• Journal of Korean Academy of Nursing
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• v.28 no.1
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• pp.117-131
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• 1998

The purpose of this study was to develop a critical pathway for case management for patients who have received Coronary Artery Bypass Graft (CABG) because of Ischemic Heart Disease(IHD) which is a factor of rising medical expenses. For this study. a conceptual framework was developed through a review of the literature including six critical pathways which are currently being used in USA. In order to identify the overall service contents required by these patients and to draw up a preliminary critical pathway, 30 cases of medical records of patients who had CABG because of IHD between January, 1995 to June. 1996 at the Cardiovascular Center of Yonsei Medical Center in Seoul were analyzed. An expert validity test was done for the preliminary critical pathway and clinical validity test was also done using seven IHD patients with CABG between November 11 and 23, 1996. After these processes. the final critical pathway was developed. The results of this study are summarized as follows : 1. The vertical axis of the critical pathway includes the following eight items : tests, nutrition, medications, consultations, activity, assessments, treatments, education discharge planning and the horizontal axis includes the time from the start of hospitalization to discharge. 2. Analysis of the 30 medical records indicated that the average length of stay was 20.2days with the average length of stay from hospitalization day to operation day being 6.2 days, and the average length of stay from operation day to discharge day was 13. 9 days. Analysis of the service contents showed that the horizontal axis of the preliminary critical pathway was set from hospitalization to the 14th post operation day and the vertical axis was set to include eight items, the contents which ought to have occurred, according to the time frames of the horizontal axis. 3. As a result of the experts validity, it was found that among the total of 571 items. there was over 83% agreement for 482 items, less than 83% for 89 items, which were then deleted and a revision of the critical pathway was done. 4. A clinical validity test was done using seven IHD patients with CABG. During the process, three patients were deleted because they were out of the criteria the investigator set. Finally, four patients were used. The result of study indicated that only one patient was discharged on the tenth post operation day, which was one day later than the expected day. Three patients were discharged later than the expected day from three days to nine days. All the cases progressed on schedule until the operation day and the first post operation day, but from the second post operation days, there were differences between the critical pathway and the actual practice. The differences came from tests, assessments, and treatments. 5. On the basis of the results of the clinical validity test. the following revisions in the final critical pathway were made : the transfer from ICU to step down ward would be the second post operation day, and the transfer to a general ward, the fifth post operation day, for patients who complained of lack of sleep from the fifth post operation day to discharge, a sleeping pill would be prescribed, skin observations would be performed routinely from immediately after the operation until the third post operation day, and would continue if there was a sign of skin injury on the fourth post operation day, and assessment of chest pain would be done from the third post operation day, and the “stairs climbing” item, expected to be done on the ninth post operation day would be deleted. In conclusion, this critical pathway is partially applicable to the care of patients with CABG but there are some parts needed to be further investigated.

• Journal of Chest Surgery
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• v.39 no.4 s.261
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• pp.310-316
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• 2006

Background: We study the QOL (quality of life) & functional improvement in patients underwent esophageal surgery for cancer by the viewpoint of the patient and would like make the guideline of recovery course. Material and Method: Between Dec. 1996$\sim$Aug. 2002, 250 patients were operated and 57 patients was enable interview, didn't have evidence of recurrence & survived more than 1 year postoperatively at Asan Medical Center. Questionnaire made by direct or telephone interview & include diet habitus, change of body weight, G-E (gastroesophageal) reflux, dumping symptom, change of daily life. Result: There were 53 men (93%), 4 women (7%) with mean age of $62.05{\pm}8.7$ (range: $37{\sim}94$). Operation method was Ivor Lewis operation in 43 case (75.4%), Esophagocolojejunostomy 4 case (7.1%), Mckeown operation 10 case (17.5%). In Diet habitus, 55 patients (96.5%) ate more than three times in a day with mean diet frequency was 3.5 times/day, 51 patients (89.5%) have been ate solid, regular diet, 5 patients (8.8%) enable to eat liquid diet. To compare with preoperative state, 32 patients (56.9%) had a diet speed more than 80%, 28 patients (39.1%) had a diet amount more than 80%. 32 patients (56.9%) had a little change of body weight within a 10%, 25 patients (43%) had a improvement rather than preoperative state. In G-E reflux, 4 patients (7%) had a reflux after every diet, 27 patients (47.4%) had a little reflux after diet. In dumping symptom. 7 patients (12.3%) had a diarrhea after meal. 38 patients (66.6%) had a normal activity 19 patients (33.3%) had a decreased activity. At present state, majority (53 patient-93%) of patient were satisfactory to the operation result, in spite of discomfort from time to time. In the emotional status, 50 patients (88%) had a well sleeping without disturbance. 65% of patients were comfortable in the psychology state. 39% of patients had a libido. Compare with their median age (63 y), it's a normal varient. Conclusion: QOL in patients underwent esophageal surgery for esophageal cancer nearly recovery to preoperative state.

