This study adopts the phenomenological approach in order to explore the experience of urinary felt by the small island women and to find the meaning and structure of their experience, for the further understanding of them. This study succeeded in detecting five topics and three basic structure from eight participants, and followings are the comprehensive statement of them. The five topics include neglect of care after childbirth, unavoidable life in the tidal flat, shame which cannot be expressed even to their husbands, endless anxiety toward the expected future, and sad(dilemmatic) lived experience. The basic structure is that small island women who have urinary incontinence are apt to regard their disease as a natural destiny of women who fail to get adequate care after childbirth, and something to be endured to live in the seashore. They think of urinary incontinence as something so shameful that they cannot reveal it even to their husband and family. They believe that it even changes their personality since they must always stay alert in order to cope with the situation; for example, when it takes place unexpectedly, like too often to go to toilet, to change the underwears, to wake up in the middle of the night to go to toilet, to try not to laugh loudly, or to have showers. In addition, they accept it as a natural process of aging and incurable disease, and they consider themselves already ruined on the way of becoming uglier. They show dilemmatic abandonment: give it up unwillingly but at the same time think it is natural for others too. The unique experience of small island women with urinary incontinence implied in those statement are inseparable with the specific conditions for survival in the island. Unlike other diseases, it is considered the result of traditionally poor care after childbirth. However this misunderstanding that it is a natural phenomena for all the women who experience childbirth and aging and thereby incurable leads to an undesirable attitude toward urinary incontinence. According to the analysis, environmental conditions specific for small islands make the women there have distinct and unique experience concerned with urinary incontinence. Consequently, the future nursing plan for urinary incontinence in the small island area must be made and enforced with the consideration of these specific phenomenological meanings. Modern Korean nursing has basically been centered to hospital or urban areas. Besides, nursing intervention has long depended upon the research of western countries. This research, however, shows how greatly the regional and cultural characteristics influence the understanding of a certain disease, and is expected to make more specific and in-depth nursing approach enable for those who have urinary incontinence in small islands.
Byun, Chun Sung;Park, Il Hwan;Bae, Geum Suk;Jeong, Pil Yeong;Oh, Joong Hwan
Journal of Trauma and Injury
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v.26
no.3
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pp.170-174
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2013
Purpose: A flail chest is one of most challenging problems for trauma surgeons. It is usually accompanied by significant underlying pulmonary parenchymal injuries and mayled to a life-threatening thoracic injury. In this study, we evaluated the treatment result for a flail chest to determine the effect of trauma localization on morbidity and mortality. Methods: Between 2004 and 2011, 46 patients(29 males/17 females) were treated for a flail chest. The patients were divided into two group based on the location of the trauma in the chest wall; Group I contained patients with an anterior flail chest due to a bilateral costochondral separation (n=27) and Group II contained patients with a single-side posterolateral flail chest due to a segmental rib fracture (n=19). The location of the trauma in the chest wall, other injuries, mechanical ventilation support, prognosis and ISS (injury severity score) were retrospectively examined in the two groups. Results: Mechanical ventilation support was given in 38 patients(82.6%), and 7 of these 38 patients required a subsequent tracheostomy. The mean ISS for all 46 patients was $19.08{\pm}10.57$. Between the two groups, there was a significant difference in mean ventilator time (p<0.048), but no significant difference in either trauma-related morbidity (p=0.369) or mortality (p=0.189). Conclusion: An anterior flail chest frequently affects the two underlying lung parenchyma and can cause a bilateral lung contusion, a hemopneumothorax and lung hemorrhage. Thus, it needs longer ventilator care than a lateral flail chest does and is more frequently associated with pulmonary complications with poor outcome than a lateral flail chest is. In a severe trauma patient with a flail chest, especially an anterior flail chest, we must pay more attention to the pulmonary care strategy and the bronchial toilet.
