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

• Korea Journal of Hospital Management
• /
• v.7 no.4
• /
• pp.24-56
• /
• 2002

The purpose of this study was to analyze the characteristics of socio-demographic, organizational culture, organizational conflict and organizational commitment, and to examine the interrelation of influential factors in the organizational commitment. The data for this study were collected through a self-administrated survey with a structured questionnaire to 1,027 subjects from several medical doctor staff members, nursing staff members, administration staff members, pharmacist, and technical expert of eleven hospitals. The data were collected by self-reporting questionnaire from July 29 to September 7, 2002. In this analysis frequency test, t-test, ANOVA, multiple regression were used. The main results of this research is as following; 1. According to socio-demographic characteristics the respondents' level of the organizational commitment was higher in a administration staff members than others, for males than females, and for employees aged more than forty, as working for longer time, and as higher level of the working position. 2. According to the organizational culture characteristics the progressive culture, affiliative culture, and task-focused culture among many types of organizational culture were moderately and positively correlated with the level of the organizational commitment while the hierarchical culture was negatively correlated. 3. According to the organizational conflict characteristics as the respondents who got less conflict experience in the organization, their level of the organizational commitment was higher. And, technical conflict experiences were expressed greater than hierarchical conflict experiences. 4. According to the job satisfaction characteristics as his or her satisfaction that is about the promotion, working itself, salary, and fellowship in the organizational was higher, the level of the organizational commitment was higher. The most important factor of the satisfactions was the fellowship among the respondents while the level of job satisfaction for the promotion and salary was average. 5. Overall, according to the result of Multiple Regression as older age and longer working hours, the level of the organizational commitment was higher and as a higher level of the satisfaction for the promotion, working itself, salary, and fellowship in the organization, it caused more effective factors for the organizational commitment. 6. According to the result of Multiple Regression for the doctor staff members in special hospitals rather than general hospitals the hierarchical culture and task focused culture was positively correlated with the satisfaction of working itself while hierarchical conflict factors in the organizational conflict characteristics was negatively correlated with the organizational commitment. For the nursing staff members the affiliative culture and the job satisfaction for the promotion, working itself, salary, and fellowship were positively correlated with the organizational commitment. For the administration staff members as the job satisfaction for the fellowship was positively correlated with the organizational commitment. For medical and pharmacy staff members as more working experience, correlation with the organizational commitment was positive. Besides, as he or she has a high perception of the affiliative culture, it caused statistically more effective factors for the organizational commitment. For the skill and technicians, male worker expressed greater organizational commitment in the organization than female worker. And also older age along with higher education also showed higher organizational commitment. Moreover, the job satisfaction for the fellowship was positively correlated with the organizational commitment. This study identified the major effective factors of the organizational commitment and analyzed the differences among the job category. In that respect, it is significant for the study to be able to provide a reference for managing hospital of industrial accident and organizational development. However, this study has a problem, which is not to identify a valuable model for examining the relationship between organizational factors such as organizational culture, conflict, satisfaction, and commitment. Therefore, further study is needed and strengthened in the field of organizational commitment for hospital for industrial accident.

• Journal of Hospice and Palliative Care
• /
• v.7 no.1
• /
• pp.17-28
• /
• 2004

Purpose: Even though there have been various efforts for the dying with dignity of terminal patients, no researches focused on the public attitudes. Methods: In February 2004, we sampled 1,055 persons over 20 years of age from the sixteen cities and local districts of Korea through the quota sampling method according to their gender, age, and location. We conducted a telephone survey with a structured questionnaire on the attitudes toward dying with dignity and hospice palliative care. Results: The most important conditions for the dying with dignity on the patients' views were 'removing burdens for other people' (27.8%). Over the half of the samples chose their home as a preference for place of death (54.8%). 82.3% of the respondents agreed to the idea of withdrawing the medically futile life-sustaining treatment. Fifty seven percents of the answered public said that they intended to use the hospice service in case of terminal illness. Eighty percents thought that health care insurance should cover hospice service, and 80.9% gave positive response to the necessity of advance directives. Respondents emphasized 'the financial support for the terminal patients' (29.8%), 'covering hospice service with health insurance' (16.5%), and 'the education and public relation for settlement of desirable dying culture and hospice service' (15.9%) as the roles and responsibilities of the government for the dying with dignity. Conclusion: This study shows that there is a possibility of significant consensus on hospice and palliative care system for the dying with dignity of patients and reduction of the suffering for their families among the general public.

