• The Korean Nurse
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• v.36 no.5
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• pp.45-62
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• 1998

The study was conducted from November 1995 to May 1996 at the one general hospital in Seoul. The total subjects of this study were 412 patients who have the experience of fall accident, among them 31 was who have fallen during hospitalization and 381 was who visited emergency room and out patient clinic. The purposes of this study were to determine the characteristics, risk factors and results of fall accident and to suggest the nursing strategies for prevention of fall. Data were collected by reviewing the medical records and interviewing with the fallers and their family members. For data analysis, spss/pc+ program was utilized for descriptive statistics, adjusted standardized $X^2$-test. The results of this study were as follows: 1) Total subjects were 412 fallers, of which 245(59.5%) were men and 167(40.5%) were women. Age were 0-14 years 79(19.2%), 15-44 years 125(30.4%), 45-64 years 104(25.2%), over 65 years 104(25.2%). 2) There was significant association between age and the sexes ($X^2$=39.17, P=0.00). 3) There was significant association between age and history of falls ($X^2$=44.41. P= .00). And history of falls in the elderly was significantly associated with falls. 4) There was significant association with age and medical diagnosis ($X^2$=140.66, P= .00), chief medical diagnosis were hypertension(34), diabetis mellitus(22), arthritis(11), stroke(8), fracture(7), pulmonary tuberculosis(6), dementia(5) and cataract(5), 5) There was significant association between age and intrinsic factors: cognitive impairment, mobility impairment, insomnia, emotional problems, urinary difficulty, visual impairments, hearing impairments, use of drugs (sedatives , antihypertensive drugs, diuretics, antidepressants) (P < 0.05). But there was no significant association between age and dizziness ($X^2$=2.87, P=.41). 6) 15.3% of total fallers were drunken state when they were fallen. 7) Environmental factors of fall accident were unusual posture (50.9%), slips(35.2%), trips (9.5%) and collision(4.4%). 8) Most of falls occurred during the day time, peak frequencies of falls occurred from 1pm to 6pm and 7am to 12am. 9) The places of fall accident were roads(22.6%), house-stairs 06.7%), rooms, floors, kitchen (11.2%), the roof-top, veranda, windows(10.9%), hospital(7.5%), ice or snowy ways(5.8%), bathroom(4.9%), playground, park(4.9%), subway-stairs(4.4%) and public-bathrooms (2.2%). 10) Activities at the time of fall accident were walking(37.6%), turning around or reaching for something(20.9%), going up or down stairs09.2%), exereise, working07.4%), up or down from a bed(2.7%), using wheelchair or walking aids, standing up or down from a chair(2.2%) and standing still(2.2%). 11) Anatomical locations of injuries by falls were head, face, neck(31.3%), lower extremities (29.9%). upper extremities(20.6%), spine, thorax, abdomen or pelvic contents(l1.4%) and unspecified(2.9%). 12) Types of injures were fracture(47.6%), bruises03.8%), laceration (13.3%), sprains(9.0%), headache(6.6%), abrasions(2.9%), intracranial hemorrage(2.4%) and burns(0.5%). 13) 41.5% of the fallers were hospitalized and average of hospitalization was 22.3 days. 14) The six fallers(1.46%) died from fall injuries. The two fallers died from intracranial hemorrage and the four fallers died of secondary infection; pneumonia(2), sepsis(1) and cell lulitis(1). It is suggested that 1) Further study is needed with larger sample size to identify the fall risk factors. 2) After the fall accident, comprehensive nursing care and regular physical exercise should be emphasized for the elderly person. 3) Safety education and safety facilities of the public place and home is necessary for fall prevention.

