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The Hospital Life of the Patient with Femoral Neck Fracture (대퇴경부 골절 환자의 입원 생활)

  • Kim, Kyung-Ja;Chi, Sung-Ai
    • Journal of Korean Academy of Nursing Administration
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    • v.2 no.1
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    • pp.35-56
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    • 1996
  • Nowerdays, the increase of traffic accidents and old age population make the Femoral Neck Fracture(FNF) patients increase. By the improvement of education and standard of living the patients demand better medical service than before. This study is designed to give practical help for the FNF patients by observing their hospital life and establish practical nursing strategies for the FNF patients. For these purposes the Ethnographic Participant Observation was adopted. By this study is focused on the hospital life patient's view. For this end, the field study adopted orthopedic ward in the C University Hospital with 400 beds in Seoul. The object patients of the study were twelve patients. The patients experienced five stages : Embarrassment, Conflict, Stability, Independent, and Extension Stage. The findings and prepared nursing strategies are stated as follows. First, in the Embarrassment Stage they suffered embarrassment, anxiety, pain, they could not do ordinary things. The patients who accidental fractures had anxiety from unfamiliar tests and from hospitalization itself. They lamented that they could not ordinary things, and do nothing but obeying the hospital, and endure the pain. They recognized the changed environment and resigned themselves to life in the ward. In this stage, full openness by the nurses is needed. Second, the attribute of the Conflict Stage were conflict, fear, curiosity, belief, reflection. When they sign the consentment form, they experience conflicts about the possibility of complication, fear of recovery from anesthesia, curiosity about the operation procedure, post - operation state, reflection on their past life, and promise to care for their family members after discharge and keep their religious life faithfully. And they accepted the operation depending on God, believing in modern medicine, and the surgeon. Asking for their changed informations, they expected positive results from the operation. In this stage, an empathic attitude by the nurses is needed. Third, the attribute of the Stability Stage were relief, gratitude, difficulty with excretion, and pain. When they awoke from anesthesia, they felt relief because of a the end of the operation, but they experienced extreme pain, difficulty of excretion in bed. They accepted the changed environment and expected recovery. In this stage, support by the nurses is needed. Fourth, the attributes of the Independence Stage were freedom, exercise, nurturing, anxiety, and discomfort. When they ambulated and exercised, they experienced freedom. They showed exhibited weakness of the digestive organs and discomfort hospital's space, structure, and facilities, the delay of medical certificate issue the lack of prompt response by the medical agents. They ate nurturious food and felt anxiety on the end of hospital life and returning to their ordinary life. They showed the independence of overcoming their environment by increasing exercise and expected their discharges. In this stage, respect by the nurses is needed for the patients to, overcome their environment and prepare for their independence. Fifth, the attributes of the Extension Stage were pessimism, isolation, dissatisfaction, and pain. Accompanied injury and old age made their ward life extend to over seven weeks. They exhibited weariness, melancholy, skeptisis, general pessimistic feeling, and desperation caused by their isolated life. They experienced the digestive discomfort caused by the prolonged medication and psycological pain caused by long-time hospitalization. As a, result, their dissatisfaction on the human, physical, and systematic environments had been increased. They acquired critical power and sought for something to do spending their time. They expected vaguely about the returning of their ordinary life. In this stage, counseling is needed by the nurse to overcome positively their psychological, social, and physical problems. The process of the FNF patient's ward life starts from the dependent state, when they are hospitalized, and gradually progresses to self-fulfillment in order to keep independent life. As a result, the FNF patients showed "Response in Challenge" or "Adaptation in Conflict" through their experiences of social, physical, and psychological difficulties.

