• Quality Improvement in Health Care
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• v.7 no.1
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• pp.72-89
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• 2000

Background : Various types of protective footwear have been used to minimize bacterial contamination in operating rooms. In recent years, debate has arisen concerning the need for use of such protective footwear. This study was designed to provide useful data about choosing shoes most suitable for the surgical environment. Methods : Between November, 1999 and January, 2000, we performed this experimental study by comparing effect of three types of shoes (i.e., disposable shoescover, operating room-restricted shoes, and ordinary shoes) on bacterial contamination of operating rooms equipped with two different ventilation systems (i.e., high air-change, low air-change) respectively. Data were collected during two- hour sham operations in which subjects and their activities were strictly standardized. Bacterial flora were sampled from the study area floor and air colony counts were measured. Results : In experiments involving high air-change ventilation system, there was a significant difference of floor contamination between three types of shoes, but no difference of air contamination. Under low air-change system, there was a significant difference of both floor and air contamination between three types of shoes. Conclusion : The results show that protective footwear would be unnecessary in the operating room with high air-change ventilation system, but it is important to choose suitable shoes carefully under low air-change system. Therefore, the use of outdoor shoes can be considered under high air-change system, but it would seem sensible to apply their first use in less bloody operations at the day surgery center or out-patient department to prevent transfer of body fluid into the outside environment.

• Journal of Chest Surgery
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• v.54 no.2
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• pp.99-105
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• 2021

Background: The number of heart transplantations (HTx) is increasing annually. Due to advances in medical and surgical support, the outcomes of HTx are also improving. Extracorporeal circulatory life support (ECLS) provides patients with decompensated heart failure a chance to undergo HTx. A medical approach involving collaboration among experienced experts in different fields should improve the outcomes and prognosis of ECLS-bridged HTx. Methods: From December 2003 to December 2018, 1,465 patients received ECLS at Samsung Medical Center. We excluded patients who had not undergone HTx or underwent repeated transplantations. Patients younger than 18 years were excluded. We also excluded patients who received an implantable durable left ventricular assist device before HTx. In total, 91 patients were included in this study. A multidisciplinary team approach began in March 2013 at our hospital. We divided the patients into 2 groups depending on whether they were treated before or after implementation of the team approach. Results: The 30-day mortality rate was significantly higher in the pre-ECLS team group than in the post-ECLS team group (n=5, 18.5% vs. n=2, 3.1%; p=0.023). The 1-year survival rate was better in the post-ECLS team group than in the pre-ECLS team group (n=57, 89.1% vs. n=19, 70.4%; p=0.023). Conclusion: We found that implementing a multidisciplinary team approach improved the outcomes of ECLS-bridged HTx. Team-based care should be adapted at HTx centers that perform high-risk HTx.

• Journal of Korean Public Health Nursing
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• v.16 no.1
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• pp.13-29
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• 2002

The purpose of this study was to describe about elders with dementia, their families, and their living environment by visiting the households where demented elders resided. The findings will be used as a basis to develop future individualized adjustment programs for demented elders and their families living in communities. The study participants were 64 demented elders and their families who were registered to a dementia counseling center at Nam-Gu community health center located in Inchon, Korea. Data were collected for two months, from May to June 2001. The length of data collection for each home visit ranged from 1.5 to 2.5 hours. Conclusion are as follows based on these study findings: Those demented elders had more than one chronic health problem in addition to their pre-existing dementia condition. Two thirds of the demented elders were not receiving any specific treatment for dementia. They showed a moderate level of independence in basic ADL, but were mostly residing at home because of lack of ability to perform more delicate and complicate routine daily activities by themselves. In addition, the primary caregivers were not well adjusted to the care-giving activities for their demented family members due to the lack of knowledge and information about dementia. The caregivers were mostly women including daughters-in-law, woman spouses and daughters, over a half of whom perceived their physical and mental health status as poor. Their image toward the demented elders was considerably negative. while their level of knowledge on dementia was moderate. The burden for the care-giving was high, whereas their coping method was passive. As the difference in image toward elderly before and after the onset of dementia in their family member increases, the caregiver burden also increased. The main resource of social support for the caregivers was their children. The caregivers showed high level of needs for knowledge and information on dementia, and day care service was the most preferred type of service by the caregivers. There was lack of safety in the living environments for the demented elders and their families, and in the surrounding environments to prevent dementia-related symptoms. Considering that home-based family care-giving is the most culturally appropriate model of providing care for the demented elders in Korea, we need to develop and apply an individualized adjustment program for the demented elders and their families.

