PURPOSE: The purpose of this paper is to identify a theoretical basis of end-of-life care by examining attributes of the concept of the nurses' acceptance of patient deaths. METHODS: Walker and Avant's approach to concept analysis was used. A literature study was performed to check the usage of the concept. To identify the attributes of the concept and come up with an operational definition, we analyzed 16 qualitative studies on nurses' experiences of death of patients, published in a national science magazine from 1999 to 2015. RESULTS: The nurses' acceptance of death of patients was identified as having four attributes: acceptance through mourning, attaining insight on life and death while ruminating life, facing with fortitude and practicing human dignity. Antecedents of the concept were experiences of patient's death, confusion and conflict, negative emotions, passive responses, denial of patients' death. The consequences of the concept were found as the holistic end-of-life care and active pursuit of life. CONCLUSION: This study on the attributes of the concept of the nurses' acceptance of death of patients and it's operational definition will likely lay the foundation for applicable end-of-life care mediations and theoretical development.
Denial (Psychology) ; Grief ; Humans ; Periodicals as Topic ; Personhood ; Walkers

PURPOSE: The purpose of this study was to identify and understand nurses' experiences of the death of patients in geriatric hospitals. METHODS: Van Manen's hermeneutic phenomenological analysis was applied in the interpretation of experiential descriptions of seven nurses who had experienced the death of patients in a geriatric hospital. RESULTS: The essential subjects derived from the experience of the nurses on the death of patients in a geriatric hospital are covered in the following 7 themes. 'Placed in death site', 'Difficult repetition of death and farewell', 'Emotional waves that rushes in after farewell', 'Dilemmas in a place with no preparation to greet expected death', 'Getting dull from continually being struck with sorrow', 'Being together with living death', and 'Showing courtesy for a good farewell and living well'. CONCLUSION: The results of this research will contribute to the development of policy on all the deaths of patients in geriatric hospitals and suggest basic data that need to be applied in real practice and directions to introduce plans for realistic improvements in nursing care of deathbed patients in geriatric hospitals.
Adult ; Attitude to Death ; Emotions ; Female ; Hospice Care/*psychology ; Hospices ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Nurses/*psychology

PURPOSE: The purpose of this study was to evaluate the effectiveness of a ventilator-associated pneumonia (VAP) bundle.METHODS: This was a retrospective study that was carried out between June 2010 and October 2015. In this study, 3,224 intubated patients were included. The VAP bundle which was applied to Group 1 patients (n=470) included head-of-bed elevation to 30 degrees, cuff pressure monitorization, prophylaxis of peptic ulcer, and prophylaxis of deep vein thrombosis. The VAP bundle for Group 2 patients (n=1,914) included all the elements of the VAP bundle for Group 1 patients and one additional element which was oral care with 0.12% chlorhexidine. The VAP bundle for Group 3 patients (n=870) added sedative interruption and assessment of readiness to extubate to the VAP bundle for Group 2.RESULTS: The numbers and incidences of VAP were significantly different among the three groups. Moreover, there were significant differences among groups in ICU length of stay and mortality.CONCLUSION: Three different VAP prevention bundles made different effects in patient outcomes.
Chlorhexidine ; Humans ; Incidence ; Infection Control ; Intensive Care Units ; Length of Stay ; Mortality ; Patient Care Bundles ; Peptic Ulcer ; Pneumonia, Ventilator-Associated ; Retrospective Studies ; Venous Thrombosis

This study was conducted to examine the differences in perceived body weight and image and various lifestyles based on the self-rated health of university students when gender was adjusted. Five hundred fifty-five participants were asked their perceived health condition, and 58, 289, 160 and 48 students answered themselves as "very healthy", "healthy", "normal", and "unhealthy", respectively. As compared to the other 3 groups, "unhealthy" group showed higher proportions in dissatisfaction of body weight and negative perception of body image (P < 0.01). As health related lifestyles, "very healthy" group reported longer sleeping time than "unhealthy" group (P < 0.05), and had a higher proportion of people with regular exercise. Among the dietary behaviors, the frequencies of followings significantly different among the groups: "Regularity of meal time" (P < 0.01), "Eat protein foods more than twice a day" (P < 0.001), "Eat vegetables" (P < 0.01), "Eat fruit and fruit juice" (P < 0.01), "Eat vegetable oil added foods" (P < 0.01), "Eat seaweed" (P < 0.01), "Eat breakfast" (P < 0.01), "Modulation in animal fat and high in cholesterol intake" (P < 0.01). Particularly, higher proportion of subjects answered "very healthy" had higher frequencies (6-7 times/week) of these dietary behaviors. Overall results suggest that healthy lifestyle including adequate sleeping time, regular exercise, and good dietary behaviors might be potential factors affecting positive perception of health. In addition, positive perception of body weight and image were related with positive perception of health.
Animals ; Body Image ; Body Weight ; Cholesterol ; Fruit ; Humans ; Life Style ; Meals ; Vegetables

