• Journal of Korean Academy of Nursing
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• v.11 no.2
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• pp.33-54
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• 1981

The purposes of this study were to determine the relevant nursing needs of patients following discharge; to identify the degree of their nursing needs; to identify types and status of discharge order and information given to patients; and to determine their specific nursing needs according to their diagnosis. In addition, opinions toward home care services provided by hospitals or by public health nurses and appointment plans with their physicians were also asked in order to determine the necessity of follow-up care for the patient after discharge. Nine hundred and eighty eight subjects were collected among patients being discharged from one national university hospital and four city hospitals. Data were collected from June,1979 to December,1979 using questionnaires and interviews. On the bases of these data the following findings were observed; 1) Almost 40 percents of total subjects discharged from the hospital with some or great degree of nursing needs in general. The most problematic nursing needs were needs for comfort which include needs for releaving pain, for sound sleep and rest, because these needs can only be met by professional help. More than 50% of total subjects have this problem. 2) Needs for mental health, general metabolism, general hygiene and activities and safety were observed in more than 20 percent of subjects. 3) Discharge orders on diet and oral medication were recorded in patients' charts in 70% of all cases. However, more than fifty percents of patients have not been told these information from doctors or nurses. Even though some of them might have had appointment plans with their physicians, they would not keep the appointments unless they completely understood the necessity of the follow-up care. If they have not had any appointment or would not visit the out-patient clinic, there is no method of caring them and prerenting funther discomfort or complications. Even in injection, ski care, dressing and bath, only one thirds of the subjects having recorded discharge orders understood what they need after discharge. The rest of cases have not known what to do for their further care. 4) More than 80 percents and 70 percents of total subjects agreed to a system of home care services provided by hospitals or public health nurses respectively. That is, regardless of sources of medical expenses, most of patients wanted to be taken care of at home following discharge. 5) While more than half of the patients having benefit of medical insurance or paying fully by themselves had appointment plans with their physicians, only one thirds of the patients fully or partially paid by government had appointment plans with their physicians. These results ex-plain that the appointment plan is directly associated with their economic power. This indicates that the home care services are more needed to the people with lower economical status. 6) Those who have been in the hospital more than 24 days wanted !o have home care services more than those who had less hospital days. They also had more appointment plans than other groups. 7) More than 70 percents of the subjects who had been in a university hospital and approximately 30 percents of the subjects in the city hospitals had appointment plans with their physicians. 8) Those who had the cerebrovascular disease, cancer or hypertension demanded more nursing needs such as needs for comfort, for general metabolism and for mental health. 9) Factors which were associated with the degree of patients' nursing needs were age, duration of hospitalization, opinion toward home care services given by public health nurses, hospital appointments and types of hospital. That is, the older they were and the longer the periods of hospitalization were, the higher were their nursing needs. The more they had nursing needs, the more they wanted to have nursing services and had appointment plans. It can be concluded that there is a great demand for a positive and systematic home care services to the people who have been discharged from hospitals following critical care. This program is definitely demanded for the low income groups of people with less education with the financial assistance of the government or other funding agencies.

• CRM연구
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• v.3 no.2
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• pp.21-41
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• 2010

The current research was conducted to examine the factors that affect outsourcing performances, and further investigate whether a discrepancy in performance exists between the medical institutions and hotel service institutions. The study surveyed both medical and hotel administrators for approximately two months, who managed outsourcing tasks. Total of 325 responses out of 350 distributed were collected. However, due to inadequate responses, six responses were excluded, amounting to total of 319 (155 medical institutions, 164 hotels) valid responses included in the final analysis. First, the informal outsourcing relationships between representatives of outsourcing service seekers and providers did not appear to have significant effects in terms of the levels of trust in neither medical institutions nor hotel industries. However, the relationships affected outsourcing degrees exclusively in medical institutions, showing the disparity between the two service institutions. This was explained due to the continuing long term efforts required to establish an informal relationship in medical institutions. Second, communication was shown to have positive effects on levels of trust in both medical institutions and hotel industries. This indicates a prominent outsourcing trait that emphasizes the significance of mutual cordial communication that contributes to establishing positive relationships. Third, opportunistic behavior of the outsourcing service providers appeared to negatively affect the levels of trust as well as outsourcing degrees for both medical and hotel industries. Therefore, opportunistic behaviors were found to have more tendencies to causing tension and discomfort rather than creating a relationship based on mutual credibility or conviviality. Fourth, the effect of service infrastructures on the level of trust did not appear to be significant on medical institutions, while showing positive influence on hotel industries. Additionally, service infrastructures were found to positively influence the outsourcing performance levels for both sectors. Fifth, trust between outsourcing service seekers and providers did not appear to have noticeable impact on the outsourcing degrees for either institution. On the contrary, trust appeared to have positive impacts on performance for both institutions. This further indicates that, when engaging in outsourcing, strengthening relationships through mutual partnership with outsourcing entities rather than establishing contractual relationships leads to improving the reciprocal trust, which in turn improves work results. Lastly the outsourcing degree of service seekers appeared to have positive impact on the outsourcing performance for both medical institutions and hotel industries, indicating the causal relationship between the affectability of outsourcing degrees and the following performance results.

