• Title/Summary/Keyword: Personal Distress

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A Study on the Effect of Physician Characteristics on the Cesarean Section Rate (의사의 일반적 특성이 재왕절개분만율에 미치는 영향에 관한 연구)

  • Cho, Eun-Hee
    • Research in Community and Public Health Nursing
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    • v.11 no.2
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    • pp.499-512
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    • 2000
  • The number of deliveries by cesarean section has increased internationally. However, The cesarean section rate is different by country to country. It is because each country has different social and cultural background and. practices its unique delivery policies. Hence, it is very important to understand the uniqueness that one country faces related with the cesarean section. In Korea, there have been many researches on the clinical. maternal. hospital and community factors and so on. However, few studies have attempted to reveal the physician factors in Korea because it is difficult to approach hospital records. So, in this study, the physician factors that influence the increase of cesarean section rate in Korea was investigated, and preliminary research agenda for policy establishment to keep the cesarean section rate from excessive increase was provided. In this study, all 2744 cesarean section deliveries performed by 36 physicians at the hospital was considered. and detailed delivery records of 12 months selected randomly from January 1996 to August 1998 was reviewed retrospectively. Chi-square analysis is used to examine the homogeneity of distribution of maternal, fetal, and clinical factors. In addition, multiple regression analysis is used to examine the effect of physician characteristics on the cesarean section rate. Physician characteristics as independent variable and the cesarean section rate as dependent variable was put in this analysis. Follows are the results of this study. 1) Total cesarean section rate is 34.8%. primary cesarean section rate is 12.5 % and repeated cesarean section rate is 22.3 %. Among the indications for the primary cesarean section, 15.6 % is for breech presentation. 40.2 % is for dystocia. 7.6 % is for fetal distress. and 36.6 % is for others. 2) There is positive correlation between physician's age and the cesarean section rate (p<0.001). And statistically significant correlation is found between the physician's educational attainment and the cesarean section rate (p<0.001). A physician with Ph.D degree has lower cesarean section rate than a physician with B.A only and M.A. degree (p<0.001). However. physician's gender, location of graduated university. position at the hospital, and the religious belief were not shown statistically significant relations with the cesarean section rate. 3) Among all cesarean sections in this study, only 15.4 % is performed during weekend. While 18.2 % is performed on monday only. This suggests that physicians may not prefer weekend operation of cesarean section. In addition, 86.1 % among all cesarean section operations is performed from 6 a.m. to 6 p.m. So the cesarean section rate could be related with a day of the week and a time of the day. From this results. there is a possibility that the physicians' personal comfort may influence the cesarean section rate.

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Gender, Labor, Emotion and Moment of Political Awakening - A Study on Life and Activities of Female Socialist Chung Chil-sung (젠더, 노동, 감정 그리고 정치적 각성의 순간 - 여성 사회주의자 정칠성(丁七星)의 삶과 활동에 대한 연구)

  • Roh, Jiseung
    • Cross-Cultural Studies
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    • v.43
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    • pp.7-50
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    • 2016
  • In the capitalized Joseon Dynasty under the Japanese colonial rule, most Gisaengs (female entertainers) were waiting for men who would save them from financial distress, but others chose to seize the opportunity imposed by the modern times and capitalization to transform their lives. Socialist Jung Chil-sung was one of those who utilized such opportunity to transform themselves through political awakening. The political awakening of Chung Chil-sung was the result of two factors-the historical occasion of the March $1^{st}$ movement and her personal labor experience as Gisaeng. The March $1^{st}$ movement was not only a colossal political incident externally manifested in nationalism and but also an occasion which educed the microscopic anger of a woman named Chung Chil-sung. In the early capitalist society, women with jobs were forced to play not only vocational tasks but also to subject themselves to emotional roles of being obedient and generous. In other words, those early career women suffered feelings such as anger, shame and humiliation, when they were defenselessly exposed to gender hierarchy and gender power in the public sphere. As shown in the case of Chung Chil-sung, these emotions led to a certain political awakening. The political awakening through the labor experience and emotional problems was the fact that helped Chung Chil-sung have a concrete and realistic understanding about the issue of women's economic dependence unlike other female socialists. But, although socialism was relatively the most appropriate language to explain Chung Chil-sung's experience, what she experienced contained several elements that cannot be explained by the elite socialist language. Therefore, her life paradoxically proved the need of lower-class women's lives to be divided and registered as a new emotion and to be politically visualized.

