• Title/Summary/Keyword: 환자분류도구

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Reliability of the Emergency Severity Index Version 4 Performed by Trained Triage Nurse (중증도 분류 간호사에 의한 응급환자 중증도 분류 신뢰도 측정 연구: Emergency Severity Index Version 4를 중심으로)

  • Choi, Hee Kang;Choi, Min Jin;Kim, Ju Won;Lee, Ji Yeon;Shin, Sun Hwa;Lee, Hyun Jung
    • Journal of Korean Critical Care Nursing
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    • v.5 no.2
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    • pp.61-71
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    • 2012
  • Purpose: The aim of this study was to measure the inter-rater reliability of Emergency severity index (ESI) version 4 among triage nurse. Methods: This study was carried out from August 11, 2010 to September 7, 2010 in a regional emergency department. Data collection was done by ten triage nurses who trained ESI v.4. Two research nurses and ten triage nurses scored the ESI version 4 to the patients as references, independently. We calculated the weighted kappa between the triage nurses and research nurses to evaluate the consistency of the ESI v.4. Results: A total of 233 patients were enrolled in this study. Classification of ESI level was as follows - level 1 (0.4%), level 2 (21.0%), level 3 (67.8%), level 4 (9.4%), and level 5 (1.3%). Inter-rater reliability by weighted kappa was 0.79 (95% Confidence Interval= 0.74-0.83) and agreement rate was 87.1%. Under-triage rate by triage nurse was 6.0% and over-triage rate was 6.9%. Conclusion: For this study, inter-rater reliability was measured good level between triage nurses and research nurses in Korean single ED.

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Data Efficient Image Classification for Retinal Disease Diagnosis (데이터 효율적 이미지 분류를 통한 안질환 진단)

  • Honggu Kang;Huigyu Yang;Moonseong Kim;Hyunseung Choo
    • Journal of Internet Computing and Services
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    • v.25 no.3
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    • pp.19-25
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    • 2024
  • The worldwide aging population trend is causing an increase in the incidence of major retinal diseases that can lead to blindness, including glaucoma, cataract, and macular degeneration. In the field of ophthalmology, there is a focused interest in diagnosing diseases that are difficult to prevent in order to reduce the rate of blindness. This study proposes a deep learning approach to accurately diagnose ocular diseases in fundus photographs using less data than traditional methods. For this, Convolutional Neural Network (CNN) models capable of effective learning with limited data were selected to classify Conventional Fundus Images (CFI) from various ocular disease patients. The chosen CNN models demonstrated exceptional performance, achieving high Accuracy, Precision, Recall, and F1-score values. This approach reduces manual analysis by ophthalmologists, shortens consultation times, and provides consistent diagnostic results, making it an efficient and accurate diagnostic tool in the medical field.

Differences of Personality Characteristics According to the Suicide Symptoms in Patients with Depression (우울증 환자에서 자살 증상 유무에 따른 성격 특성의 차이에 관한 연구)

  • Choi, Yong Lak;Oh, Mi Ae;Lee, Sang Min;Kim, Jong Woo;Kang, Won Sub
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.2
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    • pp.164-172
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    • 2019
  • Objectives : The purpose of this study was to examine personality traits associated with suicidal symptoms (with history of suicide attempt or suicidal idea) in depressed patients. Methods : A sample 186 patients diagnosed with major depressive disorder was divided into two groups : suicidal group (with history of suicide attempt or suicidal idea, n=70) and non-suicidal group (without history of suicide attempt or suicidal idea, n=116). NEO Personality Assessment System were used to evaluate personality trait. Results : Neuroticism was high in suicidal group (p=0.041). In multivariate logistic regression, Neuroticism was also a significant influence on suicidal symptoms (Odds Ratio=1.04, 95% Confidence Interval 1.01-1.07, p=0.0145). Conclusions : High Neuroticism is a useful information to identify individuals at high risk of suicide in depressive patients.

Measurement of Ambulatory Patients' Satisfaction and Its Influencing Factors in a Tertiary Hospital (병원 외래 방문 환자의 만족도 평가 및 관련 요인에 대한 연구 - 한 3차 병원 방문 환자를 중심으로 -)

  • Lee, Sang-Il
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.2 s.46
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    • pp.366-376
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    • 1994
  • Patients' evaluation of hospital care is one of the most important aspects of quality assessment. Survey allows patients to judge sujectively the events that occur during their hospital visit if performed properly. This study describes the result of a research effort to develop outpatient questionnaire that has sufficient validity and reliability to be used to measure patients' perception of satisfaction in Korea and to investigate influencing factors on patients' satisfaction. Self-administered questionnaire was developed for outpatient and the survey was conducted covering 827 outpatients in a tertiary hospital. It was confirmed by factor analysis that patients evaluate several components of ambulatory care distinctly ; hospital environment, administration and ancillary services, and medical care. We found strong evidence of construct validity and internal consistency for the above three dimensions of hospital process. On the contrary, reliability of overall outcome measures was low. It suggests that three items concerning overall outcome measures have some different meanings in patients' perception. Using logistic regression analysis it was found that previous health status, cost evaluation, and improvement in health status have significant influences on the level of patients' overall satisfaction and that patient's sex, experience of previous visit, expectation for improvement, cost evaluation, and improvement in health status are strongly related with intention to recommend hospital. In spite of some limitations the results of this study can be used helpfully as baseline informations for developing self-administered questionnaire and for exploring the influencing factors on patients' satisfaction. Further comprehensive research efforts should be made on the measurement of ambulatory patients' satisfaction and its related factors in current Korean situation.

