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Oral health status and treatment need of institutionalized elderly patients (노인요양시설에 있는 노인환자의 구강실태 및 치료수요도)

  • Yang, Soon-Bong;Moon, Hong-Suk;Han, Dong-Hoo;Lee, Ho-Yong;Chung, Moon-Kyu
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.5
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    • pp.455-469
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    • 2008
  • Statement of problems: In the area of dental care, the institutionalized elderly have placed the most vulnerable state, and we cannot find their subjective need of dental treatment because of the physical and mental disabilities, But we have no basic investigation of their oral health conditions. Purpose: The aims of the current study were to investigate the oral health status of institutionalized elderly patients who are in the least benefited side of dental service, and to analyze their dental treatment needs. Material and methods: The survey of the oral status was carried out on 758 institutionalized elderly, and 212 elderly who was more than 65 years old from D dental office, and it was based on the Guidelines of Oral Health Research of year 2000 in Republic of Korea. Results and conclusion: The DMFT index of the institutionalized elderly appeared higher than that of the same ages in control group, and it increased with age. The number of residual teeth of the institutionalized elderly appeared lower than that of the same ages in control group, and it decreased with age (P < .05). The number of fixed partial denture in institutionalized elderly was lower than that of the same ages in control group (P < .05). The percentage wearing removable partial denture was not significant between the elderly in institutions and the control group, and was not different according to age between the two groups. The percentage of institutionalized elderly wearing complete denture appeared lower than that of the same ages in control group, and it increased with age. The percentage of institutionalized elderly needing complete denture was higher than that of control group, and the percentage of elderly needing complete denture on the maxilla was higher than that of the mandible. 16.35% of the institutionalized elderly was living without denture in spite of their fully edentulous state. The need for complete denture increased rapidly with age. The number of valued teeth and dental prostheses in shortened dental arch concept and number of occluding pairs of teeth of institutionalized elderly were lower than that of the control group (P < .05). In institutionalized elderly, the number of residual teeth, the number of fixed partial dentures, and the percentage wearing removable partial dentures were higher in the mandible, and the percentage wearing complete dentures was higher in the maxilla (P < .05). The rate of institutionalized elderly needing prosthodontic treatment appeared to be 67.82%, where the number of occluding pairs of teeth was less than 10. When it is difficult to evaluate the subjective need of dental treatment as with the institutionalized elderly, estimation using the number of occluding pairs of teeth can be a useful indicator that can project treatment needs. For the oral health care of institutionalized elderly, it is essential to increase the awareness of nurses and caregivers who take care of them, about the importance of the oral health. Since the average life span and number of residual teeth are increasing gradually, the welfare policy should be changed to implementing regular dental examinations, preservative treatment forms and oral health control of dentulous patients where the traveling-treatment system and visit system are supplemented. And principles should be set that the present denture project of edentulous patients should be done by specialists who'll also be responsible for postmanagement. Through this research of institutionalized elderly, the oral health status which is worsened by aging could be confirmed. And the interest and positive participation of dental society on the elderly should come first in order to solve the rising treatment needs of the elderly patients.

An Analytic Case Study on the Management of an Upper-level General Hospital(2010-2012)

