The purpose of this study was to find out the effeet of midazolam and fentanyl on oxygcn saturation by pulse oximetry in surgical patients under spinal anesthesia. The subjects of this study were 83 patients who were operated on under spinal anesthesia, at a general hospital in Pusan. from December 1st, 1997 to March 31st, 1998. The subjects of Group 1 were 53 patients who did not receive either of midazolam and fentanyl. The subjects of Group 2 were 21 patients who received midazolam. The subjects of Group 3 were 9 patients who received both midazolam and fentanyl. Oxygen saturation was measured with a pulse oximeter by time series. The collected data were analyzed by the SPSS / PC~ program and the results of the study were as follows 1. There were no significant differences among the three experimental groups in terms of age or cardiopulmonary disease. 2. Among the three groups, there were statistically significant differences in Sp02 at 5 minutes after starting the operation or after intravenous injection of drugs. The SpO2 mean for Group 3 was 92.4%, for Group 2 it was 97.7%. and for Group 1 it was 98.2%. 3. Hypoxemia cases occurred in 88.9% of Group 3, 28.6% of Group 2, and 17.0% of Group 1, respectively. It is concluded that oxygen saturation mo4oring should be done routinely to all patients under ~spinal anesthesia, especially during operating tim4. and patients receiving midazolam and fentanyl should be monitored closely. After monitoring oxygen should be administered to all patients who developed hypoxemia.
Anesthesia ; Anesthesia, Spinal* ; Anoxia ; Busan ; Fentanyl* ; Hospitals, General ; Humans ; Injections, Intravenous ; Midazolam* ; Oximetry ; Oxygen*

Diet compliance is very important issue in patients with coronary artery disease(CAD). Diet compliance needs dietetic knowledge of patients and their families basically and families support. Therefore we studied about the dietetic knowledge level and educational needs of CAD patients and their families. For this study, we developed the study tool from the literature review. This tool consists of two main categories, one is about general dietary guidelines and specific food information, and the other is about educational needs of CAD patients & their families. The data were collected from 47 CAD patients and their families from June, 30 to to Semptember, 30, 1998. And they were analyzed using frequency, percentile, paired t-test, and ANOVA by SAS/ WIN. The results of this study were as follows : The results of the analysis of dietetic knowledge were as follows. In the general dietary guidelines, CAD patients knowledge level was lower than families in the importance of diet. And both patients and families had low knowledge level in the nutrition balance, protein intake, and relationship between fiber and cholesterol. In the specific food information, CAD patients knowledge level was low in protein-contained food, cholesterol -contained food, cooking method. The results of the relationship between the knowledge level and the demographic characteristics were as follows. In patients, there were significant statistical differences in the knowledge level of general dietary guidelines according to age and educational level, and the knowledge level of food information according to sex. In families, there were significant statistical differences in the knowledge level of general dietary guidelines according to age and educational level, and the knowledge level of food information according to sex and age. The results of the analysis of educational needs were as follows. Television was most common dietetic knowledge source. The highest educational needs were about recommended/restricted food and daily menu in both CAD patients and their families In th diet compliance, low-cholesterol diet was most difficult in both CAD patients and their farnilies. In conclusion, CAD patients and their families had high educational needs but insufficient concrete knowledge in such as recommended/restricted food, daily menu and cooking method. Nurses must be aware that it is necessary to establish an concrete dietetic educational program for CAD patients and their families.
Cholesterol ; Compliance ; Cooking ; Coronary Artery Disease* ; Coronary Vessels* ; Diet ; Humans ; Nutrition Policy ; Television

BACKGROUND: This study aimed to identify the effects of a multifaceted needlestick injury (NSI) prevention program on changes in knowledge about bloodborne infectious diseases and postexposure coping, attitudes toward postexposure reporting, preventive measures, the number of NSIs, and postexposure reporting pre- and post-intervention among nurses. METHODS: A total of 429 and 420 nurses participated in the pre- and post-intervention periods, respectively. The intervention was performed from April to September 2007, comprising NSI guideline education, the use of containers with enhanced engineering, and the supply of safety devices. RESULTS: The average score of knowledge about bloodborne infectious diseases increased significantly from 8.3 to 8.9 out of 14 points (P<0.001), but the change in score of knowledge about postexposure coping was insignificant. The average score of attitude toward postexposure reporting increased significantly from 8.9 to 9.6 out of 12 points (P<0.001). Preventive measures such as "gloves are provided whenever needed" (P<0.001), "use one-hand technique" (P<0.001), and "needle containers are provided whenever needed" (P=0.031) increased significantly. The number of NSIs decreased by 40.4%, and the postexposure reporting rate increased by 552.8%. CONCLUSION: The multifaceted NSI prevention program positively affected knowledge about infectious diseases and postexposure coping, attitudes toward postexposure reporting, preventive measures, the number of NSIs, and postexposure reporting after intervention. Therefore, we recommend that this program be applied to various healthcare workers in hospitals.
Communicable Diseases ; Delivery of Health Care ; Incidence ; Needlestick Injuries ; Post-Exposure Prophylaxis

