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An Exploratory Study about the Importance of Selected Nursing Activities during the Puerperal Period, as Viewed by Women in the Puerperal Period and by Nurses Caring for Them (산모와 간호원이 본 선택된 산욕기 간호활동의 중요도에 관한 탐색적 연구)

  • 박주봉
    • Journal of Korean Academy of Nursing
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    • v.8 no.1
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    • pp.152-162
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    • 1978
  • The desire to maintain health is increasing, consequently the role of nursing which has as one chief aim the solving of man′s basic problems is more and more important. Today, in spite of a growing concern about the nursing activities which nurses provide for individual human having specific needs, clinically in fact, it is questionable that individual′s expectation of nursing activities agrees with nurse′s performance of nursing activities. In this study the importance and agreement of the importance of the nursing activities during the hospitalized puerperal period as viewed by women in the puerperal period and by nurses caring for them, were assessed. The present study was undertaken in an attempt to furnish the basic data for expediting the progress of research activities in this area and further to be helpful in planning maternity nursing practice. The study population defined and selected was nurses (13) caring for women in the puerperal period and doing duty on obstetric & gynecologic ward at Y. hospital, and the women in puerperal period (39) as sum of 3 women selected by each nurse during the period of May 13th-June 4th 1976. The study data was collected by the direct interview method based on the questionnaire which the investigator made out. The study result was analyzed by percentage, t - test. The findings can be summarized as follows: 1. General characteristics of nurses doing duty on puerperal ward: a. Nurses′average age was 24.8 years old. b. 84.6% had educational background of 4 years of college. c. 69.2% had a religion. d. 53.8% were married. e. 53.8% had clinical experience of 1 year -3 years. f, 61.5% did duty on puerperal ward during 1 year -3 years. g. 46.2% desired to do duty on obstetric ? gynecologic ward. 2. General characteristics of the women who were studied during their puerperal period: a. Women′s average age was 26.4 years old. b. 79.5% had educational background above high school. c. 56.4% had a religion. d. 84.6% had living standard above medium. e. 89.7% had no occupation. f, 53,8% had previous hospitalization experience. g. 56.4% had previous delivery experience. 3. Examining the importance of 39 nursing activities during puerperal period selected by investigator, studied group of women considered that the most important nursing activity was "Record precisely about condition, medical treatment and nursing activity results etc". Nurses considered that the most important nursing activity was "Notice whether having pain and care for that". Both groups considered that the least important nursing activity was "Talk with her about topics such as news, hobbies, other interests". 4. Examining the importance of nursing activities in 4 specific categories, studied group of women considered that the most important nursing activity in physical nursing category was "Be sure of safety measure to prevent accidents, injuries", and nurses considered that the most important nursing activity was "Make her sleep and rest sufficiently". Studied group of women considered that the most important nursing activity in psychological category was "Explain about medical treatment and nursing activity ahead of time so she knows what to expect" , and nurses considered that the most important nursing activity was "Explain about puerperal period so she understands". Studied group of women considered that the most important nursing activity in relation to medical care was "Record precisely about condition, medical treatment and nursing activity results etc.", and nurses considered that the most important nursing activity was "Observing, cleaning and protecting the perineum" Studied group of women considered that the most important nursing activity in nursing category in preparation for discharge was "Instruct about personnel hygiene during puerperal period", and nurses considered that the most important nursing activity was "Instruct self-care to protect the perineum". 5. The analysis of this study showed a significant amount of disagreement computed by subtracting the nurse′s score from the patient′s score. Studied group of women put greater importance on physical nursing category, psychological nursing category, nursing in relation to medical care, than the nurses. These results were statistically significant at 0.01 level.