• Radiation Oncology Journal
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• v.27 no.2
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• pp.49-54
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• 2009

Purpose: To report on the clinical outcome of patients with stage I testicular seminoma by postoperative radiotherapy (PORT) or surveillance after radical inguinal orchiectomy. Materials and Methods: This study is a retrospective review of 32 stage I pure seminoma patients treated between 1996 and 2005 at the Samsung Medical Center. Twenty two of the patients were treated by PORT, which was directed at the paraaortic lymphatics with a median dose of 25.2 Gy in 14 fractions for 3 weeks. The 10 remaining patients were managed by surveillance. The median follow-up period was 96 months with a range of 24 to 155 months. Results: Clinically, most patients presented with a testicular mass or discomfort. Two of the patients had a history of undescended testes. Pathologically, 23 of the patients had intratubular germ cell neoplasia with seminoma. Both recurrence-free survival (RFS) and overall survival (OS) rates of patients treated by PORT were 100%. In the control group, 1 of the 10 patients suffered a para-aortic lymph node relapse. The RFS and OS rates of the surveillance group were 88.9% and 100%, respectively. Conclusion: No difference in survival was observed between the two groups. Moreover, symptom recurrence was only observed in 1 patient in the control group. The use of PORT may reduce the risk of relapse. With the availability of effective diagnostic and salvage modalities, surveillance monitoring may be considered for patients in good compliance.

• Research in Community and Public Health Nursing
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• v.14 no.2
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• pp.190-199
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• 2003

This study was conducted to determine the factors affecting job satisfaction in workers by using the Job Stress Model proposed by the National Institute for Occupational Safety and Health (NIOSH). Data were collected from December 1 to December 30, 1999. The subjects were 2,133 workers employed at 155 work sites, who were examined using NIOSH Job Stress questionnaire translated by the Korea Occupational Safety ${\pounds}|$ Health Academy and Occupational Safety ${\pounds}|$ Health Research Institute. SAS/PC program was used for statistical analysis using descriptive analysis. Pearson's correlation coefficient, ANOVA, and Stepwise multiple regression analysis. The results of this study were as follows. 1. According to general characteristics of the subjects, job satisfaction was high in those with less number of children. 2. By work condition, job satisfaction was higher in those who were working in a permanent job position, were working with regular time basis than with shift basis, were working in regular shift hours than in changing shift hours, were working for a short period, and were working less hours and overtime works per week. 3. In terms of physical work environment, job satisfaction was significantly related to 10 physical environmental factors. In other words, job satisfaction was high in workers who were working in an environment with no noise, bright light, temperature adjusted to an appropriate level during summer and winter, humidity adjusted to an appropriate level. well ventilation, clean air, no exposure to hazardous substance during work hour, overall pleasant work environment and not crowded work space. 4. By work-related factors, job satisfaction was high in those with less ambiguity about future job and role, high job control/autonomy, and less workload. On the other hand, job satisfaction was low in those with little utilization of competencies, and much role conflict at work and workload. 5. As for the relationships between job satisfaction and the non-work related factors, job satisfaction was high in workers who were volunteering at different organizations or active in religious activities for 5-10 hours per week. 6. In the relationships between job satisfaction and buffering factors, significantly positive correlations were found between job satisfaction and factors such as support by direct superior, support by peers, and support by spouse, friend and family. 7. There were nine factors that affected job satisfaction in the workers: age, number of children, work hours per week, noise, temperature at the work site during summer, uncomfortable physical environment, role ambiguity, role conflict, ambiguity in job future, work load, no utilization of competencies and social support from direct supervisor. These nine factors accounted for 26% of the total variance in the multiple regression analysis. In conclusion. the following are proposed based on the results of this study. 1. The most important physical environmental factors affecting job satisfaction in workers were noise, role ambiguity, and work load, suggesting a need to develop strategies or programs to manage these factors at work sites. 2. A support system that could promote job satisfaction is needed by emphasizing the roles of occupational health nurses who may be stationed at work sites and manage the factors that could generate job stress. 3. Job satisfaction is one of the three acute responses to stress proposed in NIOSH job stress model (job satisfaction. physical discomfort and industrial accidents). Therefore, further studies need to be conducted on the other two issues.

