health food group (110 adults). The subjects were comprised of a high proportion of aged (average age, $34.2{\pm}5.9$ years), graduates (71.9%), and married (65.8%) individuals. In the weight control food group, gender, age, and educational background were similar and the ratios of service/technical employees, college students, and normal-weight individuals [body mass index (BMI), < 23] were high. BMI was significantly different by gender (p < 0.001), age (p < 0.01), marital status (p < 0.001), and job type (p < 0.001). Self-perceived health status showed a higher response for "in good health" in the 35-44 year old group than that in the 25-34 year old group (p < 0.05). Male group satisfaction for body shape was significantly higher than that in the female group. The main reason for going on a diet was significantly different by gender (p < 0.05) and BMI (p < 0.01). The main motives for dieting were "because I am not at an ideal weight" and "because of the social atmosphere and the attention of others " in men, but "can't wear the clothes I want" in women (p < 0.01). The most preferable product type related to the two groups was significantly different by job (p < 0.001) and BMI (p < 0.05). However, no significant differences were observed for questions about body shape perception and weight control. Consumers who had different general characteristics and used diet products perceived body shape and weight control differently. Additionally, no meaningful differences were observed when the results were categorized by product type, except job and BMI, but the distribution of consumer characteristics showed different tendencies. These results can be utilized as basic data for developing new diet products to help people control their weight more scientifically and appropriately in the future.

A Study on the Perception of Students in the Radiation Study on the Clinical Practices (임상실습에 대한 방사선 전공 학생들의 인식에 관한 연구)

  • Lee, Byung-Ryul;Kim, Hyun-Gil;Yoon, Myeong-Kwan;Lee, Gi-Jong;Cha, Sang-Young;Lim, Cheong-Hwan
    • Journal of radiological science and technology
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    • v.37 no.3
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    • pp.211-221
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    • 2014
  • The clinical practices provide the students with a good opportunity to study the practical experiences in their field through the clinical training education in hospital. Now, in this study, comparing the perceptions of the clinic teachers with those of students at the clinical site. The study was conducted to the students attending universities located in Seoul and who finished the clinical practices in 2013. The questionnaires were distributed to the student and collected from them. The study were conducted to 275 questionnaires with frequency analysis, crosstabs, chi-square test and McNemar test. The major motivation was of the select radiography course was high employment rate(44.0%) and the satisfaction of radiography course was general(53.1%). 51.3% of the study answered 8 weeks current duration of clinical practices is proper. The 3-year course students answered that the period of clinical practices would be proper if it is performed in the winter vacation in their second year in college(47.3%). The 4-year course students answered that the first semester in their third years is proper for clinical practices( 27.7%). The students answered that they felt the lack in their knowledge on the professional field(32.4%) during the clinical practices and some of the practical training is different from the education performed at school(68.4%). Most of answered that they were satisfied with the clinical practices and among them they recognized the importance of the clinical practices ($3.94{\pm}0.89$). After the clinical practices, their desire for getting job as a radiography has changed from 84.1% to 82.9%. The reason why they want the job related to the radiation is because the job is stable (changed from 49.0% to 46.0% after the clinical practice) while the reason why they don't want be a radigrapher because that job is not proper for them (changed from 37.0% to 40.7% after the clinical practice) The effort should be made to enhance the position of radiation professionals through the improved education system to the students, rather giving them education for just employment.

Searching for the SCM Improvement Directions through the Power Attribute and Partnership (파워 유형과 파트너십 연계를 통한 공급사슬관리 개선방안 모색)

  • Jung, Dae-Hyun;Park, Kwang-O
    • Management & Information Systems Review
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    • v.35 no.3
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    • pp.57-79
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    • 2016
  • It is required to derive various conclusions by identifying the type of power and the relationship between SCMs and presenting practical implications. Thus, we can identify the differential effects of each type of power on SCM performance. We can contribute to develop the practical implications at more sophisticated multi-dimension by comparing results of this study with various SCM theories. Through previous studies, the source of power is largely divided into binding power and non-binding power. Binding power is classified into behavior coercion, binding reward and relationship legitimacy. Non-binding power is classified into work expertise, information superiority and value compliance. Enterprises should fully understand and recognize partners within supply chains including understanding of the source of power, imbalance and results. Thus, we look into types of power and effects on trust and commitment, and identify a causal relationship leading to collaboration and SCM performance. Specific research results are as follows. First, the binding power did not give a significant effect to the trust. However, the binding power gave a positively(+) significant effect to the commitment. Second, non-binding power showed a significant effect on both trust and commitment. As a result of analysis on total effects, it was shown that non-binding power gave indirect effects to collaboration and SCM performance. Third, it was shown that both trust and commitment significantly affected collaboration. From the perspectives of social exchange theory and trading cost theory among inter-organizational relationship theory, it may lead to SCM performance of trust, commitment and collaboration. Moreover, it was found that association of each attribute of power led to the significant result. Fourth, it was shown that trust and collaboration significantly affected SCM performance. However, commitment did not directly affect SCM performance, but it indirectly significantly affected SCM performance through collaboration. Proper use of this power can firmly build partnerships between members of the supply chain and induce the improvement on supply chain performance and satisfaction of members.

