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Stress and Coping for Patients with Hemiplegia during the Rehabilitation Process (편마비 환자의 재활과정에 따른 스트레스와 대처의 변화양상)

  • 강현숙
    • Journal of Korean Academy of Nursing
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    • v.24 no.1
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    • pp.18-32
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    • 1994
  • It is important to understand that patients with hemiplegia are under stress during the rehabilitation process. This study was designed to determine what changes occur in the stress perceived by these patients during the rehabilitation process. and what changes occur in the ways they coped with stress. A decriptive study with a longitudinal design was conducted. A total of 57 patients with hemiplegia who were admitted to one general hospital made up the sample for this study. A questionnaire, observations and interviews were used for the data collection which was done in three phases(within one week after admission : within one week before discharge ; within one month after discharge ). Data were analyzed using t-test, ANOVA repeated measures of ANOVA, and post hoc paired t -test, Bonferroni correction. The results of this study are : 1. Changes in the perception of stress during the rehabilitation process : There was a statistically significant differencs in the perception of stress among these patients during the rehabilitation process. On the post-hoc test. the perception of stress showed a statistically significant decrease from admission to discharge. The perception of psychological stress was high during the rehabilitation process as compared with the perception of physical and social stress. 2. Changes in the way the patients coped during the rehabilitation process : On admission passive coping was used by most of the subjects(91.2%). Passive coping showed an decrease from admission to discharge, but an increase from discharge to follow-up at one month post discharge. There was, however, no statistically significant changes in the way the patients coped during the rehabilitation process. 3. Changes in perception of stress during the rehabilitation process according to variables. Perception of stress among patients classified as So-Um was higher during the rehabilitation process, when compared with patients classified as So- Yang and Tae-Um. There was, however, no statistically significant difference in perception of stress over time. The patients with right sided paralysis perceived higher stress than those with left sided paralysis. There was, however, no statistically significant difference in perception of stress over time. Hence, stress was not influenced by which side was paralyzed th frequency of the relapse of the disease, or the time in the rehabilitation process. 4. Changes in coping during the rehabilitation process according to variables. There was a statistically significant difference in the way the patients coped at follow- up according to the three different kinds of the constitution groups. In other words, coping was not used by patients classified as Tae-Um but was used by those classified as So-Um. On the repeated measures of ANOVA, there was a statstically significant difference in stress over time, and an interaction between constitution and time. But the way of coping during the rehabilitation process was not influenced by which side was paralyzed nor by the frequency of the relapse of the disease. In conclusion, perception of psychological stress was high during the rehabilitation process, as compared to perception of physical and social stress. There was a statistcally significant difference in the perception of stress over time, Perception of stress showed a gradual decrease from over admission to follow-up period. There was. however, no statistically significant difference in the way of coping over time. Passive coping was used by most of patients. In the study, these findings suggest a need for nursing care related to the psychological support for patients with hemiplegia both in the hospital as well as at home, and the need for education and counseling on independent self-care to help the hemiplegic patients adapt to stress using active coping.

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Strategies about Optimal Measurement Matrix of Environment Factors Inside Plastic Greenhouse (플라스틱온실 내부 환경 인자 다중센서 설치 위치 최적화 전략)

