• Title/Summary/Keyword: Hospital, general

Search Result 9,294, Processing Time 0.047 seconds

Decision-making process and satisfaction of pregnant women for delivery method (임산부의 분만방법 결정과정과 만족도)

  • Jun, Hae-Ri;Park, Jung-Han;Park, Soon-Woo;Huh, Chang-Kyu;Hwang, Soon-Gu
    • Journal of Preventive Medicine and Public Health
    • /
    • v.31 no.4 s.63
    • /
    • pp.751-769
    • /
    • 1998
  • This study was conducted to assess the attitude of pregnant women toward delivery method, understanding of the reason for determining her own delivery method, participation in decision-making process and satisfaction with delivery method after labor. Study subjects were 693 pregnant women who had visited obstetric clinic for prenatal care in the last month of pregnancy in one general hospital and one obstetrics-gynecology specialty hospital in Taegu city from February 1 to March 31 in 1998. A questionnaire was administered before and after labor and a telephone interview was done one month after labor. Proportion of women who had health education and/or counselling about delivery method during prenatal care was 24.0% and this proportion was higher for women who had previous c-section(35.5%) than others. Women thought vaginal delivery is better than c-section for both maternal and baby's health regardless of previous delivery method. About 90% of primipara and multiparous women who had previous vaginal delivery wanted vaginal delivery for the index birth, while 85.6% of multiparous women who had previous c-section wanted repeat c-section. Reasons for choosing c-section in pregnant women who preferred vaginal delivery before labor were recommendation of doctors(81.9%), recommendation of husband (0.8%), agreement between doctor and pregnant woman(4.7%), and mother's demand (12.6%). Reasons for choosing vaginal delivery were mother's demand(30.6%) and no indication for c-section(67.2%). Reasons for choosing c-section in pregnant women who preferred c-section before labor were recommendation of doctors(76.2%), mother's demand(20.0%), recommendation of husband(1.3%), and agreement between doctor and pregnant woman(2.5%). Of the pregnant women who had c-section, by doctor's recommendation, the proportion of women who had heard detailed explanation about reason for c-section by doctor was 55.1%. Mother's statement about the reason for c-section was consistent with the medical record in 75.9% . However, over 5% points disparities were shown between mother's statement and medical record in cases of the repeat c-section and mother's demand. In primipara and multiparous women who had previous vaginal delivery, the delivery method for index birth had statistically significant association with the preference of delivery method before labor(p<0.05). All of the women who had previous c-section had delivered the index baby by c-section. Among mothers who had delivered the index baby vaginally, 84.9% of them were satisfied with their delivery method immediately after labor and 85.1% at 1 month after labor. However, mothers who had c-section stated that they are satisfied with c-section in 44.6% immediately after labor and 42.0% at 1 month after labor. Preferred delivery method for the next birth had statistically significant association with delivery method for the index birth both immediately after labor and in 1 month after labor. The proportion of mothers who prefer vaginal delivery for the next birth increased with the degree of satisfaction with the vaginal delivery for the index birth but the proportion of mothers who prefer c-section for the next birth was high and they did not change significantly with the degree of satisfaction with the c-section for the index birth. These results suggest that the current high technology-based, physician-centered prenatal and partritional cares need to be reoriented to the basic preventive and promotive technology-based, and mother-fetus-centered care. It is also suggested that active involvement of pregnant woman in decision-making process for the delivery method will increase the rate of vaginal birth after c-section and decrease c-section rate and improve the degree of maternal satisfaction after delivery.

  • PDF

A Study on the Effective Independent Study of Nursing Student (간호학생의 효과적인 자율학습을 위한 조사연구)