  • Park, Hyun-Suk;Lee, Jung-Min;Baek, Hong-Suck;Lee, Jun-Ho;Park, Sang-Sub
    • Journal of Korean Clinical Health Science
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    • v.2 no.1
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    • pp.1-16
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    • 2014
  • Purpose. For a more efficient hospital management, this study aims to provide basic data so that the hospital management and staff in charge of hospital administration may systematically classify and collect hospital information, by analyzing the ordinary characters of an upper-level general hospital system and its common-type balance sheet, common-type profit and loss statement and financial ratio. Methods. By using information about an upper-level general hospital in C Province, provided by Alio(www.alio.go.kr), a public organization information provision site, Health Insurance Review & Assessment Service(www.hira.or.kr) and Ministry of Health and Welfare(www.mw.go.kr), this study analyzed 3 year's data from 2010 to 2012 and provided basic data by analyzing the ordinary characters of an upper-level general hospital system, and its common-type balance sheet, common-type profit and loss statement and financial ratio. Results. After analyzing the ordinary characters, common-type balance sheet, common-type proft and loss statement and financial ration of this general hospital, based on the 2010 to 2012 data, this study came to the following conclusions. Firstly, out of all the 1,069 hospital staff, there were 272 doctors working for 24 medical departments, out of whom the majority was 33 physicians. Most of the nurses were third-class ones, and about 2,000 outpatients and 600 inpatients on average were treated per day. Secondly, as a result of analyzing the common-type balance sheet, this study discovered that intangible assets out of fixed assets accounted for 41%, the majority, out of which usable and profitable donation asset buildings were of great importance, and the liquid assets increased more in 2012 than 2011. In the financial structure, the ratio of liquid liabilities was over 50% out of all the liabilities in 2012, and the ratio of purchase payables was high as well. The ratio of fixed liabilities reached up to 40%, out of which the retirement benefit appropriation fund was quite high. The capital was over 80%, but the surplus was in a deficit state. Compared to the capital, the ratio of total liabilities was about 90%, which indicates the financial structure of this general hospital was vulnerable. Thirdly, as a result of analyzing the common-type profit and loss statement, this study found out that the medical profits from inpatients were higher than profits from outpatients. The material cost was related to the medical quality of this general hospital, and it was as high as 30% out of the total costs and was about 45% of the labor cost. This general hospital showed 10% in the ratio of non-medical profits, and it seemed because of government subsidies. The ratios of medical profits and current net income were gradually changing for the better in 2012, compared to 2011. Lastly, as a result of analyzing the financial ratio, it was found that the liquidity ratio kept decreasing, from 110.7% in 2010 and 102.0% in 2011 to 77.2% in 2012. Besides, it was analyzed that the liquidity ratio and the net working capital ratio greatly decreased, while the quick ratio and the liquid ratio kept decreasing. Conclusions. 1. It is necessary to take the risk management into more consideration, and particularly, it is needed to differentiate and manage the levels of risk in detail. 2. By considering the fact that investments into hospital infrastructures were mostly based on liabilities, it is needed to deal with the scale of losses when evaluating risks. 3. By reflecting the character that investments into hospital infrastructures were based on liabilities, it is necessary to consider the ratio of ordinary profits as well as the ratio of operating profits to sales, and it is also important to consider sales productivity factors, such as the sales amount per a sickbed, by comparing them with other hospitals. As for limitations of this study, there may be some problems in terms of data interpretation because of the lack of information about the number of inpatients and the number of outpatients per year, which are needed for the break-even point analysis. Besides, to suggest a direction for the improvement of hospital management through analyses, non-financial factors should be reflected, such as the trend of economy, medical policies, and politic backgrounds. However, this study only focused on the common-type balance sheet, common-type profit and loss statement and financial ratio, so this study is actually limited to generalizing all the factors by analyzing public data only.

The Correlation Among Health Status, Burden and Quality of Life of the Adult Stroke Patient's Family and the Elderly Stroke Patient's Family (노인층과 청·장년층 뇌졸중 환자가족의 건강상태·부담감 및 삶의 질과의 관계)