• Journal of Chest Surgery
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• v.30 no.2
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• pp.179-186
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• 1997

The frequency of primary lung cancer is increasing compared to other cancer. Complete surgical resection is the most effective method of treatment, but it is limited to only 25 to 30 percent of patients after initial clinical presentation. The survival rate is different by the subtypes of carcinoma, stages, and general condition of patients. The author investigated the survival rate of 87 patients with squamous cell carcinoma of the lung after surgery. Age ranged from 31 to 73 years, with Lean 57.1) $\pm$ 7.15 and 80.5% (70 cases) was initially diagnosed at sixth and seventh decades. Male to female ratio was 8.9'1. Initial complaints were cough with sputum in 78.1%, weight loss in 31.0%, chest pain and discomfort in 29.9%, and hemoptysis in 24.1%. The location of the tumor was right side in 44.8% and left slde in 55.2% ; LUL in 39.1%, RLL in 20.7%, LLL in'16. 1%, RUL in 14.9% and RML in 9.2%. Stage I was 19.5%, stage II 25.3%, stage olla 54.1% and stage lIIb 1.1%. Operative procedures were as follow : pneumonectomy in 52.9%, lobectomy in 47.1%, sleeve upper lobectomy in 4 cases. Single mediastinal Iymph node involvement was observed in 17 cases, and multi-level mediastinal Iymph node involvement in 23 cases. Lower paratracheal Iymph node and subcarinal Lymph node were more frequently involved in right side lung cancer, with 8 and 10 cases, respectively and subaortic Iymph node was most frequently involved in left side lung cancer with 9 cases. Operative complications were hoarseness, wound infection and chylothorax in 7, 5 and 4 cases, respectively. The operative mortality was 2.2% and the cause of death was pulmonary edema. Postoperative follow-up period ranged from 1 month to 99 months with a mean of 29.95 $\pm$ 17.21 months. Overall one-year survival rate was 75.1 % and five-year survival rate was 29.8%. One-year and five-year survival rates were 93.7% and 52.4% for stage 1, 92.2% and 30.5% for st ge ll, and 61.2% and 17.4% for stage llla, respectively. These findings correlate survival rate with tumor size, mediastinal Iymph node metastasis and surgical resectability, and long-term survival can be expected with small sized tumor, absent mediastinal Iymph node metastasis and complete surgical resection.

• Tuberculosis and Respiratory Diseases
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• v.53 no.5
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• pp.550-560
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• 2002

Background : Lung cancer is the leading cause of cancer-related mortality in both men and women. Although most cases of lung cancer occur in the sixty to eight decades of life, 5 to 10% are diagnosed at a young age. There are characteristic features in young patients with lung cancer that differ from those in older patients with lung cancer. The purpose of this study was to determine if the basal characteristics and survival in young patients with lung cancer differed from those of old patients. Methods : We retrospectively reviewed the medical records of 94 young patients who were under 45 years of age and compared them with 1,728 old patients (= 46 years of age) in 4 medical schools at Daegu, between August 1986 and July 1995. Results : Significantly more female patients and adenocarcinomas were found in the young patients group. when compared to the old patients. Cough and sputum were the most frequent presenting symptom in both age groups. This was followed by chest discomfort, dyspnea and hemoptysis. The rates of smoking was significantly lower in the young patients. There was no statistical difference in the severity of the disease in terms of staging between the two age groups. Young patients received treatment more frequently than the older patients. The location of the primary tumors was equally frequent in both the upper and lower lobe. However, the survival was bettrer in the young patients(median survival time, 67.3 weeks), when compared to the old patients (median survival time, 26.8 weeks) (p<0.05). Conclusion : Females and adenocarcinoma patients were predominant in young patients with lung cancer. The young patients appeared to have significantly better prognosis.

