No abstract available.
Hemoglobinuria, Paroxysmal*

No abstract available.
Animals ; Mice* ; Oocytes*

PURPOSE: This study was done to identify the influence of workplace violence on anger and post traumatic stress disorder among nurses. METHODS: The research design for this study was a descriptive survey design using a random sampling. Data collection was done using self-questionnaire with 477 nurses. The collected data were analyzed by descriptive statistics, chi2-test and logistics regression. RESULTS: The incidences of total violence, verbal, physical, and sexual violence were 31.2%, 28.7%, 6.3%, 3.6% of the nurses, respectively. Anger was significantly associated with verbal violence (OR: 2.34, CI: 1.40~3.91) and physical violence (OR:4.85 CI: 1.67~14.13). Post traumatic stress disorder was significantly associated with verbal violence (OR: 15.99, CI: 9.58~26.69) and physical violence (OR: 5.37, CI: 1.66~17.40). CONCLUSION: To promote psychological health in nurses, there is a need to develop prevention programs to decrease workplace violence and to develop programs supporting psychological aspects of verbal violence that nurses experience.
Anger ; Data Collection ; Incidence ; Sex Offenses ; Stress Disorders, Traumatic ; Violence

A Preliminary study for the evaluation of the Rehabilitation Nursing Program(RNP) implemented to the 25 stroke survivors at the Day Care Program Center of National Rehabilitation Hospital in Seoul was done at 1999. The purposes of this study was to assess the psychological effects as outcome-variables such as depression. powerlessness and self efficacy of the stroke survivors who were discharged from acute care hospitals. The Rehabilitation Nursing Program (RNP) integrated with the Day Care Program for rehabilitation was implemented and the psychological outcome variables were measured by 3 psychologic instruments of Zung Depression Scale. Millers's powerlessness and the Bandura's self efficacy scale. These instruments were translated into Korean and the contents validity and the reliability were tested. The subjects were 17 males and 8 females and 52% were aged over 51 years old and 24 % were from 31 to 50 years old. Most of them(72 %) had been educated more than high school level. The contents of RNP were 8 sessions composing of self-introduction. individualized assessment, health contract and feedback, management of depression, shaving experiences, effective communication, self efficacy teaching, health information. and daily care activities. This study found that the level of depression and the powerlessness were within average level and had not been changed the level of self efficacy after RNP were somewhat higher than before, but it was not changed significantly. According to the results. the psychological state of the subjects were not changed significantly. Only the level of self efficacy was a little improved after having the RNP. Based on theses results, the RNP should be focussed on the psychological nursing care and the psychological outcome variables were retested strictly with the enough sample size.
Day Care, Medical* ; Depression ; Female ; Humans ; Male ; Middle Aged ; Nursing Care ; Rehabilitation Nursing* ; Rehabilitation* ; Sample Size ; Self Efficacy ; Seoul ; Stroke* ; Survivors*

PURPOSE: The purpose of this study is to survey health requirements of middle-aged women and their families and to provide guidelines for developing nursing interventions by describing the process of family health maintenance experienced by middle-aged women and its conceptual system. METHODS: To get saturated data, each of four researchers conducted two or three times of in-depth interview with eight middle-aged women aged between 40-64 years old and living in Seoul and Chuncheon from the 10th to the 30th of October 2004 and each interview was continued one or two hours. The Grounded theory adopted by Strauss & Corbin (1998) is a substantive theory that can explain the experiencing process of middle-aged women. RESULTS: We found that the casual condition of family health maintaining by middle-aged women was "confidence of health belief", and "pouring by body moving" was found to be its phenomenon. A textual condition that might respond to the phenomenon was "fatal roles acceptance", and intervening conditions that promote their family health were "retracing" and "gathering health information". These intervening conditions impacted middle-aged women's confidence in family health and led them to take actions/interactions such as "being a model of health", "adapting to circumstances", "do-it-myself", "taking-care" "harmonious mind" and "the pursuit of cleanness". These actions/interactions produced results such as "being stronger", "being unmanageable" and "being fruitful". CONCLUSIONS: Health confidence and practical health behaviors were observed in the process that the middle-aged female participants experienced unmanageable circumstances but they accepted their roles and responsibilities and recognized that they must be get stronger. The behaviors of health-together-with were divided into enthusiastic type, adaptation type and self-sacrificing type. Therefore middle-aged woman with the understanding of family health maintaining process as well as the theoretical system and practical principals needs to implement the intervention in acceptable level of family health process of preventing psychological and physical problems.
Family Health* ; Female ; Gangwon-do ; Health Behavior ; Humans ; Nursing ; Seoul

