• Title/Summary/Keyword: 환자 중심 케어

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Short-Term Effects of an Self-Management Support Intervention on Patient Activation, Joint Flexibiltiy and Health-related Quality of Life among Korean Medical Aid Beneficiaries with Osteoarthritis (지역사회기반의 자기관리지지중재가 골관절염 의료급여수급자의 환자활력, 관절유연성 및 건강 관련 삶의 질에 미치는 단기효과)

  • Ahn, Yang Heui;Hur, Jae Bock;Choi, Eun Hee
    • 한국노년학
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    • v.36 no.3
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    • pp.595-609
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    • 2016
  • The purpose of this study was to test the effectiveness of an eight session self-management support program for improvement of patient activation, joint flexibility and health-related quality of life among medical aid beneficiaries with osteoarthritis. This study was part of a randomized and controlled research of a self-management support intervention. Participants were 60 medical aid beneficiaries who agreed to participate in this study, and were assigned to an experimental group (n=30) or control group (n=30). The 8-session and tailored program led by a trained case manager with the patient-centered approaches and cognitive-emotional-behavioral skills. Analysis included change in scores, ${\chi}^2-test$, Fisher's exact test, t-test and ANCOVA. The results showed significant increase in patient activation, joint flexibility (shoulder and right knee) except health-related quality of life in the experimental group compared to the control group. The self-management support program indicated an effect on patient activation and joint flexibility. Further research is needed to examine the outcome in the long term(9 and 12-month follow up).

Cross-cultural Adaptation and Psychometric Evaluation of the Korean Version of the A-ONE (한국판 일상생활활동중심 작업기반 신경행동평가(A-ONE)의 개발 및 평가)

  • Kang, Jaewon;Park, Hae Yean;Kim, Jung-Ran;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.10 no.2
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    • pp.109-128
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    • 2021
  • Objective : The purpose of this study was to develop a Korean version of the Activities of Daily Living (ADL)-focused Occupation-Based Neurobehavioral Evaluation (A-ONE) through cross-cultural adaptation and examine its validity and reliability. Methods : This study translated the A-ONE into Korean and performed cross-cultural adaptation for the Korean population. After the development of the Korean version of the A-ONE, cross-cultural and concurrent validities were analyzed. Internal consistency, test-retest reliability, and inter-rater reliability were also evaluated. Results : We adapted three items to the Korean culture. The Korean version of the A-ONE showed high cross-cultural validity with a content validity index (I-CVI) >0.9. It correlated with the Functional Independence Measure (FIM) (r=0.52-0.77, p<0.001), except for communication. Cronbach's α was 0.58-0.93 for the functional independence scale (FI) and 0.42-0.93 for the neurobehavioral specific impairment subscale (NBSIS). Intraclass correlation coefficients (ICCs) indicated high test-retest and inter-rater reliability for FI (ICC=0.79-1.00 and 0.75-1.00, respectively) and NBSIS (ICC=0.74-1.00 and 0.72-1.00, respectively). Conclusion : The Korean version of the A-ONE is well adapted to the Korean culture and has good validity and reliability. It is recommended to evaluate ADL performance skills and neurobehavioral impairments simultaneously in Korea.

Does Process Quality of Inpatient Care Serve as a Guide to Reduce Potentially Preventable Readmission (PPR)? (의료서비스의 과정적 질과 잠재적으로 예방 가능한 재입원율과의 관계)

  • Choi, Jae-Young
    • Korea Journal of Hospital Management
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    • v.23 no.1
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    • pp.87-106
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    • 2018
  • Objective: The objective of this study is to examine the association between process quality of inpatient care and risk-adjusted, thirty-day potentially preventable hospital readmission (PPR) rates. Data Sources/Study Setting: This was an observational cross-sectional study of nonfederal acute-care hospitals located in two states California and Florida, discharging Medicare patients with a principal discharge diagnosis of heart failure, acute myocardial infarction, or pneumonia January through December 31, 2007. Data were obtained from the Healthcare Cost and Utilization Project State Inpatient Database of the Agency for Healthcare Research and Quality, Centers for Medicare and Medicaid Services Hospital Compare database, and the American Hospital Association Annual Survey of Hospitals. Study Design: The dependent variable of this study is condition-specific, risk-adjusted, thirty-day potentially preventable hospital readmission (PPR). 3M's PPR software was utilized to determine whether a readmission was potentially preventable. The independent variable of this study is hospital performance for process quality of inpatient care, measured by hospital adherence to recommended processes of care. We used multivariate hierarchical logistic models, clustered by hospitals, to examine the relationship between condition-specific, risk-adjusted, thirty-day PPR rates and process quality of inpatient care, after taking clinical and socio-demographic characteristics of patients and structural and operational characteristics of hospitals into account. Findings: Better performance on the process quality metrics was associated with better patient outcome (i.e., low thirty-day PPR rates) in pneumonia, but not generally in two cardiovascular conditions (i.e., heart failure and acute myocardial infarction). Practical Implication: Adherence to the process quality metrics currently in use by CMS is associated with risk-adjusted, thirty-day PPR rates for patients with pneumonia, but not with cardiovascular conditions. More evidence-based process quality metrics closely linked to 30-day PPR rates, particularly for cardiovascular conditions, need to be developed to serve as a guideline to reduce potentially preventable readmissions.

