Nurses’ Perception and Performance of End-of-Life Care in a Tertiary Hospital / 한국호스피스완화의료학회지

Purpose@#This study aimed to identify levels of perception and performance of end-oflife care among nurses and to investigate correlations between perception and performance. @*Methods@#This cross-sectional descriptive survey included 321 nurses from a tertiary hospital in Seoul, Korea. The participants had at least 6 months of work experience and had been involved in end-of-life care at least once, in either ward or intensive care unit settings.A structured questionnaire was utilized to assess their perception and performance of endof-life care. @*Results@#The mean score for perception of end-of-life care was 3.23±0.34, while the score for performance of end-of-life care was 3.08±0.34. There was a significant positive correlation between nurses’ perception of end-of-life care and their performance in this area (r=0.78, P＜0.001). @*Conclusion@#It is necessary to change perceptions regarding end-of-life care and to develop systematic and standardized education programs including content such as assessing the hydration status of dying patients, evaluating mental aspects such as suicidal ideation, and providing spiritual care for nurses working in end-of-life departments.

Factors Influencing Fatigue in Mothers of Hospitalized Children

PURPOSE: Fatigue in mothers of hospitalized children is an important component for her child's health. This study was done to identify factors influencing fatigue in mothers of hospitalized children. METHODS: A descriptive correlation study design was used. Participants were 157 mothers of hospitalized children in a university hospital located in one city. Data were analyzed using t-test, ANOVA, Pearson correlation coefficients and stepwise multiple regression. RESULTS: Mean score for fatigue in mothers of hospitalized children was 2.11±0.53. There were significant differences in scores for fatigue in these mothers according to education, sleep satisfaction, and family support. Multiple regression analysis showed that the important factors related to fatigue in mothers of hospitalized children were parenting stress (β =.44), hours of sleep (β =-.25), and age (β =-.21). These factors explained 38% of the total variance. CONCLUSION: Research results suggest that nursing interventions for mothers of hospitalized children are needed in order to improve the comfort and health of the mothers and facilitate the recovery of their child.

A Predictive Model of Behavioral Problems in Elementary School Children

PURPOSE: The purposes of the study were to develop and test a model which explains the relationship among factors affecting behavioral problems in elementary school children. METHODS: The participants for the study were 368 elementary school children and their mothers at 3 elementary schools in one city. Data analysis was done using the SPSS 17.0 program for t-test, -test, and ANOVA and the AMOS 17.0 program for theoretical model testing. RESULTS: The theoretical model showed a significant goodness of fit to the empirical data (Goodness of Fit Index: .96, Adjusted Goodness of Fit Index: .93 Comparative Fit Index: .95, Root Mean Square Error of Approximation: .06, Standardized Root Mean Square Residual: .02). Six paths were found to be statistically significant including from child rearing attitude to self-esteem, stress, stress coping and behavioral problems, and from self-esteem to stress and behavioral problems. Child rearing attitude showed a significant effect to behavioral problems by total effect. Self-esteem affected behavioral problems by total and direct effects. CONCLUSION: Child rearing attitude and self-esteem of children are important factors affecting behavioral problems in elementary school children.

High School Boys' Images of Men as Nurses / 기본간호학회지

PURPOSE: The purpose of this study was to identify the images of men as nurses held by high school boys, and to provide basic data about the desirability of nursing as a career choice for them. METHODS: Q-methodology which provides a method of analyzing the subjectivity of each item was used: The 35 high school boys classified 31 selected Q-statements into a normal distribution using a 9-point scale. The collected data was analyzed by the pc-QUNAL program. RESULTS: Among the high school boys, three types of images of men as nurses were identified. Type I; A promising occupation for men through active way of thinking, Type II; Men working in a woman oriented field of work, Type III; A promising profession without any gender stereotype. CONCLUSION: The results of this study suggest that specific strategies should be developed to promote the choice of nursing among high school boys.

