• Research in Community and Public Health Nursing
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• v.13 no.2
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• pp.205-215
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• 2002

Objectives: This study was designed to develop and evaluate a stage matched exercise intervention program to effectively increase exercise behaviors in urban elders. Methods: The study included three phases: preliminary descriptive data collection, program development, and program evaluation. The data for the preliminary descriptive phase were collected between May and June 2001. The study participants were 89 urban elders who responded a questionnaire that included general characteristics, exercise related experiences, stage, and process of change in exercise behaviors. Data were analyzed using descriptive statistics, $x^2$-test, and content analysis. Development of the program was based on the preliminary data. and a literature review, and was guided by the tran theoretical model. It consisted of strategies to facilitate the process of changes used in each stage. Evaluation of the program was achieved from October to December 2001, using a case study method, in which eight urban female elders participated. Interviews were conducted on a weekly basis in the form of either an individual interview, or group discussion. Each elder subject received education in accordance with the program strategies and education materials. In the case that a subject's stage of change moved into another one, the scores for the process of change were re-measured. The data were analyzed using the content analysis technique. Results: The results were as follows: 1. Elders who participated in the preliminary data collection phase were over 75 years of age, and the majority of them were women. They had a higher educational level, and fewer number of illnesses than the subjects in other studies. Their stage of change was divided into pre-contemplation and maintenance. The social liberation scores were the highest across all stages of change. There was no difference between men and women on scores for processes of change in each stage. 2. The stage matched exercise intervention program that was developed in this study consisted of one counseling type program and three distinguished educational booklet materials. 3. The results of the case studies are as follows: 1) The study participants were 8 women between 75 and 87 years of age. At the first interviews, all of them were in the pre-contemplation stage. All of them reached the action stage before the 7th week. The scores for processes of change that were the focus in each stage increased more than the scores for other processes of change. During the early stages of change, experimental processes increased more than behavioral processes. However. this pattern was reversed during later stages of change. 2) Characteristics of the subjects in each stage were identical as presented at the tran theoretical model. The intervention strategies were effective in the transition occurred in any stage. 3) Barriers for exercise included unwillingness to exercise, fatigue, shortness of breath, and pain. Ways to overcome these barriers were 'learning an alternative exercise method that can be done at home', 'self-promising/ exercise-promising', and 'use of cues to exercise'. 4) The factors that affected the application of the program were consideration of age and personal preference in selecting an exercise pattern, individualized intervention, and use of education materials appropriate to elders. Women over 80 years of age preferred muscle strengthening and stretching exercise, because they can be easily done at home. They also preferred individualized interventions, materials that were easy to read, and education contents appropriate for elders. Conclusion: In conclusion, the stage matched exercise intervention program that considered the characteristics of the elders was effective to facilitate exercise behaviors of the elders.

• The Korean Nurse
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• v.31 no.4
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• pp.77-99
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• 1992

