• Title/Summary/Keyword: 관리의료

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The Analysis of Activities and Satisfaction of Volunteers for Hospice Care (호스피스 자원봉사자의 활동 및 만족도 분석)

  • Kim, Boon-Han;Jung, Yun;Park, Kyung-Bok
    • Journal of Hospice and Palliative Care
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    • v.5 no.2
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    • pp.163-171
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    • 2002
  • Purpose : The purpose of this study was to analyze activities and satisfaction of volunteers for hospice care. Methods : We used 271 reports of hospice care and 20 questionnaire of activities and satisfaction of volunteers for hospice care from volunteers of in a community. Window SPSS-PC was used for the data analysis and the statistical method used were the descriptive statistics, t-test, ANOVA and Pearson's correlation coefficient. Results : 1) The highest score of activity was emotional area and the next activities was physical area. 2) The degree of emotional area (t=4.94, P<.05) and spiritual area (t=3.80, P<.05) was influence by religion of volunteers. 3) The mean score of satisfaction was 3.61. 4) There was correlation between duration of activity and death experience (r=.558, P<.05), emotional care (r=.698, P<.01), spiritual care (r=.474, P<.05), satisfaction (r=.651, P<.01), and the between physical care and family care (r=.559, P<.05), and the between spiritual cue and family care (r=.512, P<.05), and between emotional care and satisfaction (r=.536, P<.05). Conclution : The above result indicated that we must develope the management and education of volunteer of hospice care for various hospice care. Also, We should to encouraged the continuous education and efficient management.

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Improvement of Patient Safety and Inspection Satisfaction by Developing Pretreatment Process System with the Patients Who Reserved CT Enhance Examination (CT 조영검사 예약환자의 전처치 프로세스 시스템 개발을 통한 환자안전 및 검사 만족도 향상)

  • Beom, Hyinam;Han, Jaebok;Song, Jongnam;Kim, Wook;Choi, Namgil
    • Journal of the Korean Society of Radiology
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    • v.10 no.1
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    • pp.29-37
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    • 2016
  • This study aims to improve the satisfaction level of the patient who undergoes CT contrast examination by developing and applying pretreatment process system, which not only can reduce the side effects caused by the test but also can help carry out the test smoothly. The subjects were 214 patients who booked CT contrast examination from January 2014 to February 2014 but could not carry out their test on schedule. We analyzed the reasons for the delay and conducted follow-up survey on them. We analyzed the usefulness of pretreatment process system by contemplating and developing pretreatment process system and applying it to the patients for whom follow-up survey was conducted from January 2015 to February 2015. The number of outpatients who came to the hospital form January to February 2014 was 2,846 and the number of patients who could not undergo the test was 214, accounting for 7.52% of the total. The specific reason for the delay includes 214 cases of unknown creatinine 98 with 120 minutes of average delay time, 40 cases of creatinine over 1.3(19%) with 30minutes of average delay time, 34 cases of past contrast media side effect 6% with 40 minutes of average delay time and 25 cases of lack of pretreatment such as fasting, etc. 11% with 120minutes of average delay time. The number of CT scan has been increasing ever since the development of CT and the frequency of using the contrast media is expected to increase. If we can employ pretreatment process system in order to effectively control the side effect of contrast media and help the CT contrast examination to be smoothly conducted on schedule, I'm sure we could improve the quality of our medical service and increase our patients' satisfaction who come to our CT scan room.

