• Journal of Korean Academy of Nursing Administration
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• v.1 no.1
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• pp.65-78
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• 1995

This is a quasi-experimental research to test the effect of using a nursing care scale. This study identified the effects of using a nursing care scale influencing on the nursing performance and job satisfaction. The subjects consisted of 63 staff nurses in 8 medical and surgical units of one hospital affiliated to university hospital in Seoul, and assigned to experimental and control group conveniently. The data were collected in September and December, 1992. The evaluation of the nursing performance were measured by the instrument from a nursing care scale of one univerrsity hospital and job satisfaction was measured by Stamp's Scale (1978). The data were analyzed by percentage distribution, 2-test, Mann-Whitney U Wilcoxon Rank Sum W test, ANCOVA and T-test. The summarized results were as follows : 1. The nursing performance of the experimental group showed markedly increase about 13 areas of nursing care. However no significant difference in the nursing performance between the two groups was found. 2. There was a significant difference in the nursing performance between the experimental and the control group about 7 areas of nursing records(W=22.0, P<.05). 3. After using a nursing scale, there was a significant difference in the nursing performance about nursing care and nursing records between the experimental and the control group(W=25.0, P<.05). Comparing before using a nursing scale with after, there was no significant difference in the nursing performance between two groups. 4. There was no significant difference in job satisfaction between the experimental and the control group. The main reasons for there being no defference in two groups could be the small size sample and the procedure of intervention. Further comparative study is needed using more strictly controlled procedure of intervention.

• Journal of Korean Academy of Nursing
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• v.16 no.3
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• pp.11-21
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• 1986

The purposes of this study were to clarify whether the health belief model could explain the women's adoption of sterilization and to find the factors which influence the adoption of sterilization. To achieve these purpose, 35 women, who visited the family planning hospital to undergo an surgical operation for sterilization, were selected and named the group of adoption. Also, 36 women, who have the same demographic characteristics as the group of adoption, and have no sterilization among the married women, were selected and named the group of non-adoption. The measuring instruments used in this study were made by the researchers on the basis of the results of the review of the related literatures. The validity of these instruments was examined by one professor majoring in nursing and two family plmanning practioners. The reliability was proven by calculation of Cronbach's α with data of the group of adoption. The data was analyzed by t-test, X²-test, and ANOVA using Computer SAS system. The results were following: 1. Health belief model could be said to explain whether women accept the sterilization or not, because the degrees of susceptibility and severity for future pregnancy and the degree of benefit or adoption of sterilization in the group of ad-option are higher than those of the group of non-adoption. 2. Influence of demographic variables on health belief variables was as follows. With advancing ages, degree of susceptibility increased in the group of adoption, and the higher the number of artificial abortion increased, the higher degree of barrier increased in the group of non-adoption. Suggestions for further studies and application to the nursing practice are as follows 1. If one wants to educate the non-adoption women, one would be better to give such information as to increase the perception of susceptibility, severity and benefit. 2. New instrument to measure the perceived barrier which includes such items as fear on well-ness of the existing children, objection of husband and postoperative complication, is needed. 3. A study to find the change of perception on health belief variables is needed, after education to increase the level of perceived susceptibility and severity on the future pregnancy, and benefit on sterilization is given.

• Archives of Plastic Surgery
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• v.41 no.5
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• pp.505-512
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• 2014

Background Laryngeal allotransplantation (LA) is a technique involving transplantation of a deceased donor's larynx into a recipient, and it may be substituted for conventional laryngeal reconstruction. There are widely different views on LA, as the recipient is administered continuous, potentially life-threatening, immunosuppressive therapy for a functional or aesthetic result, which is not directly related to life extension. The purpose of this study was to analyze the difference in risk acceptance and expectations of LA between four population groups. Methods A survey was performed to examine patients' risk acceptance and expectations of LA. The survey included 287 subjects in total (general public, n=100; kidney transplant recipients, n=53; post-laryngectomy patients, n=34; doctors, n=100), using a Korean translated version of the louisville instrument for transplantation (LIFT) questionnaire. Results All four groups responded differently at various levels of their perception in risk acceptance and expectations. The kidney transplant recipients reported the highest risk acceptance and expectations, and the doctor group the lowest. Conclusions This study examined the disparate perception between specific population groups of the risks and benefits of using LA for the promotion of the quality of life. By addressing the information gaps about LA in the different populations that have been highlighted from this survey, we suggest that LA can become a more viable alternative to classical surgery with resultant improved quality of life for patients.

