Health services on industrial noisy environment have been provided only for noise-induced hearing loss management until now. But gradually, modern diseases and death have come to be related to stress and mental health deeply, therefore noise-induced mental disorder, like a stress became very important. In this point, the purpose of this study was to analyze the relationship between noise exposure level in worksite and workers' stress symptoms. This study included a survey of 786 manual workers selected from 89 worksites in 21 factories in Puchon. The results were as follows: 1. For demographic characteristics, most of the workers were males(80.8%), the 20~29 years old were 34.5% and those who graduated from high school were 65.3%. The workers whose monthly income ranged from 500,000 to 800,000 won were 37.5% and who have a religion were 47.9%. 2. For occupational characteristics, workers who had worked 1~5 years in the factories were 33.0%. Those who felt much for them workload were 43.9% and who worked more than 8 hours a day were 73.9 %. Those who were dissatisfied with their job and pay were 31.9% and 50.6%. The workers who responded ventilation condition of their worksites were bad were 51.9% and the dissatisfied with working environment of their wofksites were 45.9%. 3. Workers who were suffering from tinnitus were 53.3% and those who perceived hearing loss were 50.l%. Persons who reported they always wore earplugs at work were 35.4%. Those who felt earplugs bigger than their ears were 30.6% and those who experienced eardiseases caused by earplugs were 25.6%. 4. For the noise exposure level in worksite, workers who were exposed to 80-90dB were 30.3%, 90-100dB were 26.4% and 50~70dB were 19.2%. 5. workers' stress symptoms were significantly related to marital status and their monthly income p< 0.05). Workers who were single and had lower monthly income showed higher PSl (Psychiatric symptom Index) scores than those who were married and had higher monthly income. Higher PSl scores were also significantly related to l~2 days night-work per week, much for them workload, dissatisfaction with their job, and bad relationship with their bosses and coworkers. 6. Higher PSl scores were significantly related to severe tinnitus and perceived hearing loss p<0.001). Workers who felt the earplugs they use did not fit their ears showed significantly higher PSl scores(p<0.01). Workers who reported that they did not feel they need earplugs showed significantly higher PSl scores(p<0.05). Increased experience of eardisease caused by earplugs that did not fit were also significantly related to higher PSl scores(p<0.001). 7. The higher noise exposure level in worksite from 80dB was, the more severe stress symptoms including PSl subparts were reported; Anxiety, Anger, Depression, and cognitive disorder(p<0.001). 8. According to the results of stepwise multiple regression analysis, factors affecting workers' PSl scores were perceived hearing loss(R2=0.160), noise exposure level jn worksite(R2=0.110), relationship with coworkers, amount of workload, monthly income and relationship with bosses orderly and the total R2 of this 6 factors was 0.371. 9. The most significant factors that have impact on manual workers' stress symptoms were perceived hearing loss and noise exposure level in worksite, especially noise exposure level in the worksite was the most affective factor on the depression symptom.
Anger ; Anxiety ; Depression ; Ear ; Ear Protective Devices ; Gyeonggi-do ; Health Services ; Hearing ; Hearing Loss ; Hearing Loss, Noise-Induced ; Humans ; Marital Status ; Mental Disorders ; Mental Health ; Noise* ; Tinnitus ; Ventilation ; Workplace*

PURPOSE: This study aimed at developing a critical pathway for the children undergoing tonsillectomy. METHOD: Six steps of critical pathway developmental process were used based on the literature review. The researcher reviewed 70 medical records of children who had tonsillectomy between January 4th and April 30th, 2001. They received 76 kinds of medical services during six average hospitalization days. Five of them had post-operative bleeding problem. A professional group carefully screened 67 out of 76 medical services and adopted them with five average hospitalization days as the critical pathway framework. This framework was applied to 34 children undergoing tonsillectomy during June 1st through August 21st, 2001. RESULT: The children who used the pathways with five average hospitalization days had post-operative bleeding problem. In other words, the group who utilized the critical pathway resulted in better outcomes compared to the group who did not use the tool. CONCLUSION: Since the critical pathway is an efficient care management tool, nurses need to participate more positively participate in developing and utilizing the tool for other health problem.
Child ; Critical Pathways* ; Hemorrhage ; Hospitalization ; Humans ; Medical Records ; Methods ; Tonsillectomy*

