• 제목/요약/키워드: physical

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헤파린 표면처리된 국산화 혈관우회도관의 개발 (Development of Korean Version of Heparin-Coated Shunt)

  • 선경;박기동;백광제;이혜원;최종원;김승철;김택진;이승열;김광택;김형묵;이인성
    • Journal of Chest Surgery
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    • 제32권2호
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    • pp.97-107
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    • 1999
  • 배경: 흉부대동맥 수술에 사용하는 헤파린 우회도관의 국산화를 위해, 헤파린 표면처리기법 중 물리분산법을 이용하여 제작한 우회도관의 동물실험을 통해 혈전저항성 및 안정성을 증명하고자 하였다. 대상 및 방법: 성견 21마리(17.5∼25 kg)를 대상으로 하행흉부대동맥 우회모델을 만들었다. 사용한 우회도관의 종류에 따라 무처리 우회도관군(CONTROL; n=3), 무처리 우회도관 및 전신 헤파린 처치군(HEPARIN; n=6), Gott 헤파린 우회도관군(GOTT; n=6), 국산 헤파린 우회도관군(KIST; n=6)로 분류하였다. 관찰지표는 말초혈액검사, 혈액응고검사, 신장 및 간기능검사, 표면전자현미경 소견 등이었다. 각 지표는 우회도관의 원위부 대동맥 혈액에서 검사하여 우회 전과 우회 후 2시간 째의 군내 변화와군간 차이를 비교하였다. 결과: 모든 관찰지표의 우회 전 기초치는 군간에 차이가 없었다. 말초혈액검사 중 혈소판치는 HEPARIN군과 GOTT군에서 유의하게 높아졌으나(p<0.05) 군간 차이는 유의하지 않았다. 기타 혈구세포의 변화는 각 군에서 군내변화와 군간차이가 유의하지 않았다. Activated clotting time, activated partial thromboplastin time, thrombin time은 HEPARIN군에서 현저히 증가하였고(p<0.05) 군간차이도 유의하였다(p<0.005). Prothrombin time은 GOTT군에서 유의하게 증가하였으나(p<0.05) 군간차이는 없었다. Fibrinogen은 각 군에서 군내변화와 군간차이가 유의하지 않았다. Antithrombin III는 HEPARIN군과 KIST군에서 유의하게 감소하였고(p<0.05) 군간차이도 유의하였다(p<0.05). Protein C는 HEPARIN군에서 유의하게 감소하였으나(p<0.05) 군간차이는 없었다. Blood urea nitrogen은 HEPARIN군과 KIST군에서 유의하게 증가하였으나(p<0.05) 군간차이는 없었다. Creatinine, aspartate aminotransferase, alanine aminotransferase는 각 군에서 군내변화와 군간차이가 유의하지 않았다. 표면전자현미경 소견에서 혈소판 및 혈구세포 응집정도는 CONTROL군이 가장 심했고, HEPARIN군은 GOTT군이나 KIST군에 비해 많았다. 결론: 이상의 결과에서 전신 헤파린 처치(HEPARIN)는 출혈경향을 증가시키면서 이물질 표면의 응고반응을 효과적으로 차단하지 못하는 반면, 헤파린 표면처리된 우회도관(GOTT & KIST)의 경우는 출혈경향 없이 표면의 응고반응을 충분히 억제하였다. 또한 국산(KIST) 헤파린 우회도관은 상용화된 외국산(GOTT)과 동등한 항혈전 성능을 보였다.

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한국인(韓國人) 중고교생(中高校生)들의 흡연실태(吸煙實態)에 관(關)한 연구 (A Study on the Smoking Status of the Korean Middle and High School Students)

