The purpose of this study was to determine the impact of situational, clinical and psychsoical factors on treatment-seeking behavior among those with acute myocardial infarction(AMI). This study used a retrospective, descriptive design. The sample consisted of 72 patients aged over 30 and who were diagnosed with an acute myocardial infarction at two large university-affiliated medical centers from July 1, 1998 to March 30, 2000. But of 72, patients 5 who were an outlier in treatment-seeking time were deleted. Data were collected by using questionnaires, which included demographic data, situational, clinical and psychosocial data. Also patient interviews and chart review were used to obtain information related to treatment-seeking time. The results of this study were summarized as follows; 1. Mean time from the onset of AMI symptoms to arrival at the hospital was 12.09 +/- 11.44 hours; 2. Treatment-seeking time was not significantly different by age, gender, or education; 3. Most(44 or 65.78%) patients were at home when they began having AMI symptoms. The remaining patients were either in a public area, workplace or in a car. Patients at home delayed longer than those who had their first symptoms elsewhere, but not significantly different. Also, most patients were with another person when they began to experience AMI symptoms: a spouse(25 or 37.3%), other family member(31 or 46.3%); the remaining 11 were alone. There were no significant differences in treatment-seeking time based on whether alone or with others. Most patients(46 or 68.7%) used an ambulance rather than taking private transportation, and patients who used an ambulance were delayed longer than those who used private transportation, but there were no significant differences; 4. Time to treatment-seeking was not significantly different by blood pressure, heart rate on admission and the peak CK-MB, CPK and Cholesterol level, Killips class; 5. There were no significant statistical differences in treament-seeking times by anxiety level, mood status or control ability.
Ambulances ; Anxiety ; Blood Pressure ; Cholesterol ; Education ; Heart Rate ; Humans ; Myocardial Infarction* ; Psychology* ; Retrospective Studies ; Transportation ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to identify effects of a self-management program on self-efficacy and compliance in patients with CHF. Hypothesis: 1) Patients with CHF who are provided with a self-management program will show higher self-efficacy scores than a control group. 2) Patients who are provided with a self-management program will show higher compliance scores than a control group. METHOD: This study was designed as a nonequivalent non-synchronized pre-posttest control group. There were eight patients in the experimental group, and twelve in the control group. According to NYHA classification, all patients belonged under the classesl to lV. Data were collected using the instruments developed by the researchers. Data were analyzed using descriptive statistics and Mann Whitney U test. RESULT: There were significant differences in self-efficacy scores and compliance scores between the experimental and control group. CONCLUSION: By utilizing the program, patients were able to monitor their symptoms routinely, comply with therapeutic regimen, and feel better able to positively influence their disease. Therefore, better compliance means fewer readmissions of patients with CHF.
Classification ; Compliance* ; Decision Trees* ; Heart Failure* ; Heart* ; Humans ; Self Care* ; Statistics, Nonparametric ; Surveys and Questionnaires

The incidence of intertrochanteric fracture of the femur in the elederly patient was lower than young in korea because of low average span and causes of injuries. But recently, the incidence is progressively in creased due to prolongation of korean average life span and improvement of residental enviroment. The mortality and morbidity are higher in spite of various treatment methods because of associated diseases and the poor general conditions of patients. Total 102 cases of intertrochanteric fracture of the femur were treated at the Department of Orthopaedic Surgery of Soonchunhyang University Hospital during the period from January, 1978 to December, 1985. Among them, 67 cases(65.7%) were over 60 years in the age, and of which 55 cases(one case was bilateral) were followed from 8 months to 3 years and 4 months(Average 14.7 months). The results were as followes: l. Out of 54 patients, 33 patients were female and the mean age was 74 years. 2. The most common cause is the injury from slip down and the ratio between in-door injury to out-door injury was 1.7: l. 3. The 41 cases(74%) out of the 55 cases were operated within 2 weeks after the accident, 35 cases were treated by Richard compression hip screw, 11 cases were by intramedullary nailing, and 9 cases were by multiple pinning. The multiple pinning were usually tried to patients of poor general condition, which was needed to shorten the operation times. 4. The mean duration of multiple pinning operation time was 1 hour 12 minutes, intramedullary nailing operation time was 1 hour 47 minutes and Richard compression hip screw operation time was 2 hour 42 minutes. 5. Among 55 cases, 20 cases(36%) were complicated.
Aged ; Female ; Femur ; Fracture Fixation, Intramedullary ; Hip ; Humans ; Incidence ; Korea ; Mortality

