PURPOSE: The purpose of this study was to identify effects of a self-management program on self-efficacy and compliance in patients with CHF. Hypothesis: 1) Patients with CHF who are provided with a self-management program will show higher self-efficacy scores than a control group. 2) Patients who are provided with a self-management program will show higher compliance scores than a control group. METHOD: This study was designed as a nonequivalent non-synchronized pre-posttest control group. There were eight patients in the experimental group, and twelve in the control group. According to NYHA classification, all patients belonged under the classesl to lV. Data were collected using the instruments developed by the researchers. Data were analyzed using descriptive statistics and Mann Whitney U test. RESULT: There were significant differences in self-efficacy scores and compliance scores between the experimental and control group. CONCLUSION: By utilizing the program, patients were able to monitor their symptoms routinely, comply with therapeutic regimen, and feel better able to positively influence their disease. Therefore, better compliance means fewer readmissions of patients with CHF.
Classification ; Compliance* ; Decision Trees* ; Heart Failure* ; Heart* ; Humans ; Self Care* ; Statistics, Nonparametric ; Surveys and Questionnaires

PURPOSE: The purposes of this study was to evaluate an occupational health promotion program for the prevention of cardiovascular disease. METHOD: This study employed a quasi-experimental non-equivalent pre and post test to evaluate the program. The subjects of this study were 48 employees selected by convenience sampling who were suspected of having hypertension and hyperlipidemia in routine physical examinations and who were working in A University Hospital in Suwon. 25 subjects were assigned to the experimental group and 23 to the control group. Data collection was done using questionnaries before and after the subjects used the program. RESULTS: The results of this study showed that systolic blood pressure, ALT, gamma-GTP in the experimental group was lower than that of the control group. There were significant differences between two groups in the percentage of 'irregularity of diet' and in health behavior compliance. There were significant differences between the two groups in the number of complaints of symptoms after using the program. CONCLUSION: This study shows that there were no obvious differences between the two groups in all areas, but this program had a positive effect on health behavior changes. It is expected that employees' lifestyles can be changed through continuous health promotion programs.
Blood Pressure ; Cardiovascular Diseases* ; Compliance ; Surveys and Questionnaires ; Gyeonggi-do ; Health Behavior ; Health Promotion ; Hyperlipidemias ; Hypertension ; Life Style ; Occupational Health* ; Physical Examination

The main purposes of this study were to determine the interval between the onset of symptoms of myocardial infarction and treatment-seeking time and identify the factors related to the interval time. This study used a retrospective design, The sample consisted of 45 patients aged over 30 who were diagnosed with an acute myocardial infarction at two large university affiliated medical center from September 1, 1997 to June 30, 1998. Data was collected by using questionnaires, which included demographic data, premonitory clinical signs and symptoms of myocardial infarction, and a measure of the severity of the signs and symptoms. Also semi-structured interviews and chart reviews were used to obtain information related to treatment seeking time. The results of this study are summarized as follows: 1. The most frequent premonitory clinical symptom was chest pain(92.9%), the second, was perspiration(81.0%), and the next were nausea(40.5%) and dyspnea(38.1%). Thirty two patients reported having more than four premonitory signs and symptoms. Patients described the characteristics of chest pain as "something very heavy pressing down "(26.2%), "felt like my chest would burst"(24.4%), or "sharp pain"(16.7%). Over 95% of the sample reported having chest pain. 2. Twenty two (52.4%) patients reported to have "very severe" premonitory pain. 3. The mean time interval between the onset of signs and symptoms and the arrival at the medical center was 6.39+/-0.80 hours in 42 samples, the mean time from the onset to arrival at a local hospital was 3.27+/-.39 hours and for transfer from a local hospital to the medical center was 4.75+/-.87 hours in patients who had arrived at medical center via local hospital. 4. The severity of premonitory signs and symptoms did not differ significantly according to existence of premonitory signs and symptoms. 5. There was no significant relationship between treatment-seeking time and age, gender, marital status, economic status, occupation, or residence. But education had significant relationship(r=-0.51, p=0.01). Analysis of difference of the time interval according to the premonitory signs and symptoms showed that the time was shorter in patients who experienced nausea or dysnea(U=115.50, p=0.01, U=132.00, p=0.04), however the severity of premonitory signs and symptoms did not have statistical significance.
Chest Pain ; Education ; Humans ; Marital Status ; Myocardial Infarction* ; Nausea ; Occupations ; Surveys and Questionnaires ; Retrospective Studies ; Thorax