  • 박순영
    • 한국학교보건학회지
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    • 제7권1호
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    • pp.57-71
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    • 1994
  • I investigated actual conditions of smoking of teenagers who were randomly chosen middle and high school students. 1. Juvenile smoking 1) Parents' opinions of juvenile smoking Most parents do not want their children to smoke after growth : 88.6% of fathers (middle school students: 88.9%, high school students: 88.4%) and 95.1% of mothers (middle school students: 93.4%, high school students :95.5%). 2) Teenagers' opinions of smoking after growth The rate of students who will smoke after growth is 10.8% (middle school students: 12.0%, high school students: 9.9%): students in agricultural areas show the higher rate than those in cities. 3) Parents' opinions of their children's smoking now 1.5% of fathers want their children to smoke now (middle school students: 1.3%, high school students: 1.6%) and 1.1% of mothers do (middle school students: 0.6%, high school students: 1.5%). This shows that most parents do not want their children to smoke now. 4) Students' opinions of their friends' smoking now Students who want their friends smoke now cover 7.8% (middle school students: 7.1%, high school students: 8.4%). This rates are higher than those of parents shown in (3). And more high school students and more girl students gave the positive reponse than middle school boy and girl students, respectively. 5) Students' views of smoking "Look like an adult" covers the rate of 4.0% (boy: 7.8%, girl:3.6%) 6.7% of middle school students have this view, while 3.7% of high school students have. 16.1% of students had an experience of smoking during the last one year (boy: 29.9%, girl: 8.6%): this shows that the rate of the boy students is more than 3 times greater than that of the girl students and high students who experienced smoking last year covers 20.2%, while middle school students shows 10.9%. 6) Actual conditions of students' smoking The present rate of students' smoking is 22.4% (boy:38.3%, girl:13.8%): the rate of boy students is greater than that of girl students. Students who smoke more than pack of cigarettes a day cover 8.2% (boy: 17.5%, girl: 3.2%): 5.2% of middle school students (boy:11.4%, girl: 2.1%) smoke more than one pack while 10.7% of high school students do (boy:21.5%, girl: 4.2%). This shows that the rate of boy students' smoking is greater than that of girl students' smoking. 7) The rate of smoking of students' parents 75.4% of fathers (city: 74.5%, agricultural area:75.9%) smoke: and more than a half (62.4%) smoke more than a pack cigarettes a day. On the other hand, the rate of smoking mothers is 5.2%(city: 4.3%, agricultural area: 7.3%): the rate is higher in agricultural areas. 8) Opinions of smoking population in the future 61.4% of students answered that smoking population will increase, while 27.0% have the opinion that smoking population will decrease. 2. Opinions of the effects of smoking on health 1) Have you heard that smokers are likely to suffer from tuberclosis? 78.3% of students said yes (boy: 80.8%, girl: 76.4%): it is shown that the rate of boys is greater than that of girls. 2) Have you heard that smokers are likely to get out of endurance? 76.6% of students (boy: 69.3%, girl: 49.7%) answered yes: it is shown that the rate of boys is greater than that of girls. 3) Have you heard that heart-beats get fast when one smokes? 32.5% of students (boy: 35.5%, girl: 30.9%) answered yes: 32.2% in cities(boy: 33.0%, girl: 31.8%) and 33.5% in agricultural areas(boy: 41.8%, girl: 28.8%): and 28.7% middle students and 35.5% of high school students answered yes. 4) Have you heard that smokers are likely to have heart-diseases? 35.1% of students (boy: 34.0%, girl: 34.1%) answered yes: 35.3% in cities (boy: 37.2%, girl: 34.2%) and 36.7% in agricultural areas (boy: 39.0%, girl: 33.9%): 34.8% of middle school students and 35.4% of high school students. 5) Have you heard that smokers are likely to have a lung cancer? 91.4% of students (boy: 93.2%, girl: 89.9%) answered yes: 90.35% in cities and 94.2% in agricultural areas. 6) Have you heard that the life of smokers gets shorter? 94.3% of students (boy:94.6%, girl: 92.2%) answered yes. 7) Have you heard that pregnant smokers will deliver a baby with low birth weight? 29.6% of students (boy: 29.8%, girl: 29.4%) answered yes: the rates of boys and girls almost the same. 8) Have you heard that one feels calm when one smokes? 80.1% of students (boy: 81.8%, girl: 79.2%) answered yes: boys and girls showed almost the same rate. 3. Preventive measures Smoking people continued to increase all over the world because smoking not only mitigated emotional uneasiness such as loneliness, nervousness and so on, but also could be very helpful from the social perspective. This was so because they did not consider harmful effects of smoking on health, and victims. However, because any -one can have physical disorders caused by smoking, people should always keep in mind the following preventive measures. 1) Doctors or teachers should set an example of giving up smoking. Informing patients or students of harmful effects of smoking to persuade their family and relatives not to smoke. 2) Through mass media like newspapers, periodicals or broadcasting, to make people know harmful effects of smoking and not smoke. 3) To prohibit selling teenagers cigarette by law. 4) To prohibit smoking in public places like work places, offices, lecture rooms, recreation rooms, buses, trains and so on. 5) To decrease the rate of life insurance for non-smokers as in foreign countries and to give a warming of the harmful effects on cigarette packets or ads.

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포장재배(圃場栽培) 수도(水稻)의 무기영양(無機營養) -II 삼요소(三要素) 이용율(利用率)과 기상권(氣象圈) 및 토양단면(土壤斷面)의 물리(物理)·화학적(化學的) 성질(性質)과의 관계(關係) (Mineral Nutrition of Field-Grown Rice Plant -II Recovery of fertilizer nitrogen, phosphorus, and potassium in relation to climatic zone and physical or chemical characteristics of soil profile)

