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A Study on the Development of an Instrument for Evaluating the Quality of Nursing Care (간호의 질 평가도구 개발에 관한 일 연구)

  • 유지수
    • Journal of Korean Academy of Nursing
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    • v.7 no.2
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    • pp.11-21
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    • 1977
  • Many in nursing look back on Nursing Research history and proudly point to the fact that emphasis in nursing research has changed from studying the nurse to studying nursing practice. In recent years, much emphasis has been placed on seeking a method of evaluating the quality of nursing care. In spite of these attempts, however, an instrument for evaluating the quality of nursing care that is actually applicable in the clinical area has not been found. The Purposes of this study are as follows: 1) To develop the instrument to be used in evaluating the quality of nursing care provided in the Neuro - Surgery Constant Care Unit of Severance Hospital 2) To evaluate the quality of nursing care in the clinical area. 3) To provide the necessary information for improvement of quality of nursing care. The instrument for evaluating the quality of nursing care, developed by the investigator, was composed of 7 nursing goals and divided into 65 standards of nursing performance. The 7 nursing goal are as follows : 1) Maintenance of airway 2) Maintenance of fluid at electrolyte balance 3) Maintenance of elimination 4) Personal hygiene 5) Optimum activity 6) Prevention of accidents 7) Emotional care The study population defined was composed of all the case (51) who were admitted in the Neuro- Surgery Constant Care Unit of Severance Hospital from May 7-13, 1976. The observation method was used and the data was subjected to the %, X²-test, T-test, F-test and Correlation. The results of tile study were as follows : 1. Levels of nursing performance regarding nursing goals. Seven different nursing care indices were constructed in terms of nursing goals. The index scores were grouped arbitrarily into ,j categories such as "excellent", "good", "moderate", "incomplete", and "poor"based upon the investigator′s personal judgement. a. The nursing index of maintaining airway showed that 78% of the patients fell within the "excellent" and 22% of the patients, fell within the "good" category. b. The nursing index of maintaining fluid & electrolyte balance showed that 95% of the patients fell within the "excellent" and 5 % of the patients fell within the "good" category. c. The nursing index of maintaining elimination showed that 100% of the patients fell within the "excellent" category. d. The nursing index of personal hygiene revealed that 49% of the patients fell within the "excellent" and 51% of the patients fell within the "good" category. e. The nursing index of optimum activity showed that 63% of the patients fell within the "excellent" and 32% of the patients fell within tile "good" and 5% of patients fell within the "moderate" category. f. The nursing index of prevention of accidents showed that 100% of the patients foil within the "excellent" category. g. The nursing index of emotional cart revealed that 27% of the patients fell within the "excellent", 24 % of the patients fell within tile "good", 29 % of the patients fell within the "incomplete" category. From these findings it is disclosed that the quality of nursing care provided in the Neuro- Surgery Constant Care Unit of Severance Hospital was excellent. h. There were statistically significant differences between the nursing index of physical care and emotional care. (t=8.73, D. F. =100. p<0.01) It is revealed that more physical care then emotional care was carried out by nurses. 2. Levels of nursing performance regarding general characteristics of the patients. No significant differences were observed statistically with the nursing indices of nursing goals according to the sex (t=0.084, D. F. =12, p>0.05). Age (F=0.1251, D. F. : 3.18. p 〉0.05), absence or presence of operating experiences (t=0.6032, D. F. =12, p〉0.05, levels of consciousness (F=0.31, D. F. :3. 18, p >0.05) 3. Relationship between the levels of consciousness and the nursing index of each nursing goal. There was negative correlation between the levels of consciousness and the nursing index of maintaining airway (r=-0. 5449, p<0.01) and personal hygiene (r= -0.4075, p<0.01) There was positive correlation between the levels of consciousness and the nursing index of optimum activity (r=0.3936, p <0.01) and emotional care (r=0.7819, p〈0.01). There was slight correlation between the levels of consciousness and the nursing index of maintaining fluid & electrolyte balance (r=-0.3418, 0.010.05) and preventing accidents (r=0.1441, p>0.05.