The purpose of this study was to determine the impact of situational, clinical and psychsoical factors on treatment-seeking behavior among those with acute myocardial infarction(AMI). This study used a retrospective, descriptive design. The sample consisted of 72 patients aged over 30 and who were diagnosed with an acute myocardial infarction at two large university-affiliated medical centers from July 1, 1998 to March 30, 2000. But of 72, patients 5 who were an outlier in treatment-seeking time were deleted. Data were collected by using questionnaires, which included demographic data, situational, clinical and psychosocial data. Also patient interviews and chart review were used to obtain information related to treatment-seeking time. The results of this study were summarized as follows; 1. Mean time from the onset of AMI symptoms to arrival at the hospital was 12.09 +/- 11.44 hours; 2. Treatment-seeking time was not significantly different by age, gender, or education; 3. Most(44 or 65.78%) patients were at home when they began having AMI symptoms. The remaining patients were either in a public area, workplace or in a car. Patients at home delayed longer than those who had their first symptoms elsewhere, but not significantly different. Also, most patients were with another person when they began to experience AMI symptoms: a spouse(25 or 37.3%), other family member(31 or 46.3%); the remaining 11 were alone. There were no significant differences in treatment-seeking time based on whether alone or with others. Most patients(46 or 68.7%) used an ambulance rather than taking private transportation, and patients who used an ambulance were delayed longer than those who used private transportation, but there were no significant differences; 4. Time to treatment-seeking was not significantly different by blood pressure, heart rate on admission and the peak CK-MB, CPK and Cholesterol level, Killips class; 5. There were no significant statistical differences in treament-seeking times by anxiety level, mood status or control ability.
Ambulances ; Anxiety ; Blood Pressure ; Cholesterol ; Education ; Heart Rate ; Humans ; Myocardial Infarction* ; Psychology* ; Retrospective Studies ; Transportation ; Surveys and Questionnaires

PURPOSE: To explore what particular types of information were important to patients diagnosed with cancer. METHODS: Seventy three patients with cancer at an outpatient clinic and hospitalized patients in W Christian Hospital Korea, responded. The structured questionnaire developed by the investigator based on previous studies. RESULTS: There was a significant negative relationship between age and the score of informational need (r=-.307, p<.05). Level of education, and level of monthly income were related to level of informational need. The top three informational priorities according to the time since diagnosis were 'Self care during treatment', 'Health food and diet', 'Likelihood of recurrence', 'Follow up care' and 'Side effects'. The top three informational priorities for patients with breast cancer were 'Likelihood of recurrence', 'Metastasis possibility', 'Treatment options', and 'Side effects. For patients with stomach cancer, they were 'Follow up care', 'Healthy food and diet', 'Likelihood of recurrence', and 'Metastasis possibility', and for patients with colon/rectal cancer, they were 'Side effects', 'Healthy food and diet', 'Likelihood of recurrence', and 'Self care during treatment'. CONCLUSION: The assessment of information needs based on demographic factors and disease-related factors is critical in helping patients with cancer to manage their illness.
Ambulatory Care Facilities ; Breast Neoplasms ; Demography ; Diagnosis ; Education ; Humans ; Korea* ; Research Personnel ; Stomach Neoplasms ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to identify effects of a self-management program on symptom and functional status, health perception, and quality of life(QOL) of patients with CHF. METHODS: Patients with CHF as defined through clinical judgment using the Framingham criteria and EF<50% were enrolled in the study (experimental: 21, control: 20). The symptom focused self-management program consisted of coping behaviors for symptoms including dyspnea, chest discomfort/pain, dizziness, ankle edema, and basic self-management including medications, diets, activity, lifestyle changes. Experimental group received an educational booklet after survey, and periodic telephone follow-up by a trained nurse. Data were collected the 3rd day after admission and at 1 month, 3 months, and 6 months after discharge using questionnaires. RESULTS: Significant differences were found in the presence of symptoms, health perception, and QOL between groups during follow-up. Although no significant difference was found in functional status, the experimental group reported better functional status than the control group. CONCLUSION: By facilitating self-management of CHF using tailored interventions including education programs and telephone monitoring, it is expected that patients will be able to monitor their symptoms routinely, adhere to therapeutic regimen, and have a better QOL.
Adaptation, Psychological ; Ankle ; Diet ; Dizziness ; Dyspnea ; Edema ; Education ; Follow-Up Studies ; Heart Failure* ; Heart* ; Humans ; Judgment ; Life Style ; Pamphlets ; Quality of Life* ; Self Care* ; Telephone ; Thorax