  • 박훈;신천수
    • 한국토양비료학회지
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    • 제6권1호
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    • pp.17-26
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    • 1973
  • 수도삼요소(水稻三要素) 이용율(利用率)(1967 및 1968년(年))과 기상권(氣象圈), 답토양(畓土壤) 단면(斷面)의 추적양식(推積樣式) 배수등급(排水等級) 토성(土性) 및 작토(作土)의 토양화학적(土壤化學的) 특성(特性)과의 관계(關係)를 검토(檢討)한 결과(結果) 다음과 같은 결과(結果)를 얻었다. 1. N이용율(利用率)은 남부(南部)>중부(中部)>북부(北部)의 순(順)이고 K이용율(利用率)은 남부(南部)>북부(北部)>중부(中部)의 순(順)이며 P이용율(利用率)은 연도별(年度別)로 다르다. 2. P이용율(利用率)은 남부(南部)의 도(道)에서 연도별(年度別) 변동(變動)이 크고 추적(推積) 배수(排水) 토성별(土性別)에서도 연도별(年度別) 변동(變動)이 커서 토양(土壤)과 기상(氣象)의 교호작용(交互作用)에 크게 영향 받는것을 알 수 있다. 3. 추적양식별(推積樣式別) N이용율(利用率)은 Alluvial Colluvial (AC)>Alluvial (A)>Fluvomarine (FM)>Old Alluvial (OA)의 순(順)이고 K이용율(利用率)은 OA>AC>A>FM의 순(順)이다. 4. N이용율(利用率)은 토양단면(土壤斷面)의 배수(排水)가 양호(良好)할수록 적어지고 K와 P의 이용율(利用率)은 약간양호(若間良好)에서 높은 경향이고 불량(不良)이나 매우 양호(良好)의 편에서 낮은 경향이다. 5. N이용율(利用率)은 미사식양질(微砂埴壤質)에서 가장높고 사질(砂質)로 갈수록 떨어지며 식질(埴質)에서도 낮으나 K와 P 이용율(利用率)은 식양질(埴壤質) 이하(以下)의 토성(土性)에서 높은 경향(傾向)이다. 6. N이용율(利用率)은 지산 극락 신답통에서 크고 화동 규암 용지 화봉에서 적었다. 7. N이용율(利用率)은 토양중(土壤中) 유기물함량(有機物含量)(OM), Ca 및 CEC와 유의정상관(有意正相關)을 보이고 P이용율(利用率)이 높았던 해에만 P함량(含量)과 유의부상관(有意負相關)을 보였으며 P이용율(利用率)은 CEC, Mg 및 Ca와 유의정상관(有意正相關)을 보였다. 8. K이용율(利用率)은 그것이 적었던 해에는 K/(Ca+Mg), P, OM, K의 순(順)으로 부상관(負相關)을 Ca, Mg, CEC 순(順)으로 정상관(正相關)을 보였는데 K/(Ca+Mg)와만 유의성(有意性)이 있으며 K이용율(利用率)이 큰 해에는 P, OM, K/(Ca+Mg) K의 순(順)으로 정상관(正相關)을 CEC, Mg, Ca 순(順)으로 부상관(負相關)을 보였는네 P, OM, CEC 와만 유의성(有意性)을 갖는다. K이용율(利用率)이 컸던 해에만 토양중 K는 토양중 P 및 OM과 유의정상관(有意正相關)을 갖는다. 9. 삼요소이용율(三要素利用率)과 pH는 유의성(有意性)은 없으나 부상관(負相關)이다. 10. OM은 P K 및 K/(Ca+Mg)와 유의정상관(有意正相關)을 Mg와는 유의부상관(有意負相關)을, P는 K, K/Ca+Mg와 유의정상관(有意正相關)을 Mg 및 CEC와 유의(有意) 부상관(負相關)을 K는 K/(Ca+Mg), Mg 및 CEC와 유의정상관(有意正相關)을 K/(Ca+Mg)는 Ca와 유의정상관(有意正相關)을 Mg 및 CEC와는 유의부상관(有意負相關)을, Ca는 Mg CEC 및 pH와, Mg는 CEC와 유의(有意) 정상관(正相關)을 보였다. 11. 삼요소(三要素) 이용율(利用率) 및 토양(土壤)의 화학적(化學的) 특성(特性) 상호간(相互間)의 관계에서 OM이 시비(施肥)N의 흡수(吸收)를 돕고 K흡수(吸收)는 K보다 K/(Ca+Mg)에 의(依)하여, P흡수(吸收)는 Mg에 의(依)하여 크게 영향받는 것을 알수있고 P와 K이용율(利用率)이 해에 따라 다른 원인(原因)이 부분적(部分的)으로 설명(說明)될 수 있었다.

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감지추구자적매체습관(感知追求者的媒体习惯) (Media Habits of Sensation Seekers)

  • Blakeney, Alisha;Findley, Casey;Self, Donald R.;Ingram, Rhea;Garrett, Tony
    • 마케팅과학연구
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    • 제20권2호
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    • pp.179-187
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    • 2010
  • 对营销和广告经理来说, 理解消费者的偏好和使用的媒体类型是非常有必要的, 尤其是在如今市场细分的情况下. 清晰的理解能帮助经理更有效的选择合适的媒体. 而且由于性格特征的不同, 个人对媒体类型的选择和使用都不相同. 本文测试了一个性格特征, 即感知追求. 这是在测试 "新" 媒体偏好和使用的文献中尚未出现的. 感知追求是被定义为 "一种对变化, 新颖和复杂的感觉的需要和经历. 以及为承担这些经历愿意承受生理的和社会的风险" (Zuckerman 1979). 根据文献回顾, 我们提出了6个假设. 我们尤其关注使用与满足理论(Katz 1959), 这个理论解释了为什么人们选择媒体类型和他们使用不同媒体类型的动机的原因. 目前的理论表明高感知追求者(HSS), 由于他们对新颖, 激励和非传统的内容和想象的需要, 他们会更多的使用新媒体. 因此, 我们假设高感知追求者比低感知追求者(LSS)(H2a)或中等感知追求者(MSS)(H2b)会更多的使用网络而不是广播(H1a)或印刷媒体(H1b). 另外, 高感知追求者有更多的社交活动及朋友, 因此他们会比低感知追求者(a) 和中等感知追求者(b)更多的使用社交网络网页例如Facebook/MySpace(H3) 以及聊天室(H4). 感知追求者可以显示出一系列的行为包括抑制解除. 我们认为具有高水平去抑制的人们比低水平或中等水平的人们会更多的使用社交网络如Facebook/MySpace (H5) 和聊天室(H6). 我们的数据来源于对参加极限运动的参与者的网上调查. 为得到这个群组的信息, 我们使用雪球样本技术的提高版, 即连锁推荐方法来选择应答者. 这种方法被认为是对隐藏人群进行有效估算的方法(Heckathorn, 1997). 最终的有效样本包括1108名应答者. 主要是年轻人(56.36%在34岁以下), 男性(86.1%)和中产阶级(58.7%的家庭收入超过50,000美元). 我们用这个样本来进行感知追求的研究. 我们用简要感知追求量表来测试感知追求(Hoyle et al. 2007). 我们用自我报告使用过的不同媒体类型来测量媒体使用. 结果并不支持H1a和b. 高感知追求者并没有更多的使用网络这样的媒体. 事实上, 同其他的媒体类型相比, 这个平均水平是较低的. 高感知追求者使用最多的媒体类型时印刷媒体, 这说明了一种对主流的反抗. 结果支持H2a和b. 高感知追求者比低感知或中等感知追求者更多的使用网络. 进一步的分析揭示了在高感知和低感知追求者之间在使用印刷媒体方面有显著不同. 高感知追求者在他们感兴趣的极限运动方面会追求更专业的印刷出版物. 假设3a和b 揭示了高感知追求者比低感知或中等感知追求者更多的使用Facebook/MySpace. 在使用聊天室方面低感知和高感知追求者之间没有显著差距. 所以结果也不支持假设H4a, 但是H4b的结果是显著的. 不同抑制解除水平的应答者被认为使用Facebook/MySpace 和聊天室的水平也不同. 去抑制水平高比低水平或中等水平的使用Facebook/MySpace的水平高. 所以H5a和b 被支持. 类似的, H6b也被支持. 去抑制水平高的人们使用聊天室的概率显著多于中等水平的但并不多于低水平的人们(H6a). 这些结果为管理者提供了一些有趣的见解. 第一, 尽管高感知追求者比低感知或中等感知追求者更多的使用在线媒体, 但他们使用在线媒体仍然少于印刷或广播媒体. 广告执行者们不应该对这个重要的客户群过分的强调在线媒体. 第二, 社交媒体, 例如Facebook/MySpace和聊天室会是接近这个群体的有潜力的方法. 最后, 对去抑制水平高的群体, 有公共关系方面的启示. 这些个体更倾向于一些社会风险的行为. 这些直接的启示包括因特网捕食者和未来的雇主. 本研究的一个不足是受访者都是参与极限运动的. 这本身就是一个高感知追求者活动. 更大范围的人群需要被测试.