  • Lee, JungKyu;Kang, DongHyun;Oh, SangHoon;Lee, DongHoon
    • Journal of Bio-Environment Control
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    • v.29 no.2
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    • pp.161-170
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    • 2020
  • There is systematic spatial variations in environmental properties due to sensitive reaction to external conditions at plastic greenhouse occupied 99.2% of domestic agricultural facilities. In order to construct 3 dimensional distribution of temperature, relative humidity, CO2 and illuminance, measurement matrix as 3 by 3 by 5 in direction of width, height and length, respectively, dividing indoor space of greenhouse was designed and tested at experimental site. Linear regression analysis was conducted to evaluate optimal estimation method in terms with horizontal and vertical variations. Even though sole measurement point for temperature and relative humidity could be feasible to assess indoor condition, multiple measurement matrix is inevitably required to improve spatial precision at certain time domain such as period of sunrise and sunset. In case with CO2, multiple measurement matrix could not successfully improve the spatial predictability during a whole experimental period. In case with illuminance, prediction performance was getting smaller after a time period of sunrise due to systematic interference such as indoor structure. Thus, multiple sensing methodology was proposed in direction of length at higher height than growing bed, which could compensate estimation error in spatial domain. Appropriate measurement matrix could be constructed considering the transition of stability in indoor environmental properties due to external variations. As a result, optimal measurement matrix should be carefully designed considering flexibility of construction relevant with the type of property, indoor structure, the purpose of crop and the period of growth. For an instance, partial cooling and heating system to save a consumption of energy supplement could be successfully accomplished by the deployment of multiple measurement matrix.

Development of a Critical Pathway for Patients with Coronary Artery Bypass Graft (관상동맥 우회술 환자를 위한 Critical Pathway개발)

  • 김기연
    • Journal of Korean Academy of Nursing
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    • v.28 no.1
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    • pp.117-131
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    • 1998
  • The purpose of this study was to develop a critical pathway for case management for patients who have received Coronary Artery Bypass Graft (CABG) because of Ischemic Heart Disease(IHD) which is a factor of rising medical expenses. For this study. a conceptual framework was developed through a review of the literature including six critical pathways which are currently being used in USA. In order to identify the overall service contents required by these patients and to draw up a preliminary critical pathway, 30 cases of medical records of patients who had CABG because of IHD between January, 1995 to June. 1996 at the Cardiovascular Center of Yonsei Medical Center in Seoul were analyzed. An expert validity test was done for the preliminary critical pathway and clinical validity test was also done using seven IHD patients with CABG between November 11 and 23, 1996. After these processes. the final critical pathway was developed. The results of this study are summarized as follows : 1. The vertical axis of the critical pathway includes the following eight items : tests, nutrition, medications, consultations, activity, assessments, treatments, education discharge planning and the horizontal axis includes the time from the start of hospitalization to discharge. 2. Analysis of the 30 medical records indicated that the average length of stay was 20.2days with the average length of stay from hospitalization day to operation day being 6.2 days, and the average length of stay from operation day to discharge day was 13. 9 days. Analysis of the service contents showed that the horizontal axis of the preliminary critical pathway was set from hospitalization to the 14th post operation day and the vertical axis was set to include eight items, the contents which ought to have occurred, according to the time frames of the horizontal axis. 3. As a result of the experts validity, it was found that among the total of 571 items. there was over 83% agreement for 482 items, less than 83% for 89 items, which were then deleted and a revision of the critical pathway was done. 4. A clinical validity test was done using seven IHD patients with CABG. During the process, three patients were deleted because they were out of the criteria the investigator set. Finally, four patients were used. The result of study indicated that only one patient was discharged on the tenth post operation day, which was one day later than the expected day. Three patients were discharged later than the expected day from three days to nine days. All the cases progressed on schedule until the operation day and the first post operation day, but from the second post operation days, there were differences between the critical pathway and the actual practice. The differences came from tests, assessments, and treatments. 5. On the basis of the results of the clinical validity test. the following revisions in the final critical pathway were made : the transfer from ICU to step down ward would be the second post operation day, and the transfer to a general ward, the fifth post operation day, for patients who complained of lack of sleep from the fifth post operation day to discharge, a sleeping pill would be prescribed, skin observations would be performed routinely from immediately after the operation until the third post operation day, and would continue if there was a sign of skin injury on the fourth post operation day, and assessment of chest pain would be done from the third post operation day, and the “stairs climbing” item, expected to be done on the ninth post operation day would be deleted. In conclusion, this critical pathway is partially applicable to the care of patients with CABG but there are some parts needed to be further investigated.

