• Title/Summary/Keyword: pattern of care

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An Ethnographic Study about Taegyo Practice in Korea (태교 실천에 대한 일상생활 기술적 연구)

  • 김현옥
    • Journal of Korean Academy of Nursing
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    • v.27 no.2
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    • pp.411-422
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    • 1997
  • The purpose of this study is twofold : (i) to investigate how much effort the married couples are making for the good health of both the pregnant woman and her unborn child from the time of their marriage to and during the period of conception : and (ii) to comprehensive investigate socio-cultural back-grounds which affect prenatal effort. Result of this study provide a basis for the prenatal care program which will be appropriate to our culture. This study has been done by the ethnographic research method. The subjects of this study are 53 people in all consisting of 33 pregnant women and 20 husbands. In order to investigate socio-cultural factors which influence Taegyo, producers of Taegyo music were interviewed. In addition the researcher surveyed the markets of Taegyo music, participated in special courses of prenatal education, analyzed the content of the books and periodicals dealing with Taegyo, and collected the concept of Taegyo distributed by the mass media. The full-fledged study continued for eight months from February to August.1996. The data were analyzed as soon as they were collected. Spradly's(1979, 1980) developmental, sequential method of domain analysis. taxonomic analysis, componential analysis, and theme analysis in this order was adopted as the procedure of analyzing the data. To obtain the exactness of study, Sandelowski's (1986) four criteria, that is, Credibility, Fittingness, Auditability, and Confirmability were applied to all stages of data collection, data analysis, the interpretation of the result, and the description of the result. The following are the result : 1. The couples' Taegyo at the stage of preconception was related to their physical, psychological, spiritual conditions under which a healthy baby will be born. Specific methods they prefer are : "the choice of one's spouse." "physical check-up," "physical good health, " "praying, " and so on. 2. When the marriod couple have sex in order to conceive, their Taegyo was related to the imposition of their physical, psychological, and environmental conditions. Specific methods they prefer are : "having sex at specific time, " "having sex in nice place." "to purify their minds while having sex," and so on. 3. The married couples' Taegyo while they are in pregnancy was related to the imposition of their physical. psychological, emotionmental. environmental, social and spiritual conditions. Specific methods they prefer are : "listening to music. " "reading," "looking at beautiful things only," "to avoid looking at or listening to bad things." "to eat food in good shape, " "to avoid drugs," "eating Korean herbal medicine." "sexual abstinence," "to avoid dangerous places," "to keep emotional tranquility," "moderate exercises and rest." "leading a pure life." "praying." "being aware of their words and behavior." "for the couple to keep a good relationship." "interaction with their unborn child," "to support Taegyo for pregnant women," and so on. 4. The married couple put Taegyo into practice on the basis of the following principles : the principle of respecting an unborn child, the principle of forming a good disposition. the principle of top-down parental love, the principle of synergy between a pregnant woman and her unborn child, the principle of expecting a good child, the principle of forming a good habit, and the principle of acquiring a parental role. 5. The practice of Taegyo is influenced by such factors as the married couple, the supporting system, and the mass media. As the husband -and-wife factor, their information of Taegyo, the degree of importance is assigned to their characters, their time to spare, their healthiness, the age of pregnant woman, their conception plan, their religion, their belief of the Taegyo effects, and the birth of a baby in this order. The factor of the supporting system consists of her husband's support, her family support, and her neighbor's support. The mass media factors include the broadcasting media, books specialized in Taegyo, periodicals for pregnant women, booklets for advertizing powdered milk, Taegyo music of record manufacturing companies, and the teaching materials for gifted children. Among these the mass media is especially taking advantage of Taegyo as its main source of economic profits are leading the public behavior pattern to a prodigal one. Taegyo is a self-control behavior which requires practice for the following : the physical and psychological good health of the pregnant woman and her unborn child, the development of the unborn child's good character, the development of the unborn child's intelligence and talents, the expectation of the unborn child's good features. shape a good habit, the expectation of the unborn child's bright future, and the learning of a parental role, the expectation of male birth. Above all it is a type of our good cultural tradition which pursues a value higher than the one that the prenatal care does. The principles of pregnancy care inherent in the habit of Taegyo will provide us a guideline for the development of the prenatal care.

