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Family's Perception of Proxy Decision Making to Authorize Do Not Resuscitate Order of Elderly Patients in Long Term Care Facility: A Q-Methodological Study (심폐소생 금지 대리 결정에 대한 요양병원 노인 환자 가족의 인식 유형: Q 방법론적 접근)

  • Cho, Hyeon Jin;Kang, Jiyeon
    • Journal of Korean Academy of Nursing
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    • v.51 no.1
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    • pp.15-26
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    • 2021
  • Purpose: This study aimed to distinguish and describe the types of perceptions of do not resuscitate (DNR) proxy decisions among families of elderly patients in a long-term care facility. Methods: This exploratory study applied Q-methodology, which focuses on individual subjectivity. Thirty-four Q-statements were selected from 130 Q-populations formed based on the results of in-depth interviews and literature reviews. The P-samples were 34 families of elderly patients in a long-term care hospital in Busan, Korea. They categorized the Q-statements using a 9-point scale. Using the PC-QUANL program, factor analysis was performed with the P-samples along an axis. Results: The families' perceptions of the DNR proxy decision were categorized into three types. Type I, rational acceptance, valued consensus among family members based on comprehensive support from medical staff. Type II, psychological burden, involved hesitance in making a DNR proxy decision because of negative emotions and psychological conflict. Type III, discreet decisions, valued the patients' right to self-determination and desire for a legitimate proxy decision. Type I included 18 participants, which was the most common type, and types II and III each included eight participants. Conclusion: Families' perceptions of DNR proxy decisions vary, requiring tailored care and intervention. We suggest developing and providing interventions that may psychologically support families.

A Study on Measures to Increase Student Enrollment in Community Colleges : Based on the Case of G College

  • Ki yeu, Jo;Ho geun, Kang
    • International Journal of Advanced Culture Technology
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    • v.10 no.4
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    • pp.137-147
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    • 2022
  • In this study, for students who gave up their studies midway through college, we investigate the reasons for dropping out of college, analyze the factors that caused students to drop out, and suggest improvement measures to effectively increase the recruitment rate of enrolled students. This study explores measures to increase student enrollment in community colleges. For this purpose, it conducted a survey of students who dropped out of G College between 2018 and 2020 from June 28 to July 9, 2021. Its analysis is based on the results of 53 students who participated in the survey. First, our results suggest that programs to develop interpersonal relationships between students, faculty, and staff are necessary. Such programs will cultivate a culture of solidarity and collective identity among students, which in turn will reinforce positive experiences in college. Moreover, by developing systems to form relationships between faculty and students, colleges can have a feedback mechanism, such as an open-study program, through which they learn what the students want and need. Through this effort, colleges can help their students adjust to campuses and enhance student satisfaction in college. Second, it is necessary to develop various extracurricular programs not only for freshmen but existing students and to run hobby and leisure activity programs. To have continuous, standing extracurricular programs instead of one-time events, colleges should set up specific goals, delivery methods and strategies. Third, colleges should renovate old and outdated buildings and facilities on campus to enhance the quality of campus life. Moreover, more comprehensive improvement of facilities and a campus environment by having various convenient and leisure facilities that meet the needs and demands of students. Fourth, it is suggested to develop programs or systems that help students to more fully engage in campus lives and activities, which in turn increases confidence and self-efficacy among students. Through such programs, students can better adjust to their majors and, therefore, will be less likely to drop out of college.

Relationship between the Perceptions of ICU Nurses on the Disclosure of Patient Safety Incidents and Communication Barriers (중환자실 간호사의 환자안전사고 소통하기에 대한 인식과 의사소통 장애 간의 관계)

  • Cho, In Sun;Choi, Su Jung
    • Journal of Korean Critical Care Nursing
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    • v.17 no.1
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    • pp.44-56
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    • 2024
  • Purpose : This study sought to explore intensive care unit (ICU) nurses' perceptions regarding the disclosure of patient safety incidents (DPSI) and identify the relationship between the perception of DPSI and communication barriers. Methods : This study used a descriptive research design. A total of 110 ICU nurses from a tertiary hospital were surveyed online between September 14 and October 5, 2022. The mean DPSI score ranged between 1.0 and 4.0, with a higher score indicating a higher perception of DPSI. Results : The mean score for ICU nurses' perceptions of DPSI was 2.92 (SD=0.37). Among the characteristics of ICU nurses, differences were observed in perceptions of DPSI according to gender, age, total work experience, and ICU work experience. Communication barriers among ICU nurses were negatively correlated with negative results as a sub-factor of perceptions of DPSI. Ambiguity in the nurse's position, lack of confidence, differences in perspectives with patients, and inadequate nurse-patient relationships as sub-factors of communication barriers exhibited a negative correlation with negative results as a sub-factor of perceptions of DPSI. Conclusions : ICU nurses' perceptions of DPSI and the sub-factors related to communication barriers are negatively related to DPSI. To improve ICU nurses' perceptions, open and non-punitive circumstances, staff education, practical guidelines, and support systems are required.