• Journal of agricultural medicine and community health
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• v.46 no.4
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• pp.280-294
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• 2021

Objectives: The purpose of this study is to investigate the effects of social capital characteristics, socio-demographic characteristics, physical condition, and health behavior characteristics on health-related quality of life of the elderly in Korea. Methods: T-test, one-way ANOVA, and regression analysis were performed by applying a complex sample design to 57.787 people aged 65 and over using the 2019 Community Health Survey. Results: First, as a result of complex-sample T-test and ANOVA analysis, it was found that there were differences in health-related quality of life according to social capital characteristics, physical condition & health behavior characteristics, and socio-demographic characteristics. Complex Sample Regression Analysis Results, the explanatory power of the model was 28%. When living in the metropolitan area, living in an apartment building, having a spouse, having a higher household income, economic activity, higher educational attainment, increase sleeping time, walking time, frequent binge drinking, health checkup, networking, trust, and social participation showed higher health-related quality of life. When people were older, their gender was female, higher BMI, number of chronic diseases, and severe stress that showed lower health-related quality of life. Conclusions: It was proved that the factors affecting the health-related quality of life of the elderly are not only physical condition and health behavior factors, but also social capital and socio-demographic characteristics. It was found that the role as a member was important.

• Korean Journal of Health Education and Promotion
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• v.4 no.2
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• pp.46-70
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• 1987

The survey with questionnaire were conducted to grasp the actual condition of four cautious drugs-antibiotics, sedative hypnctics, mincr tranquilizer, analeptics-self -medication behavior through drugstore use and to analyze the primary factors connected with it. The following six objectives were established. 1) To catch the reason why the man who medicate himself buy four cautious drugs at a drugstore, and to know the choice motive of each drug purchased. 2) To grasp the distribution of four cautious drug taken by the man who medicate himself and to analyse the reason of taking the drug. 3) To find out whether the buyer has taken the same drug past and to know the duration and the frequency. 4) To grasp the degree of recognition about four cautious drugs and the attitude toward continuous taking them. 5) To analyze the degree of recognition about the influence on human body and the attitude of medication behavior. 6) To know "the experience of side-effects" and to grasp the kind of the side-effects. The data were collected from 15 drugstores with 677 respondents in seoul from August 17 to september 21, 1987. The following results were obtained. 1) The reasons for drugstore use were first, "for easy access and convenience" (53.7%) second, "for the slightness of illness" (19.9%) third "for the cheap price" (13.2%). According to that result, the factor of "the easy access of drugstore" was most influential. In case of the poor, the factor "for the cheap price "was revealed second (37.3%). And "for the slightness of illness" was second reason in the medically insured (22. 9%), "for the cheap price" was second reason in the others (29%). 2) The kind of drugs purchased were antibiotics (62.8%), analeptics(17.2%), minor tranquilizer(13.3%) and sedative hypnotics (6.7%) on the whole. In teenagers, besides antibiotics the percentage of taking analepits came second (42.4%) and it was revealed that the percentage of sedative hypnotics, minor tranquilizer increase with age. But in proportion to the increase of age, the taking of analeptis decreased. 3) The choice motives of each drug purchased were all different. In case of antibiotics "recommendation of pharmacist" was 39.6%, sedative hypnotics "recommendation of pharmacist" and "my own judgement", 28.9%, respectively, minor tranquilizer "my own judgement", 35.2%. and in case of analeptics "my oun judgement" was most common with 53.5%. 4) The reasons for taking drugs were as follows. antibiotics was taken for the inflammation mitigation of a wound and a swelling (38.5%), sedative hypnotics for the removal of insomnia (97.5%), minor tranquilizer because of restlessness and qloominess(39.3%), and analeptics for the shortening of sleeping hours (35.1%). 5) Those experienced in taking four cautious drugs were 78.2% on the average. It was revealed that antibiotics use duration was "from one week to one month" (38.9%), the frequency was "rarely" (62.1%), sedative hypnotics and minor tranquilizer; "More than three years", (35.7%, 30.4%), respectively, "Somtimes", (43.8%, 35%), respectively. analeptics ; "from one year to three years", (27.6%), "Sometimes", (42.7%). 6) In regard to the source of information in taking drugs, 35.3 percent of male were relied on "recommendation of pharmacist", 32.6 percent of female "my own judgement", There was a difference between below the middle school graduates and over the high school graduates Thease were relied on "recommendation of pharmacist" first, those "my own judgement" first. And "my own judgement" was the first source of specialist(40%), labours(41.4%), salesman(43.5%), and jobless men(36.8%), "recommendation of ralatives on friends" was the first source of students (30.4%), "recommendation of pharmacist" was the first soure of teachers, administrative office workers (39%) and housewives (40.7%). 7) The degree of recognition about four cautious drugs was as follows. "know a little" was (43.0%), "don't know" (30.2%), "know" (26.8%), respectively. In regard to the attitude toward continuous taking them, it was revealed that "I will take it according to circumstamces" was first (56.2%), " I will not take it as possible" was first(56.2%), "I dont know well" (12.9%), "I will take it continuously" (8.3%). 8) About the influence on human body, "if proper, it is effect" was common attitude toward antibiotics (43.6%), "Probably bad influence on the health" was first toward the other drugs (46.2%), In terms of the degree of observance to taking-time and dose of drugs, "suitably" was first (37.3%), "relatively correctly" second (27%), "correctly" (17%). 9) The percentage of four cautious drugs side-effects was 27.5 on the average. The kind of side-effects were eruption and urticaria (28.5%), heart acceleration and so forth. (25.4%), headache and Giddiness, dyspepsia (23%), respectively.

