• Title/Summary/Keyword: Patients survey

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The study on the entry of dental technicians in the public health center for a manpower supply and demand plane (Centering around a denture insurance policy in 2012) (인력수급 대책을 위한 치과기공사의 보건지소 진출에 관한 연구 - 2012년 틀니보험화 정책을 중심으로 -)

  • Lee, Jong-Do;Kim, Jeong-Sook;Park, Kwang-Sig
    • Journal of Technologic Dentistry
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    • v.32 no.4
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    • pp.417-433
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    • 2010
  • Purpose: This study evaluated the manpower planning of dental technicians. Methods: Methods : Survey was conducted regarding subject's general characteristics, characteristics of dental technician's occupational view and working conditions, and reason to enter into branches of the public health enter. The survey sample consisted of 323 dental technicians (221 male/ 102 female). Survey was conducted for one month from August 1 to September 1 in 2010. Following results were obtained. Results: 1. Regarding general characteristics of the subjects, there was a slight male predilection with 68.4%. Subjects in their 40s occupied the highest proportion of 32.2%. Majority of subjects worked in the big cities (71.5%). Favored working places were dental laboratory (57.6%) and dental hospital or dental clinic (19.5%). Although no position is available in the public sector such as public health center or health care civil servant, 9.3% preferred working in the public health center. Public sector is more favored than 2-year technical colleges or dental supply and equipment companies. In respect to education, 57% of the subjects graduated college. 67.8% were married. Subjects who specialize in the porcelain or all-ceramic were 57.9%. With regard to current position, head of the dental laboratory was most common. 2. Following occupation characteristics were found. Economic reason took the highest proportion when deciding their occupation (39.9%) followed by gaining social experience (36.5%). Majority of the subjects (76.5%) wanted to work as dental technicians until their retirement. 71.5% pursuit to become a manager of the dental laboratory. 76.1% agreed on opening a dental technician position in the public health center. Regarding an authority to lead developing the dental technician position in the public sector, majority of the subject chose ministry of health and welfare (35.6%) and Korean dental technologist association (34.7%). Employment (average, 30%) and turnover rate (average, 36.5%) of dental technology college graduates ranged from 40% to 60%. Most important factors for the employment were practical experience (41.2%) and competency (34.4%). With regard to job satisfaction, so-so as 46.7% and satisfactory was 42.7% 3. In respect to the reason for opening a position in the public health center, 'It is needed to continue denture rogram for elderly patients' obtained the highest score (4.14 point). 'Institutional devices are required to open a position for dental technicians as a public healthcare provider' received high score (4.11 point). 4. Concerning the working conditions, 'professional knowledge is required' received the highest score (4.23) followed by 'too short maternity and parental leave' (4.21). 5. Relationship between general characteristics of the subjects and favor of working in the public health center was investigated. Significant differences were found according to the current and favored working area, favored occupation, education level, marital status, and specialty. Working in the public health center was favored by following subjects: working in mid- or small-sized cities (4.16 point, p<0.05); PhD degree-holder (4.59 point, p<0.01). 6. Among general characteristics of the subjects, significant difference of working conditions was found in the following factors: gender; working areas; favored working areas; favored working positions, and education level. Majority of subjects favored working in big cities and currently work in big cities although satisfaction was comparatively low (3.75 score). 7. Future plan to work in public health center was evaluated according to occupational characteristics. Subject's intention to work in the public healthcare center was significantly affected by opening of dental technician position, leading authority, average turnover rate, and factors affecting employment. Working in the public health care center was favored by the following subjects: Dental technicians who actively supported opening of the dental technician position (4.34 point, p<0.001); subjects who thought the Korean dental technologist association is responsible for the opening of positions in the public sector (4.26 point, p<0.001); and subjects who thought that attitude and character are important for the employment (p<0.001). 8. Concerning difference of working conditions according to the occupational characteristics, significant difference was demonstrated by factors such as a reason to choose to be a dental technician, work plan, pursuing position, responsible authority, average employment rate, and job satisfaction. High standard of working conditions was required in subjects who selected to be a dental technician for the leisure time after work (s.05 point, p<0.01), who planted to work until their marriage (4.25 point, p<0.001), and who pursuit to be a manager (3.98, p<0.05). 9. In respect to influence of general characteristics on the advancement to public health centers, the coefficient of determination (R2) was 0.068 and age affected the working condition with significant difference according to the pvalue. 10. Regarding influence of general characteristics on the advancement to public health centers, the coefficient of determination (R2) was 0.335 and work plan, opening of dental technician position in the public sector, and responsible authority had significant influence over the subject's intention to work in the public health center according to the p-value. 11. With regard to the influence of general characteristics on the advancement to public health centers, the coefficient of determination (R2) was 0.091 and reason to choose to be a dental technician, work plan, and responsible authority significantly affected subject's working conditions. Conclusion: Korean society is becoming a super-aged society according to several statistics. As aged population is rapidly increasing, national health insurance plans to cover denture for senior citizen over 75 years old from 2012. Therefore, dental technicians are urgently needed in the public health centers all over the nation. Many subjects in this study planed to work until their retirement and recognized dental technician's expertise. Ministry of health and welfare and Korean dental technologist association should co-operate each other to prepare foundation and institutional devices for dental technicians to advance into the public health center. This will improve oral health of the population. This study showed urgency of medical facilities and services which meets increasing number of aged population and welfare of the population.