The purpose of this study was to identify risk factors predictive of alterations in skin integrity during the intraoperative period. The predictive risk factors were studied for intraoperative pressure sores from December 1998 through January 1999. A sample of 220 patients was selected from the operating room schedule of a University Hospital in Pusan. There were two criteria in including patients : the operation lasted longer than 2 hours and the absence of skin break down according to NPUAP criteria. The data were analyzed by SPSS/PC, Stepwise multiple logistic regression was used to identify the variables which were predictive of alterations in skin integrity. Of the 220 patients studied, 41 patients(18.6%) developed stage 1 pressure sores in the immediate postoperative period. In relation to skin changes, three independent variables emerged from the stepwise multiple logistic regression as being significant(p<0.05). Factors predictive of pressure sore formation included low serum albumin(p=0.000), prone position while undergoing surgery(p=0.0004), time on the operating table(p=0.0165). Among the intrinsic factors, serum albumin was the most significant causal factor in pressure sores development in the intraoperative period. Pressure and shearing force were the most significant extrinsic factors in pressure sores development. From the results of this study we conclude that the primary nursing goal is the maintenance of the proper patient' position during the intraoperative period. Also imperative for sore prevention is the reduction of surgery time and improving preoperative nutritional status.
Appointments and Schedules ; Busan ; Humans ; Intraoperative Period ; Intrinsic Factor ; Logistic Models ; Nutritional Status ; Operating Rooms ; Postoperative Period ; Pressure Ulcer* ; Primary Nursing ; Prone Position ; Prospective Studies* ; Risk Factors* ; Serum Albumin ; Skin

We conducted this cohort analytic study to determine whether women with unexplained elevations of maternal serum hCG at 15-18 weeks' gestation are at increased risk for pregnancy complications and adverse perinatal outcomes. The inclusion criteria were a singleton gestation, a confirmed gestational age, and an hCG level greater than 2.0 multiples of the median (MoM). The exclusion criteria were fetal anomalies, an abnormal karyotype, molar pregnancy, and an MSAFP level greater than 2.5 multiples of the median (MoM). A group of randomly selected women with hCG levels under 2.0 MoM served as controls. Patients with elevated levels of hCG had a significantly higher risk for PIH (17.9% versus 4.5%; P <.05) and preterm delivery (17.9% versus 3.5%; P<, 05) than control. But no significant differences were observed in the incidence of intrauterine growth restriction and low birth weight and in the newborn weight. We suggested that pregnancies with unexplained elevated hCG levels should be regarded as high-risk pregnancies. And these patients require careful monitoring with adequate obstetric management.
Abnormal Karyotype ; Chorionic Gonadotropin* ; Cohort Studies ; Female ; Gestational Age ; Humans* ; Hydatidiform Mole ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome* ; Pregnancy* ; Pregnancy, High-Risk

PURPOSE: The purpose of this study was to explore internalized stigma of patients with schizophrenia and examine factors contributing to their internalized stigma. METHODS: Participants in this study were 173 patients schizophrenia living in Busan. Data were collected between January 2 to 16, 2012 using the Korean version of the Internalized Stigma of Mental Illness Scale (ISMI), and measurements of Self-esteem, Depression, Family and Social support, and Insight. Data were analyzed using the SPSS/WIN 18.0 program. RESULTS: The mean score for internalized stigma was 68.8+/-12.15. The significant factors influencing internalized stigma were depression, insight, admission status, mental health center services, number of admissions, self-esteem, and family support. These factors explained 40.8% of the variance. CONCLUSION: The results suggest that in development and practice of programs to decrease internalized stigma in patients with schizophrenia factors identified in this study as influencing internalized stigma should be considered.
Depression ; Humans ; Mental Health ; Schizophrenia