No abstract available.
Mycobacterium* ; Skin*

No abstract available.
Clonorchiasis* ; Clonorchis sinensis

A 42-year-old man presented with severe pancytopenia and uncontrolled epistaxis. The diagnosis of SLE was made and the pancytopenia was found to be due to myelofibrosis. The pulse therapy with methylprednisolone and maintenance therapy with prednisolone reversed both pancytopenia and myelofibrosis. Although myelofibrosis has been described in SLE, this coexistence must be very rare since there has been only 19 cases showing this combination. We report a case of SLE with myelofibrosis which was reversed by the treatment with glucocorticoid.
Adult ; Diagnosis ; Epistaxis ; Humans ; Lupus Erythematosus, Systemic* ; Methylprednisolone ; Pancytopenia ; Prednisolone ; Primary Myelofibrosis*

This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. THE SPECIFIC OBJECTIVES WERE: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i) FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the medically supervised deliveries, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. STUDY DESIGN: The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum "package" program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and "before and after" surveys were conducted to measure the change. SERVICE INPUT: This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. METHOD OF EVALUATION: a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed. b. Neverthless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the "intergration process" itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltructure, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable. Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. SUMMARY OF FINDINGS: A) PROGRAM EFFECTS AND IMPACT. 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 78% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller. 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) & delivery care (45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregnancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) EFFECTS ON INTERACTIVE LINKAGE. 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in carrying for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, 85-90% of the services provided by the health workers were other than FP/MCH, mainly for immunization such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs. 31%) and for more combined care (45% vs. 23%). C) ORGANIZATION FACTORS (ADMINISTRATIVE INTEGRATIVE ISSUES). 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub-center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwives's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea). 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through planning practice. 2) Goal consensus in FP/MCH should be made among the health workers & administrators, especially to emphasize the need of care of "wanted" child. But there is a long way to go to realize the "real" integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (ii) there should be a health sub-center director who can provide leadership training for managing the integrated program. There is a need for "organizational support", if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the management of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Workers, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.
Abortion, Induced ; Administrative Personnel ; Child ; Child Health ; Chungcheongnam-do ; Cohort Studies ; Community Health Workers ; Consensus ; Contraception ; Cooperative Behavior ; Delivery of Health Care ; Encephalitis ; Family Characteristics ; Family Health ; Family Planning Services* ; Female ; Hand ; Health Personnel ; Health Services ; House Calls ; Humans ; Immunization ; Infant ; Infant Mortality ; Insurance Benefits ; Clinical Trial* ; Jurisprudence ; Korea* ; Leadership ; Live Birth ; Local Government ; Midwifery ; Organization and Administration ; Parturition ; Population Growth ; Postnatal Care ; Pregnancy ; Prenatal Care ; Primary Health Care ; Referral and Consultation ; Social Control, Formal ; Specialization

Unsuspected pheochromocytoma in a surgical patients may lead to serial complications. These include extreme hypertension, taehycardia and cardiac arrythmias which lead to cardiac arrest, cerebrovascular accident and renal failure in the postoperative period. Pheochromocytoma arising in the urinary bladder is a rare tumor. We recently experienced a case of pheochromocytoma which was found during transurethral resection for biopsy of bladder tumor under spinal anesthesia. The blood pressure suddenly rose during resection. of the tumor. It was difficult to arrive at a correct diagnosis in this case because of the predominant bladder symptams without hypertenaive attack. Therefore, final diagnosis was made as the pheochromocytoms after histological examination. The resection of the tumor was performed under general anesthesia after careful studies. The patient was not treated during the preoperative period as she had no particular symptoms, but Regitine was glven during surgery. Regitine was used twice to control the transient hypertension during manipulation of the tumor. After removal of the tumor, the blood pressure was well regulated without vasopressor drugs. We report a case of pheochromocytoma of urinary bladder with successful anesthesia management and the use of neuroleptanesthetics.
Anesthesia ; Anesthesia, General ; Anesthesia, Spinal ; Arrhythmias, Cardiac ; Biopsy ; Blood Pressure ; Diagnosis ; Heart Arrest ; Humans ; Hypertension ; Phentolamine ; Pheochromocytoma* ; Postoperative Period ; Preoperative Period ; Renal Insufficiency ; Stroke ; Urinary Bladder Neoplasms* ; Urinary Bladder*