Relationship between Health Literacy and Life Satisfaction according to Households Type of the Elderly (노인의 세대유형에 따른 건강정보이해능력과 삶의 만족도와의 관계)

  • Ryoung Choi
    • The Journal of Korean Society for School & Community Health Education
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    • v.25 no.2
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    • pp.1-14
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    • 2024
  • Objectives: The purpose of this study is to analyze the relationship between health information literacy and life satisfaction according to households type of the elderly targeting 9,820 people aged 65 or older using data from the 2021 Community Health Survey. Methods: This study used SPSS 27.0 to conduct logistic regression analysis to analyze the relationship between the study subjects' health literacy and life satisfaction. Results: Single-person households had higher life satisfaction when they perceived written health literacy to be easy to understand, and multi-person households had higher life satisfaction when they perceived health information explained verbally by medical staff to be easy to understand. Conclusions: There is a need to develop customized education programs and elderly health policies that take into account the characteristics of each households type.

Nurses' Knowledge about and Attitude toward Cancer Pain Management: A Survey from Korean Cancer Pain Management Project (일개 병원 간호사의 암환자 통증관리에 대한 지식과 태도)

  • Park, Hyeoun-Ae;Koh, Myung-Ja;Lee, Hyun-Sook;Kim, Young-Mee;Kim, Moon-Sook
    • Korean Journal of Adult Nursing
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    • v.15 no.2
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    • pp.205-214
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    • 2003
  • Purpose: This study was conducted to examine the nurses' knowledge about and attitude toward cancer pain management. Method: Study subjects of this retrospective cross-sectional survey study were 343 nurses sampled conveniently in a tertiary teaching hospital in Seoul. Seven measurement tools were used to collect data on demographic data, knowledge about and attitude toward cancer pain management, barrier to cancer pain management, knowledge about and concerns for the opioid use, and professional education of cancer pain management. Result: Nurses showed knowledge deficit when their knowledge on the cancer pain management and the opiod use was evaluated using two case scenarios and the 15-item questionnaire respectively. Ninety-five percent of the nurses believed that cancer pain management is a major problem. However, inadequate staff knowledge of pain management was rated as the single most important barrier to adequate pain management by 20.4% of nurses. Only 10.9% and 23.2% of the nurses replied that nursing school's education and professional education in cancer pain management respectively, were adequate. Conclusion: This study confirms the existence of knowledge deficits and attitudinal barriers among Korean nurses that can impede cancer pain management. This study suggests a need for professional education for nurses on cancer pain management.

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Nutrition Knowledge, Dietary Attitude, and Dietary Behavior among Children and Adolescents with Type 1 Diabetes (제 1형 당뇨병 소아청소년의 영양지식, 식태도, 식행동에 대한 실태조사)

  • Noh, Na-Yeon;Nam, So-Young;Kang, Hee-Suk;Lee, Ji-Eun;Lee, Soo-Kyung
    • Korean Journal of Community Nutrition
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    • v.18 no.2
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    • pp.101-111
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    • 2013
  • Type 1 diabetes is on the rise worldwide. Although nutrition education for patients with diabetes has become a routine practice, specifics and impacts of such educations need to be more researched. This study examined the status of nutrition knowledge, dietary attitude, and dietary behavior among children and adolescents with type 1 diabetes (9-19 year-old) and explored factors influencing dietary behaviors related to diabetes by applying the Theory of Planned Behavior. Face-to-face interviews, using a pre-tested structured questionnaire, were conducted with 32 participants (11 boys and 21 girls) with type 1 diabetes followed by a diabetes clinic in a university hospital. This study found that the level of nutrition knowledge related to diabetes was generally low at 4 points out of a possible 10, however, the dietary attitude related to diabetes was found to be generally good at 26 points out of a possible 30. Participants were motivated to follow medical staff recommendations the most; however, their family was also important. Perceived behavioral control was low especially for eating-out and portion control. The dietary behavior related to blood glucose control showed low at 13 points out of a possible 20. Regression analysis showed that perceived behavioral control (p < 0.001) was significantly related to the dietary behavior related to blood glucose control. This rare study with children and adolescents with type 1 diabetes showed that nutrition education should include a component to improve perceived behavioral control through high-risk situation management.

Association between Efficiency and Quality of Health Care in South Korea Long-term Care Hospitals: Using the Data Envelopment Analysis and Matrix Analysis (요양병원의 효율성과 의료서비스 질의 관련성: 자료포락분석과 매트릭스 분석)

  • Sohn, Minsung;Choi, Mankyu
    • Journal of Korean Academy of Nursing
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    • v.44 no.4
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    • pp.418-427
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    • 2014
  • Purpose: Objectives of this study were to investigate the association between efficiency and quality of health care in Long-term Care Hospitals (LTCH) and determine related factors that would enable achievement of both high efficiency and high quality at the same time. Methods: Major data sources were the "2012 Korean Assessment of Propriety by Long-term Care Hospitals" obtained from the Health Insurance Review & Assessment Service. Cost variables were supplemented by a National Tax Service accounting document. First, data envelopment analysis was performed by generating efficiency scores for each LTCH. Second, matrix analysis was conducted to ascertain association between efficiency and quality. Lastly, kruskal-wallis and mann-whitney tests were conducted to identify related factors. Results: First, efficiency and quality of care are not in a relationship of trade-offs; thus, LTCH can be confident that high efficiency-high quality can be achieved. Second, LTCH with a large number of beds, longer tenure of medical personnel, and adequate levels of investment were more likely to have improved quality as well as efficiency. Conclusion: It is essential to enforce legal standards appropriate to the facilities, reduce turnover of nursing staff, and invest properly in human resources. These consequences will help LTCH to maintain the balance of high efficiency-high quality in the long-run.