PURPOSE: To analyze high-resolution CT findings(HRCT) of pulmonary lymphangitic carcinomtosis(PLC) and to correlated the HRCT findings with the results of pulmonary function test(PFT). MATERIALS AND METHODS: In Twenty eight patients with radiologically and clinically proved PLC, we retrospectively reviewed HRCT scans and PFT(N=12). PLC was classified by extent and distribution of metastatic nodules and interstitial thickenings on HRCT and the findings were correlated with the results of PFT and impairment of PFT according to the degree of FEVl(forced expiratory volume in one second). RESULTS: On the basis of distribution of PLC, HRCT findings showed 20 cases of peripheral type, 3 cases of central type, and 5 cases of mixed type. In the patients with PFT diffuse type was 10 cases and localized type was 2 cases. In diffuse types, the restrictive pattern occurred in 7 cases (p<0.05) and in localized types, restrictive pattern occurred in 2 cases. Marked impairment of vital capacity was shown as restrictive pattern in 7 cases all of which were diffuse type and were consisted of peripheral type in 4 cases and mixed type in 3 cases. CONCLUSION: HRCT findings of lymphangitic carcinomatosis correlated well the type and degree of impairment of PFT. Especially in diffuse type of lymphangitic carcinomatosis, the result of pulmonary function test were prominent restrictive patterns. Marked impairment of pulmonary function occurred in patients with diffuse type and types with peripheral interstitial thickening(periphral and mixed types).
Carcinoma* ; Humans ; Respiratory Function Tests* ; Retrospective Studies ; Vital Capacity

We followed prospectively some hospital-delivered mothers to identify characteristics of those not initiated breast-feeding and predictors of breast-feeding discontinuation in monthly telephone interviews. Recruits were composed of 482 mothers who delivered their babies at one university hospital and one OB/GYN clinic in september to November 1991. Breast-feeding discontinuation was defined as switch to 100% formula lasting more than one week regardless of solid foods. Average age of the study subjects was 27.3 years of age(standard deviation 3.2). Multiple logistic regression analysis indicated native place, occupation, method of delivery and method of feeding considered to be better for maternal health were statistically significant(p<0.1) between initiators and non-initiators of breast feeding. In starting cohort(N=242) of those initiated breast-feeding, that median of breast-feeding discontinuation were 5 months and 25th and 75th percentiles were 3 and 9 months respectively. I Cox's proportional hazard model, mothers with 10~13 years of education were 2.63 times (95% confidence interval, CI 1.50~4.60 ) more likely to discontinue than those with less than 9 years of education and those with more than 13 years of education were 3.55 time (95% CI 1.99~6.33). Compared with house wife, mothers with part-time jobs were 1.99 times (95% CI 0.86~4.57) more likely to discontinue and those with employed full-time were 1.55 times (95% CI 0.96~2.51). These results suggest that the predictors of initiation and discontinuation of breast-feeding may be different and different target populations should be selected to promote initiation and to prevent discontinuation of breast-feeding according to the period after birth.
Breast Feeding ; Education ; Health Services Needs and Demand ; Humans ; Interviews as Topic ; Logistic Models ; Maternal Health ; Mothers* ; Occupations ; Parturition ; Proportional Hazards Models ; Prospective Studies ; Spouses

Heterotopic pregnancy occurs when there are coexisiting intrauterine and ectopic pregnances. It occure, more often, due to assisted reproductive technology such as IVF-ET, GIFT and increased pelvic inflammatory diseases. We present a case of heterotopic pregnancy confirmed by surgical removal of ruptured left ovarian pregnancy and sonographic finding of the intrauterine pregnancy following natural conception.
Female ; Fertilization ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Heterotopic* ; Reproductive Techniques, Assisted ; Ultrasonography

