• Title/Summary/Keyword: Experience Program

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암환자 인식에 관한 연구 - 간호사ㆍ의사를 중심으로

  • Jo, In-Hyang
    • Korean Journal of Hospice Care
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    • v.2 no.1
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    • pp.58-74
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    • 2002
  • This paper constitutes a descriptive investigation and used a structured questionnaire to investigate nurses' and doctors' recognition of cancer patients. The subjects were extracted from the medical personnel working at the internal medicine, the surgery ward, the obstetrics and gynecology department, the pediatrics department, the cancer ward, and the emergency room of five general hospitals located in Seoul and Gyeonggi Province. The research lasted from August, 2001 to September 2001. Total 137 nurses and 65 doctors were included and made out the questionnaires directly distributed by the investigator. The study tool was also developed by the investigator and consisted of such items as the demographic and social characteristics, the medical personnel's recognition degree of cancer and cancer patients, their recognition of the management of cancer patients, and their participation in a hospice. The results were analyzed using the SPSS Window program in terms of technological statistics, ranks, t-test, and ANOVA. The reliability was represented in Cronbach' α=.75. The nurses' and doctors' recognition degree of cancer and cancer patients had an overall average of 3.86 at the 5 point-scale. The items that received an average of 4.0 or more included 'Medical personnel should explain about the cancer cure plans to the cancer patient and his or her family', 'A patient whose case has been diagnosed as a terminal cancer should be notified of it, 'If I were a cancer patient, I would want to get informed of it,' and 'Cancer shall be conquered whenever it is'. In the meantime, the items that received an average of 3.0 or less was 'My relationship with the cancer patient's family has gotten worse since I announced his or her impending death.' And according to the general characteristics and the difference test, the recognition degree of cancer and cancer patient was high among the subgroups of nurses, females, married persons, who were in their 30s, who had a family member that was a cancer patient, and who received a hospice education. The biggest number of the nurses and doctors saw 'a gradual approach over several days'(68.8%) as a method to tell a cancer patient about his or her cancer diagnosis or impending death. Those who usually tell tragic news were the physician in charge(62.8%), the family members or relatives(32.1%) and the clergymen(3.8%) in the order. The greatest number of them recommended a cancer patient's home as the place where he or she should face death because they thought 'it would stabilize his or her mentality'(91.9%) while a number of them recommended the hospital because they 'should give the psychological satisfaction to the patient'(40%) or 'should try their best until the last moment of the patient's death'(30%). A majority of the medical personnel regarded 'smoking or drinking' and 'diet' as the causes of cancer. The biggest symptom of a cancer patient was 'pain' and the pain management of a cancer patient was mostly impeded by the 'excessive fear of drug addiction, tolerance to drugs and side effects of drugs' by medical personnel, the patient, and his or her family. The most frequently adopted treatment plan of a terminal cancer patient was 'to do whatever the patient or his or her family wants' to resort to a hospice' and 'to continue active treatment efforts' in the order. The biggest reasons why a terminal cancer patient went to see a doctor were 'pain alleviation' 'control of symptoms other than pain(intravenous supply)' and 'incapability of the patient's family' in the order. Terminal cancer patients placed their major concern in 'spiritual(religious) matter' 'emotional matters' their family' 'existence' and 'physical matters' in the order. 113(58.5%) of the whole medical personnel answered they 'would recommend' an alternative treatment to a terminal cancer patient mostly because they assumed it would 'stabilize the patient's mentality.' Meanwhile, 80(41.5%) of them chose 'not to recommend it mostly due to the unverified effects and high cost of it(78.7%). A majority of them, I. e. 190(94.1%) subjects said they 'would recommend' a hospice to a terminal cancer patient mostly because they thought it would help the patient to 'mentally prepare'(66.6%) Only 17.3% of them, however, had received a hospice education, most of which was done through the hospital duty education(41.4%) and volunteer training(34.5%). The follows are results of this study: 1. The nurses and the doctors turned out to be still passive and experience confusion in dealing with a cancer patient despite their great sense of responsibility for him or her. 2.Nurses and Doctors realize the need of a hospice, but an extremely small number of them participate in a hospice education or performance. Thus, a whole recognition of a hospice should be changed, for which purpose a hospice education for nurses and doctors should be provided. 3.Terminal cancer patients preferred their home to a hospital as the place to face their impending death because they felt it would bring 'mental stability.' And most of nurses and doctors think it would be unnecessary for them to be hospitalized just for control of their symptoms. Accordingly a terminal cancer patient can be cared at home, and a home hospice care needs to be activated.