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Future Direction of National Health Insurance (국민건강보험 발전방향)

  • Park, Eun-Cheol
    • Health Policy and Management
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    • v.27 no.4
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    • pp.273-275
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    • 2017
  • It has been forty years since the implementation of National Health Insurance (NHI) in South Korea. Following the 1977 legislature mandating medical insurance for employees and dependents in firms with more than 500 employees, South Korea expanded its health insurance to urban residents in 1989. Resultantly, total expenses of the National Health Insurance Service (NHIS) have greatly increased from 4.5 billion won in 1977 to 50.89 trillion won in 2016. With multiple insurers merging into the NHI system in 2000, a single-payer healthcare system emerged, along with separation policy of prescribing and dispensing. Following such reform, an emerging financial crisis required injections from the National Health Promotion Fund. Forty years following the introduction of the NHI system, both praise and criticism have been drawn. In just 12 years, the NHI achieved the fastest health population coverage in the world. Current medical expenditure is not high relative to the rest of the Organization for Economic Cooperation and Development. The quality of acute care in Korea is one of the best in the world. There is no sign of delayed diagnosis and/or treatment for most diseases. However, the NHI has been under-insured, requiring high-levels of out-of-pocket money from patients and often causing catastrophic medical expenses. Furthermore, the current environmental circumstances of the NHI are threatening its sustainability. Low birth rate decline, as well as slow economic growth, will make sustainment of the current healthcare system difficult in the near future. An aging population will increase the amount of medical expenditure required, especially with the baby-boomer generation of those born between 1955 and 1965. Meanwhile, there is always the problem of unification for the Korean Peninsula, and what role the health insurance system will have to play when it occurs. In the presidential election, health insurance is a main issue; however, there is greater focus on expansion and expenditure than revenue. Many aspects of Korea's NHI system (1977) were modeled after the German (1883) and Japanese (1922) systems. Such systems were created during an era where infections disease control was most urgent and thus, in the current non-communicable disease (NCD) era, must be redesigned. The Korean system, which is already forty years old, must be redesigned completely. Although health insurance benefit expansion is necessary, financial measures, as well as moral hazard control measures, must also be considered. Ultimately, there are three aspects that we must consider when attempting redesign of the system. First, the health security system must be reformed. NHI and Medical Aid must be amalgamated into one system for increased effectiveness and efficiency of the system. Within the single insurer system of the NHI must be an internal market for maximum efficiency. The NHIS must be separated into regions so that regional organizers have greater responsibility over their actions. Although insurance must continue to be imposed nationally, risk-adjustment must be distributed regionally and assessed by different regional systems. Second, as a solution for the decreasing flow of insurance revenue, low premium level must be increased to an appropriate level. Likewise, the national reserve fund (No. 36, National Health Insurance Act) must be enlarged for re-unification preparation. Third, there must be revolutionary reform of benefit package. The current system built a focus on communicable diseases which is inappropriate in this NCD era. Medical benefits must not be one-time events but provide chronic disease management. Chronic care models, accountable care organization, patient-centered medical homes, and other systems that introduce various benefit packages for beneficiaries must be implemented. The reimbursement system of medical costs should be introduced to various systems for different types of care, as is the case with part C (Medicare Advantage Program) of America's Medicare system that substitutes part A and part B. Pay for performance must be expanded so that there is not only improvement in quality of care but also medical costs. Moreover, beneficiaries of the NHI system must be aware of the amount of their expenditure through a deductible payment system so that spending can be profiled and monitored. The Moon Jae-in Government has announced its plans to expand the NHI system; however, it is important that a discussion forum is created so that more accurate analysis of the NHI, its environments, and current status of health care system, can take place for reforming NHI.

Effects of Supplemental Lighting on Growth and Yield of Sweet Pepper (Capsicum annuum L.) in Hydroponic Culture under Low Levels of Natural Light in Winter (동계시설내 보광이 수경재배 착색단고추(Capsicum annum L.)의 생육에 미치는 영향)

