• 중환자간호학회지
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• 제15권3호
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• pp.115-127
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• 2022

Purpose : This study aimed to investigate sleep parameters and to identify differences according to respiratory support therapy, sedation, and pain medication in intensive care unit (ICU) patients. Methods : In this observational study, sleep parameters were measured using actigraphy. We observed 45 sleep events in 30 ICU patients receiving respiratory support therapy. We measured the sleep parameters, time, efficiency, and wakefulness after sleep onset (WASO). The differences in sleep parameters according to the respiratory support therapy were analyzed using the Mann-Whitney U test. Results : The average daily sleep time of the participants was 776.66±276.71 minutes, of which more than 60% accounted for daytime sleep. During night sleep, the duration of WASO was 156.93±107.91 minutes, and the frequency of WASO was 26.02±25.82 times. The high flow nasal cannula (HFNC) group had a significantly shorter night sleep time (𝑥²=7.86, p =.049), a greater number of WASO (𝑥²=5.69, p =.128), and a longer WASO duration (𝑥²=8.75, p =.033) than groups of other respiratory therapies. Conclusion : ICU patients on respiratory support therapy experienced sleep disturbances such as disrupted circadian rhythm and sleep fragmentation. Among respiratory support regimens, HFNC was associated with poor sleep parameters, which appears to be associated with the insufficient use of analgesics. The results of this study warrant the development of interventions that can improve sleep in ICU patients receiving respiratory support, including HFNC.

• 인간식물환경학회지
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• 제23권5호
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• pp.565-576
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• 2020

Background and objective: The elderly living in homeless living facilities for a long time suffer from various mental health problems. This study aims to determine the psychological, emotional, and social effects of a horticultural therapy program composed of gardening activities, which was designed based on the semantic structures of life for the homeless elderly living in the facilities for a long time. Methods: A total of 12 subjects (6 in the control group and 6 in the experimental group) participated in the study. The horticultural therapy program consisted mainly of gardening activities, and a total of 16 sessions were conducted once a week for 16 weeks, 60-90 minutes per session. The subjects were tested to evaluate their self-esteem, depression, and horticultural activities. The data were analyzed using the Mann-Whitney U test, Wilcoxon rank test, and Friedman test, which were nonparametric tests, conducted at a 95% significance level. Results: First, in the case of self-esteem, a significant difference was found between the groups, 20.00 points (SD = 5.69) in the control group, and 25.50 points (SD = 3.73) in the experimental group (p = .034). Second, in the case of depression, no statistically significant difference was found in the posttest. Finally, in the case of the horticultural activity evaluation, the scores of most variables gradually and significantly increased during the program [Verbal interaction during activity (p = .006), Self-concept and identity (p = .006), Need-drive adaptation (p < .001), Interpersonal and social relations (p < .001)]. Conclusion: These results support that the horticultural therapy program could help the elderly improve psychological relaxation, emotional stability, and social relationships. In order to generalize the results, it is suggested to increase the number of subjects or conduct additional repetitive experiments in further research.

• Journal of Yeungnam Medical Science
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• 제39권1호
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• pp.31-38
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• 2022

Background: To prepare for future work stoppages in the medical industry, this study aimed to identify the effects of healthcare worker strikes on the mortality rate of patients visiting the emergency department (ED) at six training hospitals in Daegu, South Korea. Methods: We used a retrospective, cross-sectional, multicenter design to analyze the medical records of patients who visited six training hospitals in Daegu (August 21-September 8, 2020). For comparison, control period 1 was set as the same period in the previous year (August 21-September 8, 2019) and control period 2 was set as July 1-19, 2020. Patient characteristics including age, sex, and time of ED visit were investigated along with mode of arrival, length of ED stay, and in-hospital mortality. The experimental and control groups were compared using t-tests, and Mann-Whitney U-test, chi-square test, and Fisher exact tests, as appropriate. Univariate logistic regression was performed to identify significant factors, followed by multivariate logistic regression analysis. Results: During the study period, 31,357 patients visited the ED, of which 7,749 belonged to the experimental group. Control periods 1 and 2 included 13,100 and 10,243 patients, respectively. No significant in-hospital mortality differences were found between strike periods; however, the results showed statistically significant differences in the length of ED stay. Conclusion: The ED resident strike did not influence the mortality rate of patients who visited the EDs of six training hospitals in Daegu. Furthermore, the number of patients admitted and the length of ED stay decreased during the strike period.

