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

OBJECTIVES: We previously developed a dish-based semi-quantitative food frequency questionnaire (FFQ) for Korean adolescents and reported that it had reasonable reliability and validity. The objective of the current study was to construct a web-based dietary evaluation system applying the FFQ for Korean adolescents and examine its applicability in the context of reliability and validity. METHODS: A web-based food frequency questionnaire system was designed using a comprehensive approach, incorporating not only dietary data survey but also up-to-date nutrition information and individualized eating behavior guidelines. A convenience sample of 50 boys and girls aged 12~18 years agreed to participate in the study and completed the FFQ twice and 3 days of dietary recall on the developed website during a two-month period. The FFQ’s reliability and validity was examined using correlation and cross classification analysis. We also measured participants’ subjective levels of the web site’s usability, visual effect, understanding, and familiarity. RESULTS: Spearman correlation coefficients for reliability ranged from 0.74 (for vitamin A) to 0.94 (for energy). From cross-classification analyses, the proportion of subjects in the same intake quartile was highest for energy (82.0%) and lowest for vitamin A (56.0%). With regard to validity analysis, Spearman correlation coefficients ranged from 0.34 (for fiber) to 0.79 (for energy). The proportions of subjects in the opposite categories between the first FFQ and 3-day diet recall data were generally low from 0.00% (for fat) to 36.2% (for sodium). Average subjective levels of the website’s usability, visual effect, understanding, and familiarity were all found to be over 4 points out of 5 points. CONCLUSIONS: The web-based dietary evaluation system developed can serve as a valid and attractive tool for administering FFQ to Korean adolescents.
Adolescent* ; Classification ; Diet ; Feeding Behavior ; Female ; Humans ; Recognition (Psychology) ; Reproducibility of Results ; Vitamin A ; Vitamins

PURPOSE: The purpose of this study is to evaluate the costs and benefits of individual home visiting health care using secondary data and literature review. METHODS: The total number of subjects was 1,008,837. A specific program was classified into disease management, care of infant, child and women, or elderly care. The costs and effects of a program were identified from a societal perspective, and the effects were converted into monetary terms or benefits. The total cost was calculated in the way that medical expenses, travel costs and productivity losses were offset by the decrease in benefits and thus only the program budget was included in the total cost. RESULTS: The total program cost was 47.6 billion won per year and the total annual benefit was estimated at 435.6 billion won. The benefits of arthritis management were the biggest among disease management programs. The net benefit was 388.0 billion won per year and the benefit/cost ratio was 9.16. CONCLUSION: Home visiting health care was validated to be economically effective. It made a positive contribution to improving the health status of vulnerable populations and reducing medical expenses. These results suggest that home visiting care should be extended more broadly to vulnerable populations.
Aged ; Arthritis ; Budgets ; Child ; Cost-Benefit Analysis* ; Delivery of Health Care* ; Disease Management ; Efficiency ; Female ; House Calls* ; Humans ; Infant ; Vulnerable Populations

Purpose: Based on a literature review of artificial intelligence (AI) applications within nursing tasks, this study delves into the feasibility of employing AI to improve nursing practice in Korea. Methods: We used "nursing" and "artificial intelligence" as keywords to search academic databases, resulting in 96 relevant studies from an initial pool of 940.After a detailed review, 35 studies were selected for analysis based on nursing process stages. Results: AI improves nursing assessment by enhancing pain diagnosis, fall detection, and movement monitoring in older adults. It aids nursing diagnosis through clinical decision support, risk prediction, and emergency patient triage. Further, it expedites the creation of precise plans utilizing predictive models in nursing planning. AI also forecasts medication errors and reduces the nursing documentation burden for nursing implementation. Additionally, it manages (re)hospitalization risks by assessing patient risk and prognoses in nursing evaluation. Conclusion AI in Korean nursing can enhance assessment and diagnosis accuracy, promote a prevention-focused paradigm through risk prediction, and ease the burden of nursing practice amidst human resource shortages.