Infantile Hypertrophic Pyloric Stenosis - A Survey by the Korean Association of Pediatric Surgeons - (영아 비후성 유문협착증 - 대한소아외과학회 정회원을 대상으로 한 전국조사 -)

  • Kim, I.K.;Kim, S.Y.;Kim, S.K.;Kim, W.K.;Kim, J.E.;Kim, J.C.;Kim, H.H.;Park, K.W.;Park, Y.S.;Park, W.H.;Song, Y.T.;Yang, J.W.;Oh, S.M.;Yoo, S.Y.;Lee, D.S.;Lee, M.D.;Lee, S.K.;Lee, S.C.;Chang, S.I.;Chung, S.Y.
    • Advances in pediatric surgery
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    • v.4 no.2
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    • pp.149-155
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    • 1998
  • Thirty three members of the Korean Association of Pediatric Surgeons were surveyed to determine the clinical manifestations and current management of infantile hypertrophic pyloric stenosis (IHPS). The members completed a registration form and a questionnaire that indicated their treatment preferences for patients treated during 1996. The response rate was 84.8 %, and 23 institutions participated. Three hundred and sixty-three cases of IHPS were analysed. The male to female ratio was 5.15: 1. The presenting symptoms were nonbilious vomiting in 363 cases(100 %), palpable mass in the upper abdomen in 200 cases (55.1 %) and visible peristaltic waves in 67 cases(18.5 %). Fluid therapy was done in 161 cases(44.4 %) for preoperative preparation. Twenty patients(5.5 %) were premature. There were 27 low birth weight babies(7.7 %). The onset of symptoms ranged from 1 to 14 weeks of age with a peak occurrence at 2 to 4 weeks of age. Two hundred and thirty-six cases(66.6 %) presented within 4 weeks of age. There was one set of male twins and a family history of twins. The modes of feedings were: breast feeding; 69 cases(24.5 %), formula feeding; 176 cases(62.4 %) and mixed feeding; 37 cases(13.1 %). The preferred diagnostic modalities were ultrasonography (US) 229 cases(63.1 %), UGI series 27 cases(7.4%) and US and UGI series combined 86 cases(23.7 %). Only 21 cases(5.8 %) were operated on without imaging study, ie. with positive physical finding. Perforation of the mucosa during pyloromytomy occurred in 5 cases. All were treated successfully with primary closure. Persistent vomiting over 2 weeks after operation were reported in 5 cases. Three wound infections, one aspiration pneumonia and one postoperative bleeding were reported. There was no mortality in 363 cases.

