• 지역사회간호학회지
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• 제33권4호
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• pp.396-407
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• 2022

Purpose: The purpose of this study was to assess insomnia and the quality of sleep, investigate the concordance between objective and self-report sleep patterns, and identify physiological, psychological, and situational factors influencing insomnia and sleep quality among firefighters. Methods: A descriptive, cross-sectional study was conducted with 103 firefighters in Korea. The collected data were analyzed using SPSS 23.0. Descriptive statistics, the independent t-test, and hierarchical logistic regression analysis were performed. Results: Insomnia was found in 66 (64.1 %) of the total subjects, and the average quality of sleep (PSQI) was 5.65 (SD=2.57). Total sleep time (401.00 minutes) and sleep latency (21.60 minutes) measured using self-reported scales were longer than the ones measured using objective measurements by approximately 48.70 and 17.10 minutes, respectively. Factors related to insomnia included the role as a paramedic (OR=4.28, 95% CI: 1.02~17.92), anxiety (OR=1.12, 95% CI: 1.01~1.24), and sedentary lifestyle (OR=0.85, 95% CI: 0.78~0.94), and factors related to sleep quality were physical illness status (OR=5.17, 95% CI: 1.53~17.51) and social support (OR=0.86, 95% CI: 0.78~0.95). Conclusion: The results show a high prevalence of insomnia, poor quality of sleep and the discrepancy between objective and subjective sleep patterns among firefighters. To promote sleep quality and health, early screening and treatment of anxiety and physical illness are required. It is necessary to conduct further studies examining the relationship between physical activity level and sleep.

• 대한간호학회지
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• 제13권2호
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• pp.87-104
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• 1983

It has been well documented that animals exposed to cold show increased activity of thyroid gland. The calorigenic action of thyroid hormone has been demonstrated by a variety of in vivo and in vitro studies. According to Edelman et al., the thyroid thermogenesis is due to activation of energy consuming processes, especially the active sodium transport by the hormone in target tissues. If so, the increase in thyroid activity during cold exposure should induce increased capacity of sodium transport in target tissue and the change in tissue metabolism should be precisely correlated with the change in Na+_K+_ATPase activity of the tissue. This possibility was tested in the present study: in one series, changes in oxygen consumption and Na+_K+_-ATPase activity of liver preparations were measured in rats as a function of thyroid status, in order to establish the effect of thyroid hormone on the tissue respiration and enzyme system in another series, the effect of cold stimulus on the serum thyroid hormone level, hepatic tissue oxygen consumption and Na+_K+_ATPase activity in rats. The results obtained are as follows: 1. The Na+_dependent oxygen consumption of liver slices, the oxygen consumption of liver mitochondria and the Na+_K+_ATPase activity of liver preparations were significantly inhibited in hypothyroidism and activated in hyperthyroidism. Kinetic analysis indicated that the Vmax. of Na+_K+_ATPase was decreased in hypothyroidism and increased in hyperth)'roidism. 2. In cold exposed rats, the serum triiodothyronine (T₃) level increased rapidly during the initial one day of cold exposure, then declined slowly to the control level after two weeks. The serum thyroxine (T₄) level decreased gradually throughout the cold exposure. Accordingly the T₃/T₄ratio increased. The mitochondrial oxygen consumption and the Na+_dependent oxygen consumption of liver slices increased during the first two days and then remained unchanged thereafter The activity of the Na+_K+_ATPase in liver preparations increased during cold exposure with a time course similar to that of oxygen consumption. Kinetic analysis indicated that the Vmax. of Na+_K+_ATPase increased. 3. Once the animal was adapted to cold, induction of hypothyroidism did not significantly alter the hepatic oxygen consumption and Na+_K+_ATPase activity. These results indicate that: 1) thyroid hormone increases capacities of mitochondrial respiration and active sodium transport in target tissues such as liver; 2) the increased T₃level during the initial period of cold exposure facilitates biosynthesis of Na+_K+_ATPase and mitochondrial enzymes for oxidative phosphorylation, leading to enhanced production and utilization of ATP, hence heat production.

• 간호행정학회지
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• 제3권2호
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• pp.61-80
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• 1997