The purpose of this study was to evaluate the knowledge level of pressure ulcer among hospital nurses through a cross-sectional survey by using the pressure ulcer knowledge assessment tool of Beitz et al.(1998). The total of subjects was 160 voluntary participants (60 were from Hospital A and 100 were from Hospital B) working at adult patients' units in two university hospitals located in the same city. None of the hospitals had expert nurses of pressure ulcer nor provided a regular pressure ulcer education program during the past one year. The survey tool consisted of 32 true-false items which were grouped into the risk factors knowledge category(13 items), the wound assessment knowledge category(4 items), and the treatment methods knowledge category(15 items). An internal consistency reliability test of the tool yielded an overall coefficient of 0.72; the coefficient for the risk factors knowledge category was 0.40, that for the wound assessment knowledge category was 0.33; that for the treatment knowledge category was 0.54. The main findings of the study are as follows. 1)Demographic characteristics of the two hospital nurses were similar except for the educational level(p=0.029) and the work units(p=0.001). These observations were maintained even if Hospital A and B were separately compared. 2)The knowledge level of the subjects about pressure ulcer in general was low as indicated by 53.3 points(of 100 possible points) on average. The knowledge level about treatment methods of pressure ulcer was the lowest as indicated by 47.0 points on average. 3)No correlation between the knowledge level of the pressure ulcer and the demographic characteristics of nurses was found except that the knowledge level of I.C.U. nurses was significantly higher(p=0.0003) than that of nurses in other units(p=0.2926) in the case of Hospital A. 4)The knowledge level of nurses in Hospital B was higher than for nurses in Hospital A. The reason was not identified, but it seems that it is related to the role of the I.C.U. or some other factors. The study results confirmed the existing literature that knowledge level of nurses about pressure ulcer is low regardless of age, educational level, or work experience. However, the working place(unit) affected the knowledge level. Further research on the exact reason for the differences in the knowledge level is needed in the future.
Adult ; Cross-Sectional Studies ; Education ; Hospitals, University ; Humans ; Pressure Ulcer* ; Risk Factors ; Wounds and Injuries

This descriptive study identifies nursing students' methods of studying related to the learning stages, based on a sample of 251 nursing students in a Korean university. The main findings of the study are as follows. The major learning styles of nursing students were accomodation (68.6%), divergen (53.6%), and convergence (38.8%) for the first, second, third, and fourth year group. For all students, the majority (71.3%) showed accomodation or the divergence. The learning styles for grade level were significantly different, (x2=110.021, df=9, p=0.001). The stage of concrete experience was the majority for all of the first year group (51.8%), the second year group (57.1%), and the third year group (61.3%). But, active experimentation (41.9%) was the majority for the fourth year group. Also there were significant differences between the stages of learning by age (x22= 64.391, df=9, p=0.001). The most significant result of the study was the establishment of different modes of learning stages by year, thus supporting the experiential learning theory. The greatest change of style from the first year group to the second year group was reflective observation (7.3%-->12.9%). That from the second year group to the third year group was the abstractive conceptualization (14.3%-->21.3%); and that from the third year group to the fourth year group was active experimentation (12.0%-->41.9%). This reflects the same cycle as indicated by the experimental learning theory of Kolb. According to the study, nursing students' learning stages tended to be more unbalanced as year increases. Therefore this calls for a careful review of the current nursing curriculum.
Curriculum ; Humans ; Learning* ; Nursing* ; Problem-Based Learning ; Students, Nursing

No abstract available.
Cartilage* ; Rabbits* ; Ribs*

Authors presented the gratifying result of treatment of chronic osteomyelitis with overlying skin defect and/or poor skin condition, which developed the wide skin necrosis after saucerization and resulted the second skin graft necessary. Five cases were treated by primary extensive saucerization of tibia which left a cavity with bleeding walls. The exposed bony surface with bleeding walls was covered by delayed free skin graft when the good granulation covered the bony surface. Through this experience, delayed free skin graft is justified the best procedure in these cases to cover the post-surgical raw bone surface and to have primary healing of the bone infection. A method of hemicylindrical pedunculated skin graft to obliterate the deeply excavated surgical bony defect is introduced.
Hemorrhage ; Methods ; Necrosis ; Osteomyelitis ; Skin ; Tibia ; Transplants