• Journal of Acupuncture Research
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• v.18 no.4
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• pp.68-81
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• 2001

Herniated lumbar intervertebral disc(H.I.V.D) is the most common reason causing low back pain and leg radiating pain. Objective : The purpose of this report is to observe the effects of oriental medical conservative treatment in the different herniated type. Methods : We investigated 30 patients suffering from low back pain with sciatica which were admitted to Taejon Cheonan O. M. hospital from Nov 1, 2000 to Apr 30, 2001. 30 patients had a diagnosis of herniated lumbar interver tebral disc by Lumbar-C.T and Lumbar-M.R.I. we treated 30 patients by oriental medical conservative treatment (Ex: acupuncture, herb-med, physical theraphy, bed-rest, etc.) Results : 1. The mean hospitalization of patients was 21.1 days. that in the bulging type was l4days, protruded type 21days, mixed type 27days, extruded type 30days. that shows the less herniation of lumbar intervertebral disc, the mean hospitalization was more short. 2. In the distribution of the clinical symptoms admitted at that time, low back pain, leg radiating pain were showed in the all types(29patients, 96.6%). and sensory disorder, muscle powerlessness were showed least in the bulg ing type(0%, 37.5%), but that were showed most in the extruded type(50%,75%). 3. In the result of treatment due to clinical syptoms, bulging type was more execellent than any other other types. 4. The less herniation of lumbar intervertebral disc, angle of straight leg raising test was higher. In the result of treatment due to angle of straight leg raising test, bulging type was more execellent than any other other types. 5. In the distribution of physical. test, positive case in the Peyton sign, Ankle Dorsiflexion were showed least in the bulging type(25%, 12.5%), but that were showed most in the extruded type(100%, 75%). 6. In the result of treatment due to physical.test, bulging type was more exec ellent than any other other types. 7. The efficacy of total treatment was 90%(when we set a standard things more than fair), that in the bulging type was 100%, protruded 92%, mixedtype 80%, extruded type 75%. Bulging type had a more remakable effectsthan any other types. Conclusions : The less herniation of lumbar intervertebral disc, clinical syptoms were slighter, physical. test were better, and efficacy of oriental medical conservative treatme nt was remakable high.

• Journal of Korean Academy of Nursing
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• v.30 no.5
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• pp.1156-1169
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• 2000

The study was aimed at developing an independent hospice center model that would be best suited for Korea based on a literature review and the current status of local and international hospices. For the study, five local and six international hospice organizations were surveyed. Components of the hospice center model include philosophy, purpose, resources (workers, facilities, and equipment), allocation of resources, management, financial support and hospice team service. The following is a summary of the developed model: Philosophies for the hospice center were set as follows: based on the dignity of human life and humanism, help patients spend the rest of their days in a meaningful way and accept life positively. On the staff side, to pursue a team-oriented holistic approach to improve comfort and quality of life for terminally ill persons and their families. The hospice center should have 20 beds with single, two, and four bed rooms. The center should employ, either on a part-time or full-time basis, a center director, nurses, doctors, chaplains, social workers, pharmacists, dieticians, therapists, and volunteers. In addition, it will need an administrative staff, facility managers and nurses aides. The hospice should also be equipped with facilities for patients, their families, and team members, furnished with equipment and goods at the same level of a hospital. represented by a center director who reports to a board and an advisory committee. Also, the center director administers a steering committee and five departments, namely, Administration, Nursing Service, Social Welfare, Religious Services, and Medical Service. Furthermore, the center should be able to utilize a direct and support delivery systems. The direct delivery system allows the hospice center to receive requests from, or transfer patients to, hospitals, clinics, other hospice organizations (by type), public health centers, religious organizations, social welfare organizations, patients, and their guardians. On the other hand, the support delivery system provides a link to outside facilities of various medical suppliers. In terms of management, details were made with regards to personnel management, records, infection control, safety, supplies and quality management. For financial support, some form of medical insurance coverage for hospice services, ways to promote a donation system and fund raising were examined. Hospice team service to be provided by the hospice center was categorized into assessment, physical care, emotional care, spiritual care, bereavement service, medication, education and demonstrations, medical supplies rental, request service, volunteer service, and respite service. Based on the results, the study has drawn up the following suggestions: 1. The proposed model for a hospice center as presented in the study needs to be tested with a pilot project. 2. Studies on criteria for legal approval and license for a hospice center need to be conducted to develop policies. 3. Studies on developing a hospice charge system and hospice standards that meet local conditions in Korea need to be conducted.

