• Journal of Korean Academy of Nursing
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• v.12 no.2
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• pp.31-44
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• 1982

The purpose of this study was to analyze the relationship between maternal attachment and discharge against advice in high risk infants and determine the factors which affect discharge against advice. Data of this study were collected by means of reviewing the medical records of 127 in-patients who were diagnosed as high risk infants in admission and interviewing of the mothers of these patients was done by telephone. The high risk categories were neonatal hyperbilirubinemia, congenital anomaly, congenital heart disease, blood disorder, neonatal infection and birth injury. Maternal attachment was measured by deviding the subjects into 2 groups, the one the continuing treatment group and the other the discharge against advice group. Maternal attachment is determined by an interplay of maternal attitude and specific infant behaviors. Maternal attachment developes through continuous physical and psychological contact between mother and infants. Later it developes into maternal love. The results were as follows: 1. There was a significant association between maternal attachment and discharge against advice, that is, the attachment score was higher in the continuing treatment group. 2. Inspite of controlling medical insurance, severity of disease and the length of stay, it was found that there continued to be either a partially significant or fully significant relationship between maternal attachment and discharge against advice. Stepwise multiple regression revealed that maternal attachment was second in importance as a predictor of discharge against advice, which indicates that maternal attachment was a significant predictor of discharge against advice. 3. Stepwise multiple regression revealed that in 32.3％ of these cases the significant predictors of discharge against advice were length of stay, maternal attachment, delivery type, feeding type and income.

• Korean Journal of Adult Nursing
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• v.22 no.5
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• pp.519-528
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• 2010

Purpose: The purposes of this study were to examine the relationships among the sense of control, social support, depression and nursing home adjustment, and to identify the influencing factors of nursing home adjustment in nursing home residents. Methods: The study design was a cross-sectional descriptive study. Data were collected from May to June of 2010 using structured questionnaires from 212 elderly residents without dementia from 15 nursing homes. Results: The levels of nursing home adjustment depended on the self-rated health, the voluntary institutionalization, and the length of stay. The nursing home adjustment was significantly correlated with a sense of control, social support and depression. The five most influential factors affecting adjustment were self-rated health, placement decision maker, the length of stay, a sense of control and depression, which explained about 51.5% of the variances. Conclusion: The findings reflect the importance of voluntary institutionalization, a sense of control, avoiding depressive mood and social support which facilitate residents' adjustment. These results can provide guidance for nursing interventions to facilitate nursing home adjustment.

• Journal of Korean Biological Nursing Science
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• v.15 no.4
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• pp.193-201
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• 2013

Purpose: The purpose of the study was to evaluate the effect of the immediate postoperative nutritional status and calorie adequacy on clinical outcomes in liver transplant recipients. Methods: A total number of 99 patients who received liver transplants were recruited from a tertiary university hospital. Demography, subjective global assessment, clinical outcomes and calorie adequacy were evaluated through personal interviews, electronic medical records and dietary records. Anthropometric measures, body mass index and percent of ideal body weight were also obtained. Results: At admission to the Surgical Intensive Care Unit (SICU), the triceps skinfold thickness and mid-arm muscle circumference were significantly lower in the malnourished group than in the well-nourished group (p<.05, respectively). In the clinical outcomes, transfusion of red blood cells, mechanically ventilated hours, length of stay in the Intensive Care Unit (ICU), length of stay in the hospital, and prothrombin time were significantly higher in the malnourished group than in the well-nourished group (p<.05, respectively). The mechanically ventilated hour was significantly higher in the group with less than 50% of their required energy intake (p<.05). Conclusion: Therefore, it is important to assess the nutritional status of immediate postoperative patients. Furthermore, studies on nutritional interventions are urgently needed to provide adequate nutritional care for patients in ICUs.