Gastroscopic Findings of Rural Residents with Symptoms of Chronic Gastrointestinal Disorder (만성(漫性) 위장장애증상(胃腸障碍症狀)을 가진 농촌주민(農村住民)들의 위내시경(胃內視鏡) 검사소견(檢査所見))

  • Park, Jung-Han;Chun, Byung-Yeol;Lee, Dong-Koo;Choi, Yong-Whan
    • Journal of Preventive Medicine and Public Health
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    • v.19 no.1 s.19
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    • pp.85-90
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    • 1986
  • This study was conducted in July-August, 1984, to define the causes of chronic gastrointestinal symptoms in rural population and to provide data for the management of such patients. A household survey was conducted to identify all the residents of Youngchun and Sungiu counties in Kyungpook province who were over 20 years of age, had chronic upper gastrointestinal symptoms for over the last 6 months, never had medical examination for the symptoms, and volunteered to participate in the gastroscopic examination. Gastroscopy was done for 106 males and 108 females. Gastric ulcer was found in 16.8% of all the examinees, duodenal ulcer in 15.4%, gastritis in 14.0%, and gastric cancer in 3.7%. No lesion was found by gastroscopy in 52.3%. Gastric ulcer more common in male(26.4%) than in female(7.4%) (p<0.01) and the same was true for duodenal ulcer(20.8% of male, 10.2% of female). Gastric cancer was found in 7.5% of the male while none of the female had gastric cancer. A higher proportion of the female (68.5%) showed normal finding in the gastroscopy than the male(35.9%) (p<0.01). No significant association was found between the upper gastrointestinal symptoms and the gastroscopic findings. The higher prevalence rate of gastric ulcer than that of duodenal ulcer in this study which is the reverse of the study findings of urban area in Korea and western countries may be related in part with the dietary habit and social environment of the rural population. Although early diagnosis is the most important for the treatment of gastric cancer, many of the people with chronic upper gastrointestinal complaints defer the diagnosis and treatment. It is may be due to lack of the knowledge of diseases and the health care attitude of the rural people. A national program for the health education and mass screening for the gastric cancer should be developed.

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Current Status of Respiratory Care in Korean Intensive Care Units (국내 중환자실내 호흡치료의 현황)

  • Park, So-Yeon;Kim, Tae-Hyung;Kim, Eun-Kyung;Shim, Tae-Sun;Lim, Chae-Man;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.3
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    • pp.343-352
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    • 2000
  • Backgrounds : Respiratory care for patients in intensive care units (ICUs) has been performed mainly by nurses in Korea. However, the current status of respiratory care in the Korea ICUs is not well known. Respiratory care and the methods of delivery in ICUs were surveyed. Method : A confidential questionnaire was distributed to the head nurses working the ICUs at 117 hospitals in Korea. One hundred hospitals returned the questionnaires, for a response rate of 85%. The hospitals were divided into three groups : Main university hospitals (MUH), university associated hospitals (UAH), and general hospitals (GH) Result : Eighteen units of 66 units in MUH and 35 units of 58 units in GH were organized as a general ICUs. The percentage of ICUs with full-time doctors was 47.1%. The nurses usually delivered respiratory care spending from 1 to 4 h during their 8 h of working time. Although the respondents felt that respiratory care should be delivered by trained respiratory therapists, these therapists were not found at the hospitals. Most of the units performed percussion, tracheal suctioning, and positional changes. However, vibration and IPPB were less frequently performed in GH. Among oxygen supply apparatus, venturi mask and T-piece were not frequently used in GH. GH applied a noninvasive ventilator mode less frequently than MUH and UAH. The percentage of Swan-Ganz catheter monitoring was only 21.4% in GH. Conclusion : Respiratory care for patients in the Korean ICUs was provided by nurses on the whole. In addition, there were many differences in the level of respiratory care according to the type of hospital. To overcome the current problems revealed, an effective in-hospital training program for the development of full-time respiratory care therapists should be established urgently in Korea.

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A Pilot Study for the Remote Monitoring of IMRT Using a Head and Neck Phantom (원격 품질 보증 시스템을 사용한 세기변조 방사선치료의 예비 모니터링 결과)

