• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.33 no.2
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• pp.206-214
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• 2023

Objectives: To determine the effect of the various type and number of shift work on sociopsychological stress in the university hospital nurses in Seoul, South Korea. Methods: Data was collected through a self-administered questionnaire that included general characteristics, the type and number of shift work in the past 4 weeks and the an sociopsychological stress based on PWI-SF. Logistic regression analysis was conducted to analyze the effect of shift work by types on sociopsychological stress of university hospital nurses using SAS 9.4 and it adjusted general characteristics by the additional models. Results: When the number of night shift work 3 or 4 compared to 0, sociopsychological stress was significantly high(OR=2.16, 95% CI=1.29-3.65). When 5 or more, it was higher(OR=2.39, 95% CI=1.55-3.72). Two continuous night shift work compared to 0 increased sociopsychological stress(OR=2.37, 95% CI=1.49-3.81) and 3 or more even more(OR=2.70, 95% CI=1.72-4.27). If the shift work type changes 14 or 15 times compare to below 11, sociopsychological stress is increased and even higher when 15 or more times but it's not significant after adjusting for covariates. Conclusions: It suggests that workplace with nurse expose to shift work should be on lookout for more than three night shift work, more than two continuous night shift work and more than 14 shift work change which can lead to burnout, absenteeism, depression and decreased productivity.

• Sleep Medicine and Psychophysiology
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• v.9 no.1
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• pp.41-47
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• 2002

Objectives: In a number of simulated night shift studies, timed exposure to bright light improves sleep quality and work performance. We evaluated the effect of bright light on adaptation to night shift work with a field study. Methods: Five female nurses working shifts at Korea University Hospital were recruited for participation in this study. We investigated two series of six consecutive shift rotations comprising three day and three night shifts, using wrist Actigraphy, the Stanford Sleepiness Scale, Visual-analogue scales, STIM and tympanic membrane temperature for daytime sleep quality, alertness, subjective feeling, attention performance, and temperature rhythm. The subjects were exposed to bright light (2,500 lux) from 24:00 to 04:00 a.m. on three consecutive night shifts during the second series, whereas they worked under normal lightening (650 lux) conditions during the first series. Results: Actigraphic assessment of daytime sleep showed no significant difference between the first and third night shift in both baseline and light exposure phase. The mean lowest temperature shifted earlier during baseline phase but not during the light exposure phase. Also, the score for subjective feelings of depression, anxiety, physical discomfort and sleepiness was significantly higher in the third night shift than the first during baseline phase but not during the light exposure phase. Attention and attention switching ability was significantly improved in the third night shift compared to the first night during the light exposure phase but there were no significant changes during the baseline phase. Conclusion: This result suggests that there were no significant differences between the two phases in measures of quality of daytime sleep, but subjective feelings, attention and alertness were enhanced during light exposure. Although some placebo effects and learning effects might influence this result, bright light exposure between midnight and 4:00 a.m. may improve adaptation to night shift. In future, further controlled studies with a larger sample size, including melatonin measurement, are needed for real shift workers.

• Transactions of the Korean Society of Pressure Vessels and Piping
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• v.10 no.1
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• pp.113-121
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• 2014

In this work, an integrated model including molecular dynamics and chemical rate theory was implemented to calculate the growth of point defect clusters(PDC) and copper-rich precipitates(CRP) which could change the mechanical properties of reactor pressure vessel(RPV) steels in a nuclear power plant. A number of time-dependent differential equations were established and numerically integrated to estimate the evolution of irradiation defects. The calculation showed that the concentration of the vacancies was higher than that of the self-interstitial atoms. The higher concentration of vacancies induced a formation of the CRPs in the later stage. The size of the CRPs was used to estimate the mechanical property changes in RPV steels, as is the same case with the PDCs. The calculation results were compared with the measured values of yield strength change and Charpy V-notch transition temperature shift, which were obtained from the surveillance test data of Korean light water reactors(LWRs). The estimated values were in fair agreement with the experimental results in spite of the uncertainty of the modeling parameters.

