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Menstrual Experience of Adolescent Girls (사춘기 여성들의 월경경험)

  • 정현숙
    • Journal of Korean Academy of Nursing
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    • v.26 no.2
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    • pp.257-270
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    • 1996
  • Studies on menstruation have focused only on menstruation itself and menstrual disorders. The menstruating girls or women have been neglected. So, the purpose of this study was to understand menstrual experience of adolescent girls in their perspective and build a theory on it, The specific purpose of this study were to find initial reaction of the girls, their strategies to adapt to menstruation. consequences of their efforts, influencing factor, and patterns of experience. The subjects of this study were eleven adolescent girls who experienced menarche three months to twenty-six months before the interview time. They were selected purposively. Their ages were in range of twelve and sixteen. One of them was a elementary school girl, three high school girls, and seven middle school girls. Two girls were handicapped because of cerebral palsy. All of them had some knowledge about menstrual physiology and hygiene during menstruation. Data were collected from September, 1994 to July, 1995. Data collection & analysis were done according to the grounded theory methodology by Strauss & Corbin(1990). Data collecting method was the long interviews and observation. Each interview took from 1 hour to 2 hours. Interview were tape-recorded and transcribed later by author. Data were analyzed immediately after interviews. Based on the results of previous interview, next interview were planned until gathered data reached the saturation point. Results were as follows. One hundred and six concepts were found. Those concepts were grouped into twenty eight categories and then fourteen higher categories. Twenty eight categories were as follows. “want to hide”, “bewildered”, “sense of burden”, “sense of heterogeneity”. “gladness”. “sense of superiority”, “negative empathy”, “positive empathy”, “limited hygenic control”, “sense of timing”, “lack of knowledge”, “lack of support”, “advance knowledge”, “informational support”, “emotional support”, “endurance”, “prayer”, “disclosing”, “avoidance”, “diversion”, “sense of powerlessness”, “discovery of sex identity”, “sense of maturation”, “sense of stability”, “acceptance of menstruation ”. fourteen higher categories were as follows. “negative feeling”, “posive feeling”, “exchange of feeling”, “limited hygenic control”, “sense of timing”, “accumulated experience”, “dysmenorrhea”, “level of knowledge”, “need for support”, “perceived support”, “sharing of feeling”, “self-control”, “passive acceptance”, “active acceptance”. The core category was “emotional shaking”, which consisted of “positive feeling” and “negative feeling”. “Emotional shaking”comes up to every adolescent girls experiencing menarche, independently of any contextual conditions, and its dimension has two directions : positive one and negative one. Its influencing factors were time of menarche, advance knowledge, support from the significant persons, expression and self-regulation. Even if they showed different process of adaptation to menstruation, general process of adaptation were as follows : 1. stage of emotional shaking 2. stage of acceptance 3. stage of internalization of the menstrual experience. Seven patterns existed on the process of adaptation to menstruation after menarche. Those are as follows. 1. If girls thought their menarche came too early and they had not much knowledge on menstruation, they had a kind of negative feeling. If they did not get enough support and dysmenorrhea superimposed, they came to accept menstruation passively. 2. If girls had menarche too early. they had negative feeling, even though they had enough advance knowledge. But support helped them accept menstruation easily. 3. If girls had menarche too early, they had negative feeling, even though they had enough advance knowledge on menstruation. But by experiencing subsequent menstruations and disclosing feeling, they began to accept menstruation. 4. If girls had menarche too lately and they had enough advance knowledge on menstruation. they had positive feeling. If dysmenorrhea superimposed later, their feeling turned in to negative one. But they came to accept menstruation positively by disclosing feeling and getting support. 5. If girls had menarche too early, they had negative feeling, even though they had enough advance knowledge on menstruation. In addition to this. if dysmenorrhes superimposed while they did not get enough support, they felt powerless and came to accept menstruation passively. 6. If girls had menarche too early and did not get enough advance knowledge, they had negative feeling. But disclosing feeling and support made them get sense of homogeneity and began to accept menstruation. 7. If girls had handicap, they had negative feeling, even though they had enough advance knowledge and menarche was late. But Menarche made them get feel sexual identity. Their limited hygenic control and negative empathy from their mothers made them accept menstruation passively. To let adolescent girls take their menstrual experience as a part of their lives forming a positive sense of feminine identity, it needs qualified teaching and, support and deep concern of the significant others. Nurses including school nurses should try to develop an educational program, which include menstrual physiology. hygiene during menstrual period, meaning of menstruation and impact of menstruation on the development of female sexual identity.

