Contemper nursing literature place much importance on human- centered and individualized care. Nursing research has related stress during hospitalization of adolescent patients to adaptation to a new environment, isolation from friends, limitation due to illness, over protection of parents and communication with member of the medical team. The investigator conducted this study in the hope that an understanding of adolescents responses to hospitalization, their perceptions, the kinds and levels of stress, and the relationships between stressors and individual characteristics would contribute to the improvement of adolescent patient care. The objective of the study was to obtain informations related to the adolescents psychological stress experience during hospitalization, specifically stress from interpersonal relationships and communication, isolation from the family, social or economic problems, illness and from the treatment environment and nursing care. An interview schedule adopted from Holmes and Rahe's Social Readjustment Rating Scale and selected items from Voicer's instrument on stress-producing events was used with 120 adolescent inpatients aged 13 to 18 years three general hospitals in Seoul during Aug. 10, to Sep. 30, 1975. 1. The sample consisted of 66 male and 54 female patients. Sixty-six percent were late adolescents, aged 16 to 18 years: 4% were early adolescents, aged 13 to 15 years. The primary cause for hospitalization was for orthopedic problems (35.8%). More than half of these (54.4%) were due to injury or accident. 2. Stress eclated to illness revealed the highest score (4.97), followed by stress related to treatment environment and nursing care (4.34) , isolation from family and social or economic problems (4.01) and interpersonal relationships and communication (3.96). 3. The perceived indifference of doctors and nurses was a serious cause of stress (mean=4.83). Fellow patients and visitors caused least stress (mean=2.06). 4. Discontinuation of education or unemployment were major stressful events (mean=4.71). Least stressful was isolation from the family (mean=3.47). 5. More than 94% of the respondents expressed fears related to body image (mean=4.97) 6. Within the category of treatment environment and nursing care, items related to restrictions because of treatment, discomfort because of treatment, inadequate explanation from nurses about procedures were rated as severe stress events (mean=4.6). Items related to the ward environment and to having a relative stay with them were seen by the group as less serious events (mean=3.7). 7. Stress related to interpersonal relationships and communication was correlated positively with female patients and those preferring passive activities. (P〈0.05) 8. Stress related to family problems was positively related to female and early adolescent patients (P< 0.05). Stress related to social problems was positively , elated to students and those preferring active pursuits (P< 0.05). 9. There were no correlation between the high stress related to disease and any of the characteristic items. (P> 0.05) 10. Stress related to treatment environment and nursing care was positively related of early adolescent and female and student patients. (P< 0.05) This group of hospitalized adolescents reported high level of stress related to treatment environment and nursing care, due to lack of consideration of normal growth and development and individual characteristics. The findings have important implications for the planning of effective, individualized, comprehensive nursing care of adolescents during hospitalization.
The purpose of this study was to provide basic materials needed to enhance quality of organizational life by identifying the improvements of labor union management in the perspective of hospital organization management. The subjects of this study were 510 employees in 1 University Hospital and 3 General Hospitals in Metro Capital including Seoul. Materials were collected from administrators, nurses and medical technicians in target hospitals from April 26 to May 7, 2004 through survey questionnaires. The main results of this study were as follows: First, From the results of multiple regression analysis to identify major influencing factors of labor union commitment level, In University hospitals, males than females, and those who had senior officer posts in labor union showed higher positive correlation with the attitude of their colleagues. In general hospitals, those who had served in Union for shorter period showed higher commitment in union. Second, When looking into the major influencing factors on the level of commitment in labor union according to their jobs, male administrators showed higher positive correlation in the level of commitment in labor union and the relationship with union. Among nurses, those who had lower education level, those who had higher job satisfaction, those who had higher emotional attachment to their job, those who had better relationship with union and better satisfaction in union showed higher commitment level. In medical technicians, those who had higher emotional attachment to their job showed higher commitment level. To summarize study results, the level of commitment in labor union depends on job satisfaction, managers' attitudes, emotional attachment to their jobs, union satisfaction factors, their colleagues attitudes toward union and thee atmosphere of employer-employee relationship. Therefore hospital managers should have democratic and flexible attitudes toward labor union. Additionally, as job satisfaction is important determinant in union commitment, hospital managers should have countermeasures to enhance the job satisfaction level of hospital employees. Moreover, as managerial factors of the principal of hospital influence union commitment directly, the attitudes of hospital managers toward union and transparency of hospital management should be improved.