• Journal of Korean Ophthalmic Optics Society
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• v.7 no.2
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• pp.33-39
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• 2002

The purpose of this study is to evaluate the effects of continuing work on VDT(video display terminal). Therefore, we examined visual fatigue by a questionnaire and measured frequency of blinking, tear film break-up time(BUT), height of palpebral fissure, visual acuity, refraction with retinoscopy and accommodation before and after two hour long VDT work. For the ocular symptoms, the greatest number was tired eyes accounting for 34%. In the visual symptoms, blurred vision was the highest rate of 83% and in case of systemic symptoms, shoulder pain was 38% marked top ranking but other symptoms were also distributed similar rate. The frequency of blinking during VDT work decreased significantly comparing with the one at rest. The average frequency of blinking is 8/min during VDT work and 22/min at rest. The BUT measured immediately after VDT work decreased much more than in the resting state. The average BUT was 7sec immediately after VDT work and 12sec at rest. The height of palpebral fissure during VDT work increased significantly comparing with the value at rest. The average height of palpebral fissure was 7.69mm at rest and 9.04mm during VDT work. The average visual acuity decreased almost 9.5% from 0.63 to 0.57, but refraction with retinoscopy increased about 0.28D to the direction of myopic shift. The amplitude of accommodation decreased approximately 1.49D from 7.98D to 6.49D and this resulted from the prolongation of near point of accommodation. Near point of convergence also was prolongated from 9.45cm to 10.30cm after VDT work.

• Journal of Korean Academy of Nursing
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• v.17 no.1
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• pp.24-32
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• 1987

This study was designed to investigate the changes of nurses' role model, perceptions toward occupation, and self actualization value in terms of the phases of socialization process. Two hundred and sixty nine nurses working in clinical settings were randomly selected from 15 general hospitals despersed over Seoul and Kyungki province. Data were gathered by the standardized Perceptual Orientation Test, the Self-actualization Test, and Questionnaires on role models and phases of socialization process developed by the investigators from October 1985 to March 1986. The data were analysed by ANOVA and Pearson's Correlation Coefficient. The results were as follows: 1. The average time period required for the shift of phases of socialization process were; phase Ⅰ, role adjustment, took average 10 months of employment: Phase Ⅱ, interpersonal adjustment, 12 months: and Phase Ⅲ, role conflict, 15 months respectively. Conflict resolution, phase Ⅳ, began to take place 18 months of employment; and shifted to phase V, internalization and self-actualization at 25 months of employment. 2. Throughout 5 consecutive phase, the number of immediate superior nurse model was dominantly the highest among the role models. The number of head nurse role model increased at phase Ⅱ, phase Ⅲ, and phase Ⅳ. Respondents with school model in phase I tended to transfer to work model at phase Ⅱ. 3. The perceptions toward occupation were not significantly influenced by the Phases of socialization process. 4. The score of self-actualization value was not significantly influenced by the phases of socialization process. 5. In regard to perceptions toward occupation, nursing director model group showed significantly lower score in phase I (p<.01). 6. The comparison of self-actualization value between the 5 phases revealed significant difference in phase I: in particular among respondents with school model at p<.05. To conclude: 1. The phase Ⅲ of socialization process is the period of role conflict which occur at 15 months of employment, an6 conflict resolution, phase Ⅳ, begins at 18 months of employment on the average in clinical settings. 2. The immediate superior nurse and the head nurse are important role models for nurses all through their socialization process.

• Korean Journal of Community Nutrition
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• v.8 no.5
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• pp.781-793
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• 2003

This study was performed to investigate the stress level and health-related behaviors of nurses and to provide basic information for developing educational programs in the health care field. The subjects of this study were 197 nurses and 94 nursing assistants working at hospitals in the Kyung-nam area. A survey was conducted using a self-administered questionnaire in November, 2002. The results were as follows : The average age and work experience of the subjects were 26.9 and 5.6 years, respectively. The number of respondents in the shift and non-shift operations was equally distributed. The mean height and weight were 161.2 cm and 52.7 kg, respectively. Even though the average body mass index (BMI) and obesity index were normal in the subjects, 9.2% of the subjects were overweight/obese, while 28.9% of the subjects were under weight, according to the obesity index. The mean score of stress was 27.5 \pm$\pm$ 4.6 out of 50 points. Most of the subjects were highly stressed about the amount of their work, problems regarding their future, and relationships with their superiors. With regard to changes in food intake due to stress, 44.1% showed an increased intake, while 32.3% showed a reduced intake. The degree of health consciousness of the married nurses, those over 36 years of age, and those with over 10 years of nursing experience was significantly higher than that of the unmarried nurses, those under 35 years of age, and those with under 10 years of nursing experience (p<0.01). Fifty-one point three percent of the subjects thought their health status was unhealthy. Fifty-seven percent of the subjects had tried weight control. Their main reason for trying weight control was to have a slender figure (62.3%), and their methods of weight control were moderation in intake(45.6%), exercise and dieting (36.9%). TV/radio (49.5%) and newspaper/magazines (47.1%) were the primary sources of nutritional and health information for the subjects, and professional (25.1%) and the internet (13.4%) were ranked relatively highly. The food components of most concern to the subjects during meal time were (in order of importance) fats (51.9%), calories (40.2%) and salt (35.1%). The subjects considered 'taking a rest' (73.5%) as the most important factor in maintaining an optimal health status, followed by self-relaxation (56.4%), moderation in diet (39.5), bathing or using a sauna (25.7%) and exercising (22.7%).

