This study was performed to find out the differences between noise levels of hospital wards and the nurses efforts for noise management in some general hospitals. The hospital wards selected were the intensive care unit(ICU), the emergency room(ER), the nursery room(NR), the internal medicine(IM), the general surgery(GS) among the 5 general hospitals located in Seoul. The data were collected from August 3 to September 13, 1999 through questionnaire survey and noise measurement in each nursing station of hospital wards. Data analysis was done by SPSS 8.0 package among the 305 questionnaires and 24 hours monitored noise levels. Frequency, Chi-square and ANOVA test were used. The study results were as belows: 1. The noise level measured by 24 hours monitoring survey were exceeded on the standard limit in all the hospital wards. Data also showed that noise levels were significantly different in each ward among the three shifts working duties. 2. The subjects were all female nurses. They were mostly working in the ICU ward(28.9%). They were 26~30 years old (43.9%), junior college graduates(57.0%), working for 1~5 years(55.1%) as staff-nurse(85.6%). There were no significant differences between hospital wards and general characteristics of nurses. 3. The noise levels perceived by nurses were regarded as 'Highly noisy'(56.4%), especially during the 11:30 and 15:30 (30.2%) o'clock. Data also showed that noise education was not ever given to nurses(89.9%). Nurses also responded that they hardly put an effort to reduce noise level(54.8%). However, there were significant differences between wards and noisy working time, experience of noise education and level of effort for noise reduction. 4. Nurses also perceived the ventilator alarm and EKG-alarm as the most disturbing sounds in the ICU, human voice and telephone ringing in the ER, human voice and EKG-alarming in the NR, human voices and telephone ringing in IM and GS both wards respectively in order. There were significant differences between hospital wards and noise making factors. 5. Nurses were shown that they regarded highly 'Sound reduction of the human voice', 'Careful handling on medical instruments', and 'Immediate appliances on alarming materials' as the practical method for noise management. There were significant differences between hospital wards and behavioral practical efforts for noise management. According to that results, the statistical differences were shown in the 24 hour monitored noise levels in each ward. Also, nurses perceived the noise severity differently and they approached variously on the practical efforts for noise reduction in each ward. Thus, author thinks that concrete and systematic endeavor will be necessary for noise reduction and management in hospitals for better working and healing environment for both of patients and staffs.
본 연구는 방사성요오드 치료 후 방사선으로 인한 부작용과 방사성 노출을 예방하기 위한 자가간호의 정도를 파악하고, 자기효능감과 사회적지지와의 관계를 규명하여 방사성요오드 치료 후 환자에게 요구되는 간호중재를 제시하고자 시도된 서술적 조사연구이다. 연구 기간은 2013년 3월에서 5월까지이며, 경기도 소재 암전문병원에서 갑상선절제술을 받고 방사성요오드 치료를 받는 환자 108명을 대상으로 실시하였다. 연구결과 대상자의 자가간호는 56점 만점에 평균 52.10점으로 나타났으며, 방사선요오드 치료 환자의 자가간호는 자녀의 유무(t=-2.312, p=.023)와 건강에 대한 관심(t=5.689, p<.001)에 따라 유의한 차이가 있었다. 또한 자가간호는 자기효능감(r=.610, p<.001), 가족지지(r=.646, p<.001), 의료인지지(r=.276, p=.004)와 유의한 양적 상관관계가 있는 것으로 나타났다. 위계적 회귀분석 결과 1단계에서는 건강에 대한 관심(t=5.301, p<.001)이 자가간호에 영향을 미치는 요인으로 나타났고, 2단계에서는 건강에 대한 관심(t=2.140, p=.035), 가족지지(t=3.353, p=.001)가 유의한 영향변수로 나타났으며 이들 변인은 자가간호에 대해 약 46.3%를 설명하고 있었으며 가장 영향력 있는 요인으로는 건강에 대한 관심(${\beta}$=1.309, p=.035)이었다.