The purpose of this study was to determine factors influencing patient satisfaction with medical services in hospital, which is classified into environmental aspect, human services and procedural services. Based on the results of literature review, the study focused on effects of social-demographical factors on patient satisfaction. The environmental aspect of medical care services included medical equipment and facilities, hygiene, ventilation, heating and air-conditioning, waiting and resting space, ward space and parking facilities. Procedural service included registration process, bill payment, waiting time after registration, examination and prescription as well as appointment process. Human services consisted of physicians listening to stories of patients, examination duration, physicians' explanation and physicians' service. As for nurses, explanation about disease, examination procedure and results, kindness and nursing care were evaluated. Services provided by other staff members were also evaluated. Patient satisfaction, defined as individual attitude toward medical service as a whole, was measured using a questionnaire. A total of 700 in-or out-patients were surveyed in 6 hospitals with more than 300 beds in North Gyeongbuk Province. 1. The level of patient satisfaction varied with characteristics of patients. Male patients and those in their 30s had a low level of satisfaction. Dissatisfaction level was positively related to education level but negatively related to economic condition. 2. As for patient satisfaction with medical service providers and other employees in hospital, satisfaction level with physician's explanation about treatment was higher. But dissatisfaction levels with treatment duration and the lack of explanation about examination procedures were high, calling for improvement. Dissatisfaction level with nursing care was high, calling for training of nurses for better service. Given the low level of satisfaction with human services, hospital employees need to be trained to improve their service. 3. It Was found that administrative service was also a significant factor influencing patient satisfaction in addition to medical service. It is therefore important for hospitals to provide patients with prompt and convenient procedural service. 4. Environmental factors such as medical equipment and amenity facilities also affected patient satisfaction. Thus environmental condition, procedural service and human service are all important to improve medical service in hospital. In summary, procedural service was the most significant factor for patient satisfaction. The level of satisfaction in patients was also affected by human service and environmental condition. It is therefore necessary to take patient-oriented approach in providing medical service in an effort to improve patient satisfaction. The finding of a lower level of satisfaction with human service signifies the need for training of healthcare providers and other hospital employees for better services. The introduction of advanced management programs is also needed to improve procedures that patients go through in hospitals.