  • Kim, Kwuy-Bun;Lee, Kyung-Ho
    • Korean Journal of Adult Nursing
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    • v.13 no.2
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    • pp.262-276
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    • 2001
  • The purpose of this study is to investigate the correlation among the stroke patient family's health, burden and quality of life which is based upon the comparative appreciation of the adult stroke patient's family and elderly stroke patient's family. For this purpose, data were collected from the family care-givers for two groups of stroke patients under sixty years old and over sixty years of age, admitted at K Hospital and H Hospital in Seoul. The instruments for this research are based on the tool for measuring physical health and psychological health developed by Yang, Young-hee(1992), the tool for measuring the sense of burden by Seo, Mee-hae and Oh, Ga-sil(1993), and the tool for the quality of life by Noh, Yoo-ja(1988). The sampling for this study was done from December, 2000 until February, 2001. Questionnaire data were drawn up by personal interviews aided by the staff nurses. The analysis of collected data are based on general characteristics calculated at the rate of 100 percent of the average, t-test, ANOVA(some difference on a level with p<.05 being subsquently confirmed by DMR) for Health Status, Burden, Quality of Life and Pearson Correlation to verify the hypothetical correlation among the subjects. The results of this study are as follows: 1. In the adult stroke patient family, the factors influencing the physical health proved to be age, present occupation and family-formation. Here, the factors influencing psychological health turned out to be age, matrimonial status, present occupation and family-formation. In the elderly stroke patient family, the factors influencing physical health proved to be age, gender, final academic status, matrimonial status, present occupation, and relation with the patient. Here, the factors influencing the psychological health were age, final academic status, matrimonial status, present occupation, relation with the patient and family-formation. In the former case, the influencing factors upon the burden were shown to be age, final academic status, matrimonial status, relation with the patient and family-formation. In the latter case, the influences upon the burden were age, gender, final academic status, matrimonial status, present occupation and relation with the patient. In the former case, the influences on the quality of life were gender, and economic situation. In the later case, the influencing factors on the quality of life were age, final academic status, matrimonial status, present occupation, and relation with the patient. 2. The rate of the physical condition in the former case turned out to be 2.83, and the psychological condition 2.37. The physical condition of the latter case was 2.76, and the psychological condition 2.46. The rate of the burden in the former case was 3.14, and that of the latter case was 3.04. The rate of quality of life in the former case proved to be 2.46, and that of the latter case 2.55. 3. The rate of correlation between the burden and the quality of life appeared to be the high counter-correlation (r= -.573). The rate of correlation between the psychological health and the burden of a simialr (r= -.565). The rate of correlation between the physical health and the psychological health proved to be a moderate correlation (r= .372), The rate of correlation between physical health and the burden turned out to be a low counter-correlation (r= -.276). According to this study, there proved to be a very close correlation among the stroke patient family's health, the burden and quality of life. Thus, it would be necessary to find out various nursing interventions in order to mitigate the stroke patient family's burden in the process of caring for the patients.

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A Study on the Effect of Cold Application Using a Sponge Bath in Healthy Adults (냉요법 적용방법에 따른 냉요법 효과에 관한 연구-건강한 성인 여성에서 스폰지 목욕방법을 중심으로)

