• Title/Summary/Keyword: Health outcome

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Models for Spiritual Care in Hospice and Palliative Care

  • Kang, Kyung-Ah
    • Journal of Hospice and Palliative Care
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    • v.21 no.2
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    • pp.41-50
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    • 2018
  • Spirituality is an essential part of human beings. Spiritual care, designed to meet the spiritual needs of terminally ill patients and their families, is one of the most important aspects of hospice and palliative care (HPC). This study reviewed and analyzed literature utilizing the most commonly used Korean and international healthcare databases to identify care models that adequately address the spiritual needs of terminally ill patients and their families in practice. The results of this study show that spirituality is an intrinsic part of humans, meaning that people are holistic beings. The literature has provided ten evidence-based theories that can be used as models in HPC. Three of the models focus on how the spiritual care outcomes of viewing spiritual health, quality of life, and coping, are important outcomes. The remaining seven models focus on implementation of spiritual care. The "whole-person care model" addresses the multidisciplinary collaboration within HPC. The "existential functioning model" emphasizes the existential needs of human beings. The "open pluralism view" considers the cultural diversity and other types of diversity of care recipients. The "spiritual-relational view" and "framework of systemic organization" models focus on the relationship between hospital palliative care teams and terminally ill patients. The "principal components model" and "actioning spirituality and spiritual care in education and training model" explain the overall dynamics of the spiritual care process. Based on these models, continuous clinical research efforts are needed to establish an optimal spiritual care model for HPC.

A Study on the Preventive Education for Adolescents′s Problems in Home Economic Education (II) - Adolescents′Culture Analyzed with Newspaper Articles Concerning Adolescents - (가정과 교육에서의 청소년문제 예방교육을 위한 기초 연구 (II) -청소년관련 신문기사분석을 통해 본 청소년 문화 -)

  • 배영미
    • Journal of Korean Home Economics Education Association
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    • v.10 no.2
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    • pp.131-144
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    • 1998
  • The lack of characteristical understanding of the Home Economics Education will have difficulty in achieving the goal of the Home Economics Education. To allow the Home Economics Education class in school contribute toward the enhancement of the quality of life, it is inevitable to reinforce the recognition of the importance and necessity of the Home Economics Education and to newly propose a directional guidance forward the coming 21st century. The purpose of this study was to provide basic data for planners of the future Home Economics Education by surveying research administrators in charge of programming the overall school curriculum. This study was conducted under the following procedure to have the outcome as follows ; 1. Answers from respondents of age over 50 or careers over 16 years tended to grasp the goal of Home Economics Education in relation to the enhancement of quality of life rather than to the accumulation of knowledge, skill or capacity. 2. Of all the surveyed, 9.64% regarded Home Economics Education as an essential part of school education and the positive ratio was higher with younger respondents. 3. To the question asking if the high school Home Economics Education could have influence on one's capacity, 97.2% of the answerers said yes. The respondents with career under 15 year showed 100% of positive agreement in this matter and of age under 40 marked much higher ratio of 98.84% than the elders. 4. The overall recognition of the necessity for separate sections in Home Economics Education programmed in accordance with the 6th Revision of High School Curriculum displayed a considerably high ratio, with a little differences among age and job groups. The purpose of this study is to analyze and understand adolescents'culture, thereby to provide fundamental information for Preventive Education for Adolescents'Problems in Home Economic Education. 745 articles collected in computer communication service were used for the analysis. The data were analyzed by frequency and percentage using the SPSS/PC+computer program. The most important results of this study were as follows ; 1) Concerning 'Adolescent's Problems's, problems such as violence, homicide and robbery were treated with the greatest frequency. It was also analyzed that the older generations are highly inclined to understand adolescents'culture as a negative one, for example, 'delinquency'or 'immaturity'. 2) Although the area of 'Adolescents'Education'was treated most frequently reflecting the high educational concern in our society, the significant part of those articles were on wrongful educational administration. As much as 70.6% of the articles analyzed were on 'Education'and 'Problems'. Thereby it may be concluded that the other areas such as health, activities, worries, values and harmful environments ere treated respectively as only a 'subculture'or'fragmentary culture'. The articles containing correlations and interactions among them and certain alternative proposals were very rare. 3) The areas such as 'Worries and Counselling'and 'Health'were occupying only a small portion of the articles. The articles which were treating the practical worries and their resolutions were even rarer. 4) 'Values'of the adolescents tended to be viewed by the older generations very negatively. It was also found that the older generations gave the tendency to see the 'consumption culture'of the adolescents as a kind of 'counter culture'or'subculture'.