The purpose of this study was to develop a critical pathway for case management for patients who have received Coronary Artery Bypass Graft(CABG) because of Ischemic Heart Disease(IHD) which is a factor of rising medical expenses. For this study, a conceptual framework was developed through a review of the literature including six critical pathways which are currently being used in USA. In order to identify the overall service contents required by these patients and to draw up a preliminary critical pathway, 30 cases of medical records of patients who had CABG because of IHD between January, 1995 to June, 1996 at the Cardiovascular Center of Yonsei Medical Center in Seoul were analyzed. An expert validity test was done for the preliminary critical pathway and clinical validity test was also done using seven IHD patients with CABG between November 11 and 23, 1996. After these processes, the final critical pathway was developed. The results of this study are summarized as follows : 1. The vertical axis of the critical pathway includes the following eight items, nutrition medications, consultations, activity, assessments, treatments, education discharge planning and the horizontal axis includes the time from the start of hospitalization to discharge. 2. Analysis of the 30 medical records indicated that the average length of stay was 20.2 days with the average length of stay from hospitalization day to operation day being 6.2 days, and the average length of stay from operation day to discharge day was 13.9 days. Analysis of the service contents showed that the horizontal axis of the preliminary critical pathway was set from hospitalization to the 14th post operation day and the vertical axis was set to include eight items, the contents which ought to have occurred, according to the time frames of the horizontal axis. 3. As a result of the experts validity, it was found the among the total of 571 items, there was over 83% agreement for 482 items, less than 83% for 89 items, which were then deleted and a revision of the critical pathway was done. 4. A clinical validity test was done using seven, IHD patients with CABG. During the process, three patients were deleted because they were out of the criteria the investigator set. Finally, four patients were used. The result of study indicated that only one patient was discharged on the tenth post operation day. which was one day later than the expected day. Three patients were discharged later than the expected day from three days to nine days. All the cases progressed on schedule until the operation day and the first post operation day. but from the second post operation days, there were differences between the critical pathway and the actual practice. The differences came from tests, assessments, and treatments. 5. On the basis of the results of the clinical validity test, the following revisions in the final critical pathway were made : the transfer from ICU to step down ward would be the second post operation day, and the transfer to a general ward, the fifth post operation day, for patients who complained of lack of sleep from the fifth post operation day to discharge, a sleeping pill would be prescribed, skin observations would be performed routinely from immediately after the operation until the third post operation day, and would continue if there was a sign of skin injury on the fourth post operation day, and assessment of chest pain would be done from the third post operation day, and the "stairs climbing" item, expected to be done on the ninth post operation day would be deleted. In conclusion, this critical pathway is partially applicable to the care of patients with CABG but there are some parts needed to be further investigated.
Appointments and Schedules ; Axis, Cervical Vertebra ; Case Management ; Chest Pain ; Coronary Artery Bypass* ; Coronary Vessels* ; Critical Pathways* ; Education ; Heart ; Hospitalization ; Humans ; Length of Stay ; Medical Records ; Patient Discharge ; Patients' Rooms ; Referral and Consultation ; Research Personnel ; Seoul ; Skin