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Impact of Mother's Oral Health Literacy on Preschool Children's Oral Health Status and Behavior (어머니의 구강건강정보이해력이 유아 자녀의 구강건강상태와 행동에 미치는 영향)

  • Kang, Yu-Min;Cho, Young-Sik
    • Journal of dental hygiene science
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    • v.16 no.1
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    • pp.26-36
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    • 2016
  • The purpose of this study was to examine how oral health literacy of mothers affect the oral health status of their preschool children. The subjects were 233 mothers and their preschool children who are between 5 and 6 years old. They were selected according to the convenience sampling method. The individual self-administered questionnaire was used for the mother's survey while the children were interviewed using structured questionnaire to examine their oral health status and behavior. According to study results, the number of decayed primary teeth and the number of decayed and filled primary teeth had a statistically significant negative correlation with the oral health literacy of the mother, the children's oral health knowledge, attitude and behavior (COHKAB), and the mother's oral health management behavior. Hierarchical multiple regression analysis was performed after including general characteristics variables, the COHKAB and the mother's oral health management behavior. Meanwhile, mother's oral health literacy had a statistically influence on children's oral health status. The higher the mother's oral health literacy level, the lower the number of decayed and filled primary teeth were. The findings suggest that efforts to improve the oral health status of preschool children should consider mother's oral health literacy as an important factor. Therefore, the effective intervention and education programs are necessary to enhance mother's oral health literacy.

A Meta-Analysis of Korean Literatures about Sick Role Behavior of Pulmonary Tuberculosis Patients applied Health Belief Model (건강신념모형을 적용한 폐결핵 환자의 환자역할행태 연구에 대한 메타분석)

  • Kim, Chun-Bae;Jo, Heui-Sug;Rhee, Jung-Ae
    • Journal of agricultural medicine and community health
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    • v.28 no.1
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    • pp.1-13
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    • 2003
  • Objectives: The purpose of this study is to summarize results from 11 domestic studies about sick role behavior applied health belief model and to assess the effectiveness of components on behavior change by using meta-analysis. Methods: We collected the existing literatures by using major web search of 'pulmonary tuberculosis patients', 'health belief model', and 'sick role behavior' as key words and by reviewing content of journals. Quantitative meta-analysis was performed by SAS program. Results: Among 66 articles, 11 studies were selected for quantitative meta-analysis. The knowledge level about pulmonary tuberculosis had more effect for only sick role behavior as general characterisitcs(d=0.7870). All the components of health belief model produced significant effects on sick role behavior with the magnitude of effect size from 0.31 to 0.73. The largest effects were benefits on actions of sick role behavior. Conclusions: Overall, these investigation provide very substantial empirical evidence supporting health belief model dimensions as important contributors to the explanation and prediction of sick role behavior among the type of health related behavior in pulmonary tuberculosis patients. Strategic intervention including health education, etc. based on health belief model showed clear advantage in improvement of behavioral change.

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Study the impact on job satisfaction in the care facility of the empowerment of the members of the organization (요양시설의 조직구성원의 임파워먼트가 직무만족에 미치는 영향에 관한 연구)

