The study aims to examine the knowledge and awareness of care workers on oral health knowledge at the geriatric care facilities in order to improve and develop oral health services. For the research method, the study carried out a questionnaire survey to 163 care workers working at the geriatric care facilities (10) in D Metropolitan City from May 1~31, 2015 and then the collected data were statistically analyzed. As a result, the oral health knowledge of care workers was 20.09 points out of total 26 points (77.2%). The highest knowledge was 'proper toothbrushing method' with 93.0% and the lowest one was 'knowledge on the use of oral supplementary goods' with 58.1%. Those with experience of oral health education had higher demand on oral health education (P<0.001), and those with higher experience of oral health education had significantly higher oral health knowledge (P<0.001), demand (P<0.01) and awareness (P<0.05). As for factors influencing care workers' oral health awareness, if they had higher oral health knowledge points (P<0.01), oral health education demand (P<0.01), they had higher oral health awareness level. Accordingly, it is required to provide efficient, sustainable and practical oral health education of care workers considering oral characteristics of the long-term hospitalized patients at the care hospital. And, the role of dental hygienist as the person in charge of oral health education is necessary. Therefore, institutional support from the government is required to assign professional personnel.
Purpose: Palliative procedures or surgical interventions not only manage various symptoms of malignant gastrointestinal obstruction, but also improve the quality of life. We investigated the clinical characteristics and prognostic factors of terminal cancer patients with palliative procedures for malignant gastrointestinal obstruction. Methods: We retrospectively reviewed the medical records of 48 terminal cancer patients with palliative procedures for malignant gastrointestinal obstruction at Sam Anyang hospital from May in 2002 to May in 2005. We excluded patients with palliative tumor resection. We analyzed prognostic factors in symtom-free survival and overall survival using Kaplan-Meier method, univariate and multivariate analysis. Results: There were 25 males (52%) and 23 females (48%), and median age of 48 patients was 65 years. The most common cause of malignant gastrointestinal obstruction was colorectal (26 patients, 55%), followed by stomach (10, 21%). Twenty patients (42%) received previous treatment (chemotherapy, surgery, and radiotherapy) and 28 (58%) never received any. Eighteen of 20 had received chemotherapy. The most common symptom was pain (15 patients, 31%). Twenty three patients (48%) had Eastern Cooperative Oncology Group(ECOG) performance status of 1 or 2 score and 25 patients (52%) 3 or 4 score. The most common palliative procedure was colostomy and there was no mortality concerning the palliative procedures. By univariate and multivariate analysis, performance status was the only independent prognostic factor in overall survival and symptom-free survival. Overall survival was 150 days and symptom-free survival was 90 days. Conclusion:. We confirmed that perftatdormance status is significant independent prognostic factor in terminal cancer patients with palliative procedures for malignant gastrointestinal obstruction.
Journal of the Korea Academia-Industrial cooperation Society
/
v.17
no.8
/
pp.407-414
/
2016
This study was conducted to provide basic data to evaluate the appropriateness of convalescent hospitalization treatment by investigating the number of hospitalization days and the total treatment expenses of a total of 44,037 monthly billing statements requested from the Health Insurance Review and Assessment Service. Evaluated data consisted of medical care expenses of patients of the diem payment system hospitalized at convalescent hospitals in Daejeon, Chungnam, Chungbuk and Sejong from January through December of 2014. According to the analysis result of the general characteristics of the study objects and the canonical correlation analysis of the top 15 main diagnosis names, 7 canonical functions have been deducted. Among them, six canonical functions were shown to be statistically significant (p<0.001), and canonical function 1 had a chi-squared value of 5955.49 and 98 degrees of freedom at p<0.001 level. Overall, the results indicated that if health and welfare service in the regional society is magnified, social hospitalization can be reduced.
Purpose: The aim of this study was to analyze the current status of end-of-life (EoL) care education of the undergraduate nursing curriculum and senior students' EoL care experience and competency. Methods: A survey was conducted with 41 nursing schools and 622 senior nursing students on June 2018. The questionnaire consisted of 38 items on teaching regarding EoL care and 17 items on EoL care competencies based on the suggestions made by the American Nurses Association. Results: Only 20% among 41 nursing schools opened an EoL care course as an elective, and the course was taken by 5.1% students. Of 622 students, 70.7% witnessed death of patients during their clinical training, but 74.8% received no or little education on EoL care from their clinical training instructors. Two of 38 education contents on EoL care were taught in class for over 80% of the students. All students scored below 3 points (2.31±0.66) for all 17 competencies, which means that they cannot perform EoL care. Conclusion: This study showed that there was a serious deficiency in undergraduate nursing education on EoL care. Accordingly, most nursing students who would graduate soon considered themselves incapable of performing EoL care. Nurses experience death and dying as a part of their practice and should be prepared to provide adequate EoL care. Therefore, it is urgent to improve EoL care training in the undergraduate nursing education.
This study was conducted to provide the base line for the use of prophylactic antibiotics and the standard of antibiotic use and the evaluation based on analysis of current use, quality assessment and periodic changes of prophylactic antibiotics in a university hospital. We chose the year 2008, 2009, 2010, 2012, and 2014 as the study periods since the primary evaluation on the first year of implementation in 2007. For this study, healthcare benefit quality assessment data from the Health Insurance Review and Assessment Service was used. We analyzed the differences each year of treatment period; one category for initial treatment timing, three categories for selecting antibiotics, and two categories for the length of treatment from multiple evaluation indices of gastric surgeries, colorectal surgeries, and cholecystectomy. The analysis revealed the followings: Regarding length of antibiotics treatment, total days of treatment decreased down to 1.5, 1.5, and 0.6 days in the year 2014, from 13.5, 12.8, and 6.9 days in the year 2007, for gastric surgeries, colorectal surgeries, and cholecystectomy. Based on these outcomes, the efforts to devise efficient delivery and distribution of the recommendations or indices which medical staff could adhere for quality improvement of the prophylactic antibiotics would be necessary. Also implementing monitoring system to help the hospitals to acknowledge their own faults may be helpful.