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Pattern of Hospital-Associated Infections in Children Admitted in the Intensive Care Unit of a University Hospital (일개 대학병원 중환자실에 입원한 소아 환자에서 발생한 원내감염의 양상)

  • Kim, Su Nam;Won, Chong Bock;Cho, Hye Jung;Eun, Byung Wook;Sim, So Yeon;Choi, Deok Young;Sun, Yong Han;Cho, Kang Ho;Son, Dong Woo;Tchah, Hann;Jeon, In Sang
    • Pediatric Infection and Vaccine
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    • v.18 no.2
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    • pp.135-142
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    • 2011
  • Purpose : Hospital associated infection (HAI) caused by multidrug-resistant (MDR) microorganisms has been recognized as an important issue in the world, especially in critically ill patients such as the patients admitted in the intensive care unit. There are fewer papers about MDR-HAI in pediatric patients compared to adult patients. In this study, we investigated the incidence and associated factors of MDR-HAI in children admitted to the intensive care unit (ICU) of a university hospital. Methods : We retrospectively evaluated 135 children who were admitted in ICU for at least 3 days between January 2009 and December 2010. HAI cases were divided into MDR-HAI group and non-MDR-HAI group. Clinical characteristics and various associated factors were compared between those groups. Results : In 39 patients, 45 cases of ICU-related HAI were developed. ICU-related HAI incidence was 47.7 per 1000 patientdays. Thirty-six cases (80.0%) were MDR-HAI. Acinetobacter baumannii was isolated more commonly in MDR-HAI group. And the followings were found more frequently in MDR-HAI group than non-MDR-HAI group: medical condition as an indication for ICU admission, mechanical ventilation, urinary catheterization and previous use of broad-spectrum antibiotics. Among the risk factors, previous use of broad-spectrum antibiotics was the independent risk factor for MDR-HAI. Conclusion : ICU-related HAI incidence was higher than previously reported. Previous use of broad-spectrum antibiotics was the independent risk factor for MDR-HAI. To investigate the characteristics of MDR-HAI in children admitted in ICU, further studies with a larger sample size over a longer period of time are warranted.

Family Welfare Policies and Fertility Rate (가족복지정책과 출산율)

  • Chai, Goo-MooK
    • Korean Journal of Social Welfare
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    • v.57 no.3
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    • pp.337-361
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    • 2005
  • This study seeks the implications for the Korean family welfare policies after examining the characteristics of fertility rates and family welfare policies of advanced OECD countries, and comparatively analyzing the fertility rates among clusters of countries having similar family welfare policies. The fertility rates of most advanced OECD countries declined below the population replacement level in the 1970s, and continuously declined slowly after that period. But in the 1990s the fertility rate of some countries increased, on the other hand that of other countries declined. Such a difference of fertility rates suggests that there is some correlation between the fertility rate and the family welfare policy of each country. Advanced countries became concerned about the decline of fertility rate, established the government Population Issues Committee in order to deal with population problems, and increased family welfare supports. But the level and pattern(focusing on maternal employment supports or child-rearing supports) of each country's family welfare policies are differently developed according to its political ideology, cultural and historical background, and economic environments. A comparative assessment of the fertility rate among clusters of countries having similar family welfare policies demonstrates that the higher the level of family welfare supports is and the level of maternal employment supports in comparison with that of maternal child-rearing supports is, the higher of fertility rate is. And a comparative assessment of the fertility rate changes among clusters of countries also shows that the higher the level of family welfare supports is and the level of maternal employment supports in comparison with that of maternal child-rearing supports is, the higher the increase of fertility rate is or the lower the decrease of fertility rate is. The implications for the Korean family welfare policies are summarized as follows. First, it is necessary to establish the government Population Issues Committee which can study systematically fertility rates and population problems, and provide comprehensive population measures. Second, family welfare supports should be expanded through the establishment of family allowances, the prolongation of maternity leave and child-care leave and the upward readjustment of child-care leave benefits, and the extension of public child-care facilities. Third, maternal employment supports such as public child-care facilities and maternity leave should be given more weight than maternal child-rearing supports such as family allowance. Fourth, it is required to prepare social environments which can provide the youth with the hope that child-rearing is not difficult and gives them happiness.

