• Title/Summary/Keyword: Psychological problems

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A Clinical Study for Promoting Quality Nusing Care in a University Hospital (질적 간호제공을 위한 간호단위 시범 운영 효과에 관한 임상적 연구)

  • Lee, A.J.;Kim, S.H.;Seong, Y.H.;Yoo, S.A.;Kwon, I.G.;Jeong, Y.I.;Nam, H.K.;Kwon, E.J.
    • The Korean Nurse
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    • v.32 no.5
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    • pp.66-77
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    • 1994
  • The purpose of this study was to develop a new nursing unit which can meet changing health care needs, enhance patients' satisfaction and nurses' job satisfaction, and finally guarantee quality nursing care with present manpower. For this, one medical unit was selected as a unit for quality care. And one medical unit which is similar in staffing and patients' characteristics was selected as a control unit. To assess present problems and identify the remedies to the problems a hospital-wide survey and a workshop were performed. According to the survey results, educational programs and improvement of the facilities and equipment supply system, managereal support for interdepartmental cooperation and intensification of bed-side nursing care were adopted as main principles for operating model unit, This model unit was operated for 3 months from Sep. 1, 1992 to Nov. 30, 1992. To evaluate the effectiveness of the model unit, derect/indirect nursing care hours, patients' satisfaction to nursing care, nurses' job satisfaction, and quality care index were measured. Direct/indirect nursing care hours were compared with that of the control unit, and patients' and nurses' satisfaction and quality care index were measured before and after operating model unit and compared with each other. The results of the study were as follows; 1. In the model unit mean direct nursing care hours per cach shift was 146.88 minutes and indirect nursing care hours was 354.72 minutes. The ratio of the direct nursing care hour to indirect nursing hour was 29.6 ; 70.4 and that of the control unit was 26.9 : 73.1. Direct nursing care hour in model unit was longer than that of the control unit. But, the difference was not significant. In subcategories of direct nursing care, the time spent in mobility and exercise, conservation of body temperature, hygiene, and communication and health education were longer than that of the con" trol unit. 2. Indirect nursing care hour in model unit was shorter than that of the control unit. But, the difference was not significant. In subcategories of indirect nursing care, the time spent in drug management and ward arrangement was shorter than that of the control unit. 3. Patients' satisfaction to nursing care was increased significantly after operating the model unit (T=-3.48, P=-0.002) and satisfaction to subcategories of physical comfort measure, psychological cate, and unit management components were significantly higher than before. 4. In the model unit, nurses' total job satisfaction was increased significantly after operating the model unit(Z=2.1004, P=.0357) and satisfaction to subcategory of satisfaction to administration was significantly higher than before (Z=-2.0732, P=.0382). 5. After operating the model unit, quality care index was increased from 89 to 93. With this results, it can be summarized that all the measures tried for quality care, such as educational programs, managereal support for interdepartmental cooperation, and improvement of the equipment and facility provision resulted in partial increase in direct nursing care hours, nurses satisfaction to their job and patients' satisfaction to nursing care. In can be postulated that managereal support and motivation without proper staff supplementation is not enough for increasing direct nursing care hours. And for the enhancement of the level in clinical nursing, and staff supplement must be considered sincerely and the measures for reducing indirect nursing care hours, such as computerization of nursing care activities, improvement of facilities and equipment and facilities supply system, must be instituted in addition.

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Relationship between health behaviors and nutrient supplement intake (건강행태와 영양제 복용 유무의 관련성)