The purpose of this study was to describe nursing decision tasks, their characteristics, and problems associated with decision making. The subjects were 32 nurses who had at least one-year nursing experience and worked on medical-surgical units or intensive care units(ICU). They were asked to describe their decision making experiences in patient care situations and to identify the characteristics of each decisions. They were also asked to describe perceived problems associated with decision making in nursing. The responses on nursing decision tasks and problems were analyzed with content analysis and the decision characteristics were identified by statistical analysis of variance. It was found that there were 16 nursing decisions which are as follows : decisions related to interpreting and selecting appropriate strategies for pain management(6.6%) ; decisions related to providing emotional support (0.7%) ; decisions related to explaining the patient's condition and rationale for procedures(1.1%) ; decisions related to assisting patients to integrate the implications of illness and recovering into their lifestyles(2.9%) ; decisions related to detecting significant changes In patients and selecting appropriate intervention strategies (17.2%) ; decisions related to anticipating problems and selecting preventive measures(4.2%) ; decisions related to identifying emergency situations(0.4%) ; decisions related to effective management of patient crisis until physician assistance becomes available(2.8%) ; decisions related to starting and maintaining intravenous therapy(2.6%) ; decisions related to administering medications(8.1%) ; decisions related to combating the hazards of immobility(7.3%) : decisions related to treating wound management strategies(5.5%) ; decisions related to relieving patient discomfort(13.9) ; decisions related to selecting appropriate strategy according to the changing situation of the patient(18.2%) ; decisions related to selecting the best strategy for patient management(5.3%) ; and decisions related to coordinating, ordering, and meeting the various needs of the patient (3.1%). The nurses reported the fellowing problems in decision making : difficulties due to lack of knowledge and experience (18.6%) ; uncertainty and complexity of decision tasks(15.2%) ; lack of time to make decisions(2.9%) ; personal values which conflict with other staff(15.7%) ; lack of selection autonomy(30.0%) ; and organizational barriers(7.6%). Continuing education programs and decision support systems for frequent nursing decision tasks can be established on the basis of these results. Then decision ability in nurses will increase through the education programs and decision support systems, and then quality of nursing service will be better.
개인 맞춤형 헬스 케어 서비스 플랫폼은 개인별 건강관리를 위하여 다양한 건강정보 데이터를 저장 관리하고 건강정보 제공 및 건강 가이드 서비스를 제공하기 위한 헬스 케어 서비스 플랫폼으로 개인의 프라이버시와 개인정보보호를 전제조건으로 서비스 되어야 한다. 본 논문에서는 개인의 역할에 따른 보안서비스를 기반으로 제공되는 개인 맞춤형 헬스케어 서비스 플랫폼을 제안한다. 제안된 개인 맞춤형 헬스 케어 서비스 플랫폼은 병원에서 측정하는 기초 임상, 영상, 약물 데이터에 대한 저장 및 관리뿐만 아니라 개인적으로 획득할 수 있는 건강 정보, 즉 스마트 기기에서 측정 및 입력 가능한 음식물, 수면, 감정, 운동에 대한 데이터를 종합적으로 관리하여 일상생활에서 개인별 건강정보를 관리할 수 있도록 하여 현대인들의 스마트한 건강생활을 지원하는 기능을 제공하는 서비스 플랫폼에 역할기반 접근제어 모델을 적용하여 개인의 사생활 및 개인 정보 침해를 방지할 수 있도록 하였다. 제안된 RBAC 기반의 스마트 헬스 케어 서비스 플랫폼은 구현환경에 따라서 다양한 사용자와 사용자의 역할 및 권한 등을 설정하여 유연하게 개인 정보보호를 할 수 있는 시스템으로 구축되어 개인 맞춤형 건강정보 서비스를 제공할 수 있다.