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Nutrition Survey of Young Children of A Day Care Center in the Low Income Area of Seoul City (일부(一部) 도시저소득층(都市低所得層) 유아원원아(幼兒園園兒)의 영양실태조사(營養實態調査))

  • Woo, Mee-Kyung;Lee, Eun-Wha;Lee, Bo-Kyung;Lee, Jung-Soo;Lee, Jung-Wha;Lee, Jong-Hyun;Mo, Su-Mi
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.14 no.3
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    • pp.235-243
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    • 1985
  • A survey of 113 children, aged 4 to 6 years, of the San Cheon a day care center, located in the upland, over populated, poor area of Seoul City, was conducted from July 28 to September 6, 1982, to investigate the dietary and nutritional status, and prevalence of parasitic inpection. House size was 10.1 Pyung; number of households per house, 3.1; number of family member per household, 4.8; and number of family members living together per room, 3.7; on the average. Only 49% of households possess own houses and the others live in the rented houses. About 40% of mothers were engaged income-producing activities within or outside of the home. Mean values of height, weight, arm circumference, girth of chest, and girth of head ranged from 98.4 to 102.2% of KIST mean. However, 13% of the subjects were assessed as undernutrition for 'weight for height'. Mean value of hemoglobin was $12.9{\pm}2.9\;g/dl$ and mean hematocrit value was $35.2{\pm}5.5%$; 17.9% of the subjects were proven to be anemic according to the criteria of the WHO. The positive prevalence of parasitic inpection was 3.3%, significantly lower than that observed in any other area, probably because of community parasitic control project. Intakes of energy and nutrients except thiamin and ascorbic acid were far below RDAs. Carbohydrates for energy provided 71. 2 to 73.8% of total energy intake; protein accounted 11.3 to 12.2%; fat provided 14.5 to 16.6%. Energy intake was divided among breakfast, lunch, evening meal and snack, on the average, in a percentage of 22.0; 23.4; 24.4; 30.2. There was significant correlation between pattern of food consumption and nutrient intakes. The nutrient intakes and quality of foods were highly correlated to the maternal factors, especially mother's educational level. The study suggested that development of nutrition guides for mother and children would be needed to improve nutritional status of those young children.

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Colon Cancer among Older Saudis: Awareness of Risk Factors and Early Signs, and Perceived Barriers to Screening

  • Galal, Yasmine Samir;Amin, Tarek Tawfik;Alarfaj, Abdulelah Khalid;Almulhim, Abdulaziz Abdullah;Aljughaiman, Abdullah Abdulmohsen;Almulla, Abdulrhaman Khaled;Abdelhai, Rehab Ahmed
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1837-1846
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    • 2016
  • Background: Colon cancer screening (CRCS) uptake is markedly affected by public awareness of the disease. This study was conducted to assess levels of knowledge of CRC, to explore the pattern of CRCS uptake and identify possible barriers to screening among Saudis older than 50 years of age and primary care providers (PCPs) in Al Hassa region, Saudi Arabia. Materials and Methods: This cross-sectional study was conducted in randomly selected primary health care (PHC) centers, 884 Saudis and 39 PCPs being enrolled for data collection. Structured interviews were conducted to obtain information regarding socio-demographic characteristics, personal information relevant to CRC, awareness about early signs/symptoms and risk factors, and barriers to CRCS. Also, a self- administered data collection form was used to assess barriers to CRCS from the physicians' perspectives. Results: More than 66% of participants were lacking knowledge about CRC. Participants with higher educational levels, having ever heard about CRC, and having relatives with CRC had a significantly higher awareness of the disease. The rate of reported CRCS was low (8.6%). After conducting a logistic regression analysis, it was observed that female gender (OR=0.28; 95% CI=0.14-0.57; P=0.001), being unmarried (OR=0.11; 95% CI=0.10-0.23; P=0.001), lower levels of education (OR=0.36; 95% CI=0.16-0.82; P=0.015), and having no relatives with CRC (OR=0.30; 95% CI=0.17-0.56; P=0.001) were significantly associated with a lower CRCS uptake. There was a significant difference between most of the perceived barriers to CRCS and gender. Exploratory factor analysis showed that personal fear (especially fear of the screening results and shyness) was the major factor that hindered CRCS with high loading Eigen value of 2.951, explaining 34.8% of the barriers of the included sample toward utilization of CRCS, followed by lack of awareness of both person and providers (high Eigen value of 2.132, and explaining 23.7% of the barriers). The most frequently cited barriers to CRCS from the physicians' perspectives were lack of public awareness, lack of symptoms and signs, and fear of painful procedures. Conclusions: Poor levels of knowledge about CRC were found among older Saudis attending PHC centers in Al Hassa, Saudi Arabia. It is crucial to implement an organized national screening program in Saudi Arabia to increase public awareness.