  • Kim, Yong-Bum;Bae, Jong-Hyang;Park, Me-Hea
    • Horticultural Science & Technology
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    • v.29 no.4
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    • pp.317-325
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    • 2011
  • This study was conducted to examine the effect of supplemental lighting on the growth and yield of hydroponically grown sweet pepper (Capsicum annuum L. cv. sprit) under low levels of natural light in winter. The plants were treated with natural light only (control), 3-hour supplemental lighting before sunrise, after sunrise and after sunset with high pressure sodium (HPS, 400W). As the result of these three treatments, the supplemental lighting promoted photosynthesis in the low light intensity condition and particularly photosynthesis was more active right after sun rise in the morning, 1.5-$3.0{\mu}molCO_2{\cdot}m^{-2}{\cdot}s^{-1}$ comparing to those of supplemental lighting after sunset, 0.5-$1.5{\mu}molCO_2{\cdot}m^{-2}{\cdot}s^{-1}$. Transpiration rate and stomatal conductance sharply increased with supplemental lighting after sunrise then they decreased again after turning the lights off. Stomatal size was observed $32.2{\mu}m^2$ after supplemental lighting, whereas the size of the natural light was almost closed at $7.7{\mu}m^2$. The average plant height of sweet papper cv. spirit was 185 cm before sunrise, 188 cm after sunrise and 208 cm after sunset with supplemental lighting for 3hours while the control was 171 cm. With supplemental lighting a better number of fruit set per plant was measured 4.3 before and after sunrise, 3.7 after sunset but 2.6 in the control. Interestingly, there were no significant differences in the sugar content ($^{\circ}Brix$) degree between treatment of supplemental lighting, whereas slight differences between seasons were seen. The marketable fruit yield of sweet pepper (cv. spirit) was $116.0kg{\cdot}ha$ with supplemental lighting, whereas the control (natural light only) was $75.8kg{\cdot}ha$. Despite of spending electricity and depreciation cost, the economic analysis showed net income with supplemental lighting after sunrise was 51% higher than control treatment in cv. spirit.

A Research Survey on the Reserved Book System of Pilot Universities in Korea (실험대학 과제도서실 운영에 관한 조사연구)

  • 최달현
    • Journal of Korean Library and Information Science Society
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    • v.5
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    • pp.119-168
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    • 1978
  • This is a survey of the reserved book system in the pilot universities in Korea. We have surveyed only 22 university libraries among 29 pilot schools as of 1977, because of the differences in the library users, library organization, library facilities, and library materials between universities and colleges. In 1972, the Korean Ministry of Education developed a reformation plan for their higher education based on the teaching method of curriculum-oriented faculty instead of that of the faculty-oriented curriculum. The former puts emphasis on the cultivation of a student's thinking, creativity, and judgement through self-teaching to do a given assignment. The reserved book system in a college or university library is one of the most important methods necessary to accomplish the above educational aim. The survey used a questionnaire with 50 question on 28 items concerning the various aspects of the reserved book system in 22 pilot universities. the survey result discovered many problems needing correction. The following list describes the measures needed to correct the problems found in the pilot universities. 1. The management of a centralized reserved book system is much more effective and economical than the decentralized reserved book system when a university is located on the same campus. 2. In the university library, an independent reserved book department requires to gain the desired educational aims as compared with the reserved book room controlled by any other department in the library. 3. The reserved book system should not be adopted by all the departments at once but enlarged gradually, for it needs the understanding and support of faculty members and the university itself. 4. As competence is essential to the effective operation of the reserved book room, the university library should not place an unqualified person in charge of the reserved book department. 5. The librarian in charge of the reserved book department is required to do more professional works such as analysis of users, collection and analysis of syllabuses, maintenance of faculty member cooperation, establishment of measures to acquire unavailable materials, and drawing up an effective management plan. However, he is spending most of his time in clerical works, that is, non-professional works. 6. Three to five titles of each reserved book are considered reasonable and required materials should be shelved in proportion to the number of students, that is, one copy per eight or ten students if the materials are allowed to lend for two hours at a time. For the supplementary materials, the library needs to place two or three copies per subject. 7. Professors must select reserved books with care so that they can be used year after year. 8. Few universities are asking professors the number of class students and the date when the reserved material will no longer be needed on reserve. 9. The library should gather all the lists of reserved books from every professor at least three to five months before the courses open, because it takes a long time to obtain foreign materials. 10. It is desirable that the reserved book department should collect the lists and prepare the materials with promptness and consistency. 11. Instead of block buying, it is desirable to purchase reserved books at the time the library gets the reserved book list from the professors. The library should also inform faculty members whether it obtained each reserved book or not before the course open. 12. The library should make a copy of materials if a professor requires to reserve an out-of-print book or partial contents of a book, journal, and thesis. 13. An independent budger for reserved books from the budget for general materials is desired. 14. The shelf arrangement of reserved books by courses or professors under the same department is much more preferable than a classified arrangement. 15. While most of the universities adopted the open shelves system for all the reserved books, it is more effective and economical to take a compromise system, that is, closed shelves for requires materials and open shelves for supplementary materials. 18. Circulation of reserved books needs a different system between required materials and supplementary materials: two or three hours and/or overnight loan for the former and two and/or three days loan for the latter. 17. A reserved book room should be open a long time after class so that students can have sufficient time to use the room. 18. The library must take daily and monthly statistic as well as statistics on every aspect of the reserved book system in order that the library ma decide on policy and management of the reserved book room in collaboration with the university. Furthermore, regular reports on the use of the reserved book room should be made to the president and the executive council by the library to acquire their understanding and cooperation for the reserved book system. 19. Cooperation of faculty members is indispensable to the effective management of the reserved book department and it is desirable to make a committee which will fix various decisions about the system. Whenever the director of the library make his decision, he must consult with his staff in order to involve them earnestly in the operation of the system.