  • Chung, Hyun-Sook;Kang, Kyu-Sook;Hwang, Ae-Ran
    • The Korean Nurse
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    • v.28 no.3
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    • pp.68-82
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    • 1989
  • This study was a quasi-experimental research study to test the characteristics of temperature regulation according to sponge bath methods of cold application. Thirteen volunteers were selected from among nursing college students according to an established criteria using a purposive sampling technique. Four different cold application methods were used: $\circled1$ tepid water sponge bath at $28^{\circ}C$, $\circled2$ 20% alcohol sponge bath at $28^{\circ}C$, $\circled3$ 40% alcohol sponge bath at $28^{\circ}C$ and $\circled4$ tepid water sponge bath at 28$^{\circ}$C plus an ice bag to the head. Changes in rectal temperature, mean skin temperature, mean body temperature, heat content change and thermal discomfort during the cold application were measured at 5 minute intervals over a 120 minute period. The data collection period was from Dec. 20, 1988 to Feb. 3, 1989. The data were analyzed using descriptive statistics, simple regression, ANOVA, Duncan's multiple range test and Pearson correlation coefficient using the SPSS-X Program. The results of the study are summarized as follows. Five general hypothesis were tested. Hypothesis 1 that "Change in heat content will be decreased for each cold application method according to the cold application time" was rejected. (tepid water sponge bath: after 10 minutes of cold application, 20% alcohol sponge bath: after 25 minutes of cold application: 40% alcohol sponge bath: after 45 minutes of cold application, tepid water sponge bath plus an ice bag to the head: after 80 minutes of cold application) Hypothesis 2 that "Thermal discomfort will be changed for each cold application method according to the cold application time" was rejected after 5minutes of cold application. Hypothesis 3 that "Change in heat content will differ among the cold application methods" was accepted except 0~5, 0~10, 0~65, 0~105 and 0~120 minute. This difference showed significance only between sponge bath methods and tepid water sponge bath plus an ice bag to the head. Hypothesis 4 that "Thermal discomfort will differ among the cold application methods" was accepted at 15, 20, 35, 45, 75, 80, 90, 95, 100, 105, 110, 115 and 120 minute of cold application time. This difference showed significance only between sponge bath methods and tepid water sponge bath plus an ice bag to the head. Hypothesis 5 that "The higher the change in heat content, the higher the thermal discomfort during the cold application time" was accepted for between 10~60 and 75 minute of cold application. In conclusion, this study showed that in sponge bath at $28^{\circ}C$, 10~80 minute was a effective cold application time in the view of heat loss through the skin. Concerning the effects of evaporation and thermal discomfort, it was found that there was no difference with regard to the solutions; tepid water sponge bath; 20% alcohol sponge bath or 40% alcohol sponge bath at a $28^{\circ}C$ controlled solution temperature. So it was thought that the type of solution itself did not have a big influence on the heat loss through skin. The combined effect of sponge bath with an ice bag to the head showed a significant difference and also showed a slight increase in thermal discomfort. On the basis of this research it can be concluded that cold application, for example, an ice bag to the head during a tepid water sponge bath is a good method as it increase heat loss through conduction, although fit can also cause a slight increase in thermal discomfort. The correlation between changes in heat content and thermal discomfort were not high. So factors other than change in heat content are considered to have an effect on the cognition of thermal discomfort.

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A Study on Third-trimester Gravidas' Konwledge of Infant Care Activity (임신 말기 임신부의 영아 돌보기 지식에 관한 연구)