Many patients of acute myocardial infarction showed delay time before seeking treatment although they needed immediate thrombolytic therapy once they perceived their symptoms. The objectives of this study were to identify the relationship between clinical symptoms and the delay, and to find the time spent before seeking the treatment. This study was a retrospective research. The delay time for the treatment consisted of the length of delay from symptom onset to patients' decision (T1), from patients' decision making to finding transportation (T2), and from taking transportation to the first hospital arrival(T3). The subjects were 89 patients who were admitted in the ICU and Cardiac Ward at Chonnam University Hospital with the first attack of acute myocardial infarction. Center, USA The data was collected for three months from March 1st to May 31st of 1998 through questionnaires and reviewing patients' charts: The chart information was suppled by two nurses working at the ICU and Cardiac Ward. The data was analyzed by using frequency, mean and ANOVA through the SAS program. The results of study summarized as follows: 1. Sixty two patients (69.7%) were male and twenty seven patients (30.3%) were female, the ratio of male to female was 2.3 : 1. 2. In daily life, the 70.8% of the patients felt chest pain and discomfort fatigue in 67.4%, dyspnea in 57.3%, and pain in arm, neck, and jaw in 52.8%. During the attack, 97.8% of the patients felt chest pain and discomfort dyspnea in 82.1%, pain in arm, neck, jaw in 67.4% and perspiration in 51.7%. 3. The length of time a patient spent seeking time for treatment (T1+T2+T3) was 94.6 minutes, in which the time for patients' decision making for treatment (T1) was 70.3 minutes, time for finding transportation (T2) was 8.2 minutes, and time for the transportation of the patient to the first hospital (T3) was 16.1 minutes. Time for patients' decision making to go to a hospital(T1) was 74.2% of the total time sought for treatment. 4. The differences of time sought for treatment between perceptions about the seriousness of the symptoms were significant (F= 6.5, p< .01). The more serious the heart symptoms they felt, the shorter the seeking time for treatment. 5. The differences of the time delay before treatment between the degree of the symptoms were significant (F= 2.9, p< .05). The patients with the typical chest pain and discomfort spent shorter the seeking time for treatment than those with the atypical symptoms of acute myocardial infarction. 6. The differences of transportation time to the first hospital between the types of cars that the patients used, were significant (F= 4.3, p< .01). When the patients used 119 or 129 they spent the least time (5.3 minutes) for transportation, and followed by way of an ambulance (15.6 minutes), private car (20.6 minutes), and taxi (24.8 minutes).
The purpose of this comparative study is to find out women and their spouses' sexual life and the factors affecting on their sexual life after women's hysterectomy. The data were the 110 questionaires which were collected from the participants, the 55 women who had undergone a hysterectomy due to gynecologic disease or benign tumor of genital organs and their spouses from January 1, 1999 to January 30, 2002 in one general hospital located in Seoul, Korea. Questionnaires were mailed to couples, who agreed to participate on the study and self reported questionnaires returned in the pre-stamped envelopes. And personal visits were made for those couples who did not respond. Tools for Sexual life and characteristics of sexual activities were reconstituted by the author based on Kim(1996) and Chang(1988)'s tools and were reviewed by a nurse specialist. Data analysis was done by SPSS 10.0 program using frequency, percentage, mean, S.D. Pearson correlation coefficient, t-test, oneway ANOVA and multiple regression. The results of this study are as follows; 1. Of all female subjects, 80% had experienced hysterectomy below the age of 50. 2. 72.8% of female subjects and 67.3% of male subjects did not receive any sexual education & counseling before and after the surgery. More than 60% of both female and male subjects answered that it was necessary to have a sexual counseling. And 40% wanted to receive sexual counseling from a professional sexual counselor. 3. More than half of couples started their first coitus within 4 weeks after the surgery. And 88.9% of females and 85.2% of males answered that they were experiencing orgasms with their sexual relationship. 4. Influencing factors on the satisfaction level of sexual life were couple's intimacy and sexual discomfort in women and couple's intimacy and sexual knowledge in spouses. These factors explained the 33% and 24% of total variance respectively. In conclusion, the result suggests that it is necessary for couples to receive a professional sexual education and counseling to improve couples' quality of life. It is also necessary for institutions to use prepared nurses by receiving sexual counseling and education program as a professional sexual counselors or educators so as to provide individualized sexual education and counseling for their clients.