  • Kim, Chang-Tae;Gwak, Gyeong-Ja
    • Management & Information Systems Review
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    • v.31 no.4
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    • pp.57-82
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    • 2012
  • The purpose of the study is to suggest the measure for the improvement of job satisfaction and level of empowerment of sanatoriums' social workers by analyzing factors of empowerments' effect on the job satisfaction, and investigating level of empowerment and job satisfaction of social workers of sanatoriums for the elderly and the handicapped. The result of investigation and analysis on subjects of 420 social workers of sanatoriums for the elderly and the handicapped in Youngnam area for this is as follows: First, job characteristic that is empowerments' influence factor of sanatoriums' social workers is appeared in order of feedback, and function variety, and in organization characteristic is appeared in order of leadership, reward, and employee development. Second, level of empowerment that is recognized by sanatoriums' social workers is appeared a little higher than normal level and significance is appeared highest, and next are capability, self-determination ability, and influence. Third, features that showed significant difference with significance in general characteristic of sanatoriums' social workers were 'sex', 'marital status', and 'religion', and features that showed significant difference with capability were sex, age, marital status, academic background, and employment history. And features that showed significant difference with self-determination ability were sex, age, marital status, and employment history, and features that showed significant difference with influence were sex, age, employment history and types of facilities. Fourth, the whole average of job satisfaction of sanatoriums' social workers was 3.82 out of 5, which is generally high, features that showed significant difference statistically were age, marital status, academic background, employment history, and types of facilities. Thus, job satisfaction was appeared as high as 'more than age of thirty' in age, 'married' in marital status, 'under graduates of colleges' in academic background, and 'less than three years' in employment history. Fifth, as for factors that had influence on job satisfaction, the indirect effect with empowerment was appeared that had significant effect in organization characteristic, and had few effect in organization features. On these results, practical measures to increase job satisfaction of sanatoriums' social workers are as follows: First, political approach is required to standardize duty system(by various types of facilities and clients' characteristic) of social workers of sanatoriums for elderly and the handicapped, and help to do the role as professionals with giving better treatment and building self-respect by enough reward. Second, to suggest chances to perform the responsibility for the duty of the scenes by the regular supervision, establish regular supervision system of social workers of sanatoriums for the elderly and the handicapped, and the extension of duty to increase the functional varieties. Third, it is required to motivate to have self confidence for the work and to use potential ability with transforming leadership, and to have more chances of education for the self-development. To increase job satisfaction of sanatoriums' social workers who give direct services in sanatoriums for the elderly and the handicapped, more active and positive empowerment's level improvement is in need by improvement of empowerment for them.

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A Study on the Gene Expression of Adipogenic Regulators by an Herbal Composition (생약복합물에 의한 지방세포형성 조절자의 유전자 발현 연구)

  • Lee, Hae-Yong;Kang, Ryun-Hwa;Bae, Sung-Min;Chae, Soo-Ahn;Lee, Jung-Ju;Oh, Dong-Jin;Park, Suk-Won;Cho, Soo-Hyun;Shim, Yae-Jie;Yoon, Yoo-Sik
    • Journal of Life Science
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    • v.20 no.5
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    • pp.729-735
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    • 2010
  • In our previous study, it was reported that an herbal mixture, SH21B, inhibits fat accumulation and adipogenesis both in vitro and in vivo models of obesity. SH21B is a mixture composed of seven herbs: Scutellaria baicalensis Georgi, Prunus armeniaca Maxim, Ephedra sinica Stapf, Acorus gramineus Soland, Typha orientalis Presl, Polygala tenuifolia Willd, and Nelumbo nucifera Gaertner (Ratio 3:3:3:3:3:2:2). The aim of this study was to investigate the detailed molecular mechanisms of the effects of SH21B on various regulators of the adipogenesis pathway. During the adipogenesis of 3T3-L1 cells, SH21B significantly decreased the expression levels of central transcription factors of adipogenesis, such as peroxisome proliferator-activated receptor (PPAR)$\gamma$ and CCAAT/enhancer binding protein (C/EBP)$\alpha$. To elucidate the detailed molecular mechanism of the anti-adipogenic effects of SH21B, we examined the expression levels of the various pro-adipogenic or anti-adipogenic regulators of adipogenesis upstream of $PPAR{\gamma}$ and C/$EBP{\alpha}$. The mRNA levels of Krox20 and Kruppel-like factor (KLF) 15, which are pro-adipogenic regulators, were significantly down-regulated by SH21B treatment, whereas the mRNA levels of C/$EBP{\gamma}$ and KLF5 were not changed. KLF2 and C/EBP homologous protein (CHOP), which are anti-adipogenic regulators, were significantly up-regulated by SH21B treatment. These results suggest that the molecular mechanism of the anti-adipogenic effect of SH21B involves both the down-regulations of pro-adipogenic regulators, such as Krox20 and KLF15, and the up-regulations of anti-adipogenic regulators, such as KLF2 and CHOP, which results in the suppression of central transcription factors of adipogenesis including $PPAR{\gamma}$ and C/$EBP{\alpha}$.