  • Lee, Su-Yeon
    • The Korean Nurse
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    • v.29 no.3
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    • pp.64-78
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    • 1990
  • The purpose of this study was to measure the degree of gravidas' knowledge of infant care activity, and to identify the factors influencing the difference of gravidas' knowledge. The subjects of this study consisted of 159 gravida visited 2 general hospitals, 2 OB/GY clinics and 2 midwives' clinics in J city for anenatal care. The data were collected from December 1 to 30, J.989. The instrument used for this study was true false type question which was developed by investigator through literature review. Data were analyzed by percentage, mean, t-test and ANOVA on significant difference with SPSS program. The results of this study were, summarized as follow: 1) The degree of gravidas' knowledge of infant care activity was 36.75, the degree of gravidas' know ledge of physical care activicy was 16.70, and the degree of gravidas' knowledge of psychosocial care activity was 20.00. 2) Among the physical care activity knowledge items, the diaper should be changed whenever it is soiled, $\lceil$shortly after feeding is over, bathing is bad$\rfloor$, $\lceil$gently patted or stroked on the back when bubbling$\rfloor$, $\lceil$10 minutes time in bathing is appropriate$\rfloor$, $\lceil$infant is crying whenever he is hungry per 3-4 hours$\rfloor$, and "room humidity controled 60 percent, more or less> were over a' percentage of 80 of right answer. Among the physical care, accivity knowledge items. $\lceil$a reason for burping was the air' he has swallowed will rise to the top of his stomach and be eructated$\rfloor$, $\lceil$burping is advisable after the feeding$\rfloor$, $\lceil$dressing of umbilical area is not necessary$\rfloor$, $\lceil$the thermometer should not be boiled for disinfection$\rfloor$, $\lceil$it is important chat the infant grasp the whole nipple within his mouth$\rfloor$, $\lceil$using alcohol sponge is bad whenever diaper is soiled", and $\lceil$when temperature is taken by the rectal method, infant legs shoud be grasped firmly_! were less than a percentage of 60 of right answer. 3) Among the psychosocial care activity knowledge items, $\lceil$it is nice, mother smile at bady frequently$\rfloor$, $\lceil$it is nice, mother praise a bady frequently$\rfloor$, $\lceil$it is nice, mother express bady's behavior$\rfloor$, $\lceil$talk frequently to the bady, the bady :should not be disturbed while feeding$\rfloor$, $\lceil$it is nice, mother see a baby face to face , $\lceil$it is nice, mother concentrate one's attention on her baby while playing$\rfloor$, $\lceil$it is nice, mother pat one's baby while he is feeding$\rfloor$, $\lceil$it is advisable, the baby is allowed to touch mother's breast while he is feeding$\rfloor$, $\lceil$it is advisable to stop feeding, if the baby protrudes one's tongue or cries while feeding$\rfloor$, $\lceil$baby is able to hear, see and smell$\rfloor$, $\lceil$it is nice, mother Concentrate one's attention on her baby while feeding$\rfloor$, and $\lceil$it is not advisable for mother to scold baby while he is crying out> were over a percentage of 80 of right answer. Among the psychosocial care activity knowledge items, $\lceil$Using' baby talks is bad when mother talks to baby> and $\lceil$it is nice, mother soothes the baby as soon as possible when he is crying I were less than a percentage of 60 of right answer. 4) There was statistically significant relationship between the degree of gravidas' knowledge of infant care activity and the demographic variables of gravida such as the age(p<0.01) and education level(p<0.01). From these results, it may be concluded that gravidas' knowledge of infant care activity is moderate level, and gravidas' knowledge of psychosocial care activity is greater than that of physical care activity. Also prenatal nursing educations should focus on subjects who have lower percentage of right answer in infant care activity knowledge items.dge items.

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Knowledge and Performance of Universal Precautions by Nursing Students (일부 간호대학생의 혈액매개질환 예방 지침에 대한 지식과 실천 정도)

  • 김경미;김민아;정여숙;김남초
    • Journal of Korean Academy of Nursing
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    • v.29 no.4
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    • pp.929-939
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    • 1999
  • The purpose of this study was to identify knowledge of universal precautions and its performance in practice. The research was conducted from November 2 to 30, 1998. A total 515 student nurses ; 249 from a baccalaureate nursing college and 266 from second and third year of a 3-year community nursing college were surveyed. The results are as following : 1. The average score for universal precautions knowledge was 270.41$\pm$19.43/300(range 150-300). The results showed that 99.2% of students avoid injury from used needles, 98.6% answered that they always wash their hands if they had contact with the patient's blood and they always dispose of used needles in special collectors (97.7%) for needles. But, 39.2% responsed that they dispose of used needles after recapping them. 2. The average score for universal precautions knowledge of the senior students in the 4-year college was the highest (277.65$\pm$13.99). 3. The average score for the performance of universal precautions knowledge was 53.18 $\pm$5.91(range 14-70). The items : ‘I cautiously avoid injury from the used needles’(4.92$\pm$0.33), ‘I always wash my hands if there has been contact with the patient's blood’(4.91$\pm$0.34), and ‘I always disposed of used needles in the appropriate collector’(4.89$\pm$0.42) showed the highest performance. However ‘I always dispose of used needles after recapping them’(2.19$\pm$1.39) and ‘I always use protection goggles when in danger of contamination’(2.19$\pm$1.20) showed low performance level. 4. The highest average score for universal precautions performance was shown among the second year students in 3-year nursing college (54.19$\pm$6.92) between the groups. It showed that the level of the universal precautions performance was higher for those who had education on university precautions prior to performance of the universal precautions than for those without any prior education. 5. The percentage of students who reported the experience of direct contact with patients' blood and/or body fluids was 42.30%. The experience of direct contact with blood and/or body fluids of the educational group was significantly higher than those were not educated. 6. The most frequent cause of the direct contact was ‘needle pricking and/or skin cut’(63.04%). The most frequent substance with which the students contact was ‘blood’(59.85%). The majority of the sample had answered that the mode of contamination was ‘unknown’(63.54%). The majority of the sample answered that strategies used after contamination included ‘washing with soap’(33.61%). Reviewing the chart of patients or asking other health professionals(28.85%). 7. The number of students who had the experience of a needle stick and/or skin cut was 145(28.16%). The clinical practice places where the incidents occurred were mainly in the internal medicine unit (45.07%) and the surgical unit (31.92%) followed by the intensive care unit and the emergency unit in order. The experience of a needle stick and/or skin cut happened during on intra-muscular injection 47.34% and intravenous injection 21.81%. The causes of the needle stick and/or skin cut were ‘putting the needle cap back on 77(35.81%)’. The number of students who took an appropriate post management blood test and/or vaccination was 27(18.62%). 8. The Pearson Correlation Coefficient between the knowledge of universal precautions and performance of universal precautions in practice showed a positive correlation.