  • Lee, Jong-suk;Kim, In-tae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.11
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    • pp.498-508
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    • 2017
  • Purpose: The present study investigated nutrient supplement intake to examine the relationship between the health behaviors of nutrient supplement users and nonusers and nutrient supplement users and other drug users. The results provide baseline data to understand whether nutrient supplements actually perform as expected in view of the fact that healthy people that take nutritional supplements may become healthier, but may also develop nutritional supplement abuse problems. Among 7,006 household heads of 24,614 household members from the Korea Health Panel data in 2008, a total of 6,009 household heads were the respondents of the Korea Health Panel Survey (appendix) in 2009. Method: The subjects of the present study were targeted household heads. The respondents who reported that they had taken (planned to take) life/health promotion-related drugs (01. vitamins/nutritional supplements) for more than three months that were purchased at pharmacies during the past one year at the time of the survey were defined as nutritional supplement users. Those who took other drugs (05. hair-loss treatments, 06. obesity treatments, 10. others) were regarded as other drug users. A chi-squared test was performed to analyze the sociodemographic characteristics of the subjects and differences between groups. Multiple regression analyses were conducted to analyze health behaviors according to nutrient supplement intake. Result: Comparison of (A) nutritional supplement users and nonusers revealed that those who were women, 50 years or older, and spent more than average living expenses were more likely to take nutritional supplements, which was not significant in health behavior variables. Analysis of nutritional supplement users and other drug users (B) revealed that those who were high school graduates or above, had a spouse, were non-smokers, took drugs, ate regular meals, and were not stressed by economic or family conflicts were more likely to take nutritional supplements. Conclusion: The results of the present study indicated that people take nutritional supplements because of their psychological desire to be healthy, not because they are not healthy, have problems, or believe supplements will make them healthier.

Problems of the Current Referral System of the Terminal Cancer Patients in Korea (말기 암 환자의 완화 의료 연계 시스템의 문제점과 개선 방안)

  • Yun, Cho-Hee;Lee, Ju-Young;Kim, Mi-Ra;Heo, Dae-Seok
    • Journal of Hospice and Palliative Care
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    • v.5 no.2
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    • pp.94-100
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    • 2002
  • Purpose : The system to refer terminally ill patients to palliative or hospice care which ultimately give them emotional, psychological, and social support hasn't been fully developed and organized yet in Korea. The controversies concerning the current referral system are being analyzed to present the improvements. Methods : The questionnaires were asked to be filled out by family members of the 76 patients by phone interview, who were referred from the Seoul National University Hospital between April, 2001 to March, 2002. They were referred to the 35 palliative and hospice care-giving institutes and hospitals which were given questionnaires by mail. Results : Of the 76 patient's family members, 47 family members accepted to answer the questionnaire. The first thing that influence to family to determine the referral of patient was solicitation of doctors or nurses (44%). And they were influenced by allowance for the other things such as convenience of patients (32%), convenience of caring family members (24%). In the course of determining of referred institutes, responders had considered at first their dwelling area, and then fame of institutes, the place which patent had wanted to spend last hours or which is suitable for patient's funeral service, and their financial condition. Thirty-eight the 47 responders answered that they had experienced difficulties in referral procedure. The worst among difficulties was unwanted discharge, and followings were lack of information about the referred institutes, concern about patient's suffering, resistance of patient and opposition of other family members, etc. Although they expressed dissatisfaction in referral procedure, most of them answered they had been satisfied with hospice care at referred institute after referral. Merits of referral which responders counted were patient's peace, caring family's comfort and reduced cost in order. Of the 35 referred institutes, 24 institutes' staffs responded mail questionnaires and sent to us in return. Except one responder, the rest approved the referral system and thought that referred patients had been satisfied with their hospice care. And they claimed that systemic support of the government is definitely necessary. The most difficult thing which responders experienced in care of referred patients was lack of information about patients. Besides, there were patient's financial problems, lack of understanding about their institutes of patients or family, and inconvenience of terminal cancer patient's pain control. Conclusion : The development and support of the organized referral system is needed to alleviate the troubles which patients, family members, and palliative or hospice institutes and hospitals have to face through the procedure of the referral.

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TOOTH MOVEMENTS TO THE SITE OF ALVEOLAR BONE GRAFT (구순구개열 환아에서의 치조골이식)

