• Title/Summary/Keyword: 입원환자 관리

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Perception and Satisfaction on Nutrition Counseling Service for Patients Consuming a Therapeutic Diet at Hospitals in Busan (부산지역 일부병원 치료식 섭취 환자의 영양상담에 대한 인식 및 만족도)

  • Yi, Jeong-Ryeh;Son, Eun-Joo;Lyu, Eun-Soon
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.39 no.9
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    • pp.1305-1312
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    • 2010
  • The purpose of this study was to investigate the perception and satisfaction on the nutrition counseling service for patients consuming a therapeutic diet at hospitals in Busan. The subjects were 153 inpatients at five hospitals with over 400 beds each. The research was performed through the interviewing process using questionnaires conducted from January to February, 2008. In a total of 88 patients, 57.5% had experienced nutrition counseling and were through the motives of counseling with doctors 64.2% and themselves 29.3% of the patients. In the method of nutrition counseling, 58% of the patients had an individual counseling. In the patients' perception on the nutrition counseling, 75.0% of the patients understood very well, 83.0% of them perceived the explanation as very important, 79.5% were very satisfied and 78.7% were helped in nutrition-management. On a scale of 5.00 for the nutrition counseling satisfaction, the average scores were 3.80 for 'explanation of knowledge', 3.71 for 'cognitive communication skills', 4.05 for 'effective communication skills' and 3.60 for 'facilitation skills'. The items of low scores in the nutrition counseling satisfaction were 'follow up diet-therapy after discharge', 'providing to personalized nutrition information', 'presentation of specific menu' and 'methods of menu planning'. There were significant (p<0.01) positive correlation between perception and satisfaction on the nutrition counseling. Therefore, it was suggested that dietitians increase the patients' satisfaction on the nutrition counseling with developing the model based on the patient-centered counseling.

Comparative Analysis of Delivery Management in Various Medical Facilities (의료기관별 분만관리 양상의 비교 분석)

  • Park, Jung-Han;You, Young-Sook;Kim, Jang-Rak
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.4 s.28
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    • pp.555-577
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    • 1989
  • This study was conducted to compare the delivery management including laboratory tests, medication and surgical procedures for the delivery in various medical facilities. Two university hospitals, two general hospitals, three hospitals, two private obstetric clinics, and two midwifery clinics in a large city were selected as they permitted the investigators to abstract the required data from the medical and accounting records. The total number of deliveries occurred at these 11 facilities between 15 January and 15 February, 1989 was 789 among which 606(76.8%) were vaginal deliveries and 183 (23.3%) were C-sections. For the normal vaginal deliveries, CBC, Hb/Hct level, blood typing, VDRL, hepatitis B antigen and antibody, and urinalysis were routinely done except the private clinics and midwifery clinics which did not test for hepatitis B and Hb/Hct level at all. In one university hospital ultrasonography was performed in 71.4% of the mothers and in one general hospital liver function test was done in 76.7% of the mothers. For the C-section, chest X-ray, bleeding/clotting time and liver function test were routinely done in addition to the routine tests for the normal vaginal deliveries. Episiotomy was performed in 97.2% of the vaginal deliveries. The type and duration of fluid infused and antibiotics administered showed a wide variation among the medical facilities. In one university hospital antibiotics was not administered after C-section at all while in the general hospitals and hospitals one or two antibiotics were administered for one week on the average. In one private clinic one pint of whole blood was transfused routinely. A wide variation was observed among the medical facilities in the use of vitamin, hemostatics, oxytocics, antipyreptics, analgesics, anti-inflammatory agents. sedatives. digestives. stool softeners. antihistamines. and diuretics. Mean hospital day for the normal vaginal deliveries of primipara was 2.6 days with little variation except one hospital with 3.5 days. Mean hospital day for the C-section of primipara was 7.5 days and that of multipara was 7.6 days and it ranged between 6.5 days and 9.4 days. Average hospital fee for a normal vaginal delivery without the medical insurance coverage was 182,100 Won for the primipara and 167,300 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 82,400 Won and a multiparous mother paid 75,600 Won. Average hospital fee for a C-section without the medical insurance was 946,500 Won for the primipara and 753,800 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 256,200 Won and a multiparous mother paid 253,700 Won. Average hospital fee for a normal vaginal delivery in the university hospitals showed a remarkable difference, 268,000 Won vs 350,000 Won, as well as for the C-section. A wide variation in the laboratory tests performed for a normal vaginal delivery and a C-section as well as in the medication and hospital days brought about a big difference in the hospital fee and some hospitals were practicing the case payment system. Thus, standardization of the medical care to a certain level is warranted for the provision of adequate medical care for delivery.