  • 김광주;이향련
    • Journal of Korean Academy of Nursing
    • /
    • v.8 no.1
    • /
    • pp.16-42
    • /
    • 1978
  • This survey was made for a month starting from November 15 to December 15, 1977 covering 711 students taking the junior. (3rd-yea.) and the senior. (4th-year) at nine college of nursing in Seoul concerning their perception and Attitude toward the profession of nursing, motive for the necessity of learning, environment of study, attitude of study and particulars relevant with study performance, particulars of library, references and reading, assignments and particulars of the degree of confidence for the learning achievement. Through the survey of the above Particulars, the following results were obtained by classifying all subject matters and by analysing motive of the selection of their course, awarding or not awarding of scholarships. 1. General characteristics: it was revealed that 406 students (57.1%) were attending at the junior. while 305 students (42.9%) were taking the senior. Thus, the total number was 711 and their average age was 21.4 years. Their dwelling category was; 73.9 percent of them resided at their parent's home, 214 students (30.1%) were awarded with scholarships. The reason to be attracted by nursing science was the possibility of continuing social life after graduation (43.5%). 2. Their perception and attitude toward the profession of nursing: According to the perception of profession by the students of each grade, students of the 4th grade showed comparatively strong conception. Also, students of the 4th grade showed more positive attitude in the purchase and reading of magazines relative with the science of nursing, in the reading of Code for Nurses and in their interest in the activity of nursing field. For the necessity of mission of nurse, 97.7 percent of the entire number of students covered responded to necessity. For the necessity of the particular humanity and particularity in the character of nurses, 95.8 percent of those students responded to necessity. By the each grade, students of the 4th grade showed more response. 3. As to professional field desired after completing the professional course: 57 percent of those students desired for clinician nurse while 55 percents desired for community health-nurse. 4. As to the environment of study: they were mostly satisfied with their present residential environment. However, they complained of inconvenience at their lecture-halls. Students of the 3rd grade showed more complain. As to their attitude toward the adjustment of environment of study, they showed a affirmative response. As to the opinion of factors which interfere with their study, comparatively strong response was showed in their scepticism in the science of nursing, insufficient comprehension in general learning, relation with professors n4 discrepancy in the method of study. According to opinions of students at each grade, students of the 4th grade showed more scepticism. 5. Particulars relative with their attitude and performance of study : As to their knowledge of the objectives of their study of subject, the majority was to study with a partial knowledge of the objectives of their study. As to the plan of study, a low percentage indicated management of routine life under regular scheduling. Students of the 4th grade responded to rather planned life. As to time spent in independent study, response to concentrated study when necessary was stronger than that to regular daily study. Students of the 4th grade showed stronger response to regular study than that of the 3rd grade. As to the contents of their note-taking, 67.4 percents of those students responded to such regulatory procedure performing in the lecture-hall as they listen to lectures. 17.3 percents of those students showed response to adding supplementary informations from references to what was entered in choir note-taking at their lecture-halls. 6. Particulars of library, references and reading books: As to receiving of instruction for the utilization of library and time of receiving such instruction 64.7 percents of those students had received such instruction. 66.7 percents of the those responded received such instruction at orientation conducted for freshmen. As to the convenience of the utilization of library, 49.9 percents of those students responded to convenience. However, students of the 3rd grade showed a much stronger response to inconvenience. As to the time of the utilization of library,92.5 percents of those students showed a response to occasional utilization for particular purpose than regular utilization. 53.2 percents of those students responded to ordinary in quantity that library have references. 34.2 percents of those students responded to insufficient. As to the particular relative with the method and field of reading: 53.5 percents of those students responded to intensive reading and was the majority. As to the reading field, fiction u as the majority. When read any books for their major, they usually rend Korean text-b, oks. 7. Particular relative with giving assignment: All respondents were well aware of the objectives of giving home tasks. As to the attitude toward assignments and performing home tasks, 54.8 percents of those students to making ostentatious study because of an excessive quantity of assignments imposed. For performing assignment, they showed comparatively positive response. Also, 52.2 percents of those students responded that they usually submitted complected assignment with references. 8. As to motive to realize the necessity of study : 55.6 percents of those students responded that they realized such necessity in communication with patients when they were engaged in clinical practice. Also, 8.6, the lowest percents of those students responded that they realized such necessity in the course of conversation with nurses when they were engaged in clinical practice. 9. As to the determination of their confidence in the performance of study relative with clinical experience: They showed a general inclination of having in nursing. The major response was that they came to well comprehend the patients families. the lowest response was that they could apply what was learned at lecture-hall to practice. This response incidentally showed the distance the lecture-hall and practical study. In general items, students of the 4th grade showed more favorable response than students of the 3rd grade and there was a significant difference. 10. As to the perception and attitude toward profession according to the motive of selecting the nursing science : Those who selected the nursing voluntarily showed stronger conception than those who selected the nursing through indirect influence. However, there was no significant difference on this point. Only there was a remarkable difference in the reading of Code for Nurses. 11. Those who showed a stronger conception in the profession of nursing according to the motives of attractive nursing science indicated a strong will and ability to manage stable life and comparatively strong response was shown in the management of good home life because of the good adaptability of the science to their character. This group showed a strong conception of the profession than those who responded that they prefer this profession out of a longing for the work of a hospital and for the easy obtaining of opportunity to immigrate to over seas and for economic cause and for high school grade. There was significant difference between these two groups, 12. As to the conception and attitude toward the profession of nursing according to benefits by scholarships, those who were benefitted by scholarship showed stronger conception of profession than those who did not receive scholarship and there was a remarkable difference between these two categories. However, there was no remarkable difference between these two categories in the extent of interest of the activities of nursing fields and in the reading of Code for Nurses. 13. As activation for study according to the benefits of scholarships, those who were benefitted by scholarships showed stronger response to the motive for study comparing with those who receive. 14. As to tile field of reading according to the benefits by scholarships, those who received scholarships tended to read autobiographies and essayers to a considerable extent. Those who did not receive scholarships tended to read novels. Those who received scholarships more read nursing boots than those who did not receive scholarships. 15. As to the attitude of study and doing of assignment according to benefits of scholarships, those who received scholarships managed a favorable life with schedules for study, More students of receiving scholarship showed a regular study for more than one hour per day. Also, in the method of doing home tasks, more students of receiving scholarship showed reference to relative books frequently for the submission of completed assignments.