Pilot Study of Single Session Song-Based Music Therapy for Decreasing ICU Caregiver Anxiety (중환자 보호자의 불안 감소를 위한 단회기 노래중심 음악치료 적용 예비연구)

  • Jung, Yu Sun;Na, Sungwon
    • Journal of Music and Human Behavior
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    • v.16 no.1
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    • pp.25-46
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    • 2019
  • This pilot study involved a single session of song-based music therapy to relieve the anxiety of intensive care unit (ICU) caregivers. Six caregivers of ICU patients participated in the intervention session individually. During the initial stage of the intervention, the participants' current emotional states were identified. Then they listened to familiar songs and playing a tone chime, which was intended to help them relax their body and reduce their psychological resistance. During singing experiences as an essential part of the intervention, the participants discussed the lyrics of songs in an attempt to find the meaning related to them. Also, they sang the songs with a live accompaniment in which their emotional states were reflected with changes in musical elements (e.g., tempo, dynamics, rhythm, or chords). In the final stage, they identified personal application to their everyday lives. To analyze the results, the State-Trait Anxiety Inventory (STAI) and a visual analog scale on emotional states were completed by participants before and after the session, and participants' verbal responses during the session were also recorded. According to the results, STAI anxiety scores significantly declined following the session. Also, they showed significant increases in positive emotions and significant decreases in negative emotions. This suggests that short-term music therapy can be an effective intervention for relieving the psychological distress of ICU caregivers.

Analysis of ROX Index, ROX-HR Index, and SpO2/FIO2 Ratio in Patients Who Received High-Flow Nasal Cannula Oxygen Therapy in Pediatric Intensive Care Unit (고유량 비강 캐뉼라 산소요법을 받은 소아중환자실 환아의 ROX Index와 ROX-HR Index 및 SpO2/FIO2 Ratio분석)

  • Choi, Sun Hee;Kim, Dong Yeon;Song, Byung Yun;Yoo, Yang Sook
    • Journal of Korean Academy of Nursing
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    • v.53 no.4
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    • pp.468-479
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    • 2023
  • Purpose: This study aimed to evaluate the use of the respiratory rate oxygenation (ROX) index, ROX-heart rate (ROX-HR) index, and saturation of percutaneous oxygen/fraction of inspired oxygen ratio (SF ratio) to predict weaning from high-flow nasal cannula (HFNC) in patients with respiratory distress in a pediatric intensive care unit. Methods: A total of 107 children admitted to the pediatric intensive care unit were enrolled in the study between January 1, 2017, and December 31, 2021. Data on clinical and personal information, ROX index, ROX-HR index, and SF ratio were collected from nursing records. The data were analyzed using an independent t-test, χ2 test, Mann-Whitney U test, and area under the curve (AUC). Results: Seventy-five (70.1%) patients were successfully weaned from HFNC, while 32 (29.9%) failed. Considering specificity and sensitivity, the optimal cut off points for predicting treatment success and failure of HFNC oxygen therapy were 6.88 and 10.16 (ROX index), 5.23 and 8.61 (ROX-HR index), and 198.75 and 353.15 (SF ratio), respectively. The measurement of time showed that the most significant AUC was 1 hour before HFNC interruption. Conclusion: The ROX index, ROX-HR index, and SF ratio appear to be promising tools for the early prediction of treatment success or failure in patients initiated on HFNC for acute hypoxemic respiratory failure. Nurses caring for critically ill pediatric patients should closely observe and periodically check their breathing patterns. It is important to continuously monitor three indexes to ensure that ventilation assistance therapy is started at the right time.

