• 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.

• 한국노년학
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• v.36 no.3
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• pp.673-691
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• 2016

As the provision of long-term care policy takes root and with a gradual increase in elderly population, the use of elderly care service has become a growing norm. More than ever, there exists an urgent need for a paradigm shift in the building of an institutional basis for the improvement of care service, from the prevalent practice of 'need based service' toward the concept of 'human rights based service'. A great focus is being shed on care-workers, at the 'front line' of advocating human rights, as their human rights advocacy behaviour is seen as a key variable in providing high quality care service for elders. This study aims to examine how care-workers' individual human rights awareness levels, and the influence of their respective organizations, as an environmental factor, affect their human rights advocacy behaviour. The study includes a comprehensive analysis of the interactions between the regulatory effect of environmental factors (service orientation?) on an organizational level, human rights awareness (individual level) and the service environment (organizational). The analysis sample consisted of 782 registered non-profit corporation of long-term care facilities all over the country in 2014. The findings of the thesis suggest that human rights awareness at individual levels has a significant influence on human rights advocacy behavior. The interaction of human resources management in service orientations was also found to influence human rights advocacy on a significant level. Both human rights awareness at individual level and service orientations at organizational level were thus determined as key variables for improving the human rights awareness of care worker in long-term care facilities in Korea.

• Clinical and Experimental Pediatrics
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• v.51 no.2
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• pp.122-128
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• 2008

Roughly one third of medical problems in children are related to the musculoskeletal system. Most of these problems are common and can be precisely diagnosed. For these problems, nonoperative treatment or reassurance can be given by the pediatrician. Occasionally, a problem needs surgical treatment, but a precise diagnosis must be made. There is little agreement about what types of orthopedic problems a primary care pediatrician should understand in order to effectively care for children. Many pediatric residencies lack an organized teaching curriculum that effectively covers these topics or that includes a required pediatric orthopedic rotation. In this article the authors delineate pediatric orthopedic problems that require recognition and urgent surgical treatment and are relatively common, but have different treatment options (observation, conservative treatment, and surgery) depending on their natural history. Whenever possible, the diagnosis should be made before a decision to refer is made. An accurate diagnosis allows the pediatrician to discuss the natural history of the condition properly. Referral to the wrong specialty can needlessly generate expensive tests and further delay in treatment or generate inappropriate treatment. The parents can be reassured rather than waiting to hear the same information from another physician. In particular, orthopedic problems are known to generate pressure from the parents to seek specialty consultation for reassurance. It is important to communicate to the specialist that the reason for the referral is for parental reassurance rather than for further work-up or treatment. After a proper diagnosis, communication directly between the pediatrician and the appropriate specialist can often avoid an unnecessary referral, and avoid unnecessary tests. The authors reviewed our experience at our outpatient clinic over last 1 year and found that it is useful to classify conditions as common or uncommon, and whether they require surgical or nonsurgical treatment. Many conditions fall in between. The following is a discussion of some of these more important or common conditions.

• Journal of Microbiology and Biotechnology
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• v.21 no.6
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• pp.659-664
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• 2011

Staphylococcus aureus (SA) bacteremia is associated with high mortality, and often results in metastatic infections. The methicillin-resistant SA (MRSA) is an urgent health care issue, as nosocomial infections with these bacteria represent limited treatment alternatives. Samples of whole blood containing challenge inoculums of SA and MRSA strains were passed through columns packed with surfaceheparinized polyethylene beads. The bound bacteria were eluted and quantitatively determined by culturing and by real-time PCR. Significant amounts of both SA and MRSA adhered to the heparinized beads (more than 65% of inoculated bacteria). After rinsing with buffer at high ionic strength, viable bacteria or bacterial DNA were eluted from the columns, indicating that the binding was specific. The conclusions that can be made from these experiments are that, as earlier reported in the literature, the high affinity of SA to heparin is retained in whole blood, and MRSA in whole blood binds to heparin with similar or higher affinity than SA. It should be possible to lower the amount of SA and/or MRSA from the blood of infected patients to levels that could be taken care of by the immune system. In previous studies, we have shown that passing blood from septic patients over beads coated with end-point-attached, biologically active heparin is a useful technique for regulating the levels of heparinbinding cytokine. These findings in combination with the present findings indicate the possibility of creating an apheresis technology for treatment of sepsis caused by SA and/or MRSA.

