The purpose of study was to contirm theory about the effectiveness of routine meatal care on the reduction of catheter-associated urinary tract infection. The study was carried out at a university hospital from September 1,1987 to April 17, 1989 : 32 patients with a foley-catheter were studied. The study compared the urinary tract infection rate of an experimental group with that of a control group and tested the antibiotic susceptibility of the isolated bacteria. The experimental group(16 patients) was given daily meatal care with 10% Betadine for periods ranging from 4 to 21 days. The control group(16 patients) was not given that care. The results obtained were as follows: 1. The urinary tract infection rate of the experimental group was 50.0%, and that of the control group 43.8%. There was no significant difference between the groups. 2. Organisms isolated in the control group were bacteria 100%, and in the experimental group bacteria 50 % and fungus 50%. The most common organisms of the 15 strains isolated in the total group were Sta- phylococcus coagulase negative (3 patients), and E-coli (3 patients). 3. Most of bacteria isolated in this study were sensitive to Norfloxacillin, but resistant to Ampicillin, Chloramphenicol, Kanamycin, Tetracycline, and Ery-thromycin. Hence the importance of controling catheter- associated urinary tract infections. Findings suggest the need to search for other sources of infection, further experimentation controling various sources of urinary tract infection and larger groups of subjects.
The increase in size and numbers of general hospitals in the process of conspicuous development of modern medicine has been accompanied by a serious increase in hospital acquired infections. Hospital aquired infections cause pain and discomfort, may threaten life, adds an economic burden, and delays recovery and return to society. Even though respiratory hospital infection rates resulting for tracheostomy and respiratory inhalation therapy, may be low, they are serious because of their bad prognosis and high mortality rates. This study was designed to assess certain aspects of respiratory infections of patients with a tracheostomy and thus provide baseline data for further research related to preventive or therapeutic nursing interventions. The specific objectives were to determine the incidence of colonization in the trachea, clinical signs, type of colonized bacteria and sensitivity to antibiotics. Data were collected from July 1 to December 10, 1989 at two university Hospital in Seoul. Subjects were 20 patients with a tracheostomy admitted to the Intensive Care Unit or Cerebral Vascular Accident Center. Clinical signs related to respiratory infection were observed using a checklist based on previous study outcomes. Bacterial culture, sensitivity test to antibiotics, WBC counts and chest X-ray were also performed. Cultures were done on the day of tracheostomy, and on the third, fifth and seventh day. Cultures were then done on seventh days after the first colonization. The results were as follows: 1. The incidence of bacteria colonization in a week was 90%(18 patients) : 50% (10/20 patients) on the day of tracheostomy, 70 %(7 /10 patients) on the third day, and 0 % on the fifth day, and 33 %(1/3 patient) on the seventh day. 3 of 18 patients (16.7%) were colonies of mixed growth isolated. 2. The observed clinical signs related to respiratory infection were high fever 38.9 %(7 patients), prulent secretion 16.7 %(12 patients) and infiltration seen on chest X-ray 33.3 %(6 patients). 3. The total number of types of bacteria isolated among the 18 subjects was 21 I gram negative 71.4 %, gram postive 28.6 %. The dominant bacteria type was Staphylococcus aureus(5 cases) for gram and Pse-udomonas aeruginosa(3 cases), Klebsiella (4 cases), Enterobacter(3 cases) for grame. The results of culture on 7th day after the first colonization, 6 cases showed same type of bacteria, 3cases showed different type of bacteria and 1 cases showed no growth. 4. The sensitivity tests to antibiotics showed that Pseudomonas aeruginosa and Staphylococcus were strongly resistant to most kinds of antibiotics, but Klebsiella and the rest of gram negative bacteria were moderately sensitive to antibiotics.
The purpose of this study was to understand the subjective breastfeeding experience of primiparous women to identify how breastfeeding was started and to explore the process of breastfeeding. The Grounded theory methodology was used. Data was collected from 6 primiparous women who had breastfeed their infants for at least over 8 weeks, recently breastfeeding or having breatfeed their infants within the last 6 months. With the permission of the subjects, the interviews were recorded and transcribed. The data were analysed in the framework of grounded theory method as mapped out by Strauss and Corbin(1990). 105 concepts and 21 subcategories were of data analysis. In the process of data analysis, "Identity as a mother" was found to be the core phenomenon. The 21 sub-categories were as follows : natural food, neighbour inducement, self purpose, good feeling, tenderness, breast pain, change of breast shape, physical discomfort, loss of physical energy, confirmation of adhesion, one body through coupling, tie, capacity, role performance, mental comfort, healthy mother, healthy infant, confidence of breast milk, feeling of satisfaction. The sub-categories were again grouped into 14 categories including infant nutritious food, formation of breastfeeding opportunity, feeling of satisfaction, injury of the breast, physical suffering, awareness of mothering, formation of maternal affection, connecting, coupling, acceptance, effort, emotional stability, mother and child health and feeling of achievement.
The purpose of this study was to describe the relationship between family stress and adaptation in families with a disabled child through literature review using McCubbin's Double ABCX family crisis framework. The literature review focused on (1) family stress and factors affecting family stress, (2) the critical individual, familial and social resources which families acquire and employ over time in managing crisis situation, (3) the changes in definition and meaning families develop in an effort to make sense out of their predicament, (4) the coping strategies families employ, and (5) the range of outcomes of these family efforts The results showed that families reported financial difficulties and the burden of care-giving demands as major family stressors. Siblings of disabled children manifested depressive symptoms and social isolation, but was not consistent study results. The parents' views of the cause of the disabling condition fundamentally affected their behavior toward their disabled child. Especially, the fathers' views of the child's characteristics made the greatest contribution to positive changes in the mothers' perceptions. The term perceived social support refers to the cognitive appraisal by individuals that they are cared for and valued, that significant others are available to them if needed, and that they are satisfied with their interpersonal relationships. The perceived social support was more protective than social support source, network size and network density. Parental adaptation was found to be related to the child's communication competence rather than family coping strategies proposed by Lazarus and Folkman. One study results showed that there was no difference in depressive symptoms and physical health between mothers with a disabled child and those without all though mothers with a disabled child had negative attitudes and perceived themselves as having significantly less social support and lower family functioning. But a longitudinal study revealed decreases in the negative impact of the child and increases in sibling and overall family adaptation.