  • Han, Young-Yih;Shin, Eun-Hyuk;Lim, Chun-Il;Kang, Se-Kwon;Park, Sung-Ho;Lah, Jeong-Eun;Suh, Tae-Suk;Yoon, Myong-Geun;Lee, Se-Byeong;Ju, Sang-Gyu;Ahn, Yong-Chan
    • Radiation Oncology Journal
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    • v.25 no.4
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    • pp.249-260
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    • 2007
  • Purpose: In order to enhance the quality of IMRT as employed in Korea, we developed a remote monitoring system. The feasibility of the system was evaluated by conducting a pilot study. Materials and Methods: The remote monitoring system consisted of a head and neck phantom and a user manual. The phantom contains a target and three OARs (organs at risk) that can be detected on CT images. TLD capsules were inserted at the center of the target and at the OARs. Two film slits for GafchromicEBT film were located on the axial and saggital planes. The user manual contained an IMRT planning guide and instructions for IMRT planning and the delivery process. After the manual and phantom were sent to four institutions, IMRT was planed and delivered. Predicted doses were compared with measured doses. Dose distribution along the two straight lines that intersected at the center of the axial film was measured and compared with the profiles predicted by the plan. Results: The measurements at the target agreed with the predicted dose within a 3% deviation. Doses at the OARs that represented the thyroid glands showed larger deviations (minimum 3.3% and maximum 19.8%). The deviation at OARs that represented the spiral cord was $0.7{\sim}1.4%$. The percentage of dose distributions that showed more than a 5% of deviation on the lines was $7{\sim}27%$ and $7{\sim}14%$ along the horizontal and vertical lines, respectively. Conculsion: Remote monitoring of IMRT using the developed system was feasible. With remote monitoring, the deviation at the target is expected to be small while the deviation at the OARs can be very large. Therefore, a method that is able to investigate the cause of a large deviation needs to be developed. In addition, a more clinically relevant measure for the two-dimensional dose comparison and pass/fail criteria need to be further developed.

Evaluation of Temperature and Humidity of a Thermo-Hygrostat of PET/CT Equipment using a Temperature and Humidity Sensor(BME 280) (온·습도센서(BME 280 센서)를 이용한 PET/CT 장비의 항온 항습기 온·습도 평가)

  • Ryu, Chan-Ju;Kim, Jeong-A;Kim, Jun-Su;Yun, Geun-Yeong;Heo, Seung-Hui;Hong, Seong-Jong
    • Journal of the Korean Society of Radiology
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    • v.14 no.1
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    • pp.15-22
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    • 2020
  • PET(Positron Emission Tomography) devices are used as PET/CT or PET/MRI devices fused with the devices of CT or MRI for obtaining anatomical information. Therefore, the devices are constructed in circular ring-type structure whose length of gantry(the main part of filming) becomes wider and the interior depth becomes longer in comparison to other common medical equipments. scintillator, one of the components in PET devices, is inside the gantry, and as it is consisted of crystal which is sensitive to the change of temperature and humidity, large temperature change can cause the scintillator to be damaged. Though scintillator located inside the gantry maintains temperature and humidity with a thermo-hygrostat, changes in temperature and humidity are expected due to structural reasons. The output value was measured by dividing the inside of the gantry of the PET/CT device into six zones, each of which an Adafruit BME 280 temperature and humidity sensor was placed at. A thermo-hygrostat keeps the temperature and humidity constant in the PET/CT room. As the measured value of temperature and humidity of the sensor was obtained, the measured value of temperature and humidity appeared in the thermohygrostat was taken at the same time. Comparing the average measured values of temperature and humidity measured at each six zones with the average values of the thermo-hygrostat results in a difference of 2.71℃ in temperature and 21.5% in humidity. The measured temperature and humidity of PET Gantry is out of domestic quality control range. According to the results of the study, if there is continuous change in temperature and humidity in the future, the aging of the scintillator mounted in the PET Gantry is expected to be aging, so it is necessary to find a way to properly maintain the temperature and humidity inside the Gantry structure.