Three hundred and fourty two patients with a fracture of tibial shaft were treated and managed in the Department of Orthopaedic Surgery, Soon Chun Hyang University Hospital from January 1981 to December 1985. In 147 cases, 62 cases had only tibial shaft fracture and 85 tibial and fibular shaft fracture. All of these were treated conservatively by manipulation and cast immibilization. We analyzed the initial fracture characteristics, the treatment employed, and the subsequent complications in fracture healing in a series of patients who had sustained a tibial shaft fracture with and without a fibular fracture. The results were as follows; 1. Duration of average bone healing was more slowly in the patients more than twenty years old who were treated for a tibial shaft fracture with and without a concomitant fibular fracture than in the patients less than twenty years old. 2. Duration of average bone healing was more slowly by one or two weeks in the the group of tibial shaft fracture without fibular fracture than in than in those with fibular fracture. 3. The frequency of delayed union, nonunion, varus malunion and pain in the ipsilateral ankle joint were more increased in the group of the tibial shaft fractures without fibular fracture in than those with fibular fracture. 4. The frequency of valgus malunion was more increased in the group of the tibial shaft fractures with fibular fracture than in those without fibular fracture.
Ankle Joint ; Fracture Healing ; Humans ; Tibia

No abstract available.
Animals ; Rats*

No abstract available.
Animals ; Rats* ; Reperfusion*

PURPOSE: This study was done to develop and test validity and reliability of on instrument for predicting nursing intention for SARS patient care. METHOD: The psychometric properties of a SARS patient care attrition prediction tool, based on the Theory of Planned Behavior, were examined in this study. The Three-phase design involved a) salient beliefs generated from clinical nurses (n=43) b) content validation by expert panel evaluations(n=5) c) face validation by plot testing (n=10) d) and instrument validation in a cross sectional survey (n=299). Psychometric analysis of survey data provided empirical evidence of the construct validity and reliability of the instrument. RESULT: Principal component analysis verified the hypothesized 6-factor solution, explaining 68.2% of variance, and Alpha coefficients of .7538 to .9389 indicated a high internal consistency of the instrument. CONCLUSION: The instrument can be used by nurse administrators and researcher to assess clinical nurses' salient beliefs about caring for SARS patients, guide tailored intervention strategies to effective caring, and evaluate the effectiveness of interventions.
Severe Acute Respiratory Syndrome/*nursing ; Reproducibility of Results ; *Questionnaires ; Nursing Methodology Research ; Nursing Care ; Nurses/*psychology ; Humans ; Female ; Attitude of Health Personnel ; Adult

In order to inquire the most-effective management of increased intracranial pressure(ICP), mannitol, steroid and hyperventilation were used in rabbits after ligation or non-ligation of the carotid artery. Mannitol was more effective than steroid and hyperventilation in the degree of the reduction of ICP. The intracranial pressure was decreased 43~45% for 25~30 minutes after injection of mannitol. Steroid was less effective than mannitol in the degree of the reduction of ICP. But the time of reduction of ICP was longer, that is, the degree of reduction was 24~60 minutes after injection of steroid. Hyperventilation is effective in the initial time only, for 10 minutes after hyperventilation. The degree of ICP reduction was 13.5~16.7 % for 10 minutes after hyperventilation. The combined group, that is three kinds of mangenent were used, is the most effective treatment to reduce ICP of ICP. The degree of the reduction of ICP was 42.1~49.3% for 20 minutes, 47.7~52.5% for 30minnutes. There was no significant difference between and non-ligation group.
Carotid Arteries ; Carotid Artery, Internal* ; Hyperventilation ; Intracranial Pressure* ; Ligation ; Mannitol ; Rabbits*

