PURPOSE: This study measures the subjectivity on stressful life events of middle- aged women. METHOD: Q-Methodological method was used for that purpose. As for the research method, Q-statements were collected reliminary to the study of through in-depth interviews and a literature review. For the study 38 Q-statements were selected. There were 28 middle aged women as subjects for the research. Q-Factor Analysis by using PC Quanl Program to supply the material. RESULT: Through the result of this study, the stressful life events of middle-aged women could be identified by 4 types. The type I is called the conflict in relationship with husband's family members. The type II is called lack of marital intimacy. The type III is called low self-esteem. The type IV is called changing life cycle itself. CONCLUSION: Therefore, identifing the subjectivity on the stressful life events of middle-aged women would be a basic step for the understanding of middle aged women.
Female ; Humans ; Life Cycle Stages ; Middle Aged

BACKGROUND: Unexpected and uncontrolled bleeding remains the principal fear of the surgeon performing transurethral resection of prostate (TURP). Many surgeons and anesthesiologists believe the spinal anesthesia reduces blood loss during TURP. This study evaluate the effects of spinal versus general anesthetic technique on the development of postoperative coagulopathies. METHODS: 20 patients undergoing TURP were randomly allocated into 2 groups. Group I (n=10) received general anesthesia and group II (n=10), spinal anesthesia. PT (prothrombin time), PTT (partial thromboplstin time), Hb (hemoglobin), FDP (fibrin degradation product), platelet and fibrinogen were measured before induction and 24 hours postoperatively. RESULTS: There was no significant difference in measured coagulation variables between the two groups, but there was significant decrease in postoperative Hb compared to preoperative values in both groups and the effect was more pronounced in the general anesthesia than in the spinal anethesia group. CONCLUSION: It is concluded that coagulopathies after TURP is not affected by the anesthetic technique.
Anesthesia, General* ; Anesthesia, Spinal ; Blood Platelets ; Fibrinogen ; Hemorrhage ; Humans ; Transurethral Resection of Prostate*

OBJECTIVE: Health insurers and policy makers are increasingly examining the hospital mortality rate as an indicator of hospital quality and performance. To be meaningful, a risk-adjustment of the death rates must be implemented. This study reviewed 5 severity measurement methods and applied them to the same data set to determine whether judgments regarding the severity-adjusted hospital mortality rates were sensitive to the specific severity measure. METHODS: The medical records of 584 patients who underwent coronary artery bypass graft surgery in 6 general hospitals during 1996 and 1997 were reviewed by trained nurses. The MedisGroups, Disease Staging, Computerized Severity Index, APACHElll and KDRG were used to quantify severity of the patients. The predictive probability of death was calculated for each patient in the sample from a multivariate logistic regression model including the severity score, age and sex to evaluate the hospitals' performance, the ratio of the observed number of deaths to the expected number for each hospital was calculated. RESULTS: The overall in-hospital mortality rate was 7.0%, ranging from 2.7% to 15.7% depending on the particular hospital. After the severity adjustment, the mortality rates for each hospital showed little difference according to the severity measure. The 5 severity measurement methods varied in their statistical performance. All had a higher c statistic and R2 than the model containing only age and sex. There was a little difference in the relative hospital performance evaluation by the severity measure. CONCLUSION: These results suggest that judgments regarding a hospital's performance based on severity adjusted mortality can be sensitive to the severity measurement method. Although the 5 severity measures regarding hospital performance concurred, more often than would be expected by chance, the assessment of an individual hospital mortality rates varied by the different severity measurement method used.
Administrative Personnel ; Coronary Artery Bypass* ; Coronary Vessels* ; Dataset ; Hospital Mortality ; Hospitals, General ; Humans ; Insurance Carriers ; Judgment ; Logistic Models ; Medical Records ; Mortality* ; Risk Adjustment ; Severity of Illness Index ; Transplants