계획된 간호 중재가 미숙아 어머니의 스트레스, 모성 역할 긴장과 역할 수행에 미치는 영향 (Effect of Planned Nursing Intervention on the Stress, the Maternal Role Strain, and the Maternal Role Performance of Mothers of Premature Infants)

  • 정경화
    • Child Health Nursing Research
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    • 제5권1호
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    • pp.70-83
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    • 1999
  • The birth of a premature infant is distressing for its parents. The parents of a premature infant experience stress according to the infant's physical appearance and behavior, the environment of the neonatal intensive care unit (NICU) , and the alteration in the parental role. Especially, a mother of a premature infant feels distressed even after the discharge of the infant : therefore, she has difficulties in maternal role performance. The main purpose of this study is to identify the effects of the planned infant care information program in order to lower the stress level for mothers of premature infants caused by the birth and hospitalization in NICU of premature infants, to reduce the maternal role strain, and to promote the maternal role performance after the infants' discharge. This study employed two methods of research at the same time : quasi -experimental non-equivalent pre and post test to compare : non-equivalent post test to compare. The total number of subjects was 19 who were assigned to the research program : 12 mothers of premature infants at the NICU at the Ch university hospital and 7 at the NICU at the Y general hospital located in Chounju city. The data were collected for 79 days from August 18 to November 5, 1998. The questionnaire method was applied for the data collection, and the measures used in this study were Parental Stressor Scale : NICU(Miles, 1993), the Maternal Role Strain Measures ( Hobbs, 1968 ; Steffensmeier, 1982) , and Self Confidence Scale (Pharis, 1978). Research procedure is as follows : after preliminary examination, the experimental subjects, the mothers of premature infants at the Nl CU at Ch university hospital were provided with slide films and information developed by the researcher based on existing documents and data. It took two 60-minute sessions a week for two weeks, and the mothers' stress level was measured using the same instrument twice one week and two week after the infants' hospitalization. The stress level of the contrast subjects, the mothers at Y general hospital was measured during the same period. The experimental subjects were provided with booklets on matters that require attention after the infants' discharge and on developmental project, and they were educated to play the maternal role in person for 2-3 hours a week : breast-feeding, burping a baby, and changing diapers. One week after the infants' discharge, the maternal role strain and the maternal role performance were examined in two groups of the subjects. The analysis of collected data was done using descriptive statistics including real numbers, percentages, averages, and standard deviations. Mann-Whitney test ; x² test ; Repeated Measures Analysis of Variance ; ANCOVA Spearman's rho correlation coefficients. The results on this study were as follows. (1) The examination of the same quality showed that there were no differences in the general and obstetrical characters between the two groups. However, in terms of the characters of premature infants. just right after their birth, the infants at the contrast group weighed more than those at the experimental group(U=16.5, p=.02), and the former was in mother's womb longer than the latter(U=15.5, p=.02). (2) The stress level of the mothers provided with the plannned nursing intervention program became lower as time passed compared to the others'(F=16.61, p=.00) Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization depending on treatment (F=8.00, p=.01) (3) The maternal role strain of the mothers provided with the planned nursing intervention program was lower than the others'(U=2.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the maternal role strain levels made a statistical difference 2 weeks after the infants' hospitalization, depending on treatment(F=14.72, p=.00). (4) The maternal role performance level of the mothers provided with the planned nursing program was higher than the others'(U=.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization, depending on treatment(F=8.00, p=.01). (5) The correlation between a mother's stress level 2 weeks after her infant's hospitalization, the maternal role strain and the maternal role performance were compared : the stress and the maternal role strain were statistically irrelevant to each other(r=.33, p=.12) : the stress was found to be in inverse proportion to the maternal role performance(r=-.53, p=.02). The maternal role strain was in inverse proportion to the maternal role performance as well(r=-.50, p=.00). In conclusion, for the mothers provided with the planned nursing intervention program, their stress level was getting lower as time passed during the infants' hospitalization, their maternal role strain reduced when they took care of their infants after their discharge, and their maternal role performance level was high compared to the other mothers. Besides, the lower the stress level of mothers of premature infants was during the infants' hospitalization, the higher the maternal role performance after their discharge was. The lower maternal role strain was, the higher the maternal role performance was as well. These results of the study suggested that the nursing intervention program for the mothers of premature infants developed by the researcher would be effectively applied to nursing practice, and it would be a foundation for the development of this kind of program.

