PURPOSE: This study aimed to develop a model for estimating the quality of life mediated by adaptation to changes experienced after stomach cancer diagnosis and surgery in patients with gastrectomy and to verify the model based on the Cancer Survivor Adaptation Model by Naus et al. (2009) and literature reviews. METHODS: Data was collected from 297 gastric cancer patients who underwent a gastrectomy at an outpatient clinic of two university hospitals in Daegu city from May to August, 2016. The exogenous variableswere perceived gastrointestinal symptoms, self-efficacy, anxiety, social support, and spiritual well-being. The endogenous variableswere adaptation and quality of life, and adaptationwas themediating variable. For data analysis, structural equation modeling was performed using IBM SPSS 21.0 and AMOS 18.0. RESULTS: The fitness parameters of the final model showed a reasonable fit to the data. Based on R², the exogenous variables explained 73.9% of the quality of life of stomach cancer patients who underwent surgery, through the mediation of adaptation; adaptation alone explained 73.5% of quality of life. Adaptation of stomach cancer patients with gastrectomy was a factor that strongly influenced their quality of life. CONCLUSION: It is important for gastric cancer patients with gastrectomy to adapt well to changes after surgery in order to improve the quality of life. Nursing interventions to aid successful adaptation would ultimately exert positive influences and improve the patients' quality of life.
Ambulatory Care Facilities ; Anxiety ; Daegu ; Diagnosis ; Gastrectomy ; Hospitals, University ; Humans ; Negotiating ; Nursing ; Quality of Life ; Statistics as Topic ; Stomach Neoplasms ; Survivors

BACKGROUND: Occupational exposure to blood and body fluids (BBFs) is a serious concern for health care workers (HCWs) and presents a major risk factor for transmission of infectious diseases such as hepatitis B virus (HBV), hepatitis C virus, and human immune deficiency virus. The main objective of this study was to assess the magnitudes of occupational exposure of blood and body fluids and associated factors among health workers at the University of Gondar Hospital. METHODS: An institution-based cross-sectional study was conducted from 1 February to 31 May 2017 at the University of Gondar Hospital. A total of 282 health care workers were selected by simple random sampling technique. Descriptive data was presented as absolute number with percentage, and multivariate analysis was used to assess the statistical association between associated factors and occupational exposure to BBFs. A P value of < 0.05 was considered as statistical significant. RESULT: A total of 282 HCWs participated with the mean (±SD) age of 30.51 ± 5.86 year. Of the total, 58.5% (165) and 42.2% (119) of the study participants had been exposed to BBFs splash and needlestick injury (NSI) in their lifetime, respectively. However, 39.0% (110) and 20.6% (58) of the HCWs were exposed to splash and NSI in the past 1 year, respectively. Not wearing eye goggle, lack of training on infection prevention, taking of HBV vaccination, and recapping of used needle were risk factors associated with BBFs splash exposure, whereas taking HBV vaccination and recapping of used needle were associated risk factors with NSI exposure. CONCLUSION This study showed a high percentage of occupational exposure to blood and body fluids among health care workers. Not wearing eye goggle, HBV vaccine status, and recapping needles were found to be independent predictors of occupational exposure to BBFs among HCWs. Therefore, relevant stakeholders need to formulate strategies to create a favorable working environment and increase their adherence to universal precautions.
Adult ; Body Fluids ; Cross-Sectional Studies ; Ethiopia ; epidemiology ; Female ; Health Knowledge, Attitudes, Practice ; Health Personnel ; statistics & numerical data ; Hospitals, University ; Humans ; Male ; Middle Aged ; Needlestick Injuries ; epidemiology ; Occupational Exposure ; statistics & numerical data ; Prevalence ; Risk Factors ; Young Adult

