• Korean Journal of Occupational Health Nursing
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• v.11 no.1
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• pp.13-30
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• 2002

Industrial shift workers feels suffer mental stresses which are caused by unfamiliar day sleep, noisy environment, sleeping disorder by bright light, unusual contacts with family, difficulty in meeting with friends or having formal social meetings and other social limitations such as the use of transportation. Such stresses influence health of the workers negatively. Thus the health promotion policy for shift workers should be made considering the workers' ways of living and shift work specially. This study attempted to provide basic information for development of the health promotion program for industrial shift workers by examining predictive factors influencing health promotion behaviors of those workers. In designing the study, three power generation plants located in Pusan and south Kyungsang province were randomly selected and therefrom 280 workers at central control, boiler and turbine rooms and environmental chemistry parts whose processes require shift works were sampled as subjects of the study. Data were collected two times from September 17 to October 8, 1999 using questionnaires with helps of safety and health managers of the plants. The questionnaires were distributed through mails or direct visits. Means for the study included the measurement tool of health promotion behavior provided by Park(1995), the tool of self-efficacy measurement by Suh(1995), the tool of internal locus of control measurement by Oh(1987), the measurement tool of perceived health state by Park(1995) and the tool of social support measurement by Paek(1995). The collected data were analyzed using SPSS program. Controlling factors of the subjects were evaluated in terms of frequency and percentage ratio Perceived factors and health promotion behaviors of the subjects were done so in terms of mean and standard deviation, and average mark and standard deviation, respectively. Relations between controlling and perceived factors were analyzed using t-test and ANOVA and those between perceived factors and the performance of health promotion behaviors, using Pearson's Correlation Coefficient. The performance of health promotion behaviors was tested using t-test, ANOVA and post multi-comparison (Scheffe test). Predictive factors of health promotion behavior were examined through the Stepwise Multiple Regression Analysis. Results of the study are summarized as follows. 1. The performance of health promotion behaviors by the subjects was evaluated as having the value of mean, $161.27{\pm}26.73$ points(min.:60, max.:240) and average mark, $2.68{\pm}0.44$ points(min.:1, max.:4). When the performance was analyzed according to related aspects, it showed the highest level in harmonious relation with average mark, $3.15{\pm}.56$ points, followed by hygienic life($3.03{\pm}.55$), self-realization ($2.84{\pm}.55$), emotional support($2.73{\pm}.61$), regular meals($2.71{\pm}.76$), self-control($2.62{\pm}.63$), health diet($2.62{\pm}.56$), rest and sleep($2.60{\pm}.59$), exercise and activity($2.53{\pm}.57$), diet control($2.52{\pm}.56$) and special health management($2.06{\pm}.65$). 2. In relations between perceived factors of the subjects(self-efficacy, internal locus of control, perceived health state) and the performance of health promotion behaviors, the performance was found having significantly pure relations with self-efficacy (r=.524, P=.000), internal locus of control (r=.225, P=.000) and perceived health state(r=.244, P=.000). The higher each evaluated point of the three factors was, the higher the performance was in level. 3. When relations between the controlling factors(demography-based social, health-related, job-related and human relations characteristics) and the performance of health promotion behaviors were analyzed, the performance showed significant differences according to marital status (t=2.09, P= .03), religion(F=3.93, P= .00) and participation in religious activities (F=8.10, P= .00) out of demography-based characteristics, medical examination results (F=7.20, P= .00) and methods of the collection of health knowledge and information(F=3.41, P= .01) and methods of desired health education(F=3.41, P= .01) out of health-related characteristics, detrimental factors perception(F=4.49, P= .01) and job satisfaction(F=8.41, P= .00) out of job-related characteristics and social support(F=14.69, P= .00) out of human relations characteristics. 4. The factor which is a variable predicting best the performance of health promotion behaviors by the subjects was the self-efficacy accounting for 27.4% of the prediction, followed by participation in religious activities, social support, job satisfaction, received health state and internal locus of control in order all of which totally account for 41.0%. In conclusion, the predictive factor which most influence the performance of health promotion behaviors by shift workers was self-efficacy. To promote the sense, therefore, it is necessary to develop the nursing intervention program considering predictive factors as variables identified in this study. Further industrial nurses should play their roles actively to help shift workers increase their capability of self-management of health.