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간호원의 환자교육 활동에 관한 연구 (Study of Patient Teaching in The Clinical Area)

  • 강규숙
    • 대한간호학회지
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    • 제2권1호
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    • pp.3-33
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    • 1971
  • Nursing of today has as one of its objectives the solving of problems related to human needs arising from the demands of a rapidly changing society. This nursing objective, I believe, can he attained by the appropriate application of scientific principles in the giving of comprehensive nursing care. Comprehensive nursing care may be defined as nursing care which meets all of the patient's needs. the needs of patients are said to fall into five broad categories: physical needs, psychological needs, environmental needs, socio-economic needs, and teaching needs. Most people who become ill have adjustment problems related to their new situation. Because patient teaching is one of the most important functions of professional nursing, the success of this teaching may be used as a gauge for evaluating comprehensive nursing care. This represents a challenge foe the future. A questionnaire consisting of 67 items was distributed to 200 professional nurses working ill direct patient care at Yonsei University Medical Center in Seoul, Korea. 160 (80,0%) nurses of the total sample returned completed questionnaires 81 (50.6%) nurses were graduates of 3 fear diploma courser 79 (49.4%) nurses were graduates of 4 year collegiate nursing schools in Korea 141 (88,1%) nurses had under 5 years of clinical experience in a medical center, while 19 (11.9%) nurses had more than 5years of clinical experience. Three hypotheses were tested: 1. “Nurses had high levels of concept and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of the T-test. Conclusions of this study are as follow: Before attempting the explanation, of the results, the questionnaire will he explained. The questionnaire contained 67 questions divided into 9 sections. These sections were: concept, content, time, prior preparation, method, purpose, condition, evaluation, and recommendations for patient teaching. 1. The nurse's concept of patient teaching: Most of the nurses had high levels of concepts and knowledge toward patient teaching. Though nursing service was task-centered at the turn of the century, the emphasis today is put on patient-centered nursing. But we find some of the nurses (39.4%) still are task-centered. After, patient teaching, only a few of the nurses (14.4%) checked this as “normal teaching.”It seems therefore that patient teaching is often done unconsciously. Accordingly it would he desirable to have correct concepts and knowledge of teaching taught in schools of nursing. 2. Contents of patient teaching: Most nurses (97.5%) had good information about content of patient teaching. They teach their patients during admission about their diseases, tests, treatments, and before discharge give nurses instruction about simple nursing care, personal hygiene, special diets, rest and sleep, elimination etc. 3. Time of patient teaching: Teaching can be accomplished even if there is no time set aside specifically for it. -a large part of the nurse's teaching can be done while she is giving nursing care. If she believes she has to wait for time free from other activities, she may miss many teaching opportunities. But generally proper time for patient teaching is in the midmorning or midafternoon since one and a half or two hours required. Nurses meet their patients in all stages of health: often tile patient is in a condition in which learning is impossible-pain, mental confusion, debilitation, loss of sensory perception, fear and anxiety-any of these conditions may preclude the possibility of successful teaching. 4. Prior preparation for patient teaching: The teaching aids, nurses use are charts (53.1%), periodicals (23.8%), and books (7.0%) Some of the respondents (28.1%) reported that they had had good preparation for the teaching which they were doing, others (27.5%) reported adequate preparation, and others (43.8%) reported that their preparation for teaching was inadequate. If nurses have advance preparation for normal teaching and are aware of their objectives in teaching patients, they can do effective teaching. 5. Method of patient teaching: The methods of individual patient teaching, the nurses in this study used, were conversation (55.6%) and individual discussion (19.2%) . And the methods of group patient teaching they used were demonstration (42.3%) and lecture (26.2%) They should also he prepared to use pamphlet and simple audio-visual aids for their teaching. 6. Purposes of patient teaching: The purposes of patient teaching is to help the patient recover completely, but the majority of the respondents (40.6%) don't know this. So it is necessary for them to understand correctly the purpose of patient teaching and nursing care. 7. Condition of patient teaching: The majority of respondents (75.0%) reported there were some troubles in teaching uncooperative patients. It would seem that the nurse's leaching would be improved if, in her preparation, she was given a better understanding of the patient and communication skills. The majority of respondents in the total group, felt teaching is their responsibility and they should teach their patient's family as well as the patient. The place for teaching is most often at the patient's bedside (95.6%) but the conference room (3.1%) is also used. It is important that privacy be provided in learning situations with involve personal matters. 8. Evaluation of patient teaching: The majority of respondents (76.3%,) felt leaching is a highly systematic and organized function requiring special preparation in a college or university, they have the idea that teaching is a continuous and ever-present activity of all people throughout their lives. The suggestion mentioned the most frequently for improving preparation was a course in patient teaching included in the basic nursing program. 9. Recommendations: 1) It is recommended, that in clinical nursing, patient teaching be emphasized. 2) It is recommended, that insertive education the concepts and purposes of patient teaching he renewed for all nurses. In addition to this new knowledge, methods and materials which can be applied to patient teaching should be given also. 3) It is recommended, in group patient teaching, we try to embark on team teaching.

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계획된 간호 정보가 수면량에 미치는 영향에 관한 연구 -개심술 환자를 중심으로- (The Effect of Structured Information on the Sleep Amount of Patients Undergoing Open Heart Surgery)

