This study examined burdens of primary family carcgivcrs of paticnto with cerebrovascular accidents (CVA) along with related factors. In addition, their needs for support group intervention were assessed to develop a support group to reduce the burdens of caregiving. Eighty-one primary family caregivers of patients with CVAs at a general hospital in Seoul participated in this study . The patients with CVAs aged from 26 to 83 years with mean age of 63 years. About 90% of the patients had some paralysis and 56.6% suffered speech problems. Fifty-eight percent of the primary family caregivers were spouses of the patients and 80.2% were women. Primary family caregivers' burdens were assessed by the Burden Scale originally devel oped by Zarit (1980) and Novak & Geust(1989) and modified by Jang (1995) for use in Korea. The instrument consists of six subscales time-dependent burden, developmental burden, physical burden, emotional burden, social burden, and financiaI burden. The results were as follows : 1. The average of burden score was 91.7, indicating moderate to severe level of burden. The time-dependent burden was scored highest followed by physical, developmental, social, financial, and emotional burdens. 2. of the characteristics of patients, age, gender, and severity of the disease were found to be associated with the level of burden. Of the characteristics of primary family caregivers, age and educational level were significantly related to the level of burden. Time of care since the CVA and the quality of relationship between a patient and a caregiver prior to the stroke were significant situational factors affecting the level of burden. 3. The need for support group intervention for the caregivero was very high (95.1%). The earcgivcrs of patients who had a CVA for the first time showed higher levels of need compared to those of patients who had a CVA more than once. The caregivers indicated a support group held once a month near home or hospital would be welcomed. In addition, they replied that a group composed of 9 to 10 caregivers and guided by health care professionals (e.g., physicians and nurses) would be most desirable. More than 85% of the earegivers identified the areas that they wanted intervention in as follows : knowledge, skills, and resources to care for a patient with a CVA. the counsel of health care professionals, share of their experiences with those who have similar situations, stress management skills, and methods to overcome emotional isolation due to the great responsibility for a patient. Given the results, support group is expected to be an effective way to reduce the burdens of primary family caregivers of patients with CVAs. As a follow up It is necessary to examine the effect of support group intervention on the patient's recovery and rehabilitation.
Caregivers* ; Delivery of Health Care ; Female ; Hospitals, General ; Humans ; Korea ; Paralysis ; Rehabilitation ; Self-Help Groups* ; Seoul ; Spouses ; Stroke*

Unstable microsatellite repeat sequences or DNA replication errors(RER) due to defective mismatch repair genes have been reported in a subset of sporadic colorectal tumors and in most tumors of patients of hereditary nonpolyposis colorectal carcinoma(HNPCC). To elucidate the clinicopathological correlation of these RER-positive cancers, we examined 16 cases of colorectal carcinoma of different histologic subtypes(6 cases of carcinoma with no gland formation, 5 cases of mucinous carcinoma and 5 cases of gland forming carcinoma). We detected RER in five cases. The patients with RER-positive cancers had a marked preponderance of carcinoma with no gland formations out of 6 carcinomas with no gland formation were RER-positive cancers) and of cancers proximal to splenic flexure(all of the RER-positive cases were proximal colon carcinomas). We conclude that RER-positive cancers have wiique pathologic features that may be useful for the screening and counselling of patients with hereditary colon cancers.

BACKGROUND: With increase of antibiotics use and invasive procedures, infections caused by multi-resistant Acinetobacter baumannii (MRAB) are increasing. Recently, we experienced the outbreak of- nosocomial infections caused by MRAB resistant to imipenem and cefoperazone/sulbactam in intensive care units (ICU) and general ward. We analyzed the clinical characteristics of the infected patients and antibiotic susceptibility of the organisms. And surveillance cultures and IRS-PCR were performed to find out the transmission route. METHODS: We collected data from physical examination and clinical records. We performed surveillance cultures of environment, patients not infected with MRAB in ICU, and hands of health care workers. RESULTS: Between November 1996 and June 1997, 49 strains of MRAB were isolated from the 26 patients hospitalized in Kangnam St. Mary' s Hospital. The lower respiratory infection (13 cases) was the most common infection and sputum was the most common sources (47.1%). All strains of MRAB showed the same genotype. In disk diffusion test, all strains were resistant to piperacillin, gentamicin, amikacin, ceftazidime, cefoperazone/sulbactam, aztreonam, imipencm, ciprofloxacin. From the surveillance cultures, the genotypically identical strains were isolated from ventilator Y-piece, the floor of ICU, and hands of health care workers. It suggested that this strain was transmitted through ventilatory device or hands of health care workers. We instructed all the health care workers to wash hands, to disinfect hospital environment completely. Since July 1997, no further case has occurred. CONCLUSIONS: Since A. baumannii could be transmitted through ventilatory devices and the hands of health care workers, it is important to wash hands and to disinfect hospital environment completely.
Acinetobacter baumannii* ; Acinetobacter* ; Amikacin ; Anti-Bacterial Agents ; Aztreonam ; Ceftazidime ; Ciprofloxacin ; Cross Infection* ; Delivery of Health Care ; Diffusion ; Genotype ; Gentamicins ; Hand ; Humans ; Imipenem* ; Critical Care Units ; Patients' Rooms ; Physical Examination ; Piperacillin ; Sputum ; Ventilators, Mechanical