This study aims to figure out the effects of dental hygienists' professionalism and self-efficacy on job satisfaction using structural equations. This research conducted a survey to 616 study subjects. According to the analysis using SPSSWIN 18.0 and AMOS 20, the results are as follows : 1. It was shown that the dental hygienists' professionalism gained 3.34 points, self-efficacy was 3.76 points, and job satisfaction received 3.36 points. 2. It was found that as their age was higher, educational degree was higher, they were married, and working experience was more, their professionalism, self-efficacy, and job satisfaction were higher, which showed statistically significant difference. 3. Regarding the study model, there was positive effect as the correlation coefficient of professionalism and self efficacy was .69, that of professionalism and job satisfaction was .33, that of self-efficacy and job satisfaction was .59. In other words, there was correlation between professionalism and self-efficacy. When self-efficacy was higher than professionalism, job satisfaction also increased. Job satisfaction is affected by various environments within an organization and each individual's internal factors. The reason why job satisfaction is important is that along with the medical service quality and productivity, it is also associated with dental hygienists' individual life quality. In order to cope with this changeful time, it is needed for an organization to make efforts for change to enhance dental hygienists' job satisfaction, and also it is necessary to make endeavors so that dental hygienists can have confidence in their job and their professionalism and self-efficacy can be improved.
The purpose of the present study was to examine daily lives of elderly welfare recipients and their experiences with social welfare services. Researchers collected and analyzed data through individual interviews with 11 elderly welfare recipients. A major theme in the time context was "Daily lives enduring physical and mental sufferings alone and mismatches of social welfare services": 'Starting same tedious days: trading diligent work for basic living assistance', 'Forced ritual of having meals', 'Struggle with depressing night: not attentive welfare services at closing hours', 'Welfare services suspended in holidays', 'Mind and body withered by economic hardship in winter', 'Social support for enduring weary lives'. In the space context, a major themes was "Inadequate welfare services and social interaction in the context of social isolation": 'Unhygienic and unsafe living environment', 'Hiding places: spending tedious days in vacant lots', 'Community welfare centers useful only for healthy elderly', 'Differences and similarities of elderly in urban and rural areas', 'Receiving restricted medical services at hospitals', 'Hard-to-reach public institutions', 'ambivalence about living as welfare recipients'. Based on the findings, the researchers proposed implications for policy and practice to improve elderly welfare recipients' quality of life.
Personal Health Record(PHR) service can be helpful to patients with diseases requiring strict everyday care and medical treatment, such as diabetes or cancer. In this paper, we propose a PHR system specialized in collecting and analyzing health record data of cancer patients, and present the process of how the system can improve the efficiency of cancer treatment process. Through the smart device application, cancer PHR system obtains daily PHR data which is highly related and critical to cancer therapy. The analysis report is provided to the medical staff with an available format suited for Electronic Medical Record used at medical institution. With the final result of PHR analysis which is easily merged with medical chart, most efficient Chemotherapy treatment can be provided for the patients. Also it is possible for the patients to give the information of side-effect and other pain experience during therapy to their doctors without loss of information. The proposed PHR system has the effect of improving the quality of patient care by allowing the medical staff to acquire the main objective data necessary for drug prescription and medical care benefits.
The purpose of this study is to evaluate the convergence effectiveness of treadmill training in patients with chronic stroke through a meta-analysis. After searching the literature based on the patients, intervention, comparison, outcome criteria, and study desigan, a total of 22 studies related to "stroke" and "treadmill" were eligible for inclusion. Effect size was calculated using the comprehensive meta-analysis program for the meta-analysis. Based on the forest plot results, the overall effect size of treadmill training was 0.661 (95% confidence interval: 0.456-0.865), which was statistically significant with a medium effect size (p < 0.05). The effects of treadmill training on patients with stroke were separated by dependent variables of interest-plantar pressure (1.147), lower limb muscle function (0.875), and balance (0.664). The effect sizes were evaluated for the subdomains of timed up and go test (0.553), Berg Balance Scale (0.760), and static balance index (0.654) for balance. Therefore, treadmill training can be expected to have a positive impact on improving the quality of life of patients with chronic stroke. This meta-analysis of treadmill training may the lead to an industry paradigm shift toward healthcare convergence of information, communication, and medical technology.
This study performed to provide the basic information about the effects of the health management importance awareness on the occupational performance and basic fitness for the people with intellectual disabilities. 16 people with intellectual disabilities participated in muscle strengthening exercise. To assess health management importance awareness, the Canadian Occupational Performance Measure was used to identify the importance of the health management. According to the results of the importance, they were divided into two groups: Extreme and Neutral Importance Group in order to analyze the changes of the occupational performance and basic fitness. In-group analysis of the performance, satisfaction level, strength, and flexibility found that all measures improved in both groups following completion of the program. Between-group analysis following completion of the program indicated group differences in the performance and satisfaction level, but no group differences were found in the muscle strength and flexibility. Thus, this study showed the positive effects from the results of the program participation targeting the people with intellectual disabilities, and highlighted the importance of the awareness for them regarding the need for the health management (as evidenced by the improvement in occupational performance). It is expected that effective health management through participation in programs such as this will help maintain a healthy lifestyle and contribute to improve the quality of life.
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