• 한국보건간호학회지
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• 제15권2호
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• pp.239-248
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• 2001

The purpose of this study was to analyze risk factors for nosocomial pneumonia in patients admitted to NS ICU, and to provide a basic data to decrease respiratory nosocomial infection rate engendered from medical environments in NS ICU. The study site was the NS ICU at a university hospital located in Seoul, Korea. The subjects were 31 patients diagnosed with nosocomial pneumonia, who were selected from the initial list of 300 potential subjects who had been a) admitted between September 1999 and January 2000, and September 2000 and January 2001, b) resided at the NS ICU over 72 hours. The diagnostic standard of nosocomial pneumonia was based on the nosocomial infection guides of C university hospital. The data were analyzed using frequencies and logistic regression analysis. The sputums obtained from the subjects were cultivated and causal viruses were separated. The results were as follows: 1. The nosocomial pneumonia rate was $10.3\%$. There were 7 types of causal viruses separated from the sputum. and the most prevalent type of virus was MRSA as $62.2\%$. 2. The factors significantly influencing the incidence of nosocomial pneumonia included age, the residential duration at the NS ICU, GCS scores, diabetes mellitus, insertion of tracheal tube and its duration, tracheostomy and its length of insertion, the use of artificial ventilator and the length of its use, and the insertion of naso-gastic tube. The most significant risk factor among these was the insertion of tracheal tube (odds ratio=18.684. $95\%$ CI=6.849-50.974), followed by the use of tracheostomy (odds ratio=15.419, $95\%$ CI=6.615-35.942), the insertion of naso-gastric tube (odds ratio=14.875, $95\%$ CI=6.396-34.595), and the use of artificial ventilator (odds ratio=13.000. $95\%$ CI=5.633­30.001). 3. Regarding the use of the mechanical aids, the insertion of tracheal tube resulted in 12.968 times increase of the nosocomial pneumonia rate, and the use of artificial ventilator lead 6.714 times increase of the nosocomial pneumonia rate. One point increase of the GCS score resulted in the 1.210 times increase of the nosocomial pneumonia rate. For patients who had tracheal tube, tracheostomy, and artificial ventilator, one day increase of their residential duration at NS ICU lead 1.073 times increase of the nosocomial pneumonia rate. 4. In terms of duration of the mechanical aid usage, one day increase in the use of artificial ventilator engendered 1.080 times increase in the nosocomial pneumonia rate. One day increase of the residential duration at the NS ICU lead 1.604 times increase in the nosocomial pneumonia rate. As one point of the GCS score increased, 0.876 times decrease of the nosocomial pneumonia rate was reported. These study findings show that the risk factors significantly influencing the incidence of nosocomial pneumonia include the use of tracheal tube, tracheostomy, naso-gastic tube, and artificial ventilator. It is recommended that nurses working at NS ICU should pay more attention to the patients with these factors as the risky group for the nosocomial pneumonia, and thus make more active efforts to provide nosocomial pneumonia prevention strategies for them. In further studies patients admitted to the different types of ICUs such as internal medicine or surgery unit ICU will be also included, and more wide investigation of nosocomial pneumonia risk factors will be conducted through one-year longitudinal follow up.

• 지역사회간호학회지
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• 제14권2호
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• pp.334-350
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• 2003