OBJECTIVE: Improvements in microsurgical and neuroanesthesiological techniques have resulted in an increasing number of operation for aneurysmal clipping in elderly patients.The authors evaluated surgical outcome of elderly patients, considering neurologic grade on admission, amount of subarachnoid hemorrhage (SAH) on computerized tomographic findings and timing of surgery. METHODS: The subjects of present study are 91 patients who were admitted to department of neurosurgery and treated surgically between May, 1983. and December, 1999. in Yeungnam University Hospital. The patients were classified by age into two groups: 65 to 69 years (59 cases), 70 years or older (32 cases). On admission, the clinical condition of patients was graded according to the scales of Hunt & Hess and the amount of SAH was graded according to grading system of Fisher. The timing of operation was dvided into two groups: 1-3 days (63 cases) & more than 3days (28 cases). The surgical morbidity & mortality according to Hunt & Hess grade, grading system of Fisher and timing of operation was analized. RESULTS: Overall 32 of the 91 patients were poor prognosis. And 10 of the 32 patients died, for a mortality rate 11%. There was close relationship between the preoperative Hunt & Hess grade, initial Fisher grade, operative timing & outcome. The most common causes of poor or death outcome were medical problems, i.e pulmonary dysfunction, cardiovascular disease and sepsis. The clinical factors of unfavorable outcome in the elderly patients were poor neurological grade on admission, symptomatic cerebral vasospasm, rebleeding and pre-existing medical conditions such as DM, hypertension, cardiopulmonary disease. CONCLUSION: In recent years, with improvement in surgical technique and neuroanasthesia, the number of operation for ruptured aneurysm has increased in elderly patients. We conclude that factors that most affects the clinical outcome of surgery in elderly patients were based on the neurosurgeon's technique and the patients neurological grade and concominant disease, not just on the patients age.
Aged* ; Aneurysm ; Aneurysm, Ruptured ; Cardiovascular Diseases ; Humans ; Hypertension ; Intracranial Aneurysm* ; Mortality ; Neurosurgery ; Prognosis ; Sepsis ; Subarachnoid Hemorrhage ; Vasospasm, Intracranial ; Weights and Measures

BACKGROUND: Transcatheter closure of patent ductus arteriosus, using the Rashkind double umbrella occluder system, had been attempted in mulitcenter since non-surgical closure of patent ductus arteriosus by Rashkind. METHODS: Between July 1991 and June 1993, transcatheter closure of patent ductus arterious was attempted in 20 adult patients(21 trials). RESULTS: Seventeen female and 3 male patients was consisted of the study. The patient age ranged from 17 to 54 years(mean 30+/-9 years). Mean pulmonary artery pressure before closure was 18.5+/-6.0mmHg(range from 10mmHg to 30mmHg). The diameter of ductus ranged from 3.5mm to 8.0mm(mean 5.2+/-1.5mm), as determined by contrast injection through 11F Mullin sheath or 7F catheter. There was significant decrease of Qp/Qs from 2.6+/-1.1 to 1.5+/-0.4 immediately after transcatheter closure of ductus(p<0.01). There was significant decrease of left ventricular end-diastolic dimension by echocardiogram from 58.7+/-7.6mm to 53.6+/-6.5mm after transcatheter closure of ductus(p<0.01). Among the 21 cases, 16 cases(76.2%) had the clinical improvement without the support of surgical closure. One 17mm Rashkind umbrella was retrieved because of position and problem of deployment. There was no device embolic experience in 21 cases. There were 2 cases of hemolytic anemia during the follow-up period ; one case was surgically ligated and another 17mm device was implanted in the other case. CONCLUSIONS: Transcatheter closure of patent ductus arteriosus in adult patients can replace the surgical correction in selected patients.
Adult* ; Anemia, Hemolytic ; Catheters ; Ductus Arteriosus, Patent* ; Female ; Follow-Up Studies ; Humans ; Male ; Pulmonary Artery