Background: The purpose of this study was to identify role ambiguity of comprehensive nursing care unit nurses. Methods: A concept analysis method by Walker and Avant was used to understand role ambiguity of comprehensive nursing care unit nurses. Results: The antecedents of role ambiguity of nurses at comprehensive nursing units were shortage of nurses, unclear admission criteria, and demands for customized nursing care according to severity. Attributes include ambiguity in role delegation, patient placement ambiguity, and professional ambiguity among nursing staff. The consequences were diminished job satisfaction due to excessive workload, difficulty in resolving role ambiguity due to the lack of work analysis studies, and poor outcome of nursing indicators. Conclusion: Improvement of nationwide awareness for comprehensive nursing care unit is required. Clear division at scope of practice for nursing staff in accordance of each medical institution's characteristics is essential. Nurses at comprehensive nursing care unit should understand nature of role ambiguity that occurs as they work in large groups. Nurses should promote communications between nursing staff and they must have volition to improve status quo. An additional research of comprehensive nursing care on the causes of role ambiguity in the practice of nursing care for ward nurses is needed, and management measures should be sought at the organizational level.
Purpose: We reconstructed the skin defect of hands exposing tendons and/or bone with distally based ulnar artery flap and report our cases. Materials and Methods: Between March 2005 and September 2007, 6 cases of skin defect were reconstructed with distally based ulnar artery flap. Defect site were 5 cases of hand dorsal side and 1 case of hand volar side. The average defect size was $3{\times}3\;cm^2$. There were 4 men and 2 women and mean age was 55.5 years. We evaluated the viability of flap, postoperaive complication, healing time, patient's satisfaction. Results: There was no flap failure in 6 cases. But 1 case with recurrent discharge was healed with several times adequate debridement and delayed suture. 1 case with flap edema which might be due to venous congestion was healed with hand elevation and use of low molecular weight heparin. Mean time to heal the skin defect was 4 weeks. No infection and recurrence was found in follow up period. Cosmetic results as judged by patients were that 3 cases are good and 3 cases are fair. Conclusion: Distally based ulnar artery flap is good treatment method among the numerous methods in the cases of skin defect, with soft tissue exposed, which is not covered with debridment and skin graft. Distally based ulnar artery flap is useful method for the skin defect of hands because it is simple procedure, has constant blood supply and relatively good cosmetic effect.
The purpose of this research was to find the present condition on dementia patients clothes design including shapes, colors, construction and details in domestic. This research was for confirming the present problems, suggestions, and basic informations for development dementia patients clothes proto-types. The research methods and process were as follows; 1. The total 20 institutes (5 dementia specialty hospitals, 3 the senior hospitals and 11 nursing care centers) were researched during from June to August, 2005 by trained researchers who had experiences researches. 2. The total 30 nurses and care-givers were interviewed for find the present problems related the dementia patients clothes. 3. The total 39 suits for dementia patients clothes were collected and the design analysed such like shapes, colors, constructions and details by taking pictures and drawing flat works. 4. The present condition about the clothes and problems were found and suggest new ideas. The results were belows; 1 The most of institutes of domestic area had two piece type like general hospital patients' clothes for dementia patients clothes. It means there are no concerning now for old dementia patients. 2. The white colors were firstly used as fabric ground and secondly pale tone or pastel tone colors were used The blue and pink were used as pattern colors. The pattern colors were usually moderate tones. 3. The characteristics of constructions and details were round neckline, buttons, full-length sleeves, straight pants, ankle length pants. 4. New functional fabrics and designs for emotional satisfaction were demanded for dementia patients.