  • PDF

Morbidity Pattern and Medical Care Utilization Behavior of Residents in Urban Poor Area (도시 영세지역 주민의 상병양상과 의료이용행태)

  • Kang, Pock-Soo;Lee, Kyeong-Soo;Kim, Chang-Yoon;Kim, Seok-Beom;SaKong, Jun;Chung, Jong-Hak
    • Journal of Yeungnam Medical Science
    • /
    • v.8 no.1
    • /
    • pp.107-126
    • /
    • 1991
  • The purpose of the study was to assess the morbidity pattern and the medical care utilization behavior of the urban residents in the poor area. The study population included 2,591 family members of 677 households in the poor area of Daemyong 8 Dong, Nam-Gu, Taegu and 2,686 family members of 688 households, near the poor area in the same Dong, were interviewed as a control group. On this study the household interview method was applied. Well-trained interviewers visited every household in the designated area and individually interviewed heads of households or housewives for general information, morbidity condition, and medical care utilization with a structured questionnaire. Individuals were interviewed from 1 to 30 December 1988. The major results were summarized as follows : The proportion of the people below 5 years of age was 4.2% of the total study population and 5.5% were above 65 years of age in the poor area. This was slightly higher than in the control area. The average monthly income of a household in the poor area was 403,000 won versus 529,000 won in the control area. Fifty-eight percent of the residents in the poor area and sixty-one percent in the control area were medical security beneficiaries, but the proportion of medical aid beneficiaries was 7.8% in the poor area and 4.6% in the control area. The 15-day period morbidity rate of acute illnesses was 57.1 per 1,000 in the poor area and 24.2 per 1,000 in the control area. Respiratory disease is the most common acute illness in both areas. The most frequently utilized medical facility was the pharmacy among the patients with acute illnesses in the poor area. Among them 58.1% visited pharmacy initially while 38.4% of the patients in the control area visited a clinic. Among persons with illnesses during the 15 days 8.8% in the poor area and 4.6% in the control area did not seek any medical facility. Mean duration of utilization of medical facilities was 3.5 days in the poor area and 3.3 days in the control area. Initially of the medical facilities in Daemyong 8 Dong, The pharmacy in the poor area and the clinic in the control area were most commonly utilized. The most common reason for visiting the hospital was 'regular customers' in the poor area and 'geographical accessibility' in the control area. The one year period morbidity rate of chronic illness in the poor area was 83.0 per 1,000 population and 28.0 per 1,000 in the control area. Disease of nervous system was the most common chronic illness in the poor area while cardiovascular disease in male and gastrointestinal disease in female were most prevalent in the control area. The most frequently utilized medical facility was the pharmacy among the patients with chronic illnesses in the poor area. Among them 24.2% visited the pharmacy initially while 34.7% of the patients in the control area visited the out-patient department of the hospital within a 15-day period. Among the patients with chronic illnesses 34.9% in the poor area and 16.0% in the control area did not seek any medical facility. Mean duration of utilization of medical facilities was 9.2 days in the poor area and 9.9 days in the control area within a 15-day period. Initially of the medical facilities in Daemyong 8 Dong, the pharmacy in the poor area and the hospital in the control area were most commonly utilized. The most common reason for visiting the hospital, clinic, health center or pharmacy in the poor area was 'geographical accessibility' while the reason for visiting herb clinic was 'good result' and 'reputation' in both areas.

  • PDF

Primiparas만 Perceptions of Their Delivery Experience and Their Maternal-Infant Interaction : Compared According to Delivery Method (초산모의 분만유형별 분만경험에 대한 지각과 모아상호작용 과정에 관한 연구)