The dislocation of metacarpophalangeal joint of the index is apparently rare injury and produeed by striking of the volar surface of the outstretched index against a resistent object. This injury presents certain characteristics which make it distinctly different from dislocation of the thumb or little finger. The proximal phalanx is displaced over the dorsum of the corresponding metacarpal, the hand is deformed, and the index is inclined toward the middle finger. In 1957 Kaplan reported his study about the pathological anatomy and proper treatment technique in the dislocation of the metacarpophalangeal joint of the index finger. In this type of dislocation, closed reduction, even if performed immediately after the injury, is unsuccessful, and open reduction is mandatory. The authors have experienced a case of dorsal dislocation of the metacarpophalangeal joint of the index finger developed 3 weeks prior to admission on 20 th, May, 1985.
Dislocations ; Fingers ; Hand ; Metacarpophalangeal Joint ; Strikes, Employee ; Thumb

This study examined effect of preceptorship on clinical education of senior nursing students of Y. University in Seoul. Quasi-experimental study design was used. Sixty students of pre-test and 80 of post-test participated in this study. Competency scores of the students before the clinical education(pre-competency scores) were compared with the competency scores after the clinical education(post-competency scores), and teacher evaluation scores between preceptors and clinical the data from students with preceptors(experimental group, N=22) and with clinical instructors(comparative group, N=58) were also examined. Study results indicated that the total post-competency scores were higher compared to the total pre-competency scores, and the difference was statistically significant. Among 7 sub-domains, differences were all statistically significant in 6 sub-domains except "self-esteem" domain. Competency scores of the students who had clinical education with had clinical education from clinical instructors. But the difference between those scores was not statistically significant. However, students gave higher evaluation scores to preceptors than clinical instructors. This study concluded that preceptorship did not influence much on clinical education at this time yet. However it is expected that when preceptors adjust their new roles and function them in expert education. This study recommended that for the preceptors to increase their motivation to teach students and to accept their roles, systemic rewards are needed.
Education* ; Humans ; Motivation ; Nursing* ; Preceptorship* ; Reward ; Seoul ; Students, Nursing*

OBJECTIVES: This study was conducted to identify the demand and willingness to pay for oral hygiene services among elderly people with long-term care insurance. METHODS: Our study was a cross-sectional analysis. Subjects comprised 126 elderly individuals from long-term home-care centers. A total of 28 centers were selected through convenience sampling from among 78 centers in ○○. For analysis, semi-structured questionnaires that required about 20–30 minutes to complete were used. Analysis was performed using SPSS 23.0 software. RESULTS: The overall demand for oral hygiene services was 44.4%, and willingness to pay was 31.0%. Thirty-three people (58.9%) of elderly those who have demand for an oral hygiene service were willing to pay for the service, and 64 people (91.4%) who did not have a demand were not willing to pay for it. Among those with partial dependence on brushing, 65.6% had demand for oral hygiene services and 50.0% were willing to pay costs. Among basic livelihood beneficiaries, 69.6% were willing to pay for oral hygiene services; general subjects and relievers were less willing to pay. CONCLUSIONS: The overall demand for oral hygiene services among elderly people was 44.4%, and the willingness to pay was as low as 31.0%.
Aged ; Cross-Sectional Studies ; Dental Hygienists ; Humans ; Insurance, Long-Term Care ; Long-Term Care ; Oral Hygiene