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A Study of the Health Problem Complaints of University Women Students (일부 여자 대학생들의 건강문제 호소에 관한 조사연구)

  • 양순옥
    • Journal of Korean Academy of Nursing
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    • v.11 no.2
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    • pp.105-123
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    • 1981
  • This study was carried out during the month of September 1976 to analyse and compare the health complaints of two groups of the university women, those who lived at home and those who lived in the university dormitory. The purpose of the study was to provide basic data required by the university health program for planning related to the health need of women students. The study sample consisted of 434 students living in the dormitory and 381 students living at home enrolled for the fall semester 1976 in a womens university in Seoul. The instrument used for the collection of data was an abridged version of a modified Cornell Medical Index. The questionarre included 35 items related to physical health complaint and 22 items related to mental health complaints. The data was treated by a computer (SPSS) using one way analysis, the Fishers' ratio and Chi-Square test at the 5% level were used for the test for statistical significance. The interpretation of this study is limited due to the sample which was restricted to one university and not randomly selected. To guide the direction of the study, it was hypothesized that the rate of expressed health problems of students living in the dormitory would be Venter than that of students living at home. The hypothesis was tested and rejected. The following is a summary of the findings; 1. Total health (physical and mental) complaints a. There was no statistically significant difference between the home and dormitory groups with regard to total health complaints expressed. b. The rate of total complaints expressed by the home group significantly higher than dormitory group only among third year students. c. There was no statistically significant between the home and dormitory groups in their satisfaction with their economic situation. d. The home group showed a significantly higher rate of complaints related to the Nervous System compared to that of the dormitory group. 2. Physical health complaints a. Students living at home showed a significantly higher rate of physical complaints than the dormitory group. b. When the year variable was controlled, the third year was the only group which showed a different rate between home and dormitory groups; the home group presented a higher rate. c. Since the year variable seemed to affect the physical complaints those data were further analysed to see whether the specific system areas were operating as variables in each year. The results were as follow: Among the home group, First year students showed a higher rate in Family History of Disease, while the third year students more Nervous System and Cardiovascular System complaints. Among the dormitory group, only fourth year students showed a higher rate in the Skeletal-Muscular System. This was the only area the dormitory group though only for the fourth year students supported the hypothesis. d. When the economic satisfaction variable was controlled, the satisfied group was the only group which showed a different rate between home and dormitory groups; the home group presented higher rate. e. Since the economic satisfaction variable seemed to affect the physical complaints those data were further analyzed to see whether the specific system areas were operating as variables in each economic satisfaction level, but there was no statistically significant difference between home and dormitory groups. 3. Mental health complaints a. There was no significantly difference between home and dormitory groups with regard to mental health complaints expressed. b. When the year variable was controlled the third year group was the only group which showed a different rate between home and dormitory groups; the home group presented a higher rate. c. Since the year variable seemed to affect the mental complaints, those data were further analyzed to see whether the specific system areas were operatings variables in each economic satisfaction level. The result were as follows: Among the home group, the third year students showed higher rates in Inadequacy and Anxiety. d. When the economic satisfaction variable was controlled, the very satisfied group was the only group which showed a different rate between home and dormitory groups: the home group presented a higher rate. Since the economic satisfaction variable seemed to affect the mental complaints, those data were further analysed to see whether the specific system areas were operating as variables in each economic satisfaction level, but there was no statistical significant difference between the home and dormitory groups. Although the social environment of dormitory life differs from family life, there was no difference in the rate of total health problem complaints between the home and dormitory groups but the home group showed a higher rate of physical health complaints than the dormitory group. Possible positive factors influencing dormitory life and negative factors influencing family life affecting health complaints must be explored in order to relate to the health needs of the university health program. This study could not define the causes for the fewer physical complaints of dormitory students living at home. Further study of such causal factors recommended in order to provide the data needed to contribute to a more effective health program.