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A STUDY ON THE COLORS OF THE ANTERIOR PRIMARY RESIN TEETH (유치레진치의 전치부 색조연구)

  • Hyun, Hong-Keun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.4
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    • pp.639-645
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    • 2007
  • Removable or fixed space maintainer could be needed if one or some anterior primary teeth were missing, where resin pontics well-matched to natural primary teeth should be demanded to get an esthetic satisfaction. Resin Natural $Teeth^{TM}$(Nissin dental, Japan) is available currently in Korea, which consists of two shades of colors; type A1 and A2. The purpose of this study is to elucidate the colors of the anterior primary resin teeth and to establish the data to compare those with the natural anterior primary teeth. CIE $L^*a^*b^*s$ were measured each three times labially from 17 sets of maxillary four anterior teeth for type A1 and A2 Resin Natural $Teeth^{TM}$ using ShadeEye $NCC^{TM}$(Shofu, Japan) which is one of spectrophotometers. The data were analysed statistically using Kruskall-Wallis Test and Mann-Whitney U Test. The results were as follows : 1. There were smaller teeth color differences in group A1 than in group A2 when it comes to distributions of ${\Delta}E$, $L^*$ and $b^*$. There were no statistically significant differences of $a^*$ between teeth in the same group(P>0.05). 2. ${\Delta}E$ in group A1 and A2 (maximum ${\Delta}E{\le}1.23$) were very small, which could not be discerned by eyesight. ${\Delta}E$ between mean CIE $L^*a^*b^*s$ of group A1 and A2 was 3.97, which could be discernible by eyesight. 3. Mean measurements of group A1 were $L^*=73.8$, $a^*=-1.8$, $b^*=-4.7$, and those of group A2 were $L^*=75.8$, $a^*=-2.7$, $b^*=-1.4$. It would be recommended that resin teeth compatible to the colors of the natural primary ones needed to be developed by investigating in vivo study.

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The Effect of Mobile Advertising Platform through Big Data Analytics: Focusing on Advertising, and Media Characteristics (빅데이터 분석을 통한 모바일 광고플랫폼의 광고효과 연구: 광고특성, 매체특성을 중심으로)

  • Bae, Seong Deok;Park, Do-Hyung
    • Journal of Intelligence and Information Systems
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    • v.24 no.2
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    • pp.37-57
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    • 2018
  • With the spread of smart phones, interest in mobile media is on the increase as useful media recently. Mobile media is assessed as having differentiated advantages from existing media in that not only can they provide consumers with desired information anytime and anywhere but also real-time interaction is possible in them. So far, studies on mobile advertising were mostly researches analyzing satisfaction with, and acceptance of, mobile advertising based on survey, researches focusing on the factors affecting acceptance of mobile advertising messages and researches verifying the effect of mobile advertising on brand recall, advertising attitude and brand attitude through experiments. Most of the domestic mobile advertising studies related to advertisement effect and advertisement attitude have been conducted through experiments and surveys. The advertising effectiveness measure of the mobile ad used the attitude of the advertisement, purchase intention, etc. To date, there have been few studies on the effects of mobile advertising on actual advertising data to prove the characteristics of the advertising platform and to prove the relationship between the factors influencing the advertising effect and the factors. In order to explore advertising effect of mobile advertising platform currently commercialized, this study defined advertising characteristics and media characteristics from the perspective of advertiser, advertising platform and publisher and analyzed the influence of each characteristic on advertising effect. As the advertisement characteristics, we classified advertisement format classified by bar type and floating type, and advertisement material classified by image and text. We defined advertisement characteristics of advertisement platform as Hedonic and Utilitarian media characteristics. As a dependent variable, we use CTR, which is the ratio of response (click) to ad exposure. The theoretical background and the analysis of the mobile advertising business, the hypothesis that the advertisement effect is different according to the advertisement specification, the advertisement material, In the ad standard, bar ads are classified as static framing, Floating ads can be categorized as dynamic framing, and the hypothetical definition of floating advertisements, which are high-profile dynamic framing ads, is highly responsive. In advertising, images with high salience are defined to have higher ad response than text. In the media characteristics classified as practical / hedonic type, it is defined that the hedonic type media has a more relaxed tendency than the practical media, and there is a high possibility of receiving various information because there is no clear target. In addition, image material and hedonic media are defined to be highly effective in the interaction between advertisement specification and advertisement material, advertisement specifications and media characteristics, and advertisement material and media characteristics. As the result of regression analysis on each characteristic, material standard, which is a characteristic of mobile advertisement, and media characteristics separated into 'Hedonic' and 'Utilitarian' had significant influence on advertisement effect and mutual interaction effect was also confirmed. In the mobile advertising standard, the advertising effect of the floating advertisement is higher than that of the bar advertisement, Floating ads were more effective than text ads for image ads. In addition, it was confirmed that the advertising effect is higher in the practical media than the hedonic media. The research was carried out with the big data collected from the mobile advertising platform, and it was possible to grasp the advertising effect of the measure index standard which is used in the practical work which could not be grasped in the previous research. In other words, the study was conducted using the CTR, which is a measure of the effectiveness of the advertisement used in the online advertisement and the mobile advertisement, which are not dependent on the attitude of the ad, the attitude of the brand, and the purchase intention. This study suggests that CTR is used as a dependent variable of advertising effect based on actual data of mobile ad platform accumulated over a long period of time. The results of this study is expected to contribute to establishment of optimum advertisement strategy such as creation of advertising materials and planning of media which suit advertised products at the time of mobile advertisement.

