• Research in Community and Public Health Nursing
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• v.21 no.3
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• pp.321-332
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• 2010

Purpose: This study examined change in healthcare utilization by disease severity after case management (CM) for Medicaid. Methods: Data were extracted from survey data on "Healthcare utilization and health status of Medicaid beneficiaries" conducted in 2007 and 2008 by the Ministry for Health, Welfare and Family Affairs. This study was designed to compare change in healthcare utilization between the CM group and the non-CM group. The subjects were 528 Type I Medicaid beneficiaries who utilized healthcare more than 365 days during 2006. Results: In beneficiaries having fewer than 3 among the 11 notified diseases, the CM group showed a significantly larger decrease in outpatient day, outpatient expense, medication day, and medication expense than the non-CM group. In beneficiaries having 3 or more among the 11 notified diseases, however, there was no significant difference in healthcare utilization between the CM group and the non-CM group. Conclusion: CM worked effectively on Medicaid beneficiaries outpatient healthcare utilization for mild diseases. However, its effects on hospitalization, which is a major cause increasing the total expense, were not observed. Therefore, a future study is needed to develope strategies to reduce hospitalization and care for Medicaid beneficiaries with severe diseases.

• Journal of Korean Critical Care Nursing
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• v.8 no.1
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• pp.71-79
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• 2015

Purpose: The purpose of this study was to compare the applicability of the Charlson Comorbidity Index (CCI) and Acute Physiology, Age, Chronic Health Evaluation III (APACHE III) to the prediction of the healthcare outcomes of intensive care unit (ICU) patients. Methods: This research was performed with 136 adult patients (age>18 years) who were admitted to the ICU between May and June 2012. Data were measured using the CCI score with a comorbidity index of 19 and the APACHE III score on the standard of the worst result with vital signs and laboratory results. Discrimination was evaluated using receiver operating characteristic (ROC) curves and area under an ROC curve (AUC). Calibration was performed using logistic regression. Results: The overall mortality was 25.7%. The mean CCI and APACHE III scores for survivors were found to be significantly lower than those of non-survivors. The AUC was 0.835 for the APACHE III score and remained high, at 0.688, for the CCI score. The rate of concordance according to the CCI and the APACHE III score was 69.1%. Conclusion: The route of admission, days in ICU, CCI, and APACHE III score are associated with an increased mortality risk in ICU patients.

• Journal of Korean Critical Care Nursing
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• v.9 no.1
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• pp.15-26
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• 2016

Purpose: The aim of this study was to identify thinking strategies in the complicated decision-making process based on real patient-based data of triage nurses in the emergency department (ED). Methods: This study used the 'think aloud' method to collect data from 8 triage nurses from one general hospital ED in South Korea. The data were analyzed with protocol analysis using thinking strategies. Results: The triage process was divided into three stages. The first stage consisted of 8 thinking strategies, including searching for information. They used intuition based on directly observed concepts for identifying a crisis. The second stage consisted of 17 thinking strategies related to the decision-making process. They assessed patients and generated a hypothesis to try to understand their health problems through analytic thinking. The third stage consisted of 10 thinking strategies, including qualifying. They considered the situation of the ED and properly triaged the patients. During the triage process, they frequently used judging the value and searching for information on 17 thinking strategies. Conclusions: Triage nurses demonstrated various connected thinking strategies for each stage. Based on our results, further studies should be done to develop a triage education program.