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Narrative Inquiry : Practical experience of an Introduction to Engineering (공학입문 교과 실행경험에 관한 내러티브 탐구)

  • Park, Kyung-Moon;Kim, Taehoon
    • 대한공업교육학회지
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    • v.34 no.2
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    • pp.128-160
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    • 2009
  • Narratively I have described interactions between two teachers performing an introduction to the engineering class with various situations such as place, teacher, student and subject. I have specifically illuminated a three-dimensional narrative inquiry space embracing the culture of the university, the college of engineering and the ABEEK(Accreditation Board of Engineering Education of Korea)program. The result of the study is as follows: First, in order to stimulate the students' motivation, the teachers have to make not only their class PowerPoint slides match the size of the classroom, but the content of the slides must be condensed with core concepts. They also should utilized some video clips to empower students' interest in the subject within their classrooms. Second, the teachers should do various class activities in the classroom. Instead of spending most of the class time with his/her explanation, it would be advantageous for the teachers to allow the students to perform a task in class. Third, the teachers should ask their students about assignments which are helping students' understanding of the subject and planning of their future. Lastly, the teachers need to design the mid-term and the final tests inducing the students' motivation. Those tests also must test students' creativity and insight of the subject. Thus, the test should consist of an interpretive exercise and an essay type of item thus reducing the multiple choice types of items. There are several limitations to the study. First it is difficult to generalize what we found here because it is a case study. Second, we could not study in depth the effect of the interaction between the two teachers who were performing the introduction to the engineering course during the academic semester. Third, this study just probed into the difficulties of teaching the course. Hence, we have to understand more by focusing on each issue such as adapting to a new learning environment as a student from abroad, a practical experience boosting the students' interest in the introduction to the engineering course, also a practical experience on process based learning-versus result based learning, and an effective management of the student team presentation etc.

The Adaptive Personalization Method According to Users Purchasing Index : Application to Beverage Purchasing Predictions (고객별 구매빈도에 동적으로 적응하는 개인화 시스템 : 음료수 구매 예측에의 적용)