The purpose of this study is to measure the direct and indirect nursing care hours with establishment of nurse substations and compare the experimental nursing units with the existing nursing units For this study, two experimental nursing units: (1) a medical nursing unit and (2) a surgical nursing unit with a nurse substation were selected. And two control nursing units : (1) a medical nursing unit and (2) a surgical nursing unit without a nurse substation were selected. After a three-month experimental operation from June 1 to August 31,1996, research data were collected for three days from September 2 to 4, 1996. We investigated the effects of the direct & indirect nursing care hours with establishment of the nurse substations (improved nursing environment) without adding the staff nurses. The effect of establishment of the nurse sub-station was measured for the differences direct & indirect nursing care hours between experimental and control nursing units. An investigator measured the time for a staff nurse to practice each nursing activity and recorded it every minute. Percentage, average, standard deviation, t-test and ANOVA were used for data analysis. The results are as follows: 1. There was no significant difference between the experimental and control nursing units in staffs' working hours during their shift. 2. There were significant diffferences between the experimental and control nursing units in dierct nursing care hours (t=0.0288, p=0.0001) and indirect nursing care hours (t=0.3886, p=0.0103) per patient. 3. There was significant difference between the experimental and control nursing units in direct nursing care hours done by nurses(t=0.0012, p=0.0111) and aids(t=0.3011, p=0.0027). There was significant difference between the experimental and control nursing units in indirect nursing care hours done by head-nurses(t=0.0051, p=0.0253), nurses(t=0.0071, p=0.0024) and aids (t=0.3227, p=0.0351). There was significant difference between the experimental and control nursing units in indirect nursing care hours done by nurses(t=0.0005, p=0.0015) and aids(t=0.2400, p=0.0013) per patient. There was significant difference between the experimental and control nursing units in indirect nursing care hours done by head-nurses(t=0.0005, p=0.0379) and nurses (t=0.0035, p=0.0198) per patient. 4. Thre were significant differences between the experimental and control nursing units in direct nursing care hours (t=0.1134, p=0.0010) and indirect nursing care hours (t=0.7106, p=0.0008) per staff during the day shift. There were significant differences between the experimental and control nursing units in direct nunsing care hours during the day(t=0.0723, p=0.0003) and evening shift (t=0.0004, p=0.0285) per patient, and indirect nursing care hours during the day shift(t=0.5565, p=0.0036) per patient. 5. There were differences between the experiemental and control nursing units in dircet nursing activities including measurement and observation, medication, communication, teratment, hygiene, and nutrition, and in indirect nursing activities including confirmantion, communication, record, computer work, management of goods. But it was not statistically proven. 6. There was difference between the experimental and control nursing units in unmet-need nursing care hours per patient, but not statistically proven.

• 디지털융복합연구
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• 제20권3호
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• pp.517-527
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• 2022

본 연구의 목적은 치매, 경도인지장애, 허혈성 뇌졸중 환자의 인지기능, 우울과 일상생활수행능력의 변화를 비교하고 도구적 일상생활수행능력의 변화를 설명하는 요인을 확인하기 위함이다. 총 86명(치매=30명, 경도인지장애=32명, 허혈성 뇌졸중=24명)으로부터 진단 시점과 1년 뒤에 인지기능, 우울, 기본적 및 도구적 일상생활수행능력 자료를 수집하여 분석하였다. 반복측정분산분석과 다중회귀분석을 이용하였다. 집행기능(p=.037)과 도구적 일상생활수행능력(p=.023)에서 측정 시점에 따른 집단 간 교호작용이 유의한 것으로 확인되었다. 경도인지장애 집단은 진단 후 1년 동안 집행기능과 도구적 일상생활수행능력의 변화가 거의 없었으나, 시간이 지남에 따라 치매 집단에서는 감소하는 양상이 나타났고 허혈성 뇌졸중 집단에서는 향상되는 양상을 나타냈다. 또한, 집행기능이 저하될수록(p=.030), 기본적 일상생활수행능력이 저하될수록(p<.001) 도구적 일상생활수행능력도 저하되는 것으로 확인되었으며 설명력은 26.9%였다. 이러한 결과는 인지변화를 주요 증상으로 가지는 치매, 경도인지장애, 허혈성 뇌졸중 환자에서 진단 후 1년까지 질병의 초기 단계에 각기 다른 집행기능 변화 양상이 나타났으며, 이로 인해 도구적 일상생활수행능력 변화 양상이 다른 것으로 보인다. 보건의료전문가는 진단 직후부터 집행기능과 도구적 일상생활수행능력 문제를 정기적으로 평가하고 이와 관련된 기능 상태를 유지 및 증진하기 위한 중재를 제공해야 할 것이다.

• 한국보건간호학회지
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• 제12권2호
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• pp.12-26
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• 1998