A study on the Practical Education in Fundamentals of Nursing (기본 간호학 실습교육의 현황)

  • Yoo Jae-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.2 no.2
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    • pp.199-211
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    • 1995
  • This study analyzed the practical education in fundamentals of nursing, for the 36 nursing schools including 12 4-year nursing schools and 24 junior college nursing schools. This survey was done from september 5th to october 5th in 1995. The results of this study were as follows : 1. Required credit in fundamentals of nursing. 1) The highest incidence of the total required credit was 7 in 4-year nursing school and 9 in junior college. 2) For the lecture course credit, the large number of 4-year nursing school gave 5 credit lessons and 6 credits provided in junior nursing colleges. 3) For the credit of practical education the major portion of 4-year nursing school gave 2 credits instruction, however junior nursing school provided 3 credits. 2. Laboratory practice in fundamentals of nursing. In laboratory practice, the ratio of instructor and student was 1 : 20 in 83.4% of the 4-year nursing school and in 66.7% of the junior nursing school. 3. Contents and hours of fundamental nursing practice. 1) In the area of health assessment and nursing process, the large number of schools allocated following hours : 6 hours for vital signs, 4 hours for nursing process, 2 hours for recording but practice for physical examination and communication was done in few schools. 2) In the area of functional health pattern, the large number of schools allocated practice hours like followings : 2 hours for I/O, 2 hours for gavage feeding, 2 hours for elimination, 6 hours for catheterization, 6 hours for bed making, 2 hours for positioning, 6 hours for personal hygiene, 2 hours for R.O.M, 4 hours for moving turning lifting, 2 hours for inhalation and suction. But C.P.R and terminally ill patient care were taught in smaller number of schools. 3) In the area of special nursing measures, the major portion of nursing schools allocated hours like followings. It consisted of 6 hours for asepsis, 16-18 hours for medication, 2 hours for heat and cold application, 2 hours for wound care. 4) 22.2% of the nursing schools had total review practice time and 36.1% of the nursing schools had the students clinical practice. Based on above mentioned results, 4-year nursing school had faithful practical education of fundamental nursing than junior nursing school. But for the contents and allocated hours for practice education, junior nursing schools were much more contents and hours than 4 year school.

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Clinical Patterns of Penetrating Torso Injury at Emergency Department (응급실을 통하여 입원한 체간부 관통상 환자에 관한 임상적인 고찰)