  • Park, Yoon-Joo
    • Journal of Intelligence and Information Systems
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    • v.17 no.4
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    • pp.95-108
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    • 2011
  • TThis is a study of the personalization method that intelligently adapts the level of clustering considering purchasing index of a customer. In the e-biz era, many companies gather customers' demographic and transactional information such as age, gender, purchasing date and product category. They use this information to predict customer's preferences or purchasing patterns so that they can provide more customized services to their customers. The previous Customer-Segmentation method provides customized services for each customer group. This method clusters a whole customer set into different groups based on their similarity and builds predictive models for the resulting groups. Thus, it can manage the number of predictive models and also provide more data for the customers who do not have enough data to build a good predictive model by using the data of other similar customers. However, this method often fails to provide highly personalized services to each customer, which is especially important to VIP customers. Furthermore, it clusters the customers who already have a considerable amount of data as well as the customers who only have small amount of data, which causes to increase computational cost unnecessarily without significant performance improvement. The other conventional method called 1-to-1 method provides more customized services than the Customer-Segmentation method for each individual customer since the predictive model are built using only the data for the individual customer. This method not only provides highly personalized services but also builds a relatively simple and less costly model that satisfies with each customer. However, the 1-to-1 method has a limitation that it does not produce a good predictive model when a customer has only a few numbers of data. In other words, if a customer has insufficient number of transactional data then the performance rate of this method deteriorate. In order to overcome the limitations of these two conventional methods, we suggested the new method called Intelligent Customer Segmentation method that provides adaptive personalized services according to the customer's purchasing index. The suggested method clusters customers according to their purchasing index, so that the prediction for the less purchasing customers are based on the data in more intensively clustered groups, and for the VIP customers, who already have a considerable amount of data, clustered to a much lesser extent or not clustered at all. The main idea of this method is that applying clustering technique when the number of transactional data of the target customer is less than the predefined criterion data size. In order to find this criterion number, we suggest the algorithm called sliding window correlation analysis in this study. The algorithm purposes to find the transactional data size that the performance of the 1-to-1 method is radically decreased due to the data sparity. After finding this criterion data size, we apply the conventional 1-to-1 method for the customers who have more data than the criterion and apply clustering technique who have less than this amount until they can use at least the predefined criterion amount of data for model building processes. We apply the two conventional methods and the newly suggested method to Neilsen's beverage purchasing data to predict the purchasing amounts of the customers and the purchasing categories. We use two data mining techniques (Support Vector Machine and Linear Regression) and two types of performance measures (MAE and RMSE) in order to predict two dependent variables as aforementioned. The results show that the suggested Intelligent Customer Segmentation method can outperform the conventional 1-to-1 method in many cases and produces the same level of performances compare with the Customer-Segmentation method spending much less computational cost.

Agency Costs of Clothing Companies with Famous Brand (유명 의류 상호 기업의 대리인 비용에 관한 연구)

  • Gong, Kyung-Tae
    • Management & Information Systems Review
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    • v.36 no.4
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    • pp.21-32
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    • 2017
  • Motivated by the recent cases of negligent social responsibility as manifested by foreign luxury fashion brands in Korea, this study investigates whether agency costs depend on the sustainability of different types of corporate governance. Agency costs refer either to vertical costs arising from the relationship between stockholders and managers, or to horizontal costs associated with the potential conflicts between majority and minority stockholders. The firms with luxury fashion brand could spend large sums of money on maintenance of magnificent brand image, thereby increasing the agency cost. On the contrary, the firms may hold down wasteful spending to report a gaudily financial achievement. This results in mitigation of the agency cost. Agency costs are measured by the value of the principal component. First, three ratios are constructed: asset turnover, operating expense to sales, and earnings before interest, tax, and depreciation. Then, the scores of each of these ratios for individual firms in the sample are differenced from the ratios for the benchmark firm of S-OIL. S-OIL was designated as the best superior governance model firm for 2013 by CGS. We perform regression analysis of each agency cost index, luxury fashion brand dummy and a set of control variables. The regression results indicate that the agency costs of the firms with luxury fashion brand exceed those of control group in the fashion industry in the part of operating expenses, but the agency cost falls short of those of control group in the part of EBITD, thus the aggregate agency costs are not differential of those of the control group. In sensitivity test, the results are same that the agency cost of the firms are higher than those of the matching control group with PSM(propensity matching method). These results are corroborated by an additional analysis comparing the group of the companies with the best brands with the control group. The results raise doubts about the effectiveness of management of the firms with luxury fashion brand. This study has a limitation that the research has performed only for 2013 and this paper suggests that there is room for improvement in the current research methodology.