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The Occurrence of Degenerative Change in the Mandibular Condyles of Korean Patients with Temporomandibular Disorders (측두하악장애 환자에서 하악과두의 퇴행성 변화의 발생 양상에 대한 연구)

  • Jo, Jung-Hwan;Park, Min-Woo;Kim, Young-Ku;Lee, Jeong-Yun
    • Journal of Oral Medicine and Pain
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    • v.36 no.1
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    • pp.53-63
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    • 2011
  • Osteoarthritis (OA), the most common form of arthritis, is a result of both mechanical and biological events that destabilize the normal coupling of degradation and synthesis of articular cartilage chondrocytes and extracelluar matrix, and subchondral bone. Although it is likely that the molecular basis of pathogenesis is similar to that of other joints, additional study of the temporomandibular joint (TMJ) is required due to its unique structure and function. This study was carried out to evaluate the epidemiologic characteristics of TMJ osteoarthritis. The purpose of this study was to investigate the prevalence of TMJ OA in Patients with temporomandibular disorders (1405 men and 2922 women whose mean age was $30.2\; {\pm}\; 15.4$ and $33.1\;{\pm}\;15.2$ years, respectively) who had visited the TMJ and Orofacial Pain Clinic of Seoul National University Dental Hospital in 2007. Orthopantomograms, TMJ tomograms and transcranial radiographs were used to evaluate degenerative change of the mandibular condyle. The obtained results were as follows: 1. Degenerative change of the mandibular condyle was observed in 883 (20.4%) of 4327 subjects. The prevalence was significantly higher in women (706 patients, 24.1%) than in men (177 patients, 12.6%), and this significant difference between genders was observed in all age groups. 2. The prevalence of degenerative change of the mandibular condyle in TMD patients showed a gentle increase along with age. Such increase was statistically significant in women (P < 0.001), but not in men. 3. Sclerosis was observed the most frequently in all age groups and the mean age of the patients with osteophyte was the highest among four types of degenerative change. 4. Although men showed degenerative change in the left side more often and women showed degenerative change more frequently in both sides, the difference of distribution in sides between genders was not significant. In conclusion, the prevalence of degenerative change of the mandibular condyle in TMD patients is higher in women than in men, and increases steadily with aging, but not as dramatically as in other joints that show a steep increase in prevalence around the age of 45 years. It can be suggested that the epidemiologic characteristic of OA of the TMJ differs from those of other joints, and that a more extensive study based on the general population is necessary.

Flavonoid intake according to food security in Korean adults: Based on the Korea National Health and Nutrition Examination Survey 2007~2012 (한국 성인의 식품안정성에 따른 플라보노이드 섭취 실태: 2007~2012년 국민건강 영양조사 자료를 이용하여)

  • Jun, Shinyoung;Hong, Eunju;Joung, Hyojee
    • Journal of Nutrition and Health
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    • v.48 no.6
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    • pp.507-518
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    • 2015
  • Purpose: The aim of this study was to examine the association of food security with the total and individual flavonoid intakes among Korean adults. Methods: Study subjects were 13,454 men and 19,563 women aged 19 years and older who participated in the 2007~2012 Korea National Health and Nutrition Examination Survey. Subjects were classified into food-secure and food-insecure groups using the answers to a self-reported question on food sufficiency of subjects' household. The total and individual flavonoid intakes were calculated by linking 24-h dietary recall data of subjects with a flavonoid database. Mean differences in dietary outcomes by food security status, and major food sources of total flavonoids were examined. Results: In this cross-sectional study, 5.8% of male adults and 6.6% of female adults were in food insecure households. Mean daily intakes of total flavonoids, flavonols, flavones, flavanones, flavan-3-ols, isoflavones, and proanthocyanidins were significantly lower in food-insecure groups than food-secure groups among both male and female adults. The differences were maintained in total flavonoids, flavones, flavanones, and flavan-3-ols after adjusting for total energy intake. Mean intakes of fruits and vegetables were significantly lower in food-insecure groups and the total flavonoid intake from fruits and vegetables was also significantly lower in food-insecure groups. The major food sources of total flavonoids were apples (20.7%), mandarines (12.0%), and tofu (11.5%) in the food-secure group, and apples (14.9%), tofu (13.3%), and mandarines (12.6%) in the food-insecure group. Conclusion: This study showed that food insecurity was associated with lower intakes of flavonoids and reduced intakes of fruits and vegetables in a representative Korean population.