The purpose of this descriptive study was to evaluate the clinical validity of QSCCII (Questionnaire for the Sasang Constitution Classification), whose high accuracy as a constitutional diagnostic tool has been recognized by medical professionals. The subjects of this study were 568 clients from an A university hospital in Suwon. Of the subjects, 259 were health center visitors and 292 were ambulatory clinic visitors. Data were collected using self-reported questionnaire and were analyzed by $X^2$-test and one-way ANOVA. The results of this study as follows: 1. In 4 types of constitution, Soeumin type was found in 41.5% of the subjects. Taeumin type in 39.2%.,and Soyangin type in 19.2%, respectively. There was no Tayangin type found in this study. There were no significant differences on types of constitution by demographic characteristics such as age, sex, marital status, education, religion, and economic status. 2. As for 15 item-selective questionnaire, there were statistically significant differences on the response rate of the 12 items, except items such as A4, A11 and A14, by the types of constitution. When the subjects' own criteria on their constitution were compared to the given constitutional criteria on each item, 4 items such as A6, A11, A13 and A14 were advisable to be excluded from the questionnaire or to be reunited to the other criteria. In the meanwhile, 3 items such as A7, A18 and A15 were desirable to be re-categorized to the other constitutional types and reconstructed to the QSCC II questionnaire. 3. In terms of 106 true-false questionnaire, there were statistically significant differences on the response rate of 46 items by the types of constitution. The 46 items include 15 items (32.6%) of the domain of 'handling something/strength and weakness', 4 items (8.7%) of the domain of 'interpersonal relationship', 9 items (19.6%) of the domain of 'state of mind at ordinary times', 2 items (4.3%) of the domain of 'distinctive emotional characteristics' area, 11 items (23.9%) of the domain of 'specific behavioral trait' and 5 items (10.9%) of the domain of 'physical characteristics'. Therefore, the areas of 'handling something/strength and weakness' and' specific behavioral trait' mainly contributed to the classification of constitutional type. 4. When the 106 true-false items were simplified to the 46 items, statistically significant differences were found on the rate of items allocated to the 3 types of constitution. The rate of selection assigned to the 3 constitutional types of the simplified 46-item questionnaire was higher than that of the original 106-item questionnaire. Conclusions; It was concluded that the rate of selection of each lay person about his own constitutional type would be still higher even though the simplified items of QSCC II questionnaire were applied. If more replicated studies are conducted on the diverse population using the simplifying QSCC II questionnaire in the future, a more simplified standardized Sasang Constitution Questionnaire that is available to the public rather than to medical staffs in the clinical settings could be developed. Moreover, the simplified scale will help nurses deliver more efficient nursing care by providing a more rapid way of health assessment.

• 한국산업보건학회지
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• 제24권4호
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• pp.528-535
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• 2014

Objectives: This study compares the differences of fit factors before and after training on the N95 mask. The results will be utilized to suggest the need of providing effective training on respirator use. Methods: A total of 49 study subjects were tested, comprised of nurses from a general hospital and undergraduate nursing students from a medical school. Anthropometric measurements of face length and face width were compared with the NIOSH(National Institute for Occupational Safety and Health) panel. Fit factors(FF) were measured with TSI Portacount Pro+8038 before and after on-site training regarding the proper use of respirators. The FF pass/fail criterion was set at 100. Results: Two subjects(4.1 %) passed the fit test before training on use of the N95. However, 36(73.5%) of the 49 passed the test after training. Overall the FF(GM(GSD)) was 13.4(3.2) before training, but improved to 106.6(2.1) after training, which was statistically significant. These findings suggest the efficacy of educational intervention, and the performance of the direct on-site training proved to be better than that of the traditional educational methods. Conclusions: This study showed the effect of on-site training of the N95 respirator among health care workers(HCW). Therefore, providing effective training on the use of N95 for HCWs before their work assignments will greatly reduce exposure to harmful agents. It is recommended that fit testing be mandated to check for adequate protection being provided by the given respirators.

• 대한간호학회지
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• 제30권6호
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• pp.1400-1410
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• 2000

Purpose : To determine whether there is a discrepancy between the medical professions perception of what patients should know and that of the patients themselves, we studied patients need to be informed about different aspects of epilepsy and compared findings with medical personnels perceptions of the issue. Methods : Our study population consisted of 39 patients with epilepsy from the inpatient epilepsy unit, and 51patients from the outpatients clinic of the S. University Hospital between July and November 1997. However, the patients who declined to participate or who were not able to understand the directions and content of the questionnaire were excluded. The medical personnel participated in this study were 56 residents or nurses who were working in either Neurology or Neuro surgery Units. The questionnaire with 5 indicating the highest need. The data were analyzed with descriptive statistics, students t-tests, and chi-square. Results : Of the 90 patients and 56 medical personnel studied, the need for lifestyle information such as smoking, drinking, sleep, driving, employment, and marriage was significantly higher from medical personnel than that of the patients(p=0.00). Regarding medical knowledge about epilepsy, the patients group had higher scores in the need for information on the structure of the brain (p=0.00), whereas medical personnel had higher scores on the symptoms of epilepsy. There was no correlation between the length of epilepsy and the need for information on every item on the questionnaire. The patients had higher rank regarding diet, although it was not significantly different from the medical personnel. Regarding antiepileptic drugs and what to do when there is an attack, medical personnel scored higher. The items on which the patients group scored higher than 4.5 were the possibility of inheritance, the factors that might reduce the number of attacks, the period of usage of AED, and the food they have to avoid or the food they have to take to reduce seizure attacks. Conclusions : Our study indicates that the patients group requires higher educational need in the structure of the brain, diet, and surgical treatment, but less in lifestyles and what to do when there is an attack. The educational program for the patients with epilepsy should emphasize medical knowledge with regard to brain anatomy, what to eat and what to avoid, and details of surgical treatment.