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A Study on the Nurses' Contingent Employment and Related Factors (간호사의 비정규직 고용실태 및 관련요인에 관한 연구)

  • Choi, Sook-Ja
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.3
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    • pp.477-500
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    • 1999
  • Korean labor market has showed remarkable change of the increase in the amount of unemployment and contingent employment since IMF bailout agreement. There is a theoretical position to explain this increase in contingent employment at hospitals with the notion of flexibility. The high flexibility of employment due to the increase of contingent employees is becoming very important part in new business strategy of hospitals. The types of contingent employment of the nurse are part-time employment temporary employment, fixed-term employment, and internship which was introduced in early 1999. Recently, Korean health care industry managers have paid attention to the customer oriented service, rationalization of business administration, service quality control so that they can adjust their business to outer environment. Especially their efforts concentrate on the wage reduction through efficient and scientific control of man power because wage shares about 40% of total cost. This dissertation aims at verifying the phenomena of the contingent employment of the nurse and analyzing the related factors and problems. To rephrase these aims in ordinal: First, verifying the phenomena of contingent employment of the nurse. Second, verifying the problems of that phenomena. Third, analyzing the related factors of the contingent employment of the nurse. To accomplish these research goals, a statistical survey was executed. in which 384 questionnaires-66 for manager nurses, 318 for contingent nurses - were given to nurses working at 66 hospitals-which have at least 100 beds-in Seoul. Among them, 187 questionnaires-38 from manager nurses, 149 from contingent nurses'- 'were returned. Then, the data coded and submitted to T-test, $X^2$ -test, variance analysis(ANOVA), correlation analysis, multiple regression analysis, Logistic Regression with SAS program. The research results of the contingent nurses are followings: 1. The average career term at the present hospital 8.4 months: duty-on days per month are 24.2 days: working time per day is 7.9 hours. These results showed little difference from regular nurses. 2. Their wage level is about 70% of regular nurses except for internship nurses whose wage level is 41% of regular nurses. To break down the wage composition, part-time nurses and internship nurses get few allowance and bonus. And contingent nurses get very low level of additional pay except for fixed-term nurses who are under similar condition of employment to regular nurses. These results show that hospital managers are trying to reduce the labor cost not only through the direct way of wage reduction but through differential treatment of bonus, retirement allowance, and other additional pay. 3. The problem of contingent employment: low level of pay; high level of turn-over rate: weakening of union; low level of working condition: heavy burden of work; inhuman treatment. The contingent nurses consider these problems more seriously than manager nurses do. What manager nurses regard problematic is the absence of feeling-belonged and responsibility of the contingent nurses. 4. The factors strongly related with the rate of the number of contingent nurses for the number of regular nurses; gross turn-over nurses; average in-patients per day; staring wage of graduate from professional college: the type of hospital ownership; the number of beds; the gap between gross newcomer nurses and gross turn-over nurses. The factors related with their gross wage per month; the number of beds; applying of health insurance; applying of industrial casualty insurance; applying of yearly-paid leave; the type of hospital ownership; average out-patients per day; gross turn-over nurses. The meaningful factors which make difference by employment type: monthly-paid leave; physiological leave. The logistic regression analysis using these two factors shows that monthly-paid leave is related with the type of hospital ownership; the number of beds; average out-patient per day, and physiological leave is related with the gross newcomer nurses; gross turn-over nurses; the number of beds.

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An Analysis of Work Stress of Physical Therapist and Reaction (물리치료사의 업무 스트레스 현황과 대응수준 -부산지역을 중심으로-)