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Impact of antimicrobial resistance in the $21^{st}$ century

  • Song, Jae-Hoon
    • Proceedings of the Korean Society for Applied Microbiology Conference
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    • 2000.04a
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    • pp.3-6
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    • 2000
  • Antimicrobial resistance has been a well-recognized problem ever since the introduction of penicillin into clinical use. History of antimicrobial development can be categorized based on the major antibiotics that had been developed against emerging resistant $pathogens^1$. In the first period from 1940 to 1960, penicillin was a dominating antibiotic called as a "magic bullet", although S.aureus armed with penicillinase led antimicrobial era to the second period in 1960s and 1970s. The second stage was characterized by broad-spectrum penicillins and early generation cephalosporins. During this period, nosocomial infections due to gram-negative bacilli became more prevalent, while those caused by S.aureus declined. A variety of new antimicrobial agents with distinct mechanism of action including new generation cephalosporins, monobactams, carbapenems, ${\beta}$-lactamase inhibitors, and quinolones characterized the third period from 1980s to 1990s. However, extensive use of wide variety of antibiotics in the community and hospitals has fueled the crisis in emerging antimicrobial resistance. Newly appeared drug-resistant Streptococcus pneumoniae (DRSP), vancomycin-resistant enterococci (VRE), extended-spectrum ${\beta}$-lactamase-producing Klebsiella, and VRSA have posed a serious threat in many parts of the world. Given the recent epidemiology of antimicrobial resistance and its clinical impact, there is no greater challenge related to emerging infections than the emergence of antibiotic resistance. Problems of antimicrobial resistance can be amplified by the fact that resistant clones or genes can spread within or between the species as well as to geographically distant areas which leads to a global concern$^2$. Antimicrobial resistance is primarily generated and promoted by increased use of antimicrobial agents. Unfortunately, as many as 50 % of prescriptions for antibiotics are reported to be inappropriate$^3$. Injudicious use of antibiotics even for viral upper respiratory infections is a universal phenomenon in every part of the world. The use of large quantities of antibiotics in the animal health industry and farming is another major factor contributing to selection of antibiotic resistance. In addition to these background factors, the tremendous increase in the immunocompromised hosts, popular use of invasive medical interventions, and increase in travel and mixing of human populations are contributing to the resurgence and spread of antimicrobial resistance$^4$. Antimicrobial resistance has critical impact on modem medicine both in clinical and economic aspect. Patients with previously treatable infections may have fatal outcome due to therapeutic failure that is unusual event no more. The potential economic impact of antimicrobial resistance is actually uncountable. With the increase in the problems of resistant organisms in the 21st century, however, additional health care costs for this problem must be enormously increasing.

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A Study on the Effectiveness of Learning Organization Managed by Medical Center (의료기관 학습조직 운영효과에 관한 연구)

  • Nam, Jong-Hae;Cho, Woo-Hyun;Lee, Sun-Hee;Kweon, Soon-Chang;Moon, Ki-Tae;Kang, Myung-Geun
    • Korea Journal of Hospital Management
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    • v.9 no.2
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    • pp.1-22
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    • 2004
  • This study was designed to suggest a learning organization in a medical center by examining the factors to influence effectiveness of the learning organization. We collected the data of 586 persons who participated once or more times in the learning organization managed from 2000 to 2002 by Y Medical Center located in Seoul, and included the data of 285 persons in the final analysis. The results of the study are summarized as follows. First, as the results of examining the regression coefficients to predict the effectiveness of and satisfaction with the learning organization through the learning level, learning method and learning organization constructing level as the general variables, the important influential factors were shown as follows: 1)knowledge creation, knowledge storing, private learning, organizational learning, and learning organization construction of occupational and human levels as the factors to predict the working competency; 2) learning organization construction of the human level as the factors to assume the duty satisfaction; 3) gender, working years, private learning, team learning and organizational construction level for the prediction of the organizational commitment; and 4) medical technical service, knowledge creation, organization learning, and constructing level of the environmental and human levels for the assumption of the satisfaction with experience in the learning organization. Based on the study results of the effects in managing the learning organization, we can conclude the followings. First, the members who are in various working positions and occupations need to continuously participate in the learning organization. Second, to raise the organizational outcome from the management of the learning organization, it is necessary to establish systematic concepts in the constituents of the organizational effectiveness such as working competency improvement, duty satisfaction and organizational commitment, and the experience satisfaction of the learning organization. Finally, the future of the organization depends on the learning competencies of the organization members. To continuously exist and develop the organization, the private learning of the organizational members should be constantly spread and shared over the organizational level, and the usual innovations such as repetitive and habitual organizational learning should be generally tried out throughout the whole field of the management.