  • 조미영
    • Journal of Korean Academy of Nursing
    • /
    • v.20 no.2
    • /
    • pp.153-173
    • /
    • 1990
  • One of the important tasks for new parents. especially mothers, is to establish warm, mutually affirming interpersonal relationships with the new baby in the family, with the purpose of promoting the healthy development of the child and the wellbeing of the whole family. Nurses assess the quality of the behavioral characteristics of the maternal-infant interaction. This study examined the relationships between primiparas pereptions of their delivery experience and their maternal infant interaction. It compared to delivery experience of mothers having a normal vaginal delivery with those having a casearean section. The purpose was to explore the relationships between the mother's perceptions of her delivery experience with her maternal infant interaction. The aim was to contribute to the development of theoretical understanding on which to base care toward promoting the quality of maternal-infant interaction. Data were collected directly by the investigator and a trained associate from Dec. 1, 1987 to March 8, 1988. Subjects were 3 random sample of 62 mothers, 32 who had a normal vaginal delivery and 30 who had a non-elective cesarean section (but without other perinatal complications) at three general hospitals in Seoul. Instruments used were the Stainton Parent -infant Interaction Scale(1981) and the Marut and Mercer Perception of Birth Scale(1979). The first observations were made in the delivery room (for vaginally delivered mothers only), followed by day 1, day 2, day 3, and 2 weeks, 4 weeks, 6 weeks and 8 weeks after birth, for a total of 7-8 contacts(Cesarean section mothers were observed on days 4 and 5 but the data not used for analysis). Observations in the hospital were made during the hour prior to scheduled feedings. The infant was placed beside the mother. Later contacts were made at home. Data analysis was done by computer using as SPSS program and indulded X² test, paired t-test, t-test, and Pearson Correlation coefficient ; the results were as follows. 1. Mothers who had a normal vaginal delivery tended to perceive the delivery experience more positively than cesarean section mothers(p=0.002). The finding supported the hypothesis I that perception of delivery would vary according to the method of delivery. Mothers' perceptions of birth were classified into three dimensions, labor, delivery and the bady. There was a significantly different and positive perception by the vaginally delivered mothers to the delivery experience(p=0.000) but no differences for labor or the bady according to the delivery method(p=0.096, p=0.389), 2. Mothers who had a normal vaginal delivery had higher average maternal-infant interaction scores(p=0.029) than mothers who had a cesarean section. There were similar higher scores for the 1st day(p=0.042), 2nd day (p=0.009), and the 3rd day(p=0.006) after delivery but not for later times. The findings supported the hypothesis Ⅱ that there would be differences in maternal-infant interaction for mothers having vaginal and cesarean section deliveries. However these differences deccreased section deliveries. However these differences decreased over time . by eight weeks the scores for vaginal delivery mothers averaged 8.1 and for cesarean section mothers, 7.9. 3. The more highly positive the pereption of the delivery experience, the higher the maternal-infant interaction score for all subjects(F=.3206, p=.006). The findings supported the hypothesis Ⅲ that there would be correlations between perceptions of delivery and maternal-infant interaction. The maternal infant interaction was highest when the perception of the bady and deliery was positive(r=.4363, p=.000, r=.2881, p=.012). No correlations between perceptions of labor and maternal-infant interaction were found(p=0.062). 4. The daily maternal-infant interaction score for the initial contact after birth to 8 weeks postpartum had the lowest average score 5.20 and the highest 7.98(in a range of 0-10). This subjects group of mothers needed nursing intervention to promote their maternal- infant interaction. The daily scores for the maternal-infant over the period of eight weeks. However, there were significantly different increases in maternal-infant interaction only from the first to second day(p=0.000) and from the fourth to sixth weeks after birth(P=0.000). 5. When the eight items of maternal-infant interaction were evaluated separately, “Expresses feelings about her role as mother” had the highest average score, 1.64(ina range of 0-3)and “Speaks to baby” the lowest, 0.9. All items, with the possible exception of “Expresses feelings about her role as mother”, suggested the subjects' need of nursing intervention to promote maternal-infant interaction. 6. There were positive correlations between certain general charateristis, namely, both a higher economic status(p=0.002) and breast feeding(p=0.202) and maternal - infant interaction. There were positive correlations between a mother's confidence in her role as a mother and the perception of the birth experience(p=0.004). For mothers who had a cesarean section, a positive perception of the birth experience was related to the duration of her marriage(p=0.010), a wanted pregnancy (P=0.030) and her confidence in her role as a mother(p=0.000). Pereptions of birth for mothers who had a normal vaginal delivery were positive than those for mothers who had a cesarean section. The level of maternalinfant interaction for mothers delivered vaginally was higher than for cesarean section mothers. The relationship between perception of birth and materanalinfant interaction was confirmed. Cesarean section has an impact on the mother's perceived experience of birth which, in turn, is positively related to maternal-infant in turn, is positively related to maternal-infant interaction. Nursing intervention to enhance maternal-infant interaction should begin in prenatal classes with an exploration of the potential impact of cesarean section on the perceptions of the birth experience and continue throughout the perinatal and post-natal periods to promote the mother's ability to control with this crisis experience and to mobilize social support. Nursing should help transform a relatively negatively perceived experience into an accepted, positively perceived and self affirming experience which enhances the maternal-infant relationship.

  • PDF

A Study of Educational System for Medical Technologists in Korea (한국(韓國)의 의료기사(醫療技士) 교육제도(敎育制度)에 관(關)한 조사(調査) 연구(硏究))