Three hundred sixty-two(male 131, female 231) elderly aged over 65 in Chungb- uk area were interviewed to determine the disease states and drug usage patterns. The prebalence of disease was 78% and women reported more chronic diseases(83%) than men(71%). Elderly who live with spouse and have an occupation have a lower rate of disease. Average number of diseases of the elderly was $1.8\pm{1.1}$, and women$(2.1\pm{1.3)}$ have significantly higher average number of diseases than that of men$(1.4\pm{0.7)}$. Also the elderly in urban areas$(2.1\pm{1.4)}$ have significantly higher number of diseases than that of the elderly in rural areas$(1.6\pm{0.9)}$. Arthritis, hypertension, cardiovascular and gastric diseases were the most frequently listed chronic diseases in order for both men and women. Anemia and fracture of bone were relatively higher in women than in men. Particularly, the arthritis of the urban elderly have a rate of 1.5 times higher than that of the rural elderly. Fifty-two percent of the elderly were currently using drugs ; among drug users 71.2% used prescription drugs and 20.5% used nonprescription drugs. The average number taken per person was 2.1$\pm$1.4 and there was no sex or age difference. However, the elderly in rural areas $(2.7\pm{1.7)}$ consumed a significantly higher number of drugs than those in urban areas$(1.7\pm{0.7)}$. The average number of prescripti- on drugs taken was 2.0$\pm$1.4 while the average of nonprescription drugs taken was $(1.3\pm{0.6)}$. Analgesics and antihypertensive drugs were most commonly used. Vitamin and analgesics were the most frequently used self-prescribed drugs. It was noted that potential adverse drug interaction by concominant drug consumption for arthritis and antihypensive drug, abuse of digestants and antiacid without treatment of the underlying disease, and misuse of quick-acting bowel medications were problematic for the elderly. In addition drugs used for the elderly have some adverse effect on the digestive system. The types and composition of drugs used by the elderly were identified and presented. Medication compliance was poor and 13.5% reported adverse reactions such as edema, heartburn, nausea, and difficulty with eating. Seventeen percent of the elderly obtained drugs arranged by those other than medical staff. Also, even among those elderly who obtained drugs prescribed by a doctor, 69.1% of subjects had not receive instruction about potential adverse reactions. These results suggest that nutritional problems related to drug usage might exist and so dietitians, either individually or as members of health teams, need to have a better understanding of drug-nutrient interaction and closer supervision, and drug information/education service should therefore be provided to prevent or minimize adverse drug reaction in elderly users of medication.
Objectives : To investigate the prevalence of Clonorchis Sinensis infestation and to determine the associated risk factors among a population in a part of the rural area of Gyeongsangnam-do, Korea, which is an area known to have a high mortality from liver cancer and a high infection of C. sinensis. Methods : The study populat ion consisted of those people who have lived in rural areas and who were over 40 years old. This study was performed in 5 areas during the period from 1999 to 200 3. Informed consents were obtained from the 2,381 study participants, and these people were interviewed about their life style habits with using the structured questionnaire that was administered by trained staff members. The subjects underwent blood sampling and their stool specimens were examined by using the Formalin-ether sedimentation technique. Results : Among the study subjects (N=2,381), the positivity for C. sinensis in the stool was 34.4% (95% CI=36.3-42.5); it was 39.4% (95% CI=36.3-42.5) in the males and 30.9% (95% CI=28.5-33.3) in the females . The positivity for C. sinensis was associated with current alcohol drinking (odds ratio=1.8, 95% CI: 1.5-2.1) and raw fish consumption (odds ratio 1.2, 95% CI: 0.9-1.6). Conclusion : The present study confirmed the high prevalence of C. sinensis in the study subjects. It is necessary to establish consistent medical management and education programs for the treatment and prevention of C. sinensis infestation in the rural inhabitants of Korea.