• Journal of agricultural medicine and community health
• /
• v.33 no.3
• /
• pp.316-323
• /
• 2008

= ABSTRACT = Objectives : Incheon metropolitan city has set a model program of community partnership for hypertensive or diabetic patients detection and follow-up since 2005. This study examines the effects of the model on the compliance and the control of blood pressure or blood sugar level Methods : Telephone-surveys were done for 140 persons selected from 408 patients who were detected newly as hypertensive or diabetic patients at Gangwha-Gun and Seo-Gu in Incheon between January 1st and August 31th in 2006, and finally completed in 110 patients(78.6%). Survey questionnaires included socio-demographic(age, gender, and educational level), health behavioral (smoking, drinking, physical activity, and diet), and therapy-related (registration state, compliance, blood pressure or blood sugar control) variables. Odds ratio and 95% CI were derived from logistic regression model. Results : Registered group exhibited high compliance and well managed blood pressure or blood sugar level. The odds ratio of registration were 5.55(95% CI:1.83~16.89) for compliance and 3.78(95% CI:1.43~9.99) for blood pressure or blood sugar control after adjusting for age, gender, disease, and area Conclusions : It is independently related to compliance and blood pressure or blood sugar control whether the patient is registered or not. To control hypertension or diabetes mellitus in terms of compliance and control state, a community-based registration program through community partnership could be a powerful tool.

• The Korean Journal of Emergency Medical Services
• /
• v.11 no.3
• /
• pp.93-109
• /
• 2007

The pre-hospital care in site transportation care and site care will be divided, it will follow in site or evacuation it will enforce it will can evacuate in condition of the emergency patient of like this at the initial stage and emergency care from inside fire fighting helicopter back transfer means and the manpower security of the specialty emergency necessary personnel(nursing and 1st EMT's) as the medical treatment agency and modernization of first aid equipment necessity inside American securing and fire fighting helicopter and specialty first aid packet won about lower the emergency care which is appropriate cannot become accomplished are the actual condition in total lack of emergency care equipment. Consequently craving augmentation, in order to be adapted with the handling kind transfer whose specialty and is appropriate and present time of rapid increase and the citizen of emergency demand by fire fighting helicopter simplicity transfer compared to it is a condition where the countermeasure preparation is earnest. Must expand emergency care equipment first even in fire fighting helicopter and 1st EMT's which it follows in him become arrangement and quickly the execution and specialty temporary disposal(ALS) must be enforced a temporary disposal and must buy the life which is. Also it gets by experience a helicopter induction outline, a radio communication method and the patient helicopter on-board hour attention point back various attention fact back with the body and when where it stands but accurately there must be it will be able to induce the helicopter. Also every manuals anger it does a helicopter transfer method and the emergency care method back and that all processes must do fixed form anger, it becomes feed. Also it related with a helicopter transfer even from the relationship agency many research to lead, difference of the advanced foreign nation and the maximum it is the actual condition where the medical emergency system construction which it reduces is earnestly demanded. Also with emergency structure(crane) it confronts to an aviation transfer even from the establishment college and education it leads intensively and 1st EMT's of the good quality which relates with an aviation structure expects is cultivate at all.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.15 no.4
• /
• pp.1905-1915
• /
• 2014

This study is to examine the effect of the thinking styles and character development efficacy of childhood educational teachers on their commitment to teaching with the intention of clarifying that these two factors of childhood educational teachers are important internal variables in enhancing their dedication to teaching, and to seek ways of finding thinking styles and character development efficacy appropriate for childhood educational teachers. Childhood educational teachers at nursing schools and kindergartens located in Daejeon, Chungnam, and Chungbuk were chosen as the study objects. The results are as follows: First, it turned out that childhood educational teachers's commitment to teaching was in close relation to their judicial, monarchy, totalitarian, internal, and liberal thinking styles. As for childhood educational teachers' character development efficacy, personal efficacy and dedication to teaching showed a high level of correlation. This indicates that as childhood educational teachers preferred certain thinking styles, their commitment to teaching also could be enhanced, and that as childhood educational teachers' personal efficacy was high, their commitment to teaching was enhanced as well. Second, as for the positive effect of childhood educational teachers' thinking styles and character development efficacy on their commitment to teaching, it turned out that such factors as judicial and internal thinking styles, common teacher efficacy, and personal teacher efficacy affected professional recognition, such factors as judicial, internal, conservative, liberal thinking styles and personal teacher efficacy influenced their affection for teaching, and such factors as legislative, monarchy, anarchic, and liberal thinking styles and personal teacher efficacy affected zeal.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.13 no.10
• /
• pp.4619-4628
• /
• 2012