  • Cho, Hae-Sung;Park, Jae-Hong;Kim, Gwang-Chul;Choi, Seong-Chul;Lee, Keung-Ho;Choi, Yeung-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.1
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    • pp.140-149
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    • 2007
  • Cleft lip and palate are congenital craniofacial malformation. Reconstruction of dental arch in patient with alveolo-palatal clefts is very important, because they have many problems in functions and esthetics. Malnutrition, poor oral hygiene, respiratory infections, speech malfunctions, maxillofacial deformity, and psychological problems may be occured without proper treatment during the long period of management of the cleft lip and palate. So the treatment should be managed with a multidisciplinary approach. Bone grafting is a consequential step in the dental rehabilitation of the cleft lip and palate patient A complete alveolar arch should be achieyed of the teeth to erupt in and to form a stable dentition. And the presence of the cleft complicate the orthodontic treatment. Therefore bone grafting in patients with cleft lip and palate is a widely adopted surgical procedure. Grafted bone stabilizes the alveolar process and allows the canine or incisor to move into the graft site. After the bone grafting, orthodontic closure of the maxillary arch has become a common practice for achieving dental reconstruction without any prosthodontic treatment. Various grafting materials have been used in alveolar clefts. Iliac bone is most widely fovoured, but tibia, rib, cranial bone, mandible have also been used. And according to its time of occurrence, the bone graft may be divided into primary, early secondary, secondary, late secondary. Bone grafting is called secondary when performed later, at the end of the mixed dentition. It is the most accepted procedure and has become part of treatment of protocol A secondary bone graft is performed preferably before the eruption of the permanent canine in order to provide adequate periodontal support for the eruption and preservation of the teeth adjacent to the cleft. In this report, we report here on a patient with unilateral cleft lip and palate, who underwent iliac bone graft. The cleft was fully obliterated by grafted bone in the region of the alveolar process. The presence of bone permitted physiologic tooth movement and the orthodontic movement of adjacent tooth into the former cleft area. Satisfactory arch alignment could be achieved in by subsequent orthodontic treatment.

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The Diagnosis for Educational Behavioral Strategies of Community Health Nurse-Community Health Worker for Control of Hypertensive Urban Young Black Men in America (간호사-지역사회건강상담자팀의 미국 도시지역 젊은 흑인 남자 집단의 고혈압 관리를 위한 전략 활동의 교육-행위진단)

  • Park, Kyung-Min
    • Research in Community and Public Health Nursing
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    • v.7 no.1
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    • pp.80-99
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    • 1996
  • Young black men(YBM) have the most severs levels of high blood pressure(HBP) and, in all reports but one, the lowest of HBP control of any age /sex /race group. To increase entry into care, remaining in care, and BP control for young(18-49 years) Black men, It is needed to review socio-demographic, medical characteristics, and behaviors(importance of and difficulty with HBP control behaviors, or worry about mdication) for experimental intervention study(educational- behavior strategies) of hypertensive urban young black men. The 204 participants had an average age of 38.8+7.0 years and an average educational level of $11.0{\pm}2.4$ years; only 23.1% were employed full- or part-time while 26% were on disability ; and 6% were married. Only 35.3% had an MD for HBP care and 37.3% had some form of health insurance. The average BP of those men currently being in care on medication(35.3%) was $148.2/95.1{\pm}19.5/11.3$ compared to those men not taking HBP care $153.7/99.1{\pm}14.0/9.8(p<.05)$. The average creatinine level was 1.3(excluding 3 marked elevations of 15.9, 9.6, and 7.7) for the 163 men consenting to have their blood drawn. Self-reported co-morbidity induded heart disease 7.8%, diabetes 8.9%, high cholesterol 18.2%, CVA 3.4%, alcohol and drug related problems 27.9% and 22.5% respectively. The kidney disease of those men currently being in care & on medication was 9.7 compared to those men not taking HBP care 0.8(p<.05). The problems of with sex life, physicl activity and dearly thinking of those men currently being in care & on medication was higher compared to those men not taking HBP care(p<.05). Questions of 'during the past month, on how many days did you have 5 or more drinks (bottles) of any alcoholic beverag?' and smoking of those men currently being in care & on medication was 18.1% and 72.2% compared to those men not taking HBP care 27.3 and 82.6%, respectively. HBP control behaviors was assessed with 1-5 point Likert subscales(5=extreme, 1-none at all), In general, th men reportd low levels of perceived psychological barrier to HBP care and control behaviors; importance of and difficulty with HBP control behaviors, or worry about mdication. For example, on a five point scale(1=none at all, 5=extreme), average ratings for perceived important and difficulty with BP care and behaviors were 2.8(SD=1.2) and 2.5(SD=1.1). Average ratings for perceived benefit with BP care and behaviors worry about medication of those men currently being in care on medication was 4.0(SD=0.9) and 2.2(SD=1.1) compared to those men not taking HBP care 3.6(SD=0.8), 2.8 (SD=1.6) respectively(p<.05). These data support the need for educational-behavioral strategies of community health nurse to improve high blood pressure control in this high risk group through perceived barriers to treatment, health care skills and use of resources, and social support.

