The purpose of this study is to demonstrate a new postoperative analgesic which minimize the physiological changes of patients. Recently, it has become popular to administer opioids to epidural space rather than intravenously or by intramuscular administration. However, the side effects of opioids have limited the usefulness of this procedure. We tried to find out a way of providing postoperative analgesia while minimizing the side effects of opioids. This study has tested the effects of administering a mixture of small doses of morphine, fentanyl and bupivacaine and epidural morphine alone. The data of this study has taken from 20 paturients who have scheduled for cesarean section. We have classified into two groups which consist of 10 paturients each. We have administered epidural morphine alone to the first group and a small doses of morphine-fentanyl-bupivacaine mixture to second group. We have evaluated analgesic effects by comparing both groups' pain scores of the operative day and of the first postoperative day and evaluated such side effects as the degree of itching, nausea, vomiting, dizziness and respiratory depression by asking to paturients. This study has found the followings: 1) Pain scores of the first group in the operative day and the first postoperative day are 1.2+/-0.4 and 0.4+/-0.5. The second group's pain scores are 0.2+/-0.4 and 0, and the second group's pain scores have significantly reduced (p<0.05). 2) Frequencies of such side effects as itching, nausea and vomiting are higher in the first group (8) than in the second group(4). In conclusion, small doses of morphine-fentanyl-bupivacaine mixture has demonstrated a more effective postoperative analgesia with minimum side effects in pain controlling after cesarean section than epidural morphine alone.
Analgesia* ; Analgesics, Opioid ; Bupivacaine ; Cesarean Section* ; Dizziness ; Epidural Space ; Female ; Fentanyl ; Humans ; Morphine* ; Nausea ; Pregnancy ; Pruritus ; Respiratory Insufficiency ; Vomiting

PURPOSE: The purposes of this study were to examine 1) functional status at 2 months after hip fracture surgery 2) health care utilization after a fall episode and 3) fear of falling experienced during first 2 months after a fall episode. METHOD: With a convenient sample of 99 elderly from six university or general hospitals with hip fracture from a fall, data were collected at 2-3 days before discharge and at 2 months after hip fracture surgery. RESULT: 1) At 2 months after hip fracture from a fall, significant proportion (25.3%) of elderly was not able to walk indoors. 2) Average length of hospital stay was 27.6 days with a range of 8 to 86 days. About 51% subjects received physical therapy during hospital stay, and only 6.1% subjects received physical therapy following discharge from the hospital. 3) Significant proportion (72.7%) had fear of falling after the fall episode. About 51% reported that they restricted their activities because they had fear of falling. CONCLUSION: Fall is a dreaded event which result in loss of independence and restriction of activity. Development and application of fall prevention program is critical especially for those with risk factors of fall.
Aged ; Delivery of Health Care* ; Hip* ; Hospitals, General ; Humans ; Length of Stay ; Risk Factors

PURPOSE: This study was done to identify the influence of nursing work environment and social support on multidimensional organizational commitment among nurses. METHODS: The survey was conducted in August 2012 with self-report questionnaire. Participants were 480 registered nurses working in one general hospital. Data were analyzed with descriptive statistics, t-test, ANOVA, Pearson correlation, and multiple regression using SPSS/WIN(16.0). RESULTS: The average scores were; for affective commitment 2.84, for continuance commitment 2.48, and for normative commitment 2.57. There were significant relationships between affective, continuance, normative commitment and sub-factors of nursing work environment and social support. The affective, continuance, and normative commitment were all influenced by 'staffing and resource adequacy' and 'nursing foundations for quality of care', sub-factors of nursing work environment. Distinctively, affective commitment was influenced by 'staffing and resource adequacy', nurses' age, 'nurse-doctor relations', 'supervisor's emotional support', 'nurse participation in hospital affairs', 'nursing foundations for quality of care', and 'supervisor's informational support', which explained 30.9% of variance in affective commitment(F=31.57, p<.001). CONCLUSION: The findings show that programs which promote supervisors' emotional and informational support are important to enhance nurses' affective commitment. Also, it is necessary to improve nursing work environment to improve nurses' organizational commitment.
Foundations ; Hospitals, General* ; Nursing* ; Surveys and Questionnaires