A Study on the System of Aircraft Investigation (항공기(航空機) 사고조사제도(事故調査制度)에 관한 연구(硏究))

  • Kim, Doo-Hwan
    • The Korean Journal of Air & Space Law and Policy
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    • v.9
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    • pp.85-143
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    • 1997
  • The main purpose of the investigation of an accident caused by aircraft is to be prevented the sudden and casual accidents caused by wilful misconduct and fault from pilots, air traffic controllers, hijack, trouble of engine and machinery of aircraft, turbulence during the bad weather, collision between birds and aircraft, near miss flight by aircrafts etc. It is not the purpose of this activity to apportion blame or liability for offender of aircraft accidents. Accidents to aircraft, especially those involving the general public and their property, are a matter of great concern to the aviation community. The system of international regulation exists to improve safety and minimize, as far as possible, the risk of accidents but when they do occur there is a web of systems and procedures to investigate and respond to them. I would like to trace the general line of regulation from an international source in the Chicago Convention of 1944. Article 26 of the Convention lays down the basic principle for the investigation of the aircraft accident. Where there has been an accident to an aircraft of a contracting state which occurs in the territory of another contracting state and which involves death or serious injury or indicates serious technical defect in the aircraft or air navigation facilities, the state in which the accident occurs must institute an inquiry into the circumstances of the accident. That inquiry will be in accordance, in so far as its law permits, with the procedure which may be recommended from time to time by the International Civil Aviation Organization ICAO). There are very general provisions but they state two essential principles: first, in certain circumstances there must be an investigation, and second, who is to be responsible for undertaking that investigation. The latter is an important point to establish otherwise there could be at least two states claiming jurisdiction on the inquiry. The Chicago Convention also provides that the state where the aircraft is registered is to be given the opportunity to appoint observers to be present at the inquiry and the state holding the inquiry must communicate the report and findings in the matter to that other state. It is worth noting that the Chicago Convention (Article 25) also makes provision for assisting aircraft in distress. Each contracting state undertakes to provide such measures of assistance to aircraft in distress in its territory as it may find practicable and to permit (subject to control by its own authorities) the owner of the aircraft or authorities of the state in which the aircraft is registered, to provide such measures of assistance as may be necessitated by circumstances. Significantly, the undertaking can only be given by contracting state but the duty to provide assistance is not limited to aircraft registered in another contracting state, but presumably any aircraft in distress in the territory of the contracting state. Finally, the Convention envisages further regulations (normally to be produced under the auspices of ICAO). In this case the Convention provides that each contracting state, when undertaking a search for missing aircraft, will collaborate in co-ordinated measures which may be recommended from time to time pursuant to the Convention. Since 1944 further international regulations relating to safety and investigation of accidents have been made, both pursuant to Chicago Convention and, in particular, through the vehicle of the ICAO which has, for example, set up an accident and reporting system. By requiring the reporting of certain accidents and incidents it is building up an information service for the benefit of member states. However, Chicago Convention provides that each contracting state undertakes collaborate in securing the highest practicable degree of uniformity in regulations, standards, procedures and organization in relation to aircraft, personnel, airways and auxiliary services in all matters in which such uniformity will facilitate and improve air navigation. To this end, ICAO is to adopt and amend from time to time, as may be necessary, international standards and recommended practices and procedures dealing with, among other things, aircraft in distress and investigation of accidents. Standards and Recommended Practices for Aircraft Accident Injuries were first adopted by the ICAO Council on 11 April 1951 pursuant to Article 37 of the Chicago Convention on International Civil Aviation and were designated as Annex 13 to the Convention. The Standards Recommended Practices were based on Recommendations of the Accident Investigation Division at its first Session in February 1946 which were further developed at the Second Session of the Division in February 1947. The 2nd Edition (1966), 3rd Edition, (1973), 4th Edition (1976), 5th Edition (1979), 6th Edition (1981), 7th Edition (1988), 8th Edition (1992) of the Annex 13 (Aircraft Accident and Incident Investigation) of the Chicago Convention was amended eight times by the ICAO Council since 1966. Annex 13 sets out in detail the international standards and recommended practices to be adopted by contracting states in dealing with a serious accident to an aircraft of a contracting state occurring in the territory of another contracting state, known as the state of occurrence. It provides, principally, that the state in which the aircraft is registered is to be given the opportunity to appoint an accredited representative to be present at the inquiry conducted by the state in which the serious aircraft accident occurs. Article 26 of the Chicago Convention does not indicate what the accredited representative is to do but Annex 13 amplifies his rights and duties. In particular, the accredited representative participates in the inquiry by visiting the scene of the accident, examining the wreckage, questioning witnesses, having full access to all relevant evidence, receiving copies of all pertinent documents and making submissions in respect of the various elements of the inquiry. The main shortcomings of the present system for aircraft accident investigation are that some contracting sates are not applying Annex 13 within its express terms, although they are contracting states. Further, and much more important in practice, there are many countries which apply the letter of Annex 13 in such a way as to sterilise its spirit. This appears to be due to a number of causes often found in combination. Firstly, the requirements of the local law and of the local procedures are interpreted and applied so as preclude a more efficient investigation under Annex 13 in favour of a legalistic and sterile interpretation of its terms. Sometimes this results from a distrust of the motives of persons and bodies wishing to participate or from commercial or related to matters of liability and bodies. These may be political, commercial or related to matters of liability and insurance. Secondly, there is said to be a conscious desire to conduct the investigation in some contracting states in such a way as to absolve from any possibility of blame the authorities or nationals, whether manufacturers, operators or air traffic controllers, of the country in which the inquiry is held. The EEC has also had an input into accidents and investigations. In particular, a directive was issued in December 1980 encouraging the uniformity of standards within the EEC by means of joint co-operation of accident investigation. The sharing of and assisting with technical facilities and information was considered an important means of achieving these goals. It has since been proposed that a European accident investigation committee should be set up by the EEC (Council Directive 80/1266 of 1 December 1980). After I would like to introduce the summary of the legislation examples and system for aircraft accidents investigation of the United States, the United Kingdom, Canada, Germany, The Netherlands, Sweden, Swiss, New Zealand and Japan, and I am going to mention the present system, regulations and aviation act for the aircraft accident investigation in Korea. Furthermore I would like to point out the shortcomings of the present system and regulations and aviation act for the aircraft accident investigation and then I will suggest my personal opinion on the new and dramatic innovation on the system for aircraft accident investigation in Korea. I propose that it is necessary and desirable for us to make a new legislation or to revise the existing aviation act in order to establish the standing and independent Committee of Aircraft Accident Investigation under the Korean Government.