It is well-known that early diagnosis and treatment is still the most important aspect of congenital dislocation of the hip. However, the orthopaedist can not see the cbildren with dislocated hip before they begin to Walk, especially in the developing countries. When the children with dislocated hips are discovered lately,it is impossible to reduce the hip by simple manipulation, and also is very difficult to maintain the reduction successfully. Our method of treatment was based on the concept that the various components of the abnormal joint will develop satisfactorily into a normal hip provided acccurate congrucus and concentric reduction is obtained as early as possible to take advantage of the maximum growth potential, and is maintained throughout growth, In this study 16 children with 18 dislocated hips among the 75 children with congenitally dislocated hips were primarily treated by open reduction,followed by 3 weeks of temporary fixation of reduced hip by Kirschner wire and 6 weeks of cast immobilization from November 1973 to April 1979. They were clinically and roentgenologically analized. The end results of treatment were assessed by 3 roent- genological determinants; the medial joint space, the acetabular angle and the centeredge angle. The results obtained were as follows: 1. The pathologically widened medial joint space of hip or hips decreased rapidly during first 6 months after reduction, irrespective of the age at reduction, and satisfactory results were obtained in 83 per cent indicated by joint space distance less than 10 mm. 2. Postoperative Kirschner wire fixation of reduced hip to maintain the reduced position did not impair the physeal growth or bring the joint stiffness. 3. The acetabular angle improved rapidly during the first year after reduction in all age groups of patients and thereafter the rate of acetabular development decreased, but the acetabular angle continued to improve throughout the period of observation and satisfactorily (less than 25 degrees) developed in 83 per cent of children. 4. The center-edge angle increased rapidly during first three months after reduction and was satisfactory (more than 20 degrees) in 78 per cent. Overall success rate of treatment was 81.3 per cent. 5. Assessment of end results by medial joint space has more advantages in evaluating the result of treatment because of the aimplicity of it's measurement and leas error regardless of the change of patients position on roentgenagrams. 6. There were only few complications (11.1%) after surgical treatment; coxa magna in a case and resubluxation in another case were complicated. 7. Parameters utilized for assessing the results were faund to be the very helpful criteria to evaluate the hip development indicated by cephalocotyloid relation when used together. 8. Simultaneous open reduction followed by temporary internal fixation with K-wire was found to be recommendable method of treatment ae a first choice of treatment even in children under age of 3 if once nonsurgical reduction fails; because by this type of treatment more easily and accurately concentric reductions were obtained, and also reduction was more easily maintained without subsequeat redislocation.
Acetabulum ; Child ; Developing Countries ; Dislocations ; Early Diagnosis ; Hip ; Humans ; Immobilization ; Joints ; Methods

The principal cause of avulsion fracture of anterior superior iliac spine is sudden powerful contraction of sartorius muscle in strenuous sporting activities. The condition usually occurs in young people in whom the apophysis has still not firmly united to the ilium. We presented the three cases of avulsion fracture of anterior superior iliac spine which occurred during sprinting in Physical Fitness Test.
Ilium ; Physical Fitness ; Spine ; Sports

Simple posterior hip dislocations requiring open reduction is very few and reported approximately 3% of all posterior hip dislocations and we have little comments of the various causes preventing or blocking a concentric reduction following traumatic posterior hip dislocation. In a review of eleven cases of posterior dislocation requiring open reduction, we divided two groups, one is a failed closed reduction group, the other is a nonconcentric reduction group. A concentric reduction was prevented from an inverted limbus or an osteocartilagenous loose body from acetabulum or femoral head.
Acetabulum ; Dislocations ; Head ; Hip Dislocation ; Hip

PURPOSE: This ethnograpy was done to explore patterns of health care behavior in patients with chronic health problems. METHODS: The participants were 15 patients with chronic hepatitis B and 2 family members. Among the patients 4 had progressed to liver cirrhosis and liver cancer. Data were collected from iterative fieldwork in a department of internal medicine of I hospital. Data were analyzed using text analysis and taxonomic methods. RESULTS: Illness and disease, relationship between health care givers and clients, and communication patterns between health professions and clients were discussed as the context of health care behavior. Health care behavior of the participants was categorized by its focus: every day work centered, body centered, organ centered, and pathology centered. CONCLUSION: Participants' health care behavior was guided by folk health concept and constructed in the sociocultural context. Folk etiology, pathology, and interpretation of one's symptoms were influencing factors in illness behavior. These findings must be a cornerstone of culture specific care for the chronic diseases.
Activities of Daily Living ; Adult ; Aged ; Asian Continental Ancestry Group ; Attitude to Health ; Communication ; Family Relations ; Female ; *Health Behavior ; Hepatitis B, Chronic/complications/*psychology ; Humans ; Interviews as Topic ; Liver Cirrhosis/etiology ; Liver Neoplasms/etiology ; Male ; Middle Aged ; Physician-Patient Relations ; *Qualitative Research ; Republic of Korea