PURPOSE: The aim of this study was to describe competency in evidence-based practice (EBP) among clinical nurses and to explore critical thinking disposition (CTD) and organizational culture (OC) as possible predictors for competency in EBP. Also this study was conducted to identify baseline data for purpose of developing evidence-based OC to ensure safety of patients and to improve quality of nursing services in clinical setting. METHODS: With a descriptive correlation study design, a competency in EBP questionnaire was administered to a convenience sample of nurses (N=393) from a single general hospital in Gyeonggi Province. RESULTS: The overall mean score for competency in EBP was 3.03+/-0.53. Factors influencing competency in EBP were education (beta=0.23, p<.001), attendance at lectures on EBP (beta=0.18, p<.001), intellectual eagerness & healthy skepticism (beta=0.27, p<.001) among CTD, and hierarchy-oriented OC (beta=0.14, p=.005), which explained about 35% of the total variance. CONCLUSION: Critical thinking and competency in EBP should be part of nursing education especially for undergraduate students as well as strengthening clinical practice by activation of EBP. The results of this study that hierarchy-oriented OC, is a significant predictor for competency in EBP is difficult to accept. Its seemed to require further exploration.
Education ; Education, Nursing ; Evidence-Based Practice* ; Gyeonggi-do ; Hospitals, General ; Humans ; Lectures ; Nursing Services ; Organizational Culture ; Surveys and Questionnaires ; Statistics as Topic ; Thinking

PURPOSE: The purpose of this study was to identify factors influencing Vancomycin-resistant enterococcus infection control among nurses in intensive care units. METHOD: Data were collected from August 15 to October 14, 2007 from 188 nurses working in intensive care units. The nurses answered a 26 item-questionnaire, which included management of the cohort (14 items), hand washing (6 items) and management of the environment (6 items). Descriptive statistics, t or F test, ANOVA, and multiple regression analysis were used with SPSS PC+ 14.0 to analyze the data. RESULTS: The participant's level of awareness of Vancomycin-resistant enterococcus infection control was 3.87; that of compliance was 3.74. Significant factors influencing the level of compliance with Vancomycin-resistant enterococcus infection control were 'the level of the awareness' and 'the type of intensive care unit'. These two variables accounted for 21.0% of variance for compliance with the Vancomycin-resistant enterococcus infection control among the participants. CONCLUSION: In order to develop a strategy to increase the compliance with Vancomycin-resistant enterococcus infection control, it is necessary to be concerned about 'the level of the awareness', 'the type of intensive care unit', and 'experiences of caring for patients with Vancomycinresistant enterococcus'.
Cohort Studies ; Compliance ; Enterococcus ; Hand Disinfection ; Humans ; Infection Control ; Critical Care ; Intensive Care Units ; Vancomycin Resistance

Congenital self-healing reticulohistiocytosis (CSHRH) typically presents at birth or in the first few weeks of life as a widespread eruption of cutaneous red-brown papulonodules that resolve spontaneously without involvement of other organs. While multiple lesions are common, a solitary lesion is rare. We describe a solitary type of CSHRH in a full-term, male neonate. He had an erythematous papule with a yellowish crust on the left heel without any systemic symptoms. Four weeks later, the skin lesion had disappeared spontaneously.
Heel ; Humans ; Infant, Newborn ; Male ; Parturition ; Skin

OBJECTIVES: This study was designed with the goal of understanding the factors affecting the frequency of skipping meals of prime-aged mothers with children as well as their nutritional status. METHODS: Utilizing data from the 2010-2011 Korea National Health and Nutrition Survey, the frequency of skipping meals of mothers aged between 30 to 49 years with children aged between 3 to 11 years during a two day period was statistically analyzed. The number of meals skipped calculated and categorized into skipping no meals, skipping one meal, skipping two meals or more. RESULTS: Compared to subjects who corresponded to mean nutrient adequacy ratio(MAR) of 4 quartile, subjects who corresponded to MAR of 2 quartile had 2.766 (95% CI: 1.552-4.931) probability of being in the 1 meal skippers group, while the probability of being in the more than 2 meals skippers group was 2.743(95% CI: 1.353-5.564). Also, compared to subjects who corresponded to MAR of 4 quartile, subjects who corresponded to MAR of 1 quartile had 3.471 (95% CI: 1.871-6.442) probability of being in the 1 meal skippers group, while the odds ratio for being in the more than 2 meals skippers group was 5.258(95% CI: 2.642-10.466). CONCLUSIONS: The results have the advantage of being generalized because the study selected subjects from probability sampling of the female population of Korea. The research results showed that the elements influencing skipping meals of prime-aged mothers with children were mean nutrient adequacy ratio and the number of nutrients, under estimated average requirement intake, and others. Therefore, to encourage dietary behaviors in the right direction, an integrated approach that considers the associated factors must be realized. Future studies are needed to understand how the frequency of skipping meals of mothers affects their children.
Child* ; Female ; Humans ; Korea* ; Meals* ; Mothers* ; Nutrition Surveys* ; Nutritional Status ; Odds Ratio