  • 이소우
    • 대한간호학회지
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    • 제12권2호
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    • pp.1-26
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    • 1982
  • The main purpose of this study was to test the effect of the structured information on the sleep amount of the patients undergoing open heart surgery. This study has specifically addressed to the Following two basic research questions: (1) Would the structed in formation influence in the reduction of sleep disturbance related to anxiety and Physical stress before and after the operation? and (2) that would be the effects of the structured information on the level of preoperative state anxiety, the hormonal change, and the degree of behavioral change in the patients undergoing an open heart surgery? A Quasi-experimental research was designed to answer these questions with one experimental group and one control group. Subjects in both groups were matched as closely as possible to avoid the effect of the differences inherent to the group characteristics, Baseline data were also. collected on both groups for 7 days prior to the experiment and found that subjects in both groups had comparable sleep patterns, trait anxiety, hormonal levels and behavioral level. A structured information as an experimental input was given to the subjects in the experimental group only. Data were collected and compared between the experimental group and the control group on the sleep amount of the consecutive pre and post operative days, on preoperative state anxiety level, and on hormonal and behavioral changes. To test the effectiveness of the structured information, two main hypotheses and three sub-hypotheses were formulated as follows; Main hypothesis 1: Experimental group which received structured information will have more sleep amount than control group without structured information in the night before the open heart surgery. Main hypothesis 2: Experimental group with structured information will have more sleep, amount than control group without structured information during the week following the open heart surgery Sub-hypothesis 1: Experimental group with structured information will be lower in the level of State anxiety than control group without structured information in the night before the open heart surgery. Sub-hypothesis 2 : Experimental group with structured information will have lower hormonal level than control group without stuctured information on the 5th day after the open heart surgery Sub-hypothesis 3: Experimental group with structured information will be lower in the behavioral change level than control group without structured information during the week after the open heart surgery. The research was conducted in a national university hospital in Seoul, Korea. The 53 Subjects who participated in the study were systematically divided into experimental group and control group which was decided by random sampling method. Among 53 subjects, 26 were placed in the experimental group and 27 in the control group. Instruments; (1) Structed information: Structured information as an independent variable was constructed by the researcher on the basis of Roy's adaptation model consisting of physiologic needs, self-concept, role function and interdependence needs as related to the sleep and of operational procedures. (2) Sleep amount measure: Sleep amount as main dependent variable was measured by trained nurses through observation on the basis of the established criteria, such as closed or open eyes, regular or irregular respiration, body movement, posture, responses to the light and question, facial expressions and self report after sleep. (3) State anxiety measure: State Anxiety as a sub-dependent variable was measured by Spi-elberger's STAI Anxiety scale, (4) Hormornal change measure: Hormone as a sub-dependent variable was measured by the cortisol level in plasma. (5) Behavior change measure: Behavior as a sub-dependent variable was measured by the Behavior and Mood Rating Scale by Wyatt. The data were collected over a period of four months, from June to October 1981, after the pretest period of two months. For the analysis of the data and test for the hypotheses, the t-test with mean differences and analysis of covariance was used. The result of the test for instruments show as follows: (1) STAI measurement for trait and state anxiety as analyzed by Cronbachs alpha coefficient analysis for item analysis and reliability showed the reliability level at r= .90 r= .91 respectively. (2) Behavior and Mood Rating Scale measurement was analyzed by means of Principal Component Analysis technique. Seven factors retained were anger, anxiety, hyperactivity, depression, bizarre behavior, suspicious behavior and emotional withdrawal. Cumulative percentage of each factor was 71.3%. The result of the test for hypotheses show as follows; (1) Main hypothesis, was not supported. The experimental group has 282 minutes of sleep as compared to the 255 minutes of sleep by the control group. Thus the sleep amount was higher in experimental group than in control group, however, the difference was not statistically significant at .05 level. (2) Main hypothesis 2 was not supported. The mean sleep amount of the experimental group and control group were 297 minutes and 278 minutes respectively Therefore, the experimental group had more sleep amount as compared to the control group, however, the difference was not statistically significant at .05 level. Thus, the main hypothesis 2 was not supported. (3) Sub-hypothesis 1 was not supported. The mean state anxiety of the experimental group and control group were 42.3, 43.9 in scores. Thus, the experimental group had slightly lower state anxiety level than control group, howe-ver, the difference was not statistically significant at .05 level. (4) Sub-hypothesis 2 was not supported. . The mean hormonal level of the experimental group and control group were 338 ㎍ and 440 ㎍ respectively. Thus, the experimental group showed decreased hormonal level than the control group, however, the difference was not statistically significant at .05 level. (5) Sub-hypothesis 3 was supported. The mean behavioral level of the experimental group and control group were 29.60 and 32.00 respectively in score. Thus, the experimental group showed lower behavioral change level than the control group. The difference was statistically significant at .05 level. In summary, the structured information did not influence the sleep amount, state anxiety or hormonal level of the subjects undergoing an open heart surgery at a statistically significant level, however, it showed a definite trends in their relationships, not least to mention its significant effect shown on behavioral change level. It can further be speculated that a great degree of individual differences in the variables such as sleep amount, state anxiety and fluctuation in hormonal level may partly be responsible for the statistical insensitivity to the experimentation.

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SVM과 meta-learning algorithm을 이용한 고지혈증 유병 예측모형 개발과 활용 (Development and application of prediction model of hyperlipidemia using SVM and meta-learning algorithm)

