The purpose of this study was to find out women's need and level of knowledge about episiotomy, pain and discomfort related to episiotomy on a cross-sectional survey design. The subjects were 102 postpartal women agreed on oral consent. 34 postpartal women admitted at obstetric ward of H university hospital, 34 postpartal women admitted at 2 Sanhujoriwons, and 34 women within one year afterbirth. They were selected in Seoul, Korea. Data were collected from July, 1 to September 30, 2000, by a structured questionnaire. The instrument used for this study was a questionaire consisted of 5 items of general characteristics, 12 items of obstetric characteristics, 10 items of level of knowledge (Chronbach alpha .8176), 8 items of need of education(Chronbach alpha.8836), 3 items of pain (Chronbach alpha.9252), and 3 items of discomfort (Chronbach alpha.8092). The data were analyzed by the SPSS/PC+ program using t-test, ANOVA and Scheffe test as a post hoc and Pearson Correlation Coefficient. The results of the study were as follows; 1. 63.2% of respondents had right answer on 6-8 items among 10 items. Only 4.4% of women got right answer on 10 items all. 2. The need of education was high(4.45%) on all items and the range of score was 4.25~4.64. 3. The strength of pain was the highest within one week afterbirth(5.93/10) and became lower in 8-14 days afterbirth(2.55). And after 15days of postpartum, the pain level became to the lowest level(1.08). However, pain was delayed until more than one month afterbirth. 4. The level of discomfort was the highest one week afterbirth(6.88/10) and became lower in 8-14 days afterbirth(4.20). And after 15days of postpartum, the discomfort level became to the lowest level(2.47). Universally, the degree of discomfort was higher than pain. 5. There was a strong positive correlation between discomforts and pain (r=.752**) and weak positive correlation between discomforts and the level of educational need(r=.308*). In conclusion, women have a right to choose whether she will have episiotomy or not according to her decision making based on the comprehensive knowledge of episiotomy before they get episiotomy with consent process and explanation in detail. Women health care providers like nurses have a responsibility to do conscious raising and empowerment for women so that they could lead themselves to choose given medical treatments for women's health and wellbeing and the quality of life in her life cycle.
Cross-Sectional Studies ; Decision Making ; Education ; Episiotomy* ; Female ; Humans ; Korea ; Life Cycle Stages ; Postpartum Period ; Power (Psychology) ; Quality of Life ; Surveys and Questionnaires ; Seoul ; Women's Health

BACKGROUND: Ventilator-associated pneumonia (VAP) is the most severe form of nosocomial infection. However the actual incidence of pneumonia associated with ventilator is not known. The purpose of this study is to examine the incidence of VAP, find out related risk factors, and establish effective preventive measures. METHODS: The medical records of 172 consecutive patients, who have been admitted to the intensive care unit (ICU) from January 2005 to October 2005 and were subjected to mechanical ventilation for more than 48 hours, have been reviewed retrospectively. VAP was defined according to the definition of CDC (1992). The statistical software SPSS (version 12.0) was used to conduct descriptive and comparative analysis including Chi-square, student's t-test, and logistic regression. RESULTS: The incidence was 163 per 1,000 persons and 19.0 per 1,000 ventilator use patient-days. The significant risk factors for VAP were type of ICU (surgical ICU, OR=5.942, 95% CI=1.894-8.644) and duration of ventilator use (OR=3.603, 95% CI=1.810-7.173). VAP developed 3.04 (+/-0.88) days after initiating mechanical ventilation. Causative agents of VAP were Acinetobacter baumanii (35.2%), MRSA (18.8%), Enterobacter aerogenes (12.4%), Klebsiella pneumonia (9.4%), Staphylococcus aureus (6.3%), Burkholderia (6.3%), Serratia marcesceus (6.3%), Stenotrophomonas (3.1%), and Pseudomonas (3.1%) spp. CONCLUSION: Type of ICU (surgical ICU, OR=5.942, 95% CI=1.894-18.644) and duration of ventilator use (OR=3.603, 95% CI=1.810-7.173) were considered to increase the incidence of VAP. Further study with larger number of cases and preventive measures would be necessary to identify risk factors related to the ventilator-associated pneumonia.
Acinetobacter ; Burkholderia ; Centers for Disease Control and Prevention (U.S.) ; Cross Infection ; Enterobacter aerogenes ; Humans ; Incidence ; Critical Care ; Intensive Care Units ; Klebsiella ; Medical Records ; Methicillin-Resistant Staphylococcus aureus ; Pneumonia ; Pneumonia, Ventilator-Associated ; Pseudomonas ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Serratia ; Staphylococcus aureus ; Stenotrophomonas ; Tertiary Care Centers ; Ventilators, Mechanical