  • Yun, Soon Young;Cheon, Young Jin;Won, Tae Hee
    • Journal of Trauma and Injury
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    • v.18 no.1
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    • pp.47-52
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    • 2005
  • Background: This study was undertaken to evaluate the clinical pattern of the patients with penetrating torso injury. We retrospectively analyzed the clinical symptoms, mechanism of injury, injury type including injured organ, and ultimate outcome of treatment. Our purpose of the study was to establish guideline of management in penetrating torso injury. Methods: This study consists of an analysis of a consecutive series of 94 patients with penetrating injury of trunk treated at one general hospital during 7year period (from January 1995 to April 2003) who was admitted through in our emergency department. All data were collected from the medical records and entered in a database for analysis on the following: age, sex, mechanism of injury, vital sign at admission, clinical outcome including hospital mortality, length of hospital stay, length of intensive care unit stay, requirement of crystalloid fluid and blood product. Results: Among 94 patients, there were 68 men and 26 women, with ages ranging from 19 to 82 years (average 38.2 years). The most frequent mechanism of injury was violence by others including rob (n=54, 57.4%) followed by suicidal attempt (n=24, 25.5%) and accidental injury (n=16, 17.0%). No injury was inflicted from gun. In 37 patients, systolic blood pressure at admission was under 90mmHg. The time interval from injury to admission, and from admission to operation was 57.8minutes and 4hour 12minutes each. Laparotomy was required in 70 patients, thoracotomy in 5 patients, and 3 patients required thoracotomy and laparotomy. Among 94 patients, an average of 1.7 organs were injured. The small bowel and colon were the organs most commonly wounded followed by liver, mesentery, pleura. Of the 94 patients, 6 died for an overall mortality rate of 6.4%, and two of them were not related with hemorrhage. The average length of hospital stay was 18.1 days, and 40 patients required ICU care. Conclusion: Of the 94 patients who were admitted from penetrating torso injury, no patient was injured from firearm. Overall mortality rate was 6.4%. In our hospital, firearm injury was relative rare.

A clinical study on the dental emergency patients visiting an University Hospital emergency room (대학병원 응급실로 내원한 치과 응급환자에 관한 임상적 연구)

  • Jang, Chang-Su;Lee, Chang-Yeon;Kim, Ju-Won;Yim, Jin-Hyuk;Kim, Jwa-Young;Kim, Young-Hee;Yang, Byoung-Eun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.6
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    • pp.439-447
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    • 2011
  • Introduction: In today's society, the rapid and appropriate care of the dental emergency patients is much more important. So, a retrospective study on the characteristics of emergency dental injuries and diseases will be very meaningful. Materials and Methods: This retrospective clinical study was carried by reviewing the radiographic films and emergency chart of 11,493 patients who had visited the emergency room of Hallym Sacred heart Hospital and were treated in the Department of Oral and Maxillofacial Surgery from January 2006 to December 2010. Results: The male to female ratio was 1.9:1. The highest monthly incidence was observed in May (10.4%) and June (8.9%) and the peak age distribution was the first decade (56.0%), followed by the second decade (16.0%). Trauma was the most common cause in dental emergency patients, followed in order by toothache, odontogenic infection, temporomandibular joint (TMJ) disorder and oral hemorrhage. Soft tissue injury was most prevalent in the trauma group, followed by tooth injury and facial bone fractures. In the tooth injury group, tooth fracture (56.7%) showed the highest incidence followed in order by tooth subluxation (18.2%), tooth concussion (16.9%), tooth avulsion (11.5%) and alveolar bone fractures (3.7%). In the facial bone fracture group, mandibular fractures (81.8%) showed the highest incidence followed in order by maxilla fractures (15.7%), nasal bone fractures (9.0%), zygomaticomaxillary complex fractures (5.4%), orbital bone fractures (2.5%). In mandibular bone fractures, the most common location was the symphysis (70.1%), followed in order by the mandibular angle (33.0%), mandibular condyle (22.8%) and mandibular body (13.6%). In the infection group, a submandibular space abscess (46.2%) was most common followed in order by a buccal space abscess (17.4%), canine space abscess (16.9%) and submental space abscess (12.3%). TMJ dislocation (89.3%) showed the highest incidence in the TMJ disorder group, followed by TMJ derangement (10.7%). In the other group, a range of specific symptoms due to post operation complications, trigeminal neuralgia, chemical burns and foreign body aspiration were reported. Conclusion: For the rapid and appropriate care of the dental emergency patients, well-organized system should be presented in oral and maxillofacial surgery. And it is possible under analysis of pattern and the variation of the dental emergency patients.