• Proceedings of the Korean Society for Food Science of Animal Resources Conference
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• 2004.10a
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• pp.297-300
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• 2004

본 연구는 국내 돼지 도축 작업장에서 이용되고 있는 돼지의 실신방법에 따른 PSE 발생율을 구명하여 돼지고기 품질개선에 기초자료로 활용하고자 수행하였다. 공시축의 도체 특성과 품질특성을 비교한 결과로서 도체중은 정상육이 74.6kg으로 중증 및 경증 PSE육의 각각 76.9 및 77.0kg에 비하여 유의적으로 낮은 결과를 보였다. 등지방층 두께에 있어서도 정상육이 16.2mm로 PSE육 17.1, 17.3에 비하여 얇았다(p<0.05). 근내지방도는 정상육이 2.1로서 경증 PSE 1.6, 중증 PSE 1.4에 비하여 유의적으로 높았다. 전살 전압별 PSE발생율을 조사한 결과 전살전압이 220V인 경우 PSE 발생율이 12.3%, 240V 17.41%, 250V 24.91%, 430V 43.12%을 보여 전살전압이 높아질수록 PSE돈육의 발생율이 증가하는 경향을 보였음으로 실신조건에 따른 PSE 발생율을 구명하기 위하여, 동일한 작업조건에서 실신방법만 달리하여 비교한 결과 고전압 전살(500V)의 경우 PSE돈육 발생율이 72.86%이였으나, $CO_2$ 실신의 경우는 39.28%로 $CO_2$실신에 의하여 33%의 PSE 감소 효과를 가져 왔다.

• Child Health Nursing Research
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• v.13 no.2
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• pp.136-146
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• 2007

Purpose: The purpose of this study was to develop a tool to assess the severity of illness in high risk newborns. Method: The research design was a methodological study. The tool was developed in 4 stages: first, preliminary items were developed based on a questionnaire about the severity of illness index that was given to 8 health professionals in Neonatal Intensity Care Units (NICU) second, a panel of specialists reduced the preliminary items using 3 validity tests; third, final items were selected from the results of a pre-test. Finally, from July 2005 to May 2006, reliability and validity were tested with a sample of 160 high risk newborns admitted to the NICU. Results: The final tool to identify the severity of illness index in high risk newborns consisted 39 items and Cronbach's alpha coefficient for internal consistency was .922. Using factor analysis, 4 factors were extracted and these factors explained 54.451% of the total variance. Conclusion: The instrument for assessing the severity of illness in high risk newborns developed in this study was identified as a tool with a high degree of reliability and validity. In this sense, this tool can be effectively utilized for assessing and implementing care for high risk newborns.

• Journal of Korean Medical classics
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• v.19 no.2 s.33
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• pp.11-29
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• 2006

${\ulcorner}$동의수세보원(東醫壽世保元)${\lrcorner}$소음인편(少陰人篇), 유신수열표열병화위수한리한병양대부분조성(由賢受熱表熱病和胃受寒畵寒病兩大部分組成). 신수열표열병(賢受熱表熱病), 분위울광증(分爲鬱狂證), 망양증(亡陽證), 태양병궐음증등삼개병증(太陽病厥陰證等三個病證). 상한론적하초축혈증시사기재하조적혈증(傷寒論的下焦血證是邪氣在下蕉魚的血證), 용저당탕(用抵當湯), 도인승기탕등파열해열지제치료(桃仁承氣湯等破血解熱之劑治療). 단동무인위상한하초축혈증위울축방광증(但東武認爲傷寒下蕉蓄血證爲鬱蓄醫謗胱證) 기병기시신국양기피사소거(其病機是賢局陽氣被邪所拒), 불능상소어비국(不能上疏於脾局), 울축방광(鬱蓄膀胱). 고동무장양기울축적병증시(故東武將陽氣鬱蓄的縮的病證視), 위울광증(爲鬱狂證), 장양기누설적한출시위망양증(將陽氣漏泄的汗出視寫亡陽證). 동무장태양상풍무한증(東武將太陽傷風無汗證), 하조축혈증(下蕉蓄血證), 귀속우울광초증(歸屬于鬱狂初證), 장열입혈실증(將熱入血室證), 양명병위가가실증(陽明病胃家實證), 귀속우울광중증(歸屬于鬱狂中證), 장양명병조열광언증(將陽明病湖熱狂言證), 귀속우울광말증(歸屬手驚狂末證), 장태양상풍한출증(將太陽傷風出證), 귀속우망양초증(歸屬于亡陽初證), 장양명병(將陽明病), 불오한(不惡寒) 반오열(反惡熱) 한자출증(汗自出證), 귀속우망양중증(歸屬手亡陽中證), 장양명병(將陽明病), 발열한다증(發熱汗多證), 귀속우망양말증(歸屬手亡陽末證). 타인위소음인음병당유복만자리(他認爲少陰人陰病當有腹題滿自利), 시병등증상(時病等症狀). 초기약무복통자리적증상이견궐음증(初起若無複痛自利的症狀而見厥歐陰證), 인위시정사상지일구이경기쇠갈소치(認爲是正邪相持日久而正氣衰竭所致).

