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

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

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

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

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

PURPOSE: The purpose of this study was to deepen understanding the nature of the care experience by the mothers with adult children in persistent vegetative state. METHODS: Participants were 7 mothers caring for their adult children in persistent vegetative state. Data were collected individually through in-depth interviews on their lived experiences. Also texts were included as data from literary works, novels, movies, essays, and arts containing on patients with persistent vegetative state and their mothers. Data were analyzed by van Manen's phenomenological methodology. RESULTS: The essential themes of caring experiences of the mothers were as follows. The theme in relation to lived time has shown as back to the past and caring experience related lived body has emerged as locked the body in children. The theme related lived space was getting into the swamp and the theme in lived others was derived as lonely struggle into. CONCLUSION: The nature of mothers' caring experiences for adult children in persistent vegetative state is summarized as ‘Do not off hand of hope in a locked state’. This study suggests long-term supports are necessary for mothers to care persistent vegetative state children.
Adult Children* ; Adult* ; Child ; Hand ; Hope ; Humans ; Mothers ; Motion Pictures as Topic ; Persistent Vegetative State* ; Qualitative Research ; Wetlands

The radiologic and clinical findings of foreign bodies in the chest of children are well recognized. Foreign bodies in adults are infrequent, however, and the radiologic findings of these unusual circumstances have rarely been described. We classified various thoracic foreign bodies into three types according to their cause: Type I, Aspiration, Type II, Trauma or Accident; Type III, Iatrogenic. This pictorial essay will illustrate the radiologic findings and consequences of thoracic foreign bodies in adults, which have rarely been described in the radiologic literature. The clinical significance of thoracic foreign bodies will be also be discussed.
Accidents ; Adolescent ; Adult ; Aged ; Aspiration ; Esophagus/radiography ; Female ; Foreign Bodies/*etiology/*radiography ; Heart/radiography ; Human ; Iatrogenic Disease ; Male ; Middle Age ; Radiography, Thoracic ; Support, Non-U.S. Gov't ; *Thorax ; Wounds and Injuries/complications ; Wounds, Gunshot/complications

PURPOSE: The purpose of this study was to investigate the knowledge and practice level of infection managements in child guardians with respiratory infections after H1N1 diffusion of 2009. METHODS: The data were collected during February and March 2010 using a self-report questionnaire. The participants were 228 child guardians. Data were analyzed using frequency, percentage, means, SD, t-test, F-test, Pearson correlation coefficients, and Cronbach's alpha with the SPSS 17.0 program. RESULTS: Mean age of the guardians and children were 37.8 years, 4.1 years respectively. For knowledge level of respiratory infections, hand washing method had the highest score and snuffles prevention method, the lowest. For practice level for respiratory infections, environmental hygiene management had the highest score and symptom management, the lowest. Infection management knowledge and practice level had a positively significant correlation in every area. CONCLUSION: The results indicate the necessity of continual education on infection management, and that the most efficient timing for the education appears be for participants during their first pregnancy or after the woman has delivered her child.
Child ; Compliance ; Diffusion ; Female ; Hand Disinfection ; Humans ; Hygiene ; Legal Guardians ; Pregnancy ; Respiratory Tract Infections ; Child Health ; Surveys and Questionnaires

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

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