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A Study on the Status of Utilization of Health Care Institution by Geriatric Patients -Focus on the Utilization of Physical Therapy- (노인환자 보건의료기관 이용실태 분석)

  • Lee, Jong-Sub;Song, Myung-Soo
    • Journal of agricultural medicine and community health
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    • v.22 no.2
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    • pp.277-293
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    • 1997
  • This study was conducted to provide basic materials required to enforce and develop welfare policies, as well as the health system, for the aged, by surveying the status of health care utilized by the daily increasing old population and the importance of receiving physical therapy. Data that need in this research was gathered from over ages of 65, during the period from Jan 4, 1996 to Jan 31, using the inquiries previously made by geriatric researchers and through literatures investigator by this writer. The data were analyzed by $X^2$, Z-test, Likert scale. The findings were as follows : 1) General characteristics of subjects. People in the age group between 65 and 69 were 55.6% and the highest number, while male were 37% and female 63%. Analysis of income group disclosed 60.6% whose monthly income, including the pocket money given by children, was less than 200,000 won. 91.1% of the elderly people surveyed owned houses; only 36.4% live with spouses; while 15.6% live alone. 2) Characteristics with respect to utilization of health care institution. 56% of the total medical institutions used by the elderly people were clinics and the rates of chronic disease and musculoskeletal disease were 73.2%. 3) Characteristics with respect to approach of health care institution. 45.1% of the respondent stated it took 20 minutes to arrive at hospital, and bus accounted for 48.6% of all transportation means used to go to hospital. 4) Degree of cognition with respect to the rights of geriatric patients. (1) There is no financial support from the government for geriatric patients(71.4%). (2) Government financial support is needed for geriatric patients(95.3%). (3) Have never been regionally surveyed or called upon for interviews with respect to treatment desire and problems relating to geriatric patients(87.2%). (4) Health and medical policies for geriatric patients must be established rapidly(98.4). (5) Expansion and construction of specialized medical facilities for geriatric patients such as elderly hospital and medical center are needed(90.2%). (6) Government's welfare policies for the elderly people is insufficient(82.0%) 5) Degree of cognition on importance of physical therapy with respect to geriatric patient. (1) Physical therapy is considered most effective in treating geriatric patients(82.9%). (2) Physical therapists specializing in only elderly people must be need of separately(76.2%). (3) It is desirable for medical specialists to visit geriatric patients at home to provide physical therapy(82.9%). (4) Hospitals specializing in physical therapy for geriatric patient are required(85.6%). Based on the result for this research, the following suggestions are presented to facilitate the utilization of health care institution for the welfare of geriatric patients. Medical facilities such as elderly hospital and geriatric patient's medical center specializing in elderly people must be constructed as early as possible; and home-visiting physical therapist system must be important to treat chronic geriatric patients; our government must establish policies to provide the old ages with means for the health care and curing chronic diseases, and carry out the plans of reasonable distribution and effective untilization of medical resources.

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THE LATERAL CEPHALOMETRIC STUDY OF THE GROWING CHILDREN WITH CLASS III MALOCCLUSION BY KIM'S ANALYSIS (Kim's analysis에 의한 III급 부정교합아동의 측모두부방사선 계측학적 연구)

  • Yang, Ku-Ho;Choi, Nam-Ki;Jeong, Jin-Gug
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.2
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    • pp.298-307
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    • 2003
  • The purpose of this study was to investigate the distribution and differences of the cephalometric measurements between normal occlusion and the class III malocclusion. Kim's analysis was achieved and compared on both the 141 elementary school students with proper profile and normal occlusion and the class III malocclusion group at the age of 7 to 9, in Gwang-ju area and the results were as follows; 1. The ODI, APDI, IIA, UL showed statistically significant differences between normal occlusion and class III malocclusion(p<0.01). But, no significant difference existed in both CF and EI. 2. The mean value of ODI was 72.62, APDI 80.47 IIA 121.37 in normal occlusion. 3. The mean value of ODI was 64.45, APDI 87.31 IIA 129.89 in class III malocclusion. 4. ODI decreased as APDI increased, and the correlation coefficient was -0.576 in both normal occlusion and class III malocclusion. 5. The correlation coefficient related to EI was CF 0.777, LL -0.670, UL -0.588, IIA 0.485. It means that UL and LL were very sensitively reflected on EI.