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Study of Utilization of Dental High School and according to the Pain Experienced Dental Fear (고등학생의 치과이용실태와 통증 경험에 따른 치과공포에 대한 연구)

  • Jun, Bo-Hye;Choi, Young-Suk
    • Journal of dental hygiene science
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    • v.14 no.1
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    • pp.59-66
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    • 2014
  • The purpose of this study was to study of utilization of dental high school and according to the pain experienced dental fear and anxiety. This survey was conducted on 370 high school students in Suwon from November 21 to 23, 2011. A total of 352 questionnaires were collected and analyzed. The collected data was analyzed using the statistical package SPSS 15.0 using frequency, mean and standard deviation analysis, t-test, one-way ANOVA, Duncan's test correlation analysis and Stepwise multiple regression analysis. The results state that students feel fear and anxiety were feeling anesthetic needle ($3.19{\pm}1.43$), seeing anesthetic needle ($3.14{\pm}1.44$). We found that students feel more rear and anxiety from caries treatment than scaling. It influence that having dental fear with past dental pain experienced during dental treatment and also hearing dental treatment of pain from their family and friends. We found out that there are some influencing factors on dental fear and anxiety, gender, oral health condition, smoking, pain experienced during dental treatment. We need to care dental fear and anxiety continuously and have prevention program. We have to try understanding students have dental fear and anxiety. So it's better they have good experience visiting dental clinic. We should develop the system and specially treat well while they have dental treatment with anesthesia and some sharp instruments.

The Levels of Anxiety and Depression according tn the Stages of Autologous and Allogeneic Hemopoietic Stem Cell Transplantation (자가 및 동종 조혈모세포이식환자의 이식단계에 따른 불안과 우울)

  • Choi, So-Eun;Lee, So-Young;Park, Hae-Ryung;Park, Ho-Ran
    • Journal of Hospice and Palliative Care
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    • v.8 no.2
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    • pp.190-199
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    • 2005
  • Purpose: Objectives of this study was to investigate the level of anxiety and depression according to the stages of autologous and allogeneic hematopoietic stem cell transplantation (HSCT). It would be provide the basis for effective psycho-emotional nursing intervention. Methods: We report on 52 patients, including 19 with autologous HSCT, and 33 with allogeneic HSCT from August 2002 to August 2003, at a university hospital. Spielberger's State-Trait Anxiety Inventory and Jung's Depression Inventory were used to measure levels of anxiety and depression, respectively, at admission time, the day before HSCT, and discharge time. Data was analyzed using SAS program that included Chi-square test, Fisher's exact test, repeated measures ANOVA and Stepwise multiple regression analysis. Results: In all stages of HSCT, the level of anxiety of patients who underwent allogeneic HSCT was significantly higher than that of autologous HSCT (P=0.047). The depression at the day before HSCT was significantly higher than that at admission. The major variable affecting anxiety in autologous HSCT was depression. Specially depression and gender were significant predictors to explain anxiety in allogeneic HSCT at admission time (61%). Experience of relapse and gender were significant predictors to explain anxiety in allogeneic HSCT at discharge time (36%). Conclusion: We recommend that the anxiety and depression be researched during the stages of allogeneic HSCT, specifically in the day before HSCT. It is necessary to develop an effective psycho-emotional nursing intervention according to the stages of HSCT.