Objectives : The purpose of this study is about discovering the basic references to find the ways to vitalize handicapped dental clinics. Methods : The study was analyzed by the satisfactions of those patients who took the advantages of using the dental care at B-welfare center and also their transformed perceptions after the services are influenced. The analysis was the questionnaire consisting of 100 items and survey data. Results : 1. The satisfaction of the dental service for the disabled was respectively high which was the average of 4.49. 2. Their satisfactions of receiving kindness services by volunteers and employees were the highest in the entire research of successful handicapped dental services and it was 4.78 overall. 3. The satisfaction of using handicapped dental clinic has the higher range of female users than male's. In the mean time treatment details of the dental care and the satisfaction towards to the volunteers and faculty at the center show the statistical significance gap. 4. The oral care service after experiencing the dental clinic for handicapped relived their discomforts of using the regular dental clinic which shows their highest satisfaction as it is the point of 4.75. 5. the change perception after dental treatment for handicapped has the higher range of females than men's and solving the problems of mouth reference and discomfort of using regular clinics show the statistical significance gap. 6. In the change perception after having dental treatment for handicapped the thought of the possibility of periodical dental care shows the highest perception when the number of visiting is usually shorter and it shows the statistical significance. Conclusions : According to the satisfaction of those inpatients who use free dental care services that belong to dental clinics for handicapped in a part of Seoul welfare centers human services were appeared as the most important factor due to their advantages of taking services from volunteers and staff members. On the other hand to enhance the medical treatment information and environment which showed the weakest factors each inpatient should be specifically specialized for their needs and also further study on plans which enhance their perceptions toward to a better quality of oral-related life is required after using dental treatment service.
The sample collection room(SCR) will have much more influence than all the other departments for the improvement of hospital image, if anyone coming to the SCR in the hospital goes back with the perfect complacency and because most clients who have much stresses and fatigues pay a final visit to the SCR via receipt-diagnosis- acceptance process. SCR has improved its image for the purpose of gratifying clients, in order for clients to visit the hospital again, the quality improvement(QI) team in the Diagnosis Inspection Medical Department has come to a conclusion as follows. The degree of client gratification before improvement marks 65.9 point, but the degree after improvement was 74.2 point. Therefore, satisfaction has increased by 8.3 points. The degree of client gratification in groups before improvement marks (1) service parts-89.2 points (2) facilities and environments-49.1 point (3) toilet facilities-46.3 point. But its gratification after improvement marks (1) 92.5 point (2) 60.1 point (3) 61.0 point. Therefore the degree of satisfaction has increased by (1) 3.3 point, (2) 11.0 point, (3) 14.7 point. The progress of facility improvement plans and the exclusion of improvement on the facility contents in the hospital have made facilities and environments of SCR and toilet facilities to be poorly improved. Although service parts have a good mark, and the facilities and environments are not scoring well, the whole degree clients' gratification of SCR couldn't be helped by the low grade. Therefore the bottom line for the clients' gratification of SCR in the future is to ameliorate the facilities and environments. SCR will take the clients' gratification survey every year and if any items get low marks, that is, below 90 point throughout the survey, SCR will immediately starts the improvement work for the clients' gratification with operating the programs of controlling quality continually, and SCR should induce the operation of services, participating in the kind campaign drive for clients. So SCR will adopt the incentive system for the best staff members who perform these kinds of services.