  • Song, Jae-Kwan;Lee, Gun-Sub;Kim, Byong-Lak;Kim, Chung-Rak;Cho, Jun-Suk;Huh, Joon;Lee, Joon-Il
    • Journal of radiological science and technology
    • /
    • v.6 no.1
    • /
    • pp.131-181
    • /
    • 1983
  • After the investigation on, and the analysis of, the educational system for medical technicians and the present educational situation for medical technologies in this country, the following conclusions were drawn. 1. As of March 1983 the current academic system for education in medical technologies included the regular 4-year college courses and those of the 2-year professional junior college courses. But except in the cases on clinical pathology and physical therapy, there were no college-level departments. Particularly, no educational institutions, at whatever level, had a department for working therapies. 2. The total number of credits needed for graduation from a department of medical technologies was 150 points at a regular 4-year college and 85 to 96 points at a 2-year professional college. The obligatory minimum number of credits for a student at a professional college was set at 80 points and above. 3. As for the number of the educational institutions for medical technologies in this country, there were one regular college and 14 professional colleges, a total of 15 institutions. As many as 14 colleges had departments of clinical pathology, 12 had departments of Radiotechnology, 11 had departments of physical therapy, 12 had departments of dental technology, and eight had departments of dental hygiene. 4. The total capacity of the professional colleges in admitting new enrollment each year were 1,920 for clinical pathology, 1,552 for radiology, 1,012 for physical therapy, 1,334 for dental technologies, 828 for dental hygiene, an aggregate of 6,646 for all of the professional college departments. 5. The total number of graduates from the 12 professional colleges by department during the period of 1965-83 were 7,595 for clindical pathology, 4,768 for radiology, 2,821 for physical therapy, 3,000 for dental technologies, and 1,787 for dental hygiene, totalling 19,971 for all departments in the professional colleges. 6. In the state examination for licensed medical technicians, 12,446 have passed from among the total of 26,609 participants, representing a 45% passing ratio. By departments the ratios showed 44% for clinical pathology, 39.7% for radiology, 51.2% for physical therapy, 42.5% for dental technology, 72.5% for dental hygiene and 73.1% for working therapy. 7. As for the degree of satisfaction shown by the people in this field, 52.2 percent of the teaching staffs who responed to the questionaires said they were satisfied with their present profession, while the great majority of medical technicians(66%) replied that they were indifferent to the problem. 8. The degree of satisfaction shown by the students on their enrollment in this particular academic field was generally in the framework of indifference(43.7%), but mere students(36.5%) were satisfied with their choice than those were not satisfied(14.4%) 9. As for the student's opinions on the lectures and practicing hours, a good many students replied that, among such courses as general science and humanities courses the basic medical course, the major course and practicing hours, the hours provided for the general courses(47.1%) and practicing(47.6%) were insufficient. 10. When asked about the contents of their major courses, comparatively few students (23.6%) replied that the courses were too difficult, while a convincing majority(58.5%) said they were neither difficult nor easy. As for the appropriateness of the number of the present teaching staffs, a great majority(71.0%) of the students replied that the level of the teaching personnel in each particular field was insufficient. 11. Among the students who responded to the poll, good part of them(49.5%) wanted mandatory clinical practicing hours, and the the majority of them(64.6%) held the view that the experimental and practicing facilities of their schools were insufficient. 12. On the necessity of the attached hospitals, 71.1% of the teaching staffs and 58.0% of the medical technicians had the opinion that this kind of facility was indispensable. 13. As for the qualifications for applicants to the state examination in the licensing system for medical technicians, 52.2% of the teacher's and 36% of the medical technicians replied that the present system granting the qualifications according to the apprenticeship period should be abolished. 14. On the necessity of improving the present system for education in medical technologies, an overwhelming majority(94.4% of the :caching staffs, 92.0% of the medical technicians and 91.9% of students) of these polled replied that the present system should be changed for the better. 15. On the method of changes for the present educational system, a great majority(89.4% of the teaching staffs, 80.4% of the medical technicians and 90.1% of the students) said that the system must be changed so that it fits into the reality of the present day. 16. As for the present 2-year program for the professional colleges, 61.6% of the teachers, 72.0% of the medical technicians and 38.8% of the students expressed the hope that the academic period would be extended to four regular years, hemming a full-fledged collegelevels program. 17. On the life-long eductional system for medical technicians, there was a considerable number of people who expressed the hope that an open university system(38.9% of the teaching staffs, 36.0% of the medical technicians) and a graduate school system would be set up. 18. As for the future prospects for medical technicians as professionals, the optimists ana pessimists were almost equally divided, and 41.1% of the teaching staffs 36.0% of. the technicians and 50.5% of the students expressed an intermediate position on this issue.

  • PDF

The Effect of Deep Breathing Methods on Pulmonary Ventilatory Function of Patients Who experiened Upper-abdominal surgery (심호흡 방법에 따른 상복부 수술환자의 폐 환기능에 미치는 효과)

  • Hwang Jin-Hee;Park Hyung-Suk
    • Journal of Korean Academy of Fundamentals of Nursing
    • /
    • v.1 no.2
    • /
    • pp.129-147
    • /
    • 1994
  • The purpose of this study was to examine the effect of deep breathing exercise with Incentive Spirometer on the pulmonary ventilatory function of postoperative patients. This experiment was operated by quasi-experimental design which was compared pre-experimental measures with post-experimental ones. The subject of this study was 46 inpatients who were scheduled for elective upper abdominal surgery under the general anesthesia in P National University Hospital in Pusan and classified into the experimental group(23 patients) and control group(23 patients) by using Incentive Spirometer or unusing one. The data were collected from November, 1, 1993, to December, 31, 1993. The effects of the deep breathing exercise on the pulmonary ventilatory function were compared between experimental group who were recieved deep breathing exercise with Incentive Spirometer and control group who were recieved same method without Incentive Spirometer. The Forced Vital Capacity (FVC) and the First Second Forced Expiratory Volume (FEV1) were represented as index of the pulmonary ventilatory function and those were measured by Vitalograph Compact. The collected data were analysed by SPSS/PC+ (percentage, average, standard deviation, chi-square test, t-test, and ANOVA). The results were as follow : (1) The FVCs of the experimental group were significantly increased in course of time, 24, 48, 72 hours after surgery(F=3.530, P=0.035). (2) The FVCs and FEV1S of the control group were significantly increased in course of time, 24, 48, 72 hours after surgery (FVCs : F=3.480, P=0.037, FEV1S : F=6. 153, P=0.004). (3) The FVC which was measured at 72 hours after surgery was significantly higher in the experimental group than in the control group(t=2.620, P=0.013). (4) The FEV1s which were measured at 24 and 72 hours after surgery were significantly higher in the experimental group than in the control group(24hr. : t=2.530, P=0.017, 72hr. : t=2.540, P=0.016). (5) Among general characteristics, sex was significant variable which influenced to effect of pulmonary ventilatory function. In conclusion, this study showed that the deep breathing exercise with Incentive Spirometer was more effective to recover the pulmonary ventilatory function after surgery than the deep breathing exercise without Incentive Spirometer.