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A case of the Improvement Low Back Pain and Lumbar Strength by isotonic lumbar extension training on lumbar strength and self Low Back Exercise Stretching Program (등장성 재활 트레이닝 및 스트레칭 프로그램이 요통의 감소 및 요부근력증가에 미치는 임상 보고)

  • Kim, Young;Yun, Je-Pil;Kim, Sung-Yong;Lim, Jin-Kang;Kim, Young-Dal;Park, Jong-Min
    • The Journal of Korea CHUNA Manual Medicine
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    • v.4 no.1
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    • pp.119-127
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    • 2003
  • Objective : We found out improvement at low back pain and lumber strength by isotonic lumbar extension training on lumbar strength and self low back exercise stretching program. Methods : We evaluated the symptom's changes VAS(Visual Analogue Scale) and lumbar strength by Medx which could estimate and exercise lumbar muscle. Conclusions: We can decrease low back pain by strengthening lumbar muscle, in additionally when patients are In admission state we may improve lumbar muscle more than Opd. state.

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Pain and Pain Management in Hospitalized Cancer Patients (입원 암환자의 통증 실태와 통증관리 실태)

  • Kim, Mi-Jung;Park, Jin-A;Shin, Su-Jin
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.15 no.2
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    • pp.161-170
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    • 2008
  • Purpose: The purpose of this study was to provide basic data for proper pain management. Method: Data were collected from 85 hospitalized patients with cancer pain. A retrospective chart review of level of pain, source of pain, verbal expression of pain, and pain management was done. The data were analyzed with the SPSS program. Results: The level of pain measured by NRS at the three time points was as follows Time 1 ($4.40{\pm}2.25$), Time 2 ($0.61{\pm}1.30$), Time 3 ($2.47{\pm}2.75$). The kinds of pain were somatic pain (51.8%), visceral pain (37.6%), neuropathic pain (12.9%). The analgesic amount measured by OME (oral morphine equivalent) was as follows: Time 1 ($70.85{\pm}69.65$), Time 2 ($91.61{\pm}89.20$), Time 3 ($96.71{\pm}94.25$). Degree of pain had significant differences according to type of cancer (F=-3.286, p= .002), cancer origin (F=2.906, p= .018), and metastasis (F=2.906, p= .018) at Time 2. Best control period had significant difference according to type of cancer (F=2.373, p= .023), and origin of cancer (F=2.466, p= .040) at Time 2 Conclusion: These finding will enable the application of nursing interventions for pain control in cancer patients, identification of kinds of nursing compared to priorities, and increased levels of comfort in cancer patients in clinical settings.

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Effects on Recovery Oriented Integrated Rehabilitation Program for Chronic Schizophrenic Patients (만성정신분열병 환자를 위한 회복지향의 통합재활프로그램의 효과)

  • Bong, Eun-Ju;Si, Youn-Hwa;Park, Myung-Sook;Bae, Kyung-Hee;Jung, Mi-Jin;Yang, Mi-Hwa;Kim, Song-Ja
    • The Journal of the Korea Contents Association
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    • v.12 no.1
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    • pp.416-429
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    • 2012
  • This study was to assess the effects of a recovery oriented integrated rehabilitation program on cognitive social function, rehabilitation motivation, and mental health recovery. This program is involved motivation enhancement program with 4 subprograms composed of cognitive rehabilitation, emotion management, vocational rehabilitation, family education program. The subjects were 34 patirents with schizophrenia who had been hospitalized at National Mental Hospital on local area. The study was a non-equivalent control group non-synchronized design with two groups, an experimental group(18 patients) and a control group(16 patients). The collected data were analyzed using SPSS 12. 0. The results of the data show that there was not a significant increase in the symptom, cognitive and social function. But there was a significant increase in readiness of rehabilitation(maintenance, p=.027) and mental health recovery (p=.039). Short term recovery oriented integrated rehabilitation programs in inpatient settings are more available for motivation of rehabilitation and mental health recovery than symptom reduction or functional improvement. Therefore there should be more efforts to create more recovery oriented service provision in clinical settings.