  • Dong, Jong Ick;Ryu, Hwang Gun;Bae, Sung-Kwon
    • The Korean Journal of Health Service Management
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    • v.2 no.1
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    • pp.37-55
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    • 2008
  • This study aims to enhance work efficiency and satisfaction by offering data that make a physical therapist cope with stress coming from the job efficiently by identifying and analyzing the job satisfaction and work stress perceived by a physical therapist, and the level of reaction of a physical therapist. The study distributed survey questionnaires to 300 physical therapists working in medical institutions in Busan via mail and by visit from March 3, 2007 by selecting them simply and randomly from the physical therapist list, and collected the questionnaires by March 20, 2007, 103 respondents were working at 17 general hospitals including a university hospital, 65 respondents at 12 medical centers, and 79 respondents at 39 doctor's offices. The study collected 251 copies, which showed the collection rate of 83.7%, and analyzed 247 copies (82.3%) excluding 4 copies of insincere answers. As a research tool for measuring job satisfaction the study used a tool employed for research into the job satisfaction of physical therapists who work at medical institutions in Gwangju, Jeonnam, and Jeonbuk by Kim Hee-Gwon(1992) and research regarding job satisfaction by Jeong Jeong-Hee(2004) as well as research regarding the factors of job satisfaction by Flippo(1980) & Seberhagen(1970) after adjusting the research tools to the purpose of the study. Also for questions about work stress, the study employed nurses' job stress measurement tool developed by Kim Mae-Ja and em Mi-Ok(1984) by modifying the tool to the purpose of the study, and for a measurement tool for reaction to stress, the study used a tool employed for research into reaction to stress of nurses at general hospitals by Choi Eun-Deok(2005) without modification. For data analysis, the study used the SPSS12.0 as a statistical method, and then used t-test or ANOVA for verifying actual numbers, percentile, average :score, standard deviation, rank, and difference. Also, the study conducted which is a post-test method for variables that show a significant difference at the level of p<.05 level after the analysis. The findings include the following. 1) The respondents' job satisfaction score was 3.21 points on the average (out of 5 full points). The peer relationship ranked the highest, posting 4.02 points on the average, and the job satisfaction with rewards was proven the lowest, posting 2.51 points. For the job satisfaction level by characteristics, there were significant differences (p<.05) in gender, hospital type, weekly working hours, monthly working days, number of patients per day, department in charge of therapy, and number of peers, and there was no significant difference in characteristics other than that. 2) The respondents' work stress score was 2.72 points (out of 5 full points) on the average. The respondents were shown to be under the highest stress when they suffered from excessive workload, posting 3.49 points on the average, and they were shown to be under the least stress when they had a conflict with peers at another department, recording 1.90 points on the average. for the job stress level by the characteristics of job, there was a significant difference in the reflection of job assessment(p<.05). 3) 1n respondents' reaction to stress, most of them were shown to make efforts in coping with stress, posting 2.80 points (out of 5 full points). For their experience of being wider stress, they answered that 'they felt depressed (2.85 points)" for their experience of coping with stress, they answered that 'they were indifferent to it or thought about something else' (2.62 points). Also, for their efforts in coping with stress, they answered that 'they were motivated to remove their strain by taking leave, playing, or using their preferences' (3.52 points), which ranked higher. For the level of reaction to stress by characteristics, there were significant differences by age, gender, marital status, total service years as a physical therapist, monthly working days, and department in charge of therapy(p<.05). It is necessary to offer correct information by conducting an in-depth analysis of the stressful situations of physical therapists who exert efforts in rehabilitating patients at hospitals by factor, and seeking management plans based on the research results. Also, it is necessary to develop a program for coping with stress efficiently for removing stress and to conduct research into the understanding and cooperation of administrators and persons in charge of physical therapists for reducing physical therapists' stress at hospitals.

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A Study on the Incidence of Thyroid Cancer in Gender Ultrasound (초음파검사에서 성별에 따른 갑상샘 암의 빈도에 관한 연구)

