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Inappropriate Care of Oncologic Emergency in Korea (암환자 응급진료의 현황 및 문제점)

  • Heo, Dae-Seog;Yun, Young-Ho;Jeong, Joo-Young;Kim, Hong-Soo;Kim, Sung-Hye;Shin, Sang-Do;Rhee, Joong-Eui;Oh, Eun-Kyung;Yoo, Chul-Gyu;Bang, Yung-Jue;Kim, Noe-Kyeong
    • Journal of Hospice and Palliative Care
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    • v.1 no.1
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    • pp.14-22
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    • 1998
  • Purpose : Cancer is a common cause for admission to emergency room(ER). Cancer patient present to ER with undiagnosed cancer, acute vague problem of cancer, or treatment related complication. But there is little information on the magnitute of the problems in the Korea. The purposes of our study were to evaluate the appropriateness of care for oncologic emergencies in Korea. Materials and Methods : This study was undertaken of all cancer patients above 15 years old presenting to the Seoul National University Hospital ER, who visited during the period from Oct. 16 to Nov. 15, 1997. ER record was reviewed and ER doctors evaluated patients' reason for visiting ER, appropriateness in patients' utilization of ER, oncology emergency Results : 266 cancer patients(17.4% of total patients) visited ER during this period and 166 cancer patients(62.4%) utilized inappropriately ER. Their average stay is 32.0 hours and 65.8% of them stayed for 6 hours. There were complaints of patients such as pain(44.8%), abdomen distension(9.4%), and dyspnea(7.5%). The most common oncologic emergency in ER during this study were gastrointestinal(34.0%), neurologic(21%), hematologic(8.0%), infectious(7.0%), respiratory(6.0%), and genitourinary(5.0%). Conclusion : For the care of symptoms like pain, most of cancer patients utilize ER inappropriately due to lack of attention from primary health delivery system. For the better care, the palliative medicine should be established in Korea.

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Model Development of Affecting Factors on Health Behavior and Juvenile Delinquency of Adolescents (청소년의 건강행위와 비행의 영향 요인에 관한 모형 구축)

  • Kim, Hyeon Suk;Kim, Hwa Jung
    • Journal of the Korean Society of School Health
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    • v.11 no.2
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    • pp.171-187
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    • 1998
  • In recent years, adolescent issues including smoking, drinking, drug abuse, juvenile delinquency, deviant sexual behavior, mental health problems, high suicide rate, juvenile delinquency and absence without due notice, etc are emerging as serious social problems and the debate on these controversial issues is heating up. The previous studies on adolescent health behavior and social juvenile delinquency such as run-away from home and absence without due notice have been conducted mostly by cause analysis utilizing social demographic factors or biological factors. In other words, the main factors analyzed were demographic and economic factors or parent's educational level, etc, which were the fixed environmental ones that were unable to cause the change in the health behavior. Accordingly, the purpose of this study is to analyze factors which are changeable and fixable among the factors influencing the adolescent's health behavior and misconducts and, eventually influencing factors which can be used as the basis to establish health policies and health promotion program to reduce the health risk behavior and misconducts of adolescents. The study subjects were selected by dividing senior high school student in Seoul by region and through random sampling. The 890 subjects were selected from 10 schools including the preparatory school, vocational schools and institutional schools. The duration of the study was for July 1-5, 1997 for the first survey and the second one, for August 25-September 10. Regarding the analysis method, the SAS program was used. The adoptablity of theoretical model was tested through covariance structural analysis utilizing PC-LISREL 8.12 Program. The major findings of the study are as follows: As a result of establishing the model of factors influencing health behavior and juvenile delinquency, in case of male students as the health behavior self-efficacy, education level of fathers, economic level, self-control and the health interest of parent were higher, students were more likely to practice the health promoting behavior. Juvenile delinquency and health risk behavior were prevalent among those with the less shyness, the lower health behavior self-efficacy, lower self-control, lower self-assertiveness, lower economic level. The self-control was the most powerful factor. In case of female students, those with higher health behavior self-efficacy were more likely to practice the health promoting behavior whereas those with lower health behavior self-efficacy, lower self-control, lower self- assertiveness, less shyness were more likely to practice health risk behavior and juvenile delinquency. In case of prep schools, those with higher health behavior self-efficacy and better perceived health status were more likely to practice the health promoting behavior while those with less shyness, lower health behavior self-efficacy and lower academic achievement were more likely to engage in health risk behavior and juvenile delinquency. In case of vocational schools, as health behavior self-efficacy and economic level were higher, the practice rate of health promoting behavior was higher. As the self-control, shyness, self-assertiveness, health behavior self-efficacy were lower, the rate of health risk behavior and juvenile delinquency were higher. In case of social institutional schools, as, the health behavior self-efficacy, social support and economic level, health interest of parents were higher, the rate of health promoting behavior were higher. As the self-control, shyness, self-assertiveness, health behavior self-efficacy and social support were lower, the rate of health risk behavior and juvenile delinquency were higher. So the health promoting behavior was positively related to the health behavior self-efficacy, health interest of parents, social support, education level of fathers, level of perceived health status, economic level. The health risk behavior and juvenile delinquency were higher with the lower health behavior self-efficacy, self-control and self-assertiveness, lower health locus control, less shyness and loneliness, lower economic level and academic achievement. In conclusion, the health risk behavior and juvenile delinquency can be reduced by enhancing self-control, self-assertiveness, health behavior self-efficacy and social support. According to the final model drawn by connecting health behavior and juvenile delinquency, the reduction of health risk behavior can greatly contribute to decreasing social juvenile delinquency as the process of juvenile delinquency was extended from common behaviors to problem behaviors and further into juvenile delinquency.