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Development of Needs Assessment Instrument for the Patients with Cancer (암환자의 요구 조사 도구 개발)

  • Kim, Gi-Yon;Choi, Sang-Soon;Pak, So-Mi;Song, Hee-Young;Hur, Hea-Kung
    • Journal of Hospice and Palliative Care
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    • v.5 no.2
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    • pp.136-145
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    • 2002
  • Purpose : This study was designed to develop an instrument that could be used for comprehensive and effective need assessment for patients with cancer. Methods : In the first phase, a conceptual framework for the instrument was established by Wingate & Lackey (1989). In the second phase, the preliminary instrument was drawn up through a review of the literature and in consultation with three professors in Nursing. In the third phase validity and reliability of the preliminary instrument were tested as follows; 1) an expert validity test of the preliminary instrument was done by nine head nurses and charge nurses who had over ten years experience caring for patients with cancer at Wonju Christian Hospital. 2) A construct validity test and reliability test was done for the instrument by 116 staff nurses selected by convience sampling from hospitals located in Kang-Won, Kyoung-Ki, and Choong-Chung Provinces. The collected data were analyzed using SPSS 10.0 WIN program. For the factors of the instrument, factor analysis was used. The reliability of the scale was analyzed by Cronbach's alpha. Results : The results of the experts' test of validity, showed that, of 32 items, only one item had less than 55.4%. It was then deleted and a total of 31 items was selected. On the basis of the results of the factor analysis, the following six components were identified: physiological, informational, spiritual, and emotional needs, available resources, and legal/financial needs. These factors explained 61.8% of the variance. In the factor analysis, the first factor (physiological needs) and the second factor (informational needs) explained 25.4% and 10.9% of the variance respectively, which were major factors for the needs of patients with cancer in Korea. Cronbach' alpha for the scale was .90 indicating internal reliability. Conclusion : This instrument can be effectively utilized for assessment of needs of patients with cancer in Korea. Use of the needs assessment instrument developed in this study will allow nurses to develop nursing interventions that provide comprehensiveness and continuity in meeting the needs of patients with cancer.

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Survey on the Hospice Care Needs of Hospice Volunteers (호스피스 자원봉사자의 호스피스 케어 요구도 분석)

  • Cho, Hyun;Kang, Hee-Sook;Kim, Jeoung-Hee
    • Journal of Hospice and Palliative Care
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    • v.5 no.2
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    • pp.155-162
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    • 2002
  • Purpose : The purpose of this study is to provide preliminary information on the hospice care needs of hospice volunteers. Methods : The sample of this study was obtained from those who completed the hospice volunteer education program in three different areas in Korea. This study was conducted by a self-administered questionnaire. The sample analyzed for this study contained 88 hospice volunteers. Frequency, percentage, mean, standard deviation, and logistic regression analysis were performed to produce the findings of this study. Results : The characteristics of the study sample were $40{\sim}49$ aged, middle class, christianity, married women with high school diplomas. They attended at the hospice center with less than 1 year experience. Majority of them had no family members who received a hospice care. The hospice care was strongly required in the field of information, particularly regarding their diseases and treatments. The identified hospice care needs were the prevention and treatment of gangrene in the field of physical needs, the maintenance of closer relationship with their doctors in the field of emotional needs, and the support of supporting medical insurance in the field of socioeconomic needs. The significant predictors were 'having hospice care taker among family members' in the field of the total hospice care needs and physical needs. Two predictable variables were found in the field of emotional needs. However, none were found to be a predictable variable in the field of information and socioeconomic needs. Conclusion : The findings or this study have a weekness of generalizability due to the sampling methodology used in this study. Thus, further research should be designed in relation to this topic with a probability sampling method.