• 한국노년학
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• v.37 no.3
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• pp.747-762
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• 2017

Recently, as the number of patients with dementia using nursing homes increases, the interest about the quality of care services is increasing. Job satisfaction of caregivers is very important factor in the quality of care service. In addition, as perception of human rights is heightened, human rights behavior in nursing homes is also recognized as an important factor. The purpose of this study is to investigate the structural relationship between job satisfaction and human rights behavior, job stress, and social support of dementia workers who have significant influence on quality of care service. For this purpose, 210 questionnaires were collected from 300 dementia workers working in the elderly nursing home, day night care center, and domiciliary visit care center in Gyeonggi province. After excluding 13 questionnaires, the questionnaires were analysed by AMOS and SPSS 21.0. The results of the analysis are following. It was found that job stress significantly affects the social support directly (-.276). Also, social support significantly affects job satisfaction (.315). On the other hand, human rights advocacy has a direct effect on job satisfaction (.175) and an indirect effect (.102), showed a total effect of (.277). This shows that social support partially mediates human rights advocacy and job satisfaction. Job stress had a direct effect on job satisfaction(-.217) and an indirect effect(-.095), indicating a total effect of (-.312), and social support partially mediated job stress and job satisfaction Could know. The results of this study suggest that in order to improve the job satisfaction of the dementia workers, it is necessary to increase the human rights advocacy behavior and reduce the job stress in an environment that recognizes the social support.

• Journal of Korean Academy of Nursing
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• v.28 no.1
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• pp.117-131
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• 1998

The purpose of this study was to develop a critical pathway for case management for patients who have received Coronary Artery Bypass Graft (CABG) because of Ischemic Heart Disease(IHD) which is a factor of rising medical expenses. For this study. a conceptual framework was developed through a review of the literature including six critical pathways which are currently being used in USA. In order to identify the overall service contents required by these patients and to draw up a preliminary critical pathway, 30 cases of medical records of patients who had CABG because of IHD between January, 1995 to June. 1996 at the Cardiovascular Center of Yonsei Medical Center in Seoul were analyzed. An expert validity test was done for the preliminary critical pathway and clinical validity test was also done using seven IHD patients with CABG between November 11 and 23, 1996. After these processes. the final critical pathway was developed. The results of this study are summarized as follows : 1. The vertical axis of the critical pathway includes the following eight items : tests, nutrition, medications, consultations, activity, assessments, treatments, education discharge planning and the horizontal axis includes the time from the start of hospitalization to discharge. 2. Analysis of the 30 medical records indicated that the average length of stay was 20.2days with the average length of stay from hospitalization day to operation day being 6.2 days, and the average length of stay from operation day to discharge day was 13. 9 days. Analysis of the service contents showed that the horizontal axis of the preliminary critical pathway was set from hospitalization to the 14th post operation day and the vertical axis was set to include eight items, the contents which ought to have occurred, according to the time frames of the horizontal axis. 3. As a result of the experts validity, it was found that among the total of 571 items. there was over 83% agreement for 482 items, less than 83% for 89 items, which were then deleted and a revision of the critical pathway was done. 4. A clinical validity test was done using seven IHD patients with CABG. During the process, three patients were deleted because they were out of the criteria the investigator set. Finally, four patients were used. The result of study indicated that only one patient was discharged on the tenth post operation day, which was one day later than the expected day. Three patients were discharged later than the expected day from three days to nine days. All the cases progressed on schedule until the operation day and the first post operation day, but from the second post operation days, there were differences between the critical pathway and the actual practice. The differences came from tests, assessments, and treatments. 5. On the basis of the results of the clinical validity test. the following revisions in the final critical pathway were made : the transfer from ICU to step down ward would be the second post operation day, and the transfer to a general ward, the fifth post operation day, for patients who complained of lack of sleep from the fifth post operation day to discharge, a sleeping pill would be prescribed, skin observations would be performed routinely from immediately after the operation until the third post operation day, and would continue if there was a sign of skin injury on the fourth post operation day, and assessment of chest pain would be done from the third post operation day, and the “stairs climbing” item, expected to be done on the ninth post operation day would be deleted. In conclusion, this critical pathway is partially applicable to the care of patients with CABG but there are some parts needed to be further investigated.

