• Journal of Korean Academy of Rural Health Nursing
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• v.3 no.2
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• pp.104-115
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• 2008

Purpose: A study of the family planning and Maternal-Child Health Services that disciplined itself in primary health care post form 1980 to 2009. Method: Investigation studies family planning in primary health care post and a change process of a Maternal-Child Health Services into case by case until 2009 from 1980. Results: Our country family planning business began at economic development dimensions in order to solve a poverty issue. This business goal were childbirth decrease of pregnancy possibility couple aged 19~49 and improve to mother and child health. For this goal, all kinds of health education included sex education and contraception education, contraception service, comprehensive maternal and child health service that management of front and back of childbirth etc. are provided. According to fail down a birthrate from 6.0(1962) to 1.25(2009), the nation reached to a dilemma called childbirth encouragement policy. Conclusions: Decrease of labor supply by low birthrate, decrease numerical an employed person by aging was brought a labor shortage and decrease of productivity of labor of industrial manpower. Deterioration phenomenon of financial income and expenditure by consumption and investment contraction caused decrease of slowdown of economic growth and potential growth rate, and a social cost burden is increased by deterioration financial old man support burden increase by this and pensions and health insurance, a sharp increase of social welfare cost etc. Now, in order to solve a low birth issue, the government establishes a whole nation forwarding system and establishes basic plan social low birth and advanced age, and to prepare for childbirth fault factors removal and advanced age society shall endeavor.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.14 no.3
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• pp.315-322
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• 2007

Purpose: The purpose of this study was to examine the effect of three kinds of modes using bolus button of PCA on level of pain and side effects of analgesic and amount of drug consumption in post-operative patients according to whether the medication is controlled by the patient, the caregiver or the nurse. Method: The participants were 684 patients using PCA after an operation. The data collection period was from March 19 to April 6, 2007. Results: It was found that there were statistical differences in gender, age, type of surgery, pain on first post-operative day, amount of drug consumption, nausea, and vomiting. The ratio for patient controlled medication was 55.7% for women, and 70.5% for men, and for care-giver controlled medication, 35.1% for women, and 20.0% for men. Average pain scores for the first post-operative day were $3.9{\pm}2.2$ for patient controlled medication and $4.5{\pm}2.3$ for care-giver controlled medication. There were statistical differences according to mode used for PCA for amount of drug consumptions, nausea and vomiting but not for pain, operation day or pruritus. Conclusion: This study was carried out to examine risks according to who controls the PCA for post-operative patients. The results can help to develop education program for everyone who is involved in PCA, patients, caregivers, nurses and doctors.

• Tuberculosis and Respiratory Diseases
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• v.72 no.5
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• pp.401-408
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• 2012

Cardiopulmonary resuscitation (CPR) is a series of life-saving actions that improve the chances of survival, following cardiac arrest. Successful resuscitation, following cardiac arrest, requires an integrated set of coordinated actions represented by the links in the Chain of Survival. The links include the following: immediate recognition of cardiac arrest and activation of the emergency response system, early CPR with an emphasis on chest compressions, rapid defibrillation, effective advanced life support, and integrated post-cardiac arrest care. The newest development in the CPR guideline is a change in the basic life support sequence of steps from "A-B-C" (Airway, Breathing, Chest compressions) to "C-A-B" (Chest compressions, Airway, Breathing) for adults. Also, "Hands-Only (compression only) CPR" is emphasized for the untrained lay rescuer. On the basis of the strength of the available evidence, there was unanimous support for continuous emphasis on high-quality CPR with compressions of adequate rate and depth, which allows for complete chest recoil, minimizing interruptions in chest compressions and avoiding excessive ventilation. High-quality CPR is the cornerstone of a system of care that can optimize outcomes beyond return of spontaneous circulation (ROSC). There is an increased emphasis on physiologic monitoring to optimize CPR quality, and to detect ROSC. A comprehensive, structured, integrated, multidisciplinary system of care should be implemented in a consistent manner for the treatment of post-cardiac arrest care patients. The return to a prior quality and functional state of health is the ultimate goal of a resuscitation system of care.