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The Effect of Scratch Programming Education for Middle School Students on the Information Science Creative Personality and Technological Problem Solving Tendency (스크래치 프로그래밍 교육이 중학생의 정보과학 창의적 성향과 기술적 문제해결 성향에 미치는 영향)

  • Kim, Ki-Yeol
    • 대한공업교육학회지
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    • v.41 no.2
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    • pp.119-133
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    • 2016
  • This study is aimed at verifying the effect of scratch programming education for middle school students on their information science creative personality and technological problem solving tendency. The results of such study can be used as basic data for raising 'future creative talents' armed with problem-solving capability they honed in software education. The results of this research are as follows. First, a statistically significant difference was confirmed between ex ante and ex post samples in a t-test which was performed to verify information science creative personality of the middle school students (t(37)=4.305, p<.01). Their information science creative personality was high in the average score as it dropped from 3.00 in the ex-ante test to 2.51 in the ex post test. It was confirmed that the education of scratch programming influences information science creative personality for middle school students positively, suggesting that middle school students are interested in new problematic situations they found in information science and discover new problem-solving methods in the programming education, thereby showing positive feedback in the education performance. However, it was revealed that the middle school students were unable to immerse themselves in the scratch programming course completely and change their psychological states. Second, a statistically significant difference was confirmed between ex ante and ex post samples in a t-test which was performed to verify their technological problem solving tendency (t(37)=3.074, p<.01). Their technological problem solving tendency was high in the average score as it dropped from 4.06 in the ex-ante test to 3.55 in the ex post test. It was confirmed that the education of scratch programming influences technological problem solving tendency for middle school students positively: they understood problems associated with technology, explored diverse breakthroughs for the identified problems and assessed and improved resolutions. Third, a moderate correlation was confirmed between their information science creative personality and technological problem solving tendency (r=.343, p<.05). Therefore, it is judged that the middle school students who took scratch programming education demonstrated its influence in the correlation between the imagination for problem solving, positivity in the information science creative personality and the confidence for problem solving in the technological problem solving tendency.

Development and Effectiveness of the Primary Hospice Education Program for Nurses (간호사를 위한 호스피스 기초 교육 프로그램 및 효과)