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A Study on Family Planning Rumors & Practice in Rural Communities (일 농촌지역 가족계획 풍문과 실천에 관한 연구)

  • 추수경
    • Journal of Korean Academy of Nursing
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    • v.8 no.2
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    • pp.63-77
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    • 1978
  • Studies pertaining to influential factors on adoption and practice of family planning are very much needed to lower fertility, for family planning has regarded as only one social acceptable means to curb the accelerated population growth. One of the influential factors is known as rumors on family planning methods that hinder the actual practice of family planning. This study generally aimed at disclosing rumors on family planning methods prevalent in rural communities so that one could gain some in sights to cope with the ill effects of rumors to promote family planning Practice in rural communities in Korea. In order to accomplish the general aims this study formulated following four specific objectives; 1. Find out types and frequencies of rumors exposed of contraceptive methods. 2. Find out the relationship between the rumors exposed and socio-economic and demographic characteristics of new village leaders and health workers. 3. Examine the relationship between family planing rumors and family planning practices. The materials for this study were drawn from the two different sets of data gathered in July and Octorber 1977 respectivily by Center for Population & family Planning, Yon sei University. One is current family planning practice among eligible women reaiding in 4 Myuns in Kwang Wha country and the other is Survey on Rumor on family planning method heard by new village leaders and health workers in the four myuns. The four Myuns were divided into 60 small areas. Current family planning practice rate in each small area and as a whole were calculated. The unit of analysis in this study was not the indviduel person but the 55 small areas. Percentage, average, F-Test t-test and a coefficient of correlation were used for statistical analysis. Results of this study could be summarized as follows: 1. Rumors by different method of contraception: Medical complications, gastro-intestinal disorders, and difficulty in usage one most prevalent rumors about oral pills. Around 49% -77% of the 55 areas were often heard and the most frequent rumor was related medical complications of oral pills. Rumors on medical complications and incomplete effect of intrauterines as contraceptive were heard 51-66% of the 55 small areas. Rumors that vasectomy resulted in family problems, for instance infiedelity of spouse were often heard to 44% of the 55 small areas. 2. Rumors by socio-economic and demographic characteristic of new village leader and health workers: Among the demographic characteristics such as sex, age and sex composition of children, sex and age differentials in frequency of rumors heard more observed, Female new village health workers have heard more frequently than male new village leader. (t = 7.137, p> 0.01, d.f. = 53, a coefficient of correlation 0.27, p>0.05) The Younger age group less than 40 years of age have heard rumors of than the group over 40 years old. (t = 7.18, p>0.01, d.f. = 53, a coefficient of correlation 0.27, p>0.05) However, it was not observable that a consistent sex and age differentials in frequency of rumors heard of each contraceptive mettled, But, more female new village health works heard of rumors about intrauterine device than male new village leaders. (t = 0.497, p> 0.01, d.f. = 53, a coefficient of correlatin 0.32, p>0.01) 3. It was found that there was no statistically significant relationship between the frequency of rumors heard and current family planning practices on the whole, However, frequency of rumors heard about vasectomy appeared to have a positive relationship with current practice of vasectomy. A rather consistent pattern of relationship between“requency of rumors heard”and current family practice rate was demonstrated of 10 graphes which showed the relation between the two variagles. The current family planning practice rate in the“never heard”group and “frequently heard”group was equally lower than that in“often heard”group. The relatively consistent ∩ pattern of relationship needs to be farther investigated, for this pattern is different from the relationship that has been assumed to exist between these two variables.