• Journal of Korean Academy of Rural Health Nursing
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• v.17 no.1
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• pp.23-33
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• 2022

Purpose: This study was conducted to identify the effects of an integrated health improvement program for the elderly based on primary health care posts during the COVID-19 pandemic. Methods: A single group pretest-posttest design (n=16) was employed to evaluate an integrated health improvement program that took place twice a week for 11 weeks. The program was conducted in a small group of no more than 10 people in compliance with the guidelines to prevent COVID-19 infection. The program consisted of various contents such as making letters using blocks, health education, and talking about one's memories. The data were analyzed using the Wilcoxon signed rank test. Results: Following the program, social support (Z=-3.50, p<.001) and quality of life of the elderly (Z=-3.74, p<.001) were significantly improved among depression, social support and quality of life. Conclusion: The integrated health improvement program based on primary health care posts, considered in this study, was useful to improve the social support and quality of life of the elderly in the community, and needs to be applied to a larger number of elderly people throughout the community.

• Research in Community and Public Health Nursing
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• v.12 no.1
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• pp.22-31
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• 2001

Purpose of this study is to compare the cost effectiveness of home care services for the cerebrovascular accident patients by the type of institution. The method is the secondary analysis using the patients' charts. 107 subjects and 1.417 visits were sampled from each type of home care institution such as one hospital based home care center. one KNA home care center, one urban health center, one rural health center and one health care post. Result: There were differences in the functional status of patients and the service contents and frequencies provided by the type of home care institution, The cost per visit for one unit of ADL by the hospital based home care was higher than by the community-based home care. Conclusion: It was suggested that the referral system among the home care institutions would be developed to improve the cost-effectiveness.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.17
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• pp.7287-7290
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• 2014

Background: Brief physician counselling has been shown to be effective in improving smokers' behaviour. If the counselling sessions can be given at the workplace, this would benefit a larger number of smokers. This study aimed to determine the effectiveness of a ten-minute physician counseling session at the workplace in improving smoking behaviour. Materials and Methods: This prospective randomised control trial was conducted on smokers in a factory. A total of 163 participants were recruited and randomised into control and intervention groups using a table of random numbers. The intervention group received a ten-minute brief physician counselling session to quit smoking. Stages of smoking behaviour were measured in both groups using a translated and validated questionnaire at baseline, one month and three months post intervention. Results: There was a significant improvement in smoking behaviour at one-month post intervention (p=0.024, intention to treat analysis; OR=2.525; CI=1.109-5.747). This was not significant at three-month post intervention (p=0.946, intention to treat analysis; OR=1.026; 95% CI=0.486-2.168). Conclusions: A session of brief physician counselling was effective in improving smokers' behaviour at workplace, but the effect was not sustained.

• The Journal of Korean Academic Society of Nursing Education
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• v.23 no.4
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• pp.463-473
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• 2017

Purpose: The purposes of study was to evaluate the effect of debriefing using reflection questions and writing on the critical thinking disposition, self-efficacy, and clinical judgement ability in simulation of post-operative care of abdominal surgery. Methods: The research method was a nonequivalent control group no-synchronized design. The study period was from August 22 to 30, 2016. The subjects were comprised of 34 people in the experimental group and 36 in the control group. In a simulation session for post-operative care of abdominal surgery, the treatment of the experimental group was to debrief for 30 minutes using Lasater's reflection questions and writing. For the control group, a typical debriefing was conducted in the same environment. Results: Critical thinking disposition, self-efficacy, and clinical judgement were significantly higher in the experimental group than the control group. Conclusion: To enhance the critical thinking disposition, self-efficacy, and clinical judgement of nursing students in simulation, it is recommended to debrief using reflection questions and writing.