BACKGROUND: The purpose of this study was to identify and compare perception of importance and satisfaction regarding communication needs among patients and nurses in emergency centers.METHODS: This study used a cross sectional design and included 64 of patients and 37 of nurses in emergency centers of university hospitals located in Daejeon. Data were collected with a self-administered questionnaire between April 2017 and June in 2017. Data analysis was conducted using descriptive statistics.RESULTS: Regarding importance of communication needs, both groups of the patients and the nurses significantly recognized the importance of providing information such as performed tests and treatments and visiting time of charged physicians. Meanwhile, emotional supports and concern about social or cultural needs was recognized as less important communication needs among the patients and nurses. Regarding satisfaction of communication needs, patients were less satisfied with the needs they regarded as the most important and nurses showed moderate levels of satisfaction. This indicates that patients and nurses differ in the standards and expectations for communication performance.CONCLUSION: It is important that emergency room nurses should recognize the current situation in which the patients' desired communication needs are not being met and they should start to focus improvement effort and new directions of emergency room care systems to meet the communication needs.
Emergencies ; Emergency Service, Hospital ; Hospitals, University ; Humans ; Statistics as Topic

This study aims to contribute to managing the human resource of dental hygienists and qualitatively enhancing dental medical services by examining factors that affect their turnover intention. Therefore, it attempted to examine their degrees of emotional labor, job satisfaction, and social support and the effects of each variable on turnover intention. This study administered self-reporting questionnaires to dental hygienists working in dental hospitals, dental clinics, and general or university hospitals in Seoul Metropolis and Gyeonggi-do by conducting convenience sampling, from May 18, 2017 to August 4, 2017. Among a total of 224 copies that were distributed, a total of 223 copies, excluding 1 copy with poor responses, were used in the data analysis. The research tools comprised 12 questions on general characteristics, 24 questions on emotional labor (4-point Likert scale), 16 questions on job satisfaction (5-point Likert scale), 8 questions on social support (4-point Likert scale), and 4 questions on turnover (5-point Likert scale). The scores of dental hygienists were as follows: emotional labor, 2.49 out of 4; job satisfaction, 3.14 out of 5; social support, 3.04 out of 4; and turnover intention, 3.07 out of 5. Their turnover intention has a positive correlation with emotional labor, but a negative correlation with job satisfaction and social support. It was found that some factors that significantly influence turnover intention included the amount of overtime work and job satisfaction. Thus, dental medical institutes should search for measures, including improvement of the working environment, to reduce the amount of overtime work and enhance job satisfaction.
Academies and Institutes ; Dental Clinics ; Dental Hygienists* ; Gyeonggi-do ; Hospitals, University ; Humans ; Intention* ; Job Satisfaction* ; Seoul ; Statistics as Topic

BACKGROUND: The purpose of this study was to investigate longitudinal changes of the utilization of operational and surgical medical care inside and outside a metropolitan area over 10 years, analyzing the residential areas of patients and the locations of medical facilities for major cardiovascular surgery. METHODS: Data analysis was conducted by classifying the addresses of patients and the locations of medical care facilities of metropolitan cities and provinces, using data from the National Health Insurance Corporation from January 2003 to December 2013. RESULTS: There is serious concentration of major heart surgery to medical facilities in Seoul; this problem has not improved over time. There were differences in percentages of surgical procedures performed in the metropolitan areas according to major diseases. In the case of Busan and Daegu provinces, at least 50% of the patients underwent surgery in medical facilities in the city, but there are other regions where the percentage is less than 50%. In the case of provinces, the percentage of surgical procedures performed in medical facilities in Seoul or nearby metropolitan cities is very high. CONCLUSION: Policies to strengthen the regional capabilities of heart surgery and to secure human resources are required to mitigate the concentration of patients in the capital area. Many regional multi-centers must be designated to minimize unnecessary competition among regional university hospitals and activate a win-win partnership model for medical services.
Busan ; Coronary Artery Bypass ; Daegu ; Health Facilities ; Hospitals, University ; Humans ; Korea* ; National Health Programs ; Seoul ; Statistics as Topic ; Thoracic Surgery*