  • 이슬기;신택수
    • 지능정보연구
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    • 제24권2호
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    • pp.111-124
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    • 2018
  • 본 연구는 만성질환 중의 하나인 고지혈증 유병을 예측하는 분류모형을 개발하고자 한다. 이를 위해 SVM과 meta-learning 알고리즘을 이용하여 성과를 비교하였다. 또한 각 알고리즘에서 성과를 향상시키기 위해 변수선정 방법을 통해 유의한 변수만을 선정하여 투입하여 분석하였고 이 결과 역시 각각 성과를 비교하였다. 본 연구목적을 달성하기 위해 한국의료패널 2012년 자료를 이용하였고, 변수 선정을 위해 세 가지 방법을 사용하였다. 먼저 단계적 회귀분석(stepwise regression)을 실시하였다. 둘째, 의사결정나무(decision tree) 알고리즘을 사용하였다. 마지막으로 유전자 알고리즘을 사용하여 변수를 선정하였다. 한편, 이렇게 선정된 변수를 기준으로 SVM, meta-learning 알고리즘 등을 이용하여 고지혈증 환자분류 예측모형을 비교하였고, TP rate, precision 등을 사용하여 분류 성과를 비교분석하였다. 이에 대한 분석결과는 다음과 같다. 첫째, 모든 변수를 투입하여 분류한 결과 SVM의 정확도는 88.4%, 인공신경망의 정확도는 86.7%로 SVM의 정확도가 좀 더 높았다. 둘째, stepwise를 통해 선정된 변수만을 투입하여 분류한 결과 전체 변수를 투입하였을 때보다 각각 정확도가 약간 높았다. 셋째, 의사결정나무에 의해 선정된 변수 3개만을 투입하였을 때 인공신경망의 정확도가 SVM보다 높았다. 유전자 알고리즘을 통해 선정된 변수를 투입하여 분류한 결과 SVM은 88.5%, 인공신경망은 87.9%의 분류 정확도를 보여 주었다. 마지막으로, 본 연구에서 제안하는 meta-learning 알고리즘인 스태킹(stacking)을 적용한 결과로서, SVM과 MLP의 예측결과를 메타 분류기인 SVM의 입력변수로 사용하여 예측한 결과, 고지혈증 분류 정확도가 meta-learning 알고리즘 중에서는 가장 높은 것으로 나타났다.

일부 농촌지역 비닐하우스 재배자들의 농부증 실태와 관련요인 (A Study on Farmer's Syndrome and Its Risk Factors of Vinyl House Worker and Farmer in a Rural Area)

  • 이인배;이연경;장성실;이석구;조영채;이동배;이태용
    • 농촌의학ㆍ지역보건
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    • 제24권1호
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    • pp.13-33
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    • 1999
  • 충청남도 청양군의 2개면 14개리에 거주하는 비닐하우스 재배자 177명과 일반 농민 213명을 대상으로 1998년 2월 24일부터 3월 15일까지 피로도, 주관적 건강상태, 농부증과 이의 위험요인을 파악하기 위하여 설문조사를 실시한 결과는 다음과 같다. 1. 피로도는 비닐하우스 재배자와 일반 농민간에 차이가 없었으며, 성별로는 여자가 남자보다(p<0.01), 교육수준이 낮을수록(p<0.01), 8시간 미만의 수면시간 (p<0.05), 비흡연자, 비음주자에서 피로도가 높았고, 연령, 식생활습관, 체질량지수는 관계가 없었다. 작업환경은 비닐하우스 재배자에서 총농사기간(r=0.159, p<0.05), 일반 농민은 총경작면적(r=-0.143, p<0.05)과 농작업동반가족수(r=-0.136, p<05)에서 약한 상관관계를 보였다. 2. 주관적 건강상태는 비닐하우스 재배자와 일반 농민간에 차이가 없었으며, 성별로는 여자가 남자보다(p<0.01), 교육수준이 낮을수록 (p<0.01), 8시간 미만의 수면시간(p<0.05), 비흡연자에서 주관적 건강상태가 좋지 않았으며, 연령, 음주, 식생활습관, 체질량지수, 작업환경은 관련성이 없었다. 3. '농부증 있음'은 비닐하우스 재배자 49.2%, 일반 농민 52.1%로 비슷하였으며, 성별로 비닐하우스 재배자와 일반 농민 모두 여자에서 57.0%, 58.8%로 남자 37.1%, 40.3%보다 높았다(p<0.01). 교육수준은 비닐하우스 재배자의 경우 무학 58.1%, 초등학교 50.0%, 중졸 이상 36.1%로 학력이 낮을수록 높았고(p<0.01), 일반 농민도 각각 56.3%, 51.0%, 33.3%로 같은 경향이었다(p<0.01). 흡연과 음주여부는 비닐하우스 재배자의 경우 비흡연군과 비음주군에서 높았으나, 일반 농민에서는 차이가 없었고, 체질량지수도 비닐하우스 재배자의 경우 세장형 57.1%, 비만형 63.9%로 정상형 42.5%보다 높았으나(p<0.05), 일반 농민은 차이가 없었다. 4. 농부증의 위험요인에 대한 다변량 로지스틱 회귀분석에서 성별, 수면시간이 중요한 요인이었으며, 남자를 기준하였을 때 여자의 교차비는 2.53(p<0.01), 수면시간 8시간 미만을 기준하였을 때 8시간 이상은 0.74로(p<0.01), 여자에서 발생위험이 높았고, 수면시간이 8시간 이상일수록 발생위험은 낮아졌다. 5. 비닐하우스 재배지와 일반 농민에서 많이 호소하는 주관적 신체증상은 '등이 결리거나 허리가 아파서 일하기가 어렵다.' '팔과 다리가 몹시 쑤시고 아픈 일이 있다', '손발이 저리거나 찌릿찌릿 하다'. '팔과 다리에 통증이 있어서 불편하다' '손의 힘이 전에 비해 약해졌다'에서 과반수 이상이 있다고 응답하였으며, 비닐하우스 재배자에서 일반 농민보다 많은 증상은 '피부의 일부분이 검게 변하였다'. '습진이나 무좀 등이 피부질환이 있다', '치질로 고생한 일이 있다'였다. 6. 대응분석 결과 비닐하우스 재배자는 피부계 질환이 높게 관찰되었으며, 남자는 소화기계 장애나 기타 질환, 여성에서는 내분비질환, 근육계통의 질환이 많은 것으로 나타났고, 농부증도 일반 농민과 여자에서 상대적으로 높은 것으로 나타났다. 결론적으로 피로도, 주관적 건강상태, 농부증도 비닐하우스 재배자와 일반 농민간에 차이가 없었으며, 주로 농사와 노동일을 병행하는 여성에서 많고, 연령이 증가함에 따라 유병률도 증가하는 경향을 감안하면 추후 농촌의 노령환된 여성들에 대한 중점적인 관리가 필요하다. 또한 작업환경의 차이에 의하여 비닐하우스 재배자에서만 나타나는 미약하지만 특징적인 증상이 있으므로 이에 대한 지속적인 조사와 관리의 필요성이 있다.