• Research in Community and Public Health Nursing
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• v.8 no.2
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• pp.347-367
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• 1997

The purpose of this study was to investigate drug abuse and to find related factors among high school students. The subjects for this study were 973 students from 10 high schools in Taegu city. The data were collected from September 30, 1996 to October 30, 1996. The questionnaire developed by Kim Soyoaja (1991) surveyed adolescent drug use and questions on smoking and drinking were readjusted and added by the researcher based on review. The data was analyzed using frequency, percentage, $X^2-test$, t -test, Pearson Correlation Coefficient with the SPSS /PC+. The results of this study were summarized as follows: 1. The proportion of students who drank alcohol 1-2 times or more per year was 52.4% and smoked Cigarette 1 -2 times or more per year was 20.8%. The 7 different drugs(Analgetics 5.7%. sleeping pills and sedatives 4.2%, antihistamines 1.1%. stimulants 7.7%, hallucinogens 0.8%, inhalants 3.3%, and narcotics 0.6%) were also evaluated. 2. There was a significant relationship between drinking and type of school($X^2$=62.97, p<.0l), grades($X^2$=33.86, P<.001), school life($X^2$= 19.04, p<.001), and delinquent friends($X^2$= 64.72, P<.001). 3. There was a significant relationship between smoking and type of school($X^2$=153.65, p<.001), grades ($X^2$=67.53, p<.001), their respect for teachers ($X^2$=33.80, p<.001) school life($X^2$ =50.87, p<.001), and delinquent friends($X^2$ =85.28, p<.001). 4. There was a significant relationship between the 7 different kinds of drug abuse and type of school ($X^2$=14.65, p<.01), grades($X^2$=12.89, p<.01), their respect for teachers ($X^2$=8.46, p<.05), and delinquent friends($X^2$=22.42, p<.001). 5. There was a significant relationship between a parent's habitual drug abuse and the 7 different kinds of drug abuse($X^2$=7.78, p<.01), as well as a parent's attitude toward drugs and the 7 different kinds of drug abuse($X^2$=6.33, p<.05). 6. There was a significant difference between drinking(t=-12.53, p<.001), smoking(t=-15.98, p<.001), the 7 different kinds of drug abuse(t=-5.77, p<.001), and the respondant's delinquent experience. 7. There was a correlation between drinking and smoking(r=.4166, p<.001), drinking and the 7 different kinds of drug abuse(r=.2200, p<.001), smoking and the 7 different kinds of drug abuse(r=.1428, p<.05). There was a correlation between drinking and smoking(r=.5977, p<.001), drinking and the 7 different kinds of drug abuse(r=.2849, p<. 001), smoking and the 7 different kinds of drug abuse(r=.1711, p<.05) among male students. There was a correlation between drinking and smoking(r=.4219, p<.001), drinking and the 7 different kinds of drug abuse(r=.2611, p<.001), smoking and the 7 different kinds of drug abuse(r=.1764, p<.001) among female students. 8. There was a correlation between drinking and family stability(r=.0709, p<.05) drinkry and parent -child relationships (r=.1321, p<.01), drinking and mother's rearing attitude(r=.0704, P<.05), smoking and parent -child relationships(r=.0813, P<.05). There was a correlation between drinking and family stability(r=.14S7, p<.01), drinkng and parent-child relationships(r=.2147, p<.001), smoking and family stability(r=.1544, p<.01), smoking and parent. -child relationships (r=. 2018, P<.01) among male students. There was a correlation between drinking and family stability(r=.1l21, p<.05), drinking and mother's rearing attitude (r=.0988, P<.05), smoking and parent -child relationships (r=. 0940, P<.05) among female students. 9. There was a significant difference between the 7 different kinds of drug abuse and family stability (t=2.23, p<.05), parent-child relationships (t=4. 34, p<.001), satisfaction with family (t=4.02, p<.001), father's rearing attitude(t=3.04, p<.01), mother's rearing attitude(t=2.87, p<.01). The distribution channel of drugs including alcohol beverages and cigarettes should be evaluated and restructured to discourage student's temptation and to limit accessibility. The step by step preventive teaching on alcohol drinking and cigarette smoking is needed from middle school to help prevent further drug abuse.