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Local Autonomy, National Economy and Local Public Finance (지방자치(地方自治)와 국민경제(國民經濟) 및 지방재정(地方財政))

  • Lee, Kye-sik
    • KDI Journal of Economic Policy
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    • v.13 no.2
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    • pp.41-67
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    • 1991
  • Local autonomy of Korea's lower-level local council has been reinstated following elections last March for the first time in thirty years. Last June, we had elections for the upper-level local council. Mayors, governors, and administrative chiefs of cities, provinces and other local government bodies are slated for elections in the first half of next year. The impacts of local autonomy are taking effect in not only the political sphere, but also the administrative and economic spheres. In fact, it seems that some modification of all economic policy making and administration is inevitable. Since the initiation of local autonomy, in order to make the economy work more efficiently, it has become quite important to examine the impact of local autonomy on the national economy. The areas of local autonomy include independent legislative power, administrative power, organizational power, and most important of all, the independent public financial power of the local governments. The purpose of this paper is to examine the effects of local autonomy on the national economy and ways of enhancing the role of local public finance to facilitate settlement and development of the local autonomy system. Local autonomy will contribute to the continuous growth of our economy, allow balanced development, and generate greater efficiency. However, local autonomy can also incur economic costs causing at times short-term price instability, inefficient resource allocation, through tax competition and tax exporting, and insolvency of local government due to abusive fiscal operation. To reduce these side effects, different alternatives must be considered. Local autonomy systems generally provide more efficient resource allocation than centralization. But in the model used in Chapter 3 of this paper, the relative efficiencies of both local autonomy and centralization are determined by comparing the elasticity of substitution between national public goods and local public goods. If the elasticity of substitution is bigger than one, centralization provides a more efficient resource allocation. The development of local autonomy could be attained through democratization of the local public finance system including the following three propositions. I) The independence of public financial power of local governments should be established over central government. Furthermore, a democratically operated scheme of intergovernmental fiscal coordination is especially necessary. 2) In the operation of local finance, direct democracy is needed to induce the voluntary participation of local residents. The residents can take part in planning both the local budget and the development of the community. To attain this goal, all the results of local finance operations should be made public. 3) Among economic ill-effects of the local autonomy system, the most serious one is the possibility of insolvency of local governments. Therefore, measures to limit abusive spending by the local governments should be introduced, such as the fiscal restraints system adopted in the United States.

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The changes of economic though (The trial of supply-side economics) (경제사상의 변화 (공급측면 경제학의 시험))

  • 서홍석
    • Journal of Applied Tourism Food and Beverage Management and Research
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    • v.8
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    • pp.89-121
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    • 1997
  • Many of the measures and policies advocated by supply-siders, such as lower taxation, less government intervention, more freedom from restrictive legislation and regulation, and the need for increased productivity can be found in writing the classical economist. Nor is supply-side economics a complete divorcement from Keynesian analysis. In both camps the objectives are the same-high level employment, stable prices and healthy economic growth, the means or suggestions for attaining the objectives, however, differ. Consequently, recommended economic policies and measures are different. keynesians rely primarily on the manipulation of effective demand to increase output and employment and to combat inflation. They assume ample resources to be available in order that supply will respond to demand. The supply-siders emphasize the need to increase savings, investment, productivity and output as a means of increasing income. Supply-siders assume that the increase in income will lead to an increase in effective demand. Keynesians suggest that savings, particularly those not invested, dampen economic activity. Supply-siders hold that savings, or at least an increase in after-tax income, stimulates work effort and provides funds for investment. Perhaps keynesians are guilty of assuming that most savings are not going to be invested, whereas supply-siders may erroneously assume that almost all savings will flow into investment and/ or stimulate work effort. In reality, a middle ground is possible. The supply-siders stress the need to increase supply, but Keynes did not preclude the possibility of increasing economic activity by working through the supply side. According to Keynes' aggregate demand-aggregate supply framework, a decrease in supply will increase output and employment. It must be remembered, however, that Keynes' aggregate supply is really a price. Lowering the price or cost of supply would there by result in higher profit and/ or higher output. This coincides with the viewpoint of supply-siders who want to lower the cost of production via various means for the purpose of increasing supply. Then, too, some of the means, such as tax cuts, tax credits and accelerated depreciation, recommended by suply-siders to increase productivity and output would be favored by Keynesians also as a means of increasing investment, curbing costs, and increasing effective demand. In fact, these very measures were used in the early 1960s in the United State during the years when nagging unemployment was plaguing the economy. Keynesians disagree with the supply-siders' proposals to reduce transfer payments and slow down the process of income redistribution, except in full employment inflationary periods. Keynesians likewise disagree with tax measures that favored business as opposed to individuals and the notion of shifting the base of personal taxation away from income and toward spending. A frequent criticism levied at supply-side economics is that it lacks adequate models and thus far has not been quantified to any great extent. But, it should be remembered that Keynesian economics originally was lacking in models and based on a number of unproved assumptions, such as, the stability of the consumption function with its declining marginal propensity to consume. Just as the economic catastrophe of the great depression of the 1930s paved the way for the application of Keynesian or demand-side policies, perhaps the frustrating and restless conditions of the 1970s and 1980s is an open invitation for the application of supply-side policies. If so, the 1980s and 1990s may prove to be the testing era for the supply-side theories. By the end of 1990s we should have better supply-side models and know much more about the effectiveness of supply-side policies. By that time, also, supply-side thinking may be more crystallized and we will learn whether it is something temporary that will fade away, be widely accepted as the new economics replacing Keynesian demand analysis, or something to be continued but melded or fused with demand management.