PURPOSE: The purpose of this study was to identify the mediating effect of head nurses' emotional leadership as perceived by nurses in the relationship between nurses' job stress and job satisfaction. METHODS: Study participants were 278 staff nurses currently working at two university hospitals in Busan, Korea. SPSS/WIN 21.0 program was used for data analysis to analyze descriptive statistics, t-test, correlation, and stepwise multiple regression. The significance level was set at p<.05. RESULTS: Nurses' job satisfaction had a significant correlation with job stress (r=-.31, p<.001) and emotional leadership of nurse managers as perceived by nurses (r=.53, p<.001). Also, head nurses' emotional leadership experienced by nurses had a partial mediating effect in the relationship between nurses' job stress and job satisfaction. CONCLUSION: The results of this study show that the nurse managers' emotional leadership has an important influence on nurses' job stress and job satisfaction. Therefore, head nurses' emotional leadership is very important for effective human resource management and the hospital should offer education and training to booster head nurses' leadership by developing emotional intelligence to promote staff job satisfaction.
Busan ; Education ; Emotional Intelligence ; Head* ; Hospitals, University ; Humans ; Job Satisfaction* ; Korea ; Leadership* ; Negotiating* ; Nurse Administrators ; Statistics as Topic

We investigated the occurrence and genetic basis of AmpC beta-lactamase (AmpC)-mediated antibiotic resistance, by examining Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis isolates at a university hospital, from 2007 to 2010. The ampC genes were detected by multiplex AmpC PCR, and AmpC-positive strains were subjected to DNA sequencing. Extended-spectrum beta-lactamase (ESBL) production was assessed using the ESBL disk test based on the utilization of boronic acid. Carbapenem-resistant isolates were further investigated by the modified Hodge test, a carbapenemase inhibition test and SDS-PAGE experiments. AmpC expression was detected in 1.6% of E. coli (39 DHA-1, 45 CMY-2, and 1 CMY-1) isolates, 7.2% of K. pneumoniae (39 DHA-1, 45 CMY-2, and 1 CMY-1) isolates, and 2.5% of P. mirabilis (8 CMY-2 and 1 CMY-1) isolates. Of the 198 acquired AmpC producers, 58 isolates (29.3%) also produced an ESBL enzyme. Among the acquired AmpC-producing K. pneumoniae isolates, the minimum inhibitory concentration (MIC) MIC50/MIC90 values for cefoxitin, cefotaxime, cefepime, imipenem, and meropenem were >32/>32, 16/>32, 1/16, 0.25/0.5, and <0.125/0.125 microg/mL, respectively. The MIC values for carbapenem were > or =2 microg/mL for 2 K. pneumoniae isolates, both of which carried the blaDHA-1 gene with a loss of OmpK36 expression, but were negative for carbapenemase production. The acquisition of AmpC-mediated resistance in K. pneumoniae isolates increased, as did the proportion of AmpC and ESBL co-producers among the hospital isolates. The accurate identification of isolates producing AmpCs and ESBLs may aid in infection control and will assist physicians in selecting an appropriate antibiotic regimen.
Anti-Bacterial Agents/pharmacology ; Bacterial Proteins/*genetics ; DNA, Bacterial/genetics ; Enterobacteriaceae Infections/*epidemiology/*microbiology ; Escherichia coli/drug effects/enzymology/isolation & purification ; Hospitals, University/statistics & numerical data ; Humans ; Klebsiella pneumoniae/drug effects/enzymology/isolation & purification/*physiology ; Microbial Sensitivity Tests ; Multiplex Polymerase Chain Reaction ; Proteus mirabilis/drug effects/enzymology/isolation & purification ; Republic of Korea/epidemiology ; beta-Lactamases/*genetics

Social factors may affect the available sources of toxic substances and causes of poisoning; and these factors may change over time. Additionally, understanding the characteristics of patients with acute toxic poisoning is important for treating such patients. Therefore, this study investigated the characteristics of patients with toxic poisoning. Patients visiting one of 3 hospitals in 2003 and 2011 were included in this study. Data on all patients who were admitted to the emergency departments with acute toxic poisoning were retrospectively obtained from medical records. Total 939 patients were analyzed. The average age of patients was 40.0 +/- 20 yr, and 335 (36.9%) patients were men. Among the elements that did not change over time were the facts that suicide was the most common cause, that alcohol consumption was involved in roughly 1 of 4 cases, and that there were more women than men. Furthermore, acetaminophen and doxylamine remained the most common poisoning agents. In conclusion, the average patient age and psychotic drug poisoning has increased over time, and the use of lavage treatment has decreased.
Acetaminophen/poisoning ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alcohol Drinking ; Child ; Child, Preschool ; Doxylamine/poisoning ; Emergency Service, Hospital/*statistics & numerical data ; Female ; Hospitals, University ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Poisoning/*epidemiology ; Retrospective Studies ; Sex Factors ; Suicide, Attempted ; Young Adult

OBJECTIVETo summarize the spectrum of disease and common diseases that cause death in children admitted to the Pediatric Intensive Care Unit (PICU), Shengjing Hospital of China Medical University between 2005 and 2012.