• 임상간호연구
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• 제18권3호
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• pp.368-380
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• 2012

Purpose: The purpose of this study was to evaluate the effects of a home-based video exercise program on cancer-related fatigue, physiological and psychological status in patients with colon and rectal cancers undergoing chemotherapy. Methods: The study design was a non-equivalent control group non-synchronized design. Data were collected from patients with colo-rectal cancers in Yonsei cancer center from July 5th to October 31st in 2011. There were 40 participants; 20 in the experimental group and 20 in the control group. The structured questionnaire was used to measure fatigue, physical function and emotional status. Data were analyzed using SPSS 18.0 and a chi-squre test, Fisher's exact test, Mann-Whitney U test and Wilcoxon signed- rank test were conducted to examine the homogeneity and the research hypotheses. Results: There was a statistically significant difference in White Blood Cell count in the experimental group compared with that of the control group. The exercise group showed a slight decrease of White Blood Cell count compared with that of the control group after 4 week program (z=-2.935, p=.003). However, there were no significant differences in fatigue, physiological and psychological status between the two groups. Conclusion: In this study, the developed video exercise program was effective in markedly slightly decreasing White Blood Cell count in patients with colo-rectal cancers undergoing chemotherapy. Therefore, utilizing the video exercise program can be an useful method to promote health among patients with cancer in clinical practice.

• 한국직업건강간호학회지
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• 제11권2호
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• pp.108-120
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• 2002

This study analyzed the managerial efficiency of 11 organizations, the branch centers of a occupational health service organization in Korea, using the Data Envelopment Analysis (DEA) method. The DEA is a good method for evaluating health services since it can handle multiple inputs and outputs simultaneously, and also identify the sources and amount of inefficiency. The author approached this study using two efficient models: the monetary value model and the real value model. The DEA method based on the monetary value model included cost factors, while the real value model excluded cost factors. The input variables used were manpower of physicians, medical technicians, nurses, industrial hygienists and administrators; labor, maintenance, and material expenses. The output variables used were the number of medical examinations, workplace evaluations, group health management services and income from each service. The major results were as follows: First, in the monetary value model, 6 out of 11 organizations (54.6%) showed an efficiency score of 1.0, which means that they have been operating in very efficient ways. However, 5 organizations (46.4%) showed themselves to be relatively inefficient. Second, in the real value model, 7 out of 11 organizations (63.4%) showed an efficiency score of 1.0, which means they have been operating efficiently, while 4 organizations (46.4%) showed themselves to be relatively inefficient. Third, the reliability of DEA method were analyzed by comparing the results of the monetary value model and real value model. The results of 8 out of 11 organizations were same in terms of being efficient or not. Thus, the DEA could be a valid application method for occupational health service organizations. Fourth, the organizations that displayed common inefficiency in both the monetary value model and in the real value model 3, 9, and 10, were also considered to be managed inefficiency from expertise opinion. In summary, this study evaluated the efficiency of occupational health service organizations applying the DEA method with different variables, and found that the results of analysis could be valid in terms of both modeling and expert sense. In the future, the DEA method will be used as a useful tool to identify and evaluate the efficiency of occupational health service organizations through more applications and refinements.

• 대한간호
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• 제36권4호
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• pp.61-74
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• 1997