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Health Care Utilization Pattern and Its Related Factors of Low-income Population with Abnormal Results through Health Examination (저소득층 건강검진 유소견자의 의료이용 양상 및 관련요인)

  • Kwon, Bog-Soon;Kam, Sin;Han, Chang-Hyun
    • Journal of agricultural medicine and community health
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    • v.28 no.2
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    • pp.87-105
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    • 2003
  • Objectives: The purpose of this study was to examine the health care utilization pattern and its related factors of low-income population with abnormal results through health examination. Methods: Analysed data were collected through a questionnaire survey, which was given to 263 persons who 30 years or over with abnormal results through health examination at Health Center. This survey was conducted in March, 2003. This study employed Andersen's prediction model as most well known medical demand mode and data were analysed through 2-test, and multiple logistic regression analysis. Results: The proportion of medical utilization for thorough examination or treatment among study subjects was 51.0%. In multiple logistic regression analysis as dependent variable with medical utilization, the variables affecting the medical utilization were 'feeling about abnormal result(anxiety versus no anxiety: odds ratio 2.25, 95% confidence intervals 1.07-4.75)', 'type of health security(medicaid type I versus health insurance: odds ratio 2.82, 95% confidence intervals 1.04-7.66; medicaid type II versus health insurance: odds ratio 3.22, 95% confidence intervals 1.37-7.53)', 'experience of health examination during past 2 years(odds ratio 2.39, 95% confidence intervals 1.09-5.21)' and 'family member's response for abnormal result(recommendation for medical utilization versus no response: odds ratio 4.90, 95% confidence intervals 1.75-13.75; family member recommended to utilize medical facilities with him/her versus no response: odds ratio 19.47, 95% confidence intervals 5.01-75.73)'. The time of medical utilization was 8-15 days after they received the result(29.9%), 16-30 days after they receive the result(27.6%), 2-7 days after they received the result(20.9%) in order. The most important reason why they didn't take a medical utilization was that it seemed insignificant to them(32.4%). Conclusions: In order to promote medical utilization of low-income population, health education for abnormal result and its management would be necessary to family member as well as person with abnormal result. And follow-up management program for person with abnormal result through health examination such as home-visit health care would be necessary.

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Predictive Factors of Hope in Patients with Cancer (암환자의 희망 예측요인)

  • Lee, Hwa Jin;Sohn, Sue Kyung
    • Korean Journal of Adult Nursing
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    • v.12 no.2
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    • pp.184-195
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    • 2000
  • It has been believed that cancer is an omnious factor threatening the future and life itself. Patients having the disease experience anxiety, fear, feeling of weakness, depression and feelings of uncertainty and hopelessness. Most cancer patients, however, have expectations of possible recovery and a better future, very different from the patients who feel hopeless. Therefore. hope allows people to respond effectively to the fatal disease they have and prevents them from detoriorating physically and spiritually, positively influencing their survival, response to treatment and sense of security. Studies previously performed showed that hope is positively correlated with social and family supports, self-esteem, spiritual well-being, responsive action, health promotion behavior and quality of life. Thus, the study attempted to provide basic information on nursing cancer patients by investigating their levels of hope and determining predictive factors which influence hope. For the study 200 cancer patients in two university hospitals located in Pusan were sampled as subjects. Data were collected for twenty nine days from Feburary 1, 1999 to March 1. Instrumets for the study included 10 items from the self-esteem scale by Rosenberg (1965), 39 hope measurements by Kim and Lee(1965), 16 of the social support scale by Tae(1986) and 16 of the general characteristics scale, all of which totaled 81 items. The data were analyzed using the SPSS program. General characteristics of the investigated based on numbers and percentage. Hope, self-esteem and social support were analyzed using means, minimum, maximum and standard deviation. Relations among the foregoing three factors were analyzed using Pearson' correlation coefficient. Levels of hope in cancer patients were determined using t-test, ANOVA and Scheffe test. Predictive factors influencing hope were investigated using multiple stepwise regression analysis. Results of the study are summarized as follows: 1. An average level of hope was $185.55{\pm}23.39$ points(96 min. and 234 max.) 2. Levels of hope showed a significant difference among them according to sex (t=-3.69, P=.000), age(F=4.714, P=.000), job(F=3.247, P=.008), monthly income (F=6.113, P=.003), treatment charge (F=3.796, P=.011), supportive resources (F=10.554, P=.000), diagnosis(F=2.287, P=.029), perceived health status(F=22.184, P=.000), level of pain(F=3.334, P=.021), religion (F=4.911, P=.001) and religion's effect in life (F=11.706, P=.000), 3. For the subjects, self-esteem and social support were $38.32{\pm}7.21$(13 min, and 50 max.) and $52.97{\pm}8.49$points(28 min, 80 max.). Concerning social support, average levels of family support and medical support were found $35.95{\pm}6.05$(18 min, and 40 max) and $27.02{\pm}4.99$ points(20 min and 40 max). The hope the cancer patients showed significant correlations with self-esteem (r=.588, P=.000), family support(r=.224, p=.001) and medical support(r=.221, P=.002). 4. The five variables related to hope (self-esteem, religion's effect in life, perceived health status, social support and age) accounted for 54.2 percent of the hope level; especially, self-esteem was the highest at 34.6%. As shown in the above results, predictive factors which most influence hope in cancer patients were self-esteem and religion's effect of life. Therefore, nursing interventions to increase self-esteem should be developed. Regarding religion's effects, studies on spiritual aspects should be carried out in a way that contributes to promotion of hope.

