The purposes of this research were to add to the developing knowledge base about the burden and social support of grandmothers involved with caring grandchildren, and to examine whether a significant relationship exists between their burden and social support perceived by the grandmothers. A convenience sample of 102 grandmothers was recruited from five collective apartment areas at a small city in Korea. The criteria of selection of sample were that the grandmothers were raising their grandchildren under the age of 36 months for 3 months or longer at own or gandchildren's home. The instruments used were a 15-item multidemensional burden scale and a 8-item social support scale. Both scales were self report, five point Likert type scales. The higher the score, the higher the degree of burden and social support. Data was collected by two prepared research assistants visiting subjects' home from December 10, 1998 to March 20, 1999. The collected data were analysed using mean, t-test, one-way ANOVA, and Pearson's correlation coefficient computed by SPSS software. The results were as follows. 1. In the age distribution of grandmothers, the over half of subjects(58.8%) were under 60 years old. The majority(69.6%) of subjects were married at time of data collection. 79(77.5%) of the sample reported that their perceived health status was good or over. 2. The burden of the grandmothers was not scored high, and the item means on burden scale were ranged from 2.26 to 4.19 out of 5. 'Short of private time'(4.19) had the highest score, followed by 'fatigue'(3.92), 'short of rest'(3.75), and 'short of contact with friends and neighbors'(3.62). The lowest item was 'family doesn't help me'(2.26), and followed by 'family doesn't understand me'(2.33), 'angry with family' (2.43), and 'angry while caring for grandchild'(2.60). 3. There were significant relationships between the burden and present health status(p<.01), childcaring confidence(p<.01), and motive of caring(p<.01). 4. The score of social support, was ranging from 3.61 to 4.01 out of 5. 5. The relationship between burden and social support was found to be correlated negatively. The relationship was statistically significant(γ= - .2833, p<.001). In conclusion, it was found that the burden was not high and burden of grandmothers caring grandchildren was correlated negatively to social support. Therefore, these results provide a basis for developing a nursing intervention to reduce the burden of grandmothers.
Purpose: The purposes of this study were to examine health-related quality of life and to identify the mediating effect of resilience on the relationship among uncertainty, distress, and health-related quality of life in lung cancer patients. Methods: A total of 149 lung cancer patients visiting the D hospital in B city completed a questionnaire, including demographic and disease-specific characteristics, uncertainty, distress, resilience, and health-related quality of life. Data were analyzed with descriptive analysis, t-tests, ANOVA, and multiple regression analyses via SPSS 24. Results: Health-related quality of life was $81.00{\pm}21.39$ (range 0~136) in lung cancer patients. In the results of hierarchical regression analyses, the health-related quality of life was associated with education, uncertainty, distress, and resilience. However, there was no mediating effect of resilience on the relationship among uncertainty, distress, and health-related quality of life. Conclusion: Lung cancer patients with high uncertainty and distress and low resilience could experience low health-related quality of life. In order to reduce uncertainty and distress, it is necessary to provide more detailed, systematic information and support, while reinforcing positive thinking.
Background: Scabies is a contagious skin infestation primarily observed in poor or overcrowded environments. However, an individual may be affected regardless of hygiene and/or socioeconomic status, and/or age. Objective: To investigate the characteristics and epidemiology of scabies in patients visiting a single tertiary hospital in Jeonbuk province. Methods: We retrospectively reviewed the medical records of 194 patients with scabies who visited the Dermatology clinic at Wonkwang University Hospital between June 2015 and May 2018. Results: Of the 194 patients investigated, 82 (42.3%) were men and 112 (57.7%) were women. The mean age of men was 46.3 years and that of women was 60.1 years. Scabies was diagnosed in patients most commonly in autumn. The most common symptom of scabies was the occurrence of papules (83.5%) followed by the presence of burrows (23.2%). The most common route of infection was a nursing hospital (26.3%), except unknown (29.4%). Medications used to treat scabies included 5% permethrin cream, 10% crotamiton ointment, and 1% gamma benzene hexachloride lotion. The mean duration of treatment was 33.9 days using 5% permethrin cream, 34.8 days using 10% crotamiton ointment, and 34.6 days using 1% gamma benzene hexachloride lotion. Conclusion: This study could help in the prevention and management of scabies, by guiding clinicians in choosing optimal therapeutic agents based on patients' condition.