  • In, Sook-Jin
    • 한국호스피스완화의료학회:학술대회논문집
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    • 2004.07a
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    • pp.100-102
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    • 2004
  • Under the current medical system, a terminal patient and his/her family who are neglected inevitably face various aspects of crises including not only physical, but also psychological, social, economic, spiritual and legal problems. Nurses often look after many terminal patents with these types of complicated problems. Therefore, educating the nurses who will take care of such patents would greatly reduce stress so the patents end could their lives in peace and without losing their dignity. This research is a quasi experimental study of nonequivalent control group. A pretest-posttest design where a basic education program is developed for nurses, who frequently treat terminal patents, to understand the importance of the role of hospice and to apply their understandings to treat terminal lancer patents. A sample of the nurses were taken from those who were working in general wards at two general hospitals in Seoul during October, 2003${\sim}$December 2003. The study was composed of 46 experimental group and 43 control group. A basic hospice education program was developed by taking emphasized and overlapping parts from advanced practice hospice nurses education course, short-term education course, an extensive literature survey and by consulting three professionals as well. With the group of 5 professors with vast experiences in oncolgy, 5 nursing administrator, 3 nursing practitioner, the tentative first version of the program was developed and reviewed. Afterwards, by utilizing person to person interviews with 2 head nurses experienced with terminal patients, 1 nurse in charge of hospice, 1 nurse on the contents of the program, and a person to person rating on the educating medium by a nurse were performed. The final version of a basic education program was developed after the second revision. The hospice basic education program consists of introduction to hospice, hospice and commucation, management of pain for terminal cancer patients, physical management for terminal cancer patients, socio-psycological caring of terminal cancer patients and management of death and separation. Total education time was four hours organized into 50 minutes of instruction and 10 minutes of break. $Powerpoint^{(R)}$ software was used as the education medium. As research tools, "Knowledge on Hospice" was developed by the author after receiving a review from one expert. "Attitude of Hospice Nursing" was revised Kim(2001)'s attitude measuring tool which was based on Wang(1998), Kwon(1989), Park and Sung(1991)'s tool. "Liability on nursing terminal patients" was used as developed by Zarits(1980) and Mongomory(1985) translated by Lee(1985). For collecting data, preliminary investigation prior to 1 week of the hospice basic education program and post-investigations after 1 week and 4 weeks of the education were carried out for the nurses at a general ward who understood and agreed on the purpose of the program. Collected data were analyzed throughout t-test, $x^2-test$, Manova test and Bonferroni correction in $SAS^{(R)}$ program. The summary of the investigation is as follows: Hypothesis 1: "Educated experimental group would possess more knowledge on hospice compared to the un-educated control group" was supported after 1 (F=12.14, p=.00) and 4 (F=5.3, p=.02) weeks of education. Hypothesis 2: "Educated experimental group would take a positive attitude toward hospice nursing compared to the un-educated control group" was supported after 1(F=3.92, p=.05) and 4(F=5.05, p=.02) weeks of education. Hypothesis 3: "Educated experimental poop would feel less liability compared to the un-educated control group in nursing terminal cancer patients' was rejected. In this study, it was found that knowledge on hospice was significantly important. By applying hospice basic education programs to nurses, the education program helped nurses to take a positive attitude toward terminal patients. It was, however, seen that the education program had no effect on alleviating liability in nursing terminal patients. Therefore, it is expected that this educational program would help hospices and nurses at general wards to understand the concept and the role of hospice so that terminal patents, now neglected under current medical system, would be able to end their lives in peace.

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The Possibility and Limitation of Age-friendly Industry Activation Policy of the Korean Government: 'From the First to Third Plan for Ageing Society and Population (2006-2020)' (한국 정부의 고령친화산업 활성화 정책의 가능성과 한계: '제1-3차 저출산·고령사회기본계획(2006-2020)'을 중심으로)

  • Park, Seung-Min
    • 한국노년학
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    • v.37 no.1
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    • pp.55-82
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    • 2017
  • The purpose of this research is to provide implications for the development of age-friendly industry of Korea by analyzing the age-friendly industry activation policy suggested by the Presidential Committee on Ageing Society and Population Policy in response to the population ageing problems. Policy and theoretical implications are derived from an analysis of age-friendly industry activation policy as directly related to the improvement of the three major problems (i.e. health, economy, and loneliness) of Korean older people. This analysis focuses on its specific content, common and core logic, and the validity of the logic. The results show that: 1)the first Plan for Ageing Society and Population suggests a policy for improving poverty, 2)the second Plan for Ageing Society and Population suggests a policy for improving health, and 3)the third Plan for Ageing Society and Population suggests a policy for improving health and loneliness. All policies not only are commonly based on the logically limited concepts of successful ageing and active ageing, but also are characterized by narrow realm, insufficient content, and fragmented policy. The results result in the following policy implications: 1)the age-friendly industry activation policy should be developed with continuity, sufficiency, and diversity, 2)lessons from the limitation related with the de-contextualisation of successful ageing and its elective affinity with consumer capitalism, 3)lessons from the prevention-oriented perspective of active ageing, and 4)lessons from the social characteristics of (non-)psychological resources, limitation of the reablement related with social investment state. The analyses also provide a theoretical implication that a different perspective on the social construct of ageing is needed beyond the dichotomy of ageing based on modelling ageing. Lastly, the paper suggests not only the limitation of the research but also the preferred follow-up studies regarding age-friendly industry activation policy.