• Journal of Nutrition and Health
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• v.51 no.4
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• pp.295-306
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• 2018

Purpose: Koreans' internet and smartphone usage hours are steadily increasing and the dependence of young people on smartphones is causing social problems. Therefore, this study was conducted to examine health and dietary habits, as well as hair mineral contents according to the level of dependence of smartphone use among adolescents to clarify the interrelation of smartphone dependence, lifestyle, dietary behavior, and mineral nutrition status. Methods: A total of 80 smartphone-addicted adolescents participated in this study and were divided into three groups (general, potential and danger group) according to smartphone dependence. The subjects' lifestyles and dietary behaviors were then surveyed, and hair mineral contents were analyzed. Results: Higher smartphone dependence was associated with lower average weekly sleeping time and later first smoking age. In the danger group, the rate of eating fast and the rate of snacking twice a day was also relatively high. Parents (45.0%) and mobile (30.0%) were the factors having the greatest influence on an individual's dietary behavior. In the hair mineral analysis, all subjects had lower selenium concentrations and higher lead concentrations than normal. In addition, the levels of aluminum in the danger group were higher than in the normal range and the highest among the three groups. Conclusions: It is necessary to guide adolescents to use smartphones correctly and manage dietary habits. In addition, careful attention is needed the mineral nutritional status of smartphone-addicted adolescents.

• The Journal of Korean Society for School & Community Health Education
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• v.3
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• pp.79-110
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• 2002