• Journal of Korean Academy of Nursing
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• v.29 no.5
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• pp.1155-1166
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• 1999

The purpose of this study was to investigate the residents' opinions about community mental health in the Taegu-Kyungpuk area for the future development of a community mental health program and model appropriate for Korea, The subjects were 152 residents in the Taegu - Kyungpuk area. In July 1999, the data was collected using a convenience sample technique. Mental health status was significantly different for the level of occupational advantage(x$^2$＝15.684, p＜.05) and physical health(x$^2$＝39.262, p＜.000). Factor structure for mental health problems with the percentage of variance was as follows. optimistic view(27.518), dark view(10.758), mastery(6.200), discomfiture(6.101) and life style(5.641). Most of the respondents(92.1%) took the mental health problems seriously. The serious aspects of the mental health problem were found to be epilepsy, mental retardation, neurosis and schizophrenia respectively. Concerning about the view of community mental health, most of the respondents answered that the a C.M.H.C. was ‘useful and urgent’ concerning the need for C.M.H,(77.6%). They answered positively on the utilization of C.M.H.C(75.7% ) and preferred the separately new community mental heath center. A psychiatrist was preferred as the key person in charge(44.1%). If community mental health centers were established in a community health center, they answered that the expected major problem would be quality control of care(44.7%). They preferred the psychiatrist's office as the recommended agency for the insane(44.7%). Opinions of the asylum system were found very negative in respect to psychiatric therapy and humanitarianism. The results of this study will help establish a relevant model for this community as the primary site for a community-based mental health model.

• Journal of Korean Public Health Nursing
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• v.11 no.2
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• pp.94-105
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• 1997

The degree of nursing service requirement can be determined by functional health status and a predictive explanation for the status on the living-alone elderly is essential to plan home-care nursing intervention. The purpose of this study is to explore the functional health status of living-alone elderly. Especially the main purpose is to contrast the differences of the status between the residential living-alone elderly and institutional living-alone elderly. This study was conducted through the interview by the students of nurse college who were previously trained during the months of Oct. and Nov. 1996. Sample participants located in Tong-Gu and Seo-Gu of Kwangju City. To contrast the functional health status. this study tried to utilize the Activity Inventory(AI). Among the AI's this study adopted the Physical Activity of Daily Living(PADL) and Instrumental Activity of Daily Living(IADL). Results of the study show that the home-care nursing intervention for the living-alone elderly is urgent more for the residential than for the institutional. It seems that the residential living-alone elderly suffer from inability in Physical Activity of Daily Living. As the residential elderly who have some physical lacks prefer the institution. it is recommended to support physical lacks for the institutional. And more mental-emotional support is recommended for the residential living-alone elderly. The degree of the residential's IADL is higher than that of the institutional. It seems that it was caused by the reason that the residential's needs for the minimum level of life is greater than that of the institutional. So the polypharmacy in elderly nursing-home residents must be considered as sigificant.

• Child Health Nursing Research
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• v.26 no.2
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• pp.212-221
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• 2020

Purpose: Nursing protocols for glucose management are well known for both healthy term newborns and high-risk newborns. However, for less risky newborns who are under only observation surveillance, hypoglycemia could be overlooked unless clinical symptoms develop. Methods: A retrospective study was performed to explore factors influencing variations in glucose levels in 91 newborns who did not require any interventions, but were under nursing surveillance, at a level II neonatal intensive care unit. Data were retrieved from electrical medical records on glucose levels, demographic characteristics, and other clinical characteristics of newborns in their first day of life from January 2016 to May 2019. Results: Glucose levels tended to stabilize within the normal range (60~80 mg/dL) as time passed during the first day of life. Cesarean section, multiple gestation, abnormal growth, and later preterm birth were associated with low glucose levels in the first 2 hours of life. Thirty-one newborns experienced a hypoglycemic episode (< 45 mg/dL) during the first 24 hours of life. Conclusion: The findings of this study support the active encouragement of early feeding within 2 hours of birth and urgent adoption of a structural protocol for glucose surveillance in newborns with potential health problems immediately after birth.