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A Study on the Actual Conditions of Smoking in Middle and High School Students in One Region (일 지역 중·고등학생의 흡연실태)

  • Kim, Hyeon-Ok
    • Journal of the Korean Society of School Health
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    • v.12 no.1
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    • pp.149-167
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    • 1999
  • To investigate the actual conditions of smoking in middle and high school students in Chinan County, I used a sturctured questionnaire for 1,579 students attending twelve middle-high schools from December 1, 1998 to December 20, 1998. I collected and data correlated the using an $SPSS-PC^+$ 1. The smoking rate of middle-high schoo1 students in Chinan County was 17.9%, relatively high. This smoking rate was different according to the gender, grade, religion, and economic situation. In mals, high school students, non-religious, students low income family students, the smoking rate was higher. The smoking rate of high school students was almost the same as the smoking rate of adults, generally higher than that of foreign teenagers. Because the smoking rat of studinets in the third grade of middle school and in the first grade of high School was six times higher, increased education should be conducted during this time in an attempt to curb the sudden increase of the smoking rate. The smoking rate of girl students was 5.0%; this has increased mor than three times from ten years ago. Consequently, counter measures should be taken against the smoking of female students as well as juvenile smoking in general. In addition, the smoking rate of middle-high school students showed interesting differences when correnated with enviornmental factors. Students with low grades, who are not satisfied with school life, who don't have both parents, who have uncaring parents who nare too strict or too arbitary, who have smoking parents, or who have experienced smoking commonly smoked. Therefore, to lower the smoking rate we should improve the school environment, improve a student's interest in school life. And parents or siblings should lead by example and quit smoking at home. Schools should educate students more effectively concerning the harmful effects of smoking and create an accurate understanding of its dancers. From the beginning, we should teach students never ever to touch cigaretts. 2. The surve discovered that most students started out of curiosity, or solicitantion from friends or elders at middle school, and had been smoking one to five cigarettes for more than a year. They obtained cigarettes at stores and most of them have friends who smoke. As a result anti-smoking education should be conducted at elementary schools prior to middle school. More than 95% of the teenagers who smoke had friends who smote and smoked out of curiosity or the recommendation of elders. Thus, we must focus on teenagers who smoke in group, rather than individually. Fuyrthermore, the strict application of the regulation of tobacco sales as well as tobacco cooperation from retailers are needed. While students did not show any mood or academic achievement difference after beginning smoking, 58.1% of the students a health situdation that was worse. Juvenile smoking is more harmful to the juvenile than adult smoking is to the adult. This should be focused on in an anti-smoking campaign. 3. Students who smoke hada more positive attitude toward smoking than students who don't smoke. Students who smoke had a tendency to have a nuetral position and are not concerned about smoking compared to non-smoking students. The survey showed that the great number of students had a nuetral position. Because this nuetrality may increase Juvenile smoking, education that provides an exact understanding of smoking should be performed to build the correct attidude toward smoking. 4. Middle school students smoke when angry, gloomy, anxious, a lone and when they have some problems to solve, on when they feel inconveniened in other wores, they smoke to reliver stress. They also smok due to addiction. Because smoking is not a praetical method to relieve stress, a program which helps to acquire positive relief stress should be provided to help reduce smoking. 5. About 65% of students who smoke want to quit smoking because of health problem, 78% of them have tried mor than once to quit but failed due to weak will power and peer pressure from friends who smoke. Juvenile smoking is group, oriented. Thus, the program that advances less smoking will be the one that focuseds on groups. 6. As for advice to students who want to quit smoking, "persuasion" was used most commonly, followed by a "presentation on how to quit smoking". Another method were severe punishment. About 70% of the students wanted the anti-smoking guide at school. 7. Most students (73.5%) had a position that more anti-smoking education at school is needed. Obriously, then, anti-smoking education at middle-high schools should be reinfoced. Although the education which explains the harmful influence of tobacco is known as an efficient way prevent smoking; it does not influence students who already smoke. Therefore, for students who smoke, multi-dimensional approaches must be attempted that include physical training, phychokogical approache, consultation and discussion, medical chek-ups, audio-visual education technigues, and professonal instructors, in addition, because smoking students have more negative on lukewarm attitude to anti-smoking education anti-smoking education should be conducted through a communicative style by dedicated teachers who care about students. In order to increase the effectiveness of this program.

