OBJECTIVE: The purpose of this study was to develop a Web-based ostomy self-care education program and to evaluate its effects on ostomates' self-care knowledge and self-care behavior. METHODS: Based on the needs assessment and literature review, a Web-based ostomy self-care education program was developed and modified incorporating feedbacks from nurse experts panel. The experimental group received the ostomy self-care using the Web-based program and the control group received the traditional education. The level of self-care knowledge and self-care behavior were measured and were compared between the experimental and the control groups. RESULTS: The levels of self-care knowledge and self-care behavior in the experimental group were significantly higher than those of the control group. CONCLUSION: This study implies that a Web-based education program for the ostomates can be used to improve ostomy self-care.
Education* ; Internet ; Needs Assessment ; Ostomy* ; Patient Education as Topic ; Self Care*

BACKGROUND: The purpose of this study is to evaluate the evidence for the effectiveness of different isolation policies in reducing the incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection in hospital in-patients. METHODS: We prospectively evaluated the effectiveness of an isolation policy on transmission of MRSA in the 745-beds hospital. First period, all patients with MRSA (March - July 2000) were not isolated Second period, strict isolation policies were performed (August 2000 - January 2002). All patients with MRSA were isolated in separated room, hand hygiene using alcohol handrub, gowning and g1oving, apply of MRSA notice sticker, criteria in isolation remove, separated disinfection and wastement. Third period, semi strict isolation policies were performed (February 2002 - August 2005). Some patients with MRSA were isolated in separated room and others were admitted in general ward for bed shortage. Only some practices were performed in hand washing and separated disinfection in general ward. RESULTS: The rates of MRSA nosocomial infection per patients during 1st, 2nd, and 3rd surveillance were reported 0.56, 0.23, and 0.42 (P<0.05). Patient-days rate of MRSA nosocomial infection during 1st, 2nd, and 3rd surveillance were reported 0.62, 0.27, and 0.38 (P<0.05). CONCLUSION: With many different isolation policies, it was possible to reduce nosocomial infection of MRSA. In this study, strict isolation policies (2nd period) were the most effective practices in reducing MRSA infection.
Cross Infection ; Disinfection ; Hand Disinfection ; Hand Hygiene ; Humans ; Incidence ; Infection Control ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Patients' Rooms ; Prospective Studies

Most obstetric anesthesiologist now consider epidural anesthesia to be the preferred anesthetic technique for patients with preeclampsia. In the severe preeclampsia effective ciirculatory volume is usually low, so appropriate preanesthetic hydration is essential feature of safe management. We performed CVP monitoring before epidural anesthesia in nine severe preeclamptic patients undergoing cesarean section. Mean CVP of them was 2+/-1 mm Hg which was not significantly different from normal term parturient. In four patients whose CVP was less than 2 mmHg, preanesthetic hydration with Hartman's solution 500~700 rrd was performed under the monitoring of CVP until it became to rise 2~3 mmHg. Five patients out of nine whose systolic blood pressure dropped below 100 mmHg during anesthesia were IV injected ephedrine 4 mg immmediately and three of them needed repeat injection of ephedrine 4 mg. With the monitoring of CVP, the operations of all the nine severe preeclamptic patients were completed successfully without any problem during and after anesthesia. lt is important to reaUze the limitation of central venous pressure monitoring : but if used with caution in proper circumstance it can provide clinically useful information with minimal risk to the patient.
Anesthesia ; Anesthesia, Epidural* ; Blood Pressure ; Central Venous Pressure* ; Cesarean Section ; Ephedrine ; Female ; Humans ; Pre-Eclampsia* ; Pregnancy

Sixty parturients scheduled for elective cesarean section at term under epidural anesthesia were randomly divided into one of two groups. Group 1 patients were given a prepared 2% lidocaine solution with 1:200,000 epinephrine plus 1ml of normal saline per 10ml of lidocaine; the solution pH was 2.45. Group 2 patients were given a prepared 2% lidocaine solution with 1:200,000 epinephrine plus 1ml(lmEq) NaHCO3 per 10ml of lidocaine; the solution pH was 7.20. Just before injection, either 2ml normal saline(group 1)or 2ml(2mEq) 8.4 % NaHCO3 solution(group 2) was added to 20ml 2% lidocaine hydrochloride with 1:200, 000 epinephrine. The time to onset of the T5 sensory block (time between completion of injection and loss of cold sensation at T5 dermatome) was significantly more rapid in the group 2 that received the pH adjusted solution. The mean onset time was 4.9+/-1.3 min in the group 2 and 6.4+/-2.0 min in the group 1. The time to peak level was also significantly more rapid in the group 2 at 10.5+/-2.7 min and group 1 at 13.3+/-4.0 min. But the peak level was not statistically signifieant between the two groups. The spread of sensory blockade was significantly more rapid in the pH-adjusted group at 5, 10 and 15 min after epi- dural injection. Incidence of maternal hypotension during the operation did not differ signifi- cantly between the two groups. The time from end of injection to Bromage scale 0 did not differ significantly between the two groups.
Anesthesia, Epidural ; Cesarean Section* ; Epinephrine ; Female ; Humans ; Hydrogen-Ion Concentration ; Hypotension ; Incidence ; Lidocaine* ; Pregnancy ; Sensation ; Sodium Bicarbonate