Effects of Life Stress and Depression in Undergraduates on Suicidal Ideation

PURPOSE: This study was conducted to identify the effects of life stress and depression in undergraduates on suicidal ideation. METHODS: The participants in this study were 306 nursing students from three different cities. Collected data were analyzed using t-test, ANOVA, Pearson correlation coefficients, and stepwise multiple regression. RESULTS: The mean score for life stress was 48.48, for depression, 28.59, and for suicidal ideation, 5.90. There were positive relationships between depression and life stress, suicidal ideation and life stress, and suicidal ideation and depression. The four factors of life stress, depression, school life, and gender were identified as factors influencing on suicidal ideation in undergraduates. CONCLUSION: The findings of this study indicate that the establishment of mental health care centers in universities, and development and implementation of nursing intervention programs for suicide prevention would be helpful.

Meconium Obstruction in Very Low Birth Weight Infants / 대한소아소화기영양학회지

PURPOSE: Mecnoium obstruction in very low birth weight infants (VLBWI), which delays enteral feeding and is one of the major causes of bowel obstruction, can be diagnosed and treated with hyperosmolar water-soluble contrast enema. The purpose of this study was to observe the clinical findings of meconium obstruction, the improvement of small bowel obstruction after contrast enema, and the complications related to the enema. METHODS: Hypersolmolar water-soluble contrast enemas were performed in 14 VLBWIs with meconium obstruction. Clinical findings, radiologic findings, feeding intolerance, effectiveness, and complications of enemas were observed. Also, clinical findings related to meconium obstruction were compared with 18 VLBWIs without meconium obstruction. RESULTS: 1) Fourteen VLBWIs with meconium obstruction had significantly lower 5 minutes Apgar scores than 18 VLBWIs without meconium obstruction (p<0.05). Moreover, the day of last meconium passing, and the day of the first trial and full enteral feeding were delayed significantly. 2) A total of 18 enemas were performed in the 14 infants. The contrast medium passed the ileocecal valve and reached the terminal ileus in 12 enemas. Of the 12 enemas, 11 were successful, but 1 infant underwent an ileotomy, even though the contrast medium reached the terminal ileum. 3) Intestinal obstruction was not relieved in three of five infants, in whom the contrast medium failed to pass the ileocecal valve. Obstruction was relieved after repeated enemas in which the contrast medium reached the terminal ileum. 4) No complications associated with water-soluble contrast enemas were observed. CONCLUSION: Hyperosmolar water-soluble contrast enema is considered to be safe and therapeutic for meconium obstruction in VLBWIs.

A Study of Parents' Satisfaction and Needs for Foodservice Quality of the Childcare Centers in Chungnam Asan Area / 대한지역사회영양학회지

We tried to find out parents' satisfaction and needs for foodservice quality of the childcare centers with an intention of improving it. Self-completed questionnaires were randomly collected from the parents of children in 174 childcare centers around Asan and were analyzed. Most of respondents were mothers who were housewives with college degrees (69%) in their 30's (80%). They thought nutrition (50%) and food hygiene (43%) were the most important factors for decision. Eighty percent of parents recognized the strong relationship between foodservice quality and childrens' mental and physical development. Most centers (94%) were delivering menu notices home, so parents well recognized the center's foodservice situation and problems of their kids' eating habits. The parents' satisfaction scores were 3.26 out of 5-point scale. The biggest dissatisfaction was from no variation in menu, but remarkable appreciation was from the effect of foodservice on the correction for kids' unbalanced diet habit. They had demands for improvement of nutritious menu and professional nutrition teacher in charge of foodservice and nutrition education for children and also for parents.