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Differences in Patients' and Family Caregivers' Ratings of Cancer Pain (암환자와 그 가족간호자가 지각하는 환자의 통증강도 차이)

  • Kim, Hyun-Sook;Yu, Su-Jeong;Kwon, Shin-Young;Park, Yeon-Hee
    • Journal of Hospice and Palliative Care
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    • v.11 no.1
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    • pp.42-50
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    • 2008
  • Purpose: Undertreatment of canter pain, especially due to the differences in the perception of pain between the patients and caregivers, is a well recognized problem. The purpose of this study were to determine if there exist differences in communication about pain intensity scores between patients and their family caregivers in Korea. Methods: A total of 127 patient-family caregiver dyads who have experienced canter pain participated in this study at a hospital in Seoul for six months. The data were obtained by fare to face interview with a structured questionnaire based on Brief Pain Inventory-Korean version and other previous researches. The clinical information for all patients was compiled by reviewing their medical records. Results: Patients' 'worst-pain for 24-hour' and 'right-now-pain' scores estimated by family caregivers were significantly higher than those by patient themselves. The degree of agreement between patients and family caregivers in the estimate of patients' 'worst-pain for 24-hour' intensity categories was 78.7% for 'severe pain', 40% for 'no pain', 27.5% for 'mild pain' and 22.9% for 'moderate pain'. In case of 'right-now-pain' intensity categories, the agreement was 50% for 'severe pain', 47.2% for mild pain, 46.3% for 'no pain', and 26.3% for 'moderate pain'. Conclusion: This study demonstrates that the degree of agreement between patients and family caregivers in the estimate of patients 'pain intensity categories was less than 50% except for 'severe pain'. The results indicate that Korean family caregivers tend to overestimate the canter pain intensity of their caring patients, especially, when a lancer patient has 'moderate' or 'mild pain'. Health Providers are advised to educate patient-family caregiver dyads to use a pain measurement scale to promote their agreement in pain Intensity stores. Further analyses and studies are needed to identify the factors and differences that influence their communication about pain intensity scores between patients and their family caregivers.

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Analysis of the Present Condition and Demand for the Assistant Workforce in Korean Childcare Center (어린이집 보조인력의 노동실태 및 요구분석: 보조교사, 대체교사, 부담임 교사를 중심으로)

  • Park, Chang Hyun;Kim, Sang Lim
    • Korean Journal of Child Education & Care
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    • v.18 no.2
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    • pp.85-102
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    • 2018
  • The purpose of this study is to determine the working conditions and demands of the assistant workforce at childcare centers, and to provide suggestions on policies for childcare teachers. To achieve the purpose of the study, a total of 190 assistant teachers, nursing helpers, alternative teachers and others were surveyed online during the month of August 2017. The survey examined the employment route and working motives, working conditions and environment, job and educational difficulties for analyzing the work conditions and demands of ancillary staff. For the analysis method, SPSS 12.0 was used to analyze frequency and difference. The main findings are as follows. First, childcare center assistants were able to work at their respective times, making it mandatory for them to enter the workforce, and making job openings for ancillary teachers. Second, 73.7% said the daily working hours were '4 hours to 8 hours' under the conditions and 57.9% said 'More than 510,000 won to less than 1 million won.' Average amount of rest time per day was about 30 minutes, and 17% had no rest periods. Third, based on the job and education status, ancillary personnel performed "infant and child guidance and interaction", "Cleaning and cleanliness related tasks" most actively, and "care for cleaning and cleanliness" and "care for morning and night care". Fourth, in the job trouble and difficulty, ancillary staff found it difficult to satisfy with wage related complaints and job insecurity, and the reason for agreeing to the non-regular workforce becoming a regular worker was found to be due to the stability of employment. Lastly, the most urgent tasks to solve the problem of non-regular workers were to fill the wage gap between regular and irregular workers, shorten the working hours and improve the working conditions. The policy implications are presented based on the above findings.

