• Journal of Korean Public Health Nursing
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• v.15 no.2
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• pp.239-248
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• 2001

The purpose of this study was to analyze risk factors for nosocomial pneumonia in patients admitted to NS ICU, and to provide a basic data to decrease respiratory nosocomial infection rate engendered from medical environments in NS ICU. The study site was the NS ICU at a university hospital located in Seoul, Korea. The subjects were 31 patients diagnosed with nosocomial pneumonia, who were selected from the initial list of 300 potential subjects who had been a) admitted between September 1999 and January 2000, and September 2000 and January 2001, b) resided at the NS ICU over 72 hours. The diagnostic standard of nosocomial pneumonia was based on the nosocomial infection guides of C university hospital. The data were analyzed using frequencies and logistic regression analysis. The sputums obtained from the subjects were cultivated and causal viruses were separated. The results were as follows: 1. The nosocomial pneumonia rate was $10.3\%$. There were 7 types of causal viruses separated from the sputum. and the most prevalent type of virus was MRSA as $62.2\%$. 2. The factors significantly influencing the incidence of nosocomial pneumonia included age, the residential duration at the NS ICU, GCS scores, diabetes mellitus, insertion of tracheal tube and its duration, tracheostomy and its length of insertion, the use of artificial ventilator and the length of its use, and the insertion of naso-gastic tube. The most significant risk factor among these was the insertion of tracheal tube (odds ratio=18.684. $95\%$ CI=6.849-50.974), followed by the use of tracheostomy (odds ratio=15.419, $95\%$ CI=6.615-35.942), the insertion of naso-gastric tube (odds ratio=14.875, $95\%$ CI=6.396-34.595), and the use of artificial ventilator (odds ratio=13.000. $95\%$ CI=5.633­30.001). 3. Regarding the use of the mechanical aids, the insertion of tracheal tube resulted in 12.968 times increase of the nosocomial pneumonia rate, and the use of artificial ventilator lead 6.714 times increase of the nosocomial pneumonia rate. One point increase of the GCS score resulted in the 1.210 times increase of the nosocomial pneumonia rate. For patients who had tracheal tube, tracheostomy, and artificial ventilator, one day increase of their residential duration at NS ICU lead 1.073 times increase of the nosocomial pneumonia rate. 4. In terms of duration of the mechanical aid usage, one day increase in the use of artificial ventilator engendered 1.080 times increase in the nosocomial pneumonia rate. One day increase of the residential duration at the NS ICU lead 1.604 times increase in the nosocomial pneumonia rate. As one point of the GCS score increased, 0.876 times decrease of the nosocomial pneumonia rate was reported. These study findings show that the risk factors significantly influencing the incidence of nosocomial pneumonia include the use of tracheal tube, tracheostomy, naso-gastic tube, and artificial ventilator. It is recommended that nurses working at NS ICU should pay more attention to the patients with these factors as the risky group for the nosocomial pneumonia, and thus make more active efforts to provide nosocomial pneumonia prevention strategies for them. In further studies patients admitted to the different types of ICUs such as internal medicine or surgery unit ICU will be also included, and more wide investigation of nosocomial pneumonia risk factors will be conducted through one-year longitudinal follow up.

• Korean Journal of Occupational Health Nursing
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• v.7 no.2
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• pp.143-154
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• 1998

The purpose of this research is to suggest basic materials for the practical infection precaution program to protect health care workers from hospital infection by grasping their compliance level of Universal Precautions and examining the factors affecting them. The number of the health care workers we studied were 486, including the doctors, the nurses, and the lab technicians who were working in a university hospital. The period of this research was from Aug. 18th, 1997 to Aug. 30th, 1997. The method of the study was to measure the compliance level of Universal Precautions with the item of "Universal Precautions" established by CDC in 1987, and examine the questionnaire of 52 questions dividing related factors into socio-populational, individual, socio-psychological and organizational management ones. The data was analyzed by t-test. ANOVA, and chi-square test. The results were as follows : 1. An the compliance level of Universal Precautions, hand washing had the highest score(85.4%), and doctors(18.9%), nurses(44.0%), and lab technicians(7.6%), had a low compliance level in the safe handling of an injection syringe, and item not to handle patients and their samples when the subject suffered from dermatitis or injury had the lowest score of 17.1%. 23.3% of them said that they wear protection gown, goggles and mask. 2. Female's Compliance level of Universal Precautions Was higher than male. 3. The health care workers who had high recognition on Universal Precautions got significantly higher compliance level of Universal Precautions than those have low recognition on Universal Precautions(P<0.001). 4. The health care workers experienced a needle stick injury had a significantly higher compliance level of Universal Precautions than those who had not(P<0.000). 5. The health care workers who had infection protection education got a significantly higher compliance level of Universal Precautions than those who didn't(P<0.000). 6. The health care workers who had a firm belief in the effect of Universal Precautions got a higher compliance level of Universal Precautions than those who didn't. 7. The health care workers who had less conflicts between treating patient arid protecting them-selves got a higher compliance level of Universal Precautions than others with many conflicts. 8. The health care workers who had a high score in organizational management factors got a significantly higher compliance level of Universal Precautions than those with a low score(P<0.000). 9. Only 16.9 percent of the all respondents(82 in number) answered that they knew well or a little about the Universal Precautions, which is very low rate of recognition. 10. The variables which affected the score in organizational management factors were age, sex, education period, work experience, the kind of work, recognition on Universal Precautions, the experience of needle stick injury, revealing dangerous circumstance related to infection, and training on precaution again infection. According to the result above, compliance level of Universal Precautions showed high correlation with sex, the recognition on Universal Precautions, the experience of needle stick injury, training on precaution against infection, the belief in the effect of Universal Precautions, the recognition degree of conflicts and organizatinal management factors. These results could be used as the basic materials for the developing infection protection programs. Also, There should have a systematic training course to elevate a effective compliance level of Universal Precautions as well as the manageeent of infection protection programs.