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Study on Depression and Ego Identity of Middle-aged Women (중년기 여성의 우울과 자아정체감에 관한 연구)

  • Kim, Hye-Young;Koh, Hyo-Jung
    • Women's Health Nursing
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    • v.3 no.2
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    • pp.129-156
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    • 1997
  • The purpose of this study is to investigate the relationship between depression and ego identity of middle-aged women and to identify the variables that show differences in the depression and ego identity of middle-aged women. The subjects in the study were 321 mothers of high school students whose age were 40-59 years old. The instruments for this study were Beck Depression Inventory(BDI) developed Beck(1978) and translated by Lee(1981) and Ego identity Scale developed Suh(1975) and modified by Nam(1975). The reliability values of BDI range from 0.83 to 0.87 and Ego identity range from 0.81 to 0.85 using Cronbach alpha. The data were analysed by using the SAS program and included Frequency, percentage Pearson Correlation MANOVA, t-test, ANOVA. The conclusion obtained from this study were as follows ; 1) There was a negative correlation(r=-0.21, p=0.0002) between depression and ego identity of middle-aged women. Thus the lower depression the higher ego identity for middle-aged women. 2) According to the analysis of interacting effects of depression and ego identity, there were significant differences in the household income(F=0.38, p=0.0035), level of education (F=6.50, p=0.0001), satisfaction of marriage(F=10.45, p=0.0001), family pattern (F=6.18, p=0.0001), menopausal status(F=7.23, p=0.0001), present disease(F=4.85, p=0.0110) and health status(F=9.00, p=0.0001). 3) There were significant differences on the level of education(F=12.98, p=0.0001) household income(F=5.78, p=0.0007), support of spouse(F=8.58, p=0.0002), satisfaction of marriage(F=20.08, p=0.0001), menopausal status(F=11.32, p=0.0001), present disease(t=2.76, p=0.0062) and health status(F=17.23, p=0.0001) of the depression of middle-aged women. 4) There were significant differences on the patterns of household(t=-2.64, p=0.0086), support spouse(F=3.58, p=0.0291), satisfaction of marriage(F=3.90, p=0.0212), menopausal status(F=4.59, p=0.0108) and disease(t=2.11, p=0.0359) of the ego identity of middle-aged women. On the basis of the above findings the following recommendations are made ; 1) According to results of this study, middle-aged women's depression is correlated with ego identity. Thus when the nurse plans the preventive strategy of middle-aged women's depression, the nurse must be considered with level of ego identity. 2) To study for middle-aged women in depth, further research is need to study regard to middle-aged men and their children.

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Successful Transplantation of 3 Cases of Oligomeganephronia (신장이식 수술로 치험한 Oligomeganephronia 3례)

  • Bae Hyun-Chul;Kim Ji-Hong;Kim Pyung-Kil;Kim Yoo-Seon;Park Ki-Il;Jeong Hyun-Ju;Choi In-Jun
    • Childhood Kidney Diseases
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    • v.1 no.2
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    • pp.189-194
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    • 1997
  • Oligomeganephronia is a rare congenital form of bilateral renal hypoplasia histologically characterized by reduction in number and hypertrophy of nephrons. Clinically, this condition is presented in early infancy with vomiting, polyuria, polydipsia and dehydration. The problems are readily corrected, but slowly progressive renal failure follows accompanied by failure to thrive, short stature, and renal osteodystrophy. We experienced three cases of oligomeganephronia. Case 1. : A 3 2/12 years old female child was incidentally diagnosed as renal failure at age of 2 months when she was hospitalized due to pneumonia. She had open renal biopsy and was diagnosed as bilateral dysplastic kidney. On OPD follow-up, she progressed to end-stage renal failure (BUN/Cr 114/4.6 mg/dl) and had renal transplantation. The specimen was shrunk remarkably and light microscopy showed oligomeganephronia. Case 2. : A 14 8/12 years old female child with proteinuria was detected in an annual urine screening program for school children, she was diagnosed as renal failure (BUN/Cr 33.9/4.1 mg/dl), and had $5{\times}4{\times}3\;cm$ sized mass on abdominal CT scan. She had renal biopsy, and the specimen showed oligomeganephronia. She had hemodialysis for six months, and renal transplantation along with bilateral nephrectomy was performed. Case 3. : A 14 8/12 years old male child was diagnosed having chronic nephritis and chronic renal failure at 3 years old, progressed to end-stage renal failure (BUN/Cr 87/9.6 mg/dl) on OPD follow-up, and had a rephrectomy and renal transplantation. The biopsy specimen showed oligomeganephronic hypoplasia, secondary focal segmental glomerolosclerosis, and chronic interstitial nephritis. We report 3 cases of oligomeganephronia that progressed to end-stage renal failure and had successful renal transplantation with a brief review of related literatures.