The purpose of this study was designed to develope and test the structural model that explains alcohol consumption behaviors among university students in Republic of Korea. The hypothetical model was constructed on the basis of the literature review and Pender's Health promotion model. Data was collected from questionnaires from 512 university students in Republic of Korea, from August to September, 2000. The reliability of instruments was adequate (Cronbach's alpha= .69-.90). Data analysis was done with SAS 6.12 for descriptive statistics and LISREL 8.13 program for covariance structural analysis. The results are as follows;1. The overall fit of the hypothetical model to the data was moderate. Thus it was modified by male and female models.2. The revised model has become parsimonious and had a better fit to the empirical data (male: x2=87.21 p=.00, GFI=.97, AGFI= .94, NFI=.99, NNFI=1.0, CN=619.17, female: x2=49.29 p=.31, GFI=.45, AGFI= .95, NFI=.99, NNFI=1.0, CN=370.02).3. Self-efficacy was most significant factor and personality of novelty seeking, reward compensation, alcohol expectancy and drinking attitude have significant effects on male alcohol consumption behavior. 4. Personality of novelty seeking was most significant factor and personality of harm avoidance, friend influence, self-efficacies, alcohol expectancy and drinking attitude have significant effects on female alcohol consumption behavior.
Alcohol Drinking* ; Compensation and Redress ; Drinking ; Female ; Friends ; Health Promotion ; Humans ; Korea* ; Male ; Models, Structural ; Surveys and Questionnaires ; Republic of Korea ; Reward ; Self Efficacy ; Statistics as Topic

Diabetes is a rapidly increasing heath care problem all over the world due to increased prevalence during past decade. Diabetic nephropathy develops in 25-30% of patients with type 1 diabetes and is the leading cause of end stage renal disease. Diabetic nephropathy is characterized by persistent proteinuria, decline in renal function, hypertension and increased cardiovascular morbidity and mortality. Early detection of diabetic nephropathy risk is an important goal because early diagnosis and treatment prevent advanced renal damage and other diabetic complications. Increased urinary albumin excretion rate is widely accepted as the first clinical sign of diabetic nephropathy. However, reduced glomerular filtration or hypertension could be the first manifestation in some diabetic patients. We need improved markers and predictors of diabetic nephropathy risk. We report a case of diabetic nephropathy and decreased glomerular filtration rate (GFR) without microalbuminuria occcured in type 1 diabetic patient.
Diabetes Complications ; Diabetic Nephropathies* ; Early Diagnosis ; Filtration ; Glomerular Filtration Rate ; Humans ; Hypertension ; Kidney Failure, Chronic ; Mortality ; Prevalence ; Proteinuria

To determine effects of the direction of the rotational work shifting on the circadian rhythm and adaptation of physiological and psychological components were investigated with nursing students. Two groups of seven volunteers participated as experimental subjects, and eight nursing students participated as a control group. The directions of rotation work shift were as follows : CW(clockwise)-shift system rotation in the direction of day shift(3 lays), evening shift(3days), off duty(1day) and night shift(5days). and CCW(counterclockwise)-shift system rotation in the reverse direction. Urinary free cortisol and 17-hydroxycorticoster oids in the urine were measured by the solid-phase radioimmunoassay and the colorimetry methods, re spectively. Plasma melatonin was measured by radioimmunoassay. The urinary free cotisol rhythm changed to ir-regular on the evening and night shift in the CCW shift system, whereas the rhythm seems to adapt on night shift in the CW shift system. The daily rhythms of urinary 17-OHCS indicate that they are well synchronized to shift work. These results show that the rotation of shift in the CW direction is more acceptable in terms of the adaptation of hormonal rhythms. These results indicate that the CCW rotation of shift work makes it more difficult for the workers to adapt on a physiological level, and has many more negative effects on nurses when compared with the CW rotation. Thus, a clockwise rotating shift systern seems to be more desirable for the optimal health and performance of nurses.
Circadian Rhythm* ; Colorimetry ; Humans ; Hydrocortisone* ; Melatonin ; Plasma ; Radioimmunoassay ; Students, Nursing ; Volunteers

