• Quality Improvement in Health Care
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• v.15 no.2
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• pp.83-86
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• 2009

연구배경: 수술적 치료가 필요한 척추관 협착증 환자들은 주로 60세 이상의 고령환자로 장기간의 입원 시 기회 감염의 증대와 불필요한 의료비의 증대를 가져오게 되며, 수술 후 환자들의 재원일수의 증가는 병원의 병상가동률을 감소시키고, 전공의에게는 불필요한 업무를 증가시킨다. 연구목적: 비용 효과면에서 최적화된 진료 지침의 개발은 불필요한 의료비의 감소 및 Hospital Induced Complication을 줄여 환자 만족도를 증진시킬 수 있으며, 각 환자에 대한 전공의 업무를 줄일 수 있다. 의료기관: 서울특별시에 소재한 2,075병상의 종합전문요양기관 연구방법: 정형외과 및 신경외과의 척추관 협착증 환자의 처방을 비교하여 최적의 표준진료지침을 개발하고 최종적으로 CP Master Program(EMR 프로그램)에 입력하여 환자에게 적용하였다. 연구결과: CP 적용 전, 후 비교를 통해 재원일수는 3.8일이 감소하였으며, 이에 따라 병상 가동률 및 진료수익이 증가했으리라고 예상되며 현재 비교 검토 중이다. 또한, CP 개발 및 CP Master Program의 사용을 통한 전공의 업무 감소에 대해 검토하고 있다.

• Journal of Cancer Prevention
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• v.23 no.4
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• pp.176-182
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• 2018

Background: Family physicians (FPs) play an important role in cancer control. The aim of this study was to understand the functions of FPs in cancer control and to explore FPs' perceptions of their own roles and the difficulties they face in cancer control in Karabuk province, Turkey. Methods: The study consisted of two methodological parts. The qualitative part included a descriptive study in which data were collected from 87.5% (n=56) out of all FPs in Karabuk using a questionnaire. In the quantitative part, in-depth interviews with 15 FPs were conducted and analyzed through content analysis. Results: Half of the FPs (50.0%) provided cancer prevention information for their registered people, focusing on especially smoking cessation. In the last three months, the proportion of FPs who had not invited anyone to screenings was 37.5% for the pap test, 26.8% for the mammography, 19.0% for the fecal occult blood test and 34.5% for the colonoscopy. Only 16.1% of them reported that they made home visits for cancer patients. In the qualitative part of study, the following themes were highlighted: the perceived responsibilities of FPs regarding cancer control; the effect of geographically undefined working area of FPs; the issues with coordination between FPs and specialists; the effect of the number of primary care team members. Conclusions: Cancer control services provided by FPs have significant problems in terms of the FPs' approach to the services and their content, continuity and coordination.

• Journal of Korean Academy of Nursing
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• v.30 no.4
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• pp.857-868
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• 2000

The purpose of the present study is to identify the mediation effect of hope between fatigue and psychosocial adjustment in women with breast cancer. The framework for this study was guided by concepts and propositions derived from the theoretical and empirical literature on fatigue, hope and adjustment. The design of this study is a descriptive correlation study using a cross-sectional design. One hundred and twenty two outpatients with early breast cancer, receiving post-surgical radiation therapy or chemotherapy, were selected from three major medical centers in Seoul, Korea. A packet including PABCF (Psychosoical Adjustment to Breast Cancer Factor), revised RPFS (Revised Piper Fatigue Scale), HHI (Herth Hope Index), and self-addressed return envelope was given to the participants at seven to eight weeks post surgery. The questionnaires were to be completed at home and returned to the researcher by mail. The obtained data were analyzed using three regression equations guided by Baron and Kenny (1986); first, hope was regressed on fatigue; second, psychosocial adjustment was regressed on fatigue; and third, psychosocial adjustment was regressed on fatigue and hope, simultaneously. In the first equation, fatigue explained 4% of the variance in hope. In the second equation, fatigue explained 47% of the variance in psychosocial adjustment. In the last equation, hope and fatigue significantly explained the variance in psychosocial adjustment. Therefore, all conditions for the test of mediation effect of hope were satisfied. For the test of the mediation effect, the beta coefficients of fatigue on psychosocial adjustment on the second and third regression equations were compared. The beta coefficients were decreased from .69 (p < .001) on the second regression equation to .63 (p < .001) on the third regression equation. Thus, the hypothesis of this study was supported. As a result of this study, the negative Influence of fatigue on psychosocial adjustment is dampened through the mediator effect of hope in women with breast cancer. Therefore, when planning care for the adverse effect of fatigue on psychosocial adjustment, oncology nurses should consider hope as a mediator between fatigue and psychosocial adjustment to breast cancer.