The occupational health problems are the major issue in the modern industrial society. Especially the small scale industries have many hazardous factors and not any occupational health programs in itself. Fortunately. the government-funded subsidiary program was developed and carried out in the past six years in our country. The purposes of this study were to find out the actual condition of the occupational health personnel's accomplishments for the government-funded subsidiary program for small scale industries and to provide basic data for setting up more developed subsidiary occupational health program. Data were collected through 6 kinds of service records review. These service records were written by 3 occupational health personnels were attached to the one subject center of KIHA. were undertaken during March to December, 1997. at 95 small scale industries which were applied the government-funded subsidiary occupational health program. Results were as follows 1. Concerning 95 small scale industries showed characteristics of a typical small scale industry. 2. A doctor visited in industries total 190 times per year, average 19 industries per month, twice per year and industry. A hygienist visited in industries total 378 times per year, average 38 industries per month, four times per year and industry. A nurse visited in industries total 477 times per year. average 47 industries per month, 5 times per year and industry. 3. 3 occupational health personnels accomplished total 3,869 items. A doctor accomplished total 539 items per year, each time 3 items In an industry. A hygienist accomplished total 1.581 items per year, each time 4 items in an industry. A nurse accomplished total 1.749 items per year, each time 4 items in an industry. 4. The major contents of doctor's accomplishment were 'health consultation for suspicious worker with general & occupational disease', 'a check of the workplace & special health education', 'guidance of special medical examination in the second half of year', etc. The major contents of hygienist's accomplishment were 'pretest & guidance of planning for evaluation of working environment'. 'evaluation for ventilating facilities & suporting self inspection', 'guidance of MSDS recording & chemicals management', etc. The major contents of nurse's accamplishment were 'health counseling of general & special medical examination results'. 'health education of preventing occupational disease & health disorder'. 'guidance of subsidiary program planning', 'selecting & guidance of health monitor', etc. It was concluded that the occupaional health personnels implemented the subsidiary program according to the order of health management guide. The current health management guide of subsidiary occupational health program in which the fixed contents, visiting number & periods is not desirable. That guide is left the characteristics of small scale industries out of consideration. It is suggested that occupational health management guide should be developed according to the general & environmental characteristics of each small scale industry, and on the other hand, the more specific guide for each occupational health personnel should be developed.

• 대한간호학회지
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• 제26권2호
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• pp.443-466
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• 1996

Young children need continuous care and fostering by their family. They help children organize and develop their potential and grow to be and integrated individuals. Children are influenced by then family at first and continuously when they grow up and develop their capability. Especially, mothers spend a lot of time with time to their children, encourage children's growth, give advice, and do their best to take care of their children. The ethnographic study is to understand the patterns and rules of human behaviors. This study utilized this method in order to interpret the maternal health promoting behaviors for their children. The data were collected through the participant observation and direct interview for about 18 months in P city. The participants were 7 mothers, from 32 to 37 years old. They have children of ages 3 to 10 and 1 or 2 children in total. The data were analyzed through the Spradley's Ethnographic method and the results were summarized as follows : The viewpoints which influence maternal health promoting behaviors include “having childlike appearance”. “having childlike character”, “living without illness”, and “eating well”. The maternal health promoting behaviors for children are classified as “adapting to nature”, “supporting of ability”, “sharing with the family”, “training”, and “praying”. The adapting behaviors include “recognizing child's innate character”, “controlling maternal desires”, “preparing natural food”, which includes breast feeding. The supporting behaviors include “recognizing childlikeness”, “empowering”, and “restricting certain actions to preventing accidents”. In order to promote child's health, it is essential to promote mother's health first of all. The sharing with the family includes “promoting family concord or acquaintanceships concord” and “adapting to circumstances beyond family”. The training behaviors include “forming good habits” and “having good moral value”. It is very important to form good habits in childhood. The praying behavior include “waiting for opportunities” and “endeavoring activity to promote child's health”. The above 5 behaviors by mothers appeared to be able to promote children's health. The results of this study can be utilized to provide the basic information necessary to develop the patterns of maternal health promoting behaviors consistent with our culture and can contribute us develop the body of knowledge about the maternal health promotion for children in nursing.

• 한국의료질향상학회지
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• 제7권2호
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• pp.156-167
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• 2000

Background: Emphasis in healthcare during the 1990s has been to provide both optimal wellness and function with quality in a Cost-effective manner. Critical pathway was developed to meet the need to guide clients along the continunm of care and to achieve continuity of care. The purpose of this study is to review and analyze articles related to the critical pathway that had developed and applied in Korea and abroad from 1995 to 1999. Methods: Total 39 studies were analyzed in terms of group of application, need of development, horizontal axis: time frame, vertical axis : items of care, task force team, identification of preliminary critical pathway, validation of preliminary critical pathway, types of final critical pathway, a person who coordinates and effects on critical pathway. Results: In the aspect of group of application, there were various diseases in the overseas than in Korea. In domestic and overseas, the horizontal axis included mainly the time from the start of hospitalization to discharge and vertical axis of the critical pathway included commonly the following nine items : tests, diet, medications, consultations, activity, assessments, treatments, education, discharge planning. Preliminary critical pathway was mainly drawn up through chart review in both. Types of final critical pathway were mostly for medical team use in Korea and were for medical team and patient use in abroad. A person who coordinates critical pathway was mostly nurse in abroad. There was positive effects on critical pathway in both. Conclusion: Staff education and information about critical pathway are needed to use it effectively.