• Journal of agricultural medicine and community health
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• v.29 no.1
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• pp.147-161
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• 2004

Objectives: There are many habitual drinking in rural area. So it is the key point of drinking control policy in rural community to understand the drinking behavior in leisure time and to have an appropriate screening method for problem drinking. CAGE and AUDIT are famous screening tools for problem drinking and alcoholics. Even though there are some studies to validate CAGE and AUDIT which translated in Korean, they were not studied with community based population but with hospital based patients. In this study we assessed the usefulness of CAGE and AUDIT for selecting problem drinking in a rural population, and compared problem drinkers with normal group about spending leisure, Methods: The study subjects were 120 residents over 20 years old who lived in 3 districts in Dong-San Myun near Chun-chon city. We made up questionnaire by interview from Feb. 13 to 19, 2004. Results: The mean age of study population was 66.01 .26 years old. Defining the problem drinking as more than 12 score in AUDIT and more than 2 score in CAGE, the proportion of problem drinker was 30.600 and 28.9% respectively. This proportions were higher than those of other national wide studies. There were significant difference in drinking frequency per week and amount per one episode between problem drinker and normal group. Experience about driving, accident, injury, disturbance in working and quarrel after drinking were also significantly different. Problem drinker were more tolerable to the bad social culture about drinking (eg. force to drink, bad drunken habit. overdrinking, drinking relay etc.) than normal group. Watching TV and playing with neighborhood were most frequent method of spending leisure in this study population, normal male group exercised more frequently in leisure time than problem drinker. Conclusions: It may be useful to use CAGE and AUDIT score for screening problem drinking in rural community. Appropriate utilization of leisure time may he important for control of problem drinking in rural area.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.3 no.1
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• pp.78-90
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• 1993

This study was designed obtain and early detection the workers exposed to excessive copper dust and also to present biological exposure index. The exposed group consisted of 62 male workers at the metallurgy workplaces. To evaluate the degree of individual exposure the copper dust, each personal air sampling was collected. Biological exposures in the exposed group was quantified for the blood and urine copper levels using flameless atomic absorption spectrophotometer. The control group consisted of 70 male adults with the history of nonexposure to copper by the inhalation occupationally. The average concentration of copper in blood and urine of the exposed group was $49.44{\pm}8.90(29.05-80.63){\mu}g/dl$, $39.99{\pm}11.04(29.62-80.63){\mu}g/l$ respectively. The average concentration of air borne copper was $0.48{\pm}0.31(0.03-1.18)mg/m^3$. The average concentration of blood and urine copper in the control group was $42.93{\pm}5.84(25.05-57.85){\mu}g/dl$, $33.02{\pm}13.38(12.00-82.05){\mu}g/l$ respectively. The difference observed in the average concentration of blood and urine copper of the exposed and control groups was statistically significant seperately (blood copper, p<0.05 ; urine copper, p<0.05). The relationship between the individual exposure concentration of air borne copper and the concentration of the blood and urine copper was statistically significant, respectively (blood copper, r=0.54, p<0.05 ; urine copper, r=0.37, p<0.05). The relationship between the working duration and the concentration of blood and urine was not statistically significant respectively (blood copper, r=0.14 ; urine copper, r=0.12). The relationship between the age and the concentration of blood and urine copper was statistically not significant respectively (blood copper, r=013 ; urine copper, r=-0.06). The relationship between blood and urine copper concentration in the exposed group was statistically significant (r=0.62, p<0.05), and the relationship between blood and urine copper concentration in the control group was also statistically significant (r=0.39, p<0.05).