• Journal of Korean Clinical Nursing Research
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• v.14 no.3
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• pp.129-140
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• 2008

Purpose: This study was to examine the effect of a taping therapy on pain relief and the improvement of daily living for elderly having degenerative knee arthritis. Method: This study was conducted with a non-equivalent control-group pre-test and post-test design. Data were collected conveniently with 63 elderly who had having(a) pain due to degenerative knee arthritis, and (b) inconvenience in daily life(30 for an experimental group and 33 for a control group). The subjects were recruited from the elderly, participating in welfare programs held in a welfare organization and day-care facilities. The experimental group received an intervention of taping therapy offered twice a week, for 4 weeks. The data collection from the experimental group was done from the beginning of the therapy throughout two weeks later after the end of the therapy. Results: For the experimental group, pain scores came to more decreased significantly, as the periods in which taping therapy was conducted were getting longer. Physical function scores became also more decreased at significantly level, as taping therapy was more conducted. However, compared to the control group, the score change for the experimental was not significantly showed in physical function after the therapy ended. That is, there was no longer-lasting effect on physical function improvement. Conclusion: This study found that this therapy could be a useful self-management method that the elderly with degenerative knee arthritis can use easily at home. Because of insignificant result in longer-lasting effect, this taping therapy would be applied properly with the interval of 2~3days.

• Journal of Hospice and Palliative Care
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• v.7 no.2
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• pp.200-213
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• 2004

Purpose: The purpose of this study was to create an electronic nursing record form to build a hospice nursing process database to be used in the u-hospital EMR system. Specific aims of the study were: 1. To generate a complete, accurate, and simple electronic nursing record form. 2. To verify its appropriateness following documentation with the standardized hospice protocol. 3. To verify its validity and finalize the hospice nursing process database through discussion among hospice professionals. Methods: Nursing records from three independent hospice organizations were collected and analyzed by five expert hospice nurses with more than 10 years of experience, and a nursing record database was developed. This database was applied to 81 hospice patients at three hospice organizations to verify its completeness. Results: 1. An electronic nursing record form with completeness, accuracy, and simplicity was developed. 2. The completeness of the standardized home hospice service protocol was 95.86 percent. 3. The hospice nursing process database contains 18 items on health problems, 79 items on related causes and major symptoms, and 229 items on nursing interventions. Conclusion: The new nursing record form and database will reduce documentation time and articulate and streamline the working process among team members. They can also improve the quality of hospice services, and ultimately enable us to estimate hospice service costs.

• Journal of Hospice and Palliative Care
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• v.13 no.4
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• pp.216-224
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• 2010

Purpose: The purpose of this study was to evaluate a community-based cancer patient management program (CBPCMP) which was collaborated between a hospice center and public health centers. Methods: The CBPCMP proceeded on four steps; 1) Signing agreements with three public health centers, 2) Enrolling the domiciliary terminal cancer patients, 3) Providing home hospice service, and 4) Inquiring patient's level of satisfaction. From February 1 to December 31 in 2009, 43 terminal cancer patients were referred and provided with home hospice service. The hospice team made a total of 605 visits. Medical records for each visit and data from satisfaction surveys were analyzed. Results: 76.7% of patients were older than 60 years, and 90.7% of the patients were alert. The level of functional status for 76.7% of patients rated as lower than ECOG grade 1. 62.8% of the patients or their caregivers signed hospice service agreements. On the initial evaluation, the most frequent reasons for referral were general weakness (86.0%), followed by anorexia (72.1%). Nurses visited the patients' most frequently (371 visits), followed by volunteers (216 visits). Nurses provided emotional support and health promotion counseling on 95.1% and 22.9% of visits, respectively. The mean satisfaction score rated by patients and their family was 4.45 out of 5. Conclusion: This study tested CBPCMP in collaboration with hospice centers and public health centers. CBPCMP showed a possibility to improve the quality of end of life care. To insure the quality care, however, the guidelines for home hospice service should be developed.