• The Korean Journal of Emergency Medical Services
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• v.26 no.1
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• pp.151-166
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• 2022

Purpose: The severity classification in association with the time of visit to and the appropriateness of using a public ambulance for visiting the emergency department (ED) have not been thoroughly evaluated, and we aimed to evaluate these aspects. Methods: In this descriptive research, we retrospectively reviewed and analyzed the medical records of patients who visited the ED of the B General Hospital, Seoul from January to December 2019. Results: Of the 54,297 patients who were included in the analysis, 34,629 (63.8%) and 14,065 (25.9%) visited the ED directly and through public ambulances, respectively; 10,328 (73.4%) patients who used public ambulances were discharged home. In the daytime and nighttime, 24,891 (45.8%) and 29,406 (54.2%), respectively, visited the ED. The mean length of ED stay (LoS) of emergency and non-emergency patients was 326 and 159 minutes, respectively, and of patients classified as Korean Triage and Acuity Scale levels 1 and 2 was 427 and 430 minutes, respectively, which was longer than the total of 236 minutes. Conclusion: Patients who visited the ED using public ambulances constituted nearly 25% of all ED visits, and more than 70% of these patients were discharged home. Patients with high severity had a longer mean LoS, and daytime ED visits were characterized by higher numbers and severity of patients than nighttime ED visits.

• Clinical Endoscopy
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• v.56 no.6
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• pp.754-760
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• 2023

Background/Aims: Endoscopic vacuum therapy (EVT) can heal a variety of defects within the gastrointestinal (GI) tract via applying negative pressure, which reduces the defect size, aspirates the infected fluid, and promotes granulation tissue. Here we present our experience with EVT as it relates to both spontaneous and iatrogenic upper GI tract perforations, leaks, and fistulas. Methods: This retrospective study was conducted at four large hospital centers. All patients who underwent EVT between June 2018 and March 2021 were included. Data on multiple variables were collected, including demographics, defect size and location, number and intervals of EVT exchanges, technical success, and hospital length of stay. Student t-test and the chi-squared test were used to analyze the data. Results: Twenty patients underwent EVT. The most common defect cause was spontaneous esophageal perforation (50%). The most common defect location was the distal esophagus (55%). The success rate was 80%. Seven patients were treated with EVT as the primary closure method. The mean number of exchanges was five with a mean interval of 4.3 days between exchanges. The mean length of hospital stay was 55.8 days. Conclusions: EVT is a safe and effective initial management option for esophageal leaks and perforations.

• Advances in pediatric surgery
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• v.10 no.1
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• pp.31-34
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• 2004

The laparoscopic splenectomy (LS) became popular over the last 10 years. The advantage of LS over open splenectomy (OS) includes short hospital stay, improved cosmesis, less development of postoperative intestinal ileus, and less analgesics required. The purpose of this study is to evaluate the outcome of LS at Asan Medical Center from January 1999 to January 2003. The records of 14 consequent children who underwent splenectomy were reviewed retrospectively. Patients characteristics, morbidity, mortality, operative time, blood loss, and hospital stay were analyzed., Seven patients age 5 to 15 years underwent LS under the indications: idiopathic thrombocytic purpura (ITP, n=3), hereditary spherocytosis (n=3), and myelodysplastic syndrome (n=l). Seven patients, age 7 to 16 years, underwent OS during the same period for ITP (n=7). Median operative time was 120 mInutes (80 to 170 mins.) in OS, and 270 minutes (110 to 480 mins,) in LS (p<0.05). Median length of hospital stay was 6 days (3 to 8) in OS, and 4 days (3 to 6) in LS (p>0.05). Median splenic length was 12.0cm (9.2 to 18.0) in OS, 14.0 cm (10.0 to 19.5) (p>0.05). Accessory spleens were identified in 3 of 7 LS and 1 of 7 OS cases. In the LS group, there was no conversion to open surgery. Two patients in LS required blood transfusion postoperatively. LS in children can be performed as effectively and safely as OS.