Purpose: The purpose of this study was to identify relationship of urinary symptom, urinary discomfort and quality of life among the bladder cancer patients and benign prostate hypertrophy patients, and to contribute health promotion of such patients and nursing intervention development based on this results. Method: Study sample recruited bladder cancer patents(n=49) and benign prostate hypertrophy patients who admitted Seoul National University Hospital from June, 2002 to June, 2003. Both group patients were operated, and prostate hypertrophy patients group (mean 67.8 years old) were older than bladder cancer patients group(60.82 years old). Instruments was composed of general characteristics, urinary symptom scale(19 items), urinary discomfort scale(19 items) and quality of life scale(21 items). Data was analysed SPSS PC + 10. using mean, standard deviation, pearson correlation coefficient. Result as follows: 1. There was a statistically significant difference in occupation between two groups (p=.027). Hypertrophy patients group's age was more older than bladder cancer patients group. 2. The prostate hypertrophy patients group had the significantly higher score in urinary symptom (p=000) and nighttime urination frequency. However, there was no significant difference in incontinence symptoms and the symptoms associated bladder cancer between two groups. 3. The prostate hypertrophy patients group had significantly higher score in urinary discomfort (p=000) than the bladder cancer patients group. However, there was no significant difference incontinence discomfort and the discomfort associated bladder cancer between two groups. 4. The prostate hypertrophy patients group suffered more urinary discomfort than the bladder cancer patients group did. The quality of life the prostate hypertrophy patients group was lower than the quality of life the bladder cancer patients group. Quality of life was no statistically significant difference between two groups (p=000). 5. There was a positive correlation between urinary symptoms and urinary discomfort. However, there was a negative correlation between the quality of life and urination symptoms and discomfort. Conclusions: The prostate hypertrophy patients group had significantly higher score in urinary symptom and urinary discomfort (p=000) than the bladder cancer patients group. The quality of life the prostate hypertrophy patients group was lower than the quality of life the bladder cancer patients group. This means that urinary symptom and urinary discomfort in prostate hypertrophy patient group is more important problem. So, prostate hypertrophy patient group need to control the symptom. Therefore, nurses will be provide the intervention program to improve the bladder function after prostate hypertrophy surgery.
This study aims to investigate smoking patterns in high school student and to give student smoker effective information. The sample of 250 male highschool students out of two different schools in Tae-Jon was questioned from July 10th to 15th. 1995. In analyzing these date. the statistics shows the realities by means of number of students. The results are summarized into 17 items as follows. Regarding the level of smoking. 140 students out of 250 admit that they have ever smoked. 52.1% of smoking students say that the motivation of beginning smoking is mainly curiosity. The survey shows that 22.9% of smoking students feel very good when smoking. It also shows that 30.0% of smoking students began smoking in the first grade of high school. With regard to the volume of smoking per day. 41.4% of smoking students smoke variably. 42.1% drink when smoking. 15.0% spend more than W 70.000 a month. About the question who knows the fact of their smoking. 51.5% answer that their friends know the fact of their smoking. In regard to the resaltionship between smoking and school per-formance. 18.2% of non smoking students make poor grades as compared with 40% of smoking students. 9.3% of smoking students say that they are satisfied with the school life. but 35.7% of them are not satisfied. Regarding the attitude to smoking teachers. 35% of smoking students state that they are affected by them. 69.3% of smoking students say that they will stop smoking. while the remaining 30.7% say that they will keep smoking. The reason of 63.9% to stop smoking is that smoking is bad for the health. The reason of 46. 5% to keep smoking is the acquired habit of smoking. 97.2% know the fact that the major element of cigarettes is nicotine and it is very harmful to the health. 40.8% recognize the harmful effect of smoking by TV and radio programs. 97.2% know that smoking could cause lung cancer. From the above results. I propose as follows We should make specific plan to keep smoking by simple curiosity from being developed into habitual smoking. We should teach them how harmful smoking is and make them stop smoking by themselves. It is very essential for family members and teachers to give continuous interest since childhood. As the teacher affect the students very much, they should give up smoking first. The incidence of smoking should be identified in each of the middle and high schools. smoking prohibition programs relevant to each school should be developed and implemented. The local community should ban cigarette vending machines. Cigarettes should not be sold to adolescents. By setting every place where adolescents gather including schools nonsmoking area. we should decrease their impulse to smoke. then smoking opportunities. and harmful effects to them caused by passive smoking.