  • Kwak, Eun-Suk;Lim, Cheong-Hwan;Yang, Oh-Nam
    • Journal of radiological science and technology
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    • v.38 no.2
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    • pp.145-153
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    • 2015
  • Thyroid nodules are an endocrine disease often found in clinical practice, and patients with thyroid nodules found by chance have rapidly increased alongside development of thyroid ultrasound techniques for health examination purposes. This study analyzes the subjects' general characteristics, thyroid ultrasounds, and fine needle aspiration cytology in order to find out the relationship between male and female thyroid nodules and thyroid cancer frequency. An ultrasound examination of the thyroid was performed for 32,973 individuals who visited the K Hospital of Health Examination. Subjects have no history of thyroid disease and are 20 years old or over. Data of general characteristics, diabetes) was collected by a written survey completed by the subject, and the ultrasound of the thyroid(thyroid nodules existence, size, number) and FNAC was used to find out the malignancy rate. Frequency of patients with thyroid nodule was 4,611(26.1%) in men and 5,341(34.9%) in women between 32,973 individuals. Women's prevalence rate is significantly higher than men, and the prevalence rate significantly increased with age in men and women(p < 0.05). The prevalence of multiple nodules was significantly higher in women(43.5%) than in men(35.6%), and significantly increased with age in men and women(p < 0.05). The fine needle aspiration cytology was performed in 692(men 342, women 350) subjects who showed signs of malignancy through ultrasound. Prevalence of malignancy of the nodules was higher in men(33.3%) than in women(29.4%) although it is not statistically significant. It is known that thyroid nodule prevalence in women is much higher than in men. But this study shows the men's prevalence rate was not too low compared with women, and the men showed a rather higher malignancy rate in nodules than women. It is considered that the role of thyroid ultrasound is both important in men and women.

Determination of Appropriate Exposure Angles for the Reverse Water's View using a Head Phantom (두부 팬텀을 이용한 Reverse Water's View에 관한 적절한 촬영 각도 분석)

  • Lee, Min-Su;Lee, Keun-Ohk;Choi, Jae-Ho;Jung, Jae-Hong
    • Journal of radiological science and technology
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    • v.40 no.2
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    • pp.187-195
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    • 2017
  • Early diagnosis for upper facial trauma is difficult by using the standard Water's view (S-Water's) in general radiograph due to overlapping of anatomical structures, the uncertainty of patient positioning, and specific patients with obese, pediatric, old, or high-risk. The purpose of this study was to analyze appropriate exposure angles through a comparison of two different protocols (S-Water's vs. reverse Water's view (R-Water's)) by using a head phantom. A head phantom and general radiograph with 75 kVp, 400 mA, 45 ms 18 mAs, and SID 100 cm. Images of R-Water's were obtained by different angles in the range of $0^{\circ}$ to $50^{\circ}$, which adjusted an angle at 1 degree interval in supine position. Survey elements were developed and three observers were evaluated with four elements including the maxillary sinus, zygomatic arch, petrous ridge, and image distortion. Statistical significant analysis were used the Krippendorff's alpha and Fleiss' kappa. The intra-class correlation (ICC) coefficient for three observers were high with maxillary, 0.957 (0.903, 0.995); zygomatic arch, 0.939 (0.866, 0.987); petrous ridge, 0.972 (0.897, 1.000); and image distortion, 0.949 (0.830, 1.000). The high-quality image (HI) and perfect agreement (PA) for acquired exposure angles were high in range of the maxillary sinus ($36^{\circ}-44^{\circ}C$), zygomatic arch ($33^{\circ}-40^{\circ}$), petrous ridge ($32^{\circ}-50^{\circ}$), and image distortion ($44^{\circ}-50^{\circ}$). Consequently, an appropriate exposure angles for the R-Water's view in the supine position for patients with facial trauma are in the from $36^{\circ}$ to $40^{\circ}$ in this phantom study. The results of this study will be helpful for the rapid diagnosis of facial fractures by simple radiography.

