ABSTRACT
Purpose@#The gradual increase in the number of children with disabilities in Korea highlights the necessity for further research on the role of school health teachers in their care. This study explored the specific experiences of school health teachers in special schools through individual in-depth interviews. @*Methods@#In this study, 11 school health teachers participated, and data were collected through individual in-depth interviews. Thematic analysis was employed to analyze the collected data. @*Results@#The experiences of health teachers at special schools were classified into 5 themes and 13 subthemes. These included "concerns about working in special schools and attachment after working," "management of diverse diseases and ongoing, careful observation," "ambivalence regarding students with disabilities," "competences needed to care for students with disabilities," and "enhancing care education for students with disabilities: demanding institutional support." @*Conclusion@#Effective student health management depends on open communication channels and the establishment of strong connections among health teachers, school personnel, and parents of impaired students. To enhance the quality of care for children with disabilities, specialized education programs to improve teachers' healthcare competency should be developed. Additionally, specific guidelines for the range of medical treatments provided by health instructors, should be devised.
ABSTRACT
BACKGROUND AND OBJECTIVES: The diagnosis of paroxysmal atrial fibrillation (PAF) and the prediction of its recurrence are sometimes difficult. There have been several recent studies attempting to detect patients at risk for PAF while in sinus rhythm by using the P wave signal-averaged ECG. We undertook to define an appropriate technique of P wave signal-averaged ECG and to estimate the reproducibility of the test. Additionally, we estimated the usefulness of P wave signal-averaged ECG in patients at risk for PAF. SUBJECTS AND METHODS: Forty-five patients with PAF were included in the study undertaken between March 1997 and June 1998. Twelve-lead surface ECG and P wave signal-averaged ECG were performed in the patients. The total P wave duration was measured by the P wave signal-averaged ECG using P wave template and least-square fit filter. The same process was followed in forty sex- and age-matched controls. RESULTS: The measurement of P wave duration with P wave signal-averaged ECG was highly reproducible. The measured P wave duration showed significant prolongation in the patient group at cutoff frequencies of 20 Hz and 30 Hz (123.6+/-15.3 vs. 114.8+/-14.5 msec, p=0.009 at 20 Hz, 120.1+/-17.8 vs. 107.5+/-18.8 msec, p=0.002 at 30 Hz). An abnormal P wave duration defined as over 120 msec in duration by P wave signal-averaged ECG was able to detect PAF with a sensitivity of 60%, specificity of 73%, positive predictive value of 71%, and a negative predictive value of 62%. CONCLUSION: A prolonged P wave duration as measured by P wave signal-averaging technique may be a simple noninvasive marker of risk for the development of atrial fibrillation.