This study measures the subjectivity(opinions attitudes)of college women. Identifying the schemata(structure of subjectivity) would be a basic step for the women's health education and the promotion to alternative strategies of women's health nursing. More concretely, these following research questions are focused. 1) The subjective schemata: find out typologies based on the opinions and attitudes toward the health lifestyle. 2) Applications: describe the characteristics of each type. 3) Alternatives: provide suggestion of the promotion to alternative strategies for women's health nursing. Q-Methodological method was used for that purpose. As for the research method, Q-statements were preliminary collected in the study fro through in-depth interviews and a literature review. For the study 36 Q-statements were selected. 33 college women were used as subjects for research. the 33 college women sorted the 36 statements using the principle of forced Normal distribution. The principle of forced Normal Distribution, which has nine scales to measure the individual opinions, was called. Q-Factor Analysis by using PC Quanl Program to supply the material. According to the outcomes of this study, there were three categories of special opinions about the health lifestyle in college women. The first type is called Initiatived Health Management Type. the second type is called Social Activity Centered Type. the third type is called Positive Outlook Type. Through the result of this study, the health lifestyle could be identified by 3 types, therefore the nurses needed to understand each women's meaning to health lifestyle so they could develop the appropriate nursing intervention based the typology of the health lifestyle this study explore. Finally, the result of the study will provide clues for developing a nursing interventional program and alternative strategies for the health promotion lifestyle in college women.
Education ; Female ; Health Promotion ; Humans ; Life Style* ; Nursing ; Weights and Measures ; Women's Health

PURPOSE: This integrative review study was done to analyze methods used for validation studies in Korean nursing research. METHODS: In this study, the literature on instrument development in nursing research from Research Information Sharing Service (RISS) and major nursing journal databases in Korea were examined. The MeSH search terms included 'nursing', 'instrument', 'instrument development', 'validation' and 189 articles were included in the review. RESULTS: The most frequently reported validity type was content validity, followed by construct validity, and criterion validity. One third reported a single type of validity, and 15% of the studies demonstrated three kinds of validity at the same time. In about 40% of the studies, both content and construct validity were examined. CONCLUSION: The results of the study indicate that it is necessary to provide a wider variety of evidence to establish whether instruments are valid enough to use in nursing research.
Databases, Factual ; Humans ; *Nursing Research ; Republic of Korea ; Social Validity, Research

OBJECTIVE: The objective of this research is to survey the requirements of Oriental Medical Informatics, and to suggest a direction that Oriental Medical Informatics development may take. METHODS: Consumers and medical experts were randomly selected, and 14 uestions for consumers and 17 questions for medical experts were sent to respondents by mail and e-mail. RESULTS: Both consumers and medical experts were greatly concerned with the systemized dissemination of Oriental Medical Information, but they were not satisfied with it because of the perceived low quality of the information. Medical experts responded that they need standards and statistical evidences for Oriental Medicine. Consumers demanded good-quality information about diseases and health management. CONCLUSION: To carry out Oriental Medical Informatics, it is necessary to conduct a joint research between the sectors of Oriental Medicine and Information Technology, followed by the development of a standard information infrastructure. Oriental Medicine must also have standards in terms of medical data content, data format, and data communication, to ensure the reliability of the disseminated information on Oriental Medicine.
Surveys and Questionnaires ; Electronic Mail ; Joints ; Medical Informatics ; Medicine, East Asian Traditional* ; Postal Service

BACKGROUND: Acne has been recognized as a common disorder amongst adolescents but recent studies have documented increased prevalence of post-adolescent acne. OBJECTIVE: The purpose of this study was to demonstrate insulin resistance in post-adolescent acne by examining insulin, insulin like growth factor-1 (IGF-1), and insulin like growth factor binding protein-3 (IGFBP-3) compared to those in normal controls. METHODS: Twenty-eight patients with acne between 25 and 45 years and 10 control individuals were studied. We classified the post-adolescent acne into persistent and late-onset types according to onset ages. We compared clinical features and the levels of fasting insulin, IGF-1, and IGFBP-3 in persistent and late-onset type of post-adolescent acne. RESULTS: Among the post-adolescent group, there were few patients of metabolic syndrome. But, the mean serum levels of IGF-1 were significantly increased in post-adolescent acne compared to those in controls. Mean serum levels of IGFBP-3 were decreased in post-adolescent acne. Compared to persistent type, late-onset type showed more inflammatory acne lesions. Increased fasting insulin, IGF-1, and decreased IGFBP-3 in late-onset type compared to those in persistent type were observed. CONCLUSION: Results of this study indicate that insulin resistance could have a role in pathogenesis of post-adolescent acne.
Acne Vulgaris ; Adolescent ; Fasting ; Humans ; Insulin ; Insulin Resistance ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Prevalence