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An Analysis of Fall Incidence Rate and Its Related Factors of Fall in Inpatients (입원환자 낙상 발생 실태와 원인에 관한 분석 연구)

  • Kim, Chul-Gyu;Suh, Moon-Ja
    • Quality Improvement in Health Care
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    • v.9 no.2
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    • pp.210-228
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    • 2002
  • Background: The purpose of this research was to examine the fall incidence rate and its related factors of fall in inpatients. Methods: The data were collected from the 138 fall incident reports in one tertiary hospital in Seoul from April 1st 1999 to September 30th 2001. The Fall Incident Report Form was originally developed based on that of Massachusetts General Hospital revised in 1995. And this was modified for this survey by the collaborating work of QI team including researcher and department of nursing service of this particular hospital. The contents of Fall Incident Form were general characteristics of patient. factors related to fall. types and places of fall. circumstances, nursing interventions. and outcome. Results: 1) The incidence rate of fall was 0.08% of total discharged patients and 0.081 per 1000 patient-day. This incidence rate is much lower than that of several hospitals in USA. This finding might result from the different incidence report system of each hospital. 2) The characteristics of fall-prone patient were found as follows. They were mostly over 60 years old, in alert mental status, ambulatory with some assistance, and dependent on ambulatory device. The types of diseases related high incidence rate were cerebrovascular disease(3.2), hypertension(1.6), cardiovascular disease(1.4), diabetes(1.3) and liver disease(0.6). 3) The majority of fall events usually occurred m bed. bedside(walking or standing) and bathroom in patient room. Usually they were up on their own when they fell. And there were more falls of elderly occurred during night time than day or evening. 4) 63.8% of fall events resulted in physical injuries such as fracture and usually the patients had diagnostic procedures and some treatment(ex. suture) which caused additional cost to the patients and their families. 5) The found risk factors of fall were drugs(antihypertensive drug, diuretics) and environmental factors like too high bed height, long distance of bedside table and lamp switch, and slippery tile of bathroom floor. Conclusion: Considering these results, every medical and nursing staff should be aware of the risk factors of patients in hospital, and should intervene more actively the preventive managements, specially for the elderly patients during night. Therefore, it is recommended that the development of Fall Prevention Programs based on these results.

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Effects of Diaphragmatic Breathing Training Using Real-time Ultrasonography on Chest Function in Young Females With Limited Chest Mobility (실시간 초음파를 이용한 횡격막 호흡 훈련이 흉곽 가동성 제한이 있는 젊은 여성들의 폐 기능에 미치는 영향)

  • Nam, Soo-jin;Shim, Jae-hun;Oh, Duck-won
    • Physical Therapy Korea
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    • v.24 no.2
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    • pp.27-36
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    • 2017
  • Background: Research efforts to improve the pulmonary function of people with limited chest function have focused on the diaphragmatic ability to control breathing pattern. Real-time ultrasonography is appropriate to demonstrate diaphragmatic mechanism during breathing. Objective: The purpose of this study was to investigate the effects of diaphragmatic breathing training using real-time ultrasonographic imaging (RUSI) on the chest function of young females with limited chest mobility. Methods: Twenty-six subjects with limited chest mobility were randomly allocated to the experimental group (EG) and control group (CG) depending on the use of RUSI during diaphragmatic breathing training, with 13 subjects in each group. For both groups, diaphragmatic breathing training was performed for 30-min, including three 10-min sets with a 1-min rest interval. An extra option for the EG was the use of the RUSI during the training. Outcome measures comprised the diaphragmatic excursion range during quiet and deep breathing, pulmonary function (forced vital capacity; FVC, forced expiratory volume in 1-sec; FEV1, tidal volume; TV, and maximal voluntary ventilation; MVV), and chest circumferences at upper, middle, and lower levels. Results: The between-group comparison revealed that the diaphragmatic excursion range during deep breathing, FVC, and middle and lower chest circumferences were greater at post-test and that the changes between the pretest and post-test values were greater in the EG than in the CG (p<.05). In addition, the subjects in the EG showed increased post-test values for all the variables compared with the pretest values, except for TV and MVV (p<.05). In contrast, the subjects in the CG showed significant improvements for the diaphragmatic excursion range during quiet and deep breathings, FVC, FEV1, and middle and lower chest circumferences after the intervention (p<.05). Conclusion: These results indicate that using RUSI during diaphragmatic breathing training might be more beneficial for people with limited chest mobility than when diaphragmatic breathing training is used alone.