The study was carried out at W. hospital, an affiliated hospital of Y university, involved a total of 163 patients who were discharged from the hospital between May 1990 und March 199J. Data collection was twice, just prior to discharge and a minimum of three months post discharge. Thirty patients who lived within a hour travel time of the hospital received home care during the three months post discharge. Nursing diagnoses and nursing interventions For these patients were analyzed in this study. The results of the study are summarized as follows : 1. Discharge needs for the subjects of the study were analyzed using Gordon's eleven Functional categories and it was found that 48.3% of the total sample had identified nursing needs. Of these, the needs most frequently identified were in the categories of sexuality, 79.3 %, health perception, 68.2 % self concept, 62.5 %, and sleep and rest 62.5 %. Looking ut j he nursing diagnosis that were made for the 30 patients receiving home care, the following diagnoses were the most frequently given; alteration in sexual pattern 79.3%, alterations in health maintenance, 72.6%, alteration in comfort, 68.0%, depression, 64.0%, noncompliance with diet therapy, 6.3.7%, alteration in self concept, 55.6%, and alteration in sleep pattern, 53%. 2. In looking at the effects of home nursing care as demonstrated by changes in the functional categories over the three month period, it was Found that of the 11 functional categories, the need level for health perception, nutrition, activity and self concept decreased slightly over the three month period. On the average sleep patterns improved, but restfulness was slightly less and bowel elimination patterns improved but satisfaction with urinary elimination was slightly less. On the other hand, role enactment, sexuality, stress management and spirituality decreased slightly. The only results that were statistically significant at the 0.05 level were improvement. in digestion and decrease in pain. No statistically significant changes were found in ability related to ADL, the total ADL Score at discharge was $19.78{\pm}8.234, and after 3 months $19.01{\pm}8.12$. Considering that a majority of the patients were over 60 years of age and that many had brain or spinal cord injuries, the fact that their ADL ability did nor deteriorate after discharge can be interpreted as related to a positive impact by the home health care nurses. Similarly there was a slight be not statistically significant decrease in the quality of life scores between the two lest times(l47.83 at discharge and 113.02 at the three month period). Again, when the chronic nature of thee problems facing these patients is considered this maintenance of quality of life can be interpreted as a positive impact by the home health care nurses. 3. One of the home care nursing activities was diagnosis. For this activity it was found that for nine functional health categories(sexuality and spirituality excepted) there were 20 nursing diagnoses. The most frequent were noncompliance, alteration in skin integrity both actual and potential, and impaired physical mobility in that order. 4. Delivery of home health care by the home health nurses included the following nursing activities; assessment, patient education, demonstration of care activities, counselling, direct care to the patient and referrals. Direct care included changing dressings, bladder irrigations, changing Foley catheters, measurement of residual urine, perineal care, position change, back care, oral hygiene, exercise and massage of motion exercises, cleansing enemas, tracheostomy suctioning and tracheostomy care, care of dentures, applications of heat and other similar nursing activities. In conclusion almost 50% of (he sample indicated a need for continued nursing care at the time of discharge and for the patients in the sample who received home care there was a slight decrease in nursing needs but while the patients had chronic and debilitation problems there was ill decrease in ADL abilities or in quality of life. Further study needs Lo be done La increase the reliability and validity of the tool that was used to measure home health care needs. It is also recommended that study by done using a randomized sampling with a control group to compare patients who receive home care with those who do not.

• 대한공업교육학회지
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• v.37 no.1
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• pp.21-41
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• 2012

The objective of this study was to examine the relation between delinquency and career maturity in school adolescents and to determine whether activities for enhancing career maturity can have protective effects against juvenile delinquencies. Research questions for this study are: first, how serious school adolescents' delinquencies are; and second, what relation there is between delinquency and career maturity in school adolescents. Third, how different is school adolescents' career maturity according to their experience in delinquencies? The results of this study were as follows. First, 55.8% of the school adolescents committed one or more of the 14 types of delinquent acts included in the delinquency inventory during the last one year, and the percentage was higher among male students than among female ones. Second, no correlation was observed between the school adolescents' overall delinquency level and overall career maturity. According to the sub-factors of career maturity, however, the overall delinquency level was in a negative correlation with objectiveness and a positive correlation with independence/decisiveness. That is, objectiveness was higher in the group without experiences in delinquencies than in the group with such experiences. and Type II status offenses (truancy, runaway) was in a negative correlation with overall career maturity, and in a negative correlation with objectiveness and confidence. Third, no significant difference was observed in career maturity between those with experience in delinquencies and those without. Among the sub-factors of career maturity, however, objectiveness was higher in those without experience in delinquencies than in those with. and Overall career maturity, and objectiveness and confidence among the sub-factors of career maturity were significantly higher in those without experience in Type II (truancy, runaway) status offenses than those with. The results of this study suggest that the objectiveness of career maturity can be a protective factor against juvenile delinquency. Furthermore, they suggest that activities for enhancing career maturity may protect adolescents from Type II status offenses. These results may provide basic materials necessary to develop career counseling approaches and interventions strategies for preventing school adolescents' delinquencies.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.63-71
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• 2009