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The Experience of the Family Whose Child Has Died of Cancer (암으로 자녀를 잃은 가족의 경험에 대한 질적연구)

  • 이정섭;김수지
    • Journal of Korean Academy of Nursing
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    • v.24 no.3
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    • pp.413-431
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    • 1994
  • The purpose of this study was to build a substantive theory about the experience of the family whose child has died of cancer The qualitative re-search method used was grounded theory. The interviewees were 17 mothers who had cared for a child who had died of cancer Traditionally in Korea, mothers are the care givers in the family and are considered sensitive to the family's thoughts, feelings. The data were collected through in-depth interviews by the investigator over a period of nine months. The data were analyzed simultaniously by a constant comparative method in which new data are continuously coded into categories and properties according to Strauss and Corbin's methodology. The 16 concepts which were found as a result of analyzing the grounded data were, -left over time, the empty place, meaninglessness, inner sadness, situational sadness, heartache, physical pain, guilt, resentment, regret, support / stigmatization, finding meaning in the death, changing attitudes about life and living, changing attitudes about health, changing religious practice and changing family relations. Five categories emerged from the analysis. They were emptiness, consisting of left over time, the empty place and meaninglessness ; sadness, consisting of inner sadness and situational sadness ; pain, consisting of heartache and physical pain ; bitterness, consisting of guilt, resentment, regret, sup-port / stigmatization and finding meaning in the death : and transition, consisiting of changing attitudes about life and living, changing attitudes about health, changing religious practice and changing family relations. These categories were synthesized into the core concept, -the process of filling the empty space. The core phenomenon was emptiness. Emptiness varied with the passing of time, was perceived differently according to support / stigmatization and finding meaning in the death, was followed by sad-ness, pain, and bitterness, and finally resulted in changes in attitudes about life and living and about health, and in changes in religious practice and family relations. The process of filling the empty space proceeded by ① accepting realty, ② searching for the reason for the child's death, ③ controlling the bitter feelings, ④ reconstructing the relationships ameng death, illness and health and ⑤ filling the emptiness by resolving causes of child's death, adopting, having another child or with work. Six hypotheses were derived from the analysis. ① The longer the bereavement, the mere the empty space becomes filled. ② The longer the hospitalization, the more sup-port the family needs. ③ The more the sadness, pain and bitterness are expressed, the mere positive changes emerge. ④ Family support faciliates the process of filling the empty space. ⑤ Higher family cohesiveness faciliates the process of filling the empty space. ⑥ The greater the variety of reasons attributed to the child's death, the greater the variety of patterns of change. Four propositions related to emptiness and bitter-ness were developed. ① When the sense of emptiness is great and bitterness is manifested by severe feelings of guilt and resentment, the longer the process of fill-ing the empty space. ② When the sense of emptiness is great and the family is highly motivated to get rid of the bitterness, the shorter the process of filling the empty space. ③ When the sense of emptiness is less and bitter-ness is manifested by severe feelings of guilt and resentment, the process of filling the empty space is delayed. ④ When the sense of emptiness is less and the family is highly motivated to get rid of the bitterness, the process of filling the empty space goes on to completion. Through this substantive theory, nurses under-stand the importance of emptiness and bitterness in helping the family that has lost a child through cancer fill the empty space. Further research to build substantive theories to explain other losses may con-tribute to a formal theory of how family health is restored after human tragedies are experienced.

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The Pain Behavior of Patients with Joint Pain (관절통환자의 통증정도와 통증연관 행위에 관한 연구)