Analysis of Relative Risk of Stroke by Nutrient Intake Levels - Case-Control Study in Daegu.Gyeongbuk Area, Korea - (영양소 섭취 수준에 따른 뇌졸중 위험도 분석 - 대구.경북지역 환자-대조군 연구 -)

  • Sung, Su-Jung;Jung, Doo-Gyo;Lee, Won-Kee;Kim, Yoo-Jung;Lee, Hye-Sung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.8
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    • pp.1050-1061
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    • 2009
  • The present study was performed to evaluate energy and nutrients intakes of stroke patients in Daegu Gyeongbuk region, and to analyze the relative risk of stroke related to the intake levels of energy and nutrients. The case subjects (n=100) were selected from newly diagnosed stroke patients at Kyungpook National University Hospital. The control subjects (n=150) were selected from community residents who did not have stroke history and were sex and age-matched with the case subjects. The survey was conducted by individual interviews by trained dietitians using semiquantitative food frequency questionnaires. The odds ratios were calculated by using unconditional logistic regression. In male subjects, patient group had significantly higher consumption than the control group in mean daily intakes of energy, all energy yielding nutrients, vitamin $B_1$, $B_6$, niacin, folic acid, vitamin E, phosphorus, potassium, zinc and dietary fiber, and also in the ratio of energy intake from protein and fat. In women subjects, the patient group consumed significantly lower intakes than the control group in fat, vitamin C, folic acid, vitamin E, iron, but vice versa in carbohydrate energy ratio. As for men, the increased intakes of energy, protein, carbohydrate vitamin $B_1$, E and niacin, zinc, total fatty acids, monoand poly-unsaturated, n-6 fatty acids significantly raised the relative risk of stroke. As for women, the increased intakes of fat, vitamin A, $B_2$, $B_6$, niacin, vitamin C and E, iron, sodium, potassium, selenium, mono-, poly-unsaturated, n-6 fatty acids, cholesterol, taurine and dietary fiber significantly lowered the relative risk of stroke. The results of the study demonstrated that the effect of several nutrient intake levels, such as niacin, vitamin E and fatty acids, on the relative risk of stroke was inconsistent between sex. The reason for this sex difference needs to be elucidated in a larger scale study.

Development of the Somatization Rating Scale (신체화 평가 척도의 개발)

  • Koh, Kyung-Bong;Park, Joong-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.2
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    • pp.78-91
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    • 2002
  • Objective : The purpose of this study was to develop the somatization rating scale (SRS), and then to use the scale in clinical pracitice. Methods: First, a preliminary survey was conducted for 109 healthy adults to obtain 40 response items. Second, a preliminary questionnaire was completed by 215 healthy subjects. Third, a comparison was made regarding somatization responses among 242 patients (71 with anxiety disorder. 73 with depressive disorder, 47 with somatoform disorder, and 51 with psychosomatic disorder) and 215 healthy subjects. Results : Factor analysis yielded 5 subscales : cardiorespiratory and nervous responses, somatic sensitivity, gastrointestinal responses, general somatic responses, genitourinary, eye and muscular responses. Reliability was computed by administering the SRS to 62 healthy subjects during a 2-week interval. Test-retest reliability for 5 subscales and the total score was significantly high, ranging between .86-.94. Internal consistency was computed, and Cronbach's ${\alpha}$ for 5 subscales ranged between .72-.92, and .95 for the total score. Convergent validity was computed by correlating the 5 subscales and the total score with the total score of the global assessment of recent stress (GARS) scale, the perceived stress questionnaire (PSQ), and the symptom checklist-90-revised (SCL-90-R). The correlations were all at significant levels. Discriminant validity was computed by comparing the total score and the 5 subscale scores of the patient and control groups. Significant differences were found for 5 subscales and the total score. Only the depressive disorder group was siginificantly higher than control group in all the subscale scores and total scores of SRS among 4 patient groups. In somatic sensitivity, only depressive disorder patients were significantly higher than the normal controls, whereas in general somatic subscale, depressive disorder and somatoform disorder groups were significantly higher than the normal controls. In total scores of the SRS, female subjects were significantly higher than males. Conclusion : These results indicate that the SRS is highly reliable and valid, and that it can be utilized as an effective measure for research in stress- and somatization-related fields. The depressive disorder and somatoform disorder groups showed more widespread somatization than the anxiety and psychosomatic disorder groups.