METHODSA retrospective analysis was carried out on the clinical data of 4484 children admitted to the PICU of Shengjing Hospital between 2005 and 2012.

RESULTSAcute bronchopneumonia, which was found in 1099 (24.51%) of the 4484 cases, was the most common disease in the PICU between 2005 and 2012. The incidence of intracranial infection, sepsis, hand-foot-mouth disease and trauma showed an increasing trend from 2005 to 2012, but that of non-traumatic intracranial hemorrhage, epilepsy and congenital heart disease showed a decreasing trend. The mortality decreased from 11.5% in 2005 to 3.1% in 2012, and the overall mortality was significantly higher in 2005-2008 than in 2009-2012 (11.98% vs 4.41%; P<0.01). The main causes of death included severe acute bronchial pneumonia, severe sepsis, complex congenital heart disease, severe cerebral trauma, respiratory failure, severe hand-foot-mouth disease, acute poisoning and circulatory failure.

CONCLUSIONSAcute bronchopneumonia was the most common disease in the PICU of Shengjing Hospital between 2005 and 2012, but the spectrum of disease changed over time. The mortality showed a decreasing trend among the children in the PICU between 2005 and 2012, and the main causes of death included severe acute bronchial pneumonia and severe sepsis.

Adolescent ; Cause of Death ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Hospital Mortality ; Hospitals, University ; Humans ; Infant ; Intensive Care Units, Pediatric ; statistics & numerical data ; Male ; Retrospective Studies ; Time Factors

The pandemic H1N1/09 emerged rapidly in Korea. Here, we describe the clinical characteristics of outpatients in Seoul, Korea who were infected in the 2009 H1N1 pandemic. We reviewed the cases of outpatients with pandemic H1N1/09 who visited a tertiary care teaching hospital between September 1 and December 31, 2009. Infection with pandemic H1N1/09 was confirmed by molecular tests. Of a total of 7,182 tests, 3,020 (42.0%) were positive. Compared with 473 cases of influenza-like illness (ILI), the 586 confirmed cases of pandemic H1N1/09 differed in age [odds ratio (OR) 0.975] and fulfilling at least one of the following factors: age <5 or > or =65 years, history of contact with other pandemic H1N1/09-infected individuals (OR 0.611), fever > or =37.8degrees C (OR 3.567), cough (OR 2.290), and myalgia (OR 1.559). The sensitivity of the best criteria, "fever (> or =37.8degrees C) plus cough" (41.03%) in this study was lower than that of the Korea Centers for Disease Control and Prevention (KCDC) criteria (47.95%), whereas the positive likelihood ratio (3.55) and positive predictive value (81.6) of this criteria was higher than those of the KCDC criteria (2.98 and 78.7, respectively). The clinical characteristics of pandemic H1N1/09 are, in many regards, indistinguishable from those of ILI. Moreover, the accuracy and predictability of criteria which include only symptoms or signs were not sufficient to diagnose pandemic H1N1/09 infection. Therefore, use of a combination of symptoms with confirmatory laboratory testing is necessary for accurate diagnosis of pandemic H1N1/09.
Adolescent ; Adult ; Child ; Comorbidity ; Female ; Hospitals, University/statistics & numerical data ; Humans ; *Influenza A Virus, H1N1 Subtype ; Influenza, Human/*diagnosis/*epidemiology/physiopathology ; Male ; Multivariate Analysis ; Outpatients/*statistics & numerical data ; Pandemics/*statistics & numerical data ; Republic of Korea/epidemiology ; Risk Factors ; Young Adult