PURPOSE: The purpose of this study was to investigate the nutritional status of 3~5 year old children attending kindergarten and childcare facilities in 2010 and 2014. METHODS: Data were obtained from the 2010 and 2014 Korea National Health and Nutrition Examination Surveys (KNHANES) and included 509 subjects aged 3~5 years old attending kindergarten and childcare facilities. RESULTS: In 2014, rate of skipping meals by children was 16.2%, an increase of 5.5% compared with the rate of skipping meals by children in 2010. Calcium intake in 2014 was 397.41 mg at 3 years old, 419.27 mg at 4 years old, and 414.01 mg at 5 years old. For the mean nutrient adequacy ratio (MAR) of subjects in 2010 and 2014, MAR at 3 years old (0.86) was significantly lower than those at 4 and 5 years old (0.90, 0.91) (p < 0.01). In 2010 and 2014, EAR intake at 3 years old (2.72) was significantly higher than those at 4 years old (2.14) and 5 years olds (1.92) (p < 0.01). CONCLUSION: As a result, compared with 2010 before establishment of the Children's foodservice management center, there was no improvement in the polarization of nutrient intake of children in 2014. Therefore, researchers believe that a continuous monitoring system developed by nutrition experts and children's foodservice management center are needed to improve the nutritional status of children. Of children between the ages of 3~5 years old, those with intakes under EAR were mostly 3 years old. Therefore, researchers suggest that the infant age group of KDRIs, which is classified as 1~2 years old and 3~5 years old, needs to be reestablished considering the growth and development of infants.
Calcium ; Child* ; Ear ; Growth and Development ; Humans ; Infant ; Korea* ; Meals ; Nutritional Status*

PURPOSE: The purpose of this study was to construct and test a structural equation model for pressure ulcer prevention action by clinical nurses. The Health Belief Model and the Theory of Planned Behavior were used as the basis for the study. METHODS: A structured questionnaire was completed by 251 clinical nurses to analyze the relationships between concepts of perceived benefits, perceived barriers, attitude, subjective norm, perceived control, intention to perform action and behavior. SPSS 22.0 and AMOS 22.0 programs were used to analyze the efficiency of the hypothesized model and calculate the direct and indirect effects of factors affecting pressure ulcer prevention action among clinical nurses. RESULTS: The model fitness statistics of the hypothetical model fitted to the recommended levels. Attitude, subjective norm and perceived control on pressure ulcer prevention action explained 64.2% for intention to perform prevention action. CONCLUSION: The major findings of this study indicate that it is essential to recognize improvement in positive attitude for pressure ulcer prevention action and a need for systematic education programs to increase perceived control for prevention action.
Education ; Intention ; Nursing ; Pressure Ulcer*

This study was undertaken to investigate the characterization and distribution patterns of MHC class II positive dendritic cells[DCs] and ED2 positive tissue macrophages throughout the estrous cycle and during pregnancy in the rat ovary. The immunohistochemical characterization of the cells was carried out using the monoclonal antibodies OX6 and ED2 in cryostat-cut sections. DCs were distributed in the theca cell layer of the growing and mature follicles,stroma and corpus luteum. Tissue macrophages were distributed in the theca externa of the growing and mature follicles, stroma and corpus luteum but they were smaller in number than DCs. None of DC and tissue macrophage was found in the ovum, granulosa layer and follicular cavity of the ovarian follicle. However, DCs and tissue macrophages were present in the granulosa layer and follicular cavity in the atretic follicles. Degenerating corpus luteum contained a vast number of OX6 positive cells. On the contrary, fewer tissue macrophages were founcl in the degenerating corpus luteum. More macrophages tended to be observed in the former follicular cavity and theca lutein cell layer than in the granulosa lutein cell layer of the corpus luteum. In stroma,DCs and tissue macrophages were more frequently found around the blood vessels than in the other region, however, DCs were relatively greater in number than tissue macrophages. There was no estrous cycle and pregnancy dependent variation in the numbers and distribution patterns of DCs and tissue macrophages. In conclusion, the rat ovary contains rich networks of MHC class II positive dendritic cells and ED2 positive tissue macrophages. These findings suggest the existence of a well-developed system of immunological surveillance in the rat ovary. The results of this study have potentially important implications for the understanding not only of the ovarian immune system and the pathogenesis of various ovarian diseases but also of various physiologic functions of the ovary.
Animals ; Antibodies, Monoclonal ; Blood Vessels ; Corpus Luteum ; Dendritic Cells* ; Estrous Cycle ; Female ; Immune System ; Immunologic Surveillance ; Luteal Cells ; Macrophages* ; Ovarian Diseases ; Ovarian Follicle ; Ovary* ; Ovum ; Pregnancy ; Rats* ; Theca Cells