Estimated flavonoid intakes according to socioeconomic status of Korean adults based on the Korea National Health and Nutrition Examination Survey 2007~2012 (우리나라 성인의 사회경제적 수준에 따른 플라보노이드 섭취현황 : 2007~2012년 국민건강영양조사 자료를 이용하여)

  • Kim, Seong-Ah;Hei, Yang;Jun, Shinyoung;Wie, Gyung-Ah;Shin, Sangah;Hong, Eunju;Joung, Hyojee
    • Journal of Nutrition and Health
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    • v.50 no.4
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    • pp.391-401
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    • 2017
  • Purpose: The purpose of this study was to estimate the dietary flavonoid intakes of Korean adults according to socioeconomic status. Methods: Using data from the 2007~2012 Korea National Health and Nutrition Examination Survey, a total of 31,112 subjects aged over 19 years were included in this study. We estimated individuals' daily intakes of total flavonoids and seven flavonoid subclasses, including flavonols, flavones, flavanones, flavan-3-ols, anthocyanins, proanthocyanidin, and isoflavones,by linking food consumption data with the flavonoids database for commonly consumed Korean foods. We compared intakes of flavonoids according to the levels of household income and education. Results: Average dietary flavonoid intakes of the study subjects were 321.8 mg/d in men and 308.3 mg/d in women. Daily flavonoid intakes were positively associated with household income level (p < 0.0001) and education level (p < 0.0001). The subjects in the highest household income and highest education level group (OR 0.37, 95% CI 0.30~0.45, p < 0.0001 in men, OR 0.50, 95% CI 0.41~0.60, p < 0.0001 in women) had a lower likelihood of having low total flavonoid intake (less than 25 percentile) compared to the lowest household income and lowest education level group. The food group that contributed to total flavonoid intake with the biggest difference between the lowest and highest groups for both household income level and education level was beverages. Conclusion: This study shows that socioeconomic status was positively associated with flavonoid intake in a representative Korean population. Further research is needed to analyze the association of flavonoid intake with health outcomes according to socioeconomic status such as household income and education level.

Differential Association of History of Premenstrual Syndrome/Premenstrual Dysphoric Disorder with Vasomotor Symptoms According to Menopausal Stage (폐경 단계에 따른 월경전 증후군/월경전 불쾌장애의 과거력과 혈관운동증상의 차별적 연관성)

  • Hyun, Hong-Dae;Joe, Sook-Haeng;Jeong, Hyun-Ghang;Ko, Young-Hoon;Kwon, Eunjoo;Kim, Hyekyeong;Ko, Seung-Duk
    • Korean Journal of Psychosomatic Medicine
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    • v.23 no.1
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    • pp.57-65
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    • 2015
  • Objectives:Within the normal reproductive cycles of women, dramatic fluctuations of sexual hormones occur in the premenstrual and menopausal periods. In both periods, women are vulnerable to mood disturbances and show several somatic complaints. Based on these common clinical profiles and physiological changes, a relationship between vasomotor symptoms and the premenstrual syndrome has been suggested. However, attempts to establish such a link have yielded inconclusive results. The purpose of this study was to investigate the association between histories of premenstrual syndrome and menopausal vasomotor symptoms within different menopausal stages. Methods:This cross-sectional study recruited Korean women aged 45-64 years who were perimenopausal and postmenopausal from 16 branch offices of the Korean Association of Health Promotion. All subjects completed self-report questionnaires that asked about a history of premenstrual syndromes, vasomotor symptoms, and several other variables. Results:A total of 1054 participants(361 perimenopausal women and 693 postmenopausal women) completed the study. Severity of premenstrual symptoms significantly correlated with postmenopausal vasomotor symptoms, only in late perimenopausal(r=0.213, p=0.010) and early postmenopausal women(r=0.246, p<0.001). After adjusting for several factors related to vasomotor symptoms, a history of premenstrual syndrome was a significant predictor of moderate to very severe vasomotor symptoms in late perimenopausal(OR=5.197, p=0.005) and early postmenopausal women(OR=3.017, p=0.010). Conclusions:This study suggests that a history of premenstrual syndrome/premenstrual dysphoric disorder is differentially associated with vasomotor symptoms in the menopausal stage. Prospective studies with larger population are needed to confirm these findings