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Perspective on Population Characteristics and Health Problems of Koreans in 21st Century (21세기 초 한국의 인구구조 및 질병양상)

  • Kim, Joung-Soon
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.2 s.46
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    • pp.175-185
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    • 1994
  • In order to anticipate disease pattern and health problems of Koreans in the 1st part of 21st century (by the year 2020), transition of population characteristics, mortality and morbidity data during the last 30 years Koreans have experienced were reviewed. On the actual basis of epidemiologic transition process that has undergone during last 30 years since 1960 along with socioeconomic development and successful implementation of selective national health policies (family planning, medical insurance and etc.), following changes can be expected in the 21st century in Korea, under the assumption that the current rate of progress is maintained. The population of South Korea alone will be doubled the population of 1960 by the year 2013 : aged Population older than 65 years will be increased from 3.3% in 1960 to 11.4% in 2020 with increased average age of the population from 23.6 year in 1970 to 39.2 year in 2020; urban population from 28% in 1960 to 83% in 2005. GNP/capita has increased tremendously from U.S. $120 in 1970 to $6,749 in 1992, and the government estimated it would be 519,350 in 2010 and $29,460 in 2020. Growth and developmental indices of children, educational achievement and social status of women also showed a remarkable improvement and anticipated to make futher progress. Leading causes of mortality and morbidity have shown a striking change during the last 30 years, from infectious diseases to chronic degenerative diseases and man-made injuries. Occurrence of communicable diseases may become minimal although viral hepatitis, venereal diseases Including AIDS, and well adapted herpes virus infections will maintain their endemic level. Newly evolving infectious agents, however, should be carefully monitored because of rapidly changing environments and human behaviours. Tuberculosis may increase up to the epidemic level when AIDS prevails. Ischemic heart diseases may increase steadily with increasing occurrence of hypertension and diabetes mellitus whereas cerebrovascular diseases may be decreased slowly. Musculaskeletal diseases which contribute a lot to the disability of aged people may be a major health problems due to increased aged population. Mental diseases, particularly that caused by alcohol and drug abuse, and senile dementia may become a prominent health problem. On the other hand injuries caused by traffic and industrial accidents that have shown most striking increase till now may be decreased considerably by intensive intervention. The health policies in the 21st century will be oriented to the health promotion for good quality life rather than life-savings.

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Pain Relieving Effect of Intraoral Sucrose Replacement in Neonates (신생아의 통증완화를 위한 자당(sucrose) 경구투여 효과)

  • Yoon Hea-Bong
    • Child Health Nursing Research
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    • v.7 no.1
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    • pp.35-50
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    • 2001
  • The ability of neonates to perceive and react to pain, has been acknowledged recently. Recent researches have been shown that even short term pain can have lasting negative effects. We know that most of the anatomical pathway and neurotrans-mitter function necessary for pain perception are fully or nearly fully developed in the neonatal period. Many people are still reluctant to believe that pain felt by neonates may be as severe as that felt by older children or adults yet. The objective of the study is to assess and compare the analgesic effects of orally administered sucrose and pacifiers. And to determine the synergistic analgesic effects of sucrose and pacifiers. The tools for this study is Lawrence's NIPS (neonatal infant pain scale) with behavioural pain responses and index for pain physiological reponses as heart rate, respiratory rate and degree of SaO₂. The participants are 96 healthy infants of neonatal age 1-7days and randomised to receive heel prick before 2minutes to blood sampling and physiological test in Nursery of K Medical University Hospital on May-July, 2000. The experimental group assigned to one of three treatment groups : no treatment; a pacifier; placebo(2ml 25% sucrose). Collected data were analyzed with the SAS program using X²-test, ANOVA and Duncan's multiple range test as post hoc. The results were as follows. 1) Pain behaviour responses: The pain score of placebo group(2ml 25% sucrose) is lower than no treatment group and pacifier group significantly(P=.000). Placebo group is different from no treatment and pacifier group with Duncan's multiple range test. 2) Pain physiologic responses (1) heart rate: The heart rate of placebo group(2ml 25% sucrose) is different from that of no treatment group and pacifier group significantly(P=.000). The heart rate change of placebo group is less than the other groups. (2) respiratory rate: The respiratory rate of placebo group(2ml 25% sucrose) is different from that of no treatment group and pacifier group insignificantly (P=.2340). But, the respiratory rate of placebo group is lower than the other groups. (3) SaO₂: The SaO₂ score of placebo group(2ml 25% sucrose) is different from that of no treatment group and pacifier group insignificantly (P=.3265). But, the change of SaO₂ score of placebo group is less than the other groups. In conclusion, the sucrose placebo showed pain relief effect in behavior responses and less physiological responses. Accordingly, the sucrose placebo should be applied nursing intervention for simple pain management as heel prick.