Background: The treatment of tracheal stenosis includes less invasive bronchoscopic intervention and more invasive segmental resection & anastomosis. Depending on the patient's clinical features, sometimes all these methods are inappropriate. Silicone T-tube stenting has recently been used as an alternative, safe management of tracheal stenosis. We studied the short term and Intermediate term results of using T-tubes in patients with tracheal stenosis, and this tracheal stenosis was caused by various underlying diseases. Material and Method: We retrospectively reviewed 57 patients with tracheal stenosis and who were treated with T-tubes between Jan 1997 and Apr 2007. Based on the patient's medical records and the imaging studies, we evaluated the clinical findings and status of T-tube removal. Result: There was no T-tube related morbidity or mortality in this series. On follow-up, one patient underwent sleeve resection and end-to-end anastomosis. The T-tube could be successfully removed from 13 patients (13/57, 22.8%) without additional interventions. For another four patients, a T-tube was again inserted after removal of the first T-tube due to tracheomalacia or recurrent stenosis. Four patients died of underlying disease and cancer. The patients' gender and previous tracheostomy significantly affected T-tube removal. By contrast, multiple logistic regression analysis identified gender as a predictor of successfully removing a T-tube. Gender (p=0.033) and previous tracheostomy (p=0.036) were the two factors for success or failure of T-tube removal. Conclusion: A T-tube provided reliable patency of a stenotic airway that was caused by any etiology. We have proven that using a T-tube is safe and effective therapy for patients with tracheal stenosis for the short term or the intermediate term.

• Journal of Chest Surgery
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• v.42 no.2
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• pp.226-232
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• 2009

Background: Blunt chest trauma accounts for 90% of all chest traumas in Europe and the United States and this causes 20% of all trauma-related deaths. The major cause of morbidity and mortality after blunt chest trauma is undetected injuries. For this reason, chest computerized tomography has gained popularity for the evaluation of trauma, but it is expensive and it exposes patients to radiation. This study identified the clinical features associated with the diagnosic information obtained on a CT chest scan, as compared with a standard chest X-ray, for patients who sustained blunt trauma to the chest. This study also evaluated the role of a routine computed tomographic (CT) scan for these patients. The patients who had chest computed tomography done after the initial chest x-ray were analyzed separately for the presence of occult injuries. Material and Method: We studied 100 consecutive patients from November 2006 to July 2007: 74 patients after motor vehicle crashes and 26 patients after a fall from a height >2m. Simultaneous with the initial clinical evaluation, an anteroposterior chest radiograph and a helical chest CT scan were obtained for all the patients. The data extracted from the medical record included the vital signs, the interventions and the type and severity of injury (RTS). Result: Among the 100 cases, 79 patients showed at least more than one pathologic sign on their chest radiograph, and 21 patients had a normal chest radiograph. For 17 of the patients who had a normal chest X ray, the CT scan showed multiple injuries, which were pneumothorax, hemothorax, lung contusion, sternal fracture etc. This represents that a CT scan is statistically superior to a chest radiograph to diagnose the pathologic signs. But on the other hand, as for treatment, only 31 patients were diagnosed by CT scan and they were treated with chest tube insertion ect. 42 patients needed ony conservative management without invasive thoracosurgical treatment such as chest tube insertion or open thoracotomy. 27 patients were treated based on the diagnosis made by the chest radiograph and physical examination. Conclusion: Chest computerized tomography was significantly more effective than routine chest X-ray for detecting lung contusion, pneumothorax and mediastinal hematoma, as well as fractured ribs, scapula and, sternum. Although the occult findings increased, the number of patients who needed treatment was small. Therefore, we suggest making selective use of a CT scan to avoid its overuse in ERs.