• Korean Journal of Occupational Health Nursing
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• v.6 no.1
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• pp.23-43
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• 1997

The work-related diseases due to continuous overwork are mainly cerebro- and cardio-vascular ones, which is commonly called 'Karoshi', death from overwork. Many factors are capable for Karoshi : occupational stress in relation to technological renovation and industrial rationalization, competitive social structure, and accumulated fatigue accured to long time or irregular working. And its occurence is on the rise. The World Labor Report 1993 released by ILO, pointed out the diseases related to overwork and stress as one of the most important occupational health problem. In Korea, social awareness of Karoshi is at an infant stage, and reliable statistics for its occurence are not compiled in a convenient manner. Despite the rising Karoshi, there are no reliable clauses in workmen's compensation enough to settle down the disputes. Therefore, it is not uncommon that the Labour Ministry and Civil Court find difficulties in reaching an agreement. This study was intended to provide proper compensation and prevention program for workers by suggesting reasonable compensation clauses for the death from overwork. This study consists of two comparative reviews on the compensaton clauses for the death from overwork. One is to review legal standards of Karoshi among three countries, such as Korea, Japan and Taiwan. The other is to investigate the cases of Karoshi in Korea, 121 cases identified at the Labor Welfare Corperation and the Labour Ministrial process of examination and reexamination, and 73 leading cases at the High Court of Justice. The main findings of the study are as follows : 1. Comparisons of comperative review on compensation clauses for the death from overwork among three countries. 1) All of three countries have the same kinds of disease for compensation, which were cerebro-and cardiao-vascular diseases, while for cardiac disease group, Korea has the smaller number of diseases for compensation than Japan. 2) As for the definition of overwork, the three countries share equally that overload for one week prior to collapse is considered as an important factor, but accumulated chronic fatigue is disregarded. 3) As the basis of overwork, in Japan, there is a tendency to move from the conditions of an ordinary healthy adult to those of the individual concerned in Japan, whereas there is no such concern yet in Korea. 4) All the three countries use a common standard of medical judgement in demonstrating causal relationship between a job and a disease. However, Korea is progressive in the sense that in the case of CVA at worksite, the worker himself has no obligation to prove the cause. 2. The results of a comparative review on excutive decisions by Labor Ministry and judicial decisions by the Court in Korea : A judicial decision is based on the legalistic probability, but a excutive decision is not. Therefore, excutive decisions have such restrictions that : 1) TIA (transitory ischemic cerebral attack) and myocarditis are excluded from compensation, and there is little consistency of decision in the case of cause-unknown death. 2) There is a tendency not to compensate for the death from overwork since the work terms such as repeated long-time working, shift work or night-shift work are not considered as overloading. 3) There is a tendency to regard the conditions of a ordinary healthy adult rather than those of the individual concerned(age, existing diseases, health state, etc.) as the comparative basis of overload. 4) There remains a tendency not to compensate for the death from overwork in the case of collapse occuring out of workplace, on the ground of 'on the course of working' and 'in the cause of accident'. Through the study, the fact manifests itself that Korea's compensation clauses for work-related diseases due to overwork are very restrictive. So, it is necessary to extend the Labor Ministry's clauses of compensation for the death from overwork following to the recent changes of other countries and internal judicial decisions. This is very important in the perspective of occupational health that aims at health promotion of workers including prevention of the Karoshi.

• Journal of Korean Academy of Nursing Administration
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• v.3 no.1
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• pp.119-133
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• 1997