This study is a descriptive study which was done to examine the circumstances surrounding burn accidents in children in order to develop a burn prevention program. The subjects for the study were the mothers of 107 children admitted to two burn specialty hospitals in seoul and the mothers of 172 healthy children attending day care or kindergarten. The tool used in the study was developed by the researchers, pretested and refined. Cronbach's alpha was 0.72. Data collection was done between November 1995 and April 1996. Statistically analysis was done using SAS Version 6.04 and the data was analyzed using test, chi square, regression and logistic analysis. A suumary of the results shows the following : Eighty percent of the children in both groups lived in nuclear families but comparatively more of the children with burn accidents lived in apartments. More of the parents in the group of healthy children had university education and held white collar or professional jobs, while the parents of the children with burn accidents were slightly younger than the parents of the healthy children. but not significantly younger. A significantly greater number of families of children with burn accidents had more than one child and the characteristics of the children with burn accidents that they were more frequently boys, either first or last born and very active. Most of the burn accidents occurred in fall or winter. sometime between noon and midnight and the majority occurred in the home and were caused by hot liquid. In 86% of the cases emergency care was not given at home but the child was brought to the hospital emergency unit. Most of the burns were second degree or greater. involved the arms or legs. required admission, and 41.5% occurred when the parents were preparing or eating meals. In a test of knowledge of preventive measures, the mothers of children who had suffered burn accidents scored slightly higher than the mothers who had no experience with burn accidents, but this was not statistically significant. As to what to do in the case of a fire, the mothers of the healthy children had more knowledge about who to notify. but 70% of the mothers in both groups did not know how to escape from the house if it was of fire. 80 to 96% did not know what do to in case of a fire, such as rolling if clothes were on fire. 80% did not know what emergency care to give for a burn, and 74 to 87% did not know when it is appropriate to try to put out a fire. It can be concluded from this study that. since the results show that the most frequent situation which resulted in burn accidents was when the parents were not aware of the danger of burns or were not paying attention to the child. and when there were no protective devices to prevent burns. and that accidents most frequently occurred at home. the most effective way of preventing accidents is to develop in the parents a "safety mind", Since burn accidents in children are usually more severe than in adults. the physical. emotional. psychological and social damage is greater. In order to develop and awareness of this in the general public. the use of mass media. books and pamphlets and other educational media that provide education on prevention of burn accidents need to be utilized.

• 간호행정학회지
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• 제4권1호
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• pp.5-17
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• 1998

The Purpose of this study is to find out differences among the leader's traits on the hierarchy of Nurse managers in Nurse system of the hospital. In this study 152 managers over head nurse working in 6 University hospitals and 5 general hospitals were selected and the questionary paper answered by them was collected from 1st to 30th in September in 1997. The measuring instrument used in this study is the one integrated and classified by Stogdill (1981), which nurse professor and 2 students of the master's course translated and modified with myself. And its validity was verified through making a test on 130 nurses. The measuring instrument used in this study is made up of 4 items about physical characteristics, 3 items about social background, 4 items about intelligence and ability, 17 items about personaity, 6 items about task-related characteristics, 9 items about social characteristics and 8 items about general background in the triats of leader. And this instrument is made to be marked using five point Likert type. It's reliability is Cronbach's Alpha =.93. The data for study were analyzed through SPSS/PC+ The result of this study are as follows: 1. The order in importantly perceptible degree of the leader's traits showed like these: the intelligence and ability (M=4.683), the task-related characteristics (M=4.605), the personality (M=4.39), the social characteristics (M=4.327), the social back-ground (M=4.056), the physical characteristics (M=3.601). 2. The order in degree to percept the importance of 44 detailed items of the leader's traits showed like these: the judgement and decisiveness (M=4.967), the sense of responsibility (M=4.904), the activity and energy (M=4.796), the self-confidence (M=4.776), the creativity (M=4.748), the intelligence (M=4.743), the responsibility in the pursuit of objectives (M=4.743), the enthusiasm (M=4.717), the objectivity (M=4.704), the moral sense and ethical conduct (M=4.704), the ability to enlist cooperation (M=4.694), the strength of conviction (M =4.678), the enterprise (M=4.691), the administrative ability (M=4.678) and the cooperativeness (M=4.638) 3. As the result of analyzing the leader's trait differences on the hierarchy of nurse managers in six factors of the leader's traits, the social background showed the meaningful differences(F=4.983, P=0.008). 4. As the result of analyzing the leader's traits defferences made from the upper first to 15th rank among the detailed items of the leader's trait factors on the heirarchy of nurse managers, the meaningful defferences appeared in the following items: the objectivity(F=3.413, P=0.033), the creativity (F=3.550, P=0.031), the sense of responsibility(F=3.345, P=0.049), and the administrative ability (F=3.363, P=0.037). 5. As the result of analyzing the leader's trait factors in general background, only the social background of 6 leader's trait factors showed the meaningful differences according to the working place (F=4.057, P=0.008). The study shows that we should consider the above leader's trait factors in selecting nurse managers and that we should develop the educational program for hierarchy of nurse managers urgently.