Ginseng has been used in maintaining physical vitality throughout the far-eastern countries and recently its metabolism and actions on neurologic, cardiovascular, and endocrinologic systems are studied. Korean red ginseng (KRG) has been used in various ailments, and to prove its efficacy for erectile dysfunction an international study on Asians other than Korean was performed. Patients with borderline organic and psychogenic erectile dysfunction were included. KRG were given daily, and placebo were given as controls. Treatment lasted a total of 3 months. Surveys including libido, erection, ejaculation, sexual activity, and sexual satisfaction were given. Serum testosterone and erectile function study were taken. Among the 64 patients, 37 patients were followed with KRG. Five had diabetes, 5 hypertension, 5 hypercholesterolemia, 6 low testosterone, 6 psychogenic, and 11 idiopathic. The improvement after KRG administration was $70.2\%$ on objective questionnaire and $75.7\%$ on subjective analysis. When KRG were given, all parameters surveyed have shown improvements compared to the placebo. The effects of KRG in Chinese and Singapores were similar to the Koreans. Serum testosterone levels were nonnalized in 6 patients with KRG, who's serum testosterone levels were reduced from pre-study. Two patient reported constipation, and 2 gastric upsets in the KRG group. In conclusion, KRG has beneficiary action on male erectile capabilities with little side effects. KRG is effective in Koreans and also Asians. The exact action mechanism and the active ingredients in KRG need to be studied.
This retrospective descriptive study was conducted to survey the use of alternative therapy by chronicly ill patients. The subject of this study were 205 chronicly ill patients at Pusan National University Hospital. The data for this study were patient record. The data were gathered from August, 1 to September, 30 1998 and analyzed through SPSSWIN program for frequency, percentile and $x^2-test$. The important results of this study are as followings. Of population-sociological characteristics on studied objects, sexual distribution showed a similar percentage male 47.8% and the female 52.2%. Age distribution showed that the 60-69 year old group made up 31.5%, and was the highest. Of religion Buddism was the most frequest. The diagnosis distribution showed cancer at 28.8% and coronary artery disease at 16.1%. According to the results of the study, 51.2% of subjects had used alternative therapy. The most common type of alternative therapy was dietary and nutritional therapy, 40.2%, the place of use, home, 44.0%, duration, less than 3 months, 51.5%. The most common motive was a recommendation by friends or family. The degree of satisfaction after the use of alternative therapy was high for 21.0%, and slight for 53.3%. The reaction after the use of alternative therapy was increasing power for patients with coronary artery disease and cancer, sugar control for those with DM, and pain control for those with chronic arthrits. The study showed that for chronicly ill patients, age, religion, diagnosis name have an important effect on the use of alternative therapy. In conclusion, chronicly ill patients showed high-use of alternative therapy but they did not used alternative therapy as a healing method. Therefore we must provide an education program nurses and physicians. And we must provide more information or healing method's and support chronicly ill patients.
Purposes: The purposes of this study were to identify factors related to burden and well-being in primary caregivers of patients who have had a stroke and examine the correlation between burden and well-being of the caregivers. Methods: Between April 2006 to June 2007 data were collected using self-report questionnaires and interviews with 85 primary caregivers of stroke patients in C University Hospital. Data were analyzed using t-test, ANOVA, Duncan test and Pearson's correlation with SPSSWIN 15.0. Results: Factors related to burden of primary caregivers were sex and activities of daily living of the patients, and age, education level and satisfaction with income of the caregivers. The factors related to well-being of primary caregivers were sex of patients, and age and education level of caregivers as well as cohabitation with the patient. A negative correlation was found between burden and well-being of the caregivers (r= -.393, p<.001). Conclusion: These results indicate a need to develop a nursing intervention program for caregivers and education program for other family members to reduce caregiver burden. These programs should lead to improvements in the well-being of the caregiver.
Orthognathic surgery for Class III malocclusion requires an elaborate preoperative planning using cephalometries or Mock surgery models which enable the surgeon to anticipate postoperative skeletal changes of maxilla and mandible as well as dentition. After surgery, patient's satisfaction is greatly influenced by appearance of soft tissue change. Therefore, it is imperative to predict a relatively accurate soft tissue change prior to surgery. A 5 year retrospective study was designed to evaluate the soft tissue change after sagittal split osteotomy of ramus(SSRO) for class III malocclusion. Analyses of preoperative and postoperative anthropometric measurements were performed. Patients who were treated only by SSRO for class III malocclusion and could follow up for 6 months were studied. Among them, the patients who had history of cleft palate and lip or hemifacial microsomia were excluded. Soft tissue changes were estimated by using the frontal and lateral photographs. Skeletal changes were observed by measuring amount of set back and angular changes of mandible to the reference line by using cephalometries. Relapses were also measured 6 months after the operation. We could observe skeletal changes were more profound than soft tissue changes concerning amount of set back, but soft tissue changes were also profound in angle. Relapse was more profound in skeleton than soft tissue but the amount was not significant. In spite of the variables which may affect proper assessment of the soft tissue change after skeletal relocation, this study can serve as a guide for exact prediction of the postoperative change of soft tissue and skeleton.