Transcriptome Analyses for the Anti-Adipogenic Mechanism of an Herbal Composition (생약복합물의 지방세포형성억제 기전규명을 위한 전사체 분석)

  • Lee, Hae-Yong;Kang, Ryun-Hwa;Bae, Sung-Min;Chae, Soo-Ahn;Lee, Jung-Ju;Oh, Dong-Jin;Park, Suk-Won;Cho, Soo-Hyun;Shim, Yae-Jie;Yoon, Yoo-Sik
    • Journal of Life Science
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    • v.20 no.7
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    • pp.1054-1065
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    • 2010
  • SH21B is a natural composition composed of seven herbs: Scutellaria baicalensis Georgi, Prunus armeniaca Maxim, Ephedra sinica Stapf, Acorus gramineus Soland, Typha orientalis Presl, Polygala tenuifolia Willd and Nelumbo nucifera Gaertner (Ratio 3:3:3:3:3:2:2). In our previous study, we reported that SH21B inhibited adipogenesis and fat accumulation in 3T3-L1 cells through modulation of various regulators in the adipogenesis pathway. The aim of this study was to analyze the transcriptome profiles for the anti-adipogenic effects of SH21B in 3T3-L1 cells. Total RNAs from SH21B-treated 3T3-L1 cells were reverse-transcribed into cDNAs and hybridized to Affymetrix Mouse Gene 1.0 ST array. From microarray analyses, we identified 2,568 genes of which expressions were changed more than two-fold by SH21B, and the clustering analyses of these genes resulted in 9 clusters. Three clusters among the 9 showed down-regulation by SH21B (cluster 4, cluster 6 and cluster 9), and two clusters showed up-regulation by SH21B (cluster 7 and cluster 8) during the adipogenesis of 3T3-L1 cells. It was found that many genes related to cell proliferation and adipogenesis were included in these clusters. Clusters 4, 6 and 9 included genes which were related with adipogenesis induction and cell cycle arrest. Clusters 7 and 8 included genes related to cell proliferation as well as adipogenesis inhibition. These results suggest that the mechanisms of the anti-adipogenic effects of SH21B may be the modulation of genes involved in cell proliferation and adipogenesis.

Factors affecting the Organizational Commitment of Industrial Accident Hospital Employees by Job Category (병원 구성원들의 직종별 조직몰입의 영향요인에 관한 연구)