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The Effects of work and psychosocial stress on job satisfaction, organizational commitment, and leaving intention in general hospital female office workers (종합병원 사무직 여성의 직무 및 사회심리적 스트레스가 직무만족, 조직몰입, 이직의향에 미치는 영향)

  • Lee, Jeong-Hyun;Cho, Woo-Hyun;Chang, Sei-Jin;Kim, Young-Hoon
    • Korea Journal of Hospital Management
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    • v.17 no.1
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    • pp.1-22
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    • 2012
  • This study tires to examine affects that job and socio-psychological stresses of female office workers influence job satisfaction, organization commitment, and leaving intentions. A complete data are collected by conducting a survey with 240 female office workers from 9 medical institutions regarded as almost general hospital in Seoul. It is analyzed that the relation between socio-psychological stress and job satisfaction, organization commitment, and leaving intentions by using t-test; analysis of variance; correlation analysis; principal component analysis; linear structural equation modeling; etc. The results of this study are summarized as following. First, as it was comprehended by specific characteristics of subjects that the female office workers' level of job and socio-psychological stress, job satisfaction, organizational commitment, and leaving intention, there were statistically significant distinctions from their age, marital status, presence of children, position in the organization, type of employment, and monthly average income. Second, this study regarded relationship between the female office workers' level of job and socio-psychological stresses, job satisfaction, organizational commitment, and leaving intention. Job and socio-psychological stresses were negatively correlated with job satisfaction and organizational commitment, but the stresses were positive with leaving intention. Third, after evaluating effect that 8 features related to the job stress could influence job stress, the most effective valuables were in order to unfairness in organizational structure, workplace culture, inadequate compensation, and relationship conflict. Fourth, when looking at the overall effects of the job and sociopsychological stresses on job satisfaction, organizational commitment, and leaving intention, work autonomy was the most influencing factor of work stress levels. The level of the job stress seemed to be a prevalent impact on the leaving intention and it showed the most negative relationship that path coefficient from leaving intention to organizational commitment and also from organizational commitment to job satisfaction. Based on these findings, it can be defined that the job and socio-psychological stresses strongly influence job satisfaction, organizational commitment, and leaving intention.

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A Clinical Observation on Childhood Shigellosis Occurred in Mass Outbreak (소아에서 집단 발병한 세균성 이질의 임상적 고찰)

  • Lee, Soo-Jin;Yu, Young;Kim, Sin-Na
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.1
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    • pp.33-38
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    • 2002
  • Purpose: The incidence of shigellosis had been decreased due to the use of antibiotics and the improvement of environmental sanitation but recently increases again. Shigellosis occurrs in mass outbreak through unsanitized meal preperation refered from welfare facility and school. We observed epidemic aspect and clinical coarse of childhood shigellosis. Methods: from December 2001 to January 2002, 22 inpatients with shigellosis in Dongbu Municipal Hospital were observed epidemiologically, clinically and microbiologically. Results: 1. The sexual ratio was 1:1 and mean age was $5.5{\pm}1.4$ years (14 months to 11 years). 2. The clinical manifestations were following: diarrhea (95.5%), high feve (10%) and asymptomatic (4.5%). The mean duration was $3.9{\pm}2.1$ days (1 to 12 days). All patients had no complication and normal serologic test. 3. S. sonnei was cultured in rectal swab, and was resistant to TMP/SMX and ampicillin, but susceptible to ampicillin/sulbactam and the 3rd generation cephalosporins. 4. The patients were treated by antibiotics with conservative treatment including electrolytes and fluid therapy for 5 days, resulting in improvement confirmed by negative reaction on stool culture. 5. These cases were all occurred in mass outbreak in day care center and were suspected to be secondary infection by members of family. Conclusion: This shigellosis occurred in day care center was secondary infection due to S. sonnei and had mild clinical coarse and improvement after antibiotic treatment.