• Korean Journal of Community Nutrition
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• v.25 no.2
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• pp.91-101
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• 2020

Objectives: The aim of this study was to investigate dietary intakes and nutritional status among Uganda primary school children from two selected schools in urban and rural areas. Methods: Data were collected from 350 pupils (6-14 years) in Mpigi district, Uganda. All participants were offered a school lunch meal (usually maize porridge and boiled beans). Dietary survey was conducted in October 2016. Data for dietary intake levels were collected by the 24-hour recall method with trained school staffs. The data were converted into nutrient intakes using the CAN-Pro 5.0 Program and compared with KDRIs to evaluate the nutritional status of the subjects. Diet quality indexes such as nutrient density, nutrient adequacy ratio (NAR), mean adequacy ratio (MAR), and index of nutritional quality (INQ) and a diet diversity index such as diet diversity score (DDS) were calculated to evaluate nutritional status among subjects. Data were analyzed using SPSS statistical programs. Results: Results show that the intakes of most nutrients were significantly different by schools. The nutritional status of micro-nutrients was very low in both schools according to analysis of nutritional indexes such as NARs and INQs. Students from both schools should improve intakes of micro-nutrients related to child growth such as calcium, Vitamin B₆, zinc and folate. According to the analysis of dietary diversity, there was difference in dietary patterns by schools presumably due to their locations. Conclusions: This suggests that current meals could not provide adequate nutrients for the subjects and urgent nutrition interventions for school food services are needed to improve their nutritional well-being. New foods supplements based on local cuisine are also needed to ensure dietary diversity and sustainable development plans.

• Korean Journal of Psychosomatic Medicine
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• v.9 no.1
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• pp.49-57
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• 2001

Objectives : This study was designed to investigate the relationship between gastric emptying, psychopathology(especially anxiety and depression), and various factors that can mediate stress and response, such as coping style, social support and level of perceived stress. Methods : A total 30 patients who complained of the non-ulcer dyspepsia and did not have any abnormal finding on the gastroduodenal endoscopic examination, 24 hour ambulatory esophageal manometry and conventional gastroesophageal manometry were tested with gastric emptying that would be a functional examination of stomach. The correlations between the gastric emptying and psychological vaiable such as quantity of perceived stress, Symptom Checklist-90-Revision(SCL-90-R), Beck Depression Inventory(BDI), Spielberger Stait-Trait Anxiety Inventory(STAI), Ways of Coping Checklist and Interpersonal Support Evaluation List were evaluated. Results : 1) The mean and standard deviation of the time for half of the meal to empty(T50%) was $118.50{\pm}23.64$ minute which showed no gastric stasis in terms of gastric emptying test. 2) There were significant positive correlations between T50% and the state anxiety, T50% and thedepression. 3) There was no significant correlation between T50% and the quantity of perceived stress, T50% and mediating factors(coping style and social support). Conclusion : These results suggested that psychopathology, especially emotional components such as depression and anxiety, could affect on the current physiological functional gastric activity(gastric emptying), but quantity of perceive stress and mediating factors of stress and response such as coping style and social support could not affected on the functional gastric activity. These results showed that psychological interventions should considered in management of the patients with functional dyspepia.

• Korean Journal of Psychosomatic Medicine
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• v.25 no.1
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• pp.46-55
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• 2017