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Development of a Critical Pathway for Patients with Coronary Artery Bypass Graft (관상동맥 우회술 환자를 위한 Critical Pathway개발)

  • 김기연
    • Journal of Korean Academy of Nursing
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    • v.28 no.1
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    • pp.117-131
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    • 1998
  • The purpose of this study was to develop a critical pathway for case management for patients who have received Coronary Artery Bypass Graft (CABG) because of Ischemic Heart Disease(IHD) which is a factor of rising medical expenses. For this study. a conceptual framework was developed through a review of the literature including six critical pathways which are currently being used in USA. In order to identify the overall service contents required by these patients and to draw up a preliminary critical pathway, 30 cases of medical records of patients who had CABG because of IHD between January, 1995 to June. 1996 at the Cardiovascular Center of Yonsei Medical Center in Seoul were analyzed. An expert validity test was done for the preliminary critical pathway and clinical validity test was also done using seven IHD patients with CABG between November 11 and 23, 1996. After these processes. the final critical pathway was developed. The results of this study are summarized as follows : 1. The vertical axis of the critical pathway includes the following eight items : tests, nutrition, medications, consultations, activity, assessments, treatments, education discharge planning and the horizontal axis includes the time from the start of hospitalization to discharge. 2. Analysis of the 30 medical records indicated that the average length of stay was 20.2days with the average length of stay from hospitalization day to operation day being 6.2 days, and the average length of stay from operation day to discharge day was 13. 9 days. Analysis of the service contents showed that the horizontal axis of the preliminary critical pathway was set from hospitalization to the 14th post operation day and the vertical axis was set to include eight items, the contents which ought to have occurred, according to the time frames of the horizontal axis. 3. As a result of the experts validity, it was found that among the total of 571 items. there was over 83% agreement for 482 items, less than 83% for 89 items, which were then deleted and a revision of the critical pathway was done. 4. A clinical validity test was done using seven IHD patients with CABG. During the process, three patients were deleted because they were out of the criteria the investigator set. Finally, four patients were used. The result of study indicated that only one patient was discharged on the tenth post operation day, which was one day later than the expected day. Three patients were discharged later than the expected day from three days to nine days. All the cases progressed on schedule until the operation day and the first post operation day, but from the second post operation days, there were differences between the critical pathway and the actual practice. The differences came from tests, assessments, and treatments. 5. On the basis of the results of the clinical validity test. the following revisions in the final critical pathway were made : the transfer from ICU to step down ward would be the second post operation day, and the transfer to a general ward, the fifth post operation day, for patients who complained of lack of sleep from the fifth post operation day to discharge, a sleeping pill would be prescribed, skin observations would be performed routinely from immediately after the operation until the third post operation day, and would continue if there was a sign of skin injury on the fourth post operation day, and assessment of chest pain would be done from the third post operation day, and the “stairs climbing” item, expected to be done on the ninth post operation day would be deleted. In conclusion, this critical pathway is partially applicable to the care of patients with CABG but there are some parts needed to be further investigated.

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Lived Experience of patients with Terminal Cancer : Parses Human Becoming Methodology (말기 암환자의 체험에 관한 현상학적 연구)