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Trends in Serotype Distribution of Clinical Isolates of Streptococcus pneumoniae: A Single Center Experience from 2001 to 2006 (임상검체에서 분리된 폐구균 혈청형의 변동추이)

  • Lee, Taek Jin;Chun, Jin Kyong;Choi, Kyoung Min;Yong, Dong Eun;Lee, Kyoung Won;Kim, Dong Soo
    • Pediatric Infection and Vaccine
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    • v.13 no.2
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    • pp.115-123
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    • 2006
  • Purpose : We investigated whether there had been any change in the epidemiology of Streptococcus pneumoniae in Korea before and after introduction of heptavalent pneumococcal conjugate vaccine(PCV7). Methods : Between September 2001 and August 2006, clinical isolates were collected from patients with pneumococcal infection in Severance Hospital, Seoul, Korea. We analyzed trends in serotype distribution and antibiotic resistance before and after the introduction of PCV7. Results : There were 363 strains of Streptococcus pneumoniae isolated from clinical specimens; 143 before and 220 after PCV7 introduction. The predominant serotypes, in order of decreasing frequency, were 19F, 19A, 23F, 6B, 6A, 3, 9V, 14, 11A, 4, 29, and 18C; 152 isolates(41.9%) belonged to types included in PCV7. The proportion of clinical isolates that were nonsusceptible to penicillin increased from 58.8% in 2001 to 83.6% in 2006(P=0.046). There was no significant diminution in pneumococcal infection caused by vaccine serotypes after the introduction of PCV7. In children younger than age 2 years, the proportion of clinical isolates that were vaccine serotypes was higher than in persons older than age 15 years (59.3% vs 37.8%, P=0.004). Conclusions : There was no significant diminution in pneumococcal infection caused by vaccine serotypes after the introduction of PCV7, therefore more universal pneumococcal immunization program is recommended especially for children younger than age 2 years.

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A study on analysis of the Relationship Oral bacteria to dental caries experience in disabled student's: in Gyeong-nam (경남지역 특수학교 학생의 구강내 세균검사에 따른 영구치우식경험률에 관한 연구)