Journal of the Korean Society of Food Science and Nutrition
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v.44
no.10
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pp.1558-1566
/
2015
The purpose of this study was to examine dietitians' perception of importance about standards of foodservice management associated with long-term care hospital accreditation. This study was carried out through a postal survey consisting of 500 questionnaires, and 157 returned questionnaires were used in the statistical analysis. The results were summarized as follows. Average scores of perception of importance were 4.54/5 points in foodservice production management domain, 4.56/5 points in foodservice facilities management domain, and 4.70/5 points in foodservice sanitation domain. The average scores of importance of long-term care hospitals without accreditation were significantly (P<0.05) lower than those of hospitals with accreditation in items of 'establishment of ventilation equipment in kitchen', 'establishment of hand-washstand in toilet (warm-water, soap)', 'setup of sterilizing foothold in entrance of kitchen and toilet', 'division and use of knife, chopping board, gloves, and utensils before and after cook', 'establishment of cleaning plan and cyclic practice', and 'recording of receiving diary'. Results indicate that there is a need to supplement a casebook of regulations by suggesting detailed and critical limits in the case of below average points of importance. A manual, including HACCP standards for foodservice management of long-term care hospitals, is needed, along with education and webpage for comparing notes on accreditation of long-term care hospitals.
1. Introduction Community medicine with the concept of comprehensive medical care and an ideal medical care delivery system not only for an individual or family but for the whole community has emerged. In April 1970, the Presbyterian Medical Center started a hospital based community health service project in order to improve the health of the people in rural areas. Prior to commencing a comprehensive medical care system, a family survey was needed. The major objective of this survey was to obtain information concerning the people and their environment so as to be able to plan and implement a comprehensive medical care program in Soyang-Myun. 2. Survey Method An interview using a family record form was carried out for each household. This family record form was designed to get information about demography, family planning, environmental sanitation and vital statistics. Prior to beginning, the members of the survey team were trained in interviewing techniques for three days. The team consisted of a public health nurse, four nurse-aides, a sanitarian and four health extension workers who are working in our project, The survey was carried out during the period November 1971 to March 1972. 3. Project area 1) Population of Soyang-Myun was 11,668; male, 5,962 and female, 5,706. Sex ratio: 104.5. 2) Households : 1,858 3) Family size: The average household consisted of 6.3 persons. 4) Educational level of householder a. Illiterate 13% b. No schooling but able to read 10% c. Preschool children 19% d. Primary school 47% e. Middle school 7% f. High school 3% g. College or University 1% 5) Occupational distribution of householders a. Farmer 67% b. Laborer 13% c. Office worker 4% d. Merchant 4% e. Industrial worker 2% f. Unemployed 8% g. Miscellaneous 2% 6) Religious affiliation a. No religion 74% b. Buddhist 12% c. Protestant 10% d. Catholic 4% 4. Survey results Living Environment : a. Home ownership 95% b. Kinds of roofing Straw-thatched house 84% Tile-roofed house 10% Slate-roofed house 5% Other 1% c. Floor space Less than 6 pyong 10% 6-10 pyong 53% 11-15 pyong 24% 16-20 pyong 9% More than 20 pyong 4% d. Radio ownership 80% Environmental Sanitation : a. the source of drinking water public well 49% private well 30% drainage water 9% steam water 8% well pump 3% water distribution system 1% b. Distance between well and toilet more than 16meters 38% 6-10 meter 31% 11-15 meters 14% Less than 6 meters 17% c. The status of well management Bad 72% Fair 26% Good 2% d. General sanitary state of house Bad 37% Fair 51% Good 12% e. House drainage system had no house drainage. 77% Family Planning : a. 24% of the people have used contraceptives, but 12% ceased to use them. 76% have never used contraceptives. b. used methods 1oop 68% oral pill 16% vasectomy 4% condom 1% tubal ligation 1% two or more methods 10% Maternal Health : a. The number of conceptions of housewives under 50 years of age. 11 times 26% 6 times 11% 5 times 11% 4 times 9% b. The place of delivery own house 88% hospital 1% others 11% Treatment of general sickness : a. The place of treatment Soyang Health Center 31% Hospital (private or otherwise) 26% Pharmacy 14% Herb medicine 5% Private care 5% No treatment 12% Miscellaneous 7% b. Usual causes of diseases Unknown 46% Tuberculosis 29% Neuralgia 8% CVA 3% Bronchitis 3% Others 11%