• Therapeutic Science for Rehabilitation
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• v.2 no.2
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• pp.47-59
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• 2013

Objective : This study is conducted to find the influence on upper extremity function, cognitive function and activities of daily living when stroke patients receive task-oriented training in group or individually. Methods : Twenty-six inpatients are assigned to two groups(task training group and individual training group) randomly, who receive rehabilitation therapy after stroke diagnosis for 5 months(june to november, 2012) in a hospital. Both groups receive a task-oriented training for 30 minutes a day for 3 weeks. FMA were used to measure upper extremity function, K-MMSE were used to measure cognition, and MBI for ADL. Results : Before training. two groups were not different significantly in upper extremity function and cognitive function. But in activities of daily living, bathing self(p<.001), feeding, personal hygiene and total score(p<.05) are higher in group training group. After training, upper extremity function is higher in individual training group(p<.001). In both training group, upper extremity function, feeding, personal hygiene, bathing self, dressing, toilet, chair/bed transfers, ambulation and stair climbing, total score are improved significantly(p<.05). In comparing of variation before and after training, upper extremity function(p<.001), feeding and total score of activities of daily living are more improved significantly in individual training group(p<.05). Conclusion : The outcome shows that task-oriented training can improve upper extremity function and activities of daily living in both training group. Especially, the more upper extremity function is improved, the more activities of daily living is improved. In the future, it will be necessary longitudinal study for a long time for more patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.6
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• pp.449-458
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• 2016

The study verified the work capacity (job performance, perception, knowledge) and satisfaction on managing the inventory of operating room nurses working in a more than 700-bed hospital. The purpose of this study was to provide basic data of education for work capacity and satisfaction and quality insurance by analyzing the scores between the three different operating rooms and the correlation between the work capacity and satisfaction by investigating the related factors. This study presented a structured and self-administered questionnaire to 181 nurses who had been working in the operating room more than six months. The mean and standard deviation of the job performance, perception, knowledge, and satisfaction were 4.2(${\pm}0.56$), 3.4(${\pm}0.76$), 3.5(${\pm}0.40$), and 3.4(${\pm}0.55$), respectively. The work capacity and satisfaction of each group did not show a statistically significant difference. The correlations between the job performance and knowledge, knowledge and perception, perception and satisfaction were positive (r=.627, p<0.01), (r=.663, p<0.01) and (r=.485, p<0.01), respectively. Among the factors related to the general characteristics of operating room nurses, only age significantly affected their job performance. This study provides basic data on the maintenance and improvement of their competence and satisfaction by being served as a resource for sustainable human resources management and training, and efficient management of the communication channel between hospitals.

• Journal of Preventive Medicine and Public Health
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• v.23 no.3 s.31
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• pp.285-295
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• 1990