Effects of Anxiety, Resilience, and Self-efficacy on the Professional Competence of Nurses during the COVID-19 Pandemic (COVID-19 팬데믹 동안 간호사의 불안, 회복탄력성, 자기효능감이 전문직 역량에 미치는 영향)

  • Pratibha, Bhandari;Jinsook, Kim;Su Kyoung, Chung
    • Journal of Industrial Convergence
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    • v.21 no.2
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    • pp.43-52
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    • 2023
  • This study was conducted to examine the relationship of the COVID-19-related anxiety, self-efficacy, resilience, and professional competence of nurses working in hospitals where COVID-19 patients are hospitalized. Additionally, this study attempted to identify factors that affect the professional competence of nurses. Using a cross-sectional descriptive study design, an online survey of 120 nurses working at hospitals where COVID-19 patients were hospitalized was conducted between February 9 and February 19, 2021. Pearson's correlations were used to assess correlations between the main variables, and stepwise multiple regression was used to identify factors influencing professional competence. Results of the study showed that the professional competence of nurses was positively correlated with self-efficacy (r=.58, p<.001) and resilience (r=.56, p<.001). The correlation between professional competence and COVID-related anxiety was not significant (r=-.03, p=.766). Factors affecting professional competence included self-efficacy (β=.36, p=.004) and resilience (β=28, p=.021). The model explained approximately 35% of the variance in nurse professional competence (F=33.65, p<.001). To fully demonstrate the professional competence of nurses during the COVID-19 pandemic, institution-based programs should be developed and applied to improve their self-efficacy and resilience. In order to prevent the burnout of nurses in the longer-than-expected COVID-19 pandemic, efforts and policies at the nursing organization level are needed to systematically manage and monitor self-efficacy and resilience of nurses.

Clinical Observations in Vancomycin-Resistant Enterococci Isolated from Pediatric Patients (소아 환아에서 분리된 Vancomycin 내성 장구균에 대한 임상적 고찰)

  • Lee, Dong Woo;Lee, Kyung Jae;Jang, Gwang Choen;Kim, Dong Soo;Lee, Kyung Won;Park, Eun Suk
    • Pediatric Infection and Vaccine
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    • v.8 no.2
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    • pp.199-205
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    • 2001
  • Purpose : Since the first report of vancomycin-resistant enterococci(VRE) in 1986, the resistance to vancomycin in enterococci has been increasingly rapidly. In this study, we investigated the clinical manifestations of pediatric patients with VRE and the pattern of the antibiotic use with increasing the rate of VRE in pediatrics Methods : We studied retrospectively 36 pediatric patients who were isolated VRE from January 1998 to December 2000. We classified patients into ICU and non ICU groups and reviewed species of VRE, specimens in which VRE were first detected and procedures performed before VRE detected. Results : We have found that the number of pediatric patients isolated VRE is increasingly annually in this study. In addition, the number of VRE-isolation in the ICU group and in patients who were operated or who underwent active procedures is much higher than that of in the non ICU group and in patients who were taken medication only. Enterococcus faecium is the main species of VRE. VRE showed high resistance to almost all antibiotics except tetracycline, and resistance was closely related to the duration of hospitalization and history of the antibiotic use. The proportion of the cephalosporin use was higher than any other antibiotic before VRE detection. In contrast, that of teicoplanin was higher than any other antibiotic after VRE detection(P<0.05). The cases of superinfection is higher in the ICU group than in non ICU group. Conclusion : In the hospital level, prevention of nosocomial infection through proper administrative policies, through surveillance of high risk VRE regions and prudent antibiotic use can prevent VRE outbreaks and corresponding side effects.

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Change of Antimicrobial Use Density According to Application of Computerized Management Program for Restriction of Antimicrobials Use in a University Hospital (일개 대학병원에서 제한 항생제 전산 프로그램 운용에 따른 항생제 사용량 변화)

  • Lee, Bo Young;Kim, Chun Soo;Ryu, Seong Yeol;Kwon, Ki Yung;Lim, Jung Geun;Lim, Tae Jin;Min, Byung Woo;Ryoo, Nam Hee;Cha, Soon Do
    • Pediatric Infection and Vaccine
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    • v.13 no.2
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    • pp.155-162
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    • 2006
  • Purpose : Appropriate use of antimicrobials is an essential factor to treat infectious diseases and prevent acquisition of antimicrobial resistant pathogens. This study was undertaken to search that application of computerized management program for restriction of antimicrobials use in a hospital is helpful to decrease antimicrobial use density. Methods : Antibiotics utilization committee decided to restrict the use of 16 antimicrobials(14 expensive drugs having fear of drug resistance by pathogens and additional two drugs with inappropriate using tendency). Retrospective evaluation of antimicrobial user numbers between May and July of 2004 and 2005(study group) was conducted to compare with previous use density during same period of 2002 and 2003(control group). Results : Inpatients number of control group($823.5{\pm}37.1$ persons) was more than study group($809.2{\pm}39.3$ persons, P<0.001), but, outpatients number and hospitalized duration were equal in two groups. Antimicrobial user number/100 inpatients per day of glycopeptides and antifungal agents was equal in two groups, and study group was significantly higher density than control group in the use of carbapenems, piperacillin-tazobactam and quinolones(P<0.001). But study group was significantly lower density than control group in the use of drugs with inappropriately using tendency and expensive cephalosporins having broad antimicrobial spectrum(P<0.001). Conclusion : Application of computerized management program for restriction of antimicrobials use in a hospital is effective to decrease the use density of antimicrobials with inappropriately using tendency, but it is an insufficient measures for the restricted use of other antimicrobials on the whole.