Patterns of care and treatment outcomes for primary thyroid lymphoma: a single institution study

  • Cha, Hyejung;Kim, Jun Won;Suh, Chang-Ok;Kim, Jin Seok;Cheong, June-Won;Lee, Jeongshim;Keum, Ki Chang;Lee, Chang Geol;Cho, Jaeho
    • Radiation Oncology Journal
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    • v.31 no.4
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    • pp.177-184
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    • 2013
  • Purpose: The aim of this study was to analyze the patterns of care and treatment outcomes in patients with primary thyroid lymphoma (PTL) in a single institution. Materials and Methods: Medical records of 29 patients with PTL treated between April 1994 and February 2012 were retrospectively reviewed. Diagnosis was confirmed by biopsy (n = 17) or thyroidectomy (n = 12). Treatment modality and outcome were analyzed according to lymphoma grade. Results: The median follow-up was 43.2 months (range, 3.8 to 220.8 months). The median age at diagnosis was 57 years (range, 21 to 83 years) and 24 (82.8%) patients were female. Twenty-five (86.2%) patients had PTL with stage IEA and IIEA. There were 8 (27.6%) patients with mucosa-associated lymphoid tissue (MALT) lymphoma and the remaining patients had high-grade lymphoma. Patients were treated with surgery (n = 2), chemotherapy (n = 7), radiotherapy (n = 3) alone, or a combination of these methods (n = 17). Treatment modalities evolved over time and a combination of modalities was preferred, especially for the treatment of high-grade lymphoma in recent years. There was no death or relapse among MALT lymphoma patients. Among high-grade lymphoma patients, 5-year overall survival (OS) and 5-year progression-free survival (PFS) were 75.6% and 73.9%, respectively. Complete remission after initial treatment was the only significant prognostic factor for OS (p = 0.037) and PFS (p = 0.003). Conclusion: Patients with PTL showed a favorable outcome, especially with MALT lymphoma. Radiotherapy alone for MALT lymphoma and chemotherapy followed by radiotherapy for high-grade lymphoma can be effective treatment options for PTL.

A CLINICAL STUDY ON THE EMERGENCY PATIENTS OF ORAL AND MAXILLOFACIAL SURGERY VISITING SANG-GYE PAIK HOSPITAL EMERGENCY ROOM. (상계백병원 응급실에 내원한 구강악안면외과 응급환자에 대한 임상적 연구)

  • Baik, Jee-Seon;Yoon, Kyu-Ho;Park, Kwan-Soo;Cheong, Jeong-Kwon;Shin, Jae-Myung;Choi, Min-Hye;Kwon, Jun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.6
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    • pp.561-566
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    • 2008
  • This is a retrospective clinical study on 2,955 patients who had visited the Emergency Room of Sang-gye Paik Hospital and then been treated in the Department of Oral and Maxillofacial Surgery during recent 4 years from Aug. 2002 to Dec. 2006. The obtained results were as follows. The total number of patients was 2,955 and the ratio of male to female was 1.72:1. The age distribution peak was the 1st decade (30.8%), followed by the 3rd decade (14.3%) and the 4th decade (14.0%). Trauma (62.3%) was the most frequent cause in dental emergency patients, pulpitis (13.0%) and infection patients were next in order of frequency. In trauma patients group, facial bone injury, tooth injury, soft tissue injury were included and soft tissue injury group was most prevalent, followed by tooth injury group and facial bone group. In total patient, the ratio of admission was 3.5%. We obtained the results of the distribution of primary emergency care in the traumatic injury, causal distribution of the jaw fracture, distribution of related medical department in multiple associated injuries, distribution of emergency care in infection, causal distribution and control methods of oral bleeding, distribution of TMJ disorder. The trauma patient group was major in the dental patients who had visited the emergency room, but other various groups were included. So we should analyze the pattern and the variation of the dental emergent patient to provide the proper treatment.