• Journal of Korean Academy of Nursing Administration
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• v.2 no.2
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• pp.97-107
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• 1996

Nursing standards determine the type and extent of services that are delivered to the patients and define quality care and communicate the institution's expectations of care. Thus, taking the standard of care and incorporating it into a welldefined indicator of excellent patient care becomes one of the first activities in setting up the nursing service's quality assurance process. The purpose of this study was to determine the impact of using a nursing care standards for the quality of nursing care in gastrectomy patients. The subjects were composed of fourty-two under going gastrectomy patients with stomach cancer in general surgery nursing care unit of K University Hospital in Pusan. The data was collected from January 3 to April 13,1996. The subjects were divided into a control group - those admitted from Jan.3 to Feb.12 and an experimental group those admitted from Feb.18 to April 13. The instruments used for this study were a nursing care standards in gastrectomy patients developed by the investigator and an evaluation tool for the quality of nursing care in abdominal surgery patients developed by Byoung-Sook Lee in 1995. The data was analized by means of chi-square test, t-test and Cronbach-alpha test with the SAS System. The result was as follows : The hypothesis, that scores of the quality of nursing care in the experimental group would be higher than that of the control group. was supported(t=-6.12, p=0.00). The detailed results of each standards of evaluation tool were as follows : The mean score of the experimental group was significantly higher than that of the control group in audit standard 1:'Collection of basic data of the patients', (t=-3.76, p=0.00). The mean score of the experimental group was significantly higher than that of the control group in audit standard 2 : 'Defining nursing diagnoses(or nursing problems)', (t= (-), p= (-) ). The mean score of the experimental group was significantly higher than that of the control group in audit standard 3:'Estabilishment of nursing care plan according to nursing diagnoses(or nursing problems)',(t= (-), p= (-) ). The mean score of the experimental group was significantly higher than that of the control group in audit stndard 4:'Implimentation of nursing care plan', (t=-2.38, p=0.01). The mean score of the experimental group was significantly higher than that of the control group in audit standard 8 : 'Increase of the knowledge of health related to surgery',(t=-2.40, p=0.01). No significant differences between the mean scores of the experimental group and that of the control group in audit standard 5 : 'Recover and maintain of the physical function', audit standard 6:'Prevention of the post-operative complication', audit standard 7 : 'Decrease of discomfort caused by operation', and audit standard 9 : 'Patient satisfaction in nursing care' were found. The standards of evaluation tool were devided into two dimension. One was process dimension which contains four standards(audit standard 1 to 4), the other was outcome dimension which contains five standards(audit standard 5 to 9). The mean score of the experimental group was significantly higher than that of the control group in process dimension (t=-12.30, p=0.00), but no significant difference between the mean scores of the experimental group and that of the control group in outcome dimension was found. From these results, it is concluded that using a nursing care standards in gastrectomy patients promotes quality of nursing care and nursing care standards of various fields are necessary for effective nursing care.

• Journal of Korean Ophthalmic Optics Society
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• v.9 no.2
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• pp.333-343
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• 2004

Impression cytology refers to application of cellulose acetate filter material to the ocular surface to remove the superficial layers of the conjunctival epithelium. The technique is non-invasive, is easy to perform, causes minimal discomfort to the patient, and can be used to follow changes in the conjunctival ocular surface over time. With this method, the morphology of the conjunctival ocular surface can be studied and the degree of squmaous metaplasia assessed. This study was performed to evaluate the conjunctival surface by impression cytology in dry eye patients. A total of 70 students with no contact lens wearing history were recruited. Subjects were required to fill in a McMonnies dry eye symptom questionnaire. The non-invasive tear thinning time(TIT) test of each subject was measured, followed by Schirmer tear test(STI), tear film break-up time(TBUT) tests and Rose-bengal staining were performed as a baseline. Conjunctival epithelial cells from the inferior bulbar conjunctiva were harvested by the impression cytology technique. The specimens collected were labelled and stained with PAS(Periodic Acid Schift)-haematoxylin. The goblet cells and conjunctival epithelial cells were observed under a light microscope of 400x magnification. The specimens were classified according to the Nelson Grading scale which was based on the degree of squamous metaplasia such as changes of goblet cells density, size/form, N:C(nucleus : cytoplasm) ratio. Dry eye patients were observed morphological changes of the epithelial cells, different nuclear alterations, decrease of the goblet cells density. The degree of cytological changes was related to severity of dry eye conditions. When the epithelial cell morphology was graded according to the system described by Nelson, specimens from the control group revealed 91.43% of the eyes to be grade 0 and 8.57% to be grade 1, whereas of the dry eye patients, 20% were grade 0, 42.86% grade 1, 34.29% grade 2 and 2,86% grade 3. Impression cytology represents a non- or minimally invasive biopsy of the ocular surface epithelium with no side effects or contraindications. It has demonstrated to be a useful diagnostic aid for a wide variety of processes involving the ocular surface. This technique is a safe, simple method and may help increase understanding of various ocular surface alterations in dry eye patients.