  • 이은옥;한윤복;김순자;이선옥;김달숙;김조자;김광주;김주희;박점희
    • Journal of Korean Academy of Nursing
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    • v.18 no.2
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    • pp.197-210
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    • 1988
  • The purposes of this study were : 1) to assess the level of pain and to identity the varieties and the degree of pain-related behavior, 2) to measure the level of correlation between the level of pain and the degree of pain- related behavior, 3) to test the correlation between the Korean Pain Rating Scale (KPRS) and Graphic Rating Scale(GRS), and 4) to gather data relevant to the Socio-demographic status of the subjects. The level of pain was measured by KPRS and GRS developed by the researchers. The KPRS consists of three dimensions ; the sensory, the affective and the miscellaneous and the GRS of two separate scales ; the intensity scale and the unpleasantness scale. Of the 2, 025 who had visited orthopedic and neurosurgical out-patients department of 11 university hospitals in various districts of Korea with the episode of Joint pain, 405 subjects were self-selected by responding to the data gathering tools and questionaires mailed. The results are summaried as follows : 1. Maale(217, 53.6%) exceeded female patients(188, 46.4%) in number and the onset of joint pain was more prevalent in the age groups of the 20s and the 30s. 160(39.5%) had been hospitalized for the treatment of, and 87(21.5%) had retired because of the joint pain. 2. Mean pain score measured by KPRS was 128.31 (range; 0-1.344.8) ; mean sensory score was 43.23(range ; 0-645.88%), mean affective score was 46.09(range ; 0- 356.72), and mean miscellaneous score was 39.99(range ; 0-341.68). Mean pain scores measured by GRS were ; sensory intensity score ; 109.1(range ; 0-200) and distress score ; 99.1 (range ; 0-200). 3. The prevalent sites of joint pain revealed to be the right knee joint(203; 50.1%), left knee joint(181(44.7%), left ilium(147, 36.3%), lumbar region (106; 26.2%), hip joint(92; 22.7%) and the ankle(84; 20.7%). 4. The average sleep hour was 6.8hours per day and the average rest hour during the day hours was 3.3hours (range 0-20). 5. The average duration of suffering from joint pain was 49.1 months. 6. Most of the subjects(298; 73.6%) used some sorts of pain relieving practices ; the most prevalent pain relieving practice was the compliance with the physician prescribed treatments(34.4%). 7. The level of discomfort in carrying out the ADL(activities of daily living was 101.16(38.83) and the level of needs for aid in carrying out the ADL was 76.62(31.79). 8. The interrelation between KPRS total score and GRS sensory intensity score(.4438), as well as that of GRS distress score(r=.4446) were not highly correlated, however, sensory and affective dimension within KPRS (.7547) and pain intensity and distress score of GRS(.6975) revealed moderate intercorrelation. 9. Pain-related behaviors such as discomfort in carrying out ADL, the need for aids in carrying out ADL, frequency of pain relieving practices, varieties of pain sites and length of rest hours during the day hours revealed to be highly correlated with the level of pain measured by KPRS, GRS sensory intensity scale and GRS distress scale. The following are recommended ; 1. Test for the correlation of KPRS total score and the summated score of GRS ; sensory intensity and distress scores. 2. Possibilities of utilization of the pain-related behaviors which revealed high correlation as indirect assessment tool for measuring the level of pain.

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Arm Morbidity after Breast Cancer Treatments and Analysis of Related Factors (유방암 환자의 상지 부작용과 관련 요인)

  • Chun Mi Son;Moon Seong Mi;Lee hye Jin;Lee Eun-Hyun;Song Yeoung Suk;Chung Yong Sik;Park Hee Bung;Kang Seung Hee
    • Radiation Oncology Journal
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    • v.23 no.1
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    • pp.32-42
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    • 2005
  • Purpose : To evaluate the incidence of arm morbidity following breast cancer surgery including axillary dissection and to identify related factors. Materials and Methods : One hundred and fifty nine patients were studied using a self-report questionnaire and a clinical examination. Lymphedema, reduction of range of motion in shoulder joint and subjective symptoms (pain, impaired arm movement, numbness, stiffness) were evaluated. As related factors, demographic, oncologic characteristics and types of treatment were analysed. Results : The incidence of lymphedema ($\geqq$2 cm difference comparing to unaffected arm) was $6.3\%$, $10.7\%$, $22.5\%$ and $23.3\%$ at each 10 cm, 20 cm, 30 cm, and 40 cm from wrist. Reduction of range of motion in shoulder joint ($\geqq$ 20 degree difference comparing to unaffected arm) was noted In more than 1/3 patients for flexion, abduction and internal rotation. Especially the reduction of range of motion in internal rotation was severe ($>50\%$ reduction) in 1/3 patients. Approximately 50 to $60\%$ of patients complained impaired arm movement, numbness, stiffness and pain. Body mass index (BMI) was the significant risk factor for lymphedema. Conclusion : Lymphedema was present in 1/3 of patients and the common sites of edema were 30 cm 40 cm proximal from the wrist. Also most severe reduction of range of motion in shoulder joint was with internal rotation. There needs weight control for lymphedema because BMI was the significant risk factor for lymphedema. Also rehabilitation program for range of motion especially internal rotation In shoulder joint should be developed.