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Characteristics of Upper Gastrointestinal Tract Involvement in Korean Pediatric Crohn's Disease: A Multicenter Study

  • Park, Ji Hyoung;Nam, Hye Na;Lee, Ji-Hyuk;Hong, Jeana;Yi, Dae Yong;Ryoo, Eell;Jeon, In Sang;Tchah, Hann
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.20 no.4
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    • pp.227-235
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    • 2017
  • Purpose: Crohn's disease (CD) can involve any site of the gastrointestinal tract (GIT). However, the characteristics of upper GIT involvement in CD are unclear, especially in the Eastern pediatric population. This study aimed to estimate the prevalence of upper GIT involvement and identify the clinical features of Korean children with CD. Methods: This was a retrospective multicenter cohort study that included 52 pediatric patients with CD who underwent esophagogastroduodenoscopy and biopsy. The clinical symptoms and endoscopic and histologic features of the upper GIT were identified according to the presence or absence of upper gastrointestinal symptoms. Results: Among the 52 patients, upper GIT involvement was noted in 50.0% (26/52). The mean age at CD diagnosis was $14.1{\pm}2.1$ years. Gastric ulcer was the most common lesion (19.2%) found on upper GIT endoscopy, followed by duodenal ulcers (15.4%). Chronic inflammation was the most common histopathologic feature (75.0%), followed by gastric erosion (17.3%). Granuloma was found in 9.6% of patients. Helicobacter pylori infection was identified in 5.8% of patients. Endoscopic and histologic findings were not significantly different, but the mean values of erythrocyte sedimentation rate ($60.7{\pm}27.1$ vs. $43.0{\pm}27.6mm/h$, p=0.037) and C-reactive protein ($16.5{\pm}28.2$ vs. $6.62{\pm}13.4mg/dL$, p=0.014) were significantly different between patients with and without upper gastrointestinal CD symptoms. Conclusion: Upper GIT involvement was relatively common in pediatric patients with CD irrespective of upper gastrointestinal symptoms, and H. pylori infection was relatively uncommon. The results of this study should aid the establishment of regional guidelines for upper GIT examination.

Components for Early Childhood Horticultural Education Program derived from Expert Delphi Research

  • Jeong, Yeojin;Kim, Mijin;Chang, Taegwon;Yun, Sukyoung
    • Journal of People, Plants, and Environment
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    • v.24 no.2
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    • pp.119-135
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    • 2021
  • Background and objective: This study was conducted to identify the components of kindergartener horticultural education by deriving objective components of horticultural education using the Delphi survey method, and then to provide basic data that can be used when creating horticultural programs in the regular curriculum. Methods: A total of 32 experts including professors of early childhood education, kindergarten directors, horticultural therapy professors, and horticultural therapists were selected as the Delphi panel. Of the 32 selected, only 29 answered all three rounds of the surveys. For the first round of the survey, an open-ended questionnaire, was used, and in the second and third rounds closed-ended questionnaires were used. Results: Results indicated that under the category of the goals of horticultural education, there were 7 items related to the current problems of horticultural education, 16 items related to the need for horticultural education in the smart age, 18 items related to the direction of horticultural education, and 5 items related to the areas most suitable for horticulture education for young children in the Nuri Curriculum. Results in the category of the implementation of horticultural education indicated that 2 items related to horticultural education hours, 3 items related to the venue for horticultural education, 2 items related to the activity types applicable to the Nuri Curriculum, and 4 items related to the objects of horticultural activities were derived. As the current problems of horticultural education, the following items were identified: event-oriented activity (M = 4.24) and lack of kindergarten teachers' opportunities for systematic gardening education (M = 4.21). The results related to the necessity of horticultural education indicated the following items: education on respect for life through caring (M = 4.59), emotional intelligence and stability (M = 4.55), directly experience of the growth process of plants (M = 4.55), and development of the five senses (M = 4.55). Finally, within the direction of horticultural education: nurturing the desire to live with nature (M = 4.50), and learning about life (M = 4.44) was identified, which had higher averages. Within the areas of the Nuri Curriculum, which is most consistent with horticultural education, nature exploration (M = 4.69) and the integration of all areas (M = 4.59) were derived as priorities. Also, regarding the implementation of horticultural education, the following items were derived as the priority from the expert group: 30-40 minutes (M = 4.14) and 40-50 minutes (M = 4.14) for class periods, outdoor garden in a kindergarten(M = 4.66) for the venue of gardening education, outside play (M = 4.59) for the activity type, and vegetable crops (M = 4.55) for the objects of gardening activities. Conclusion: It is significant that the goal and implementation of kindergartner horticultural education were objectively derived through collecting opinions of expert panels. Based on the results of this study, a horticultural education program for kindergarten teachers should be implemented.