  • 이옥자
    • Journal of Korean Academy of Nursing
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    • v.25 no.3
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    • pp.510-537
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    • 1995
  • Human health is an integral part of experience in the process of Human Becoming. Through continual interaction with the environment human beings freely choose experience and develop as responsible beings. The process of the health experience of patient with terminal cancer is a unique. he objective of this study is to understand the lived experience of patients with terminal cancer in order to provide basic information for nursing care in the clinical setting and to develop a theoretical background for clinical practice. This study is to de-scribe and define the lived experience of patients with terminal cancer in order to provide a foundation for nursing research and education. Data collection has been done between December 1993 and November 1994. The subjects included five persons -four females and one male : one who was in her sixties, one in his fifties, two in their forties, and one who was in her thirties. The researcher has met with these patients 35 times, but at eight times the patient was in a stuporous condition and not able to participate, so these were not included in the data analysis. Parse's "Human Becoming Methodology", an existential phenomenological research methodology is used for this study. Data has been collected using he dialogical engagement process of "I and You", the participant researcher and the participant subject. Dialogical engagement was discontinued when the data was theoretically saturated. Data was analyzed using the extraction - synthesis and heuristic interpretation. The criteria of Guba and Lincoln(1985). and Sandelo wski(1986) : credibility, auditability, fitness and objectivity were used to test the validity and reliability of the data. The following is a description of the structure of the lived experience of patients with terminal cancer as defined by this study : 1. Structure : 1) Suffering through the reminiscence of past experience 2) The appearance of complex emotions related to life and connectedness 3) The increasing importance of significant people and of the Absolute Being 4) The increasing realization of the importance of health and belief 5) Desire for a return to health and a peaceful life or for acceptance of dying and a comfortable death In summary the structure of the lived experience of these patients can be said to be : suffering comes through reminiscence of past experience, and there are complex emotions related to life and connectedness. Significant people and the Absolute Being become increasingly important along with a realization of the importance of health and faith. And finally there is a desire for either a return to health and a peaceful life or for the acceptance of dying and a comfortable death. 2. Heuristic Interpretation : Using Parse's Human Becoming Methodology, the structure of the lived experience of patients with terminal cancer identified in this research is interpreted as. The lived experience of patients with terminal cancer involves the solving of past conflicts, and the experience of the healing and valuing of sorrow and pain. Through the relation of life and health, and the complex emotions that arise, the lived experience of revealing - concealing is of paradoxical emotions. The increasing importance of significant others and of the Absolute Being shows Connecting and Separating an on- going process of nearness and farness. Revision of thoughts about health and faith is interpreted as transforming and desire for restoration to health and a peaceful life or acceptance of dying and a cowfortable death, as powering. In summary, it is possible to see, in the lived experience of patients with terminal cancer, the relationship of the five concepts of Parse's theory : valuing, revealing -concealing, connecting-separating, transforming, and powering. From Parse's theory, the results of this study show that meaning is related to valuing, rhythmicity to revealing-concealing and connect-ing-separating, and cotranscendence to transforming and powering.

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Problems Analysis Related to Nutrition and the Development of Nutrition Education Programs for High School Students(II) - A Study Centered on the Development of Nutrition Education Programs for High School Students - (고등학생의 영양 관련 문제점 분석 및 영양 교육 프로그램 개발 ( II ) - 고등학생 대상 영양 교육 프로그램 개발 -)

  • Lee, Eun-Ju;Soh, Hye-Kyung;Choi, Bong-Soon
    • Journal of the East Asian Society of Dietary Life
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    • v.17 no.3
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    • pp.351-363
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    • 2007
  • Previously, we analyzed for nutrition knowledge and the use of nutrition knowledge in the everyday lives of students in order to develop nutrition education programs that focus on desirable behavior change. From this, we found that female students desired to participate in nutrition education more than male students, and regarding their concerns for nutrition education, 73.2% of the females and 50.0% of the males displayed interest in 'obesity and the regulation of body weight'. Therefore, this study showed female students give more attention to the obesity and the regulation of body weight than male students(p=.000<.001). In addition, female students had higher interests($8.63{\pm}1.67$) than male students ($7.45{\pm}2.03$) in nutrition knowledge(p=.000<.001). By investigating the use of nutrition knowledge in everyday life, our research indicated that the actual use of nutrition knowledge was less. To encourage students to persue dietary lives addressing the concerns confirmed above, the following needed to occur. 1) Provide them nutrition information for the main processed foodstuffs encountered when dining out(breads, cakes, cookies, and carbonated beverage). 2) Teach them to read food nutrition labels. 3) Help them find a lifestyle connection through lasting self-management methods and the generation of social support. Accordingly, this required developing effective and practical nutrition education programs that considered regional characteristics and gender differences. The most important factors considered during nutrition education program development were the need for motivation and ongoing education by stage of change, rather than temporal education through specific problem analysis, in order that those being educated may bring about a change of behavior by themselves. Therefore, from this study, we have suggested the use of multilateral operating strategies for successful nutrition education. In addition the phase model of behavior change should be applied. Our programs were aimed at self owned nutritional management so that students could master their own methods for acquiring skills and enjoying dietary life. The research may be summed up as follows. First, the purpose of education at the recognition stage of change was to attempt motivation for nutrition improvement, by analyzing the problems such as food buying habit and the main purchasing viewpoints when dining out. Second, the purpose of education at the action stage of change was to help students acquire of concrete methods for behavior modification by linking the program to their home as well as to teachers with various activities that suited the situation at school. This was done by analyzing the processes and decisions pertaining to dining out the main processed foodstuffs and principal components, etc. through data and experimental practice. Third, the purpose of education for changing of habits and values, or the maintenance stage, was to investigate the various reasons that undesirable behaviors were induced, and then determine a lasting self-management method as well as how to generate social support. If the nutrition education program developed in this study is utilized on site, someone in the primary role as the nutrition educator and trained specifically in nutrition, can help induce the health promotion in the community as well as lasting dietary management, by executing a link with families in parallel with educating teaching staff and students' parents. In addition, this program can playa role in the government policies related to the health promotion for our youth who are the foundation of our nation and who can enhance our national competitive power.