The purpose of this study was to provide basic data necessary for creating a more successful health enhancement program, health education and health policy which can enhance health management abilities and enable a healthy school life by examining relations between high school students' health perception, who are in early adolescence, and their health promotion behavior. The subjects in this study were 813 students from 8 high schools on Jeju Island. The collected data were analyzed with t-test and one-way ANOVA through questionnaires by researcher on the basis of advance research. The findings of this study were as belows : 1. When general characteristics were considered, health perception was more significantly affected by those who were boys, whose family income was on a higher level, who scored better in school, whose parents were more concerned about their children's health, and who had experiences of being hospitalized. Especially, the more parents were concerned about their children's health, the higher the child's self-confidence on health(p<.05), anxiety on health(p<.05), practicality on disease prevention(p<.05), self-confidence on future health(p<.01), health care ability(p<.01), and family roles on health(p<.05). The less parents were concerned about their children's health, the higher the child's anxiety on disease(p<.01) and uncertainty on future health(p<.01). 2. When students' health promotion behavior was concerned, in the area of Eating Habits, having regular meals(72.9%), moderate consumption of meat(89.7%) and a balanced diet(64%) were common, whereas having a regular breakfast(37.4%) and eating vegetables and fruits(43.6%) were rare. In the area of Exercise, all subareas such as exercising 3 or 4 times a week(76.7%), more than one hour of exercise at a time(74.9%), a short distance walk(51.8%), exercise within one hour after meals(87%), and whether wanning up or not(88.6%) were above average. In the area of Personal Hygiene, all subareas such as drinking boiled water(57.3%), washing hands after using the bathroom(71%), brushing teeth after eating(42.4%), washing up after going out(50.3%), and washing hair and taking a frequent bath(77.2%) were rare. In the area of Control of Personal Relations, consulting personal problems with family(78.7%) had a positive response, whereas meeting someone new(59.8%), maintaining sound relations with the opposite sex(47.3%), having respect for one's opinion(51.5%), and maintaining peaceful relations with people(58.4%) had rare negative results. In the area of Stress Management, not being competitive(69.4%), releasing problems(62.4%) and sleeping soundly(66.2%) were common, whereas having your own ways to relieve stress(46.8%) and having your own dreams and hopes(58.5%) were rare. 3. When general characteristics were considered, as far as relations of health promotion behavior were concerned, the boys were significantly different in the area of Eating Habits(p<0.01) and Exercise(p<0.01), and the girls were in the area of Personal Hygiene. As family economic status was high and parents were concerned about their children's health, the entire areas of health promotion behavior were significantly different. Whether or not they were hospitalized made no significant difference in statistics. 4. When their regions were considered, it comparing city to town, there was no statistically significant difference in health perception and relations of health promotion behavior according to general characteristics. As seen in the results above, high school students' level of health perception and level of practicing health promotion behavior were generally low. In conclusion, by enhancing health perception, a plan for activating health education, which can implement positive health promotion behavior, should be made.

• Journal of Nutrition and Health
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• v.42 no.3
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• pp.256-267
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• 2009

This study was conducted to investigate nutritional knowledge related to breakfast and dietary behavior of elementary school students by gender and skipping breakfast. The subjects of this study were the 6th grade elementary school students (Total 237; 119 males and 118 females) in Daejeon. The group who ate breakfast six to seven times per week was 58.6%; The group who ate breakfast zero to five times per week was 41.4%. Most of subjects' families (84.4%) were 'nuclear family' and 63.8% of mothers held jobs. There was a significant difference between family income and skipping breakfast. As for the type of breakfast, 79.0% of the male students and 81.4% of female students answered 'cooked rice' and the reasons for skipping breakfast were 'no appetite' followed by 'not enough time', 'over sleeping'. In the eating breakfast group, frequency of having breakfast with family was higher compared to the skipping breakfast group. Total scores of nutritional knowledge related to breakfast in the female students were significantly higher than those of the male students. Also significant differences were found on such questions as 'the relation between eating breakfast and body weight control' and 'importance of breakfast' by skipping breakfast. The dietary behavior scores of the group who ate breakfast were higher than those of the group who skipped breakfast. Therefore, a need exists to develop and distribute a simple breakfast menu that contains Korean-style food and can be more appetizing and appealing to Korean elementary school students. Also it is necessary to develop a systemic awareness program that emphasize the importance of breakfast and the harmfulness of skipping breakfast.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1972.03a
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• pp.7-8
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• 1972

The effects of noise exposure are of two types: Nonauditory effects and auditory effects. Nonauditory effects of noise exposure are interference with communication by speech, sleeping and emotional behavior. The noise will cause the high blood pressure and rapid pulse, also that decrease the salivation and gastric juice. in experimentaly showed that the Corticoid hormon: Gonatotropic hormone were decrease and Thyrotropic hormoone is increase. Auditory effect of noise exposure. when the normal ear is exposed to noise at noise at hamful intensities (above 90㏈) for sufficiently long periods of time, a temoral depression of hearing results, disappearing after minutes or hours of rest. When the exposure longer or intesity greater is reached the Permanent threshold shift called noise-induced hearing loss. Hearing loss resulting from noise exposure presents legal as well as medical problems. The otologist who examines and evaluates the industrial hearing loss cases must be properly informed, not only concerning the otologic but also about the physical and legal aspects of the problems. The measurement of hearing ability is the most important part of a hearing conservation, both preplacement and periodic follow-up tests of hearing. The ideal hearing conservation program would be able to reduce or eliminate the hazardous noise at its source or by acoustic isolation of noisy working area and two ear protections (plugs and muff type) were developed for personal protection.