Purpose: Gynecomastia is an abnormal increase in the volume of the male breast. Patients affected by gynecomastia with significant glandular enlargement may respond to suction alone and/or sharp dissection and excision. The purpose of this report is to introduce the indications and results of authors' two techniques. Methods: The diameter of parenchyme was determined by a pinch test after liposuction. For the parenchymal diameter less than 4 cm, ultrasound-assisted liposuction was performed, in conjunction with the "pull-out technique" to effectively remove the fibrofatty tissue of the male breast through a single 5-7 mm incision. For the parenchymal diameter more than 4 cm, ultrasound-assisted liposuction and excision were applied through 2.5 cm periareolar approach. Results: A total of 94 patients (185 breasts) underwent the operation from October 2000 to October 2003 and mean follow-up period was 12 months. The volume of aspirates ranged from 50 to 450 cc per breast. There were no major complications such as skin flap necrosis. Five reoperations were performed for 1 hypertrophic scar, 2 under-resected and 2 hematoma cases. The patient's satisfaction was high and most of them were pleased with the shape of the breasts and scars. Conclusion: These procedures can minimize scars and reduce the incidence of contour problem such as saucer deformity, and provides consistent results. Patients can return to full activities in 48 hours. It can be offered as an option for the treatment of gynecomastia.
Objective : The present study is aimed at providing basic data to help oriental medical hospitals devise efficient operational plans by analyzing the medical expenses of in-patients in an oriental medical hospital and the factors affecting such expenses. Methods : PASW 18.0 was used to analyze the medical insurance program data of 929 patients who were discharged from a university oriental medical hospital(with 105 sick-beds) during the period from January 1 to December 31, 2010 after treatment under the coverage of health insurance and medical aid. Results : 1) Of all the patients hospitalized, 63.3% were females, their mean age was 52.73 years old, and 87.7% was covered by the health insurance program. The biggest number or 31.2% of the patients were treated by the department of acupuncture, 31.5% suffered mainly from the diseases of musculoskeletal system and connective tissues, and the average length of stay at the hospital was 19.49 days. 2) There were statistically significant differences in total medical expenses by age, clinical department in charge, principal diagnosis, and number of days hospitalized while daily average medical expenses differed depending on age, type of medical security, clinical department, principal diagnosis, and number of days staying at the hospital. 3) Total medical expenses were found significantly influenced by age, type of medical security, clinical department, principal diagnosis, and number of days hospitalized(explanatory power : 95.9%), whereas type of medical security, clinical department and principal diagnosis turned out to exercise significant influence on the daily average medical expenses(explanatory power : 26.9%). Conclusion : Oriental medical hospitals are suggested to make efforts to ensure geographical and economical accessibility for their main clients, the elderly and middle-aged, as well as to improve satisfaction of the clients with the medical service provided. They are also encouraged to work out systems to specialize in treatment with a focus on chronic degenerative and adult diseases. In addition, they are expected to try to enhance people's awareness of oriental medicine in an attempt to diversify the brackets of clients and increase frequency of their utilization.
Objectives : To examine various dimensions of consumer ratings of health care service with factor analysis and to find which factors influence the overall quality of health care service. Methods : A cross-sectional study was conducted on outpatients of a general hospital located in Sungnam City. A self-administered questionnaire was used to assess the consumer's ratings of health care service received. The response rate was 92.8% with a total of 537 persons completing the questionnaire. Factor analysis was performed on 34 items evaluating the quality of health care service. Items were grouped into 5 dimensions as a result of factor analysis and the reliability and validity of influence on patient service assessment were evaluated for each dimension. Results : The 5 dimensions were as follows, 1) physician services, 2) non-physician services, 3) process 4) facilities, and 5) cleanliness A positive correlation with the quality of health care service was found for the dimensions of non-physician services and process, while no significant correlation was found for the dimensions of physician services, facilities, and cleanliness. Conclusions : The result of this study may provide basic information for the development of future self-administered questionnaires of consumer ratings and for the evaluation of quality improvement activities in hospital outpatient settings.
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