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A Study on Public Health Doctors' Participation in District Public Health Program of Health Sub-centers in Korea (보건지소 공중보건의사의 지역보건사업 참여 실태)

  • Lee, Jae-Chun;Park, Yong-Moon;Ahn, Song-Vogue;Lee, Hae-Young;Hwang, Jin-Won
    • Journal of agricultural medicine and community health
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    • v.28 no.1
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    • pp.53-66
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    • 2003
  • Objectives: To investigate the state of medical care around health sub-centers, public health doctors' participation and opinion in the process of district public health programs. Methods: The study included 1,036 public health doctors who worked at health sub-center all over the country. The data were collected for Feb, 2002 using self-administered questionnaire by mail. Results: One or two doctors were working at health sub-center and 33.5% of health sub-centers was located in the region of the separation of prescription and dispensing. There were another medical facilities in 45.9% of the administrative district(eup or myon) where health sub-centers were located. The count of medical utilization went down to 14.8${\pm}$14.8 per a day in Nov, 2001 from 18.0${\pm}$15.6 in May, 2000, and the decline was much more in the region of the separation of prescription and dispensing. Among public health programs in health sub-centers, public health doctors participated mostly in preliminary medical examination for vaccination and least in health education. They participated in implementation rather than planning or evaluation of health program. Over a half of public health doctors were found to be positive that health programs implemented in their health sub-centers would promote the level of health in community people and they were willing to participate in district public health program if community people were in need. Conclusions: Recently health sub-centers are required to turn into health promotion facilities rather than medical practice facilities. Health program in health sub-centers will be advanced in both quality and quantity by turning the role of public health doctors who have provided medical services mainly into managing health program. Persistent education about managing health program and the policy to motivate participation in health program should be provided for public health doctors.

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Health Behavior and Health Condition of the Rural Young-Old and the Rural Old-Old in an Agricultural District (농촌 전기노인과 후기노인의 건강행태와 건강상태)

  • Hwang, Seong-Ho;Lee, Myeong-Sook;Lee, Sung-Kook
    • Journal of agricultural medicine and community health
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    • v.36 no.4
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    • pp.207-217
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    • 2011
  • Objectives: The purpose of this study is to garner useful information through a comparative analysis of health behaviors and health states between the young-old and old-old elderly in a rural Korean area. Methods: We define the young-old elderly as those 65 to 74 years of age, and the old-old as those over 70. The survey was administered in October and November of 2009 at senior citizen centers in Sangju City, Kyongsangbuk-do, South Korea. The number of subjects surveyed approximated the demographics of the aged population of the administrative district of centers of 24 eup, myeon, and dong. Results: Compared with the young-old elderly, the old-old were vulnerable to population sociological characteristics. While there were many cases of contraction of diseases, only a small percentage of old-old elderly were engaged in regular exercise. In addition, the old-old elderly lagged behind the young-old in terms of physical activity, mental and oral health, hearing, and vision. Conclusions: The vulnerability of the old-old elderly in terms of physical and mental health needs to be acknowledged as various characteristics of the elderly that appears according an age group. A variety of disease prevention and health promotion programs that focus on the health behavior and status of the young-old and old-old elderly need to be developed and put into practice.