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Classification of Fall in Sick Times of Liver Cirrhosis using Magnetic Resonance Image (자기공명영상을 이용한 간경변 단계별 분류에 관한 연구)

  • Park, Byung-Rae;Jeon, Gye-Rok
    • Journal of radiological science and technology
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    • v.26 no.1
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    • pp.71-82
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    • 2003
  • In this paper, I proposed a classifier of liver cirrhotic step using T1-weighted MRI(magnetic resonance imaging) and hierarchical neural network. The data sets for classification of each stage, which were normal, 1type, 2type and 3type, were obtained in Pusan National University Hospital from June 2001 to december 2001. And the number of data was 46. We extracted liver region and nodule region from T1-weighted MR liver image. Then objective interpretation classifier of liver cirrhotic steps in T1-weighted MR liver images. Liver cirrhosis classifier implemented using hierarchical neural network which gray-level analysis and texture feature descriptors to distinguish normal liver and 3 types of liver cirrhosis. Then proposed Neural network classifier teamed through error back-propagation algorithm. A classifying result shows that recognition rate of normal is 100%, 1type is 82.3%, 2type is 86.7%, 3type is 83.7%. The recognition ratio very high, when compared between the result of obtained quantified data to that of doctors decision data and neural network classifier value. If enough data is offered and other parameter is considered, this paper according to we expected that neural network as well as human experts and could be useful as clinical decision support tool for liver cirrhosis patients.

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Differences in Verbal Fluencies and Discourse Comprehension Abilities associated with Working Memory in Alzheimer's Disease and Vascular Dementia (알츠하이머와 혈관성 치매 환자 선별에서의 작업기억 능력 관련 구어유창성 및 이야기이해 능력의 차이)

  • Yeo, Hangyeol;Kim, Choong-Myung
    • Journal of the Korea Convergence Society
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    • v.11 no.12
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    • pp.383-390
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    • 2020
  • The present study was conducted to examine the differences and correlations between verbal fluency and story comprehension according to the working memory(WM) capacity, and to find out what WM factors influence the linguistic competence in Alzheimer's disease(AD) and vascular dementia(VaD) groups each consisting of 15 patients. The results of their performance produced firstly significant differences in phonemic fluency, story comprehension, delayed recall and recognition task between the two groups. Further analysis shows that VaD group had significant correlations between the scores of story comprehension and the recognition test scores additionally. These findings suggest that it is possible to differentiate the two groups even by story comprehension tasks and WM. In conclusion, the clinical application of the results is likely to contribute to appropriate treatment plans and effective interventions for elderly with AD and VaD as well as to improve the classification criteria for both types of dementia.

Psychological Characteristics of Psychiatric outpatients with High Suicide Risk : Using MMPI-2-RF (정신건강의학과 외래 환자 중 자살 고위험 집단의 심리적 특성 : MMPI-2-RF를 이용하여)

  • Nam, Jisoo;Kim, Daeho;Kim, Eunkyeong
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.1
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    • pp.8-19
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    • 2020
  • Objectives : The purpose of this study was to examine whether the MMPI-2-RF serves as a useful tool to differentiate between the subtypes of high risk of suicide among psychiatric outpatients. Methods : Patients were recruited from the department of psychiatry of university hospital. Participants were diagnosed using DSM-5 criteria by board certified psychiatrists. Their medical records were reviewed retrospectively. And participants were put into 4 groups (Suicide ideation, Suicide attempt, Non-suicidal self-injury, and general psychiatric diagnosis as a control group). For statistical comparison, the MANCOVA with gender as a covariate was used. Results : The results indicated that as previous research with non-clinical sample suggested, psychiatric outpatients with high suicide risk also have significantly higher Emotional/Internalizing Dysfunction, Helplessness/Hopelessness, Suicidal/Death Ideation, Demoralization, Cognitive complaints, Cynicism, Dysfunctional negative thoughts than general psychiatric patients group. But group differences within the high suicide risk patients have not been observed. However, suicide attempt group and NSSI group has higher Behavioral/Externalizing Dysfunction, RC4, AGG than general psychiatric patients group. But there was no difference between suicidal idea group and general psychiatric patients group. Conclusions : There was no group difference observed between all three subtypes, which mean the MMPI2-RF may not be the useful diagnostic tool to navigate high suicide risk subtypes. Even though there was no difference observed in the suicide ideation group, suicide attempt group and NSSI group have higher aggression and externalization. So those indexes could serve as a useful marker to investigate riskiness of suicide related symptoms.