A Study on the Coexistance of Ganghak(講學) and Yusik(遊息) space of Oksan Confucian Academy, Gyeongju: Directed Attention Restoration Theory Perspectives (주의집중 피로회복이론의 장으로 본 경주 옥산서원 강학 및 유식공간의 일원적 공간성)

  • Tak, Young-Ran;Sung, Jeong-Sang;Choi, Jong-Hee;Kim, Soon-Ae;Rho, Jae-Hyun
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.34 no.3
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    • pp.50-66
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    • 2016
  • This study attempts to understand and explain how "Directed Attention Restorative Environment (DARE)" is managed and fostered in "Gang-Hak (講學)" and "Yu-Sik (遊息)" spaces both inside and outside of Oksan Seowon Confucian Academy, Gyeongju. Directed Attention is a pivotal element in human information processing so that its restoration is crucial for effective thinking and learning. According to Kaplan & Kaplan's Attention Restoration Theory, an environment, in order to be restorative, should have four elements: 'Being Away,' 'Extent,' 'Fascination,' and 'Compatibility.' We could confirm OkSan Seowon Confucian Academy has an inner logic that integrates two basically different spacial concepts of "Jangsu" and "Yusik" and thus fosters the Attention Restorative Environment. Particularly, the Four Mountains and Five Platforms (四山五臺) surrounding the premises provides an excellent learning environment, and is in itself educational in terms of the Neo-Confucian epistemology with "Attaining Knowledge by way of Positioning Things (格物致知)" as its principle precept, and of its aesthetics with "Connectedness with Nature" as its central tenet. This study attempts to recapture the value of Korea's cultural heritage concerning the Human/Nature relationship; and it may provide useful insights and practical guidelines/grounds in designing today's schools and campuses, where the young people's needs for the Directed Attention- and Attention Restorative- Servicescapes seem to be greater than ever.

Re-interpretation of Aging: Gerotranscendence & Erikson & Erikson's Nineth Stage (노화에 대한 재해석: 노년초월 이론과 9단계이론을 중심으로)

  • Yoon, Min-Suk
    • 한국노년학
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    • v.32 no.2
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    • pp.431-446
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    • 2012
  • The objective of this study is to introduce the theory of Gerotranscendence and the ninth stage of Erikson & Erikson(1997)'s psycho-social development theory in order to enable the academic Korean field to have a more positive and fresher point of view on aging. In order to meet this objective, this study will first take a look at Erikson's 9th stage expansion theory on human development. Then we will study Gerotranscendence as the most representing phenomena among the 9 stage theory so that the Korean Gerontology field can utilize it for future plans. The definition of Gerotranscendence was first introduced by Tornstam(1994) and has been applied as Erikson & Erikson's 9 stage theory ever since. Gerotranscendence can be described as an individual that has entered his golden years after middle age, which transforms one's point of view on life from a materialistic and logical one to a more universal and transcending one. Gerotranscendence is a voluntary and overcoming process of oneself that is displayed in many seniors which leads to a lesser focus on oneself in the eyes of the society, but increases the inter-relational bonding between past and future generations. The following is a summary of the theorhetical evaluation on Gerotranscendence which was analyzed in this study. First, this study introduces the Gerotranscendence theory, which is recognized as the most representative phenomena among Erikson's 9th stage theory that has hence expanded the application of Gerontology theories in the academic field of Gerontology. Second, this study has provided a new point of view towards the elderly in the practical field of senior citizen social welfare. With this understanding, practical levels of services from various points of view can be provided to acknowledge the needs of the elderly. Third, a much wider field of research can be exchanged and provided along with other fields of studies by applying and extending this Gerotranscendence theory in Korea. It would also be especially beneficial to exchange researches within related fields of study such as psychology, sociology, nursing science, family science and the study of religion. Not to mention also lending support to hospitals for the elderly(nursing homes) and institutions related to senior welfare, or practical fields where there is an active exchange of research using Gerotranscendence theory.