The Foodservice Sanitation Status of the Child Care Centers at Asan City in Chungnam / 대한지역사회영양학회지

We investigated the foodservice sanitation status of the childcare centers in Chungnam Asan area to provide the information for sanitation guidelines and checklist in various operation types of childcare centers. Self-completed questionnaires were collected from the directors of 95 centers: national-public 9 (9.5%), corporation 10 (10.5%), private 52 (54.7%), and home care 24 (25.3%) types. The analyzed results are shown in foundation type; the investigated items are about critical hygienic problems and safety recognition level, presence of sanitation guideline, demand of dietian's employment and the role, hygienic management and education level, and the present and future of sanitary facility and equipment. From this study we found that home care center, which had low capacity, was comparatively poor at sanitation status, the use of hygienic standard and guideline, and safety recognition level. In our opinion, the use and application of same sanitation standard to any type and size of center is not appropriate and rational. The reestablishment of the sanitation guideline and checklist considering the conditions of various operation types would be necessary. Also periodic hygienic education by hygenic professionals, continuous parents' attention and cooperation of related government organizations are needed for improvement of foodservice sanitation status of childcare centers.

A Survey on the Foodservice Management System of the Child Care Centers in Chungnam Asan Area / 대한지역사회영양학회지

We investigated the foodservice management practices in various operation types of childcare centers in Asan, Chungnam Province, with the intention of improving the quality of foodservice and providing the basic information for establishing more effective and efficient foodservice model system. Self-completed questionnaires were collected from the directors of 174 child care centers. The statistical analysis was completed using SPSS Ver. 12.0 program. The followings are about the results of this study. Approximately 94.8% of the directors were women with the average age of 40.3. All of the investigated facilities executed foodservice; the facilities of 96.2% had been self-operated, 1.9% was contract-managed and the remaining 1.9% served delivered meal from outside. Only 20.0% of the investigated centers employed a dietitian. In most of the centers, meals were prepared in a conventional manner and approximately 85.3% of the centers are serving only snacks twice a day as a supplementary due to financial difficulties. Menu planner of the facilities, which have no dietitian was the director (35.8%) or the cook (25.7%). In most centers, the directors purchased the food materials (67.5%). Material inspection was done by the director (54.9%) or the cook (40.5%). However, home care centers did not inspect the food material. These results indicate that food service management guidelines need to be established by the facility type with the government control and financial support. Especially, dietitian employment and the efficient foodservice model system establishment are questions that confront us.

The Changes of Aqueous Vasopermeability Factors After Intravitreal Triamcinolone Injection for Branch Retinal Vein Occlusion

PURPOSE: To investigate the changes of aqueous vascular endothelial growth factor (VEGF) and interleukin (IL)-6 in patients with acute macular edema secondary to recent-onset branch retinal vein occlusion (BRVO) after a single intravitreal injection of triamcinolone acetonide (IVTA) METHODS: Aqueous and plasma levels of VEGF and IL-6 were measured by ELISA in ten controls and thirty patients at the time of IVTA and 3 months afterward. We compared the aqueous levels of VEGF and IL-6 and the clinical course between responders and non-responders. RESULTS: The aqueous levels of VEGF and IL-6 were significantly higher in non-responders than in responders at baseline measurements (495+/-259 pg/ml vs. 223+/-110 pg/ml, P<.001; 36+/-32 pg/ml vs. 16+/-19 pg/ml, P=.037, respectively). The aqueous levels of VEGF were still higher in non-responders (303+/-75 pg/ml) 3 months after IVTA, while the aqueous levels of VEGF in responders returned to normal (77+/-23 pg/ml, P<.001). The aqueous levels of IL-6 normalized in all patients 3 months after IVTA. In non-responders, central foveal thickness was significantly higher, and foveal ischemia and a wide non-perfused area were more common. CONCLUSIONS: Non-IL6-dependent VEGF may contribute to persistent or recurrent ischemic macular edema associated with BRVO after IVTA.