A Study on the Distribution of Startups and Influencing Factors by Generation in Seoul: Focusing on the Comparison of Young and Middle-aged (서울시 세대별 창업 분포와 영향 요인에 대한 연구: 청년층과 중년층의 비교를 중심으로)

  • Hong, Sungpyo;Lim, Hanryeo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.16 no.3
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    • pp.13-29
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    • 2021
  • The purpose of this study was to analyze the spatial distribution and location factors of startups by generation (young and middle-aged) in Seoul. To this end, a research model was established that included factors of industry, population, and startup institutions by generation in 424 administrative districts using the Seoul Business Enterprise Survey(2018), which includes data on the age group of entrepreneurs. As an analysis method, descriptive statistics were conducted to confirm the frequency, average and standard deviation of startups by generation and major variables in the administrative districts of Seoul, and spatial distribution and characteristics of startups by generation were analyzed through global and local spatial autocorrelation analysis. In particular, the spatial distribution of startups in Seoul was confirmed in-depth by categorizing and analyzing startups by major industries. Afterwards, an appropriate spatial regression analysis model was selected through the Lagrange test, and based on this, the location factors affecting startups by generation were analyzed. The main results derived from the research results are as follows. First, there was a significant difference in the spatial distribution of young and middle-aged startups. The young people started to startups in the belt-shaped area that connects Seocho·Gangnam-Yongsan-Mapo-Gangseo, while middle-aged people were relatively active in the southeastern region represented by Seocho, Gangnam, Songpa, and Gangdong. Second, startups by generation in Seoul showed various spatial distributions according to the type of business. In the knowledge high-tech industries(ICT, professional services) in common, Seocho, Gangnam, Mapo, Guro, and Geumcheon were the centers, and the manufacturing industry was focused on existing clusters. On the other hand, in the case of the life service industry, young people were active in startups near universities and cultural centers, while middle-aged people were concentrated on new towns. Third, there was a difference in factors that influenced the startup location of each generation in Seoul. For young people, high-tech industries, universities, cultural capital, and densely populated areas were significant factors for startup, and for middle-aged people, professional service areas, low average age, and the level of concentration of start-up support institutions had a significant influence on startup. Also, these location factors had different influences for each industry. The implications suggested through the study are as follows. First, it is necessary to support systematic startups considering the characteristics of each region, industry, and generation in Seoul. As there are significant differences in startup regions and industries by generation, it is necessary to strengthen a customized startup support system that takes into account these regional and industrial characteristics. Second, in terms of research methods, a follow-up study is needed that comprehensively considers culture and finance at the large districts(Gu) level through data accumulation.