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.10 no.1
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• pp.60-65
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• 2007

An unconscious 5-year-old girl was admitted to the Intensive Care Unit. She was neglected by her parents; she suffered from inadequate nutritional, medical and emotional care. The girl appeared to be emotionally detached, dehydrated and malnourished; she had edematous extremities, moderately bruised skin and brittle coarse hair. Laboratory testing showed electrolyte imbalance, anemia, pneumonia, copper deficiency, and liver dysfunction in addition to severe protein-energy malnutrition (PEM). Medical intervention was followed by improvement of most of the symptoms. During the rehabilitation phase, the patient showed a voracious appetite and gained weight too fast. The liver became enlarged and the patient developed a mild fever due to excessive nutrition. The microcytic anemia with severe PEM did not responded to iron supplementation possibly due to the copper deficiency. Addition of copper without zinc and iron helped to improve the anemia. The patient was discharged to a childcare center where she received cognitive and psychosocial therapy.

• Proceedings of the Korea Institute of Fire Science and Engineering Conference
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• 2003.04a
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• pp.248-254
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• 2003

According to the analysis of the patient transport in the fire disaster occuring at Taegu Subway Jungangro Station February 18th, 2003, authors concluded as follows. Patients were transported mainly to medical institutes which were larger and that had shorter distance. Because of non-emergenct patient's transport to larger and nearer institutes, some critical patients should be transported to more distant institutes. Dead patients before arrival were transported relatively evenly. An adequate transport according to adequate triage should be performed in the future. Early mitigation and response, correlation with the method of transport, regional guide line of disaster transport and correlation between disaster information and emergency medical information should be corrected and need research in the future.

• Child Health Nursing Research
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• v.21 no.3
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• pp.227-235
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• 2015

Purpose: The purpose of this study was to investigate disease prevalence, parent's educational needs, and disease management according to severity of respiratory infections in early childhood. Methods: Participants for this study were 173 mothers whose child was admitted to I university hospital in Seoul and whose child was an infant or toddler. Data were collected from December, 17, 2014 to February, 15, 2015 using self-report structured questionnaires. Data were analyzed using IBM/SPSS 21.0 program. Results: There were significant differences in the severity of respiratory infection according to neonatal admission due to dyspnea, feeding type, atopic dermatitis in the infant or allergic disease in father and siblings. Parent's educational needs for the severe respiratory infection group were higher than for the non-severe group. Parent's disease management for the severe respiratory infection group was lower than the non-severe group. Conclusion: As important care factors in neonatal admissions include dyspnea, cow milk feeding, eczema, family history of allergies, parent's educational needs and disease management, they should be considered when caring for young children with respiratory infections and their parents.

• Journal of Digital Contents Society
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• v.10 no.3
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• pp.469-477
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• 2009

This study is about Augmentative and Alternative Communication as handicapped people actively pursue their life. Especially, although there are many ways and devices for communicating the same as a normal person, descriptive supplementation and sustaining studies are needed for perfect communication as a normal person. The purpose of the paper is to help handicapped people who have hardships about communication. This study develops the function of Smart Workflow AAC(Augmentative and Alternative Communication) and IR sensor_based context aware function that can offer services convenient to classified handicapped people for helping them to communicate effectively. This system from an experimental basis has improved efficiency to communicate more harmoniously within individual handicapped situations to schedule management and communication of handicapped people.