• Korean Parent-Child Health Journal
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• v.3 no.1
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• pp.60-72
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• 2000

Studies are needed to determine the standard norms for sleep/activity patterns in new born baby and there have been no established reports of discrepancy of sleep/activity patterns in new born baby among various races. The purpose of this study is to determine whether the NCASA(Nursing Child Assessment Sleep Activity Record) would be suitable to evaluate and to provide the basic resources for a Korean model of sleep/activity patterns during the new born baby, and to provide a basis for nursing intervention for mothers of new born baby. The subjects of this study were 38 normal new born baby who visited the postpartum care center and two general hospitals located in pusan from January 1 to April 28, 2000. They all agreed to participate in this study. The method of data collection was through convenient sampling. Data were collected through questionnaires including demographic data, birth hi story, and general informations concerning the infant, mother and family. The instrument of this study was the NCASA translated by the Korean parent Child Health Academic Association. The collected data were analysed by mean. standard deviation, frequency, and percentage by use of SPSS/PC. The conclusions obtained from this study are summarized as follows: 1. The mean amount of daytime sleep was 10.23 hours. The mean amount of nighttime sleep was 5.53 hours. The mean amount of total daily sleep was 15.77 hours. The mean of the longest sleep period was 4.49 hours. The mean regularity of daytime sleep was 49.69%. The mean regularity of nighttime sleep was 66.98%. The mean regularity of total daily sleep was 55.81%. The mean frequency of nighttime wakenings was 3.09 times. 2. The mean amount of daytime awake periods was 6.12 hours. The mean amount of nighttime awake periods was 2.11 hours. The mean amount of daily total awake periods was 8.23 hours. The mean of the longest awake periods was 3.76 hours. 3. The mean frequency of daytime feeding was 5.71 times. The mean frequency of nighttime feeding was 2.65 times. The mean frequency of total daily feeding was 8.36 times. The mean frequency regularity of feeding was 62.50%. 4. The mean amount of a mother's day time was 16.36 hours. The mean amount of a mother's night time was 7.64 hours. In conclusion, The new born baby slept more during the daytime compare than nighttime and more active during the daytime. On the other hand. although nighttime sleeping the length of the mother was normal, but sleep was interrupted by the infant over 3 times on average. Therefore this research study will contribute to nursing practice and nursing research by its implication through postnatal educational nursing programs at hospital and nursing intervention programs that would help individual caring of early infant mothers at home.

• The Korean Nurse
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• v.36 no.2
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• pp.49-63
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• 1997

This study was performed to provide preliminary data for the development of a useful instrument to measure the effect of sex education. The study was conducted with the voluntary participation of 155 college students enrolled in the course "Sexuality and Relationship" at Y university in Seoul. At the end of that course, they were asked to write freely about the change they had experienced on sexuality. All meaningful statements were elicited and classified into 7 categories; "Change of Knowledge", "Enlightenment", "Change of Attitude on Sexuality", "Buildup of Ability", "Buildup of. Identity", "Change of Emotion", "Change of Behavior:' There were significant changes in the areas of knowledge(28. 6%), enlightenment(27.4%), and attitudes(20.3%) about sexuality among these 7 categories. The Change of Knowledge category consists of 3 areas: "concretion of knowledge", "increase of information", and "correction of misunderstanding." In the category of Enlightenment, total 12 areas are included: "sex role", "erception of lack of knowledge", "importance of family", "life plan", "parent role", "value of life", "equality", "sexual autonomy", "importance of sexuality", "freedom of sexuality", "perception of sexual problem", and "meaning of love." The Attitude Change category consists of 8 areas. These are "being natural", "being progressive", "being sensitive", "being truthful", "being expressive", "being cautious", "being responsible", and "being confident". The category of Buildup of Ability includes 4 areas: "problem solving", "sex education", "relationship", and "communication". The category of Buildup of Identity includes "sexual identity", and "value of sexuality". The Emotional Change category includes 3 areas: "positive feeling", "negative feeling", and "breaking from negative feeling on sexuality". The Behavior Change category includes "sex-related behavioral change". In conclusion, up to now most researches on sex education effect measures only changes of knowledge, attitude, and behavior. But we believe the changes in "Enlightenment", "Buildup of Ability", "Buildup of Identity", "Change of Emotion", should be included in addition to knowledge, attitude, and behavior in the development of an instrument to measure the sex education effects. And the effect of sex education should measure the degree of learning of autonomy, enlightenment, and ability of behavior and so on rather than studying the simple changes in sexuality.enment", "Buildup of Ability", "Buildup of Identity", "Change of Emotion", should be included in addition to knowledge, attitude, and behavior in the development of an instrument to measure the sex education effects. And the effect of sex education should measure the degree of learning of autonomy, enlightenment, and ability of behavior and so on rather than studying the simple changes in sexuality.ng the simple changes in sexuality.