Low Frequency Noise and It's Psychological Effects

  • Eom, Jin-Sup;Kim, Sook-Hee;Jung, Sung-Soo;Sohn, Jin-Hun
    • Journal of the Ergonomics Society of Korea
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    • v.33 no.1
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    • pp.39-48
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    • 2014
  • Objective: This entire study has two parts. Study I aimed to develop a psychological assessment scale and the study II aimed to investigate the effects of LFN (low frequency noise) on the psychological responses in humans, using the scale developed in the study I. Background: LFN is known to have a negative impact on the functioning of humans. The negative impact of LFN can be categorized into two major areas of functioning of humans, physiological and psychological areas of functioning. The physiological impact can cause abnormalities in threshold, balancing and/or vestibular system, cardiovascular system and, hormone changes. Psychological functioning includes cognition, communication, mental health, and annoyance. Method: 182 college students participated in the study I in development of a psychological assessment scale and 42 paid volunteers participated in the study II to measure psychological responses. The LFN stimuli consisted of 12 different pure tones and 12 different 1 octave-band white noises and each stimulus had 4 different frequencies and 3 different sounds pressure levels. Results: We developed the psychological assessment scale consisting of 17 items with 3 dimensions of psychological responses (i.e., perceived physical, perceived physiological, and emotional responses). The main findings of LFN on the responses were as follows: 1. Perceived psychological responses showed a linear relation with SPL (sound pressure level), that is the higher the SPL is, the higher the negative psychological responses were. 2. Psychological responses showed quadric relations with SPL in general. 3. More negative responses at 31.5Hz LFN than those of 63 and 125Hz were reported, which is deemed to be caused by perceived vibration by 31.5Hz. 'Perceived vibration' at 31.5Hz than those of other frequencies of LFN is deemed to have amplified the negative psychological response. Consequently there found different effects of low frequency noise with different frequencies and intensity (SPL) on multiple psychological responses. Conclusion: Three dimensions of psychological responses drawn in regard to this study differed from others in the frequencies and SLP of LFN. Negative psychological responses are deemed to be differently affected by the frequency, SPL of the LFN and 'feel vibration' induced by the LFN. Application: The psychological scale from our study can be applied in quantitative psychological measurement of LFN at home or industrial environment. In addition, it can also help design systems to block LFN to provide optimal conditions if used the study outcome, .i.e., the relations between physical and psychological responses of LFN.

Perception of Privacy and Sensitivity of Personal Information among University Students (대학생들의 개인정보보호의 인식과 개인정보의 민감도에 대한 연구)

  • Boo, Yoo-Kyung;Noh, Jin-Won;Kim, Yun-Mi;Kim, Sung-Soo;Rha, Young-Ah
    • Culinary science and hospitality research
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    • v.21 no.5
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    • pp.25-37
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    • 2015
  • By studying the awareness level of students, for the need to protect personal information, and also by studying students' level of perception as to which information needs protection, this study aims to show that increased education is beneficial, and necessary, across all university majors. This increased education is necessary to improve information security, and increase the responsible sharing of private data which has many benefits, specifically in the Healthcare field. Utilizing student volunteers across multiple majors at a university in South Korea. These questionnaires measured the students' awareness of private information, their perception of private information and also the students' experience in receiving university level education regarding private information and the need for its protection. This study shows that, when compared to students in other fields, students in the field of public health had a higher level of awareness regarding the consequences of personal information disclosure for both public purposes and medical research. Within the parameters of this study, this outcome can be explained as the result of exposure to educational curriculum which contained information related to personal information protection. This increased education raised the student's awareness of which information is considered private, as well as, which information is valuable when responsibly shared. As a result, this study shows that an increase in education regarding information privacy, should be included in all university majors, and gives us evidence to support that this additional education is valuable to students at all levels and should be encouraged.