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A Study on Awareness of Automated External Defibrillator, Usage Intention and Related Educational Experience in Workers at Public Institutions (공공기관 종사자들의 자동제세동기에 대한 인식과 시행의도 및 교육경험에 관한 연구)

  • Kim, Mu-Nui;Lee, Hyeon-Ji
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.11
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    • pp.416-424
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    • 2017
  • This study was conducted to examine the awareness of workers in public institutions of automated external defibrillators, their usage intention and related educational experience in an effort to increase the efficiency of education and the rate of automated external defibrillator usage in emergency situations. The subjects in this study were 243 selected. male and female adults who worked in public institutions in Gangwon Province. A survey was conducted from June 13 to August 21, 2016. The statistical analysis was based on the frequency analysis and the $X^2$-test. There were significant differences among the public institution workers awareness of how to use an automated external defibrillator according to gender (${\chi}^2=6.32$, p<0.05) and academic credentials (${\chi}^2=5.91$, p<0.05). Additionally, there were significant differences in usage intention according to academic background (${\chi}^2=5.70$, p<0.05). The most common reason for having no intention to use an automated external defibrillator for patients with cardiac arrest was that the respondents did not know how to use it (31.5%). There were also significant differences in educational experience with automated external defibrillators according to age (${\chi}^2=6.15$, p<0.05), academic credentials (${\chi}^2=11.56$, p<0.01) and career (${\chi}^2=11.92$, p<0.01). The most common form of education that the workers received pertaining to automated external defibrillators was a combination of theoretical and practical education, which represented 55.9%. The findings of the study seem to suggest that workers in public institutions used by many people must receive compulsory standard education regarding automated external defibrillators and try to boost the revival rate of patients with cardiac arrest in real emergency situations.

Clinical Survey of Cesarean Section (제왕절개술에 대한 임상적 고찰)

  • Kim, Jae-Wung;Lee, Young-Gi;Kim, Jong-Wook;Lee, Tae-Hyung;Park, Wan-Seok;Lee, Sung-Ho;Chung, Wun-Yong
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.249-260
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    • 1986
  • Recent reports have noted the increase of and questioned the justification for cesarean section rate in the past decade. This study was carried out retrospectively based on the clinical charts of 510 patients who had been performed cesarean section among 3,357 deliveries at Yeungnam University Hospital from May, 9, 1983 through Nov., 30, 1986. The results were as follows : 1. Overall incidence of cesarean section was 15.7% of total deliveries. Of these, 10.9% were by primary cesarean section and 4.7% by repeat operation. There has been a gradual increase in the cesarean section rate. 2. In the distribution of age, the 26-30 aged group was the most prevalent(60.2%). 3. The most common indications for cesarean section were previous cesarean section(30.2%), CPD (26.9%), Malpresentation(22.7%), and fetal distress(3.5%). In primipara, CPD was the most frequent and in multipara malpresentation. 4. A great proportion(31.6%) was done at 40th gestational week. 5. In the weight distribution of infants, the group of 3,000-3,499gm was the most prevalent(39.8%), premature baby was 9.1%, and giant baby was 5.6%. 6. In the type of operation, lower segment transverse cesarean section was the most(97.5%). 7. In the combined surgery, sterilization was the most prevalent and the next was ovarian cystectomy, hysterectomy, and myomectomy in order. 8. In the type of the anesthesia, general anesthesia was 83.5%. 9. Maternal morbidity was 14.7%. Among the causes of this morbidity, wound infection was the most and the next was urinary tract infection, fever of unknown origin, and atonic bleeding in order. 10. It was found that 18.4% was maternal morbidity in the patients below 10gm Hb. In this group, maternal morbidity was markedly increased as the level of Hb was decreased. 11. Maternal morbidity was increased as the duration of ruptured membrane was prolonged. In the group of over 24 hours after rupture of membrane, it was markedly increased(44.4%). 12. Maternal morbidity was increased as the duration of labor was prolonged. In the group of over 12 hours after the onset of labor, it was 24.6%. 13. Maternal morbity of lower segment transverse cesarean section was the least(14.1%). 14. Maternal morbidity of emergency cesarean section was about two times as much as elective cesarean section.

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