• 대한간호학회지
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• 제5권1호
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• pp.133-143
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• 1975

Most of mothers place their babies in either supine or prone position without change of position. Studies comparing supine and prone position of the newborn infants -have already been performed with the result that the prone position is relatively better than the supine position. However, one kind of position recommended to the mothers is not sufficient for the good rearing practice of children, because the same position placed for period long of time may bring out physical, mental tension and fatigue, and deformities of the skull and the thorax. For this reason nurses have to find out other position which has identical or more advantages than prone position so as to perform the position change for the babies. Main purpose of this study is to identify the differences of vital signs, the number of urination, defecation, diaper rash, crying and amount of feeding of the newborn infants with prone position or lateral position during the first three days of life. Sixty two newborn infants who were delivered at Seoul National University Hospital during the period from July 1 to September 5, 1974 were chosen as subjects for this study. The criteria for the choice of subjects were the babies born with vaginal delivery; body weight 2.5kg or over at birth; Apgar score Seven or over; and gestation period between thirty-eight months ana forty- two months. Of these subjects, by random sampling, thirty-one newborn infants were placed in the prone position and the other thirty-one in the lateral position. The results of this study reviewed in a statistical analysis of the t-test to obtain the following findings : 1. The heart rates of babies in the prone position were the mean heart rates of 135.03 and those in the lateral position 135.98 without any statistically significant difference. 2. There was no significant difference of respiration rate between two groups : a group in the prone position showed the mean respiration rates of 45,57 and the other in the lateral position 46.49. 3. There was no significant difference of body temperature between two groups: the mean body temperature of a group placed in the prone position was 98$^{\circ}$18'F(36$^{\circ}$77'C) and that of the other group 98$^{\circ}$20'F(36$^{\circ}$78'C). 4. One baby showed diaper rash only in a group of infants in the prone position. 5. The number of crying of the babies in the prone position were 23.70 and those in the lateral position 30.00 with a statistical difference at 5 percent level. 6, There was no difference of frequency of urination between two groups: the mean frequency of a group placed in tile prone position was 5.44 and that of the other group 5.06, 7. There was no significant difference of frequency of defecation between two groups : the mean frequency of a group placed in the prone position was 4.20 and that of tile other group 4.21, 8. There was no significant difference of feeding amount between two groups : the average amount of a group in the prone position showed 325.03 and that of the other group in the lateral position 291.51. All the above results mean that we may substitute tile lateral position for the Prone position or utilize both position for tile rearing practice of the babies.

• 대한간호
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• 제29권3호
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• pp.36-48
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• 1990

This study was attempted to provide us with basic information on how to improve understanding with patients for operation, and to offer then better nursing and treatment. This kind of study will help scientific application to nursing practice and operating room. The data was collected by interviewing 29 patients who underwent the elective surgery under the general anesthesia at Y hospital in Seoul. The interview ran from October 15 to December 15, 1989. The research instrument was a anxiety measurement device (SAAI) originally developed by Spielberger, et al and modified by Jung-Tack Kim. 1. Hypothesis Testing Hypothesis one was that there would be a difference in state anxiety level according to a time difference in watiting for operation. This hypothesis was rejected(state.anxiety level one hour before operation P>.05, r-.747, State anxiety level half an hour before operation P>.05, r-.1550, state anxiety level just before operation, P>.05, r=.1099). However, state anxiety, evel appeared to be associated with a longer watiting period, like one day before operation (P<.05, r-.4628). Hypothesis two was that there would be a difference according to state anxiety level of patients for operation. This was rejected. (Change of blood perssure in systolie P>.05 r=.1082, Change of blood pressure in diastolic P>.05, r=.088, Change of pulse rate, P>.05, r-1.909) 2. Examining trait anxiety and state anxiety levels, the average level of trait anxiety was 42.034, and the average level of state anxiety one day before operation was 43,000. The average level of state anxiety was averaged 42.356 in a waiting room for operation. 3. Examining the state anxiety level by time period, the one hour before was 42.379 the level half an hour before 42.276, and the level just before operation 42.414. The low level of state anxiety was due to the fact that premedication was not eliminated. 4. Age and time period like one day before operation was related to state anxiety level (F=5.271, P<.0.01) and blood pressure in waiting room for operation. That is, state anxiety level and blood pressure of patients one day before operation appeared high. Sex was relation to changes of blood pressure ; the blood pressure of male patients appeard higer than of female patients. A marital status was also related anxiety level one hour before operation the married patient for operation showed a higher state anxiety level than that of the unmarried patient for operation. Education was similarily related to trait anxiety level in which highly educated patients show lower levels of trait anxiety than poorly educated ones. Motive for hospitalization was related to state anxiety level for patient one hour before operation (F=6.464, P<.05) likewise, patients who are supposed to undergo operation hastily showed higher levels of anxiety than patients who expect elective surgeries.