  • Bang, Yong-Joo;Ha, Ho-Wook;Sohn, Tae-Yong
    • Korea Journal of Hospital Management
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    • v.7 no.4
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    • pp.24-56
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    • 2002
  • The purpose of this study was to analyze the characteristics of socio-demographic, organizational culture, organizational conflict and organizational commitment, and to examine the interrelation of influential factors in the organizational commitment. The data for this study were collected through a self-administrated survey with a structured questionnaire to 1,027 subjects from several medical doctor staff members, nursing staff members, administration staff members, pharmacist, and technical expert of eleven hospitals. The data were collected by self-reporting questionnaire from July 29 to September 7, 2002. In this analysis frequency test, t-test, ANOVA, multiple regression were used. The main results of this research is as following; 1. According to socio-demographic characteristics the respondents' level of the organizational commitment was higher in a administration staff members than others, for males than females, and for employees aged more than forty, as working for longer time, and as higher level of the working position. 2. According to the organizational culture characteristics the progressive culture, affiliative culture, and task-focused culture among many types of organizational culture were moderately and positively correlated with the level of the organizational commitment while the hierarchical culture was negatively correlated. 3. According to the organizational conflict characteristics as the respondents who got less conflict experience in the organization, their level of the organizational commitment was higher. And, technical conflict experiences were expressed greater than hierarchical conflict experiences. 4. According to the job satisfaction characteristics as his or her satisfaction that is about the promotion, working itself, salary, and fellowship in the organizational was higher, the level of the organizational commitment was higher. The most important factor of the satisfactions was the fellowship among the respondents while the level of job satisfaction for the promotion and salary was average. 5. Overall, according to the result of Multiple Regression as older age and longer working hours, the level of the organizational commitment was higher and as a higher level of the satisfaction for the promotion, working itself, salary, and fellowship in the organization, it caused more effective factors for the organizational commitment. 6. According to the result of Multiple Regression for the doctor staff members in special hospitals rather than general hospitals the hierarchical culture and task focused culture was positively correlated with the satisfaction of working itself while hierarchical conflict factors in the organizational conflict characteristics was negatively correlated with the organizational commitment. For the nursing staff members the affiliative culture and the job satisfaction for the promotion, working itself, salary, and fellowship were positively correlated with the organizational commitment. For the administration staff members as the job satisfaction for the fellowship was positively correlated with the organizational commitment. For medical and pharmacy staff members as more working experience, correlation with the organizational commitment was positive. Besides, as he or she has a high perception of the affiliative culture, it caused statistically more effective factors for the organizational commitment. For the skill and technicians, male worker expressed greater organizational commitment in the organization than female worker. And also older age along with higher education also showed higher organizational commitment. Moreover, the job satisfaction for the fellowship was positively correlated with the organizational commitment. This study identified the major effective factors of the organizational commitment and analyzed the differences among the job category. In that respect, it is significant for the study to be able to provide a reference for managing hospital of industrial accident and organizational development. However, this study has a problem, which is not to identify a valuable model for examining the relationship between organizational factors such as organizational culture, conflict, satisfaction, and commitment. Therefore, further study is needed and strengthened in the field of organizational commitment for hospital for industrial accident.

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Research about CAVE Practical Use Way Through Culture Content's Restoration Process that Utilize CAVE (가상현실시스템(CAVE)을 활용한 문화 Content의 복원 과정을 통한 CAVE활용 방안에 대한 연구)

  • Kim, Tae-Yul;Ryu, Seuc-Ho;Hur, Yung-Ju
    • Journal of Korea Game Society
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    • v.4 no.3
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    • pp.11-20
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    • 2004
  • Virtual reality that we have seen from the movies in 80's and 90's is hawing near based on the rapid progress of science together with a computer technology. Various virtual reality system developments (such as VRML, HMD FishTank, Wall Type, CAVE Type, and so on) and the advancement of those systems make for the embodiment of virtual reality that gives more sense of the real. Virtual reality is so immersive that makes people feel like they are in that environment and enable them to manipulate without experiencing the environment at first hand that is hard to experience in reality. Virtual reality can be applied to the spheres, such as education, high-level programming, remote control, surface exploration of the remote satellite, analysis of exploration data, scientific visualization, and so on. For some connote examples, there are training of a tank and an aeroplane operation, fumiture layout design, surgical operation practice, game, and so on. In these virtual reality systems, the actual operation of the human participant and virtual workspace are connected each other to the hardware that stimulates the five senses adequately to lend the sense of the immersion. There are still long way to go, however, before long it will be possible to have the same feeling in the virtual reality as human being can have by further study and effort. In this thesis, the basic definition, the general idea, and the kind of virtual reality were discussed. Especially, CAVE typed in reality that is highly immersive was analyzed in definition, and then the method of VR programming and modeling in the virtual reality system were suggested by showing the restoration process of Kyongbok Palace (as the content of the original form of the culture) that was made by KISTI(Korea Institute of Science and Technology Information) in 2003 through design process in virtual reality system. Through these processes, utilization of the immersive virtual reality system was discussed and how to take advantage of this CAVE typed virtual reality system at the moment was studied. In closing the problems that had been exposed in the process of the restoration of the cultural property were described and the utilization plan of the virtual reality system was suggested.

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