PURPOSE: This study was conducted to identify the effects of educational video program delivered using Tablet PC on physical discomfort, uncertainty, state anxiety, and nursing education satisfaction among early gastric cancer patients undergoing endoscopic submucosal dissection. METHODS: The study design was nonequivalent control group pretest-posttest design. The subjects were 60 patients who were hospitalized to undergo endoscopic submucosal dissection. The experimental group watched educational video using Tablet PC (n=30) and the control group received only the usual education (n=30). The collected data were analyzed using independent t-test to examine study hypothesis. RESULTS: The level of physical discomfort (t=3.05, p=.003) and nursing education satisfaction (t=−2.20, p=.032) in the experimental group were significantly different from that of the control group. However, the level of uncertainty (t=−0.82, p=.418) and state anxiety (t=−1.69, p=.097) in the experimental group were not different from that of the control group. CONCLUSION: The study findings confirm that the educational video program delivered using Tablet PC as an effective intervention alleviating physical discomfort and improving satisfaction regarding nursing education among early gastric cancer patients undergoing endoscopic submucosal dissection. Based on the findings, we believe that the educational video program can be helpful in decreaseing physical discomfort, and it also can be utilized to improve nursing education satisfaction.
Anxiety ; Education ; Education, Nursing ; Endoscopy ; Humans ; Nursing ; Stomach Neoplasms ; Uncertainty

OBJECTIVES: Although the nationwide inoculation rate of varicella vaccine was approximately 95% in Korean children recently, the number of notified varicella cases is unexpectedly continuously increasing till now. To suggest some hypotheses regarding this discrepancy, an age-period-cohort (APC) analysis as a descriptive epidemiology study was conducted for children residing in Jeju-do, Korea. METHODS: The raw data were obtained from the nationwide database for insurance claim of healthcare fee provided by the National Health Insurance Service, Korea. The selection criteria were children aged 2–13 years who visited any healthcare center due to varicella from 2005 to 2016 while residing in Jeju-do. After calculating the birth cohort-specific crude incidence rates by age and year, the intrinsic estimator method was used to perform the APC analysis. RESULTS: As the annual crude incidence rates decreased with increasing age between 2005 and 2016, the age and period effects also decreased. The intrinsic estimator coefficients suggesting the cohort effect shifted from positive to negative in 2011, the starting year of free varicella vaccine program in Jeju-do. CONCLUSIONS: The results suggested that inoculated varicella vaccines have preventive effects. However, further studies to evaluate waning immunity would be needed.
Chickenpox Vaccine ; Chickenpox* ; Child* ; Cohort Effect ; Delivery of Health Care ; Epidemiology ; Fees and Charges ; Humans ; Immunization Programs ; Immunization Schedule ; Incidence* ; Insurance ; Jeju-do* ; Korea* ; Measles-Mumps-Rubella Vaccine ; Methods ; National Health Programs ; Parturition ; Patient Selection ; Vaccines