Changes in Arterial Oxygen Tension($PaO_2$) and Cardiac Arrhvthmias after Endotracheal Suction (기관내 흡인 실시 후의 동맥혈 산소 분압 변화와 심부정맥 발현에 관한 연구)

  • Kim, Sun-Wha;Shin, Jung-Sook;Choi, Young-Hee
    • The Korean Nurse
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    • v.33 no.4
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    • pp.62-85
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    • 1994
  • The data were analyzed by using an S. P. S. S. computerized program for mean, standard deviation, percentage and paired t-test. The results of this study were as follows: 1. The increase in $PaO_2$ after hyperoxygenation and hyperinflation was highly statistically significant(p=0.041), and the increase in $PaO_2$ immediately after suctioning was not significant (p=0.752). The time of lowest $PaO_2$ was 30 seconds after the endotracheal suction. 2. The occurrance of cardiac arrhythmia after the endotracheal suction included sinus tachycardia, sinus arrhythmia, sinus bradycardia, premature atrial contraction (PAC), and premature ventricular contraction (PVC). The most frequent cardiac arrhythmia was sinus tachycardia (a subjects). Sinus arrhythmia was observed in 5 subjects and continued till 10 minutes after suctioning in two of these. Sinus bradycardia occurred in only 3 subjects and among them, 1 subjects shows sinus arrythmia till 10 minutes after suctioning along. PAC was observed in only one subject and continued till five minutes after suctining along with sinus arrhythmia. PVC was observed in three subjects: it lasted for only 30 seconds after suctioning in two subjects. but continued for 10 minutes after suctioning in the third. 6 subjects manifested two kinds of Cardiac arrhythmia Three of them showed sinus tachycardia with PVC, another 2 showed sinus bradycardia with sinus arrhythmia, and the other subject showed sinus arrhythmia with PAC. 3. The increases in heart rate during the endotracheal suction immediately after and at 30 seconds after suctioning were statistically significant (p=0.005). The increase in heart rate at one minute after suctioning was also significant (p=0.023). The increase in heart rate continued until 10 minutes after the endotracheal suction, but was not statistically significant In this study, endotracheal suctioning with hyperoxygenation and hyperinflation was effective in preventing a decrease in $PaO_2$ after suctioning, but not in preventing cardiac arrhythmias. Nurses should be aware of the complications of endotracheal suctioning and do effective hyperoxygenation and hyperinflation before and after suctioning. Further research is needed to develop a efficient endotracheal suction method which will minimize complications. This study needs to be replicated with different population of patients intubatted or having a tracheostomy, specifically, patients who cardiac or pulmonary desease. The data were analyzed by using an S. P. S. S. computerized program for mean, standard deviation, percentage and paired t-test. The results of this study were as follows: 1. The increase in $PaO_2$ after hyperoxygenation and hyperinflation was highly statistically significant(p=0.041), and the increase in $PaO_2$ immediately after suctioning was not significant (p=0.752). The time of lowest $PaO_2$ was 30 seconds after the endotracheal suction. 2. The occurrance of cardiac arrhythmia after the endotracheal suction included sinus tachycardia, sinus arrhythmia, sinus bradycardia, premature atrial contraction (PAC), and premature ventricular contraction (PVC). The most frequent cardiac arrhythmia was sinus tachycardia (a subjects). Sinus arrhythmia was observed in 5 subjects and continued till 10 minutes after suctioning in two of these. Sinus bradycardia occurred in only 3 subjects and among them, 1 subjects shows sinus arrythmia till 10 minutes after suctioning along. PAC was observed in only one subject and continued till five minutes after suctining along with sinus arrhythmia. PVC was observed in three subjects: it lasted for only 30 seconds after suctioning in two subjects. but continued for 10 minutes after suctioning in the third. 6 subjects manifested two kinds of Cardiac arrhythmia Three of them showed sinus tachycardia with PVC, another 2 showed sinus bradycardia with sinus arrhythmia, and the other subject showed sinus arrhythmia with PAC. 3. The increases in heart rate during the endotracheal suction immediately after and at 30 seconds after suctioning were statistically significant (p=0.005). The increase in heart rate at one minute after suctioning was also significant (p=0.023). The increase in heart rate continued until 10 minutes after the endotracheal suction, but was not statistically significant In this study, endotracheal suctioning with hyperoxygenation and hyperinflation was effective in preventing a decrease in $PaO_2$ after suctioning, but not in preventing cardiac arrhythmias. Nurses should be aware of the complications of endotracheal suctioning and do effective hyperoxygenation and hyperinflation before and after suctioning. Further research is needed to develop a efficient endotracheal suction method which will minimize complications. This study needs to be replicated with different population of patients intubatted or having a tracheostomy, specifically, patients who cardiac or pulmonary desease.