Purpose: The severity classification in association with the time of visit to and the appropriateness of using a public ambulance for visiting the emergency department (ED) have not been thoroughly evaluated, and we aimed to evaluate these aspects. Methods: In this descriptive research, we retrospectively reviewed and analyzed the medical records of patients who visited the ED of the B General Hospital, Seoul from January to December 2019. Results: Of the 54,297 patients who were included in the analysis, 34,629 (63.8%) and 14,065 (25.9%) visited the ED directly and through public ambulances, respectively; 10,328 (73.4%) patients who used public ambulances were discharged home. In the daytime and nighttime, 24,891 (45.8%) and 29,406 (54.2%), respectively, visited the ED. The mean length of ED stay (LoS) of emergency and non-emergency patients was 326 and 159 minutes, respectively, and of patients classified as Korean Triage and Acuity Scale levels 1 and 2 was 427 and 430 minutes, respectively, which was longer than the total of 236 minutes. Conclusion: Patients who visited the ED using public ambulances constituted nearly 25% of all ED visits, and more than 70% of these patients were discharged home. Patients with high severity had a longer mean LoS, and daytime ED visits were characterized by higher numbers and severity of patients than nighttime ED visits.
Purpose: The purpose of this study was to describe the characteristics of children who visited the pediatric emergency department (PED) following an accident. Method: Data were obtained from the medical records of 4,010 children who visited the PED from January 1, 2004 through December 31, 2006. Data were analyzed using SPSS WIN 13.0 version. Results: The percentage of children who visited the PED for treatment following an accident was 14.9%. There were more boys (63.5%) than girls. The largest age group for children visiting the PED was preschool aged children. Slip downs were the most frequent accident (37.1%). The face was the most frequently injured area of the body (26.0%). Most (93.3%) of the children who visited the PED were classified as non-emergency, 6.5% as emergency and 0.2% as urgent. About 70.0% of children were examined and 50% of children were medicated. Fifty percent stayed in the PED department for less than 2 hours, and 88.0% of children were discharged to home. Nine percent were admitted, and 2.2% were transferred to other hospitals. Conclusion: The results of this study suggest the need for accident prevention education for parents, and the need to develop effective education for clinical nurses working in PED.
Park, Eun-Sook;Lee, Sook-Ja;Park, Young-Ju;Ryu, Ho-Sihn
Journal of Home Health Care Nursing
/
v.7
no.1
/
pp.58-72
/
2000
This study was an attempt to encourage the development of a rehabilitation delivery system and programs as a substitute service for hospitalization on the case of car accident patients, such as hospital based home health care nursing services. Various substitute services for hospitalization are required to curtail the length of stay for inpatients who were hospitalized with car accident compensation insurance. It focused on developing an estimation an early discharge day for car accident inpatients based on detailed statements of treatment for 111 inpatients who were hospitalized at the General Hospital in 1997. This study had four specific purposes as follows. First. to find out the utilization of medical services. Second, to estimate the time of early discharge and income increasing effect based on early discharge for those patients. Third, to identify the factors affecting total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze the length of stay and medical expenditure for inpatients who were hospitalized due to car accidents, the authors conducted micro- and macro-analysis of medical and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria, such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the test consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, and stable conditions. In addition to identifying variables affecting medical expenditure, and the length of stay and income effect due to early discharge day, the data was analyzed with a multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study were as follows. First. the mean length of stay was 50.3 days. whereas the mean length of stay due to early discharge was 34.3 days at the hospital. The estimation of time of early discharge depended on the length of stay. The longer the length of stay, the longer the length of time of early discharge : for instance a length of stay under 10 days was estimated as correlating to a mean