NEW ANTIDEPRESSANTS IN CHILD AND ADOLESCENT PSYCHIATRY (소아청소년정신과영역의 새로운 항우울제)

  • Lee, Soo-Jung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.12-25
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    • 2003
  • Objectives:As increasing number of new antidepressants have been being introduced in clinical practice, pharmacological understanding has been broadened. These changes mandate new information and theories to be incorporated into the treatment process of children with depressive disorders. In light of newly coming knowledge, this review intended to recapitulate the characteristics of new antidepressants and to consider the pivotal issues to develope guidelines for the treatment of depression in childhood and adolescence. Methods:Searching the Pub-Med online database for the articles with the key words of 'new', 'antidepressants' and 'children' ninety-seven headings of review articles were obtained. The author selected the articles of pertinent subjects in terms of either treatment guideline or psychopharmacology of new antidepressants. When required, articles about the clinical effectiveness of individual antidepressants were separatedly searched. In addition, the safety information of new antidepressants was acquired by browsing the official sites of the United States Food and Drugs Administration and Department of Health and Human Services. Results:1) For the clinical course, treatment phase, and treatment outcome, the reviews or treatment guidelines adopted the information from adult treatment guidelines. 2) Systematic and critical reviews unambiguously concluded that selective serotonin reuptake inhibitors(SSRIs) excelled tricyclic antidepressants( TCAs) for both efficacy and side effect profiles, and were recommend for the first-line choice for the treatment of children with depressive disorders. 3) New antidepressants generally lacked treatment experiences and randomized controlled clinical trials. 4) SSRIs and other new antidepressants, when used together, might result in pharmacokinetic and/or pharmacodynamic drug-to-drug interaction. 5) The difference of the clinical effectiveness of antidepressants between children and adults should be addressed from developmental aspects, which required further evidence. Conclusion:Treatment guidelines for the pharmacological treatment of childhood and adolescence depression could be constructed on the basis of clinical trial findings and practical experiences. Treatment guidelines are to best serve as the frame of reference for a clinician to make reasonable decisions for a particular therapeutic situation. In order to fulfill this role, guidelines should be updated as soon as new research data become available.

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The Code of Medical Ethics for the Korean Academy of Child and Adolescent Psychiatry: Why Is It Important? (대한소아청소년정신의학회 의료윤리규정: 왜 필요한가?)

  • Koo, Young-Jin;Hwang, Jun-Won;Lee, Moon-Soo;Yang, Young-Hui;Bang, Soo-Young;Kang, Je-Wook;Lee, Dae-Hwan;Lee, Ju-Hyun;Kwack, Young-Sook;Kim, Seungtai Peter;Noh, Kyung Sun;Park, Sung-Sook;Bahn, Geon Ho;Song, Dong-Ho;Ahn, Dong Hyun;Lee, Young Sik;Lee, Jeong-Seop;Cho, Soo-Churl;Hong, Kang-E Michael
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.27 no.1
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    • pp.2-30
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    • 2016
  • This article provides an overview of the developmental history and rationale of medical ethics to establish the code of ethics and professional conduct of the Korean Academy of Child and Adolescent Psychiatry (KACAP). Most medical professional organizations have their own codes of ethics and conduct because they have continuous responsibility to regulate professional activities and conducts for their members. The Ethics and Award Committee of the KACAP appointed a Task-Force to establish the code of ethics and conduct in 2012. Because bioethics has become global, the Ethics Task Force examined global standards. Global standards in medical ethics and professional conduct adopted by the World Medical Association and the World Psychiatric Association have provided the basic framework for our KACAP's code of ethics and professional conduct. The Code of Ethics of the Americal Academy of Child and Adolescent Psychiatry has provided us additional specific clarifications required for child and adolescent patients. The code of ethics and professional conduct of the KACAP will be helpful to us in ethical clinical practice and will ensure our competence in recognizing ethical violations.