Personality-based Contraception Behavior of Female College Students / 여성건강간호학회지

PURPOSE: The purpose of this study was to analyze the types of female college students' personality-based contraception behavior. METHOD: A Q-methodology was used to identify factors in female college students' personality-based contraception behavior. The 32 selected Q-sample from each of 28 subjects were classified into a shape of normal distribution using a 9 point scale. The collected data was analyzed using a QUANL PC program. RESULT: Three types of contraception behavior of female college students were identified. Type I is corporate responsibility, Type II is self-protection type, Type III is perceived risk of pregnancy. CONCLUSION: These results suggest that sexual health education for contraception behavior promotion should focus characteristics influencing on contraception attitudes. Also, efficient contraception should be educated by continuous qualitative research based on contraceptive experiences of college students.

Activity of Matrix Metalloproteinase-2 and its Significance after Resection of Stage I Non-small Cell Lung Cancer / 대한흉부외과학회지

BACKGROUND: Matrix metalloproteinase-2 (MMP-2) is a class of proteolytic enzymes that digest collagen type IV and other components of the basement membrane. It plays a key role in the local invasion and the formation of distant metastases by various malignant tumors. The aim of this study was to evaluate the activity of MMP-2 and its significance as a prognostic marker in resected stage I non-small cell lung cancer (NSCLC). MATERIAL AND METHOD: In this study we obtained fresh-frozen samples of tumor and non-tumor tissues from 34 patients with stage I NSCLC who underwent resection without preoperative radiotherapy or chemotherapy. After the extraction of total protein from tissue samples, MMP-2 activities were assessed by gelatin-substrate-zymography. The activities were divided into the higher or lower groups. RESULT: The MMP-2 activities were higher in tumor tissues than in non-tumor tissues. The MMP-2 activity of non-tumor tissues in recurrent group was higher than in non-recurrent group (p<0.01). Also the patients with higher MMP-2 activity of non-tumor tissues showed poor 5 year survival (p<0.01). CONCLUSION: This result indicates that the higher level of MMP-2 activity in the non-tumor tissue is associated with the recurrence and survival after the resection of stage I NSCLC. Therefore, MMP-2 activity in the non-tumor tissue could be used as a potential prognostic marker for the resected stage I-NSCLC.

Comparison of the Usefulness of the Computed Tomographic Angiography with Conventional Cerebral Angiography in Patients with Cerebral Aneurysm / 대한뇌혈관외과학회지

OBJECTIVE: Computed tomographic angiography (CTA) is useful for rapid and relatively noninvasive detection of aneurysms in the circle of Willis. The purpose of this study is to compare CTA with conventional cerebral angiography (CCA) and to assess usefulness of CTA in detection of the anatomic delination of intracranial aneurysms of the circle of Willis in subarachnoid hemorrhage. PATEINTS AND METHODS: 126 consecutive patients with known SAH or suspected intracranial saccular aneurysms underwent CTA and CCA from January 2002 to June 2003. Using surface shaded display post-processing technique, CTA was interpreted for the presence, location and anatomic features of the aneurysms and also the image obtained with CTA was compared with CCA image. RESULTS: In 112 operated patients, 125 aneurysms were detected. CCA revealed 123 cerebral aneurysms and CTA revealed 113 aneurysms. Two of the 125 cerebral aneurysms were located outside of the imaging volume of CTA, 10 cases were not detected and false positive were 2 cases. The sensitivity of CTA was 90.3%. The results obtained with CTA comparing with that of CCA were almostly equal in detection of aneurysm location and delineation of aneurysmal neck. However, CTA provided a 3-dimensional representation of aneurysm and also it was very useful for surgical planning. CONCLUSION: CTA can be a diagnostic tool for the patients with acute subarachnoid hemorrge due to a ruptured aneurysm of the circle of Willis and provides adequate anatomic detail for surgical planning especially to complex cerebral aneurysms. However, it is obvious that CCA is necessary because of the limitations of CTA including its difficulty in detecting unusually located aneurysms including those in cavernous sinus or distal artery, and acquiring dynamic flow information.