Levels of Physicians' Self-assessment of Life Satisfaction and Associated Factors (임상의사의 삶의 만족도 자가평가 수준과 관련 요인)

  • Jong Sun Ok;Hyeongsu Kim
    • Journal of agricultural medicine and community health
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    • v.48 no.1
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    • pp.28-40
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    • 2023
  • Objectives: This study aimed to identify the level of self-assessment of life satisfaction and various factors related to the life satisfaction of Korean physicians. Methods: This study is a secondary data analysis using the 2016 Korean physician survey Korean Physician Survey(KPS) data collected by the Research Institute for Healthcare Policy of the Korean Medical Association. The member database(DB) of the Korean Medical Association was used for sampling and the target population was formed and surveyed by using stratified quota sampling. A questionnaire was sent by E-mail as an online survey method and was conducted for a total of 7 weeks from November 21, 2016 to January 8, 2017. The final number of respondents was 8,564 (response rate 13.8%). In this study, a total of 7,228 physicians, excluding residents and public health doctors who are currently treating patients directly, were studied. Factors affecting the life satisfaction of physicians were analyzed using ordinal logistic regression analysis. Results: The physical factors positively related to the life satisfaction of physicians were those who were in their 60s, female, and thought they had good health status. As for psychological factors, stress was low. As for economic factors, satisfaction with income was high. As for social factors, the physicians lived with their families and were satisfied with the time they could spend with them. Also, the physicians were satisfied with the social respect they received as a doctors. Conclusions: Based on the results of this study, it is thought that a multifaceted approach is needed to increase the life satisfaction of physicians.

A Study on Estimation of Environmental Value of Tentatively Named 'East-West Trail' Using CVM (CVM기법을 이용한 가칭 '동서트레일'의 환경가치 추정)

  • Kee-Rae Kang;Yoon-Ho Choi;Bo-Kwang Chung;Dong-Pil Kim;Hyun-Kyeong Oh;Woo-Sung Lee;Su-Bok Chae
    • Korean Journal of Environment and Ecology
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    • v.36 no.6
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    • pp.676-683
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    • 2022
  • Due to the effects of rapid changes in the living environment since 2000 and the recent unforeseen pandemic, people are refraining from domestic and international traveling and movement, and outdoor activities for health and the public value of forest trails, called Dullegil Trail in Korea, have become more important. This study estimated the environmental value of the tentatively named "East-West Trail," which connects the forest trails crossing Chungcheong and Gyeongsang Provinces using CVM (Contingent Valuation Method). It surveyed visitors to the East-West Trail, and 725 questionnaires were used for analysis. The average characteristics of respondents were those who exercised 2-3 times per week, visited a forest trail not far from their residence with friends or family, and showed a tendency to spend 50 thousand Korean won or more per visit. Visitors to the Dullegil Trail felt that there was a shortage of information boards on the forest trail, and they preferred a shelter in appropriate locations. We used a double-bounded dichotomous choice (BDDC) logit model proposed by Hanemann to measure the conservation value of the East-West Trail. It was estimated that the environmental value that a visitor to the East-West Trail could obtain was 30,087 won per trip. The estimated environmental value of the East-West Trail can be converted to about 94 billion won total visitors annually based on the population belonging to the direct-use zone near the East-West Trail. As there has been no study on the environmental value of forest trails using CVM, the results of this study will be able to suggest the feasibility of the government policies on forest trails.

Effect of Subject Satisfaction and Relationship Satisfaction on Job-seeking Stress : Focusing on the Difference between Engineering College Students and Social Science College Students (교과 만족도 및 관계 만족도가 취업 스트레스에 미치는 영향: 이공계열 대학생과 인문 사회계열 대학생의 차이를 중심으로)