• Child Health Nursing Research
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• v.7 no.2
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• pp.245-257
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• 2001

This study analyzed the services as operated by the Child Health Telephone Service Center. The Center is a toll free service operated as part of the community services of the Korean Academic Society of Child Health Nursing. The aim of the study was to describe the concerns of child caregivers regarding child health care as discussed during telephone counseling. Specific objectives were as follows: 1. To analyze the activities of the Center. 2. To describe the characteristics of caregivers who made phone calls for counseling services and also the characteristics of their children. 3. To analyze the content of the counseling sessions. 4. To analyze counseling content according to the characteristics of the caregivers and their children. Data used for the study were obtained from the counseling records for the period from Sept. to Dec. 1999, as kept by the three counselors at the Center. The total number of calls was 8,261 and that consisted of 15,150 questions. The total questions were merged into 13,236 by eliminating those questions which overlapped or were of similar content. The final 13,236 questions were used for the final analyses. Almost of the callers (98.4％) were mothers. Among them 89.6％ were between 25 and 35 years of age. Geographical distribution of the callers covered the whole nation. The largest numbers who made the calls were from the Seoul metropolitan area (36％), followed by 28％ from Kyung Gi Province, and 20％ were from the Kyung Sang area. Among 8,261 callers, 72.8％ were first users. Sex of the babies and children in question for counseling was about even for males and females and ages ranged from one month to six years. The largest group (62.5％) was the less than six month age group. The finalized 13,236 questions/problems were categorized into 11 problem areas. They were in order of frequency, physical problems, feedings and nutrient concerns, information on child rearing, growth and development, guidance on utilization of child care facilities, elimination problems, sleeping concerns, immunization related concerns, behavior problems, injury and accidents, and safety measures. The most frequent problems for counseling were physical signs and symptoms (27.3％), followed by feeding and nutrients, information on child rearing, and growth and development. Of physical problems, abnormal gastrointestinal signs and symptoms were the most frequent concern and skin problems were next at 25％ and 23.3％ respectively. Loose bowels, vomiting and constipation were the most frequent gastrointestinal problems. Atopic dermatitis had the highest frequency at 53.3％ with diaper rash being the second highest among the skin problems. About 80％ of the growth and developmental category were physical development concerns related to physiological, body growth, and motor and sensory development. This study constitutes the activity report for the first year of the Center. The findings correspond with literature reports on child health problems and parents educational needs. One recommendation from this study is that since the services of the Center are carried out only by telephone, the psychology of the counselees and the counselor relationship must be considered for better services.

• Sleep Medicine and Psychophysiology
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• v.9 no.1
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• pp.48-55
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• 2002

Objective: Stress is known to be a common cause of short-term insomnia and insomniacs often complain that stress induces sleep problems. However, previous studies on the correlation between stress and sleep do not show consistent results. We aimed to investigate the effects of minor stressful events on sleep among college students. Method: Physically and mentally healthy college student volunteers filled out a self-assessment questionnaire to evaluate their stress and sleep. To find out the status of average stress and sleep, the volunteers filled out K-DSI and daily sleep assessments on three consecutive days. In addition, we surveyed the amount of caffeine beverage intake and assessed the degree of depression and anxiety. Results: The total number of students participating in this study was 202, 101 men and 101 women. Minor stress turned out to significantly affect non-restorative sleep and secondary symptoms of insomnia (awakening difficulty, displeasure, feeling of dissatisfaction with sleep, physical uneasiness or pain at awakening, daytime sleepiness, depressive moods, tiredness and concentration difficulty). However, global PSQI score, self-reported sleeping hours, sleep latency, awakening frequency, frequency and duration of napping, were not explained by stress scores. Conclusion: In this study, minor stresses seemed to affect sleep, especially secondary symptoms caused by non-restorative sleep. We can thus infer that minor stresses impair the restorative effects of sleep by inducing arousal, and the direct relationship the two can be confirmed by polysomnogram.