In this study, nutrient intake status and energy expenditure were examined to investigate the nutritional status of the elderly in a rural community. The results obtained by questionaries, the 24 hour recall method, and time-diary were as follows: The elderly men surveyed were 73.8 years old, on the average. The elderly women surveyed were 73.5 years old, on the average. The proportion of the elderly with diseases was 51.9%. Most of the subjects (86.1%) had a regular meal pattern of consuming three meals a day. The average daily energy intake of the rural elderly was much lower than the Korean RDA. The dietary assessment data showed that each energy intake of the males and the females was 79.5% and 84.3% of the RDA, respectively. The dietary intake of Ca, Fe, niacin, thiamin, and riboflavin was lower than the Korean RDA, and that of P and Vitamin C was adequate. The Fe intake was significantly different with respect to age and sex (p < 0.05). Although, in both elderly men and elderly women it decreased with age, the elderly men's intake was lower than the elderly women's. The heights of the elderly men and the elderly women was 159.7 cm and 147.5 cm, respectively, and the weights were 60.0 kg and 52.2 kg, respectively, and the BMI was in the moderate range. Heights significantly decreased with age (p < 0.05). According to daily living schedules, leisure time (11.0 hour) was the longest, physiological time (9.6 hours) was next, and work time (3.4 hours) was the shortest. Energy expenditure significantly decreased with age (p < 0.01). Energy intake also decreased with aging. Energy balance (energy expenditure/ energy intake) was 93.4% in elderly men and 104.0% in elderly women. Especially, in elderly men in the 65 to 74 age range, the energy balance was the lowest, and the nutrient intake was also much lower than that of elderly women.
Aged* ; Aging ; Appointments and Schedules ; Ascorbic Acid ; Energy Intake ; Energy Metabolism* ; Female ; Humans ; Leisure Activities ; Male ; Meals ; Niacin ; Nutritional Status* ; Riboflavin ; Rural Population* ; Weights and Measures

OBJECTIVES: Disasters exert substantial effects on the mental health of victims and bereaved populations. Thus, a systematic framework for preparing and providing psychosocial and mental health services is necessary. The current attitudes toward and knowledge of disaster mental health-related factors among the general population provides one component for development of the disaster mental health services framework. METHODS: The authors analyzed a web-based survey for disaster mental health-related factors among the general population. Responses for the knowledge and perception for the disaster mental health services were compared between people who experienced and did not experience disaster. RESULTS: One thousand and three people completed the questionnaire. One hundred and seventy (16.9%) people experienced more than one disaster. People who experienced a disaster were more disturbed by disaster broadcasting or reporting than people who had not. People who experienced a disaster gave disaster mental health services an average score 63.5. People who experienced a disaster perceived group psychotherapy and self-help meetings as less important than those who had not. The recognition of both community mental health center and disaster mental health center was higher in the experienced group than non-experienced. CONCLUSION: This study revealed that general satisfaction with the current disaster mental health service is low, particularly among people who have used disaster mental health services. A national mental health system for disaster victims should be established with consideration for efficiency, effectiveness and accessibility.
Disaster Victims ; Disasters* ; Health Policy ; Mental Health Services* ; Mental Health* ; Psychotherapy, Group ; Public Health

PURPOSE: This study compared climacteric symptoms, knowledge of menopause and menopausal management of middle aged women living in urban and rural areas. METHOD: The study subjects included 287 women aged 40-64 years in P city and G town. The instruments used in this study were a climacteric symptoms scale and knowledge of menopause and a menopausal management scale. Data was analyzed with SPSS Win 10.0. RESULT: The mean age of middle-aged women living in urban areas was 47.9 years and that of women in rural areas was 48.0 years. The mean score of the climacteric symptoms of middle-aged women living in urban and rural areas was 48.8 and 50.4 respectively, and was not significantly different. The mean score of the knowledge of menopause of middle-aged women living in urban areas was higher than that of women in rural areas (p=.017). In addition, the mean score of the menopausal management of middle-aged women living in rural areas was higher than that of women in urban areas. CONCLUSION: This study suggests that not only general characteristics but also living areas should be considered in developing nursing interventions to manage the climacteric symptoms of middle aged women.
Climacteric* ; Female ; Humans ; Menopause* ; Middle Aged* ; Nursing