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A Study on a Prevention of Long-term Care self-reliance Support for the Elderly in Home: Proposal of an Prevention and Support for Self-reliance Support Model (재가노인의 장기요양예방과 자립지원에 관한 연구: 예방·자립지원 모형설계 방안제언)

  • Kim, Hyun-Sil;Hwang, Sung-Ja
    • 한국노년학
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    • v.30 no.4
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    • pp.1359-1375
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    • 2010
  • Expecting the expansion of the elderly population under long-term home care with the coming of the aged society, this study purposed to propose a prevention and self-reliance support model and to get practical implications for minimizing dependency on care benefits and enhancing the effectiveness of prevention and self-reliance support. Research methods employed for this study were: first, reviewing theoretical literature for clarifying the concept of prevention and self-reliance support in providing long-term care benefits for the elderly; second, identifying factors hindering prevention and self-reliance support through analyzing standard long-term care use plans and documents related to long-term care benefits at elderly welfare centers to which the research subjects belonged; and third, surveying care benefit users on factors hindering their use of prevention and self-reliance support and their needs in the use of care benefits. Based on the results of the three types of qualitative research, we proposed directions for prevention and self-reliance support modeling and suggested practical implications for enhancing the effectiveness of prevention and self-reliance support. For this study, we collected documentary materials and conducted in-depth interviews with the participants with the consents and cooperation of managers and professional social workers at day care centers and elderly welfare centers in D City. According to the results of this study, literature review suggested that long-term care prevention and self-reliance support should be provided in a way of 'strengthening user-centered support systems,' which support elderly long-term care beneficiaries' right to lead a life as the subject of their own life. Document analysis found the absence of benefits related to health and medicine and lack of social support systems for prevention and self-reliance support, and the results of in-depth interviews suggested the necessity to strengthen services related to elderly long-term care beneficiaries' prevention and self-reliance, and the keen needs of the long-term care elders for prevention and self-reliance included: ① loneliness, anxiety, fear; ② missing for and worry about children and people; ③ moving, outing; ④ health and medical services, rehabilitation programs; ⑤ desire to use day care; ⑥ inconvenience of house structure; ⑦desire for meal menus; and ⑧ the occurrence of disuse syndrome. Based on these results, we suggested the base of prevention and self-reliance support modeling with three axes: ① strengthening user-centered support systems; ② strengthening support systems connected to health and medicine; and ③ strengthening social support systems.