OBJECTIVES: Outbreaks of scarlet fever in Mexico in 1999, Hong Kong and mainland China in 2011, and England in 2014-2016 have received global attention, and the number of notified cases in Korean children, including in Jeju Province, has also increased since 2010. To identify relevant hypotheses regarding this emerging outbreak, an age-period-cohort (APC) analysis of scarlet fever incidence was conducted among children in Jeju Province, Korea. METHODS: This study analyzed data from the nationwide insurance claims database administered by the Korean National Health Insurance Service. The inclusion criteria were children aged ≤14 years residing in Jeju Province, Korea who received any form of healthcare for scarlet fever from 2002 to 2016. The age and year variables were categorized into 5 groups, respectively. After calculating the crude incidence rate (CIR) for age and calendar year groups, the intrinsic estimator (IE) method was applied to conduct the APC analysis. RESULTS: In total, 2345 cases were identified from 2002 to 2016. Scarlet fever was most common in the 0-2 age group, and boys presented more cases than girls. Since the CIR decreased with age between 2002 and 2016, the age and period effect decreased in all observed years. The IE coefficients suggesting a cohort effect shifted from negative to positive in 2009. CONCLUSIONS: The results suggest that the recent outbreak of scarlet fever among children in Jeju Province might be explained through the cohort effect. As children born after 2009 showed a higher risk of scarlet fever, further descriptive epidemiological studies are needed.
Child ; China ; Cohort Effect ; Delivery of Health Care ; Disease Outbreaks ; England ; Epidemiologic Studies ; Exotoxins ; Female ; Hong Kong ; Humans ; Incidence ; Insurance ; Korea ; Methods ; Mexico ; National Health Programs ; Scarlet Fever ; Streptococcus pyogenes

OBJECTIVES: Although the nationwide inoculation rate of varicella vaccine was approximately 95% in Korean children recently, the number of notified varicella cases is unexpectedly continuously increasing till now. To suggest some hypotheses regarding this discrepancy, an age-period-cohort (APC) analysis as a descriptive epidemiology study was conducted for children residing in Jeju-do, Korea.METHODS: The raw data were obtained from the nationwide database for insurance claim of healthcare fee provided by the National Health Insurance Service, Korea. The selection criteria were children aged 2–13 years who visited any healthcare center due to varicella from 2005 to 2016 while residing in Jeju-do. After calculating the birth cohort-specific crude incidence rates by age and year, the intrinsic estimator method was used to perform the APC analysis.RESULTS: As the annual crude incidence rates decreased with increasing age between 2005 and 2016, the age and period effects also decreased. The intrinsic estimator coefficients suggesting the cohort effect shifted from positive to negative in 2011, the starting year of free varicella vaccine program in Jeju-do.CONCLUSIONS: The results suggested that inoculated varicella vaccines have preventive effects. However, further studies to evaluate waning immunity would be needed.
Chickenpox Vaccine ; Chickenpox ; Child ; Cohort Effect ; Delivery of Health Care ; Epidemiology ; Fees and Charges ; Humans ; Immunization Programs ; Immunization Schedule ; Incidence ; Insurance ; Jeju-do ; Korea ; Measles-Mumps-Rubella Vaccine ; Methods ; National Health Programs ; Parturition ; Patient Selection ; Vaccines

OBJECTIVES: Although the nationwide inoculation rate of varicella vaccine was approximately 95% in Korean children recently, the number of notified varicella cases is unexpectedly continuously increasing till now. To suggest some hypotheses regarding this discrepancy, an age-period-cohort (APC) analysis as a descriptive epidemiology study was conducted for children residing in Jeju-do, Korea. METHODS: The raw data were obtained from the nationwide database for insurance claim of healthcare fee provided by the National Health Insurance Service, Korea. The selection criteria were children aged 2–13 years who visited any healthcare center due to varicella from 2005 to 2016 while residing in Jeju-do. After calculating the birth cohort-specific crude incidence rates by age and year, the intrinsic estimator method was used to perform the APC analysis. RESULTS: As the annual crude incidence rates decreased with increasing age between 2005 and 2016, the age and period effects also decreased. The intrinsic estimator coefficients suggesting the cohort effect shifted from positive to negative in 2011, the starting year of free varicella vaccine program in Jeju-do. CONCLUSIONS The results suggested that inoculated varicella vaccines have preventive effects. However, further studies to evaluate waning immunity would be needed.