The purpose of this study is to clarify the correlation between the degree of patients daily activities and that of a sense and social support of families. This study covers families of 252 patients under home health nursing care at 6 University Hospitals during the period of March to May. 1999. The data were collected by using three different questionnaires. Data were analysed by utilizing SAS program such as frequency. average. percentage. t-test. ANOVA. Scheffe test and Pearson Correlation Coefficient. The results were as follows: 1. The average score of patients' daily living activity was $2.36\pm0.67$. $97.2\%$ patients turned out to be. in part. dependent on their family's care. $66.5\%$ of the patients were still dependent on their families in walking: $66.3\%$ In bathing: and $61.0\%$ in using toilet. 2. The average score burdened family caregivers had felt was 2.25 in 4 full point which can be interpreted as average. Among the six burden dimensions. time was said to be the No. 1 burden-yielding factor. When it comes to the characteristics of patients. there were tendencies for patients with lower incomes residing in communal housing. with cerebrovasculal diseases and with higher score of daily living activity to show a higher burden scores. 3. The average score of social support was 2.49 in 5 point. which represents a average score. Among other items. the opportunity of social integration was 2.66. topping the list whereas a chance of upbringing was starkly low at 2.42. The higher scores of social support were shown in cases where the caregiver was male spouse. total care giving duration exceeded 25 months and malignant patients daily living activity scores were low. 4. The score of patients daily activity was positively correlated to the degree of the family burden (r=0.1942). Data indicates there was direct correlation between daily living activity and burden of time consuming, self-improving and physical impairment. 5. The score of the patients daily living was negatively correlated to the social support (r=0.3414), As a whole. there was negative correlation between social support and the formation of intimacy and self-confidence.
To describe how to perform urological evaluation in children with tethered cord syndrome (TCS). Although a common manifestation of TCS is the development of neurogenic bladder in developing children, neurosurgeons often face difficulty in detecting urological problems in patients with TCS. From a urological perspective, diagnosis of TCS in developing children is further complicated due to the differentiation between neurogenic bladder dysfunctions and transient bladder dysfunctions owing to developmental problems. Due to the paucity of evidence regarding evaluation prior to and after untethering, I have shown the purpose and tools for evaluation in my own practice. This may be tailored to the types of neurogenic bladder, developmental status, and risks for deterioration. While the urodynamic study (UDS) is the gold standard test for understanding bladder function, it is not a panacea in revealing the nature of bladder dysfunction. In addition, clinicians should consider the influence of developmental processes on bladder function. Before untethering, UDS should reveal synergic urethral movement, which indicates an intact sacral reflex and lack of TCS. Postoperatively, the measurement of post-void residual urine volume is a key factor for the evaluation of spontaneous voiders. In case of elevation, fecal impaction, which is common in spinal dysraphism, should be addressed. In patients with clean intermittent catheterization, the frequency-volume chart should be monitored to assess the storage function of the bladder. Toilet training is an important sign of maturation, and its achievement should be monitored. Signs of bladder deterioration should be acknowledged, and follow-up schedule should be tailored to prevent upper urinary tract damage and also to determine an adequate timing for intervention. Neurosurgeons should be aware of urological problems related to TCS as well as urologists. Cooperation and regular discussion between the two disciplines could enhance the quality of patient care. Accumulation of experience will improve follow-up strategies.
Purpose: Patients with Parkinson's disease suffer many restrictions in daily life. This case report investigated how intervention with proprioceptive neuromuscular facilitation (PNF)-based physical therapy can affect the activities of Parkinson's patients. Methods: The subject was a 67-year-old female patient diagnosed with Parkinson's disease 3 years ago. Since the last five months, overall activities have become difficult for her, and she finally visited a hospital to take outpatient physical therapy because of the gait difficulties she suffered. The patient's medical history, system review, body structure and function, and activities were evaluated. The patient had difficulties in activities such as lying down, sitting, standing, maintaining a standing position, and walking. The PNF-based intervention was used for treating the impairments and improving the activities. The intervention was performed for 30 min a day, three times a week, for eight weeks. The qualifier of the international classification of functioning, disability, and health was used to measure the result, and the measurement was conducted before and after the intervention for eight weeks. Results: According to the result, the scores for maintaining a standing position, moving around within the home, and going to the toilet improved to "no problem" from "moderate problem." The scores for shifting the body's center of gravity, walking short distances, and washing oneself improved from "moderate problem" to "mild problem." The scores for sitting and standing improved to "no problem" and "mild problem" from "complete problem." The scores for preparing meals and doing housework improved from "severe problems" to "mild problem" or "moderate problem." The scores for walking long distances, moving around outside the home and other buildings, and using transportation did not show significant changes. Conclusion: Intervention with PNF-based physical therapy improved the activity of patients with Parkinson's disease, thus proving its effectiveness. The case report suggested that a therapist can use PNF as a physical therapy intervention for patients with Parkinson's who suffered restrictions in daily activities.