Continuing shift service of clinical nurses can be not only the cause of occupational dissatisfaction by being connected with the change of circadian rhythm and the burden of duties to be applicable to such changes. But also of inviting the lowering of nursing quality by being affected to the resignation of the nurses as the threat to the health of the nurses. This study has selected 500 nurses at random under non-probability sampling who have been serving by shift in 7 general hospitals which have over 400 sickbeds for the purpose of cross-sectional survey design from Sep. 7 through 20, 1996. Standardized modification of the CMI has been used which was designed for Koreans with Cornell Medical Index developed by Broadman and his fellow workers as the study device. The structure of the device was composed of 35 questions on physical appeal(Chronbach's ${\alpha}=8507$) and 22 questions of mental appeal(Cronbach's ${\alpha}=.8166$ totalling 57 questions. The collected data has been computerrized by using SPSS. General character, present symptom, perceived symptom and others are sought by practical number and percentage, and the health condition comparison followed by general characters was conducted by t-test and ANOVA. The post test was by Duncan's test by the level of p<.05. 1) The items of the answer that they have the physical symptom presently by 50% or over of the nurses were as "Do you often have spells of severe dizziness", "Are your eyes often red or inflamed", "Does press or pain in the head often make like miserable", "Are your ankles often badly swollen", "Do pains in the back make it hard for you to keep up with your work". 2) The items of the answer by over 50% of the nurses as the mental symptom at present were "do you fell bad when criticized?", "Do you get angry when everything is against your will?", "do you get angry when ordered to do this and that?", "do you feel uneasy by such a trifle thing?", "do you tremble or are you freightened by sudden sound?". The mental and physical symptoms which have appeared presently in connection with the shift service have been agreed with each other. But the physical condition has been worse than the mental one. 3) In the physical health conditions followed by demosociological character, there were the significant differences by sex, religion and place of residence(p<.05), and in the mental health conditions, there were the significant differences by age, marital status, residence place and the required time for attending hospital(p<.05). 4) There was significant difference by the degree of satisfaction about the duty in both the physical and mental health conditions. In short, the higher the degree of duty satisfaction, the better the health conditions. 5) There were the significant difference according to the times of night duty and whether they take the drug or not or the kinds of the drugs in the physical health conditions related with the characters of night shift. Mental health conditions in the night shift case showed significant differences according to their taking drug or not or the kinds of the drugs(p<.05). I can confirm that the nurses have been affected continuously by the shift service mentally and physically. The maintenance of the physical and mental health of the nurses and its promotion are very important problem to guarantee the quality nursing in the performance of the nursing service continuously and effectively, so the hospital should make every effort to improve the duty conditions by finding out the causes affecting to their health. In the nursing management viewpoint, I think that elevating the satisfaction degree about the duty would be a great help to the promotion of physical and mental health conditions. But what is most important is that the nurses themselves should take care of themselves in maintaining the good conditions in their service in the hospital.

• The Korean Nurse
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• v.36 no.1
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• pp.77-96
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• 1997