• Journal of the Korean Society of Food Science and Nutrition
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• v.36 no.7
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• pp.840-848
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• 2007

This study was performed in order to investigate the stress levels, sleep, anthropometric measurement and nutrient intakes their correlations of college students. General characteristics, stress scores using a stress test, sleep scores using a sleep test, anthropometric measurement, body composition using Inbody 3.0 and nutrient intakes using 3-day recalls were measured in 353 subjects (183 males and 170 females). Mean total stress score of the male students was 68.2${\pm}$45.0 and that of the female students was 86.5${\pm}$48.7. Stress for study, future, economic and value-related factors were higher than other factors in both male and female students. Female students were more stressed than male in friend, family, study, future and value-related factors. Mean sleeping time and sleep scores of the male students were 7.0 hrs and 40.6${\pm}$5.7, respectively and that of the female students were 7.1 hrs and 41.5${\pm}$5.3, respectively. Mean height, weight, percent body fat (PBF) and waist-hip ratio (WHR) of the male students were 174.8 cm, 73.3 kg, 19.0% and 0.84, respectively. Mean height, weight, PBF, and WHR of the female students were 161.7 cm, 55.3 kg, 28.7% and 0.81, respectively. Mean energy and protein intakes of the male students were 2026.3 kcal (77.9% EER) and 83.0 g (150.9% RI) and those of the female students were 1538.2 kcal (73.2% EER) and 60.7 g (134.9% RI), respectively. In male students, sleep duration, professor and future problem showed significantly negative correlation (p<0.05). For both male and female students, in correlations between sleep scores, life stress experience frequency and importance, the total scores showed significantly negative correlation (p<0.01). Sleep scores (sleep quality) have more significant correlation than sleep duration in life stress. In male students, correlations between economic problem and weight, waist circumference and hip circumference showed significantly negative correlation. In female students, correlations between different gender problem and body mass index (p<0.05), PBF (p<0.01), WHR (p<0.01) and obesity degree (p<0.05) showed significantly negative correlation while correlation between study problem and PBF (p<0.05), WHR (p<0.05) showed significantly positive correlation. In male students, there were significantly positive correlations between life stress experience frequency and carbohydrate calcium, iron, vitamin A; correlation between importance and calcium, iron as well as correlation between total life stress scores and iron (p<0.05). In female students, correlation between life stress experience frequency and thiamin along with correlation between importance and thiamin showed significant negative correlation (p<0.05). College students need to practice good life habits for the purpose of correctly managing life stress.

• Tuberculosis and Respiratory Diseases
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• v.48 no.6
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• pp.956-963
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• 2000

Backgrounds : Obstructive sleep apnea syndrome(OSA) can divided into two groups, positional(PP) and non-positional(NPP) obstructive sleep apnea syndrome, according to the body position while sleeping. In this study, we evaluated the differences of anthropometric data and polysomnographic recordings between the two types of sleep apnea syndrome. Materials : Fifty patients with OSA were divided two groups by Cartwright's criteria. The supine respiratory disturbance index (RDI) was at least two times higher than the lateral RDI in the PP group, and the supine RDI was less than twice the lateral RDI in the NPP group. This patients underwent standardized polysomnographic recordings. The anthropometric data and polysomnographic data were analyzed, statistically. Results : Of all 50 patients, 30% were found to be positional OSA. BMI was significantly higher in the PP group(p<0.05). Total sleep time was significantly longer in the PP group (350.6$\pm$28.2min, 333.3$\pm$46.0min, (p<0.05). Sleep efficiency was high in the PP group(89.6$\pm$6.4%, 85.6$\pm$9.9%, p<0.05). Deep sleep was significantly higher and light sleep was lower in the PP group than in the NPP group but no difference was observed in REM sleep between the two groups. Apnea index(AI) and RDI were significantly lower( 17.0$\pm$10.6, 28.5$\pm$13.3, p<0.05) and mean arterial oxygen saturation was higher in the PP group(92.7$\pm$1.8%. p<0.05) than in the NPP group. Conclusion : Body position during sleep has a profound effect on the frequency and severity of breathing abnormalities in OSA patients. A polysomnographic evaluation for suspected OSA patients must include monitoring of the body position. Breathing function in OSA patients can be improved by controlling their obesity and through postural therapy.