Correlational Study on Health Behaviors, Menopausal Symptoms and Sexual Satisfaction in Korean Middle-aged Women / 성인간호학회지

PURPOSE: The purpose of this study was to identity the relationships among self reported health behaviors, menopausal symptoms, and sexual satisfaction in middle-aged women. METHOD: The subjects of this study were 155 women from 40 to 60 years. The data was analyzed using SPSS program for frequency, percentage, mean, t-test, ANOVA, Duncan and Pearson's correlation coefficients. RESULTS: 1. The mean score of health behaviors was 3.10 out of maximum 4. 2. The mean score of self-reported menopausal symptoms was 1.73 out of maximum 2. 3. The mean score of sexual satisfaction was 2.73 out of maximum 4. 4. Women's degree of menopausal symptoms had negative correlations with the degree of health behaviors(r=-0.437, p<.001) and the degree of sexual satisfaction(r=-0.439, p<.001). The degree of health behaviors had a positive correlation with the degree of sexual satisfaction (r=0.470, p<.001). CONCLUSION: In conclusion, menopausal symptoms-based complaints by middle-aged women were negatively correlated to health behavior and sexual satisfaction. Therefore, health behavior should be considered when developing nursing strategies for middle- aged women, especially when dealing with menopausal symptoms and sexual satisfaction.

Association between RASSF1A Methylation and Clinicopathological Factors in Patients with Squamous Cell Carcinoma of Lung / 결핵및호흡기질환

BACKGROUND: RASSF1A, which is one of tumor suppressor genes, is frequently inactivated by hypermethylation of the promoter region in a variety of human cancers, including lung cancer. This study was performed to investigate the association between RASSF1A methylation and the clinicopathological factors in patients with squamous cell carcinoma of the lung. METHODS: Eighty-one samples from the patients with squamous cell carcinoma of lung were examined. The promoter methyation of RASSF1A was analyzed by methylation specific PCR and sequencing. Statistical analysis was made to examine the association between RASSF1A methylation and the clinicopathological parameters. RESULTS: RASSF1A methylation was observed in 37.0 % (30 of 81) of the patients with squamous cell carcinoma of the lung. RASSF1A methylation was found to be associated with cellular differentiation(p=0.0097) and the overall survival(p=0.0635). However, there was no association between RASSF1A methylation and the other clini?copathological parameters, such as the pathological TNM stage, the recurrence rate, lymph node invasion and the amount of cigarettes smoked. CONCLUSION: RASSF1A methylation might be associated with a poor prognosis in patients with squamous carcinoma of the lung. A larger scale study is needed.

A Case of Primary Malignant Lymphoma Occurred in Orbit and Cavernous Sinus

PURPOSE: Primary malignant lymphoma is rarely occurs in orbit, and it needs systemic evaluation after confirmed diagnosis and radiotherapy or chemotherapy. We report a very rare case of malignant lymphoma occurred in orbit and cavernous sinus METHODS: A 69 year-old male patient was consulted for right blepharoptosis manifested about 2 months ago. Orbital CT revealed 3 X 2 cm sized orbital mass simultaneously involving cavernous sinus. Biopsy and histological examination were performed. RESULTS: The examination showed a diffuse large B cell-type malignant lymphoma, and the mass was markedly reduced by radiation. CONCLUSIONS: We report a rare case of malignant lymphoma simultaneously involving orbit and cavernous sinus with lirerature review. We confirmed it by biopsy and obtained satisfied result by radiation therapy.