• 여성건강간호학회지
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• 제28권1호
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• pp.18-26
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• 2022

Purpose: This study investigated whether parenting stress, work-family conflict, resilience affect retention intent in Korean nurses returning to work after parental leave. Methods: The participants in this study were 111 nurses recruited from 10 hospitals in Korea, who were working after formal parental leave from their hospitals. Collected data were analyzed using descriptive statistics, the t-test, analysis of variance, the Mann-Whitney U-test, Pearson correlation coefficients, and hierarchical regression. Results: Retention intention (33.80±7.78), parenting stress (101.70±17.57), and resilience (85.02±12.75) were at greater than moderate levels and a midpoint level of work-family conflict (29.63±7.00) was noted in this sample of mostly women nurses in their 30s. The factors affecting retention intent were parental leave duration, the number of times that participants had taken parental leave, health condition, work-family conflict, and resilience. The total explanatory power of these variables was 36.7%. Retention intent had a negative correlation with parenting stress and work-family conflict. Conversely, retention intent was positively correlated with resilience. Conclusion: This study supports the need for flexible adjustment of returning nurses' working hours and family-friendly policies to promote balance between work and family. It is also necessary to develop and apply measures that boost resilience and support health improvement for nurses returning to work.As nurses are often assigned to new areas of work upon return, training programs to aid their adjustment may also be helpful.

• Investigative Magnetic Resonance Imaging
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• 제18권3호
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• pp.232-243
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• 2014

목적: 축추이하 경추 손상시 발생하는 연속적, 비연속적 연골하골 압박손상의 빈도와 원발부위 손상 패턴에 대해 알아보고자 하였다. 대상과 방법: 축추이하 경추 손상이 있는 환자 47명의 전산화 단층촬영, 자기공명영상, 의무기록을 후향적으로 검토하여 연속적, 비연속적 연골하골 압박손상의 발생유무와 수, 레벨, 손상 부위를 기록하였다. 원발부위 손상 패턴을 알아보기 위하여 손상된 원발부위의 레벨, 수, 손상 형태, 전/후방 추간판인대복합체의 손상유무, 후방인대복합체의 손상유무, 척수 손상유무를 분석하고 손상 기전을 분석하였다. 분석된 원발손상 패턴과 손상기전은 Mann-Whitney U test, Pearson's chi square test, Fisher's exact test의 통계적 기법으로 연골하 압박손상의 발생유무와 연관성을 조사하였다. 결과: 총 18명에게서 (18/47, 38.29%) 연골하 압박손상이 발생했으며 그 중 9명은 원발부위와 인접하여 연속적으로, 다른 9명은 원발부위와 떨어져 비연속적으로 발생하였다. 3번 흉추에 가장 흔하게 발생하였고 (15/47, 31.91%), 세 개의 레벨에 걸쳐있는 경우가 가장 많았다 (6/18, 33.33%). 모든 연골하 압박손상은 척추체의 전상방 부위나 상종판 주변에 발생하였으며 강한 외력의 외상과 연관되었다. 연골하 압박손상의 발생은 원발부위의 손상형태와 후방인대복합체의 손상과 통계학적으로 유의한 연관성을 보였다. 비연속적 연골하 압박손상은 연속적 연골하 압박손상에 비해 비교적 상부 경추에 원발 손상부위가 있고 후방추간판인대 복합체의 손상을 동반하는 경우가 통계학적으로 유의하게 많았다. 그외 분석한 다른 인자들은 통계학적으로 유의한 결과를 보이지 않았다. 결론: 이차성 연골하 압박손상은 흔하며 강한 외력에 의한 굴곡압박성 경추 외상과 관련 있을 것이다.