• Korean Journal of Psychosomatic Medicine
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• v.7 no.1
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• pp.103-115
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• 1999

Objectives : A large of studies have found an association between premenstrual syndrome and affective disorder, in particular, depression. Some studies have reported that women with depressive disorders may experience menstrual cycle-associated changes in the severity of their symptoms. This study was designed to compare the characteristics of premenstrual changes between control group and affective patient group, and to assess possible risk factors for premenstrual changes in patients. Methods : Eighty normal controls and eighty outpatients given maintenance therapy with fixed dose for at least more than four weeks were asked to complete questionnaires on menstrual history, obstetric-gynecological history, and functional impairment. In addition, to compare the characteristics of premenstrual changes, 16 items based on DSM-IV criteria A for premenstrual dysphoric disorder were rated on the following scale : 0(no change), 1(mild), 2(moderate), 3(severe). Moderate or severe change in each item was considered as premenstrual change and the subjects who reported more than one premenstrual change were defined as premenstrual change group. Results : The results were as follows : 1) The percentage of premenstrual change group was 32.6% in patient group and 50% in control group. 2) Frequently reported premenstrual changes were as follows in control group : breast tenderness; anger ; affective liability ; lethargy, easy fatigability, or marked lack of energy ; abdominal pain or discomfort. In patients, the mood or behavioral changes were frequently reported. The changes were as follows : lethargy, easy fatigability, or marked lack of energy ; change in appetite; affective liability ; sense of difficulty in concentrating : hypersomnia or insomnia. 3) In the premenstrual change group, the patients with only mood or behavioral changes were significantly more than those with only physical changes or both changes. 4) The severity of functional impairment was significantly correlated with the frequency of mood or behavioral changes in patients. 5) There were no significant differences in menstrual characteristics between patients with premenstrual changes and patients without them except the severity of dysmenorrhea. And the severity of dysmenorrhea was correlated with the frequency of premenstrual change. Conclusion : The proportion of patients with affective disorder, who reported moderate-to-severe premenstrual changes, experiencing mood or behavioral changes larger than those experiencing physical changes during premenstrual period. It is possible that some patients with affective disorder, who reported premenstrual mood or behavioral changes, suffer from coexisting premenstrual syndrome with affective disorder or premenstrual exacerbation of affective disorder. Since the more premenstrual changes, the severer functional impairment, the patients reporting mood or behavioral disturbance in premenstrual period should be carefully evaluated, and appropriate therapeutic stategies might be considered.

• Journal of Korean Ophthalmic Optics Society
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• v.21 no.1
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• pp.1-10
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• 2016

Purpose: The study was aimed to suggest the most effective color of the tinted lenses by evaluating the effect of the prescription with tinted lenses on the visual quality of the elderly at the age of the sixty or more. Methods: The visual acuity of fifty subjects at the age of sixty or more (17 males, 33 females with the averaged age of $71.0{\pm}6.3$) were corrected to have the visual acuity at a far distance of 0.5 or more using a trial lens frame, and non-tinted, brown-tinted, and gray-tinted lenses were randomly applied on the trial frame. The minimum legibility and minimum separability were measured at a far distance in the aspect of the visual acuity and calculated as LogMAR and then, the visual acuity was compared. The stereopsis and contrast sensitivity were also estimated at a near distance in the aspect of the visual function. The participants' preference for tinted lenses and their subjective symptoms of the visual perception and the movement were further surveyed. Results: The best minimum legibility and minimum separability was shown when wearing non-tinted lenses, and brown-tinted and gray-tinted lenses were in the next. The stereopsis and the contrast sensitivity at a near distance and the visual perception was the best when wearing brown-tinted lenses. It was surveyed that the subjective discomfort was the biggest when wearing gray-tinted lenses, and brown-tinted lenses were the best in the aspect of the subjective preference. Conclusions: As the result of this study, it was revealed that the visual acuity and visual function could be improved by the use of tinted ophthalmic lenses however, its change of visual acuity and visual function was not completely correlated with the subjective satisfaction. Therefore, the appropriate color of ophthalmic lenses should be selected in accordance with the individual visual perception and the main vision lifestyle in the elderly generation. From the present study, the use of non- or brown-tinted lens and brown- or gray-tinted lens can be recommended for distance work and near work, respectively, in the elderly generation under the illumination of about 1,000 lux.