The purpose of this study was to investigate the relationship between alcohol use and drinking problems among college students. Data were collected by structured questionnaires from 400 college students by convenient sampling methods from September 26 to October 14, 2011. Data were analyzed by SPSS/WIN 15.0 program. The results were as follows: According to the Alcohol Use Disorder Identification Test (AUDIT), subjects were classified into four groups such as 40.2% of no problem, 36.7% of drinking problem, 6.8% of high risk drinking problem and 16.3% of alcohol dependence. The alcohol use and drinking problems were significant difference for gender, age, type of residence, age of first drinking, cause of drinking, frequency and amount of drinking. The alcohol use was correlated with drinking problems: social function impairment(r=.601, p<.01), behavior problem(r=.579, p<.01), family and interpersonal impairment(r=.637, p<.01). The influencing factors of drinking problems were alcohol use(${\beta}$=.640, p=.000). This study concludes that it is necessary to establish alcohol use policies on campus and develop temperance education program to reduce alcohol consumption and drinking problems.

• Journal of dental hygiene science
• /
• v.16 no.6
• /
• pp.432-441
• /
• 2016

This study was conducted to investigate the effects of professional oral healthcare program in eldery residents long-term care facilities. Ninety-four elderly residents from 5 different facilities in Asan participated in this study. The subjects were divided into 3 groups, with 32 in experimental group I, 30 in experimental group II, and 32 in the control group. Subjects in experimental group I were treated by a dental hygienist with professional oral healthcare and received daily oral care from caregivers who had completed elderly oral healthcare course. Subjects in experimental group II received daily oral care from caregivers who had completed elderly oral healthcare course. Control group received daily oral care from caregivers. These 3 groups were tested for dental plaque, halitosis, tongue coating, and salivary flow at baseline, and after 4 and 12 weeks of treatment. There were significant differences in the dental plaque index between the groups, mediate times, and mediate methods, in halitosis between the mediate methods, and in tongue coating between the mediate times, as well as the mediate methods. Finally, salivary flow was significantly different with regard to mediate methods between experimental group II and the control group. Therefore, to improve the oral health condition of elderly residents, involvement of a part-time dentist and scheduled professional oral healthcare are necessary. Furthermore, elderly oral healthcare education for nursing staff, including managers, should be provided.

• Journal of Digital Convergence
• /
• v.16 no.9
• /
• pp.197-206
• /
• 2018

This purpose of this study was to investigate self-esteem, body image and maternal fetal attachment behavior in pregnant women and to identify factors influencing maternal fetal attachment behavior. Data were collected 188 pregnant women. Data were analyzed using t-test, ANOVA, Scheffe's test, Pearson's correlation coefficient, Stepwise Regression Analysis. There were statistically significant difference in self-esteem on variables such as religion, income. There were statistically significant difference in body image on variables such as planned pregnancy. There were statistically significant difference in maternal fetal attachment behavior on variables such as religion, planned pregnancy. Self-esteem was positively correlated with body image. Maternal fetal attachment behavior was positively correlated with self-esteem and body image. Factors influencing maternal fetal attachment behavior were body image, religion, and planned pregnancy, which explained 15.6%. Findings provide useful information for further studies in maternal fetal attachment behavior of pregnant women. Therefore, to promote maternal fetal attachment behavior of pregnant women, it is necessary to standardized prenatal education program.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.16
• /
• pp.7365-7374
• /
• 2015

Background: Over the past decade, bladder cancer was associated with a significant increase. Given the importance of the impact of socioeconomic status on the distribution of cancer incidence and mortality, and the need to information on these parameters for prevention planning, the aim of this study was to evaluate data for bladder cancer and their relationship with human development index (HDI) and its components in Asia in 2012. Materials and Methods: The study was conducted based on data from the world data of cancer and the World Bank (including the HDI and its components). The incidence and mortality rates were drawn for Asian countries. To analyze data, correlation tests between incidence and death rates, and HDI and its components were employed with a significance level of 0.05 using SPSS software. Results: A total incidence of 696,231 cases (68.7% in males and 31.3% in females, sex ratio of 2.19:1) and 524,465 deaths (67.0% in men and 32.9% in women, sex ratio was 2.03:1) were recorded in Asian countries in 2012. Correlation between HDI and standardized incidence rate was 0.241 overall (p=0.106), 0.236 in men (p=0.114) and -0.250 in women (p=0.094). Also between HDI and standardized mortality rate 0.025 (p=0.871) in men 0.118 (p=0.903) and in women 0.014 (p=0.927). Conclusions: Bladder cancer incidence is higher in developed countries, but the rate is declining, and in less developed and developing countries it is growing. There was no statistically significant correlation between the standardized incidence rate of bladder cancer and the HDI and its dimensions in Asia, except for the level of education.