• Journal of Korean Neurosurgical Society
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• v.54 no.3
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• pp.159-163
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• 2013

Objective : Cerebral hyperperfusion syndrome (CHS) is a serious complication after carotid endarterectomy (CEA). However, the prevalence of CHS has decreased as techniques have improved. This study evaluates the role of strict blood pressure (BP) control for the prevention of CHS. Methods : All 18 patients who received CEA from February 2009 through November 2012 were retrospectively reviewed. All patients were routinely managed in an intensive care unit by a same protocol. The cerebral perfusion state was evaluated on the basis of the regional cerebral blood flow (rCBF) study by perfusion computed tomography (pCT) and mean velocity by transcranial doppler (TCD). BP was strictly controlled (<140/90 mm Hg) for 7 days. When either post-CEA hyperperfusion (>100% increase in the rCBF by pCT or in the mean velocity by TCD compared with preoperative values) or CHS was detected, BP was maintained below 120/80 mm Hg. Results : TCD and pCT data on the patients were analyzed. Ipsilateral rCBF was significantly increased after CEA in the pCT (p=0.049). Post-CEA hyperperfusion was observed in 3 patients (18.7%) in the pCT and 2 patients (12.5%) in the TCD study. No patients developed clinical CHS for one month after CEA. Furthermore, no patients developed additional neurological deficits related to postoperative cerebrovascular complications. Conclusion : Intensive care with strict BP control (<140/90 mm Hg) achieved a low prevalence of post-CEA hyperperfusion and prevented CHS. This study suggests that intensive care with strict BP control can prevent the prevalence of post-CEA CHS.

• Journal of Chest Surgery
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• v.55 no.2
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• pp.118-125
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• 2022

Background: A time course analysis was undertaken to evaluate how perioperative process-of-care and outcome measures evolved after implementation of an enhanced recovery after thoracic surgery (ERATS) program. Methods: Outcome and process-of-care measures were compared between patients undergoing major elective thoracic surgery during a 9-month pre-ERATS implementation period to those at 1-3, 4-6, and 7-9 months post-ERATS implementation. Outcome measures included length of stay, the 30-day readmission rate, 30-day emergency department visits, and minor and major adverse events. Process measures included first time to activity, out-of-bed, ambulation, fluid diet, diet as tolerated, as well as removal of the first and last chest tube, epidural, patient-controlled analgesia, and Foley and intravenous catheters. Results: In total, 704 patients (352 pre-ERATS, 352 post-ERATS) were included. Mobilization-related process measures, including time to first activity (16.5 vs. 6.8 hours, p<0.001), out-of-bed (17.6 vs. 8.9 hours, p<0.001), and ambulation (32.4 vs. 25.4 hours, p=0.04) saw statistically significant improvements by 1-3 months post-ERATS implementation compared to pre-ERATS. Time to Foley removal improved by 4-6 months post-ERATS (19.5 vs. 18.2 hours, p=0.003). Outcome measures, including the 30-day readmission rate and emergency department visits, steadily decreased post-ERATS. By 7-9 months post-ERATS, both minor (18.2% vs. 7.9%, p=0.009) and major (13.6% vs. 4.4%, p=0.007) adverse events demonstrated statistically significant improvements. Length of stay trended towards improvement from 6.2 days pre-ERATS to 4.8 days by 7-9 months post-ERATS (p=0.06). Conclusion: The adoption of ERATS led to improvements in multiple process-of-care measures, which may collectively and gradually achieve optimization of clinical outcomes.

• Tuberculosis and Respiratory Diseases
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• v.85 no.4
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• pp.332-340
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• 2022

Background: Cardiac dysfunction patients have long been considered at high risk of reintubation. However, it is based on past studies in which only conventional oxygen therapy was applied after extubation. We investigated association between cardiac dysfunction and reintubation rate in situation where high-flow nasal cannula (HFNC) was widely used during post-extubation period. Methods: We conducted a retrospective observational cohort study of patients treated with HFNC after planned extubation in medical intensive care unit of single tertiary center. Patients were divided into normal function group (ejection fraction [EF] ≥45%) and cardiac dysfunction group (EF <45%). The primary outcome was reintubation rate within 72 hours following extubation. Results: Of 270 patients, 35 (13%) had cardiac dysfunction. Baseline characteristics were similar in both groups. There were no differences in the changes in vital signs between the two groups during the first 12 hours after extubation except diastolic blood pressure. The reintubation rates were 20% and 17% for cardiac dysfunction group and normal function group, respectively (p=0.637). In a multivariate Cox regression analysis, cardiac dysfunction was not associated with an increased risk of reintubation within 72 hours following extubation (hazard ratio, 1.56; p=0.292). Conclusion: Cardiac dysfunction was not associated with increased reintubation rate within 72 hours when HFNC is immediately applied after planned extubation.