• Clinical and Experimental Reproductive Medicine
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• 제30권1호
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• pp.95-103
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• 2003

Objective : To assess and compare the clinical outcomes between GnRH agonist long protocol and GnRH antagonist short protocol in oocyte donation program. Materials and Methods: Of total 18 oocyte donation cycles, controlled ovarian hyperstimulation (COH) were performed with GnRH agonist long protocol and GnRH antagonist short protocol in initial 9 cycles and later 9 cycles, respectively. Oral estradiol valerate and progesterone in oil we re administrated to all recipients for endometrial preparation. Oral estradiol administration was started from donor cycle day 1 after full shut down of gonadal axis with GnRH agonist in patients with ovarian function. Progesterone was injected from oocyte retrieval day of donor initially, then continuously till pregnancy 12 weeks if pregnancy was ongoing. We compared the parameters of clinical outcomes, such as number of the retrieved oocytes, fertilization rate, high grade embryo production rate, clinical pregnancy rate, implantation rate, ongoing pregnancy rate, COH duration, total gonadotropin dose for COH between GnRH agonist long protocol group and GnRH antagonist group. Statistical analysis was performed using Mann-Whitney test, p<0.05 was considered as statistically significant. Results: The number of retrieved oocytes, fertilization rate, high grade embryo production rate, clinical pregnancy rate, implantation rate, ongoing pregnancy rate were $14.89{\pm}7.83$, 81%, 64%, 78%, 31%, 78%, respectively in GnRHa long protocol group and $11.22{\pm}8.50$, 79%, 64%, 67%, 34%, 56%, respectively in GnRH antagonist group. There was no significant differences in parameters of clinical outcomes between 2 groups (all p value >0.05). Duration and total gonadotropin dose for COH were $10.94{\pm}1.70$ days and $43.78{\pm}6.8$ vials in 18 cycles, $12.00{\pm}1.73$ days and $48.00{\pm}6.93$ vials in agonist group, $9.88{\pm}0.78$ days and $39.55{\pm}3.13$ vials in antagonist group, respectively. In GnRH agonist long protocol group, significantly longer duration and higher gonadotropin dose for COH were needed (p=0.012). Conclusion: In oocyte donation program, clinical outcomes from controlled ovarian hyperstimulation with GnRH antagonist were comparable to those from GnRH agonist long protocol group, so controlled ovarian hyperstimulation with GnRH antagonist may be effective as GnRH agonist long protocol. At least there may not be harmful effects of GnRH antagonist on oocyte development and quality.

• Journal of Periodontal and Implant Science
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• 제30권3호
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• pp.699-707
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• 2000

The purpose of this study was to analyze the statistical errors of articles in the Journal of Korean Academy of Periodontology from 1973 to 1999. Of the 662 articles examined, 263 were included which analyzed the data. They were classified into 2 groups with time lapse; group 1: 1973∼1989, group 2: 1990∼1999. Authors made checklists for analyzing the data and detecting the errors and analyzed them with professional statistician. The results were as follows: 1. Of 263 atricles which applied statistical method, 40(19.3%) was in group 1, 223(49.0%) in group2. 2. In the number of statistical method applied, 170(64.6%) were analyzed with 1 statistical method, 73(27.8%) with 2 methods, 18(6.8%) with 3 methods, and 2(0.8%) with 4 methods 3. The number of statistical methods applied was 14, and they were applied in order of 119 of ANOVA, 72 of Student t-test, 63 of Paired t-test, 36 of CORRELATION, and 21 of Mann- Whitney U test. 4. In 87(33.1%) of 263 articles and in 18 error items, statistical errors were found out. In group I, 9 items (55%) of error were found out, and were in order of 5 of Student t-test instead of Paired t-test, and 4 of unnecessary statistical analysis. In group II, 16 items (29.1%) of error were found out, and were in order of 22 of Student t-test instead of Paired t-test, 7 of no multiple comparison test after ANOVA, 6 of Student t-test instead of ANOVA, 6 of unnecessary statistical analysis, and 5 of ANOVA instead of Paired t-test. In conclusion, the results noted that statistical analyses were increased, but statistical errors were decreased with time. But authors suggest that researchers should refer to standard statistical texts and seek advice from professional statisticians to avoid the statistical errors.