The utilization of medical care services has been partly regionalized with the implementation of referral requirement by the government since July 1, 1989 when the health insurance coverage was extended to all the people. For the purpose of regionalization, the whole country has been primarily divided into tertiary care regions, and each of them again into secondary care regions. This study investigates the self-sufficiency for in-patient care services of secondary care regions focusing on why it varies among the regions. In doing so, analysis is performed to examine a model which embodies three sets of hypotheses as follows : 1) The regional self-sufficiency for medical care services would be subject to direct influences of regional characteristics, amount of available services and structural properties of regional medical care system ; 2) The regional characteristics would have indirect effects on the self-sufficiency which are mediated by medical care services ; and 3) The amount of available services would indirectly affect the self-sufficiency by influencing the structure of regional medical care system. The results of analysis were generally consistent with the model. The findings have some practical implications. The regional self-sufficiency for medical care services partly depends upon basic properties of each region which cannot be changed in a short period of time. Thus the self-sufficiency for medical care services can be improved mainly by health policy measures. In some of the regions the self-sufficiency for in-patient care services was much higher or lower than can be predicted from the bed-population ratio. Indication is that the allocation of health resources should be made considering a variety of factors bearing upon the supply of and demand for health care ; not on the basis of just a single criterion like the availability. The self-sufficiency of a certain region is related to not only its own characterstics but also the characteristics of neighboring regions. Therefore, attention should be also directed to the inter-regional relationships in health care when the needs for investment of health resources in a region are assessed. However, it should be noted that this study used the data collected before the referral requirement was imposed. A replication of this analysis using recent data would provide an evaluation of the impact on the self-sufficiency of the referral requirement as well as a confirmation of the findings of this study.

• Journal of Korean Academy of Nursing
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• v.27 no.4
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• pp.807-819
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• 1997

The purpose of the study was to identify the effects of a 12-week low-intensity exercise program on muscle strength, flexibility, balance, and cognitive characteristics related to the performance of activity of daily living(ADL). A total of 16 patients who were admitted to the medical unit of a general hospital in ChoongChung province were recruited, eight for the exercise group and eight for the comparison group. Four levels of low-intensity exercise from 'ROM on bed' to 'exercise while walking' were then applied to the exercise group according to their physical condition. During hospitalization, patients in the exercise group performed each level of the prescribed exercise with the researchers until they felt comfortable doing it independently. The researchers also visited the patients' homes after discharge to make sure they could perform the exercise with Theraband in their living environment. The exercise group was contacted by phone once a week to assess the frequency and intensity in which they performed the exercise as well as their physical condition. The subjects in the comparison group participated in measurements for the study without performing the exercise and were contacted by phone after discharge, in a matched time frame with the exercise group, to assess physical condition. Muscle strength, flexibility, balance, cognitive characteristics, and performance of ADL for the two groups were compared at the pretest and the posttest after the low-intensity exercise program by utilizing SPSSWIN and the results are as follows : 1) At the postest, measurements of muscle strengths showed that the strength of the dorsal flexor in the exercise group was significantly higher than in the comparison group. 2) Objective balance for the exercise group was significantly better than for the comparison group as measured by 'standing on one foot' and Tinetti gait and balance control. 3) The exercise group showed significantly higher task self-efficacy than the comparison group. 4) Perceived exertion for ADL for the exercise group was significantly lower than for the comparison group. 5) Improvement of performance of ADL without assistance was significantly higher for the exercise group than the comparison group. The findings suggest that a low-intensity exercise program would be useful for the elderly who show decline in their physical functioning due to hospitalization by partly improving physical strength, task self-efficacy, and performance of ADL. Directions for further research on issues of motivating people to exercise as well as of standardizing various types of exercise were discussed.

• Clinical and Experimental Pediatrics
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• v.46 no.12
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• pp.1274-1278
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• 2003

Syncope in children and adolescents have a common occurrence according for up to 15% before adulthood. Micturition syncope, a kind of situational syncope, can be considered a form of reflex syncope. It can typically occur in healthy young men after rising from bed in the early morning who experience sudden loss of consciousness during or immediately after urination. The mechanism of micturition syncope is not completely understood, but it has been suggested that vasovagal reflex mediated bradycardia and peripheral vasodilation and decreased venous return due to Valsalva effect and standing position lead to the decrease in cerebral blood flow resulting in syncope. The causes of syncope are variable. So complete history taking, physical examination, electrocardiography, exercise stress test, echocardiography, head-up tilt table test, electroencephalography(EEG), brain magnetic resonance image and urodynamic study should be required for the diagnosis of micturition syncope. There were several reports about micturition syncope. However, literature of micturition syncope at the pediatric age has rarely been reported in Korea so far. Therefore, we report a case of a 9-year-old boy with micturition syncope with typical EEG findings of high amplitude delta wave and flattening during syncope.