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A Study to Determine the Effectsiveness of Severance Hospice Home Care Program (호스피스케어에 대한 평가 연구 - 세브란스호스피스 중심으로)

  • Kingsley, Marian R.N.;Cho, Won-Jung;Kim, Cho-Ja;Lee, Won-Hee;Yoo, Ji-Soo
    • The Korean Nurse
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    • v.29 no.4
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    • pp.51-72
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    • 1990
  • The purpose of this study was to determine whether Severance Hospice Home Care Pro gram was able to meet its objectives. This was done in order to show in detail the effects of hospice home care on the quality of life of terminally ill patients and to provide rationale for setting up more hospice home care programs in korea. The results of the study were as follows: The subjects of the study were 100 terminally ill patients who hnd died 'while in the hospice program and 64 family members who were registered with Severance Hospice Home Care Program between march 1988 and Feb. 1990. The nursing needs of these terminally ill patients were assessed by the nursing records of these patients. The need for pain control(82%) was the highest nursing need so far as the physical aspects were concerned. This was followed by poor appetite(37%), 8 dyspnea(34%), nausea and vomiting(30%) in that order of frequency. In reqard to spiritual needs, the need for religious' support was also high at 72%. Their main psychological symptoms were anxiety and fear(34% ). Burn-out was a major problem for 44% of the family members. The psychological process experiencel by the terminal ill patients was compared to the dying process, described by Kiibler Ross. In comparison of the five stages outlined by kubler Ross with the dying process of the subjects it was found that the subjects not only experienced the five stages but also experienced denial and doubt-fulness or denial with acceptance or acceptance with the expectation of a miracle. But rather than acceptance of the dying process, giving up was a frequent end point of the psychological process, of the subjects. However, when the combination of states was observed, most of the patients reached the state of acceptance in the dying process. It was difficult to identify a definite pattern of change in the psychological process of the subjects. Also it was difficult to identify the factors that influenced the psychological process. The symptoms of the terminally j]] subjects just before dying, that is, 3-4 days before dying included apparent signs of dying. These were a reduction of intake(77%), reduction of the amount of urination(63%), increase in sleeping time (64%) and acceptance of dying by patients and their families who had been unaccepting be before that time(66%). The primary care givers(family member's) degree of satisfaction with the care given to the patient by the hospice was 88.7%. The results of this study show that Severance Hospice Home Care Program had a positie effeet on the quality of life of the terminally ill patients and their family members as they faced the death of the patient. It can be seen from this study that there is an urgent need to extend hospice programs - in order to provide quality of care for terminally ill patient and their families. Based upon the reesults of this study several suggestions are presente as follows: 1) A follow up study should be carried out to identify the dying process as it is unique to Korea. 2) A comparison should be made of other hospice care programs. 3) A comparison study should- be made with subjects who do not receive any hospice care as compared to those who do by use of an experimental and control group methodology. 4) There is a need to determine a scientific method to adequeto measure the interventions carried out to meet the hospice patients nursing care needs. 5) A study should be made using quality research methodology to evaluate effects of hospiec care from the patients, their family members and the nurrse's perspective.