• Journal of Korean Academy of Nursing
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• v.4 no.1
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• pp.107-120
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• 1974

Necessity and purpose of this study: In a large number of countries it has been founded that children′s domestic accidents are at great risk year by year In the United States, they publish detailed accident statistics at regular intervals. In Korea. there have been just a few studies on Accidents-At-Home of preschool children. But it can not be said that there have been any systematic statistics about this area. and any study accounting for the relations of home accidents and preschool: children in detail, Therefore, the purpose of this thesis was focused on the inquire of these relations so as to make a little contribution to Korean preschool children′s health and security measures. So, the detail-purposes are to study following questions and to testify following hypothesis. Prob. 1. What the types of accidents of Preschool children, where the place accidents occurred\ulcorner Prob. 2. What the cause of accidents and, the main factors of the cause\ulcorner Prob. 3. How about the number of their children. the disparity of age among their children and mother′s age in each case of accidents\ulcorner hypothesis 1. There will be differences in the density of protection of parents according to the number of their children. hypothesis 2, There will be differences in accident-types and first-aid methods according to parents socio-economic background. Method; This study employed the interviewing survey method, in which 130 preschool children ware random.sampled, who visit hospital to have medical care. These children (from 1 to 6 years olds) were selected at the emergency room of five hospitals in Seoul (Hosp: Severance, Woosok, Medical Center, Hanyang Medical College Hospital and Seoul Medical Col1age Hospital during study-period (from Aug. to Oct, 1973). Four head nurses in above Hospitals were employed as accident members for this study. Concerning research analysis, the method of hypothesis verifying is used. Conclusion: As two American experts on this subject. Dr, Raymond Neuter and Mr. Ross Mc Garland have drawn attention to "minor epidemics of accidents" that could be avoided by fairly simple measures. preschool children′s accidents could be avoided by parents fair attentions. In other words, one of the most common causes of preschool children′s accidents derived from their parent′s inattention. Therefore, one important task on this subject is to instruct the parents fairly about the children′s accidents. Many accidents could be avoided by the exorcist of a little self-discipline. Also, as much the prevention of accidents is important, as the first-aid Is Important and necessary at the case of the accidents. So, the methods of proper first-aid treatment must be emphasized, and must be taught in school, especially in girls school. And there could be other means available for prevention of accidents. Firstly, the public authorities can take legal measures. More stringent safety standards can be made enforceable by law. Building materials and equipment for domestic us: ought to meat minimum safety criteria at all times. Next the public itself has to understand the seriousness of the problem, and here the dissemination of information is of great importance. All mass media should be brought into play to promote greater public awareness of the question. At last, it will be needed to obtain more detailed epidemiological data through additional surveys and statistics after this study.

• Korean Journal of Hospice Care
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• v.2 no.1
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• pp.87-111
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• 2002

The hospice activities in Korea have still stood in the premature stage, although the contemporary hospice program, which professionally accommodates terminally ill patients, appeared in the history 35 years ago. Especially, the availability of the facility hospice is not only poor in number, but also lack of a guideline for the conduct of the facility. Saemmul Hospice has keenly felt the necessity of more facility hospices and has interchanged experiences and informations with people interested in hospice. However, the number of facilities has fallen short of one's expectations, and many problems have been revealed in order to maintain the operation. This paper was written in order to improve these atmospheres and to help more terminally ill cancer patients properly. This paper clarifies in detail the principle of management, the method of practice in each departments of Saemmul Hospice, expected effects and supplemental items. We try to provide concrete and practical informations and to help extensively for all peoples who are to begin or currently working. 1.Facility: It secures, maintain, and manage the hospice environment for all around care of patients effectively. 2.Education and Volunteer: It trains and manages hospice volunteers devoted to hospice. 3.Financial: It manages donation by healthy soul with an effective method. 4.Administration and Organization: It executes the administration efficiently and constitutes the organization to operate. 5.Medical and Nursing: It offers the maximum professional supports to a hospital. 6.Medicine and alternative medicine: It improves the quality of life of patients by medical and pharmaceutical approach and by other possible methods available. 7.Nutrition: It helps patients to have diets in accord with the order of the creation. 8.Belief: It offers spiritual care which allows the profound relationship with God. 9. Funeral ceremonies: Funeral ceremonies may heal grieves of families faced with their deaths. 10. Bereaved families: It supports the families after the deaths of patients. 11.Reception and consultation: It seeks to help the patients who meet the purposes for which Saemmul Hospice is established. 12.Publication: It allows publicity activities for Saemmul Hospice. Facility hospice programs are able to overcome the disadvantages that the other type of the hospice possess, like as the economic burdens of the families, and the patients' losses of comforts of home after being transferred to a hospital. Facility hospice can provide home atmosphere with professional manpower and facilities like hospital to the patients. Therefore, it can also improve patients' qualities of life and make them comfortable death. We anticipate that the hospice program in Korea would be more active to let more people be indebted to maintain the nobel human dignity and to cross beautifully in the most painful process of dying in the journey of their lives.