• Journal of Chest Surgery
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• v.41 no.5
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• pp.568-572
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• 2008

Background: Minimally invasive surgery is currently popular, but this has been applied very sparingly to cardiac surgery because of some limitations. Our study evaluated the safety and efficacy of atrial septal defect (ASD) closure through a video-assisted mini-thoracotomy. Material and Method: Fifteen patients were analyzed. Their mean age was $31{\pm}6$ years. The mean ASD size was $24{\pm}5mm$ and there were 3 cases of significant tricuspid regurgitation. The working window was made through the right 4th intercostal space via a $4{\sim}5cm$ inframammary skin incision, CPB was conducted with performing peripheral cannulation. After cardioplegic arrest, the ASDs were closed with a patch (n=11) or direct sutures (n=4), and the procedures were assisted by using a thoracoscope. There were 3 cases of tricuspid repair and 1 case of mitral valve repair. The mean CPB time and aortic occlusion time were $160{\pm}47\;and\;70{\pm}26 $minutes, respectively. Result: There was no mortality, but there were 3 minor complications (one pneumothorax, one wound dehiscence and one arrhythmia). The mean hospital stay was $5.9{\pm}1.8$ days. The mean follow-up duration was $10.7{\pm}6.4$ months. The follow-up echocardiogram noted no residual ASD or significant tricuspid regurgitation. Three patients suffered from pain or numbness. Conclusion: This study showed satisfactory clinical and cosmetic results. Although the operative time is still too long, more experience and specialized equipment would make this technique a good option for treating ASD.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.58-63
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• 2010

Purpose: To evaluate clinical results of a single percutaneous injection of platelet-rich plasma in patients with refractory lateral epicondylitis. Materials and Methods: Between Jan and Dec 2009, fifteen patients (5 male, 10 female) received a diagnosis of lateral epicondylitis of the elbow and were evaluated in this study. Their average age was 43.5 years. All patients were initially given a variety of non-surgical treatments for more than 1year. All patients were considering surgery. These patients were given a single percutaneous injection of 3cc of platelet-rich plasma. To assess pain, we used a visual analogue scale (VAS) at rest and during work & the Patient-Rated Tennis Elbow Evaluation (PRTEE) score. We compared the score before treatment with scores 4 and 12 weeks after treatment. Results: Average VAS scores at rest improved from 4.6 before treatment to 2.5 at week 4, and 1.8 at week 12. The average VAS score while working also improved from 7.8 before treatment to 6.2 at week 4, and 4.25 at week 12. The average PRTEE score improved from 60.13 before treatment to 46.12 at week 4 and 24.6 at week 12. Conclusion: Treatment using a single percutaneous injection of platelet-rich plasma in patients with refractory lateral epicondylitis appears to be an effective treatment modality. Platelet-rich plasma should be considered before surgical intervention.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.8
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• pp.3958-3970
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• 2013

This study was carried out to grasp the job stress and intention to change their jobs of nurses at general hospitals by their socio-demographic, job-related and health-related behavior characteristics and especially to investigate their relationship to the job stress and intention to change their jobs. The subjects were 355 nurses working at three university hospitals located in Daejeon City, and data were collected by a survey using self-administered questionnaires structured from April 1 to May 31, 2012. As a results, the average point of the nurses' intention to change jobs by the causes for job stress was significantly higher in the boss group with low support than in that with high support while it was higher in colleague group with low support than in that with high support. To look into the correlation between the points of intention to change their jobs and the causes for job stress, their intention to change their jobs showed a significant negative correlation to the boss's support and colleagues' support while there was no significant relationship with job demands and job autonomy. As a result of hierarchical multiple regression, age, drinking coffee, department, job satisfaction, the boss's support and colleagues' support were selected as significant related variables affecting the nurses' intention to change their jobs and these variables' descriptive power was 29.4%. Viewed from the above results, it is suggested that the nurses' job stress and intention to change their jobs has a significant relationship with various variables such as socio-demographic, health-related behavior and job-related characteristics. In addition, there were a significant positive correlation between the causes for the job stress cause and intention to change their jobs, and among the causes for the job stress, support by their boss or colleagues turned out to be those affecting their intention to change their jobs. Thus, it is considered that it is necessary to minimize the nurses' job stress and at the same time to seek for specific measures for preventing their turnover.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.2 no.2
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• pp.79-84
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• 2009