PURPOSE: Purposes of this study were to identify the level of parental fever phobia and to investigate the relationship between level of parental concern about fever and related variables. METHODS: Participants were 151 parents of children who visited a pediatric outpatient clinic. A self-reported structured questionnaire was used for data collection and data were analyzed using descriptive statistics and chi2-test. RESULTS: Almost half of participants defined a minimum temperature for fever as 37.8degrees C and a minimum temperature for high fever as 38.9degrees C. About 75% of participants identified harmful effects of fever as seizure and brain damage, were 'very worried' about fever, measured their child's temperature every hour or less, provided tepid massage and woke children to give antipyretics during febrile illness. There were significant relationships between level of parental concerns about fever and prior experience of febrile seizures, and/or being parents of a single child. CONCLUSION: Results indicate that fever phobia is prevalent among parents. Further studies are needed to develop and evaluate childhood fever management educational programs for parents. Considering health care providers as a primary information resource about fever management, health care providers should play a vital role to reduce parental unrealistic concerns about fever.
Ambulatory Care Facilities* ; Antipyretics ; Brain ; Child ; Data Collection ; Fever* ; Health Personnel ; Humans ; Massage ; Parents* ; Phobic Disorders* ; Seizures ; Seizures, Febrile ; Surveys and Questionnaires

This study was conducted to identify the effects of a planned exercise program based on Bandura's self efficacy model on metabolism, and the exercise compliance in type 2 diabetes mellitus patients. The study design was a nonequivalent pre-test post-test control design. Thirty four type 2 diabetes mellitus patients, who received follow-up care regularly through the diabetic out-patient clinic, were randomly sampled for this study. Twenty patients were assigned to the experimental group and fourteen patients were assigned to the control group. In the experimental group, a planned exercise program is composed of an individualized exercise prescription for 12 weeks, an individual education, and even a telephone coach program. In the case of the control group, they were instructed to continue with their usual schedules. The data collection period was from March 1999 to February 2000 Data were analyzed using SPSS/WINDOW 10.0program. The results were as follows. 1. In the experimental group, the level of fasting blood sugar has significantly decreased from 188.20 mg/dl to 155.55 mg/dl after planned exercise program (F= 16.86, p=.000). For lipid metabolism, body fat per cutaneous decreased from 27.16% to 26.57% after planned exercise program. The score of self efficacy has increased from 64.20 to 66.65 after planned exercise program and it was statistically significant (F=4.850, p=.040) The functional vital capacity has increased from 3.28 liter to 3.37 liter and it was statistically significant(F=7.300, p=.020). 2. In an after effect of a planned exercise program, 35 percent of the subjects who participated in a planned exercise program continued to exercise for another six months. In conclusion, the planned exercise program can improve cardiopulmonary function, glucose, and lipid metabolism. This program was show a positive effect on the self efficacy and exercise compliance.
Adipose Tissue ; Appointments and Schedules ; Blood Glucose ; Compliance* ; Data Collection ; Diabetes Mellitus, Type 2* ; Education ; Fasting ; Follow-Up Studies ; Glucose ; Humans ; Lipid Metabolism ; Metabolism* ; Outpatients ; Prescriptions ; Self Efficacy ; Telephone ; Vital Capacity

PURPOSE: The purpose of this study was investigate the relationships among perceived social support, instrumental support needs, and depression of healthy, community dwelling elderly women. METHOD: This study was designed to examine whether the perceived social support and instrumental support were correlated with depression in elderly women. Data were cross-sectional and community- dwelling elderly individuals. The subject was 98 elderly women recruited from Elderly Welfare Center and Community center for Elderly. The instruments for this study were Personal Resource Questionnaire-part II, Geriatric Depression Scale (Short Form), and Instrumental Support Activities Checklist. Data were gathered by means of structured personal interviews. The internal consistency of the instruments was relatively good. RESULT: The participants' perceived social support was moderately high and instrumental support needs was low. Depression was mild and moderate relatively. The correlation analysis showed that the perceived social support was negatively related to depression and negatively related with instrumental support needs. CONCLUSION: The findings suggested that more perceived social support, less their depressive symptom in elderly women. It also revealed that the age, marital status, and socioeconomic status of elderly women also are important indicator of the elderly depression. Therefore nursing assessment and the design of intervention that incorporate the determinants supported in this study, such as perceived social support of the elderly women are needed in adopting and maintain health promoting lifestyle for the mental health and effective functioning in later life in women.
Aged* ; Checklist ; Depression* ; Female ; Humans ; Life Style ; Marital Status ; Mental Health ; Nursing Assessment ; Social Class