  • PDF

On the Influence Each Other Between the Monks in the Buddhist Temples and the Society in Towns or Villages (중국(中國) 지방사회(地方社會)와 불교사원(佛敎寺院) 그리고 승인(僧人)의 상호(相互) 영향(影響)에 관한 일고(一考))

  • Yan, Yao zhong
    • Korean Journal of Heritage: History & Science
    • /
    • v.45 no.3
    • /
    • pp.60-79
    • /
    • 2012
  • Environment of ancient Chinese Buddhist temple can be classified to three types such as regional society(鄕村), famous mountain(名山), and urban areas(都市). This made differences in environment where a temple existed and in turn, affected development of Buddhism. And this made another type in relationship between Buddhist temple and a society. This study explains influences which regional society gave on not only Buddhist temple and a monk but also existence and development of Buddhism. When temples are placed in different environmental position, that is, urban areas and regional society, among a social structure, they eventually should adapt to a different society externally and internally. As told in above, ancient Chinese Buddhist temple was located in regional society, famous mountain, and urban areas. Since Eastern Jin and Sixteen Kingdoms, as number of temple much increased, and temples and monks were concentrated on famous mountain, temples in famous mountains and urban areas had developed showing similar aspects each other. But because temples in regional society were influenced a little differently, this study focused on the point. There are four kinds of influences between temples and monks in regional areas. Monks in regional areas had a comparatively close relationship with a society because they came from same area or surrounding areas. Therefore,powers of regional areas restrict influences made by monk group in temple. Second, temples in regional areas shared their joys and sorrows depending on regional economy. Temples in regional areas became a public place for the society and often a market place. In fact, construction and existence of a temple originally became a driving force in regional economy. This is because construction of temple needs artisans and materials and some temples had visitors and included market economy like consumption of incense and candles, though the economic size was large or small. And when regional areas experienced natural disaster or man-made disaster or had poor harvest or economy was in depression, monks left temples and then, temples themselves could not exist. Third, the relationship between temples in regional areas and Buddhists was distinguished from the temples in urban areas and famous mountains. This is because temples in China were places where monks practiced and at the same time, places where general Buddhists worshipped. So there were always a number of Buddhists around the temples. Forth, Buddhism in resional areas was connected to regional Folk beliefs. As a result, Buddhism was spread across the nation, worship with local color often was changed to Buddhist belief or was tinged with Buddhism. While temples in regional areas maintained a close relationship with regional society.they were influenced by the region or gave influences. As a representative example, temples in regional areas showed model behaviors instead of roles of facilities related to various cultures with comparatively advanced level - for example, school, hospital etc. The temples highly affected funerary rites in regional areas. Chinese tombs were mainlymade in regional areas. After death,people living in urban areas were buried in hometown or at least, they were buried in suburbs not urban areas. Temples in regional areas generally participated in funerary rites. Above shows that though most of famous Buddhist temples were located in urban areas not in famous mountains,majority of temples were located in vast regional areas. Through mutual interaction between temples and regional society, the temples in the regional areas were related to Chinese people of over 90% and regional areas became the most important foundation for Buddhism in China. Mutual influences between temples in regional areas and the general public in regions were omnidirectional and spreaded to every aspects of social life in small or large degree. Thus Tombs in temple were widely spreaded across regional areas over time and space. This is enough to explain a close relationship between Buddhist temples and rural society in ancient China.

The National Survey of Acute Respiratory Distress Syndrome in Korea (급성호흡곤란증후군의 전국 실태조사 보고)