Purpose: Medial or Lateral epicondylitis is one of the most common causes of elbow pain and recently ESWT (Extracorporeal Shockwave Therapy) is welcomed as a new treatment modality and has been performed in many clinics. The purpose of this study is to report the clinical result after the ESWT treatment for the lateral or medial epicondylitis of the elbow. Materials and Methods: From Nov. 2005 to Jan. 2009, seventy four cases of seventy two (11 male, 61 female) patients diagnosed as medial or lateral epicondylitis of the elbow are included in this study. The average age was 52.4 years old. Authors used visual analogue scale (VAS) to assess the degree of pain at rest and during work, comparing the score before the ESWT treatment with that of $6^{th}$, $12^{th}$ and $24^{th}$ week after the treatment. Authors also checked the number of awakeness during sleep due to pain and compared them before and after the ESWT treatment. Results: Average resting pain score improved from 4.60 before the treatment to 2.01 at $6^{th}$ week, 0.43 at $12^{th}$ week and 0.16 at $24^{th}$ week. Average pain score during working also showed quite an improvement with time from 7.20 before the treatment to 4.05 at $6^{th}$ week, 2.01 at $12^{th}$ week and finally 0.36 at $24^{th}$ week. We checked the frequency of sleep arousal during a week, and also found similar significant treatment efficacy as the average frequency decreased from 9.64 per week before the treatment to 1.21, 0.08 and 0.09 per week at $6^{th}$ week, $12^{th}$ week and $24^{th}$ week, respectively. Conclusion: ESWT for medial or lateral epicondylitis is thought to be one of the effective treatment modalities for those patient group not quite responsive to other conservative treatment.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.8 no.1
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• pp.57-69
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• 1997

Objective：At the present time in Korea, for a considerable proportion of children and adolescent, delinquent behavior and violence has become as a way of life in their lives and a major social problem issue as well. The contributing factors to this problem were assumed to be the negative interaction between family environment and character of adolescent. The purpose of this study is to search the relationship between these constructs and juvenile delinquency. Method：Data were collected through questionnaire survey over a period of 2 months. Subjects served for this study consisted of 1,863 adolescents including 657 delinquent adolescents and 1,206 student adolescents in Korea, sampled from Korean student population and delinquent adolescent population confined in juvenile corrective institutions, using proportional stratified random sampling method. Their age ranged between 12 and 18 years. Data were analysed by IBM PC using SAS program. Statistical methods employed were Chi-square and principal component analysis. Results：The results of this study were as follows：Inconsistency by parental child rearing patterns tended to affect delinquent behavior among delinquent adolescents. On the other hand, adolescent students were consistently reared by their parent with democratic, flexible, trusting their children and reward-oriented attitudes. In comparison of both parents in the degree of influence on their children, it was revealed that paternal child rearing pattern was more influential on their children’s behaviors than maternal’s. The psychological instability of family, disharmonious parent-child relationships tended to be contributing to delinquent behavior among delinquent adolescents. Especially, It was an interesting finding that student’s mother is the higher employed than delinquent’s mother. However working mother was more prevalent in the student’ adolescents than in student adolescents in previous studies. The delinquent adolescents have more depressive trend, more complaints of psychosomatic symptoms, the higher degree of need frustration, the more maladaptive and antisocial personality pattern than student adolescents. Conclusion：Recently, many studies on association between family factor, character of adolescent and juvenile delinquent behavior have produced relatively consistent results. This study showed that family environment and character trait of adolescent also were linked with delinquent behavior such as smoking, drinking, runaway and physical assaults etc. The results of this survey may provide impetus for future speculation and study of correlation or reciprocal interaction between family factor, character trait of adolescent and delinquent behavior during adolescence and beyond.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.7 no.2
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• pp.161-170
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• 1997

This is an effort to confirm changes biological monitoring according to changes in levels of exposure to styrene for industrial workers. This study was conducted on 108 workers, including male of 64 and female 44 who were working at factories of FRP, dipping, and coating. An improved passive monitor method(organic vapor monitor; OVM) was employed to determine levels of exposure. The biological monitoring include blood styrene concentration, urinary mandelic acid(MA), and urinary phenylglyoxylic acid(PGA). Biological monitoring were made through the Collection of blood and urine. The mean value of exposure to styrene was 21.0ppm, which is measured by organic vapor monitor, one of improved passive monitors. The highest exposure level was observed among workers in boat factories, laminating procedure workers, processing workers, respectively(p<0.01). For exposure level, 11% of subjects under study showed over 50ppm which is time weighted average(TWA). The correlation coefficient between biological specimens and the exposure level was 0.62 for blood styrene concentration, 0.58 for MA corrected by creatinine, and 0.70 for PGA corrected by creatinine, respectively(p<0.01). The regression analyses found exposure level relative importance in explaining variance in biological monitoring. In additional to that, gender was a significant factor in explaining variance of MA and MA+PGA. Almost half of variance(49%) in blood styrene concentration was explained by predictors, including exposure level, age, gender, duration, and drinking volume during the last week(p<0.01). The very high correlation(higher than 0.95 was found when a comparison was made among three types of corrected methods, including uncorrected specific gravity and creatinine. In conclusion, these findings suggest OVM to represent levels of exposure to styrene for industrial workers. A discussion was made on possible use of specific gravity sample for biological monitoring. Exposure level may be predicted on MA, PGA in urine, which could be applied to represent biological monitoring.