To compare the differences in the recognition on hospital utilization and satisfaction, 368 hospital employees and 485 patients were selected in four hospitals in Seoul and Kyung-gi do. The survey was done using a constructed form of checklist from Apr. 30 to May 10, 1999. And the results are as follows: l. Gaining knowledge of hospitals available among hospital employees differed from that of patients. When finding out about sources of information concerning hospitals, direct visit to the hospital was recognized to be the main factor for the hospital employees in contrast to the patients' recognition which were mass media, personal involvement of job related workplace and recommendations from other hospitals. There was no difference between university and general hospitals. 2. The factors that concern which hospital to choose there was a difference between hospital employees and patients. Hospital employees recommended their own hospital solely based on the reason that it was their work place. On the other hand, the patients made a choice based on the type of medical staff, transportation available and whether it was a university hospital or not. There was no difference between university and general hospitals. 3. The recognition of employees concerning hospital image of a hospital between hospital employees and patients was different. In university hospitals, the employees recognized the name value of university hospital and cooperation as most important, whereas the patients thought convenience, kindness were the main factors. Patients considered general hospitals to be more convenient. There was some difference between university and general hospitals. For university hospitals employees' recognition was higher and for the general hospital patients' recognition is higher on hospital image. 4. The recognition of employees was different from that of patients' on hospital satisfaction. The patients' satisfaction was higher than that of employees'. There was no difference between university and general hospitals. Based on the above findings, the employees' recognition on hospital utilization and satisfaction was different from that of the patients, but there was no difference between university and general hospitals. In both groups choice of hospital was associated with satisfaction. Results showing difference between employees' and patients' recognition can be applied to implement customer-oriented attitude and be used as a baseline data for internal-external marketing planning of hospital management. The study may be limited in that the results cannot be generalized due to its small sample size and not being able to reflect demographic variables and life style. Further studies to investigate the difference of hospital utilization and hospital satisfaction will be necessary to define demographic characteristics and recognition of employees which influences patients' hospital satisfaction.
Parish nursing is a community health nursing role developed in 1983 by Lutheran chaplain Granger Westberg. An increasing emphasis on holistic care, personal reseponsibility for a healthy lifestyle, and changes in healthcare delivery systems have undoubtedly facilitated the establishment and nurturance of an innovative nursing role in the community. Parish nurses are functioning in a variety of church congregations of various denominations. The parish nurse is a educator, a personal health counselor, a coordinator of volunteers. The parish nurses helps people relate to the complexed medical care system and assists people to integrate faith and health. The autors conducted a study on pastor's expectations from parish nurses. Results of this study will be useful to those instrumental in planning, initiating, supporting, and evaluating a parish nurses program The research was done on 130 pastors in Taegue and Kyong Sang Buck Do, of various ages ranging from their 20's to 60's: and pastoring churches of various sizes, ranging from under 100 to over 300 members. 94.6% agreed that they needed a parish nurse on their staff; and 86.2% said they wanted to start a parish nurse program in their churches if certain basic conditions were met. The pastors responded that some would hire the nurses on a full-time basis(22.3%), a part -time basis (37.7%) or use volunteer nurses (40%). The pastors said they would expect the following from a parish nurse: health counselling (80.0%) regular health check-ups (78.5%) health care for the elderly (78.5%) health information and education (72.3%) hospice care (72.3%) visiting sick church members at home (69.2%) arranging and training volunteers to help the seek (59.2%) health care for expectant mothers (50.0%) introducing and taking people to health care facilities (46.2%) The pastors were surveyed about specific areas of health education they would want the parish nurse to teach(for example, high blood pressure and heart disease prevention and management(76.2%) ; stress management(74.6%); and diabetes prevention and management(73.8%). The pastors were surveyed about specific areas of health counselling they would expect the parish nurse to do (for example, drug abuse, (73.1), alcohol abuse(64.6%), marriage conflict(60.0%), recovery after the loss of a loved one(56.9%), and women's conflict with parents-in-law(53.8%). The pastors were surveyed about types of things they would want included in regular health check-ups, what they would want a parish nurse to do on home visits, and what they would want included in home care for the elderly. They were also surveyed on what kind of spiritual care they would like parish nurses to give. Most (90.7%) wanted their parish, parishioners to be involved in the parish nurses program as volunteers, and in a variety of ways(such as visiting sick in their homes(68.5%) and helping with housework(63.1%) and taking sick people to health facilities(60%). Parish nurses role, activities, and boundaries of practice should be continuously monitored and refined and a 'case manager' should be conceptualized as an additional or all-encompassing role. An initial parish / community needs and readiness assessment should be done prior to establishing a program to detemine if the congregation is ready, willing, and able to support such a position for at least a 2 to 3 year period.
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