• Korean Parent-Child Health Journal
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• v.6 no.1
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• pp.70-81
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• 2003

The otitis media has the highest rate of occurrence in 6-36 month after birth, and relatively high rate of occurrence to six years old. It is one of major cause for hearing loss problem because of its high rate of recurrence. The researcher observed at bed that feeding posture and feeding habit at night have some relationship with occurrence of otitis media. I found that medical research in this area was very weak, and it caused her to concentrate her research on the topic. This paper was undertook a retrospective case-control study to find out the relationship between the mode of feeding and the occurrence of otitis media among the otitis media patients and the healthy persons. As the controling groups, the researcher chose fifty eight mothers whose children received the treatment of otitis media(6-36 months after birth) from the pediatrics clinic of two general hospitals in Seoul, as the patient group, and forty five mothers who consulted with their child to well baby clinic at the general hospital and kindergarten in Seoul as the control group. The results of the survey can be summarized as followed : 1. "Otitis media patient group may have more lying posture mothers while feeding than the healthy control group". The first hypothesis is supported by the fact that the children who have lying posture feeding habit mothers are more easily exposed to otitis media than those who have sitting posture feeding habit mothers as the analysis show : $X^2=8.142$, p = .017 2. "Otitis media patient group may have higher rate of sleeping habit with milk bottle on the month at night than the healthy control group does". The second hypothesis was supported by the fact that the patients group has higher rate of expected sleeping habit than the healthy group dose as the analysis show : $X^2=4.35$, p = .037 3. "Otitis media can be found more in the artificial feeding group than in the healthy children group". The hypothesis is rejected by the analysis, $X^2=1.550$, p = .416. Though the hypothesis is not supported by this research, we need to encourage mothers to feed mother's breast milk on the ground that healthy group has mother's milk feeding tendency, and the best food for infants is their mother's milk, and psychological-sociological effects of breast feeding os quite good for children. It will improve the health of infants. It can be summarized as follows : Otitis media is more concerned with posture of feeding and night feeding habits than feeding modes. On the basis of this survey, feeding education problem for mothers of infants need to be developed. In the education, sitting-embracing posture of feeding, mother's breast feeding, and prohibition of children's lying posture feeding at night need to be emphasized.

• The Journal of Korean Medicine
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• v.26 no.3 s.63
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• pp.66-73
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• 2005

Objectives : The purpose uf this study was to evaluate the effect of Choksmni$(ST_{36})$ moxibustion in hypertensive patients who showed sudden elevation of blood pressure. Methods : Among patients admitted to Woosuk University Hospital from June to September 2004, sixty-one patients who had shown sudden elevation in systolic blood pressure over 100mmHg were chosen by random sampling and divided into a treatment group (Choksamni moxibustion group) and a control group. In the Choksamni $(ST_{36})$ moxibustion group, moxibustion was done at the point between tibial tuberosity and head of fibula where the $ST_{36}$ is known to be located. Direct moxibustion was practiced on the patients 5 times with an increase of size from a grain of rice to a bigger cluster. Male patients were chosen to practice on the left meridian and female patients were chosen to practice on the right meridian point. Changes in blood pressure after He moxibustion were checked 4 times at tine intervals of 30 minutes. In the control group, the patients took bed rest without my medical treatment. The two groups were compared in order to demonstrate whether then were any remarkable changes in depression of blood pressure. Results : There were significant decreases in the systolic and diastolic blood pressure before and after moxibustion. We found significant decreases in systolic blood pressure at 60 minutes, 90 minutes, and 120 minutes ana diastolic blood pressure at 120 minutes in the patient group compared with the control group. Conclusions : There was a statistically significant depressing effect on blood pressure elevation observed in the group with moxibustion at $ST_{36}$ versus the control group without any medical treatment.