• Journal of Trauma and Injury
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• v.31 no.1
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• pp.1-5
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• 2018

Purpose: Although there has been substantial progress for the treatment of thoracic trauma, the mortality of the penetrating neck injury is still high, has been reported about 10-15%. However, there has not been a report which is reflecting Korean medical present. We retrospectively analyzed the penetrating neck injury patients based on the Korean Trauma Data Base. Methods: Between December 2013 and June 2017 at the trauma center of the Pusan National University Hospital, Busan, Korea, total of 36 patients with isolated low-velocity penetrating neck injuries were included. We analyzed the patients' age, gender, injury mechanism and causes by medical chart review. Results: Among total of 36 patients, 26 (72.2%) were male and 10 (27.8%) were female. Homicidal neck injuries were most common, followed by accidental and suicidal injuries (47% vs. 33% vs. 19%, respectively). All penetrating injuries in our study were low-velocity trauma such as following: knife (n=16, 44.4%); glass or glass bottle (n=11, 30.6%); scissors (n=4, 11.1%); grinder (n=2, 5.6%); and three (8.3%) of miscellaneous injuries. Twenty-seven (75.0%) patients underwent emergency surgery, and only one (2.8%) patient underwent elective surgery. Eleven (30.6) patients were diagnosed with superficial injuries, including six patients who had conservative treatment. Twelve (33.3%) patients had arterial injuries and 10 (27.8%) patients had venous injuries. The patients who had deep injuries showed significant difference against the patient with superficial injury (98.0 vs. 129.1, p=0.008). Conclusions: Low velocity penetrating injury confined to the neck is able to be successfully treated with prompt surgical management. Regardless of the conditions which are evaluated at emergency department, all penetrating neck injury patients should be regarded as urgent surgical candidates.

• The Korean Journal of Community Living Science
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• v.21 no.2
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• pp.201-210
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• 2010

Over the past few decades, the proportion of elderly people in Korea has been rapidly increasing. In particular, rural areas are experiencing aging of communities more rapidly compared to urban areas. However, public policy for the elderly does not respond to the needs of rural elderly. To distribute health care resources equitably, it is necessary to gather reliable information on the health status of the elderly. The purpose of this study is to explore factors affecting Korean elderly people's ADL functional status. The data sources are from 2004 Elderly Living Condition Survey. The Analysis sample consists of 3,278 cases. Analysis results show that there is a significant residential variability in education, monthly stipend, living arrangement, subjective health status, regular food in-take, and regular exercise. Logistic regression analysis results also show that 'cognitive ability'(exp(B)=6.603), 'subjective health status'(exp(B)=4.576), 'age'(exp(B)=2.610), and 'living arrangement'(exp(B)=.589) are factors affecting ADLs. Namely, when a respondent's cognitive ability is limited, subjective health status is poor, or if their age is over 75, the probability of having a limited ADL has been 6.6 times, 4.6 times, and 2.6 times higher than otherwise. Among these variables, cognitive ability was the best explanation. In contrast, respondents who live with a spouse or adult children have a lower probability of having limited ADL compared with those who live alone. Considering that the most critical criteria in determining eligibility for social welfare services is ADLs, the development of appropriate ADL assessment tools is in an urgent need. Without the accurate assessment on ADLs, particularly on rural as well as the urban elderly, it seems to be hard to achieve effectiveness in the health care policy for the elderly.

• Industry Promotion Research
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• v.3 no.2
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• pp.41-51
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• 2018

This study is to see the problem of child abuse as a social problem and sees that the society as a whole needs to find a solution and suggest solutions. The results of this study are as follows. First, legal supplement should be given priority. This can be solved through legal amendments to relevant laws and legislative amendments. Second, institutional complement should be done. Physical and psychological treatment is more urgent for school children than school education for victim child. In the future, children's welfare facilities should be expanded to include child counseling centers for children who are living in homes rather than nursing homes but who have problematic behaviors and treatment facilities for children who need professional treatment. Third, measures should be taken against abused children. Results of action for affected children include home care, separation protection, home return, and death.