Long-term Results of Primary Trabeculectomy in Glaucoma

PURPOSE: This study was carried out to identify the usefulness of mitomycin C (MMC) used in trabeculectomy. METHODS: We retrospectively reviewed the medical records of 47 eyes of 37 patients who underwent primary trabeculectomy with mitomycin C (MMC group). Thirty four eyes of 30 patients underwent primary trabeculectomy without MMC (control group) from January 1991 to July 1996 at Chonnam National University Hospital. RESULTS: The mean intraocular pressure(IOP)'s at the last follow-up were 17.30+/-5.70mmHg and 18.96+/-7.57mmHg in MMC and control group, respectively. The mean numbers of postoperative anti-glaucoma medications were 0.89+/-0.89 and 1.26+/-0.66 in MMC and control group, respectively. By Kaplan-Meier survival analysis, the survival rate of filtration was higher in MMC group than control group up to postoperative 60 months. However, the rate was reversed after 60 months. Postoperative complications in MMC group were cataract, hypotony, shallow anterior chamber, hyphema, bleb leakage, bleb infection and hypotonic maculopathy. CONCLUSIONS: MMC was effective in IOP-control in primary trabeculectomy, but there was no significant difference in long-term IOP-lowering effect compared to control group. However, there were more serious complications in the MMC group compared to control group. Therefore MMC should be used selectively.

A Study on Motivation for Pregnancy of Married Women in Korea / 여성건강간호학회지

PURPOSE: This study is to define the structural patterns of pregnancy motivation of married women. METHOD: Q-methodology was used on 110 statements collected from interviews with women and a literature review. 38 Q-samples were selected. The Q-samples were administerd to 30 randomized P-sample. RESULT: Data analysis of Q-type obtained by QUANL program shows three types of subjectivity in the perception of pregnancy motivation. Type 1, "Family-connection strengthening", Pregnancy motivation is characterized by the tendency to make home, to tie family member, to connect couple firmly. Type 2,"Self-satisfaction", Women of this type take pleasure and happiness from child rearing in terms of being a mother and having maternal affection. Type 3, "Self-centered", This type of pregnancy motivation puts on high emphasis on self achievement and they make a family planning suitable for the maternal role. CONCLUSION: The stronger was women's pregnancy motivation, the more positive were women's pregnancy experience and maternal role attainment. Therefore, When nurses take care of pregnancy women, they should understand the women's psycho-social aspects and then apply a program of nursing intervention to the pregnant women, It is necessary to continue to study on social and psychological problems related to pregnancy.

Family Support, Intention of Pregnancy and Antenatal Self-Care of Pregnant Women / 여성건강간호학회지

OBJECTIVES: A Pregnancy becomes a developmental challenge and a life-turning point for both the woman herself and her family. The purpose of this study was to identify the correlation amomg the family support, intention of pregnancy and the antenatal self-care of pregnant women. METHOD: The data were collected from 129 pregnant women by a questionnaire. The collected data were analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, using the SPSS program. RESULT: The findings of the study are as fellows : Statistically significant variables related to family support were age, religion, educational level, occupation, relationship with husband, relationship with mother. Statistically significant variables related to intention of pregnancy were religion, abortion history. Statistically significant variables related to antenatal self-care were age, religion, occupation, abortion history, relationship with mother, the term of marriage. There was a significant correlation between family support and intention of pregnancy, family support and antenatal self-care, intention of pregnancy and antenatal self-care. CONCLUSION: Therefore, it is proposed that family support is an appropriate nursing intervention to improve the antenatal self-care and intention of pregnancy in pregnant women.

Effects of Enternal Nutritional Support on Tube-fed Elderly Patients

BACKGROUNDS: As life expectancy is increasing, it is necessary to evaluate the health and nutritional status in elderly, especially in tube-fed elderly patients whose malnutritional status is related to the increase in mortality. This study was conducted to improve the nutritional status in tube-fed elderly patients. METHODS: Effects of nutritional support on tube-fed elderly patients(> or =65years) for 8 weeks were investigated by biochemical assessment and weight. RESULTS: When comparing the biochemical changes of the control group(n=8) with those of the case group(n=8), it showed significant differences in total protein, serum albumin and TLC(p0.05). CONCLUSION: This study suggests the in tube-fed elderly patients can be improved if nutritional support is properly administrated.