Analysis of Bone Mellow Density in Adults of Domestic Local Area Using Multi-Detector Computed Tomography: Focus on Corelation About Eating Habits, Lifestyle, Physical Features and Social Characteristics (다중 검출 전산화단층촬영을 이용한 국내 일부 지역 성인의 골밀도 현황 분석: 식습관, 생활습관, 신체적, 사회적 특성과의 상관관계를 중심으로)

  • Lee, Tae Hui;Kim, Tae-Hyung;So, Woon Young;Lim, Hei Gyeom;Lim, Cheong-Hwan;Park, Myeong Hwan;Cheoun, Myung-Ki
    • Journal of radiological science and technology
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    • v.39 no.4
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    • pp.517-526
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    • 2016
  • This study analyzed the correlation between BMD (bone mineral density) value calculated in the MDCT (multidetector computed tomography) and lifestyle, physical features and social characteristics. From July 15 2015 to June 6 2016, we converted from HU (hounsfield unit) value measured by using MDCT to T-score for BMD of 141 patients (male: 63, female: 78) in W medical center. We measured the 2nd, 3rd and 4th lumbar spine and analyzed the correlation between gender differences in BMD and lifestyle, physical features and social characteristics. Statistical significance was validated using independent sample T test with one way Anova. Gender BMD was confirmed that a statistically significant difference (p<0.05). BMD values decreased with increasing age but for the statistically men, there was no significant difference from 20s to 50s, it only showed a significant difference in 20s and 60s (p<0.001). For the statistically women, there was no significant difference from 20s to 40s. but since 50s BMD was decreased rapidly, which showed a significant difference (p<0.001). women showed significant differences for the menstruation and menopause, childbirth, alcohol, cereals and greasy food in bone mineral density (p<0.05) but there were no significant differences in men. The bone mineral density values calculated by the MDCT and lifestyle, physical features and social characteristics correlation analysis method is considered to be used as a basis for estimating the state in BMD and osteoporosis management.

Quality of Life among Family Caregivers of Terminal Cancer Patient (말기 암 환자 가족 간병인의 삶의 질)

  • Jung, Jin-Gyu;Kim, Sung-Soo;Kang, Dong-Soo;Kim, Sung-Min;Lee, Dong-Hoon;Han, Kyung-Hee;Kim, Jong-Sung
    • Journal of Hospice and Palliative Care
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    • v.9 no.1
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    • pp.1-10
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    • 2006
  • Purpose: Terminal cancer influences on patients as well as their family members. This research was performed to evaluate the quality of lift of primary family caregivers and to investigate the influencing factors. Methods: The results of survey were collected from 81 family caregivers who were taking care of hospitalized terminal cancer patients at an oncology department of university hospital in Daejeon from March 2005 to January 2006 with questionnaires. The questionnaires were consisted of the general characteristics of the subjects, and 36-items short-form Health Survey (SE-36) Korean version to evaluate the quality of life of family caregivers, the characteristics of patients and family caregivers' caring trait. Results: Family caregivers' mean (${\pm}SD$) SF-36 score was 47.9 (${\pm}20.7$). Influential factors on family caregivers' life quality were daily raring hours, economic burden, type of treatment; only supportive care, caring duration, sex, the numbers of ADLs (activity of daily livings) items that patients needed help in order by stepwised multiple logistic regression analysis (overall $R^2=0.639$, P=0.044). Conclusion: Daily raring hours and economic burden were two influential modifiable factors on family caregivers' quality of life. Therefore, social supportive systems are required to reduce family caregivers' daily caring hour and economic burden.

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$H_2$ Receptor Antagonists and Gastric Cancer in the Elderly: A Nested Case-Control Study (노인 인구에서 $H_2$ Receptor Antagonist와 위암과의 관련성: 코호트 내 환자-대조군 연구)