A Study on Experiences of Total Knee Replacement in Patients with Osteoarthritis (골관절염 환자의 슬관절 전치환술 경험)

  • Park, Hyun-Ok;Park, Kyung-Sook
    • Journal of muscle and joint health
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    • v.3 no.2
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    • pp.135-150
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    • 1996
  • This study was performed to analyze the patient's experience during the progress of disease in the patients with osteoarthritis, who are taken the replacement surgery of knee Joint. The examine was consisted of five patients with osteoarthritis, who are taken the replacement surgery of knee joint from Dec. 4. 1995 to May, 20, 1996 at C university hospital. After hospitalization, the physical and psycho-logical status of the patients during preoperation, postoperation and discharge was examined. The data were examined according to the ethnographic method. The results are as follows. The patients experienced the periods of embarrasment, conflict, before surgery suffering, acceptance period after surgery. In the embarrasment period, the patients take a multiple medication therapy including hospital treatment, oriental medication and folk medication to ameliorate joint pain after first diagnosis on arthritis. The embarrasment period includes compulsive drug medication, oriental medication, folk medication, trouble some, sadness and survey of hospitals. In the conflict period, the patients consider the operation of knee because of working difficulty and severe Joint Pain, while they feel anxiety about the surgery. They condemn their physical situations. They have the conflict and anxiety on surgical operation. they consider the quality of life. They hope the surgery makes patients to improve walking ability. This period includes self-condemned, sorry, tiresomeness, expectation, worrisomeness, anxiety and hesitance. In the suffering period, the patients experience post operation physical discomfort after the total knee replacement. They do physical exercise, including extension and straight leg raising to maintain walking ability, while they endure to wait approximately 6 months for normal walking movements and they are also unstable to environmental people's sight. This period includes postoperative pain, continuous discomfort, inability and communication difficulty to other's people. In the acceptance period, the patients consider longerity of artificial Joint and also endure mild remaining joint pain. Some of them have religions for their wellbeing of life. This period include a self-protesting policy, abandonment, self-consolation, dependence on religions. According to the result from this study I suggested these shown below. 1) After replacement surgery of knee joint, continuous investigation on outcome patient is necessary. 2) It is also necessary to analyze on patient's experiences, who are taken the replacement surgery of hip Joint. 3) Study on disease experiences of patients with rhematoid arthritis, who take drug medication and physical therapy alone without surgery, is necessary. 4) Investigation on patient's favorable folk medication may be helpful to analyze disease experience of patients with osteoarthritis.

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The Prediction Model of Adaptation in Patients with Rheumatoid Arthritis - Propositional Synthesis of Roy's and Lazarus & Folkman's Theory - (류마티스 관절염 환자의 적응 예측모형 -Roy이론과 Lazarus 및 Folkman 이론의 명제 합성-)

  • Kim, In-Ja;Suh, Moon-Ja
    • Journal of muscle and joint health
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    • v.4 no.2
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    • pp.197-220
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    • 1997
  • The lack of a comprehensive theory describing the mechanism of adaptation scientifically has been one of the limiting factors for the development of nursing intervention of patients with chronic illness. Since Roy's theory provides the general conceptual framework depicting adaptation process with structural stimuli and control mechanism, it is appropriate to understand the process of adaptation. But in Roy's theory, the propositions about cognator and regulator as control mechanisms are not clearly defined. For this reason, most of the previous researches applying the Roy's theory have disregarded the study of cognator and regulator. For the patients with chronic illness such as rheumatoid arthritis, it was reported that adaptation states were different for the same stimuli due to the difference of the control mechanism. Moreover in nursing it is important to identify the control mechanism which can be and must be intervened by nurses. It was the Lazarus and Folkman's theory that proposed the control mechanism. They suggested that individual differences in the reaction against the perceived stress are due to the difference in appraisal and coping. Therefore, the synthesis of Roy's and Lazarus and Folkman's propositions might help to clearly understand the mechanism of adaptation. From this point, a theoretical framework has been developed and tested. The subjects were the 297 patients who had been diagnosed rheumatoid arthritis and attended the outpatient clinic. A hypothetical prediction model of adaptation was tested by the covariance structure analysis with PC-LISREL 7.13. As a result, the overall fit was good($x^2$=78.83, p=0.00 ; GFI=0.96 : AGFI=0.90 ; RMR=0.04) for the hypothetical model. In the final model added GA(5, 1), the overall fit was increased ($x^2$=57.82, p=0.003 ; GFI=0.97 ; AGFI=0.93 : RMR=0.036). Except the fact that illness symptoms affected physical adaptation directly, it was supported that focal and contextual stimuli affected physical and psychosocial adaptation through appraisal and coping. Therefore, it was asserted that the synthesis of two theory's propositions was appropriate. So this model would be useful for the theoretical framework in the nursing practice. And this study synthesizing and testing the theory might contribute to establish nursing's scientific base.

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