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다양(多樣)한 황금약침제제(黃芩藥鍼製劑)의 안전성(安定性) 및 효능(效能)에 관한 연구(硏究) (Studies on effect and Safety of various Aqua-acupunctures from Scutellariae Radix)

  • 김호경;마진열;전원경;윤수영;강은정;주혜정;고병섭
    • 한국한의학연구원논문집
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    • 제3권1호
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    • pp.183-197
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    • 1997
  • 황금약침제제(黃芩藥鍼製劑)의 안정성(安定性) 및 효능(效能)에 관한 연구(硏究)하기 위해, 약침제제(藥鍼製劑)들은 황금(黃芩)을 원료(原料)로 하여 전탕(煎蕩) 여과(濾過) 희석(稀釋)의 방법으로 제조(製造)하였다. 황금약침제제(黃芩藥鍼製劑)들은 랫트의 족삼리 근육에 반복투여(反復投與)하여 아급성(亞急性) 독성(毒性) 및 효능(效能)을 조사(調査)하였고, 대조군(對照群) 주사용(注射用) 생리식염수(生理食鹽水)와 연유수(燕溜水)의 매체대조군(媒體對照郡) 침자재군(鍼刺栽郡)을 설정하여 비교(比較)하였다. 1. 랫트에 황금약침제제(黃芩藥鍼製劑)들을 0.2cc 근육투여(筋肉投與)한 결과(結果) 대조군(對照群)과 시험군(試驗群)에서 1마리도 사망하지않았고, 일반증상(一般症狀) 및 부검소견(剖檢所見)에서도 특별한 이상이 발견(發見)되지 않았다. 또한 검액(檢液) 황금약침제제(黃芩藥鍼製劑)들 각각을 랫트에 반복 약침(藥鍼) 시술(施術)하여 체중변화(體重變化) 장기중량(臟器重量) 및 혈액생화학적(血液生化學的) 검사등(檢査等)을 실험(實驗)한 결과(結果), 검액(檢液)에 기인한 독성증상(毒性症狀)은 나타나지 않았다. 따라서 시험군(試驗群)에 사용한 황금약침제제(黃芩藥鍼製劑)은 안전성(安全性)에는 문제가 없는 것으로 사료되었다. 2. 경시적(輕視的) 체중변화(體重變化)의 결과(結果)에서 침자재군(鍼刺栽郡)(acupuncture)은 시술(施術) 3일후(日後)부터 p-value가 <0.05, 7일(日)부터는 p-value가 <0.001로 유의성(有意性)이 있는 체중감소(體重減少)가 나타났고, 9일후(日後)에는 모든 시험군(試驗群)이 체중(體重) 증가(增加)가 억제되었다. 3. 장기중량(臟器重量)에 대한 결과(結果)에서 D-2군(群)과 생리식염수군군(生理食鹽水群)은 간장중량(肝臟重量)이 통계적(統計的) 유의성(有意性)을 보이고 있는데 침자재(鍼刺栽)의 경우 간장(肝臟)과 비장(脾臟)에서 유의(有意)한 결과(結果)를 얻었다. 이러한 결과(結果) 효능면(效能面)에서 약침(藥鍼)의 침(鍼)과 약(藥)이 효과(效果)에서 침(鍼)의 효과(效果)가 우선하고 있다고 추측되어진다. 4. 약침(藥鍼) 시술군(施術群)에 대한 혈액생화학적(血液生化學的) 검사(檢査)는 GLU, T.G., CHOL에 대해 조사하였는데, glucose에 대한 영향(影響)은 황금약침제제(黃芩藥鍼製劑) ${\times}$10군(群)에서 대조군(對照群)에 비해 유의성(有意性) 있는 감소를 확인할 수 있었고, 황금약침제제(黃芩藥鍼製劑) ${\times}$100군(群), Distillation-2군(群), 생리식염수군군(生理食鹽水群)에서는 대조군(對照群)에 비해 유의성(有意性) 있는 증가(增加)를 확인할 수 있었고, 모든 시술군(施術群)에서 CHOL의 유의성(有意性)있는 감소(減少)를 보였고, T.G는 황금약침제제(黃芩藥鍼製劑)와 복합주사제군(複合注射劑群)를 제외한 모든 시술군(施術群)에서 통계학적(統計學的) 유의성(有意性)이 있었는데, 황금약침제제(黃芩藥鍼製劑)를 희석(稀釋)한 황금수액희석제제군(黃芩水液稀釋製劑群)에서 유의성(有意性)있는 감소가 일어나는 것을 확인(確認)할 수 있었다. 농도와는 관계없이 황금약침제제(黃芩藥鍼製劑)들이 함유하고 있는 성분상호간(成分相互間)의 작용에 의해서 T.G.가 감소(減少)된다고 생각되어진다. 또한 침자재군(鍼刺栽群)에서도 T.G.를 감소시키는 유의성있는 흥미로운 결과(結果)를 얻을수 있었다. 5. 혈액학적(血液學的) 검사결과(檢査結果)는 과립구(顆粒球)에서 황금수액제제(黃芩水液製劑)만을 제외한 모든 시술군(施術群)에서 유의성(有意性)있는 증가(增加)를 보였으며, 황금수액희석제제군(黃芩水液稀釋製劑群)들에서의 과립구(顆粒球)는 매우 유의적(有意的)인 증가(增加)(p-value가 <0.001)를 보였다. 침자재군(鍼刺栽群)은 과립구(顆粒球)와 평균혈구용적(平均血球容積)에서 통계적(統計的) 유의성(有意性)이 인정되었다.

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