A Study on the Relationship of Wounds in the Growth Period, Inferiority Complex, Personality Disorder and Mental-Health among Secondary Students (중·고등학생의 성장과정 상처와 열등감, 성격장애, 정신건강과의 관계 연구)

  • Man-pyo Lee
    • Korean Journal of Culture and Social Issue
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    • v.18 no.4
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    • pp.505-532
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    • 2012
  • The purpose of this study was to examine the relationship among the growth period wounds, inferiority complex and personality disorder of teenaged students, which affected their mental health. The subjects in this study were 2,110 secondary students. After a survey was conducted, the collected data were analyzed. Whether there would be any differences among the adolescents in those factors were analyzed, and multiple regression analysis and path analysis were carried out. As a result, there were relatively more significant problems with the growth period wounds, inferiority complex, personality disorder and mental health of the students who were girls, who were high schoolers, whose household economy was more vulnerable and whose academic standing was lower. The growth period wound that exerted the largest significant influence on inferiority complex was happiness, followed by wound of security and wound of recognition, and the growth period wound that had the greatest significant impact on personality disorder was happiness, followed by wound of security, wound of confidence, wound of love and wound of equity. The growth period wound that exercised the biggest influence on mental health was happiness, followed by wound of security, wound of confidence, wound of love and wound of equity. As for the influence of the variables related to mental health, the indirect effects of the growth period wounds through personality disorder and inferiority complex were greater than their direct effects. The findings of the study suggest that growth period wounds are likely to lead to inferiority complex and personality disorder and ultimately to the injury of mental health, and indicate the importance of healthy family environments and of educational environments in the growth period.and mental health was analyzed, there was a statistically significant positive(+) correlation among all the variables. Third, the wound factors related to happiness and stability were identified as the factors that affected inferiority complex among the growth period wound factors. Personality disorder was found to be under the influence of the wound factors related to happiness, stability, love, confidence and a sense of equality in the growth period, and mental health was found to be affected by the wound factors related to happiness, stability, confidence, love and a sense of equality. Fourth, the growth period wounds had a direct impact on mental health, and inferiority complex played a significant mediating role at that time. Every subfactor of personality disorder also produced significant mediating effects except the wound factor of pride. The above-mentioned findings suggest that every possible effort should be made to let secondary students get hurt less to promote their mental health and resolve their mental health problems, and that professional counseling intervention and institutional assistance are required to help them to remove their inferiority complex and personality disorder.

Analytical Psychology in Psychiatric Clinics (진료현장에서의 분석심리학 : 정신건강의학과 진료실에서 접하는 문제들의 분석심리학적 접근 경험)

  • Sang-Hag Park
    • Sim-seong Yeon-gu
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    • v.35 no.2
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    • pp.85-112
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    • 2020
  • How does analytical psychology help understand patients at general psychiatric clinics? It's necessary to think about how knowledge of analytical psychology can help young psychiatrists who are in training. Patients who come to us bring symptoms(problems). Symptoms can be compared to tickets to a movie theater. Symptoms accompanied by complaints of pain are not only pathological phenomena to be eliminated, but an important pathway to access the patients' inner problems. In terms of seeing the whole, the point of view in analytical psychology is to see the unconscious as well as the consciousness, even the elements the patients do not speak or know of. When determining indications and contra-indications during the initial process of treating a patient, it is more important to acknowledge the therapist's capabilities and limitations than the patient's condition or limitations The approach to complaints of the same symptoms may differ depending on whether the patient is in the first half or the second half of one's life. Analytical psychology is empirical psychology that experiences and it adheres to a phenomenological position that recognizes the phenomenon as true in itself, not logically right or wrong. The analytical psychological view of understanding mental phenomena asks the causal perspective of why the symptoms occurred. At the same time, the therapist, along with the patient, must seek answers to the question of why now and for what purpose. A therapist is a person who experiences the patient's personal development process together. In analytical psychotherapy, the therapist's attitude is more emphasized than the treatment method or technique; it is regarded as of the utmost importance. In this regard, analytical psychology is a practical and useful therapeutic tool, and is a field of study that can be widely used in actual psychiatric clinics. In addition to understanding the patient, it is also the most important discipline for the therapists, especially for the education and growth of those who want to become a treatment tool themselves.