The Journal of Korean Academic Society of Nursing Education
/
v.7
no.1
/
pp.157-169
/
2001
The purposes of this study were to investigate stress responses of senior high school students(examines) preparing for college entrance examination and to identify the relationship between stress responses and self-esteem. The subjects of this study were 261 senior high school students from three high schools located in three different Gu Seoul Korea. Data were collected from 19th to 27th march, 1998. Stress responses were measured by SOS (symptoms of stress) inventory and self- esteem was measured by Rosenberg's self-esteem scale. The data were analyzed with descriptive statistics, t-test, ANOVA and Pearson's correlation coefficient. The results were as follows : 1. The mean SOS score of subjects was 1.22 and that showed statistically significant according to gender difference (t=-6.00, P<0.0001) and father's occupations (F=3.10, P=0.006). 2. The mean self-esteem score was 2.77 and that showed statistically significant difference according to economic status(F=3.96, P=0.02) and father's occupations (F=2.71, P=0.01). 3. There was significant negative correlation between the mean SOS score and the mean self-esteem score(r=-0.31, P=0.0001). In conclusion, the examines had very high physiological and psychological stress responses and especially female showed higher stress responses than male. For this reason, school nurses are recommended (1)to develop appropriate stress management technique, (2) to provide more intensive care for health of female examines Nursing intervention should be developed for enhancing self-esteem of examines because self-esteem is negatively correlated with SOS.
This study has been performed to investigate group differences and determining factors of burnout of the workers in elderly living facilities. In this study, 131 male and female workers composed of social workers, health practitioners, and other management workers were selected among 23 retirement and nursing facilities in Korea between 2003 and 2005. They were asked about their socioeconomic background, working environment, and their perceptions on burnout in the working places. As for main dimensions of the burnout, there were three elements such as emotional weariness, diminishing personal accomplishment, and depersonalized behaviors. Particularly in this study, the depersonalized behaviors were defined as aggressive or rude verbal and behavioral outbursts from anger. As a result of this study, the following results were found: Most workers have medium level of perception on their commitment and burnout, but there. are some risk factors; newly married young workers were less satisfied or fairly rewarded with their job and as a result, they have significantly higher level of emotional weariness but lower feeling of personal accomplishments. In addition, they occasionality practiced aggressive or rude behaviors such as yelling, threatening, and physically harassing As for the influence of determining variables, long-time workers of long established facilities were more satisfied and less burnout. In addition, there are some impacts of job category; health practitioners were more burnout than social workers. In this study, suggestions are made as follows: first, guiding and settlement programs should be developed for the newly started young married workers, particularly at early stage of their career. Second, future aspects of facility visions should be guided for the workers, so that they are relieved from stressful routines without any future plan. Third, medical workers such as physical therapists and nurses should be further monitored for main reasons of increasing their stress.
The Journal of Korea Assosiation for Disability and Oral Health
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v.6
no.2
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pp.116-119
/
2010
Trauma to the lips and tongue can occur by accidental self-biting after dental treatment. After local anesthesia, it is likely that the patient may feel painless even in biting the tongue. In case of young children and disabled patients, the dentists should be careful not to bite the tongue. In this report, we present a case of deep lingual laceration due to biting the tongue in the course of dental treatment under general anesthesia. A 33 year-old male was transferred to our hospital to treat tongue laceration. Before 2 hour on arrival, he had received dental care under general anesthesia at a dental hospital for the disabled because of cooperation difficulty and cerebral palsy. During recovery from general anesthesia, he tried to bite his own tongue involuntary. The doctors and nurses tried to prevent the patient from being injured. Despite these efforts, massive bleeding occurred from the injured sites of the tongue. Because we could not communicate with him, we decided to evaluate the extent of the injury and treat the injured sites under general anesthesia. The laceration wound was sutured for nearly 1 hr general anesthesia. During recovery we inserted mouth prop into the oral cavity to prevent further injuries from tongue biting. After full recovery from general anesthesia he didn't try to bite his tongue. After 4 hour admission, he was discharged without other complications.
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