  • Kang, Eun-jeong;Chung, Byoung-gyu
    • Journal of Venture Innovation
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    • v.4 no.2
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    • pp.29-42
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    • 2021
  • The stress on finding a job is also increasing in a situation where the difficulty in finding a job is aggravating due to the COVID-19 pandemic. In this study, the major satisfaction of college students was subdivided into subject satisfaction and relationship satisfaction, and the relationship between these and job-seeking stress was investigated. In addition, We tried to find out whether there is a difference in the influence relationship between these majors according to their current major, that is, whether they majored in a science, engineering major or a social science major. The population for the study was the students currently enrolled in the 4th grade, and the research sample was obtained from students of H and N universities in the metropolitan area. A total of 220 people were analyzed, 110 people from science and engineering and 110 from social sciences. For analysis, SPSS 24.0 and Process Macro 5.0 were used. The empirical analysis results are as follows. First, subject satisfaction had a negative (-) effect on job-seeking stress. Second, relationship satisfaction also had a significant negative (-) effect on job-seeking stress. Third, there was a significant difference between science, engineering students and social science students in the effect of subject satisfaction on job-seking stress. Fourth, in the effect of relationship satisfaction on job-seeking stress, there was also a significant difference between science, engineering students and social science students. Therefore, the higher the satisfaction with the major you are majoring in, the lower the job-seeking stress, and the extent of this decrease is social science students were larger than science, engineering students. It is necessary to be cautious in generalizing the results of this study, which was made in the context of the COVID-19 pandemic. Based on the empirical analysis results, the academic and practical implications of this study are presented.

The Ability of Anti-tumor Necrosis Factor Alpha(TNF-${\alpha}$) Antibodies Produced in Sheep Colostrums

  • Yun, Sung-Seob
    • 한국유가공학회:학술대회논문집
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    • 2007.09a
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    • pp.49-58
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    • 2007
  • Inflammatory process leads to the well-known mucosal damage and therefore a further disturbance of the epithelial barrier function, resulting abnormal intestinal wall function, even further accelerating the inflammatory process[1]. Despite of the records, etiology and pathogenesis of IBD remain rather unclear. There are many studies over the past couple of years have led to great advanced in understanding the inflammatory bowel disease(IBD) and their underlying pathophysiologic mechanisms. From the current understanding, it is likely that chronic inflammation in IBD is due to aggressive cellular immune responses including increased serum concentrations of different cytokines. Therefore, targeted molecules can be specifically eliminated in their expression directly on the transcriptional level. Interesting therapeutic trials are expected against adhesion molecules and pro-inflammatory cytokines such as TNF-${\alpha}$. The future development of immune therapies in IBD therefore holds great promises for better treatment modalities of IBD but will also open important new insights into a further understanding of inflammation pathophysiology. Treatment of cytokine inhibitors such as Immunex(Enbrel) and J&J/Centocor(Remicade) which are mouse-derived monoclonal antibodies have been shown in several studies to modulate the symptoms of patients, however, theses TNF inhibitors also have an adverse effect immune-related problems and also are costly and must be administered by injection. Because of the eventual development of unwanted side effects, these two products are used in only a select patient population. The present study was performed to elucidate the ability of TNF-${\alpha}$ antibodies produced in sheep colostrums to neutralize TNF-${\alpha}$ action in a cell-based bioassay and in a small animal model of intestinal inflammation. In vitro study, inhibitory effect of anti-TNF-${\alpha}$ antibody from the sheep was determined by cell bioassay. The antibody from the sheep at 1 in 10,000 dilution was able to completely inhibit TNF-${\alpha}$ activity in the cell bioassay. The antibodies from the same sheep, but different milkings, exhibited some variability in inhibition of TNF-${\alpha}$ activity, but were all greater than the control sample. In vivo study, the degree of inflammation was severe to experiment, despite of the initial pilot trial, main trial 1 was unable to figure out of any effect of antibody to reduce the impact of PAF and LPS. Main rat trial 2 resulted no significant symptoms like characteristic acute diarrhea and weight loss of colitis. This study suggested that colostrums from sheep immunized against TNF-${\alpha}$ significantly inhibited TNF-${\alpha}$ bioactivity in the cell based assay. And the higher than anticipated variability in the two animal models precluded assessment of the ability of antibody to prevent TNF-${\alpha}$ induced intestinal damage in the intact animal. Further study will require to find out an alternative animal model, which is more acceptable to test anti-TNF-${\alpha}$ IgA therapy for reducing the impact of inflammation on gut dysfunction. And subsequent pre-clinical and clinical testing also need generation of more antibody as current supplies are low.

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