• Clinical and Experimental Pediatrics
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• v.45 no.9
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• pp.1065-1074
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• 2002

Purpose : The purpose of this study is to analyze the epidemiologic characteristics of sudden unexpected death in infancy and to evaluate the importance of postmortem autopsy. Methods : We reviewed, retrospectively, medical records of 34 infants admitted to Kangnam General Hospital from January 1987 to December 2001 because of sudden unexpected death. We investigated the cause of death through medical history, death scene examination, autopsy findings, acylcarnitine and organic acid analysis. Results : Among the total 34 infants, 18 were male(52.9%) and 16 were female(47.1%). Thirty infants(88%) were below the six months of age. Winter was the most affected season(38.2%). Eighteen infants(52.9%) died between 6 and 12AM. The prone sleeping position was observed more frequently than the supine position at death; nine cases in the prone position, six cases in the supine position. The cause of death of 23 cases could not be found by only history and death scene examination. Autopsy was done in 13 cases. Seven cases of them were thought to be SIDS. In six cases, we explained the cause of death with autosy findings. They were an endocardial fibroelastosis, a nesidioblastosis, a subdural hematoma, a bronchopneumonia and two fatty changes of liver. Metabolic screening tests performed in three cases to rule out metabolic disorder since 2000 were all normal. Conclusion : We concluded that autopsy and metabolic screening test should be performed to find out the cause of death in sudden unexpected death in infancy.

• The Korean Journal of Community Living Science
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• v.17 no.4
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• pp.151-161
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• 2006

This study was made to find out how health practice affect on nutrition status of the college freshmen in male and female. 400 freshmen students in 4year colleges were surveyed. Questionnaire and blood analysis were made. The contents of questionnaire contained general characteristics, health practice behavior, and food intake. The physical measurement included height, weight and blood pressure. The questions for health practice were about drinking, smoking, BMI, skipping breakfast and sleeping. Nutrient intake was expressed by DDS(Dietary Diversity Score by 5 food groups) and DVS (Dietary Variety Score) and 24-hrs recall method was used to find out the quantity of daily food intake. EAR% was calculated and NAR and MAR were produced. The results are as follows: 1) BMI was $22.77kg/m^2$ for males and $20.42kg/m^2$ for females. The ratio maintaining normal weight indicated by BMI of 18.5-23 was higher(p<0.001) for female students(63.2%) than males(56.5%). The ratio of overweight with over $23kg/m^2$ of BMI was 28.5% for males and 8.8% for females(p<0.001). 2)The ratio of drinking students was 59.4% for males and 40.6% for female(p<0.001). And the ratio of smoking students was 95.2% for males and 4.8% for females(p<0.001). 3) The ratio of poor health practice group was 35.7% for males and 25.5% for females, and that of excellent one was 25.4% for males and 33.1% for females(p<0.05). 4) In NAR, the lowest ratio was observed for the intake of Ca, Fe, Vitamin C and Vitamin $B_2$. The intake of Fe, Vitamin $B_2$ and phosphorus were different significantly according to sexuality. For Fe, female students showed lower level than male students(p<0.001). For Vitamin $B_2$, and phosphorus female students showed higher level(p<0.001). 5) In MAR, there was no difference according to sexuality in almost all of the ingredients. 6) For energy intake, male and female students showed 59% and 66% of EAR and it was insufficient for them. 7) For protein, more than 100% was obtained. The lowest ratio was observed for the intake of vitamin C 50.8%, Ca 53.6% and Fe 65.1% of EAR were obtained. The lowest intake ratio and for the intake of Fe female students obtained just 37.5% of EAR showing high risk of anemia. The intake of energy(p<0.001), phosphorus(p<0.01), niacin(p<0.05), Fe(p<0.001), and Vitamin $B_2$ (p<0.001) were different significantly according to sexuality. For Fe, female students showed lower level than male students(p<0.001). For energy, phosphorus, niacin, and Vitamin $B_2$ female students showed higher level(p<0.001) than male students. 8) For blood pressure, male students showed normal level of 120.7/79.1 mmHg, however, female students showed 114.5/75.4 mmHg lower than male (p<0.001). 9). In blood, for hemoglobin female students showed significantly lower level than that of male(p<0.001). T-Cholesterol and HDL-Cholesterol female students showed higher level than males (p<0.001), And for triglyceride male students showed higher level than females(p<0.001). Ca and Fe female students showed lower level (p<0.001).