PURPOSE: The study was done to investigate physical assessment skills used by, and educational needs of, advanced practice nurses (APNs) and nurse specialists in Korea. METHODS: A total of 123 APNs and nurse specialists working in five major hospitals in Seoul were surveyed from July 15 to August 20, 2007. RESULTS: Fourteen skills out of 126 items were reported as being performed on a regular basis by participants. The majority of these skills involved general observation. Forty-six skills were rarely used. Some participants showed a lack of confidence in certain assessment skills, such as in doing a rectal or pelvic exam, and the use of some assessment equipment. Over 90% of participants required in-depth education on health assessment provided by specialists or nursing professional organizations. CONCLUSION: More educational opportunities in physical assessment should be provided including education programs based on the nurses' skill levels and needs. This effort will help to increase confidence of APNs and nurse specialists in physical assessment skills, ultimately resulting in better nursing outcomes.
Adult ; *Clinical Competence ; Education, Nursing, Continuing ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Middle Aged ; Nurse's Role ; Nurses/*standards ; Nursing Assessment ; Physical Examination/methods/*nursing ; Questionnaires

PURPOSE: To analyze the hyperacuity defects of preferential hyperacuity perimeter (PHP) in myopic CNV and correlate with the other macular anatomical or physiological properties obtained with fluorescein angiography (FA), Optical coherence Tomography (OCT), and central perimeter. METHODS: Seven patients with myopic CNV diagnosed by FA underwent PHP, OCT, central visual field (VF). We examined the locational correlation among FA, central VF and PHP hyperacuity defect and then compared PHP hyperacuity defect with the CNV size by OCT. Also we made a comparison with macular sensitivity change in VF and hyperacuity defects change in PHP after PDT in 4 patients. RESULTS: All the 7 eyes with myopic CNV tested positive for hyperacuity defects. 5 eyes showed locational correlation among PHP and FA, central VF. The size of hyperacuity defect of PHP and CNV size by OCT was positive correlation (p=0.007). Four eyes treated with PDT showed decrease of PHP hyperacuity defect size and changes in location according to decrease of CNV size after PDT. CONCLUSIONS: Our results suggest that the PHP may be used to detect myopic CNV and beneficial for analyzing functional effect following PDT in myopic CNV patients. These results require further validation in a larger population.
Fluorescein Angiography ; Humans ; Photochemotherapy ; Tomography, Optical Coherence ; Visual Fields

BACKGROUND: Poly-gamma glutamic acid (gamma-PGA) is a natural polymer that is synthesized by Bacillus subtilis. Because of the reported anti-tumor effect, gamma-PGA and its derivatives have attracted enormous interest in the past few years. OBJECTIVE: The anti-tumor effects of gamma-PGA against ultraviolet B (UVB) were evaluated by irradiating hairless mice with UVB. METHODS: The experimental animals were 12-week-old male Albino hairless Skh:HR-1 mice. Thirty-two mice were divided into 4 groups: a chronologic aging (control); irradiation with UVB without gamma-PGA administration (T1); irradiation with UVB and 2,000 kDa gamma-PGA orally (T2); and irradiation with UVB and 5,000 kDa gamma-PGA orally (T3). The irradiation period was 12 weeks. The anti-tumor effect of gamma-PGA was evaluated with photographs and skin biopsy. A 51Cr release assay was performed to determine nutural killer cell (NK cell) activity. RESULTS: After 20 weeks of UVB irradiation, seborrheic keratosis, actinic keratosis, Bowen's disease, squamous cell carcinoma, and basal cell carcinoma were observed on the backs of mice. The most common skin lesion was seborrheic keratosis. gamma-PGA showed inhibitory effects on the total number of skin tumors and the premalignant and malignant skin lesions induced by UVB. The NK cell activities showed a tendency to increase based on the molecular weight of gamma-PGA. CONCLUSION: We suggest that gamma-PGA shows anti-tumor effects that inhibit the tumor generation induced by UVB, and the antitumor effects are related to the molecular weight of gamma-PGA.
Aging ; Animals ; Bacillus subtilis ; Biopsy ; Bowen's Disease ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Glutamic Acid ; Humans ; Keratosis, Actinic ; Keratosis, Seborrheic ; Killer Cells, Natural ; Male ; Mice ; Mice, Hairless ; Molecular Weight ; Polyglutamic Acid ; Polymers ; Skin