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MENTAL REPRESENTATION OF PRESCHOOL CHILDREN:ASSOCIATION WITH PARENTAL MENTAL REPRESENTATION (학령전기 아동의 심적 표상 : 부모에 대한 심적 표상과의 관계를 중심으로)

  • Lee, Kyung-Sook;Lee, Hae-Ran;Shin, Yee-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.1
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    • pp.21-33
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    • 1999
  • The clinical assessment for preschool children who are known to have problems in selfreporting tends to be dependent on outsiders' reporting. Thus, the direct assessment of children's inner experience, thoughts and feelings is difficult. MacArthur Story-Stem Battery(MSSB) developed to learn more about preschool children's mental representation in play is used in this study to help assess clinical preschool children through developmental study of normal children's mental representation. Fifty five children(32boys and 23girls) who performed MSSB, IQ Test, Peabody Picture Vocabulary Test-Revised(PPVT) were videotaped and were analyzed. The results of this study were as follows:1) Children frequently displayed negative mental representation such as atypical negative response, reparation/guilt, punishment, personal injury and so on during emotionally laden play situation. 2) Mental representation of parent appeared positive, disciplinary, and negative in respective. 3) As a result of factor analysis of MSSB content themes, aggressive, prosocial, and oppositional content theme composites were generated. Aggressive content included atypical negative response, aggression, personal injury, and exclusion. Prosocial content included affection, affiliation, and reparation/guilt. Oppositional content included punishment and non-compliance. 4) Mental representation of parent and content themes showed significant correlation. Positive, negative, and disciplinary representation were significantly correlated for prosocial(r=0.40), aggressive (r=0.52), and oppositional(r=0.75) content theme respectively. 5) Among the correlations between parental mental representations and emotional responses, positive parental representation and anxiety showed significant negative correlation(r=-0.43). 6) Among the correlations between content themes and emotional responses, there were significant positive correlations between aggressive(r=0.28) and oppositional content themes(r=0.29) and distress, and were significant negative correlations between prosocial content theme and concern(r=-0.29) and anxiety(r=-0.43). According to the above results, preschool children frequently displayed negative mental representation in emotionally conflictual play situation. Children with more prosocial themes in their stories exhibit more positive parental mental representation. Also, children with more aggressive themes tend to display more negative parental representation and negative emotional responses.

