This study was designated to investigate communication barriers of nurses in clinical settings. This study was done in 2 phases, first content analysis on descriptions of 50 nurses in three general hospitals and 40 nursing students on communication barriers for nurses in clinical settings, and second a survey to investigate the factors related to communication barriers and the relation between the nurse's characteristics and the extent of communication barriers in clinical settings from two nurses educators, 13 nursing students who experienced clinical practice and 71 nurses in 11 general hospitals. The results are as follows : 1. Through content analysis, 11 properties of communication barriers for nurses in clinical settings were identified. These were inappropriate communication style as a nurse, lack of professionalism, in appropriate control of emotions, lack of knowledge about the clincal setting, the lack of preparation about content of communication, the problem in trust relation, differences in priorities in needs, uncontroleable situation for nurses, inappropriate nurses' perception about patients, conflict with medical team and inadequate systematic support were identified and grouped in to four categories, communicator, message, feedback and communication context. 2. The four factors in communication barriers for nurses in the clinical setting were identified and named as ambiguity in the nurses' position, lack of confidence, difference in perspectives with patients and inadequate nurse -patient relationship. 3. There was a significant difference (F=5.31, P=0.0022, F=3.62, p=0.0316, F=2.80, P=0.067, F=9.01, p=0.0003) among the groups according to work place in rating the extent of the communication barrier in the clinical setting and In the four factors, the nurses working in the psychiatric patient unit rated the communication barrier in the clinical setting lowest among the groups. There was a significant negative correlation between the length of the nurses's carrier and the extent of communication barrier in three factors, ambiguity in the nurses' position, lack of confidence and inadequate nurse-patient relationship.
Communication Barriers* ; Hospitals, General ; Humans ; Students, Nursing ; Workplace

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

The syndrome of lower-back pain associated with sciatic pain has probably been a problem since man first assumed the upright position. In 1937 Barr delineated herniation of the nucleu pulposus as a pathologic entity. Since that time, the standard surgical treatment has become laminectomy or laminectomy combined with fusion, with the emphasis on the disc between L4−5 and L5−Sl. Another mode of treatment was suggested when Smith and Brown” reported their clinical experience using intradiskal injection of chymopapain as the definite treatment of lumbar disk disease in 1967. In recent many years investigators in separate clinical studies showed that a benificial result can be achieved in a high percentage of patients treated by chymopapain injection. Our 29 patients who can be observed for more than 6 months after chemonucleolysis were clinically analysed. The results were as follows: 1. Of the 29 patients studied, 15 were males and 14 were females. 11 patients (37.9%) were in age between 41 and 50 years. 2. On clinical symptoms, 24 patients (82.8%) had radicular pain in the lower extremity. All patients had the limitation of the straight leg raising. 3. The most common level of herniated area was L4−5 disk as 22(75.9%) cases. In four cases (13.8 %) two levels of disks (L4−5 and L5−Sl) were involved. 4. On myelography the hour glass appearance was shown in 14 patients (49.3%).Complete block was found in 4 (13.8%) cases. 5. The increase of the straight leg raising was found within 3 weeks after chemonucleolysis in all cases. Motor power were recovered in 20 out of 22 cases and abnormal sensation were recovered in 17 out of 19 cases within 3 months after chemonucleolysis. 6. There were no correlation between persisting low back pain and narrowing of the disk space after chemonucleolysis, statistically. 7. In 23 out of 29 cases discometry test was positive. Among 23 cases, 21 cases recovered from their symptoms successfully after chemonucleolysis. 8. In chymo. R.A.S.T., 9 out of 15 cases were positive in 3 weeks after chemonucleolysis, and 12 out of 15 cases were positive in 3 months after chemonucleolysis.
Chymopapain ; Female ; Glass ; Humans ; Intervertebral Disc ; Intervertebral Disc Chemolysis ; Laminectomy ; Leg ; Low Back Pain ; Lower Extremity ; Male ; Myelography ; Research Personnel ; Sensation

No abstract available.
Paget Disease, Extramammary

No abstract available.
Neck*

The aim of the spine fusion is to obtain the stability of the spine. Spinal fusion have been used for the treatment of tuberculosis and arrest of the progress of spinal deformity such as scoliosis. Nowadays the spine fusion is used often in conditions which present the instability; spondylosis, spondylolisthesis and the unstable postlaminectomy spine. Unilateral posterolateral fusion plus hemiposterior fusion were done only in the cases who had wide hemilaminectomy, while in rest of cases bilateral posterolateral fusion was indicated in this series. Fifty-two cases, treated with posterolateral lumber fusion during the period from June 1980 to Dec. 1985, were analysed clinically and radiologically and the following results were obtained. l. Among the 52 cases, 25 cases(48.1%) were male; and 27 cases(51.9%) were female; The youngest was 16 years of age and the oldest one was 63 years of age. Average age of the patient was 39.6 years. 2. Fifteen patients had spinal stenosis, 14 cases of spondylolisthesis, 11 cases of H.N.P., 6 cases of spondylolysis, 4 cases of tuberculous spondylitis and 2 cases of fracture-dislocation of lumbar spine. 3. As a method immobilization after operation, postoperatively hips spica cast was applied in 4 cases for 12 weeks, Norton-Brown back brace in 9 cases following 6 weeks of posloperative hip spica cast immobilization and Norton-Brown brace 39 cases following 2 weeks of postoperative bed rest. 4. In 41 cases bilateral posterolateral fusion was done, and in 11 cases unilateral posterolateral fusion plus hemiposterior fusion were done. The bony union was established within 4 months after bilateral posterolateral fusion in 37 cases and after unilateral posterolateral fusion in 9 cases. In 2 cases complete union was obtained within 6 months after fusion. 5. The union rate was 92.7% in bilateral posterolateral fusion and 90.9% in unilateral posterolateral fusion. There was no significant differences of the union rate between bilateral and unilateral fusion groups. Therefore, the unilateral posterolateral fusion is a suitable method in the treatment of mild spinal instability regardless of its causes. The procedure has benefits, such as short operation time, less blood loss, and less surgical burden to the patient.
Arthrodesis ; Bed Rest ; Braces ; Clinical Study ; Congenital Abnormalities ; Female ; Hip ; Humans ; Immobilization ; Male ; Methods ; Scoliosis ; Spinal Fusion ; Spinal Stenosis ; Spine ; Spondylitis ; Spondylolisthesis ; Spondylolysis ; Spondylosis ; Tuberculosis