The duty shifts of hospital nurses not only affect nurses' physical and mental health but also present various personnel management problems which often result in high turnover rates. In this context a study was carried out from October to November 1995 for a period of two months to find out the status of hospital nurses' duty shift patterns, and preferred duty hours and fixed duty shifts. The study population was 867 RNs working in five general hospitals located in Seoul and its vicinity. The questionnaire developed by the writer was used for data collection. The response rate was 85.9 percent or 745 returns. The SAS program was used for data analysis with the computation of frequencies, percentages and Chi square test. The findings of the study are as follows: 1. General characteristics of the study population: 56 percent of respondents was (25 years group and 76.5 percent were "single": the predominant proportion of respondents was junior nursing college graduates(92.2%) and have less than 5 years nursing experience in hospitals(65.5%). For their future working plan in nursing profession, nearly 50% responded as uncertain The reasons given for their career plan was predominantly 'personal growth and development' rather than financial reasons. 2. The interval for rotations of duty stations was found to be mostly irregular(56.4%) while others reported as weekly(16.1%), monthly(12.9%), and fixed terms(4.6%). 3. The main problems related to duty shifts particularly the evening and night duty nurses reported were "not enough time for the family, " "afraid of security problems after the work when returning home late at night." and "lack of leisure time". "problems in physical and physiological adjustment." "problems in family life." "lack of time for interactions with fellow nurses" etc. 4. The forty percent of respondents reported to have '1-2 times' of duty shift rotations while all others reported that '0 time'. '2-3 times'. 'more than 3 times' etc. which suggest the irregularity in duty shift rotations. 5. The majority(62.8%) of study population found to favor the rotating system of duty stations. The reasons for favoring the rotation system were: the opportunity for "learning new things and personal development." "better human relations are possible. "better understanding in various duty stations." "changes in monotonous routine job" etc. The proportion of those disfavor the rotating 'system was 34.7 percent. giving the reasons of"it impedes development of specialization." "poor job performances." "stress factors" etc. Furthermore. respondents made the following comments in relation to the rotation of duty stations: the nurses should be given the opportunity to participate in the. decision making process: personal interest and aptitudes should be considered: regular intervals for the rotations or it should be planned in advance. etc. 6. For the future career plan. the older. married group with longer nursing experiences appeared to think the nursing as their lifetime career more likely than the younger. single group with shorter nursing experiences ($x^2=61.19.{\;}p=.000;{\;}x^2=41.55.{\;}p=.000$). The reason given for their future career plan regardless of length of future service, was predominantly "personal growth and development" rather than financial reasons. For further analysis, the group those with the shorter career plan appeared to claim "financial reasons" for their future career more readily than the group who consider the nursing job as their lifetime career$(x^2$= 11.73, p=.003) did. This finding suggests the need for careful .considerations in personnel management of nursing administration particularly when dealing with the nurses' career development. The majority of respondents preferred the fixed day shift. However, further analysis of those preferred evening shift by age and civil status, "< 25 years group"(15.1%) and "single group"(13.2) were more likely to favor the fixed evening shift than > 25 years(6.4%) and married(4.8%)groups. This differences were statistically significant ($x^2=14.54, {\;}p=.000;{\;}x^2=8.75, {\;}p=.003$). 7. A great majority of respondents(86.9% or n=647) found to prefer the day shifts. When the four different types of duty shifts(Types A. B. C, D) were presented, 55.0 percent of total respondents preferred the A type or the existing one followed by D type(22.7%). B type(12.4%) and C type(8.2%). 8. When the condition of monetary incentives for the evening(20% of salary) and night shifts(40% of. salary) of the existing duty type was presented. again the day shift appeared to be the most preferred one although the rate was slightly lower(66.4% against 86.9%). In the case of evening shift, with the same incentive, the preference rates for evening and night shifts increased from 11.0 to 22.4 percent and from 0.5 to 3.0 percent respectively. When the age variable was controlled. < 25 yrs group showed higher rates(31.6%. 4.8%) than those of > 25 yrs group(15.5%. 1.3%) respectively preferring the evening and night shifts(p=.000). The civil status also seemed to operate on the preferences of the duty shifts as the single group showed lower rate(69.0%) for day duty against 83. 6% of the married group. and higher rates for evening and night duties(27.2%. 15.1%) respectively against those of the married group(3.8%. 1.8%) while a higher proportion of the married group(83. 6%) preferred the day duties than the single group(69.0%). These differences were found to be statistically all significant(p=.001). 9. The findings on preferences of three different types of fixed duty hours namely, B, C. and D(with additional monetary incentives) are as follows in order of preference: B type(12hrs a day, 3days a wk): day shift(64.1%), evening shift(26.1%). night shift(6.5%) C type(12hrs a day. 4days a wk) : evening shift(49.2%). day shift(32.8%), night shift(11.5%) D type(10hrs a day. 4days a wk): showed the similar trend as B type. The findings of higher preferences on the evening and night duties when the incentives are given. as shown above, suggest the need for the introductions of different patterns of duty hours and incentive measures in order to overcome the difficulties in rostering the nursing duties. However, the interpretation of the above data, particularly the C type, needs cautions as the total number of respondents is very small(n=61). It requires further in-depth study. In conclusion. it seemed to suggest that the patterns of nurses duty hours and shifts in the most hospitals in the country have neither been tried for different duty types nor been flexible. The stereotype rostering system of three shifts and insensitiveness for personal life aspect of nurses seemed to be prevailing. This study seems to support that irregular and frequent rotations of duty shifts may be contributing factors for most nurses' maladjustment problems in physical and mental health. personal and family life which eventually may result in high turnover rates. In order to overcome the increasing problems in personnel management of hospital nurses particularly in rostering of evening and night duty shifts, which may related to eventual high turnover rates, the findings of this study strongly suggest the need for an introduction of new rostering systems including fixed duties and appropriate incentive measures for evenings and nights which the most nurses want to avoid, In considering the nursing care of inpatients is the round-the clock business. the practice of the nursing duty shift system is inevitable. In this context, based on the findings of this study. the following are recommended: 1. The further in-depth studies on duty shifts and hours need to be undertaken for the development of appropriate and effective rostering systems for hospital nurses. 2. An introduction of appropriate incentive measures for evening and night duty shifts along with organizational considerations such as the trials for preferred duty time bands, duty hours, and fixed duty shifts should be considered if good quality of care for the patients be maintained for the round the clock. This may require an initiation of systematic research and development activities in the field of hospital nursing administration as a part of permanent system in the hospital. 3. Planned and regular intervals, orientation and training, and professional and personal growth should be considered for the rotation of different duty stations or units. 4. In considering the higher degree of preferences in the duty type of "10hours a day, 4days a week" shown in this study, it would be worthwhile to undertake the R&D type studies in large hospital settings.