A Study on the perceived Social Support in the Elderly (일지역 노인이 지각한 사회적 지지에 관한 연구)

  • Kim, Sang-Soon
    • Journal of agricultural medicine and community health
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    • v.24 no.2
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    • pp.233-243
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    • 1999
  • This study was designed to investigate the level of the Perceived Social Support and Instrument Activities of Daily Living(IADL) of the elderly. The subjects were 239 individuals of 65 years of age and over, living in Taegu city and Kyungpook Province. The data were collected through interviews with questionnaires from July 20 to August 30, 1998, and analyzed by frequency, percentage, mean, Pearson Correlation, t-test and ANOVA using the SAS program. The results of this study were as follows. 1. The mean score of the Perceived Social Support of elderly was 2.37/5. The instrumental support(M=2.52) out of type of the Perceived Social Support was the highest and the self-esteem support(M=2.18) was the lowest. 2. The shopping(M=2.89) out of IADL was the highest and the laundry(M=1.24) was the lowest. 3. The Social Support was significantly related to the IADL. The self-esteem support(r=.58) out of type of the Perceived Social Support was the highest correlation and the instrumental support(r=.32) was the lowest correlation. 4. Of the demographic characteristics of the subjects, age(F=4.61), educational level(F=4.04), living with a spouse(t=3.37), pocket money(F=3.51), satisfaction of pocket money(F=5.21) were significantly resated to the Social Support scores.

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A Survey on the Dietary Intake of the Elderly in an Urban Area and on Analysis of the Related Factors (일부 도시지역 노인의 영양섭취 실태와 그 관련요인에 관한 조사연구)

  • Kim, Sun-Hee
    • Journal of Preventive Medicine and Public Health
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    • v.18 no.1
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    • pp.73-82
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    • 1985
  • This study was conducted to evaluate nutritional status with the analysis of the factors which might influence on the prevalent condition of nutrients-intake. 373 persons who are above 60 years old in Chung-Gu, Seoul were surveyed from March 15 to March 30 in 1985. Results were as follows ; 1. General Characteristics 1) Male respondents among the entire respondents comprised 54.3% and female respondents comprised 45.7%. As for age, male and female respondents comprised 55.0% and 37.2% respectively. 2) As for the educational level of the respondents, illiteracy was 49.9% which was the highest. and those who graduated elementary school was 28.1% which was the second highest. And as for the comparison of the education of the male and female respondents, the educational level of male respondents was much higher than that of female respondents. 3) As for the final occupation of the respondents, those who were engaged in commerce comprised 30.8% which was the highest rate, and who were engaged in agriculture comprised 20.1% which was the second highest rate. And those who were engaged in labor comprised 12.3%. 2. The State of Nutrients-intake The energy of the male respondents was 61.4% of RDA and the protein was nothing but 66.8% of RDA. Except vitamin A, vitamin $B_1$ and niacin, calcium, iron, vitamin $B_2$, vitamin C were lower than RDA (the range: $67.5%{\sim}97.3%$). The energy of the female respondents was 70.0% of RDA and the protein was 58.8% which were lower than RDA. Except vitamin A and vitamin $B_1$, calcium, iron, vitamin $B_2$ vitamin C, niacin were lower than RDA (the range: $68.2%{\sim}98.9%$). 3. The various factors related to nutrients-intake 1) The composition of family and the food environment those who were living with their spouses comprised 44.8% which was the highest rate, and those who were living with their son's family comprised 33.5% which was the second highest rate and those who were living with their doughter's family comprised only 4.6%. Those who were living alone comprised 16.4%. The correlation with nutrient intake didn't show a clear relation. 2) Socio-economic state Those who said that they lacked in living expense comprised 32.7% and those who said that they lacked in pocket-money comprised 23.9%, The female respondents outnumbered the male respondents in lacking living expense or pocket-money. In the correlation with socio-economic, there was no striking relation with education level. However, it was shown that little relation in energy, fat in male and also fat and iron in female. The living expense and the satisfaction in pocket-money had also little relation with energy fat and vitamin C in male. 3) Nutrition knowledge and food habit (a) The state of nutrition knowledge and food habit In nutrition knowledge, those who scored less than 60 points were 32.9%, and those who scored more than 90 points were 21.0%. In food habit, those who scored less than 60 points were 26.5% and those who scored more than 80 points were 45%. (b) The corelation with nutrition knowledge and food habit In case of female respondents, nutrition knowledge had a little relation with the intake of cabohydrate, iron, and vitamin C. And we couldn't see a distinct phenomenon in food habit.

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