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Health Assessment of Shift Workers in a Automobile Manufacturing Plant (자동차공장 교대작업 근로자들의 건강상태평가)

  • Lee, Jung-Jeung;Chung, Jong-Hak
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.1 s.49
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    • pp.103-121
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    • 1995
  • An investigation on psychophysiological health and social well-being of shift workers been carried out on workers of a automobile manufacturing plant in Ulsan, for 1 month from April, 1993. This cross-sectional survey compared shift workers(n=544) with day workers(n=115). Each subject completed a questionnaire about his personal habit, background, shift schedule, sleep and eating patterns, subjective digestive symptom and psychological well-being and distress using the General Well-Being Schedule(GWB) by self administrated questionnaire that was developed for the U.S. Health and Nutrition Examination Surveys (HANES I). Chi-square analysis was used for discontinuous data and the t-test was used for continous data to determine whether differences noted between the two groups. In terms of sleep quality, a greater percentage of shift workers frequently had trouble getting back to sleep once awakend(p<0.01), and a greater percentage of shift workers awakend tired or sleepy frequently more often than day workers(p<0.05). In rating the quality of their sleep, more shift workers rated their sleep fair to poor than day workers, and greater percentage of shift workers felt tired or sleepy at work two or more times per week(p<0.01) and a much higher percentage of shift workers felt tired or sleepy after work every days(p<0.01). In terms of sleep patterns, a much higher percentage of day workers reported uninterrupted sleep per 24hours than shift workers. The shift workers reported different eating patterns from day workers but there were no statistically significant and rate of their appetite. Thirteen percent of day workers reported the best appetite but only 6.6% of shift workers had the best appetite. The gastric complaints is more frequent in shift workers than day workers(p<0.01). Among subscores in General Well-Being Schedule, anxiety, depression, positive well-being and vitality subscale of shift workers were lower than those of day workers(p<0.05) and general health and self control subscale of shift workers were lower than .those of day workers but there were no statistical significant difference. Based on these study result, it could be concluded that the shift work has significant effects on some psychophysiological conditions of the workers.

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The Differentiation Process of the Soul and the Opposites in God in The Red Book (『레드 북』에 나타나는 심혼의 분화 과정과 신의 대극성의 문제)

  • Ki-Hwan Kim
    • Sim-seong Yeon-gu
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    • v.36 no.2
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    • pp.105-159
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    • 2021
  • The Red Book is a personal record that contains Jung's psychological self-experiment and describes his own experiences of the individuation process. Throughout The Red Book, Jung describes how he got caught by the spirit of the depths and dethroned the spirit of this time, how he regained his lost soul by getting to the bottom of inner processes, how he differentiated the soul upon encountering the various aspects of his soul, and finally how he confronted God approaching Jung in the form of the divine opposites. The spirit of the depths as a personification of the collective unconscious caught up with Jung and launched him into the individuation process. The spirit of the depths was "the God yet to come". Jung realized that he had been driven by the collective spirit of his time and then set off on a journey into a new territory of life under the guidance of the spirit of the depths. Jung first encountered his lost soul, afterwards experiencing various aspects of the soul-spirit duo such as Salome-Elijah, Helena-Simon, and Baucis-Philemon. In the process of individuation, the initial experience of the soul can appear to the ego as a Satanic force which darkens the consciousness. The Red Book describes how Jung consciously integrated the Satanic force and came to realize the meaning of it. Jung's experience of emotionally gripping aspects of the soul led him to the awareness of the dark side of God, Satan, while the insights he gained from that Satanic emotionality led him to the awareness of the bright side of God, Christ. Through this process, he finally encountered the opposites in God. Jung also referred to the Self as an image of God which manifests itself in the psyche. Jung later discovered God as a phenomenal psychic reality which incarnates itself from the unconscious into the conscious. He did it in terms of strict empirical science. Although the incarnation process of the deity is the main cause of psychological conflict and distress of a human being, if accepted consciously, we come to realize that the incarnation process of the deity in the psyche is the ultimate teleology and meaning of our life as well.