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A Study Analyzing Nursing Diagnoses and Nursing Interventions used in a Demonstration Home Care Project (가정간호 시범사업 간호진단 및 간호중재 분석 연구)

  • Suh, Mi-Hae;Lee, Hae-Won;Chun, Choon-Young
    • The Korean Nurse
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    • v.34 no.5
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    • pp.52-67
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    • 1996
  • As home care in developing and becoming part of the health care delivery system in Korea, it is necessary to examine the use of nursing diagnoses and related nursing interventions with a view to increasing the standardization of nursing recording. This study was done to examine the nursing diagnosis and related nursing interventions used in home care. Data were collected using a chart review of the nursing notes written for the home care given to 38 patients who had pulmonary diseases or traumatic brain or spinal cord injuries and who had received home care as part of a demonstration home care project in a college of Nursing in Seoul. Early on in the project discussions as to format and use to nursing diagnosis was done and a tool was developed based on Gordon's eleven functional catergories with the addition of categories to cover family and environment. This tool was used in the data collection. Data included nursing diagnosis, etiologies and interventions. Real numbers and percentages were used in the analysis. The results show that the most frequently used diagnoses were in the category of physical function (75.6%), followed by the category of emotional and social function (21.8%). The least frequently used category was the one for family and environment (2.6%). The order of the frequency of recorded nursing interventions was the same, 82.3% for physical function, 16.2% of emotional and social function and 1.5% for family and environment. Under the category of physical functioning the most frequently used nursing diagnoses were related to mobility (62.2%), nutrition (23.6%) and elimination (11.9%). The frequencies of nursing interventions for these three diagnostic categories were 69.8%, 16.0% and 10.8% respectively. For emotional and social functioning, the most frequently used diagnoses were for cognition-perception (37.1%), self-perception (30.6%) and perception of health (23.7%). The ordering of the frequency of nursing interventions varied slightly. The most frequently used interventions were for the category of self-perception (31.7%) followed by cognition-perception (24.1%) and perception of health (22.9%). Looking at individual diagnoses, it was found that within the categroy of physical functioning, the most frequently used diagnosis was "impaired physical mobility" (29.5%) and this diagnosis involved 43.9% of the interventions. This was followed by "ineffective breathing pattern" (19.4%) with 17.7% of interventions, and "alteration in nutrition, less than body requirements" (11.2%) with 8.1% of the interventions. For the emotional social category, noncompliance was the most frequently used nursing diagnosis (18.2%) with 19.2% of the interventions. This was followed by "anxiety" (13.4%) with 13.6% of the interventions and by "knowledge deficit" (13.4%) but with only 5.5% of the interventions. The other diagnoses and interventions did not follow this pattern of frequency. Although there were a large number of diagnostic and intervention events, the number of actual diagnoses and interventions used were relatively small ranging from six interventions for "knowledge deficit" to 40 interventions for "imparied physical mobility". From this it can be concluded that the results of this study could be used as basic data for the development of standardized charts with respect to nursing diagnosis and interventions for clients with pulmonary disease and clients with traumatic brain or spinal cord injuries. Interventions that were direct care activities (1178) were much more frequent that education (430), and assessment and observation (148). There were also few diagnoses or interventions related to the family and the environment. This suggests two areas that need to be developed in home care and that need to be considered in the development of standardized records for use in home care.