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Relationship between Sleep Insufficiency and Excessive Daytime Sleepiness (수면 부족과 과도한 주간졸림증의 관련성)

  • Choi, Yun-Kyeung;Lee, Heon-Jeong;Suh, Kwang-Yoon;Kim, Leen
    • Sleep Medicine and Psychophysiology
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    • v.10 no.2
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    • pp.93-99
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    • 2003
  • Objectives:Sleep loss and excessive daytime sleepiness may have serious consequences, including traffic and industrial accidents, decreased productivity, learning disabilities and interpersonal problems. Yet despite these adverse effects, there are few epidemiological studies on sleep loss and daytime sleepiness in the general population of Korea. This study investigates the number of people who suffer from sleep insufficiency, how much recovery sleep occurs on weekends, and the relationship between the amount of recovery sleep and daytime sleepiness. Methods:A total 164 volunteers, aged 20 and over, were recruited by advertisement. The subjects were workers and college students living in Seoul, Korea. Subjects were excluded if they were aged over 60;if they had medical, neurological, psychiatric or sleep disorders that could cause insomnia or daytime sleepiness;if they were not following a regular sleep schedule;if they traveled abroad during the study;or if they did not leave home to work or were shift workers. They were interviewed and given a sleep log to complete on each of 14 consecutive mornings. They also completed the Epworth Sleepiness Scale (ESS) at noontime on the last day of the second week. All statistical data were analyzed by t-test, $X^2$-test or ANOVA, using SPSS/PC+. Results:The results showed that the subjects woke up at 6:50 (${\pm}1$:16) on weekdays, 7:09 (${\pm}1$:29) on Saturdays, and 8:12 (${\pm}1$:39) on Sundays and holidays. They took more frequent and longer naps on Sundays than on weekdays and Saturdays. The mean sleep duration was 6h 35 min. on week nights, with a mean increase of about 1h on weekends. Only 9.1% of the subjects spent more than 8h in bed on week nights, with 67% spending less than 7h, and 49.4% reported recovery sleep of more than 1h on Sundays. The subjects who reported recovery sleep of more than 2h on Sundays, showed significantly more excessive daytime sleepiness than those who reported less than 30 min (F=2.62, p<.05). Conclusions:These findings suggest that sleep insufficiency and excessive daytime sleepiness are relatively common in Korea, and that the people who get insufficient sleep on weekdays try to compensate for sleep loss with oversleeping and daytime napping on Sundays and holidays. It appeared that daily sleep insufficiency had a cumulative effect and increased daytime sleepiness.

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