The Effect of the Participative Leadership on Creative Behavior - Focusing on Unidimensional and Multidimensional Mediating Effects of Psychological Empowerment - (참여적 리더십이 창의적 행동에 미치는 영향 - 심리적 임파워먼트의 단일차원과 다차원 매개효과를 중심으로 -)

  • Tak, Je-Woon;Shin, Je-Goo
    • Management & Information Systems Review
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    • v.36 no.5
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    • pp.61-83
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    • 2017
  • The purpose of this study is to investigate the mediating effects of psychological empowerment between participative leadership and creative behavior. Especially, it aims to analyze the unidimension and multidimension of psychological empowerment in an integrated manner, and to suggest effective practice of participative leadership together with theoretical and methodological implications. In this study, the dependent variable was measured separately with time lag as a method to solve the common method bias that can be shown by the self-report type survey method, and positive emotions and negative emotions expressing emotional states in job situations were employed as control variables along with rank. A total of 283 questionnaires were collected from employees who work for companies in various industries with more than 300 domestic employees. SPSS PROCESS macro program('model 4') was used for statistical analysis. Results, First, the full mediation effect of psychological empowerment(unidimension) was confirmed in the relationship between participative leadership and creative behavior. Second, the analysis of the multidimension of psychological empowerment revealed the full mediating effect of meaning, self-determination, and impact, and the mediating effect of competence was not significant. Third, as a result of comparing the mediating effects of unidimension of psychological empowerment and the mediating effects of multidimension, the magnitude of mediating effect of unidimension was found to be much greater than mediating effect of multidimension. And The magnitudes of the three multidimensional mediating effects were similar. This is a case in which the motivational model of participative leadership revealed in the overseas study is proven in the domestic management environment and is significant in that it is the basis of future research. Based on the results of the empirical studies, the implications and limitations of the study and future research directions are presented.

A Legal Study on Safety Management System (항공안전관리에 관한 법적 고찰)

  • So, Jae-Seon;Lee, Chang-Kyu
    • The Korean Journal of Air & Space Law and Policy
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    • v.29 no.1
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    • pp.3-32
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    • 2014
  • Safety Management System is the aviation industry policy for while operating the aircraft, to ensure the safety crew, aircraft and passengers. For operating a safe aircraft, in order to establish the international technical standards, the International Civil Aviation Organization has established the Annex 19 of the Convention on International Civil Aviation. As a result, member country was supposed to be in accordance with the policy of the International Civil Aviation Organization, to accept the international standard of domestic air law. The South Korean government announced that it would promote active safety management strategy in primary aviation policy master plan of 2012. And, by integrating and state safety programmes(ssp) and safety management system(sms) for the safe management of Annex 19 is to enforce the policy on aviation safety standards. State safety programmes(ssp) is a system of activities for the aim of strengthening the safety and integrated management of the activities of government. State safety programmes(ssp) is important on the basis of the data of the risk information. Collecting aviation hazard information is necessary for efficient operation of the state safety programmes(ssp) Korean government must implement the strategy required to comply with aviation methods and standards of the International Civil Aviation Organization. Airlines, must strive to safety features for safety culture construction and improvement of safety management is realized. It is necessary to make regulations on the basis of the aviation practice, for aviation safety regulatory requirements, aviation safety should reflect the opinion of the aviation industry.