• Journal of Hospice and Palliative Care
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• v.14 no.1
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• pp.28-33
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• 2011

Purpose: Recognition of impending death is crucial not only for efficient communication with the caregiver of the patient, but also determination of the time to refer to a separate room. Current studies simply list the events 'that have already occurred' around 48 hours before the death. This study is to analyze the predictability of each event by comparing the time length from 'change' to death. Methods: Subjects included 160 patients who passed away in a palliative care unit in Incheon. The analysis was limited to 80 patients who had medical records for the last week of their lives. We determined 9 symptoms and 8 signs, and established the standard of 'significant change' of each event before death. Results: The most common symptom was increased sleeping (53.8%) and the most common sign was decreased blood pressure (BP) (87.5%). The mean time to death within 48 hours was 46.8% in the case of resting dyspnea, 13.6% in the ease of low oxygen saturation, and 36.9% in the case of decreased BP. The symptom(s) which had the highest positive predictive value (PV) for death within 48 hours was shown to be resting dyspnea (83%), whereas the combination of resting dyspnea and confusion/delirium (65%) had the highest negative PV. As for the most common signs before death within 48 hours, the positive PVs were more than 95%, and the negative PV was the highest when decreased BP and low oxygen saturation were combined. The difference in survival patterns between symptoms and signs was significant. Conclusion: The most reliable symptoms to predict the impending death are resting dyspnea and confusion/delirium, and decline of oxygen saturation and BP are the reliable signs to predict the event.

• Journal of forensic and investigative science
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• v.2 no.1
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• pp.5-22
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• 2007

From the numerous social problems generated by the unbalanced social development and the social trend of belittling life overall, we found the causes of suicide getting worse in its seriousness day by day. In reality, the problem has been approached in a collateral level in contrast with other social problems. There have been an active involvement in studying the definition, causes and ways of prevention of suicide theoretically until now. However, different from other social problems, it is almost impossible to treat or fix the problem of suicide. Only ways to treat or fix the problem is when the suicide has ended in failure. Thus, this study intends to examine the suicide rate among the total accidents during the year 2005, perform the analyses on the actual causes according to the relations such as the means of suicide, occupation, age group, educational background, etc. In order to present a solution to the issue of suicide becoming serious each day. Among the total accidents in 2005, the suicide rate came out to be approximately 52.4%. Among the result, 52.4%, male with 69% resulted higher than female with 31%, which appears to be related to the social functions. While men tends to take more active(80%) means of suicide like jumping off, poison, hanging, etc., women tends to take more passive(60%) means of suicide like sleeping pills, slitting wrist, etc. In terms of the cause, pessimism, illness, denial, mental disorder, etc resulted more than 75%, and there were many cases of suicide after exhibiting the signs of depression. Also there were higher suicide rate of the unemployed engaged in direct labor with educational background lower than college level related to the pessimism regarding the family living cost. We were able to determine the recent increase in the suicidal tendency of the educated people higher than the college level and the retired people with depression caused by the sudden change in social status. Overall there are several reasons for suicide, however, in most cases the signs of depression were exhibited until the final suicide, which tells us the serious psychological problem of suicide. Assuming that the current development of suicide will continue in future, the result of this study will guide the corresponding social policies, be utilized in preparing the insurance or management at the national level dealing with the real social problems that are not just a conflict of an individual, but could spread like a fad and become much bigger than the present by the continuous support at the environmental, social and political levels, and be utilized as the basic data to establish the research plan.