PURPOSE: The purpose of this study was to determine the factors that affect suicidal ideation in patients with chronic mental illnesses, such as schizophrenia, depressive disorder, and bipolar disorder. METHODS: The research participants were 160 patients with mental illnesses residing in B City and G Province. They responded to questionnaires about their suicidal ideation, self-esteem, depression, family support, social support, and internalized stigma of mental illness. The collected data were analyzed using t-test, ANOVA, Pearson correlation coefficients, and STEPWISE multiple regression with the SPSS/WIN 18.0 program. RESULTS: History of self-esteem, Depression, Social support, Psychiatric diagnosis of MDD and suicide attempt showed an explanatory power for 64% of suicidal ideation in patients with chronic mental illnesses. CONCLUSION: Specialized health and medical service personnel providing services to patients with chronic mental illnesses must determine the risk factors and protective factors for suicidal ideation associated with each illness, and establish a more individualized and systemized case management system based on customized approach.
Bipolar Disorder* ; Case Management ; Depression ; Depressive Disorder* ; Depressive Disorder, Major ; Humans ; Mental Disorders ; Risk Factors ; Schizophrenia* ; Suicidal Ideation* ; Suicide

PURPOSE: The purpose of this study is to investigate employer's attitude towards mentally disabled people. METHODS: The Lee (1996)'s questionnaire of community people's attitude on perception for mentally disabled people was used to collect data from 208 employers in Busan City. chi2-test and t-test were used to explore related factors of employer's attitude. RESULTS: Employers having experience of hiring physically or mentally disabled people showed higher CAMI scores (p=.002). Especially, employers having experience of hiring mentally disabled people showed higher scores in four components of authoritarianism, benevolence, social restrictiveness, and community mental health ideology than any other groups. In addition, we found differences in employers' attitude on authoritarianism and benevolence according to types of industries and the number of employees. CONCLUSION: We could suggest that employers experience of employing disabled and mentally disabled people could improve their positive attitude. Therefore, we call for various efforts and programs development to encourage employers to hire mentally disabled people.
Authoritarianism ; Beneficence ; Humans ; Mental Health ; Mentally Disabled Persons ; Surveys and Questionnaires ; Rehabilitation, Vocational

PURPOSE: This study was done to develop a internalized stigma reducing program based on cognitive-behavioral therapy and appropriate for patients with schizophrenia and to evaluate its effectiveness. METHODS: The study design was a mixed method research. Qualitative study, 13 patients with schizophrenia who had experience in overcoming stigma were purposively chosen for interviews and data were analyzed using Giorgi method. Quantitative study, 64 patients with schizophrenia (experimental group=32, control group=32) were recruited. The cognitive-behavioral therapy-based program for reducing internalized stigma in patients with schizophrenia was provided for 8 weeks (12 sessions). Data were collected from June. 20, 2013 to Feb. 14, 2014. Quantitative data were analyzed using χ²-test, t-test, repeated measures ANOVA with the SPSS program. RESULTS: Qualitative results, from the experience of coping with stigma in patients with schizophrenia seventeen themes and five themes-clusters were drawn up. Quantitative results showed that internalized stigma, self-esteem, mental health recovery and quality of life were significantly better in the experimental group compared to the control group. CONCLUSION: Study findings indicate that this program for reducing internalized stigma in patients with schizophrenia is effective and can be recommended as a rehabilitation program intervention to help patients with schizophrenia to cope with internalized stigma.
Cognitive Therapy ; Humans ; Mental Health ; Methods ; Quality of Life ; Rehabilitation ; Schizophrenia* ; Social Stigma ; Stereotyping

PURPOSE: This phenomenological study was done to identify comprehensively and in depth the experience of overcoming internalized stigma in persons with psychiatric disabilities. METHODS: Data were collected from December 2015 to June 2016 with 10 persons who had psychiatric disabilities. The participants took part in interviews on their experiences of overcoming stigma. The collected data were analyzed using Colaizzi method. RESULTS: From the raw data obtained from the study participants, 12 themes and 5 theme clusters were identified. The 5 theme clusters were found to be ‘being locked up in one's own stigma’, ‘trying to escape from the self in constraints’, ‘overcoming oneself by oneself’, ‘getting to see the true self’, and ‘living the life desired’. CONCLUSION: Study findings indicate the necessity of developing a mediation program to reduce and overcome the internalized stigma in the persons with psychiatric disabilities. A national and social effort is necessary for persons with psychiatric disabilities to help them overcome the internalized stigma.
Humans ; Mentally Disabled Persons ; Methods ; Negotiating ; Qualitative Research ; Social Stigma ; United Nations