• Archives of Craniofacial Surgery
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• v.17 no.2
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• pp.68-76
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• 2016

Background: In scalp allotransplantation, the scalp from a brain-dead donor, including hair, is transferred to a recipient with scalp defects. Opinions differ on the appropriateness of scalp allotransplantation. In order to maintain graft function and cosmetic outcomes, scalp transplantation recipients would need to receive lifelong immunosuppression treatments. The risks of this immunosuppression have to be balanced against the fact that receiving a scalp allotransplant does not extend lifespan or restore a physical function. Therefore, the present study aimed to investigate risk acceptance and expectations regarding scalp allotransplantation in different populations. Methods: A questionnaire survey study was conducted. A total of 300 subjects participated; survey was conducted amongst the general public (n=100), kidney transplantation recipients (n=50), a group of patient who required scalp reconstruction due to tumor or trauma (n=50), and physicians (n=100). The survey was modified by using the Korean version of the Louisville instrument for transplantation questionnaire. Results: Risk acceptance and expectations for scalp transplantation varied widely across the groups. Kidney transplantation recipients revealed the highest risk acceptance and expectations, whereas the physicians were most resistant to the risks of scalp transplantation. Conclusion: Our study demonstrates that, in specific groups, scalp allotransplantation and the need for immunosuppression carries an acceptable risk despite the lack of lifeextending benefits. Our results suggest that scalp allotransplantation can be an acceptable alternative to existing scalp reconstruction surgeries in patients with pre-existing need for immunosuppression.

• Journal of Korean Clinical Nursing Research
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• v.18 no.2
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• pp.296-306
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• 2012

Purpose: This study was done to compare the physical injury, emotional response and unplanned self-removal of medical devices in patients with physical restraints and patients not restrained. Methods: Eighty patients admitted to the intensive care unit (ICU) of a university hospital in Seoul participated in this study. Forty patients made up each group and the group not restrained was matched with the restraint group for age and history of smoking and alcohol consumption. Data on occurrence of physical injury, intensity of anxiety, stage of agitation and unplanned self-removal of medical devices were collected by observation and medical chart review using a structured instrument. Statistical processing of collected data was done with the SPSS WIN 17.0 program. Results: The physically restrained group experienced more physical injuries and recorded significantly higher levels of anxiety and agitation than the unrestrained group. However, there were no significant differences between the groups in occurrence of unplanned self-removal of medical devices. Conclusion: Results indicate a need for critical care nurses to carefully monitor physical injuries and emotional responses of physically restrained patients and to develop nursing interventions to prevent adverse effects associated with restraint use. There is also a need to develop patient safety guidelines when using physical restraints.

• Archives of Plastic Surgery
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• v.47 no.1
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• pp.33-41
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• 2020

Background Closed-suction drains are widely used in expander-based breast reconstruction. These drains are typically removed using a volume-based criterion. The drainage volume affects the hospital stay length and the recovery time. However, few studies have analyzed the factors that influence drainage volume after expander-based breast reconstruction. Methods We retrospectively analyzed data regarding daily drainage from patients who underwent expander-based breast reconstruction between April 2014 and January 2018 (159 patients, 176 expanders). Patient and operative factors were analyzed regarding their influence on total drainage volume and drain placement duration using univariate and multivariate analyses and analysis of variance. Results The mean total drainage volume was 1,210.77±611.44 mL. Univariate analysis showed correlations between total drainage volume and age (B=19.825, P<0.001), body weight (B=17.758, P<0.001), body mass index (B=51.817, P<0.001), and specimen weight (B=1.590, P<0.001). Diabetes history (P<0.001), expander type (P<0.001), and the surgical instrument used (P<0.001) also strongly influenced total drainage. The acellular dermal matrix type used did not affect total drainage (P=0.626). In the multivariate analysis, age (B=11.907, P=0.004), specimen weight (B=0.927, P<0.001), and expander type (B=593.728, P<0.001) were significant predictors of total drainage. Conclusions Our findings suggest that the total drainage and the duration of drain placement needed after expander-based breast reconstruction can be predicted using preoperative and intraoperative data. Patient age, specimen weight, and expander type are important predictors of drainage volume. Older patients, heavier specimens, and use of the Mentor rather than the Allergan expander corresponded to a greater total drainage volume and a longer duration of drain placement.