• 한국식품위생안전성학회지
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• 제19권2호
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• pp.74-83
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• 2004

Raw-fish food contains a lot of moisture and is a high-protein food. It is a first-stage processed food taking a lot of manual work. Therefore, it is classified as a PHF food, very liable to cause a bacterial food-poisoning. But its manufacturers are usually small-sized and a systematic sanitation management is difficult to expect. But the manufacturer participating in this study produces chilled fresh raw-fish food. Fish are sliced into two fillets, which are packaged under vacuum, kept and distributed in refrigerators, and sold within a day. It is a newly-developed kind of raw-fish food, and a more improved kind of raw-fish food making possible a systematic sanitation management. The HACCP (Hazard Analysis and Critical Control Point) is a systematic and continuous process-control method which is very efficient for controling food sanitation and reducing the expenses. A new HACCP model has been developed to be applied to a large-sized chilled fresh raw-fish food manufacturer. To ascertain its efficiency, the baterial examination was done to its workplace and products. The significance test was done on its data by "SPSS 12.0 for Window" and "Mann-Whitney U Test". The numbers of bacteria on its final products were significantly different in flatfish and porgy. The number of bacteria tended to decrease in each time-differential sampling (P＜.00l). The final food products showed no food-poisoning bacteria in all the time-differential tests and in all the samplings, which proves that the CCP of the HACCP system is under control. After the SSOP program was applied, no pathogenic bacteria were found in the work-place, and the kinds and numbers of bacteria decreased. The numbers of general bacteria and colon bacilli also showed a significant difference from those before the SSOP program in the filleting board (P＜.05), in the skinning board (P＜.0l), in the neck-removing knife (P＜.05), and in the filleting knife (P＜.01). The working equipments, periodically disinfected, also showed a significant difference in sanitary conditions (in the dehydrator, P＜.05). The number of bacteria found on the food-touching surface was within the standard (below 500/l00 cm$^2$) After the SSOP program was applied, the general bacteria and colon bacilli were not found. The quality of water used in the food processing was also within the standard. The numbers of bacteria falling from the air in the work-place were negligible in all the samplings (＜30CFU/l000ι). The staphylococci and fungi were not found.

• 대한간호
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• 제36권2호
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• pp.73-83
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• 1997

Bed rest is recommended to prevent postlumbar puncture headaches(PLPHA), but the period of bed rest varies in the literature from 6 hours to 24 hours. In clinical practice the period of bed rest varies but nursing methods for adults and children have little difference. In Seoul National University Hospital, children have been given at least 6 hours bed rest after a lumbar puncture. Pediatric oncology patients require a lumbar puncture for an initial diagnosis, follow up treatment or administration of chemotherapeutic agent. But it is difficult for young children to lie supine or to refrain from their usual activities in any way, and unpleasant problems related to a shortage of beds often occurs during discharge or in an outpatient setting. The purpose of this study is to substantiate the preventive effect of PLPHA by the period of bed rest, to identify the other factors that influence PLPHA, and to use the nursing methods proper to children. The subjects were 65 children, ages 1-17, undergoing treatment in the children's cancer center at SNUCH during the period June 1, 1995, to Aug. 31, 1995. The team nurses asked questions about PLPHA of the parents and children in order to fill out a questionnaire. The data were evaluated by percent, t-test, Chi-square test and Mann-Whitney U test. Result; 1. There was no significant difference relating the bed rest time spent to the occurrence of postspinal headaches (t-test). 2. There was a significant risk of PLPHA in the children who were irritable before procedure and/or had experienced previous PLPHA(p<0.05, ${x^2}-test$). 3. The following factors were not found to be associated with increased risk of PLPHA: previous puncture experience, giving analgesics, the choice of puncturist, inpatient/outpatient status, gauge of needle, purpose, the amount of CSF removed, gender, diagnosis, the number of peripheral WBCs, previous lumbago experience after LP, position after bed rest, age, the number of aural puncture at the time. A longer period of bed rest is unlikely to be more effective to prevent PLPHA and seems impractical. A shorter period will save time and effort. Perhaps it will also allay some of the fears which surround LP. So 1 hour bed rest after LP is suggested and nursing methods for emotional support should be investigated to reduce PLPH.