  • Scientific Subcommittee for National Survey of Acute Respiratory Distress Syndrome in Korean Academy of Tuberculosis and Respiratory Disease
    • Tuberculosis and Respiratory Diseases
    • /
    • v.44 no.1
    • /
    • pp.25-43
    • /
    • 1997
  • Introduction : The outcome and incidence of acute respiratory distress syndrome (ARDS) could be variable related to the varied definitions used for ARDS by researchers. The purpose of the national survey was to define the risk factors of ARDS and investigate the prognostic indicies related to mortality of ARDS in Korea according to the definition of ARDS determined by the American-European Concensus Conference on 1992 year. Methods : A Multicenter registry of 48 University or University-affliated hospital and 18 general hospital s equipped with more than 400 patient's beds conducted over 13 months of patients with acute respiratory distress syndrome using the same registry protocol. Results : 1. In the 12 months of the registry, 167 patients were enrolled at the 24 hospitals. 2. The mean age was 56.5 years (±17.2 years) and there was a 1.9:1 ratio of males to females. 3. Sepsis was the most common risk factors (78.1%), followed by aspiration (16.6%), trauma (11.6%), and shock (8.5%). 4 The overall mortality rate was 71.9%. The mean duration was 11 days (±13.1 days) from the diagnosis of ARDS to the death. Respiratory insufficiency appeared to be a major cause in 43.7% of the deaths followed by sepsis (36.1%), heart failure (7.6%) and hepatic failure (6.7%). 5. There were no significant differences in mortality based on sex or age. No significant difference in mortality in infectious versus noninfectious causes of ARDS was found. 6. There were significant differences in the pulse rate, platelet numbers, serum albumin and glucose levels, the amounts of 24 hour urine, arterial pH, Pa02, PaCO2, Sa02, alveolar-arterial oxygen differences, PaO2/FIO2, and PEEP/FI02 between the survivors and the deaths on study days 1 through 6 of the first week after enrollment. 7. The survivors had significantly less organ failure and lower APACHE III scores at the time of diagnosis of ARDS (P<0.05). 8. The numbers of organ failure (odd ratio 1.95, 95% confidence intervals:1.05-3.61, P=0.03) and the score of APACHE III (odd ratio 1.59, 95% confidence interval:1.01-2.50, P=0.04) appeared to be independent risk factors of the mortality in the patients with ARDS. Conclusions : The mortality was 71.9% of total 167 patients in this investigation using the definition of American-European Consensus Conference on 1992 year, and the respiratory insufficiency was the leading cause of the death. In addition, the numbers of organ failure and the score of APACHE III at the time of diagnosis of ARDS appeared to be independent risk factors of the mortality in the patients with ARDS.

  • PDF

CLINICAL AND NEUROPSYCHOLOGICAL CHARACTERISTICS OF DSM-IV SUBTYPES OF ATTENTION DEFICIT HYPERACTIVITY DISORDER (주의력결핍 과잉행동장애의 아형별 신경심리학적 특성 비교)

  • Cheung, Seung-Deuk;Lee, Jong-Bum;Kim, Jin-Sung;Seo, Wan-Seok;Bai, Dai-Seg;Chun, Eun-Jin;Suh, Hae-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
    • /
    • v.13 no.1
    • /
    • pp.139-152
    • /
    • 2002
  • Objectives:This study was conducted to compare the clinical and neuropsychological characteristics by DSM-IV subtypes of attention deficit hyperactivity disorder(ADHD) patients who did not have comorbid psychiatric disorders. Methods:5-15 year old children with ADHD were recruited at psychiatric outpatient clinic of Yeungnam University hospital and the patients with comorbidity or neurological abnormalities were excluded. Finally, total 404 children with ADHD were selected for this study. There were 234 subjects of ADHD-C(57.9%), 156 subjects of ADHD-I(38.6%) and 14 subjects of ADHD-HI(3.5%), who fulfilled the DSM-IV diagnostic criteria. The mean age of the total subjects was 9.63±2.49 years old. The psychopathology, IQ, behavioral problems, neuropsychological executive function were evaluated before pharmacological treatment. The measures were Korean Personality Inventory of Child(K-PIC) for psychopathology, 4 behavioral check lists(ADDES-HV, ACTeRS, CAP, SNAP) for behavioral symptoms of ADHD, K-ABC and KEDI-WISC for IQ and Conner's CPT, WCST, SST for neuropsychological executive functions. Results:1) The prevalence of subtypes was ADHD-C, ADHD-I, ADHD-HI in decreasing order. There was no sex difference of prevalence among three subtypes. The mean age of ADHD-I was older than other subtypes. 2) There was significant differences of psychopathology among subtypes, the ADHD-C and ADHD-HI had higher than the ADHD-I in the scores of delinquent, hyperactivity and psychosis;the ADHD-C had higher than the ADHD-I in the scores of family relation and autism, the scores of ego resilience were lower than the ADHD-I. However, there was no difference in anxiety, depression and somatization scores among them. 3) The results of behavioral symptom check lists, the ADHD-C had higher the score of inattention, hyperactivity and impulsivity than the ADHD-I. Meanwhile the results of ACTeRs, which rated by the teachers, were different. 4) There were significant differences of sequential processing scale and arithmetics among subtypes in IQ using K-ABC, but there was no significant difference between the ADHD-C and the ADHD-I after excluding the ADHD-HI due to small numbers. 5) There was numerical difference among subtypes but did not reach statistical significance in three neuropsychological executive function tests. Conclusion:In conclusion, our results revealed that there was significant difference in clinical features among three subtypes but, no significant difference in executive functions.