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Survey of Current Status of the Patients with Home Ventilator in Seoul and Kyunggi Province (가정용 인공호흡기를 사용하는 서울 및 경기 지역 환자의 실태)

  • Ahn, Jong-Joon;Lee, Ki-Man;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.5
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    • pp.624-632
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    • 2000
  • Background : Home ventilation can decrease hospital-acquired infection, increase physical activity, improve nutritional status, enhance quality of life, and reduce medical costs. The number of patient using home ventilators has been increasing, particularly in Europe and United States. Although the number of patients with home ventilation has been increasing in Korea, the current status of these patients is not well known. This study was undertaken to obtain basic information upon these patients in addition to evaluating any problems related to patients' home care in our country. Methods : A register of 92 patients with home ventilators in Seoul and Kyunggi Province were obtained from commercial ventilator supply companies. The patients were contacted by phone and 29 of them accepted our visit. Information concerning education about home care before discharge, equipment cost, and problems related to home care were documented. The mode and preset variables of the home ventilator were checked; tidal volume (TV), peak airway pressure, and oxygen saturation were measured. Results : There were 26 males (90%) and their mean age was 48.0 (${\pm}20.1$) years. The underlying diseases were : 21 neuromuscular disorders, 2 spinal cord injuries, 6 chronic lung diseases. Among the caregivers, spouses (n=14) predominated. Education for home care before discharge was performed primarily by intensive care unit nurses and the education for ventilator management by commercial companies. Twenty-five of the 29 patients had tracheostomies. Volume targeted type (VTT ; n=20, 69%) was more frequently used than the pressure targeted type (PTT). Twenty-three of the 29 patients purchased a ventilator privately, which cost 7,450,000 (${\pm}$3,290,000) won for a PTT, and 14,280.000 (${\pm}$3,130,000) won for a VTT. Total cost for the equipment was 11,430,000 (${\pm}$634,000) won. The average cost required for home care per month was 1,120,000 (${\pm}$1,360, 000) won. Conclusion : The commonest underlying disease of the patients was neuromuscular disease. The VTT ventilator was primarily used with tracheostomy. Patients and their families considered the financial difficulties associated with purchasing and maintaining equipment for home care an urgent problem. Some patients were aided by a visiting nurse, however most patients were neglected and left without professional medical supervision.

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Prevalence and Treatment Pattern of Korean Patients with Temporomandibular Disorders (한국인 턱관절장애 환자의 유병률과 진료 양태)

  • Yang, Hee-Young;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.34 no.1
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    • pp.63-79
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    • 2009
  • While previous epidemiological studies on temporomandibular disorders (TMD) have been based on a given health center or population sample, no study has been performed on general population of Korea, especially concerning about treatment pattern such as clinician’s specialty involved in TMD treatment, types and amount of prescription medication and cost. This study aimed to investigate magnitude of health visits and treatment patterns for Korean patients with TMD through the computerized database of Health Insurance Review and Assessment Service (HIRAS). Inclusion criteria were all patients registered on the HIRAS database over 3 years' period from 2003 to 2005 and the medical records of patients with TMD as a main diagnosis were extracted. Information collected was as follows; distribution related to gender, age and region and type of hospital the patients visited, treatment duration, clinicians' specialty involved in treatment, cost, types of prescription medication and surgical treatment. The results of this study indicated that 0.15% of the population yearly sought TMD treatment, presenting with increase of incidence over the three years. Most of TMD patients were women (99.8%) and the biggest age group was second and third decades and decreased with age. Seoul and Kyeonggi province presented with higher incidence of TMD compared to the other regions of Korea, which seems to be related with magnitude of population. 56% of TMD patients visited primary care sector and the numbers of treatment visits was the highest in dental clinic (38.4%), followed by orthopedics (28%) and ENT (13.6%) clinics in order. Duration of prescription medication was the longest for anti-inflammatory analgesics, followed by antipsychotic drugs and muscle relaxants. Inpatient care related to TMD was primarily performed in dental hospital compared to medical hospital. Medical database of HIRAS provided comprehensive and vast information on epidemiologic characteristics and treatment patterns for patients seeking TMD treatment, which can be more reliable data to expect medical demand for TMD in condition that accurate diagnosis and standardized treatment is delivered in clinical settings.