OBJECTIVES: Outbreaks of scarlet fever in Mexico in 1999, Hong Kong and mainland China in 2011, and England in 2014-2016 have received global attention, and the number of notified cases in Korean children, including in Jeju Province, has also increased since 2010. To identify relevant hypotheses regarding this emerging outbreak, an age-period-cohort (APC) analysis of scarlet fever incidence was conducted among children in Jeju Province, Korea. METHODS: This study analyzed data from the nationwide insurance claims database administered by the Korean National Health Insurance Service. The inclusion criteria were children aged ≤14 years residing in Jeju Province, Korea who received any form of healthcare for scarlet fever from 2002 to 2016. The age and year variables were categorized into 5 groups, respectively. After calculating the crude incidence rate (CIR) for age and calendar year groups, the intrinsic estimator (IE) method was applied to conduct the APC analysis. RESULTS: In total, 2345 cases were identified from 2002 to 2016. Scarlet fever was most common in the 0-2 age group, and boys presented more cases than girls. Since the CIR decreased with age between 2002 and 2016, the age and period effect decreased in all observed years. The IE coefficients suggesting a cohort effect shifted from negative to positive in 2009. CONCLUSIONS The results suggest that the recent outbreak of scarlet fever among children in Jeju Province might be explained through the cohort effect. As children born after 2009 showed a higher risk of scarlet fever, further descriptive epidemiological studies are needed.

PURPOSE: This study identified the relationship between dietary habits and health-related behaviors depending on the Big Five personality factors (extraversion, openness, agreeableness, conscientiousness, neuroticism). METHODS: The NEO-II test was administered to 337 male and female college students in Seongnam City, Gyeonggi Province, and their dietary habits and health-related behaviors were surveyed. RESULTS: The male participants showed higher scores for extraversion, openness, agreeableness, and conscientiousness compared to that of their female counterparts, while the female participants showed higher scores for neuroticism. As for the results of multivariate logistic regression analysis, in the case of men, higher scores for extraversion were related to a lower intake of instant/fast foods and a higher intake of vegetables; higher agreeableness scores were related to a lower intake of fruit; and higher neuroticism scores were related to a heavy intake of high-cholesterol foods. It was found that higher openness scores were associated with a higher intake of burnt fish/meat and a lower intake of animal fat, while higher agreeableness scores were related to a lower intake of burnt fish/meat in women. Also, those subjects with higher openness and agreeableness scores were found to better consider the nutritional balance when having a meal. In the case of the male participants, higher openness scores were related to increased physical activity, while higher neuroticism scores were related to increased smoking and a lack of sleep. As for the women, those with higher extraversion scores smoked more, while those who recorded higher agreeableness scores were involved in more physical activities. CONCLUSION Differences were observed in dietary habits and health-related behaviors between men and women depending on personality factors, and the analysis results of some dietary habits according to personality factors were inconsistent with those of the overseas studies. Therefore, to provide customized nutritional counseling when considering each individual's personality factors, more research results from domestic samples should be collected and accumulated.

BACKGROUND: Primary multidrug-resistant tuberculosis is defined as Mycobacterium tuberculosis isolates that are resistant to at least isoniazid and rifampin in never-been-treated tuberculosis patients, and this malady is caused by the transmission of a resistant strain from one patient, who is infected with a resistant Mycobacterium tuberculosis strain, to another patient. The prevalence of primary multidrug-resistant tuberculosis could be a good indicator of the performance of tuberculosis control programs in recent years. We conducted a case-control study to identify the risk factors for primary multidrug-resistant tuberculosis. METHODS: From January 1, 2001 to, June 30, 2003, by conducting prospective laboratory-based surveillance, we identified 29 hospitalized patients with P-MDRTB and these patients constituted a case group in this study. The controls were represented by all the patients with culture-confirmed drug susceptible tuberculosis who were admitted to National Masan Hospital during the same study period. The odds ratios for the patients with primary multidrug-resistant tuberculosis, as compared with those of the patients with drug susceptible tuberculosis, were calculated for each categorical variable with 95% confidence intervals. RESULTS: Multivariate logistic regression showed that the presence of diabetes mellitus (odds ratio 2.68; 95% confidence interval, 1.05-6.86) was independently associated with having primary multidrug-resistant tuberculosis. CONCLUSION: This study has shown that diabetes mellitus might be one of the risk factors for primary multidrug-resistant tuberculosis.
Case-Control Studies ; Diabetes Mellitus ; Drug Resistance ; Humans ; Isoniazid ; Logistic Models ; Mycobacterium tuberculosis ; Odds Ratio ; Prevalence ; Prospective Studies ; Rifampin ; Risk Factors* ; Tuberculosis* ; Tuberculosis, Multidrug-Resistant