Type 2 Diabetes Mellitus patients have chronic metabolic disorder and they need self care for their lifetime. But most Diabetes Mellitus patients don't know how to do a self care due to the lack of adequate support from health care professionals. It has been reported that lack of exercise therapy compliance guide is very important one. This study was conducted to develop an exercise therapy protocol applied to an efficacy expectation promoting program based on Bandura's self efficacy model for type 2 Diabetes Mellitus patients. Firstly, a conceptual framework was developed through efficacy expectation promoting program based on Bandura's self efficacy model. In order to identify the contents of program and to design a preliminary protocol, a with the consultation experts was made. A clinical validity was tested using twenty type 2 Diabetes Mellitus patients who received follow-up care regularly through the diabetic out-patient clinic from October, 1998 to May, 2000. After this process, the final protocol was developed. The results of this study are summarized as bellows : The final exercise therapy protocol applied to an efficacy expectation promoting program for type 2 Diabetes Mellitus patients consists of individualized exercise test and prescription, a small booklet relating personal experience with Diabetes Mellitus and a telephone coaching program for 12 weeks on performance accomplishment, vicarious experience and verbal persuasion, which are all induction modes of efficacy expectation. It is concluded that the exercise therapy protocol applied to an efficacy expectation promoting program is applicable to type 2 diabetes mellitus. And this exercise therapy protocol could show a positive effect on the exercise compliance of Diabetes Mellitus patients.
Compliance ; Delivery of Health Care ; Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Exercise Test ; Exercise Therapy* ; Follow-Up Studies ; Humans ; Outpatients ; Pamphlets ; Persuasive Communication ; Prescriptions ; Self Care ; Self Efficacy ; Telephone

Results: Among grit’s sub-areas, consistent effort was significantly associated with gender (male students scored higher than female students (t=2.20, p=.029), scores were higher when parental relationships were intimate (F=5.88, p=.003), and the closer the relationship with the homeroom teacher, the higher the score (F=3.51, p=.032). The regression model in this study was statistically significant (F=26.730, p<.001), and the variables that influenced steady effort (Grit) were self-resilience (β=.331, p<.001), and self-emotion regulation (β=.290, p<.001), sex (β=-.142, p=.024), the explanatory power of the variable’s continuous effort was 29.4%. Conclusion The middle school age is the time to discover life goals and dreams. Grit is persistent efforts to achieve our goals and in order to raise the level of Grit, we need to develop and provide ongoing curriculum and tailored school programs that will increase self-resilience and self-emotion control skills.

BACKGROUND: Peak expiratory flow (PEF) provides a simple, quantitative, and reproducible measure of the existence and severity of airflow obstructions. Peak flow meters are designed to monitor the condition asthma patients. There are many reports showing the normal predicted value of PEF in other countries. studies on healthy Korean adults have been performed in a relatively small sample number and a lower limit for the normal value was not reported. therefore, an attempt to provide normal predictive PEF value with a lower limit was made. METHOD: The PEF(Mini-Wright peak Flow Meter) measurements and spirometry were done in 233 men and 631 woman without history of respiratory disease. all subjects were non-smokers with no respiratory symptoms. the normal predictive value and its lower limit were developed by multiple regression analysis. The result was compared with regression equations in other reports. RESULTS: The regression equation for the normal PEF predictive value(L/min) is 25.117+4.587×Age(year)-0.064×Age2+2.931×Height(cm) in men in men(R2=0.25), and 146.942-0.011×Age2+1.795×Height(cm)+0.836×Weight (kg) in women(R2=0.21). The regression equation for the lower limit of this value (L/min) is 25.117+4.587×Age(year)-0.064×Age2+1.936×Height (cm) in men, and 146.942-0.011×Age2+1.232× Height (cm)+0.481×Weight (kg) in women. The residuals were normally distributed. The PEF in Korean males was similar to those reported in British and Japanese subjects. The PEF in Korean females was similar to that in British subjects, But higher than the PEF in Japanese subjects. The lower limit of normal value was 71% of normal predictive PEF value in men and 76% in women. CONCLUSION: The normal predictive PEF value and its lower limit was measured from 233 male and 631 female asymptomatic, lifelong non-smoking participants. The normal predictive value was different from those of other studies on Korean subjects. Therefore, further studies are required.
Adult ; Asian Continental Ancestry Group ; Asthma ; Female ; Humans ; Male ; Reference Values ; Spirometry