• Clinical and Experimental Reproductive Medicine
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• 제36권2호
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• pp.111-119
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• 2009

목 적: 클로미펜을 사용한 배란유도시 얇은 자궁내막을 보였던 환자들에서 성선자극호르몬에 클로미펜 또는 레트로졸을 병합 투여하는 과배란유도 방법의 임상적 효용성을 비교 분석하고자 하였다. 연구방법: 이전의 클로미펜을 사용한 배란유도 주기에서 8 mm 미만의 얇은 자궁내막을 보였던 불임 환자들에서 시행된 성선자극호르몬 병합 과배란유도/인공수정 51주기가 연구에 포함되었다. 월경주기 제3일째부터 5일 동안 클로미펜+성선자극호르몬 군은 일일 클로미펜 100 mg을 투여하였고 (n=26) 레트로졸+성선자극호르몬 군은 일일 레트로졸 2.5 mg 또는 5 mg을 투여하였다 (n=25). 양 군에서 월경주기 제5~7일째부터 우성난포의 크기가 18 mm 이상에 도달할 때까지 이틀에 한 번씩 성선자극호르몬은 75~150 IU를 투여하였다. 양 군에서 성선자극호르몬 총 사용량, 자궁내막의 두께, 자궁내막의 형태, hCG 투여일의 14 mm 이상 난포의 수, hCG 투여일, 임신율, 다태 임신율을 비교하였으며 통계 분석은 Mann-Whitney U test or Fisher's exact test 등을 이용하였다. 결 과: 연령, 불임기간, 이전 인공수정 횟수, 기저 혈중 LH, FSH, $E_2$ 농도, 불임의 원인 등의 임상적 특성은 양 군간 차이가 없었다. 성선자극호르몬 병합 과배란유도시 배란전 자궁내막의 두께는 이전의 클로미펜을 사용한 주기와 비교하여 유의하게 증가되었다. 성선자극호르몬 총 사용량, hCG 투여일, 자궁내막의 삼중선 비율, 임신율 및 다태 임신율은 유의한 차이가 없었다. 클로미펜+성선자극호르몬 군에 비하여 레트로졸+성선자극호르몬 군에서 14 mm 이상 난포의 개수는 유의하게 적었고 ($3.7{\pm}1.7$ vs. $2.8{\pm}1.7$, p=0.03). 배란 전 자궁내막 두께는 유의하게 두꺼웠다 ($7.7{\pm}1.5\;mm$ vs. $9.1{\pm}1.7\;mm$, p<0.05). 결 론: 배란유도를 위하여 클로미펜 사용시 얇은 자궁내막을 보였던 환자들에서 인공수정을 위한 과배란유도시클로미펜 또는 레트로졸을 성선자극호르몬과 병합하여 사용하는 방법은 클로미펜의 자궁내막에 대한 부정적인 효과를 피할 수 있는 것으로 사료된다. 적절한 자궁내막의 발달 및 적절한 난포의 성장 측면에서 성선자극호르몬에 레트로졸을 병합하는 과배란유도 방법이 클로미펜을 병합하는 방법에 비하여 더 유용할 수 있으나 추가적인 대규모 전향적 연구가 필요할 것으로 사료된다.