PURPOSE: This study was aimed to identify gender-based health inequality and explore impacting factors on health inequality in one province in Korea. METHODS: This was an explanatory study using the secondary data on Chungnam province from the Fifth Community Health Survey from August 16 to Oct 31, 2012. Variables included in this analysis were education level, poverty, marital status, and residential community for socio-cultural characteristics and subjective health status as an indicator of health inequality. Data were analyzed by chi2-test, t-test, ANOVA, and multiple linear regression. RESULTS: There were gender inequalities and disparities in health, and these inequalities were greater in woman than in man (chi2=161.8, p<.001). The impacting factors were education level, poverty, marital status, and residential community, which was accounted for 22.6% of variances of health inequality. Among these variables, gender showed the largest influence in health inequalities. CONCLUSION: To solve health inequalities, it should be considered gender differences based on social determinants of health. It is necessary to develop long term project based on these results and the social determinants model of World Health Organization.
Chungcheongnam-do ; Education ; Female ; Health Surveys ; Humans ; Korea ; Linear Models ; Marital Status ; Poverty ; Social Determinants of Health ; Socioeconomic Factors* ; World Health Organization

Both Mycoplasma hominis (M. hominis) and Ureaplasma urealyticum (U. urealyticum) are important genital mycoplasmas which are found in the cervix, vagina and the urogenital tracts of females. It has been associated with various disease states including non-gonococcal urethritis, spontaneous abortion, low birth weight and chorioamnionitis. Moreover they can be transmitted up to 40% of infants born to infected mothers. The culture methods which is commonly used for the determination of above mycoplasmas requires special culture media and can take up to 7 days. Recently the polymerase chain reaction (PCR) has been successfully applied for the detection of pathogenic microorganisms. In this study, M. hominis and U. urealyticum were determined using PCR in 70 vaginal swabs and 48 urine samples. In a total of seventy vaginal swabs, thirteen (18.5%) and twenty four (34.3%) samples were positive for M. hominis and U. urealyticum, respectively. In forty eight urine samples, M. hominis and U. urealyticum were found in 3 cases (6.3%), respectively. Among vaginal swab and urine samples, one case was found to be coinfectious state. Amplified DNA bands were more frequently found in vaginal swabs than urine samples. This study shows that PCR is a relatively simple, fast and practical tool for the detection of M. hominis and U. urealyticum in a clinical materials instead of culture method.
Abortion, Spontaneous ; Cervix Uteri ; Chorioamnionitis ; Culture Media ; DNA ; Female ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Mothers ; Mycoplasma ; Mycoplasma hominis ; Polymerase Chain Reaction* ; Pregnancy ; Ureaplasma urealyticum ; Urethritis ; Vagina

PURPOSE: The purpose of this study was to identify the effects of sex education using multimedia program on knowledge and attitude about sex. METHOD: The subjects of this study were 282 middle school boys in seoul. The data were collected from the 4th of Jun. to 30th of Jun. 2001. This program consisted of 6 subtopics and provided 3 sessions for each class. The per-test was given before the therapy to measure variables and the post-test was performed after intervention. The data were analyzed by the SAS program using t-test. RESULT: The results of this study are as follows. After intervention, the level of knowledge and attitude were increased significantly. CONCLUSION: The sex education using multimedia program is effective in helping middle school boys improve their healthy attitudes and thoughts toward sex.
Humans ; Multimedia* ; Seoul ; Sex Education* ; Child Health

PURPOSE: The purpose of this study was to examine the meaning and essence of suicide for elderly people who had previously attempted suicide as an older person. METHODS: Giorgi's descriptive phenomenology was used for analysis. The researchers carried out in-depth interviews, recordings and memos individually with four elders. The elders were individuals who had attempted suicide sometime in the past 5 yr. They were interviewed from 5 to 10 times using open-ended questions and a semi-structural format. Demographic data were also collected. RESULTS: The meaning of suicide before a suicide attempt in older people had four core components: conflict with family, powerlessness and despair in their life with a drop in self-esteem, using internal and external resources to resolve their troubles and awareness of imminent crisis. CONCLUSION: These results of this study will increase understanding of suicide in older people by defining their subjective experience of suicide attempts and applying grounded data in the development of programs that provide concrete intervention strategies to prevent suicide in elderly people.
Aged ; Conflict (Psychology) ; Depression ; Female ; Humans ; Interviews as Topic ; Male ; Self Concept ; Self Psychology ; Suicide, Attempted/prevention & control/*psychology