Objectives : Outpatient treatment orders refer to a mandatory social program in which mentally ill persons are ordered by the court to participate in specified outpatient treatment programs. This study aimed to investigate the factors that affect outpatient treatment orders and adherence to outpatient treatment in mental health patients. Methods : A survey on outpatient treatment orders and adherence to outpatient treatment was conducted on 60 psychiatrists between October and November 2016. The questionnaire items were drafted based on a literature review, and they were then evaluated by 3 psychiatrists and 1 law school professor before being finalized. Answers from the respondents were analyzed using descriptive statistics, and the median, maximum, and minimum values of the effectiveness scores of outpatient treatment orders were calculated. Results : Among the 60 psychiatrists, 45(75.0%) were aware of outpatient treatment orders; however, only 2 out of the 45(4.0%) had actually used the program in the last 12 months. The subjective effectiveness was very low, with only 40 points out of 100. Furthermore, of the readmitted patients, 37.7% had received continued outpatient treatment, whereas 53.1% chose to quit the outpatient treatment programs, meaning that the number of dropouts was higher. Among the discharged patients, approximately two-thirds were receiving continued treatment. With regard to follow-up for dropouts, majority of the responses were either "Not taking any action"(n=27) or "Not following up"(n=15). Only two respondents answered "Contact the community mental health promotion center," meaning that this response was very rare. Meanwhile, when asked about efficient measures to be implemented for dropouts, a vast majority of the respondents(n=30) selected the answer "Work with the community mental health promotion center." Conclusions : The outpatient treatment orders currently being administered were found to be ineffective, and the associated adherence to outpatient treatment was also found to be extremely poor. Hence, the effectiveness of the therapeutic interventions could benefit from institutional as well as administrative improvements. Community mental health promotion centers are expected to have an important role in the future.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.1
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• pp.19-25
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• 2018

Objectives : Firefighters frequently experience traumatic events, high-tension situations and shift work. Therefore, the prevalence of insomnia of firefighters is higher than one of general population. Not only does the quality of sleep affect the satisfaction of personal life, but it also influences their performance for the public's safety. We investigated which factors affect the quality of sleep of firefighters. Methods : After personally delivering 120 questionnaires to 3 fire stations, the survey was conducted when the consents were signed. It inquired about alcohol use, smoking, shift work, sleep quality, depression, anxiety, and experience of traumatic events. We then divided the firefighting officers in two groups according to the quality of sleep and compared the variables examined to conduct the logistic regression analyses according to the results. Results : The poor sleeper group reported a higher level of current alcohol consumption, depression, anxiety and experience of traumatic events. Logistic regression analyses showed that the current alcohol intake (Crude odds ratio=3.707, 95% confidence interval=1.288-10.672, p=0.015 ; Adjusted odds ratio=3.288, 95% confidence interval=1.011-10.694, p=0.048) has a significant effect on sleep quality. Conclusions : Current alcohol consumption, depression, anxiety and experience of traumatic events were respectively associated with sleep quality of firefighters. When all significant factors considered, the current alcohol use was the only statistically significant. To improve the quality of sleep for firefighters, it will be necessary to evaluate alcohol intake, educate the poor sleep quality caused by alcohol, and provide specific interventions to reduce consumption.

• Journal of Hospice and Palliative Care
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• v.8 no.1
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• pp.37-44
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• 2005

Purpose: To provide the basic data in developing the nursing intervention for patients who have symptoms of insomnia after undergoing hemopoietic stem cell transplantation (HSCT). This was achieved through investigating sleep quality and sleep patterns according to admission time, and discharge time. Methods: Data was put together by studying 52 HSCT patients who have been admitted to the department of HSCT from August 2002 to August 2003, in a university hospital. Research instruments used were, PSQI for sleep quality and a specified questionnaire for sleep patterns. Results: The PSQI regarding the past mono which was measured at the last day of hospitalization, was 11.8. This was significantly higher than 5.3, which was a measurement for the past month before the hospitalization (t=11.41, P=0.000). Looking at it with 7 categories-quality of sleep, consistency of sleep, sleep period, effectiveness of sleep, sleeping disorder, usage of sleeping pills, impediment of daily life- the PSQI for a month after admission increased significantly compared to the rate measured for a month before admission. Comparing the subjects sleep pattern before and after admission, it showed a significant difference regarding time attending sleep, time it takes to sleep, wake-up time, total time of sleep, day time sleep, number of times waking up during sleep, number of usage of sleeping pills, actions that are taken during sleep disorder, reasons for insomnia. Conclusion: The PSQI score of patients who undergo hemopoietic stem cell transplantation have increased significantly after hospitalization. Compared to the change of sleep patterns when hospitalized, significant changes were observed. Therefore nursing interventions addressing sleep are needed.