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A Study on the Influence of Positive Psychological Capital of Small and Medium Business Members, Job Burnout, and Organizational Citizen Behavior (중소기업 구성원의 긍정심리자본, 직무소진, 조직시민행동의 영향관계)

  • Choi, Sung Yong;Ha, Kyu Soo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.15 no.3
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    • pp.159-174
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    • 2020
  • This study is an empirical study analyzing the effects of positive psychological capital on job burnout. In addition, positive psychological capital played a role in organizational citizenship behavior, and tried to verify the role of organizational citizenship behavior as a black box, or parameter, between job burnout. And then, the sub-factors of organizational citizenship behavior were divided into two: individual-oriented organizational citizenship behavior and organization-oriented organizational citizenship behavior. To this end, a questionnaire survey was conducted for members of small and medium-sized enterprises to compare and analyze the relationship between variables. Positive psychological capital is increasing interest in that it can reduce the job burnout of members and embrace the propensity of young generations represented by millennials because it can improve the effectiveness by developing positive mental states and strengths of the organization. There is a need for research as a keyword. As a result of this study, first, it was found that positive psychological capital of SME(small and medium-sized enterprises) members had a positive effect on organizational citizenship behavior. Second, positive psychological capital was found to have a significant negative effect on job burnout. Third, it was a verification of how positive psychological capital and organizational citizenship behavior affect job burnout. In the relationship between positive psychological capital and job burnout, organization-oriented organizational citizenship behavior was found to play a mediating role. However, it was found that individual-oriented organizational citizenship behaviors among the organizational citizenship behaviors are not valid. In this study, positive psychological capital and job burnout, which have been mainly studied in service workers' emotional workers(crew, nurses, counselors, etc.), nursery teachers, and social workers, were applied to SME members by using the parameters of organizational citizenship behavior. You can put that implication on things. The positive psychological capital and organizational citizenship behavior can be further enhanced through SME members' love for the company, improvement of consideration among employees and resulting organizational commitment and work performance. It could also provide momentum for sustainable management for small and medium-sized enterprises that are relatively short of capital and resources.

Lumbar Puncture in Patients Who Experienced First Seizure with Fever (열이 동반된 첫 경련시의 뇌척수액검사)

  • Kim, Jung;Lee, Jun Su;Lee, Sang Eun;Choi, Wan Suk;Han, Sung Ryoung;Cho, Kyunglae
    • Clinical and Experimental Pediatrics
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    • v.46 no.10
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    • pp.1008-1012
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    • 2003
  • Purpose : We aimed to ascertain whether lumbar punctures should be done to prove febrile seizure, and to study what conditions can delay or abolish lumbar puncture. Methods : This retrospective study was done for four years, from January, 1996 to December, 1999. The subjects were the patients who visited Masan Samsung Hospital for the first convulsion with fever, and whose age ranged from 1-month to 5-years old. The total number of patients was 197. We investigated the rate of meningitis, which was classified by age, season, convulsion type, associated symptoms, and results of blood test. All data were tested chi-square. Results : The diagnosis rate of meningitis among all 197 patients was 7.6%, and of these only one patient was proved to have bacterial meningitis. The rate was high in the young(below 6 month), in males and in summer and autumn. Although the general appearance was good after resolution of the fever, the rate of meningitis was 6.5%. Patients with nausea and vomiting totalled 11%; 9.1% of them were diagnosed with meningitis. The diagnosis rate of meningitis in cases in which additional seizures took place were 33.3%. Conclusion : The ultimate goal of lumbar punctures in seizure patients with accompanying fever is to rule out bacterial meningitis, which, has been demonstrated to be rare. So we think that lumbar puncture can be postponed by close observation of pediatrics specialists and skilled nurses.