• The Korean Nurse
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• v.29 no.4
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• pp.51-72
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• 1990

The purpose of this study was to determine whether Severance Hospice Home Care Pro gram was able to meet its objectives. This was done in order to show in detail the effects of hospice home care on the quality of life of terminally ill patients and to provide rationale for setting up more hospice home care programs in korea. The results of the study were as follows: The subjects of the study were 100 terminally ill patients who hnd died 'while in the hospice program and 64 family members who were registered with Severance Hospice Home Care Program between march 1988 and Feb. 1990. The nursing needs of these terminally ill patients were assessed by the nursing records of these patients. The need for pain control(82%) was the highest nursing need so far as the physical aspects were concerned. This was followed by poor appetite(37%), 8 dyspnea(34%), nausea and vomiting(30%) in that order of frequency. In reqard to spiritual needs, the need for religious' support was also high at 72%. Their main psychological symptoms were anxiety and fear(34% ). Burn-out was a major problem for 44% of the family members. The psychological process experiencel by the terminal ill patients was compared to the dying process, described by Kiibler Ross. In comparison of the five stages outlined by kubler Ross with the dying process of the subjects it was found that the subjects not only experienced the five stages but also experienced denial and doubt-fulness or denial with acceptance or acceptance with the expectation of a miracle. But rather than acceptance of the dying process, giving up was a frequent end point of the psychological process, of the subjects. However, when the combination of states was observed, most of the patients reached the state of acceptance in the dying process. It was difficult to identify a definite pattern of change in the psychological process of the subjects. Also it was difficult to identify the factors that influenced the psychological process. The symptoms of the terminally j]] subjects just before dying, that is, 3-4 days before dying included apparent signs of dying. These were a reduction of intake(77%), reduction of the amount of urination(63%), increase in sleeping time (64%) and acceptance of dying by patients and their families who had been unaccepting be before that time(66%). The primary care givers(family member's) degree of satisfaction with the care given to the patient by the hospice was 88.7%. The results of this study show that Severance Hospice Home Care Program had a positie effeet on the quality of life of the terminally ill patients and their family members as they faced the death of the patient. It can be seen from this study that there is an urgent need to extend hospice programs - in order to provide quality of care for terminally ill patient and their families. Based upon the reesults of this study several suggestions are presente as follows: 1) A follow up study should be carried out to identify the dying process as it is unique to Korea. 2) A comparison should be made of other hospice care programs. 3) A comparison study should- be made with subjects who do not receive any hospice care as compared to those who do by use of an experimental and control group methodology. 4) There is a need to determine a scientific method to adequeto measure the interventions carried out to meet the hospice patients nursing care needs. 5) A study should be made using quality research methodology to evaluate effects of hospiec care from the patients, their family members and the nurrse's perspective.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.2
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• pp.90-100
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• 2019

Objectives : This study aimed to investigate the association between depression with atypical features and metabolic syndromes in Korean adults using the 2016 Korean National Health and Nutrition Examination Survey (KNHANES) data. Methods : We used the 2016 KNHANES data to enroll 277 participants with a score of 10 or higher on Patient Health Questionnaire-9. Depression with atypical features was diagnosed when at least two of the following criteria were met : 1) sleeping more than 10 hours a day ; 2) weight gain of more than 3 kg in a year ; and 3) fatigue/anergia. Depression was divided into two groups based on the presence/absence of atypical features. Physical and mental health, and risk of metabolic syndrome were compared between the groups. Results : Among the 277 participants, 91 had depression with atypical features. We identified significant differences in age, sex, income, and education between the two groups. After adjusting for these variables, depression with atypical features had lower EuroQol-5D index scores (p<0.001) and higher prevalence of metabolic syndromes (p=0.035) compared to the depression without atypical features. Depression with atypical features had higher odds ratio (OR) in association with metabolic syndromes after adjusting for confounding variables (OR=1.923 ; 95% confidence interval : 1.069-3.460). Conclusions : Depression with atypical features increases the risk of metabolic syndromes and lowers the quality of life.