length of stay of 6.6 days and early discharge of 6.5. The mean length of stay was 217.4 days and the time of early discharge was 110.1 respectively. The mean medical expenditure per day was found to be 169.085 Won and the mean medical expenditure per day showed negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to being discharged 16 days early was around 2,244,000 won per bed. However. this sum does not represent the real benefits resulting from early discharge, but rather the income increasing amount without considering medical prime cost in the general hospital. Therefore, further analysis is required on the cost containments and benefits as turn over rate per bed as the medical prime costs. The length of stay was most significant and was positive to the total medical expenditure, as expected. Surgery and patient's residential area was also an important variable in explaining medical expenditure. The level of complications was the most significant variable in explaining the length of stay. There was a high level for need a home health care nursing service which further supports early discharge for accident patients. In addition, when the patient was discharged. they needed follow up care for complications suffered during the car accident. $86.8\%$ of discharged patients responded that they needed home health services after early discharge. From these research findings, the following suggestions have been drawn. Strategies on a health care delivery system must be developed in order to focus on the consumer's needs and being planned for 21 century health policy in Korea. Community based intermediate facilities or home health care should be developed for rehabilitation services as a substitute for hospitalization in order to shorten the length of stay would be. A hospital based home health care nursing service. it would be available immediately to utilize by patients who want rehabilitation services as a substitute for hospitalization with the cooperation of car insurance companies.
This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.
Background: Hwa-Byung is known as a specific Korean cultural syndrome which corresponds to DSM-IV(MMPI). Some Korean women who have experienced heart aching anger(Hwa-Byung) complain physical pains as well as psychological problems. As for these physical pains, upper limb arthropathy(e.g. golf elbow pains, tennis elbow pains, or shoulder-joint pains) have not been paid attentions. In spite of not having done her excessive physical endeavor or exercise, some Korean middle aged women complain those arthropathy pains. And they go round orthopedics, pain clinics, and oriental medicine clinics. Purpose: This study was practiced in Severance Oriental Medicine Clinic. The oriental medicine doctor had a question about the major origin of upper limb pains which were not caused by excessive physical endeavor. To answer the question, this study has been practiced. In the process of interview with some those women, the major cause of those syndromes has been revealed as Hwa-Byung. The purpose of this study is to discover the meanings of the women's life who have been experienced Hwa-Byung with upper limb arthropathy. Results: These upper limb arthropathy can be explained by meridian theory. Shoulder-joint pain and golf elbow with Hwabyung can be explained by Heart meridian of hand-shoyin and the points of these pains are in the flow of this meridian. Tennis elbow with Hwabyung can be explained by Small intestine meridian of hand-taiyang and this point is in the flow of this meridian. The results of interview with 9 middle aged women was analyzed and interpreted according to Spradley's method of ethnography. The analysis revealed three core cultural themes : 1) There are certainly external cause to provoke Hwa-Byung. A patricentric family system, husband's playing around with another woman, cruel treatment by husband's family, or financial failure may be present anteriorly. 2) The chief existing condition is the discord between husband and wife. The stoppage of mutual communication, lacking in understanding, unfeeling, heartless, or unsympathetic is an major phenomenon of married life. So the important factor is not the sexual relations or problems but the discords of communication. 3) The feeling of anger, the sense of nihility, the desire to escape, and the effort to forgiveness coexist together. At a glance, they seemed to be a process. For example, anger seemed to present at first, then nihility seemed at second, then escape seemed at third, and then forgiveness seemed at last. But at point of visiting clinic to be treated, they are mixed up together as if in a jumble.