  • PDF

A Study on the Perceived Stress of Mothers in Neonatal Intensive Care Unit (신생아 중환자실에 입원한 환아 어머니의 스트레스)

  • Choi Sung Hee
    • Child Health Nursing Research
    • /
    • v.4 no.1
    • /
    • pp.60-75
    • /
    • 1998
  • The parents have much expectation upon the pregnancy and child birth, and in most cases, they expect the healthy parturient child. However, we can be placed on the high-risk conditions which have the physical, social and immature infant, due to the unexpected results, among the new-born. Accordingly, these high-risk newborn and premature infants will be mostly in NICU, which the concentrated medical treatment can be given, upon their conditions. After their birth and during these periods, they will be divided from the parents, and the nurse will accomplish the bringing-up activities which they can take care of the infant, expected by the parents after their birth. The hospitalization of high-risk newborn including these premature infants is the shocking experience to the parents of family, and thus they can feel the fear and uneasiness, and these reactions of parents are troubled in the behavior at the usual days, and cause the disorder and spiritless status, and these results break the supporting ability of parents, and cause the obstruction. Also, the unavoidable division between the parents and the children as like hospitalization of children can make the parents to feel the alienation emotionally, and this causes the results which the pride on the bringing-up ability of baby gets to be lost. These problems can cause the difficulties on the bonding or the parenting in the further days, and can be related to the neglect and abuse of children. Also, it is gradually increased to study and report which the emotional division by the physical division between the mother and the baby obstructs the normal affection course between the parent and the infant. The stress caused by the birth and the hospitalization of high-risk newborn, as like this, is important in the points which it can uncertainly affect the potential energy for the relationship of parent-child who are finally healthy. Accordingly, the significance and purpose of this study are to understand the contents and degree of stress which the parents of high-risk newborn including the immature child can be experienced from the hospitalization of ICU for their new borns, and thus to offer the basic program to the nursing intervention program for these. The subject of this study is the mother of newborn in NICU of 10 General Hospitals located at the 3one of Pusan, Korea from September 1997 to October 1997, and thus makes the subject of 95 person of parents who agreed to take part in the study and it is descriptive study related to the stress of mother having the newborn in NICU. The method is based on the preceding study related to the stress of mother having the experience of child hospitalization and chronic disease child, and then acquires the advice of specialists group as like 5 nursing professors, and then is amended and supplemented. Total number of questions is 43 items and consists of 5 factors as like medical treatment &nursing procedures, disease status & prognosis, role of parents, communication & inter-personal relationships, hospital environment, and is 5 point Likert Scale. The reliability of this study method is very highly shown to be Cronbach α=0.95. The collected data is analysed as Average, Frequency, Standard Deviation, T-test, ANOVA, Pearson Correlation Coefficient, Duncan multifulrange test by use of SPSS /PC (V7.5). The results of this study is summarized as under. 1. Every characteristics of subject is which the party of mother is 28.70age(±7.48) in the average ages, 51% in the high-school graduate, 38.5% in the christianity, total monthly income is 212.55 thousand won(±1.971), 74.5% in the housewife, 72.9% in the parents and children together living and the number of children to be 1.48person(± 0.6) in average, the recognition on the prognosis of baby is 74.0% in 'Don't know', the relationship with the husband after the hospitalization of babyis 37.3% in 'More Intimate', the relationship with the family of husband to be 48% in 'No-change', and the degree which is consulted with the husband about the baby is 55% in 'very frequently' and the visiting number per week is 4.59(±1.63) in average and the accompanying person in the time of visiting is which the number of husband is 56.3% and thus is the highest. The characteristics of baby is which the age is 21.88days(±16.47) after the birth in average, the sex to be 50 person in the female 52.1% and the order of birth to be 54.2% in the first chid, and the weight in the birth to be 2770gm(±610) and the height in the birth to be 46.26cm(±7.62) in aver age. The medical diagnosis is 37.5% in the premature infant, the career of hospitalization is 96.9% in 'None', and the operation plan is 90.6% in 'None' and the execution of operation is 88% in 'None' and the nursing of incubator is 55.2% in 'Yes', and the method of feeding is 50.5% in 'Oral' and the contents of feeding is 46.9% in the 'Milk'. 2. The total stress degree of subject is almost highly shown to be as 3.36(±0.86). If it is compared upon each cause, 'stress on disease status & prognosis' is highest 3.79(±1.28), and it is in the order of 'stress on medical treatment & nursing procedures' 3.70(±0.93), 'stress on hospital environment' 3.14(±0.86), 'stress on role of parents' 3.18(±0.92) and 'stress on communication & inter personal relationship' 2.62(± 0.77) 3. As the results of checking the notworthiness of stress degree upon each variable of subject, the variable showing the noted difference was the birth weight(γ=-0.16, P=0.04), birth height(γ=-0.23, P=0.03), nursing in the incubator(F=8.93, P=0.04), feed method(F=2.94, P=0.04). That is to say, it is shown which the smaller the birth weight is, the higher the stress degree of mother is noteworthily. Also, the smaller the birth height baby is, the higher the stress of mother is. In the incubator, it os shown which the mother whose baby is nursing in the incubator is higher in the stress degree than other mothers. Upon the feeding method of baby, that is to say, TPNis the highest, and it is shown in the order of NPO, Tube feeding, and P.O. feeding. When we review the above-mentioned results, as the status is serious, it is thought which we include the supporting nursing for coping with the stress of parents in the setting-up od nursing plan for the baby in the NICU.

  • PDF