• Korean Journal of Childcare and Education
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• v.10 no.1
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• pp.43-58
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• 2014

The purpose of this study was to investigate the effect on child care teachers' self-efficacy in teaching science. Subjects were 297 childhood teachers who were working at a day care center. The data were collected by using three questionnaires(Science Teaching Efficacy Belief Instruments, Inventory of Science Attitude, and Attitude Test for Child Care Teachers). The data were analyzed by Pearson's correlation and step-wise Regression. The results of this study are as follows; First, there were positive correlations between aptitude for child care teacher and self-efficacy in teaching science. Second, there were positive correlations between science attitude and self-efficacy in teaching science of child care teachers. Third, the significant predictors of self-efficacy in teaching science were interest in science, social value of science, interpersonal relationship management abilities, and positive emotions. The results of this study can be used to develop effective teacher training programs for early childhood science education.

• Journal of Korean Academy of Nursing
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• v.29 no.4
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• pp.766-779
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• 1999

The purpose of this study was to investigate the relationship between the burden on families who live with an elderly person suffering from senile dementia, and the degree of their depression. There were 400 participants in this study, staying in the Seoul and Kyonggi areas from August 1, 1997 to February 28, 1998. Among the group, 100 participants took care of their patient at home, and another 300 participants left 100 patient at a day-care center, 100 sanatorium for senile dementia(asylum for helpless elderly people), 100 an infirmary for elderly people. Eventually 242 subjects out of the 400 were selected for the data analysis. The Zarit (1980) tool was employed to measure the degree of burden and Zung's(1965) “Self-Rating Depression Scale” was employed for the data analysis. The data was analyzed, and the percentage, t-test, ANOVA and Person's Correlation Coefficient were calculated. The results are as follows : 1. The average degree of burden that care-giving families felt was 49.13, which is somewhat high. 2. The average degree of depression that care -giving families felt was 51.95, which is relatively high. 3. The degree of burden was directly affected by the relation with the patient(F＝2.48, P＜.05), and the socio-economic status of the family(F＝5.17, P＜.05). Its also affected by the patient's educational status(F＝2.17, P＜.05). 4. The degree of depression of the family was significantly dependent on sex(t＝-2.05, P＜.05), age (F＝2.99, P＜.05), the relationship with the patient(F＝3.65, P＜.01), socio-economic status (F＝7.74, P＜.001), occupation(t＝2.82, P＜.01), health status(F＝4.42, P＜.01), and the place of residence(F＝4.30, P＜.01), The patient characteristics was significantly dependent on his/her educational status(F＝3.85, P＜.01), the period of suffering from senile dementia(F＝2.47, P＜.05), and smoking habit(F＝6.17, P＜.001). 5. The relationship between the degree of burden and that of depression reads r＝0.43, which is statistically positive correlation in the high significant level. Upon analyzing the entire summation, most care-givers for elderly patients suffering from senile dementia lack time in caring for themselves. They also experience chronic fatigue and mental discomfort caused by the isolation from society, curtailment of certain activities, a sense of responsibility for their patients, and limits of their endurance in taking care of their patients over time. In conclusion, this study emphasizes the necessity for the following propositions : 1. In order to measure the degree of burden that Korean care-giving families undergo, a new tool must be developed on the basis of Korean culture. 2. An educational program based on the demands that care-giving families undergo must be developed, and its clinical effect also has to be examined.

• Journal of the Society of Cosmetic Scientists of Korea
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• v.45 no.1
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• pp.9-17
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• 2019

In this study, $L-{\alpha}-amino$ acid, which is a constituent of natural moisturizing factor, was applied to skin in periodic cycle to improve skin tone and texture roughness. Based on the polarity of the alkyl group (R) of the $L-{\alpha}-amino$ acid, the acid was categorized into two groups and their efficacy was studied. As a result, it was found that the improvement rate of $L-{\alpha}-amino$ acid complex with polar alkyl group ($L-{\alpha}-AAC-1$) is 21% higher than that of $L-{\alpha}-amino$ acid complex with non-polar alkyl group ($L-{\alpha}-AAC-2$). For clinical trials, emulsions containing $L-{\alpha}-amino$ acid complex ($L-{\alpha}-AAC-1$) were applied to the randomly selected 20 to 40 year old female participants, as an experimental group, on the right facial cheek once per day for 8 weeks, and emulsions without $L-{\alpha}-amino$ acid complex, as a control group, were applied to the left facial cheek in the same way. Improvements in skin tone were measured using $JANUS^{(R)}$ equipment and analyzed using image analysis software. Skin texture improvement was measured and analyzed mechanically using the phaseshift rapid in-vivo measurement of the skin (PRIMOS) equipment. As a result, improvements of skin tone and skin texture were 11.7% and 6.7%, respectively. In addition, a questionnaire survey was conducted to the participants on the aesthetic improvement and the degree of the feeling of skin improvement. The results suggest that $L-{\alpha}-amino$ acid can be used as a cosmetic substance that can provide aesthetic satisfaction through physiological skin tone and texture roughness.