PURPOSE: Mothers who give birth prematurely experience parenting stress after their babies are discharged and find it difficult to emotionally bond with them. Forming an emotional bond with a baby promotes the baby's growth and development, helps the mother cope with parenting stress after discharge, and is important for maintaining family functioning. This study aimed to identify the attachment experiences of mothers with low-birth-weight infants (LBWIs) in a follow-up program using early intervention. METHODS: A phenomenological perspective was used for this qualitative research. Data were collected from in-depth interviews with twelve mothers who participated in a follow-up program using early intervention for mothers with LBWIs from September 2017 to December 2017. Colaizzi's method was used to analyze the data. RESULTS: The experience of mothers' attachment was investigated on the basis of three categories: ‘beginning of changes in parenting methods,’ ‘forming an intimate mother–child bond,’ and ‘concerns and expectation about the child's development.’ CONCLUSION: The results indicate that the follow-up program using an early intervention designed to increase mothers' confidence in their parenting skills can promote mother' attachment and the quality of life of families with LBWIs.
Early Intervention (Education) ; Follow-Up Studies ; Growth and Development ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Methods ; Mothers ; Object Attachment ; Parenting ; Parents ; Parturition ; Qualitative Research ; Quality of Life

PURPOSE: This study was done to evaluate the adequacy of nurse staffing in integrated nursing care. METHODS: Statistical data on integrated nursing care from the National Health Insurance Corporation was used in this study. We extracted hospital data and patient data related to patient needs for nursing care. We analyzed the differences in patient needs by staffing level of each type of medical institution. RESULTS: Approximately 70% of medical institutions provided nursing care by the mid level of nurse staffing, which was 1:6, 1:10 and 1:12 in the tertiary hospital, general hospital and semi-hospital, respectively. The patients' characteristics were significantly different by hospital type. Especially, the distribution of the main diagnosis was completely different between the tertiary hospital and semi-hospital. In the tertiary hospital, the patient needs measured by severity and activities of daily living dependency were higher at higher staffing level than at lower staffing level. However, the nurse staffing was less relevant to the patient needs in the general hospital and semi-hospital. CONCLUSION: To provide high-quality nursing care, accurate workload forecasting is required at the start, and then the standard nurse staffing level can established based on workload forecasting.
Activities of Daily Living ; Diagnosis ; Forecasting ; Hospitals, General ; Humans ; National Health Programs ; Nursing Care ; Nursing ; Tertiary Care Centers

Objectives: : The purpose of this study is to investigate depression and suicide ideation according to socioeconomic changes after COVID-19 among Korean adolescent. Methods: : Data on the study population were obtained from the 16th Korea Youth Risk Behavior Web-based Survey (KYRBS). The KYRBS is a nationally representative sample of Korean adolescents (aged 12-18 years) that originally included over 103 questions in 15 domains of health-risk behaviors. In the 16th KYRBS, a total 54,948 students from 793 schools responded to the survey. Chi-square test and logistic regression analysis were conducted regarding depression and suicide ideation. Results: : This study suggests that changes in the family household before and after COVID-19 pandemic are also affecting the mental health of the adolescents. The study shows that worse change of family household is significant associations with suicidal ideation and depression. Adolescents reporting worse (AOR 1.38; 95% CI 1.38-1.57) and much worse (AOR 2.07; 95% CI 1.87-2.29) were significantly more likely to report depression. Adolescents reporting worse (AOR 1.34; 95% CI 1.34-1.60) and much worse (AOR 2.01; 95% CI 1.76-2.29) were significantly more likely to report suicide ideation. Conclusions : In this study, it was confirmed that young people from socially disadvantaged backgrounds are at high risk of suicide ideation and more depression. The results of this study suggest that we should consider improving the screening and prevention of mental health problems for adolescents with poor socioeconomic changes of COVID-19.