The Prevalence of Metabolic Syndrome and Related Risk Factors Based on the KNHANES V 2010 (제 5기 국민건강영양조사로 추정한 한국 성인의 대사증후군 유병률과 관련 요인)

  • Park, Eunok;Choi, Su Jung;Lee, Hyo Young
    • Journal of agricultural medicine and community health
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    • v.38 no.1
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    • pp.1-13
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    • 2013
  • Objectives: This study is to investigate the prevalence and related factors of metabolic syndrome among Korean adults aged 20 years and above. Methods: From the database of the $5^{th}$ Korea National Health and Nutrition Examination Survey (KNHANES V) conducted in 2010, data of 5,670 adults who responded to all the questionnaires of health interview and had metabolic syndrome in the health examination were included in this analysis. SAS 9.2 was used for statistical analysis with complex sample survey modules and commands. Results: The prevalence rate of metabolic syndrome based on the criteria proposed by International Diabetes Federation (IDF) was 18.8%. The prevalence of metabolic syndrome in each group was: 20.7% of women, 43.1% among elderly over 70 years old, 40.6% of the divorced or the separated, 27.6% of recipients of economic support from the government, 23.6% of people who had alcohol dependency problem, and 43.7% of overweight or obese adults. Independent risk factors based on the multiple logistic regression analysis revealed that prevalence of metabolic syndrome was associated with female (odds ratio 1.59 [95% confidence interval 1.20-2.11]), age (50s 3.95 [2.11-7.37], 60s 5.62 [2.98-10.61], 70s 10.56 [5.25-21.25]), high school education (0.52 [0.37-0.74]), clerk occupation (2.14 [1.27-3.60]), divorced marital status (1.72 [1.15-2.59]), alcohol dependency (1.86 [1.16-2.98]), higher BMI (14.08 [10.60-18.70]). Conclusions: The metabolic syndrome is prevalent among Korean adult population according to IDF criteria. Several demographic characteristics and potentially modifiable factors are associated with metabolic syndrome. Identification of this high-risk group and management of these modifiable factors are warranted to reduce the prevalence of metabolic syndrome.

Survey on Period Prevalence Rate and Therapeutic Practice For Low Back Pain in Adult Population of Rural Area (농촌지역 성인의 요통 유병률과 치료방법 조사)

  • Lee Seung-Ju;Park Jung-Han
    • The Journal of Korean Physical Therapy
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    • v.3 no.1
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    • pp.109-121
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    • 1991
  • To investigate the period prevalence rate and therapeutic practic for low back pain (LBP) in the adult population of rural area, a personal interview was conducted for 2.024 persons or 20-59 years old in Seohu Myon, Andong County, Kyungpook Province between 1st and 20th of April, 1991. The period prevalence rate (l February 1990-31 January 1991) of LBP for 1,106 adults who were interviewed was $47.9\%$. The age adjusted period prevalence rate for males was $43.7\%$ and that for females was $52.3\%$ and the difference was statistically significant (p<0.005). Clinical course of th LBP was acute in $14.1\%$ of males and $9.0\%$ of females, recurrent in $57.0\%$ and $55.2\%$, and chronic in $28.9\%$ and $35.8\%$, respectively. Common causes of the LBP were insidious on set with aging without known cause$(48.1\%)$, heavy work $(15.1\%)$, and trauma $(11.3\%)$. Due to LBP $12.5\%$ of the patients were not able to stand or walk for more than an hour and $2.5\%$ were bed-ridden or unable to carry out daily routine. To have the LBP diagnosed $10.2\%$ of the patients utilized a oriental medical clinic or hospital, $31.3\%$ visited a clinic or hospital, and $56.6\%$ hat not utilized any medical facility. Main reason for not having the LBP diagnosed was that the LBP was tolerable. The most popular therapeutic method that the LBP patients chose at the first was drug and physical therapy. Herb medicine was most commonly used when the first therapeutic method was not effective and the acupuncture was the most popular choice of therapy when the second therapeutic method failed. Folk medicine was utilized in $15.5\%$ of the LBP patients and it included 36 regimens such as tincture of motherwort (Leonurus sibiricus), boiled chicken with liquor, etc. It was revealed by this survey that the LBP is a serious health problem in the rural area and many of the LBP patients do not utilize a clinic or hospital but take non-scientific folk remedy. To prevent the economic waste and side effects of the folk remedy, public health education is needed for tile rational therapy of LBP.

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