  • Kim, Yoon-I;Heo, Dae-Seog;Lee, Seung-Mi;Youn, Kyoung-Eun;Koo, Hye-Won;Bae, Jong-Myon;Park, Byoung-Joo
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.3
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    • pp.245-254
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    • 2002
  • Objective : To test if the intake of $H_2$ receptor antagonists ($H_2$-RAs) increases the risk of gastric cancer in the elderly. Methods : The source population for this study was drawn from the responders to a questionnaire survey administered to the Korea Elderly Pharmacoepidemiological Cohort (KEPEC), who were beneficiaries of the Korean Medical Insurance Corporation, were at least 65 years old, and residing in Busan in 1999. The information on $H_2$-RAs exposure was obtained from a drug prescription database compiled between inn. 1993 and Dec. 1994. The cases consisted of 76 gastric cancer patients, as confirmed from the KMIC claims data, the National Cancer Registry and the Busan Cancer Registry. The follow-up period was from Jan. 1993 to Dec. 1998. Cancer free controls were randomly selected by 1:4 individual matching, which took in to consideration the year of birth and gender. Information on confounders was collected by a mail questionnaire survey. The odds ratios, and their 95% confidence intervals, were calculated using a conditional logistic regression model. Results : After adjusting for a history of gastric ulcer symptoms, medication history, and body mass index, the adjusted OR (aOR) was 4.6 (95% CI=1.72-12.49). The odds ratio of long term use (more than 7 days) was 2.3 (95% CI=1.07-4.82). The odds ratio of short term use was 4.6 (95% CI=1.26-16.50). The odds ratio of parenteral use was 4.4 195% CI=1.16-17.05) and combination use between the oral and parenteral routes (aOR, 16.8; 95% CI=1.21-233.24) had the high risk of gastric cancer. The aOR of cimetidine was 1.7 (95% CI=1.04-2.95). The aOR of ranitidine was 2.0 (95% CI=1.21-3.40). The aOR of famotidine was 1.7 (95% CI=0.98-2.80). Conclusion : The intake of $H_2$-RAs might increase the risk of gastric cancer through achlorhydria in the elderly.

Temporal Variations of Cerebrovascular Diseases in a University Hospital (일개 대학병원을 대상으로 한 뇌혈관질환의 시간적 변동양상)

  • Lee, Mi-Yon;Lee, Sang-Bock;Lee, Jun-Hang;Lee, Sam-Yul;Lee, Tae-Soo;Jin, Gye-Hwan
    • Journal of the Korean Society of Radiology
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    • v.1 no.1
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    • pp.17-23
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    • 2007
  • Background: Cerebrovascular diseases are known to show different patterns of incidence among regions and races. Therefore, it is very important to determine the incidence pattern of a specific area in order to diagnose, treat and prevent cerebrovascular diseases. The objective of the present study is to analyze quantitatively the incidence ratios of hemorrhagic and ischemic cerebrovascular diseases by season, by gender and by age. Methods: The subjects of this study were 1603 patients hospitalized for hemorrhagic or ischemic cerebrovascular diseases at the Department of Neurosurgery or the Department of Neurology of a University Hospital. Statistical analysis of data used Excel 2003 of Microsoft, and t-test was conducted using ORIGIN 6.0 of MICROCAL. Results: In the subjects, the incidence ratios of hemorrhagic and ischemic cerebrovascular diseases for four years, the period of this research, were 38.55% and 61.45%, respectively. The mean and standard deviation of age when hemorrhagic cerebrovascular diseases occurred were 58.20 and 12.60, respectively, and the percentages of subjects in their 40s, 50s, 60s and 70s were all around 20%. On the contrary, the mean and standard deviation of age when ischemic cerebrovascular diseases occurred were 65.01 and 13.59, respectively. The average age of patients with ischemic cerebrovascular diseases was older than that of patients with hemorrhagic brain diseases, and the percentages of those in their 60s, 70s and 80s were 15.53%, 37.06% and 27.72%, respectively. The season when hemorrhagic cerebrovascular diseases appeared most frequently was winter, which was followed by summer, spring and autumn. The season when hemorrhagic cerebrovascular diseases appeared most frequently was spring, which was followed by summer, winter and autumn. Conclusions: In this study, the incidence rates of hemorrhagic and ischemic cerebrovascular diseases were 38.55% and 61.45%, showing the rising percentage of ischemic cerebrovascular diseases. For making adequate prevention and disease control plans, it is considered necessary to make a long-term epidemiological investigation of cerebrovascular diseases.

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