PURPOSE: This study aimed to identify nurses' job satisfaction, patients' satisfaction, and direct nursing time according to the change in grade of nursing management fee.METHODS: Descriptive design was used in this study. Nurses (n = 200) and patients (n = 200) were recruited from one university hospital in Busan. Four aspects were measured: direct nursing time, overtime, nurses' job satisfaction, and patients' satisfaction. Data were analyzed using descriptive statistics, χ2-tests, and t-tests.RESULTS: There was a significant difference in patient satisfaction (t = -2.09, p = .038) and direct nursing time (t = -4.77, p < .001) when the nurse staffing grade was changed from the level two to the level one.CONCLUSION: The findings from this study showed that a higher nurse-to-patient ratio can provide a greater amount of direct nursing time for individual patients and increase patient satisfaction.
Busan ; Fees and Charges ; Humans ; Job Satisfaction ; Nursing Staff ; Nursing ; Patient Satisfaction

The purpose of this study was to investigate the weight control attempts and related factors among 220 female college students in Seoul. Factors examined included body image, body satisfaction, interest in weight control, beliefs related to weight control, social norms, social expectations regarding subjects' body size and weight change. Data were analyzed using t-test and chi-square test(at alpha=0.05). The average height and weight of subjects were 160.7 cm, 52.2 kg respectively. BMI and body fat(%) were 20.2 and 25.2%, respectively. One hundred seventy two students(78.2%) had attempted to control their weight, mainly to lose weight, and were categorized as the weight control attempt group. Subjects used diet modification as well as unhealthy method to control weight. 48.2% in the attempt group were underweight or normal weight(by BMI), suggesting that their weight control attempts were was unnecessary. Students in the attempt group described their own size as heavier than those in the no-attempt group(p<0.01) or other girls of their age(p<0.05) ; more dissatisfied with their body size(p<0.01), and showed more interest in weight control(p<0.01). Several differences in beliefs were also noted(p<0.001). The attempt group believed less strongly in the harmful effects or difficulties in weight control and believed more strongly in the advantages of weight control. With respect to social factors, the attempt group perceived that their family and friends wanted them to be smaller than they were(p<0.001), perceived that significant others felt that they should lose weight(p<0.05). These results suggest that educational programs for college female students should start focusing on the harmful effects of excessive dieting and information about desirable weight control methods. Students should be helped to have a correct body image. In addition, educational programs should incorporate strategies to change beliefs regarding weight control, as well as modifying social expectations from significant others.
Body Image ; Body Size ; Diet ; Female* ; Food Habits ; Friends ; Humans ; Seoul ; Social Control, Formal ; Thinness

This study was carried out to see the effect of individualized diet education on the improvement of blood glucose level according to the changes of nutrient intake with the subjects of 25 people. Among 25 people who participated in diabetic education program held in Chilgok-gun public health center, Gyeongbuk, there were 15 diabetic patients(3 males and 12 females) and 10 healthy people(2 males and 8 females) and after the diet education, the results were as follows. As for clinical characteristics, the diabetic group tended to have slightly higher blood pressure than the control group, especially diastolic blood pressure of diabetic group was higher than the control group with a significant level(p<0.05). Blood glucose level measured 2 hours after the meal was higher in the diabetic group than the control group with significant level(p<0.0001). For the clinical characteristic changes before and after the diet education, the blood glucose level in the diabetic group reduced significantly(p<0.01). For the daily diet intake, intake of fat in the diabetic group increased significantly compared to the one before the education(p<0.05). When comparing the ratio of carbohydrate: protein: fat, it was changed from 72.9 : 16.2 : 12.9 before the education to 63.8 : 15.1 : 21.1 after the education. From the above results, it is necessary to perform the diet education which carries out in the health center for diabetic patients with individualized goal by stepwise way rather than as one time try, and by developing the diabetic education media which is appropriate for the patients.
Blood Glucose ; Blood Pressure ; Diabetes Mellitus ; Diet* ; Education* ; Gyeongsangbuk-do ; Humans ; Male ; Meals ; Public Health*