• Archives of Craniofacial Surgery
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• v.20 no.5
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• pp.284-288
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• 2019

Background: Closed reduction of nasal fracture with various instrument is performed to treat nasal fracture. Depending on the type of nasal fracture and the situation in which it is being operated, the surgeon will determine the surgical tool. The objective of this study was to investigate whether a periosteal elevator (PE) was a proper device to perform closed reduction for patients with simple nasal fractures. Methods: From March 2018 to December 2018, 50 cases of simple nasal bone fracture underwent closed reduction performed by a single surgeon. These patients were divided into two groups randomly: nasal bone reduction was performed using only PE (freer) and nasal bone reduction was performed using Walsham, Asch forcep, and Boies elevator (non-freer, non-PE). Results: The paranasal sinus computed tomography was performed on patients before and after operation to carry out an accurate measurement of reduction distance at the same level. According to the results, the interaction between instruments and fracture types had a significant influence on reduction distance (p = 0.021). To be specific, reduction distance was significantly (p= 0.004) increased by 2.157 mm when PE was used to treat patients with partial displacement compared to that when non-PEs were used. Conclusion: Closed reduction using PE and other elevator is generally an effective treatment for nasal fracture. In partial-displacement type of simple nasal fracture, closed reduction using PE can have considerable success in comparison with using classic instruments.

• Archives of Plastic Surgery
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• v.50 no.6
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• pp.627-634
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• 2023

In recent decades, a number of simulation models for microsurgical training have been published. The human placenta has received extensive validation in microneurosurgery and is a useful instrument to facilitate learning in microvascular repair techniques as an alternative to using live animals. This study uses a straightforward, step-by-step procedure for instructing the creation of simulators with dynamic flow to characterize the placental vascular tree and assess its relevance for plastic surgery departments. Measurements of the placental vasculature and morphological characterization of 18 placentas were made. After the model was used in a basic microsurgery training laboratory session, a survey was given to nine plastic surgery residents, two microsurgeons, and one hand surgeon. In all divisions, venous diameters were larger than arterial diameters, with minimum diameters of 0.8 and 0.6 mm, respectively. The majority of the participants considered that the model faithfully reproduces a real microsurgical scenario; the consistency of the vessels and their dissection are similar in in vivo tissue. Furthermore, all the participants considered that this model could improve their surgical technique and would propose it for microsurgical training. As some of the model's disadvantages, an abundantly thick adventitia, a thin tunica media, and higher adherence to the underlying tissue were identified. The color-perfused placenta is an excellent tool for microsurgical training in plastic surgery. It can faithfully reproduce a microsurgical scenario, offering an abundance of vasculature with varying sizes similar to tissue in vivo, enhancing technical proficiency, and lowering patient error.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.6
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• pp.750-758
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• 2016

In general, a system can be stable when it is designed with a rigid material. However, the use of a rigid system can be limited, such as grasping a glass or using a small surgical instrument. To resolve this limitation, a variable stiffness mechanism was developed using a flexible material. Previous research verified the variable stiffness mechanism where flexible segments and rigid segments were connected alternately in series. However, research into the design parameters of the variable stiffness structure is needed to satisfy the desired stiffness. Therefore, a variable stiffness structure was tested by varying the design parameters to confirm the trend of the stiffness variation. When the radius of the structure becomes larger, the stiffness increases. The stiffness increased with decreasing length of the flexible segments. Under the same design parameters, the length of the flexible segments had a greater effect on the stiffness than the length of the rigid segments. In addition, the stiffness was estimated using the pseudo rigid body model and was compared with the experimental results. This parametric study can be used as a design guideline for designing the variable stiffness mechanism to satisfy the desired stiffness.

• Journal of Chest Surgery
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• v.32 no.5
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• pp.465-470
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• 1999

Background: Facial hyperhidrosis patients have as much difficulty in personal relationships as the palmar and axillary hyperhidrosis patients. There have been no appropriate treatment, but recently, satisfactory results have been obtained through sympathetic blockade. Thoracoscopic thoracic sympathectomy for facial hyperhidrosis has been known to resect cervicothoracic (stellate) ganglion, but its inherent complications such as Horner syndrome have made the surgeons hesitant to use this method. We, through our experiences in treating palmar and axillary hyperhidrosis for the past 6 years, believed that T2 sympathicotomy would be enough for facial hyperhidrosis and have experimented and obtained satisfactory results. Material and Method: From June 1997 to May 1998, 38 consecutive patients underwent bilateral thoracoscopic T2 sympathicotomy with 2mm instruments at Seoul National University Hospital. Result: All patients were relieved of excessive sweating in their faces immediately after the operation. Postoperatively, 5 patients (13.2%) required insertion of chest tubes because 3 had incomplete reexpansion of the lung, and 2 had hemothorax from severe adhesion. Other complications related to the surgical procedures, such as Horner's syndrome, and brachial plexus injury, were not detected in any cases. The mean hospital stay was mean 1.7$\pm$0.9 days after surgery. Conclusion: T2 sympathetic ganglion is the appropriate resection site for facial hyperhidrosis, and complications such as Horner syndrome can be prevented by not cutting the stellate ganglion. In addition, it is possible to perform the operation by using a 2 mm thoracoscopic instrument, and may obtain much better results.