No abstract available.
Humans ; Infant, Newborn* ; Membranes* ; Rupture*

PURPOSE: The purpose of this study was to investigate the relationships among variables of transtheoretical model for exercise in the elderly. METHOD: A hypothetical model explaining the stage of change was constructed based on a transtheoretical model. Empirical data for testing the hypothetical model was collected from 246 old adults over 65 years old in a community settings in Seoul, Korea in June and July, 2000. Data were analyzed by descriptive statistics and correlational analysis using pc-SAS program. The Linear Structural Modeling(LISREL) 8.0 program was used to find the best fit model which explain causal relationship of variables. RESULT: The fitness of modified model to the data was X2= 96.75(df=49, p=.00005), GFI= .98, NFI=.99, AGFI=.95, NNFI=.99. The the predictable variables of stage of change explained 64% of stage of change for exercise. CONCLUSION: Results are consistent with the studies of application of the transtheoretical model, which has been used to understand how people change health behaviors. The findings of this study give useful informations to construct exercise intervention program for the elderly about relationships among variables influencing to the stage of change of exercise.
Adult ; Aged* ; Health Behavior ; Humans ; Korea ; Seoul

BACKGROUND: Autoimmune hemolytic anemias are characterized by autoantibodies recognizing antigens on the Individual's own red blood cells, resulting in immune- mediated hemolysis. Blood transfusions have been regarded as hazardous in patients with autoimmune hemolytic anemia (AIHA) because of potential intensification of hemolysis and a presumed high incidence of alloimmunization. METHODS: We examined the pretransfusion and posttransfusion hemoglobin levels in 6 patients with autoantibodies in their sera, which showed panagglutinations with all bloods tested in the compatibility testing. They received 'least' incompatible blood because of inability to find compatible blood. RESULTS: When we compared pretransfusion hemoglobin level with posttransfusion hemoglobin level, in 5 of 6 patients with AIHA, the hemoglobin levels were increased after red cell transfusion. 4 patient who did not respond to transfusion therapy initially had an increase in hemoglobin level after steroid treatment. Any signs or symptoms indicating hemolytic transfusion reaction were not observed ducting the transfusion period in all patients. CONCLUSIONS: The decision to transfuse in AIHA should consider multiple factors including the patient's clinical status, the potential benefit of transfusion, the potential response to other therapeutic modalities, but must never be regarded as contraindicated, even though the compatibility test may be strongly incompatible.
Anemia, Hemolytic* ; Anemia, Hemolytic, Autoimmune ; Autoantibodies ; Blood Group Incompatibility ; Blood Transfusion ; Erythrocyte Transfusion* ; Erythrocytes* ; Hemolysis ; Humans ; Incidence

BACKGROUND: Autoimmune hemolytic anemias are characterized by autoantibodies recognizing antigens on the Individual's own red blood cells, resulting in immune- mediated hemolysis. Blood transfusions have been regarded as hazardous in patients with autoimmune hemolytic anemia (AIHA) because of potential intensification of hemolysis and a presumed high incidence of alloimmunization. METHODS: We examined the pretransfusion and posttransfusion hemoglobin levels in 6 patients with autoantibodies in their sera, which showed panagglutinations with all bloods tested in the compatibility testing. They received 'least' incompatible blood because of inability to find compatible blood. RESULTS: When we compared pretransfusion hemoglobin level with posttransfusion hemoglobin level, in 5 of 6 patients with AIHA, the hemoglobin levels were increased after red cell transfusion. 4 patient who did not respond to transfusion therapy initially had an increase in hemoglobin level after steroid treatment. Any signs or symptoms indicating hemolytic transfusion reaction were not observed ducting the transfusion period in all patients. CONCLUSIONS: The decision to transfuse in AIHA should consider multiple factors including the patient's clinical status, the potential benefit of transfusion, the potential response to other therapeutic modalities, but must never be regarded as contraindicated, even though the compatibility test may be strongly incompatible.
Anemia, Hemolytic* ; Anemia, Hemolytic, Autoimmune ; Autoantibodies ; Blood Group Incompatibility ; Blood Transfusion ; Erythrocyte Transfusion* ; Erythrocytes* ; Hemolysis ; Humans ; Incidence