The objectives of this study are : 1) To understand self-care ability, living habits, utilization patterns of medical facililties for the elderly in Puk-Cheju county which has the highest percent age of senior citizens among Cheju rural community: 2) To identify factors which influence living quality and long life for the eldely 3) To develop health care service with a view to guaranteering living quality The eldely population of Puk-Cheju county was $10.8\%$ in 1995. It will be increasing and is projeted $23.0\%$ by 2030. The result indicated that utilizations rate by out-patient were 5.89 claims and utilizations rate by in-patient were 0.17 claims per person. The highest disease among respondents were disease of musculoskeletal system and connective tissue. A total of 310 elderlys were responded to analyze self-care ability and health behavior. The most important factors of long life were to have peaceful mind$(50.0\%)$. The common disease of acute and chronic disease was musculoskeletal system disease. $66.8\%$ of respondents went to hospital and local clinic when they got sick. The most needed health care service was home visiting service among public health center, representing $31.4\%$. The repondent's self-care ability and self-efficacy were relatively superiority. A total of 92 elderlys were conducted the intelligence test for the rate of dementia and their average age was 74.3. The result of Minimental State Scale indicated that 25% of respondents were suspected to be dementia. The followings are recommendations based on the survey result. 1) Concidering every conditions of self-care ability and health status for elderly. It is important to embody appopriate health care service. 2) Considering concrete method, it is necessary to establish health service, which match health status and self-care ability, and various planning for sepecial facilities for the elderly. 3) It is desiable to make actual programs for the elderly in each community level. 4) It must be develop the better use of volunteers and programs for prevention of dementia. Finally, Concerning the orgarnization of public health center, community health center need to be reorganized for health service for the elderly. It is important to develop and operate health promotion for the elderly, and it is necessary to form the foundation for the support of facilities equipments. This contribute to promote health status for the rural elderly.
Mother and infant relationship has a great influence on child's developments. Expecially, mother and infant relationship is affected by mother and infant interactions during one year after birth and an omen of mother-infant interaction after birth is mother-fetus interaction. This study was conducted to develop mother-fetus interaction promotion program of talking and tactual stimulation aimed at enhancing sensitivity of primiparas and to evaluate the effect of the nursing intervention program on mother-fetus interaction and mother-infant play interaction. Non-eguivalent control group posttest design was used, and Blumer's symbolic interaction theory and Barnard's mother-infant interaction model was used a conceptual framework of this study. Fifty primiparas and infant(26 mother-infant dyads for intervention group and 24 dyads for control group) were recruited from three general hospital and an OBGY clinic located in Kwang Nung city. Data was collected from January 30th to December 20th in 2001. For the intervention group, programed education which focused on mother-fetus interaction in the 1st trimester. Telephone counselling was provided with interval of two weeks. For two groups, home visiting for data collection of mother- fetus interaction was conducted at 36 to 38 weeks of gestational age. And mother-infant play interactions were assessed at 4 to 6 weeks after birth using videotapes. Play situations were videotaped and two trained observers analyzed the tapes. The data were analyzed using chi-square test and Fisher's Exact Test to test the equivalence of two groups, and the effect of intervention progrom was determined with t-test and Wilcoxon Rank Sum test. The results were as follows: 1. The significant difference was found in mother-fetus interaction between two groups(t=2.085, P=0.0425). It indicated that intervention progrom was effective in improving mother-fetus interaction. 2. The significant difference was found in mother-infant play interaction between two groups(W=347.5, P=0.0001). In subscale analysis, three subscales showed significant differences between the groups: interactional behavior of mother(t=5.921, P=0.0001), interactional behavior of infant(t=5.736, P= 0.0000), and synchronic interactional behavior of mother and infant(t=7.940, P= 0.0000). In conclusion, this study has shown that the applied nursing intervention aimed at enhancing sensitivity of primiparas promoted mother-fetus interaction and mother-infant play interaction. Therefore, this study suggests that this nursing interventions to increase maternal sensitivity to the fetus's movement should be broadly applied to primiparas, which can be beneficial for formation of mother - infant relationship, and for promotion the social, affective, and cognitive developments of their children.
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