Practical Communication Strategies to Improve the Surgical Outcomes in a Pediatric Cardiac Intensive Care Unit (소아심장외과 중환자실에서의 실무의사소통 프로토콜이 수술 후 성과에 미치는 영향)

  • Uhm, Ju-Yeon;Lee, Worlsook
    • Journal of Korean Academy of Nursing Administration
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    • v.21 no.3
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    • pp.243-253
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    • 2015
  • Purpose: The purpose of this study was to identify the impact of practical communication strategies (PCS) on the reduction of AEs (Adverse Events) in pediatric cardiac ICU (PCICU). Methods: Intra-operative findings and care plans were documented and shared between staff members on a daily basis from the day of operation to the day of general ward transfer. Incidence of AEs was investigated in all patients who were admitted to the PCICU and was compared with incidence of AEs one year after establishment of PCS. Results: The study population consisted of 216 patients in pre-PCS group and 156 patients in post-PCS group. Incidence of readmission decreased from 6.0% (13/216) in pre-PCS group to 0.6% (1/156) in post-PCS group (${\chi}^2=7.23$, p=.010). Incidence of other major complications decreased from 4.2% (9/216) to 0.6% (${\chi}^2=6.66$, p=.012). Minor AEs such as intervention omission, order error, and protocol misunderstanding were reduced from 23.3 cases per 100 patient-days to 7.5 cases per 100 patient-days (${\chi}^2=20.31$, p<.001). Conclusion: Handover protocol is an effective strategy to reduce AEs for critically ill patients after pediatric cardiac surgery. Efforts to develop effective communication strategies should be continued and outcome research about communication strategies for patient safety should be further studied.

HIGH DOSE RATE BRACHYTHERAPY IN PRIMARY AND RECURRENT TONGUE CANCER (고선량율 근접 방사선치료법을 이용한 원발성 및 재발된 설암의 치료)

  • Lee, Ui-Lyong;Lee, Jong-Ho;Choung, Pill-Hoon;Kim, Myung-Jin;Park, Joo-Yong;Choi, Sung-Weon;Cho, Kwan-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.5
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    • pp.470-476
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    • 2006
  • Low-dose rate brachytherapy(LDR) has been effective modality for treatment of oral cancer. But the disadvantage of LDR is radioexposure of medical staff. To overcome this problem, high dose rate(HDR) brachytherapy has been developed. Our study evaluates the outcomes of patients with tongue cancer as treated by HDR brachytherapy. Between 2002 and 2005, eight patients with carcinoma of the tongue were treated with HDR brachytherapy. Five patients had AJCC stage I or II disease and the remaining three patients had AJCC stage III or IV. The male-to-female ratio was 2:6 and the mean age was 60.1 years (range: 21-80 years).The median follow-up time was 23.8 months (range: 7-55 months). There was no local failure until now. Three patients showed some complications. Two patients showed soft tissue necrosis. There was no bone sequela in all cases. Our experience in treating tongue cancer with HDR brachytherapy is encouraging, because it gave a satisfactory local control. Prospective studies are necessary to delineate the optimum indication for this treatment modality and long-term outcome.

Comparison Analysis of Foot Pressure Characteristics during Walking in Stroke and Normal Elderly (뇌졸중 고령자와 정상인의 보행 시 족압 변화 및 비교 분석)

  • Jung, NamKyo;Park, Se Jin;Kwon, Soon-Hyun;Jun, Jongarm;Yu, Jaehak
    • Journal of Platform Technology
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    • v.9 no.3
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    • pp.36-43
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    • 2021
  • Stroke disease is one of the leading causes of death worldwide, and in particular, it is the most important causative disease that causes disability in the elderly. Since stroke disease often causes death or serious disability, active primary prevention and early detection of prognostic symptoms are very important. In particular, it is necessary to detect and accurately predict stroke prognostic symptoms in daily life and prompt diagnosis and treatment by medical staff. In recent studies, image analysis such as computed tomography (CT) or magnetic resonance imaging (MRI) is mostly used as a methodology for predicting prognostic symptoms in stroke patients. However, this approach has limitations in terms of long test time and high cost. In this paper, we experimented with clinical data on how stroke disease affects foot pressure in elderly in walking. Experiments have shown that there is a significant difference in * p < .05 in 12 cells between the stroke elderly and the normal elderly during walking. As a result, it is significant that we found a significant difference in the gait patterns in daily life of the stroke elderly and the normal elderly.