• Korean Parent-Child Health Journal
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• v.2
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• pp.83-110
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• 1999

The purpose of this study was to identify the sleep/activity patterns of neonates and to provide a baseline data for the development effective mother-infant relationship. Subjects of this study were 36 newborns aged 1-21 days and stayed in Postpartum Care Center in Taejon during the period of October 28th, 1999 to February 10th, 2000. The data were collected using NCASA developed by Barnard et al. and were analyzed with SPSS 7.5 for window program. The results of this study were as follows: 1. An average day sleep of neonates was 8.0 hours, night sleep was 3.6 hours, and total sleep was 11.6 hours. A longest period of day sleep was 3.8 hours and a longest period of night sleep was 3.4 hours. The regularity of day sleep was 22.1%, night sleep was 23.3%, and total was 22.1%. 2. The frequency of daytime feeding was 6.9, nighttime fee ding was 3.4, resulting in total of 10.3. The regularity of feeding was 37.4%, and the frequency of night awakening was 2.4. 3. Associations among variables related to neonate's sleep/activity records were as follows : - The regularity of total sleep was positively correlated with the frequencies of day sleep(r=.57, P=.00), night sleep (r=.40, P=.01), and total sleep(r=.65, P=.00). - The frequency of total feeding was negatively correlated with the frequencies of day sleep(r=-.29, P=.04), night sleep(r=-.39, P=.02), and total sleep(r=-.42, P=.00), as well as longest day sleep(r=-.50, P=.00). - The regularity of feeding was negatively correlated with the frequency of night sleep(r=-.35, P=.02), longest period of day sleep(r=-.32, P=.04), and longest period of night sleep(r=-.30. P=.04), whereas positively correlated with frequencies of daytime feeding (r=.29, P=.02) and nighttime feeding (r=.32, P=.05). - The frequency of night awakening was negatively correlated with amount of night sleep(r=-.39, P=.02) and frequency of daytime feeding(r=-.42, P=.01) while positively correlated with frequencies of nighttime feeding(r=.68, P=.00) and total feeding(r=.50, P=.00). 4. Although there was no statistical significant difference between sleep pattern and infant's age, following tendency was noted: - As baby gets older, total amount of sleep and longest period of day sleep decreased while longest period of night sleep increased. - As baby gets older, the regularity of day sleep decreased while the regularity of night sleep and total sleep slightly increased. - The frequencies of daytime and total feedings increased while the frequency of nighttime feeding decreased. In conclusion, the author found that the neonates of this study showed less amount of sleep, more night awakening, and more night time feedings than NCAST sample. There was a certain sleep/activity pattern existed: If babies were fed more frequently, daytime or nighttime sleeping hours became shorter, and if babies had longer daytime sleep, frequent nighttime awakenings were noted. This pattern illustrated the significant influence of feeding and sleep periods on each other. Awakening in the night is natural and normal patterns in the newborn period. The result of this study will provide information to parents about what to expect their infants.

• Proceedings of the KAIS Fall Conference
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• 2011.05b
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• pp.785-788
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• 2011

본 연구는 보육교사들의 이야기나누기 수업 운영의 어려움에 대해 구체적으로 알아보기 위해 수업운영과정에서 교사가 경험하는 내용과 의미에 대한 질적인 분석을 하였다. 연구의 목적은 보육교사의 반성적 사고능력의 향상과 다양한 수업에 대한 지원을 통한 보육교사의 수업능력 향상을 돕는데 있다. 이 연구를 위하여 어린이집에서 담임으로 근무하는 교사 7명이 연구에 참여하였고, 참여관찰, 심층면담, 동료교사와의 협의, 교사의 저널쓰기 등의 자료를 수집하여 분석하였다. 연구의 결과는 다음과 같다. 첫째, 이야기나누기 수업 운영에서 교사들은 이야기나누기 수업준비를 위한 시간부족과 유아와의 상호작용, 교사의 발문, 유아의 주의집중에서 어려움으로 느끼고 있었으며 수업 운영에 필요한 다양한 지원과 함께 교사가 수업의 질을 향상시킬 수 있는 장학의 필요성을 인식하게 되었다.