• Women's Health Nursing
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• v.26 no.2
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• pp.180-190
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• 2020

Purpose: The purpose of this study was to identify the effects of a supportive program on uncertainty, anxiety, and maternal-fetal attachment in high-risk pregnant women. Methods: The participants were 59 high-risk pregnant women admitted to the maternal-fetal intensive care unit. The control group (n=30) received usual treatment and antenatal care, while the experimental group (n=29) received an additional supportive program. Uncertainty, anxiety, and maternal-fetal attachment were measured in both groups prior to the intervention and at 3 days and 10 days after the intervention (or at discharge). Data were analyzed with the t-test, chi-square test, repeated-measures analysis of covariance, and the Greenhouse-Geisser correction in SPSS version 23.0. Results: A supportive program including information provision, nutritional care, emotional care, and exercise care was developed from the literature. All variables except women's length of stay were found to be homogeneous the between experimental and control groups in the pre-test. Length of stay was calculated as a covariate for testing hypotheses. There was a significant difference in state anxiety over time between the two groups, while there were no differences in uncertainty or maternal-fetal attachment. Conclusion: This supportive program was identified as an effective nursing intervention on state anxiety in high-risk pregnant women during their stay in the maternal-fetal intensive care unit. It is suggested that nurses could apply this program to alleviate high-risk pregnant women's state anxiety, and that this program could be modified to be more effective on uncertainty and maternal-fetal attachment in high-risk pregnant women.

• Journal of Digital Convergence
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• v.13 no.5
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• pp.89-99
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• 2015

This study aims to develop a LOS(Length of Stay) bench-making system that can provide efficient by comparing the LOS management of other hospital and level evaluation for inducing the LOS to manage their own activities. The convergence LOS bench-making web program has been implemented to compare a variety of beds, regional group, followed reporting with excel files downloads by using the severity-adjusted LOS model of Korean National Hospital Discharge in-depth Injury Survey data. Features that are computed in real-time severity-adjusted LOS was also implemented. Trial operating results, bench-making system was confirmed efficient for management of LOS on the long-term care and group of disease in hospital from the staff or medical department, receive requests comparative statistics by area and disease group. Therefore the policy alternative on extension of severity-adjusted LOS is needed to utilized bench-making system on LOS.

• Journal of Korean Academy of Nursing Administration
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• v.16 no.4
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• pp.399-408
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• 2010

Purpose: The purpose of this study was to compare the cost using different methods of costing nursing activities for patients with chronic otitis media having surgery. Method: Data were collected from 30 patients who had mastoidectomy and tympanoplasty. To compare the cost, the researchers used three different costing methods; consumed time, resource based relative value scale (RBRVS), and critical pathway (CP). Results: Twenty-six nursing activities for surgical patients with chronic otitis media were found. Total cost was 83,843.7 won using RBRVS. The costliest activity was recording at 9,734.4 won, followed by confirmation of doctors' orders at 9,302.4 won, and injection with infusion pump at 9,072.0 won. There was a difference in nursing activities performed according to the length of hospital stay, and the cost was highest on the surgery day at 13,417.8 won. Comparatively, the total cost was 72,014.4 won using CP. Conclusions: Nursing activities are performed in various forms according to the disease and patient's condition, and different nursing activities are executed according to the length of hospital stay. In order to measure the load of nursing activities and distribute it appropriately, it is necessary to analyze the cost of nursing activities by the process of nursing services performed.

• Preventive Nutrition and Food Science
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• v.18 no.2
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• pp.117-123
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• 2013

This study investigated the prevalence of and risk factors for malnutrition in hospitalized patients in Busan, Republic of Korea. 944 patients (440 men and 504 women) were hospitalized in four Busan general hospitals from March through April, 2011. Nutritional status was assessed on admission by the Nutritional Risk Screening 2002. Data were collected from the electronic medical records system for the characteristics of the subjects, clinical outcomes, biochemical laboratory data, and nutrition support states. Clinical dietitians interviewed the patients using structured questionnaires involving data on weight loss and problems related to oral intakes. Malnourished patients were significantly older (P<0.001) than well-nourished patients, but the values for BMI, serum albumin, total cholesterol, TLC, hemoglobin, and hematocrit were significantly lower (P<0.001) for malnourished than for well-nourished patients. Logistic regression indicated that the main determinant factors for nutritional status were the age, length of stay, BMI, serum albumin, and total cholesterol. In order to increase therapeutic effects of hospitalized patients, clinical dietitians need to offer proper nutritional intervention based on the results of nutrition assessment and identification of malnutrition.