Purpose: The purpose of this study is to examine how well patients who had hip arthroplasty comply with medical regimens given to them after the operation. Method: The subjects of the study were patients who had arthroplasty at P Hospital between April 1, 2001 and August 30, 2002. 20 patients of the subjects experienced complications after the operation and the other 20 did not. Data from a survey using the qustionnaire were statistically analyzed in terms of real number, percentage point, mean and standard deviation by using $X^2$-test, t-test and ANOVA. Result: 1) the surveyed patients were significantly different in the compliance of medical regimen among them according to their education background as one of the subjects general characteristics. 2) It was found that the group of complication was higher in the compliance of medical regimen than that of non-complication. The two groups showed statistically significant difference with each other in the degree of compliance with therapeutic instructions than the experimental group in terms of the maintenance of abduction after the operation, training instructions on step-by-step basis, urination cotrol on bed, accurate use of crutch, compliance with medication, balance among medical treatment, training, leisure, rest and nutrition, instructions by physicians, nurses and physical therapists, use of low armchairs and toilet bowels and no bending of the body forward, and use of a non-operated leg in case of go upstairs or downstairs. Conclusion: It seems necessary to develop systematic and sessional education programs for improving the compliance of medical regimen, ultimately reducing complications following hip arthroplasty.
Park, Hyoung-Sook;Kim, Dong-Hee;Kim, Yun-Jin;Son, Yong-Jin;Lee, Jeong-Gyu;Lim, Jie-Hyang
Journal of Korean Academy of Fundamentals of Nursing
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v.16
no.3
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pp.316-324
/
2009
Purpose: The aim of the study was to identify the relationships among age, activities of daily living and health-related quality of life (HRQoL) for centenarians in Busan. Methods: Forty-nine centenarians (2 males and 47 females) participated in the study, done from April to July, 2006. Pace-to-face interviews were used to collect data. Activities of daily living were measured using K-ADL, K-IADL and health-related quality of life, using the Short Form Health Survey (SF-36). Results: Over 50% of the centenarians reported independence for six-items but not for bathing. With regard to type of dependency, 77.6% were independent in transferring, 71.4%, in using the toilet, 67.3%, in feeding and in continence and 57.1% in dressing but just 24.5% were independent in bathing. Age was significantly associated with K-IADL (r= -.303, p= .03). The centenarians were more impaired in physical health components compared to mental health components for health-related quality of life. Conclusion: These results may contribute to a better understanding of activities of daily living and health-related quality of life of centenarians. The findings are relevant to health professionals, in particular professionals who are developing wellness programs to optimize health-related quality of life and functional status for the extremely old age population.
Journal of agricultural medicine and community health
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v.47
no.1
/
pp.27-39
/
2022
Objectives: The purpose of this research was to explore Fall Risk Home Environment(FRHE) and to investigate the association between FRHE and fall experience among community-dwelling older adults. Methods: The data were collected from 299 older adults using FRHE through observation and interview at home of the participants and were analyzed with SPSS 22.0 applying descriptive statistics, χ2-test, t-test, and logistic regression analysis. Results: The prevalence of fall experience during the past year was 51.5%. 'No handles beside the toilet or bathtub'(73.2%) was most common FRHE factor, 'thresholds in your room or kitchen'(68.9%), 'wearing socks, outer socks, or slipper when you move in the house'(59.5%), and threshold on the gate (apartment entrance)(55.5%) were followed. The findings of logistic regression of FRHE on fall experiences showed darkness of house had the highest Odds Ratio (OR 9.83 95% CI 3.75-25.71), followed by furniture obstructs your walking in the house(OR 7.07, CI 2.88-17.36), dark kitchen (OR 5.13, CI 2.38-11.03). The group having fall experiences presented significantly higher score of FRHE than the group of non experiences of fall. Conclusion: The community dwelling older adults exposures to various FRHE factors and FRHE might increase the risk of falls. Assessing and modifying the home environment could be a good strategy to prevent fall among older adults.
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