• 중환자간호학회지
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• 제9권1호
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• pp.66-76
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• 2016

Purpose: This study was conducted to examine the relationship between lateral position change and sternal complications after cardiac surgery through median sternotomy. Methods: This study was a retrospective descriptive case-control study, involving 241 patients who underwent cardiac surgery through median sternotomy. Data from October 2011 to September 2014 were collected. Results: Sternal complications (i.e. dehiscence, sternal instability, mediastinitis) developed in 33 patients (13.7%). Primary symptoms of complications were discharge and erythema, and the mean time difference from surgery to appearance of symptoms was 15 days (range, 1-138 days). The factors associated with sternal complications were cancer comorbidity (${\chi}^2=5.22$, p=.039), internal mammary artery procedure (${\chi}^2=4.16$, p=.041), and duration of extra-corporeal membrane oxygenation (p=.033). Position change was not related to incidence of sternal complications (${\chi}^2=0.14$, p=.704). Pressure ulcers appeared in 63 patients (26.1%). Mean time difference from surgery until occurrence of ulcers was 6.7 hours (range, 0-323.0 hours), but position change was started from 132.4 hours (range, 27.1-503.2 hours) after intensive care unit admission. Conclusions: These results provide baseline data to create a standard position change and activity protocol for patients after median sternotomy. Furthermore, the study could help clinical practitioners establish evidence-based nursing practices.

• 재활간호학회지
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• 제13권1호
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• pp.23-31
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• 2010

Purpose: The purpose of this study were to describe the level of activities of daily living (ADLs) and fatigue of stroke patients and to identify related factors of ADLs and fatigue. Method: A sample of 132 were used who were recovering from stroke. The face-to-face interviews were conducted to collect data. The levels of ADLs and fatigue were evaluated using the Modified Barthel Index and Kim's fatigue scale respectively. A series of t-test and analysis of variance analyses were conducted to examine study purposes using SPSS 15.0. Results: The levels of fatigue and ADLs were 65.6 (SD=16.52) and 74.6 (SD=22.32) respectively. Significantly poorer ADLs were found: women (t=2.05, p=.001), older people aged ${\geq}$ 70 years (F=2.74, p=.046), the duration of onset (F=4.34, p=.006), the use of assist devices (F=35.64, p<.001), the parts of paralysis (F=4.25, p=.007), the time to attack (F=3.34, p=.039), and accompanying symptoms (F=15.23, p<.001). There was a significant difference in fatigue with patients with lower accompanying symptoms having lower fatigue (F=11.08, p<.001). Conclusion: These findings suggest gender, the duration from onset, the use of assist device, the parts of paralysis, the time to attack and accompanying symptoms were significant factors of the ADLs and fatigue post stroke. These factors should be considered when developing and testing nursing intervention programs for stroke survivors.

• 대한간호학회지
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• 제20권1호
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• pp.79-87
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• 1990

Clinical and epedemiologic studies of coronary heart disease(CHD)have from time to time over the last three decades found associations between prevalence of CHD and behavioral attributes and cigarette smoking. The main purpose of this study is reduced to major risk factor of coronary heart disease through prohibition of smoking and control of behavior pattern. The subjects consisted of 120 smokers and 90 non-smokers who were married men older than 30 years working in officers. The officers were surveyed by means of questionnaire September 26 through October 6, 1989. The Instruments used for this study was a self-administered measurement tool composed of 59 items was made through modifications of Jenkuns Activity Survery(JAS). The Data were analysed by SAS(Statistical Analsis System) program personal computer. The statistical technique used for this study were Frequency, x$^2$-test, t-test, ANOVA, Pearson Correlation Coefficient. The 15 items were chosen with items above 0.3 of the factor loading in the factor analysis. In the first factor analysis 19 factors were extracted and accounted for 86% of the total variance. However when the number of factors were limited to 3 in order to derive Jenkins classification, three factors were derived. There names are Job-Involvement, Speed & Impatience, Hard-Driving. Each of them includes 21 items, 21 and 9, respectively. The results of this study were as follow : 1. The score of the smoker group and non-smoker group in Job-Involvement(t＝5.7147, p＜0.0001), Speed & Impatience(t＝4.6756, p＜.0001), Hard-Driving(t＝8.0822, p＜.0001) and total type A behavior pattern showed statistically significant differences(t＝8.1224, p＜.0001). 2. The score of type A behavior pattern by number of cigarettes smoked daily were not statistically significant differences. 3. The score of type A behavior pattern by duration of smoking were not significant differences. It was concluded that the relationship between smokers and non - smokers of type A behavior pattern was statistically significant difference but number of cigarettes smoked daily and duration of smoking were not significant differences. Therefore this study is needed to adequate nursing intervention of type A behavior pattern in order to elevated to educational effect for prohibition of cigarette smoking.