  • Cho, Pyeong-Kyu;Park, Sung-Suk
    • Journal of Korean society of Dental Hygiene
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    • v.8 no.4
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    • pp.115-125
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    • 2008
  • The purpose of this study was to examine the relationship between the Dentocult SM and LB scores of students and their DMF rate. The subjects in this study were 134 special school students in south Gyeong-sang province. After they were tested to find out their, they received tooth brushing education and preventive treatment. The test, education and treatment were all conducted from March 17 to April 9, 2008. Their oral state was checked and recorded by using a mirror and explorer, and then the data on oral state were analyzed to their DMFT, DT, FT and MT rates. All the collected data were analyzed with SPSS 15.0 for Windows program, and independent-samples t-test, one-way ANOVA and crosstabs analysis were implemented to see what differences their disability type, gender, Dentocult-SM scores and Dentocult-LB scores made. The findings of the study were as follows: 1. As for connections between disability type and DMFT rate, the students with mental retardation were similar to the other students in that regard. The mentally retarded students had higher DT and FT rates than the other students, and the MT rate of the latter was higher than that of the former. 2. Concerning the relationship of gender to DMFT and DT rates, the girls had larger DMFT and DT rates than the boys, and the FT and MT rates of the boys were higher than those of the girls. 3. As to links between Dentocult SM scores on the tongue and DMFT, the students whose bacteria was mildly activated had the highest DMFT rate, and the students who had a severely activated bacteria had the highest DT and FT rates. Those who had a moderately activated bacteria had the highest MT rate. 4.Regarding the connection of Dentocult SM scores on maxillyright molar to DMFT and DT rates, the students whose bacteria was severely activated had the highest DMFT and DT rates. Those who had no activated bacteria had the largest FT rate, and the students who had a mildly activated bacteria had the highest MT rate. 5.Regarding the connection of Dentocult SM scores on maxillyleft molar to DMFT and DT rates, the students whose bacteria was severely activated had the highest DMFT and DT rates. Those who had no activated bacteria had the largest FT rate, and the students who had a mildly activated bacteria had the largest MT rate. 6. Regarding the connection of Dentocult SM scores on mandibularright molar to DMFT and DT, FT rates, the students whose bacteria was severely activated had the highest DMFT and DT, FT rates. Those who had a moderately activated bacteria had the highest MT rate. 7. Regarding the connection of Dentocult SM scores on mandibularleft molar to DMFT and DT rates, the students whose bacteria was mildly activated had the highest DMFT and DT rates. Those who had no activated bacteria had the largest FT rate, and the students who had a moderately activated bacteria had the highest MT rate. 8. Regarding the connection of Dentocult LB scores to DMFT and DT rates, the students whose bacteria was severely activated had the highest DMFT and DT rates. Those who had no activated bacteria had a moderately FT rate, the students who had a mildly activated bacteria had a mildly MT rate.

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A Suvey on Satisfaction Measurement of Automatic Milking System in Domestic Dairy Farm (자동착유시스템 설치농가의 설치 후 만족도에 관한 실태조사)

  • Ki, Kwang-Seok;Kim, Jong-Hyeong;Jeong, Young-Hun;Kim, Yun-Ho;Park, Sung-Jai;Kim, Sang-Bum;Lee, Wang-Shik;Lee, Hyun-June;Cho, Won-Mo;Baek, Kwang-Soo;Kim, Hyeon-Shup;Kwon, Eung-Gi;Kim, Wan-Young;Jeo, Joon-Mo
    • Journal of Animal Environmental Science
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    • v.17 no.1
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    • pp.39-48
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    • 2011
  • The present survey was conducted to provide basic information on automatic milking system (AMS) in relation to purchase motive, milk yield and quality, customer satisfaction, difficulties of operation and customer suggestions, etc. Purchase motives of AMS were insufficient labor (44%), planning of dairy experience farm (25%), better performance of high yield cows (19%) and others (6%), respectively. Average cow performance after using AMS was 30.9l/d for milk yield, 3.9% for milk fat, 9,100/ml for bacterial counts. Sixty-eight percentage of respondents were very positive in response to AMS use for their successors but 18% were negative. The AMS operators were owner (44%), successor (44%), wife (6%) and company worker (6%), respectively. The most difficulty (31%) in using AMS was operating the system and complicated program manual. The rate of response to system error and breakdown was 25%. The reasons for culling cow after using AMS were mastitis (28%), reproduction failure (19%), incorrect teat placement (12%), metabolic disease (7%) and others (14%), respectively. Fifty-six percentages of the respondents made AMS maintenance contract and 44% did not. Average annual cost of the maintenance contract was 6,580,000 won. Average score for AMS satisfaction measurement (1 to 5 range) was 3.2 with decrease of labor cost 3.7, company A/S 3.6, increase of milk yield 3.2 and decrease of somatic cell count 2.8, respectively. Suggestions for the higher efficiency in using AMS were selecting cows with correct udder shape and teat placement, proper environment, capital and land, and attitude for continuous observation. Systematic consulting was highly required for AMS companies followed by low cost for AMS setup and systematization of A/S.