Evaluation of Hypertension Prevention and Management Programs Conducted by Community Health Nurse Practitioners in Rural Areas of Korea (농촌지역 보건진료소의 고혈압 예방 및 관리사업 평가)

  • Kwon, Myung-Soon;Cho, Won-Jung;Kim, Mi-Ja;Lee, Hyeon-Kyeong
    • Korean Journal of Health Education and Promotion
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    • v.27 no.5
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    • pp.41-50
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    • 2010
  • Objectives: This study aims to evaluate effectiveness of hypertension prevention and management programs (HPMPs) in rural Korea. Methods: A questionnaire survey was conducted with 700 community health practitioners working at primary health care posts (PHCPs). The questionnaire had four domains, which were hypertension management, hypertension prevention, the PHCP environment, and evaluation system, each with different maximum weighted values (WVs). Weighted values of 100 indicate the best effectiveness for the HPMP in all four domains. Results: The average WVs and percent effectiveness of all four domains combined was 61.65 (62%); the hypertension management domain was 28.81 (72%); the hypertension prevention domain was 23.44 (67%); the PHCP environment was4.29(43%); and the evaluation system was5.10(34%). Conclusion: The HPMPs were generally effective, and hypertension management was the most effective. The environment of PHCPs and the evaluation system of HPMPs should be improved to increase the effectiveness of the HPMPs.

Role of neutrophil/lymphocyte ratio as a predictor of mortality in organophosphate poisoning (유기인계 살충제 중독환자의 사망 예측 인자로서 중성구/림프구 비율의 역할)

  • Jeong, Jae Han;Sun, Kyung Hoon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.5
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    • pp.384-390
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    • 2020
  • Purpose: Organophosphate insecticide poisoning can have clinically fatal results. This study aimed to evaluate the relationship between the neutrophil/lymphocyte ratio (NLR) and the occurrence of death in patients with organophosphate insecticide poisoning. Methods: For this retrospective study, data on patients with organophosphate insecticide poisoning who visited the emergency room between January 2008 and November 2018 were collected. The NLR was measured at the time of arrival in the emergency room. The patients were divided into survival and death groups. Results: Overall, 150 patients were enrolled: 15 (10%) in the death group and 135 (90%) in the survival group. In the univariate analysis, the following variables were significantly different between the two groups: age, white blood cell count, amylase level, creatinine level, Acute Physiology And Chronic Health Evaluation (APACHE) II score, and NLR. In the logistic regression analysis of variables with significant differences in the univariate analysis, there were significant differences between the two groups with respect to age, APACHE II score, and NLR. The NLR was significantly higher in the death group than in the survival group (20.83 ± 22.24 vs. 7.38 ± 6.06, p=0.036). Conclusion: High NLR in patients with organophosphate insecticide poisoning may be useful in predicting mortality.

Criterion-Related Validity of the Critical Patients' Severity Classification System Developed by the Hospital Nurses' Association (병원간호사회 중환자 중증도 분류도구 준거 타당도 검정: 뇌손상 환자를 대상으로)

  • Oh, Hyun-Soo;Seo, Wha-Sook;Park, Jong-Suk;Bae, Eun-Kyung;Lee, Su-Jing;Chung, Youn-Yee;Choi, Young-Eun;Choi, Hee-Jeong
    • Korean Journal of Adult Nursing
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    • v.21 no.5
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    • pp.489-503
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    • 2009
  • Purpose: This study was conducted to test criterion-related validity of the Critical Patients' Severity Classification System (CPSCS) developed by the Hospital Nurses' Association by examining relationships with brain injury severity measured by Glasgow Coma Scale (GCS), recovery state measured by Glasgow Outcome Scale (GOS), and days of stay in ICU of brain injury patients. Methods: Prospective correlational research design was adopted by including 194 brain injury patients admitted to ICU of one university hospital. Results: The score of CPSCS appeared to significantly discriminate the severity of brain injury. Among nursing activities in CPSCS, Respiratory therapy, IV Infusion and Medication, Monitoring, Activities of Daily Living (ADL), Treatment and Procedure were significant to discriminate the severity of brain injury. Respiratory therapy, Vital Signs, and Monitoring appeared to significantly discriminate the recovery states of 1- and 3-months. Nursing activities significantly contributed to predict the days of ICU stay were Respiratory therapy, ADL, and Teaching and Emotional Support. Conclusion: CPSCS developed by the Hospital Nurses Association appeared to be valid to discriminate or predict brain injury severity, recovery states, and days of stay in ICU for brain injury patients.

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