An Intervention Model to Help Clients to Seek Their Own Hope Experiences: The Narrative Communication Model of Hope Seeking Intervention

  • Kim, Dal Sook;Kim, Hesook Suzie;Thorne, Sally
    • Journal of Hospice and Palliative Care
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    • v.20 no.1
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    • pp.1-7
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    • 2017
  • The paper describes The Narrative Communication Model of Hope Seeking Intervention developed by the authors as an approach to help clients to have individually specific hope experiences. The Model is founded upon the existential conceptualization of hope that views hope as subjective, unique experiences of meaning and processes. The Model has been developed based on the findings both in the literature and the authors' work on the nature of hope and hope experiences and integrating the concept of hope as subjective meanings and experiences, the processes of story-telling and the concept of narrative configuration as a way to engage in person-specific experiences, and person-centered communication. The results of the experiences with the application of the model in a study are used to clarify the model further. The Model incorporating story-telling and narrative construction through person-centered communication is identified in three components-the story-telling, the narrative intervention, and the communication components. These components are processed as an intervention to culminate into person-specific hope experiences in which active participation of clients as the story-teller and of interventionist as the communicative facilitator is required to produce narratives of hope with individual specific thematic plots that become the basis for hope experiences. The application of the Model has shown positive outcomes in clients with successful seeking of own hope experiences. The success of the Model application seems to depend upon interventionists' understanding of the model and the competency with the application of person-centered communication strategies.

A Study on key attributes to congenital disease factors regarding the patients of the four most-common serious chronic illnesses and their relatives in the light of Myeongrihak -centering on the elderly in Seoul nursing homes- (4대 중증질환자와 혈연 관계자에 대한 명리학적 선천성질환 특성요인 분석 -서울시 요양원 입소노인을 중심으로-)

  • Kim, Il-Sin;Cho, Sung-Je
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.11
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    • pp.5610-5615
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    • 2013
  • The objective of this study is to identify key attributes to congenital disease factors regarding the patients of the four most-common serious chronic illnesses and their relatives in the light of Myeongrihak. For the purpose of this study, a survey was conducted from March 15 to July 31, 2013, of 147 elderly people with the four most-common serious chronic illnesses admitted to nursing homes located in Seoul. Data were analyzed by frequency analysis and Kai-square tests by use of SPSS/WIN 18.0. The analysis found that the patients and their relatives had very similar disease factors, and cerebrovascular diseases presented the strongest correlations. The subjects also showed meaningful differences according to the health factors of their relatives. As this study found that meaningful correlations regarding congenital diseases between patients of the four most-common serious chronic illnesses and their relatives in the light of Myeongrihak, this will serve as basic data to predicts health conditions of families and relatives.

Space Usage and Satisfaction with Privacy in General Hospital Inpatients (종합병원 입원환자의 공간사용 및 프라이버시 만족도)

  • Choi, In Young;Park, Hey Kyung
    • Korea Science and Art Forum
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    • v.36
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    • pp.391-400
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    • 2018
  • To ensure a user-centered treatment environment, hospital construction needs an approach that is not centered on functional aspects such as efficiency or economic feasibility but on the consideration of needs as reflected in user psychology and behavior. Patients who are physically and psychologically vulnerable experience psychological pressure when they are placed in an unfamiliar environment. Most of existing studies however focus on the evaluation of the physical environment, without paying attention to the psychological or behavioral approach to anxiety and stress that patients may experience in a special environment that a hospital may be to them. This study examines general hospital inpatients to understand the usage of major space available and their satisfaction with privacy. This study provides useful primary information needed for the user-centered design of general hospital for improved patient health and welfare. For the purpose of the study, literature review, site investigation, and survey were conducted. Major functional space and privacy in general hospitals were studied, and the site investigation was performed to identify the plans and their status. Survey was also performed to understand the usage of functional space and satisfaction with such space usage as well as satisfaction with privacy. The findings were as follows: (1) Space usage was rated as average in general. It was found that patients used their rooms and lobby on a daily basis. By age, the usage was highest in the group in their 40s; the usage was relatively lower in the groups in their 30s or younger. (2) Space satisfaction was above average, indicating that patients were fairly satisfied. Satisfaction was highest in the lobby space designed with distinct features. By case, satisfaction was highest in Case B, characterized by its wide horizontal space in the rural settings. (3) Satisfaction with privacy in hospital was average, indicating that the demand for privacy was relatively higher but what patients receive in return was lower than their expectation. It was also found that satisfaction with privacy was a crucial element that affected the overall satisfaction with hospital.

The Trends and Prospects of Health Information Standards : Standardization Analysis and Suggestions (의료정보 표준에 관한 연구 : 표준화 분석 및 전망)

  • Kim, Chang-Soo
    • Journal of radiological science and technology
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    • v.31 no.1
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    • pp.1-10
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    • 2008
  • Ubiquitous health care system, which is one of the developing solution technologies of IT, BT and NT, could give us new medical environments in future. Implementing health information systems can be complex, expensive and frustrating. Healthcare professionals seeking to acquire or upgrade systems do not have a convenient, reliable way of specifying a level of adherence to communication standards sufficient to achieve truly efficient interoperability. Great progress has been made in establishing such standards-DICOM, IHE and HL7, notably, are now highly advanced. IHE has defined a common framework to deliver the basic interoperability needed for local and regional health information networks. It has developed a foundational set of standards-based integration profiles for information exchange with three interrelated efforts. HL7 is one of several ANSI-accredited Standards Developing Organizations operating in the healthcare arena. Most SDOs produce standards (protocols) for a particular healthcare domain such as pharmacy, medical devices, imaging or insurance transactions. HL7's domain is clinical and administrative data. HL7 is an international community of healthcare subject matter experts and information scientists collaborating to create standards for the exchange, management and integration of electronic healthcare information. The ASTM specification for Continuity of Care Record was developed by subcommittee E31.28 on electronic health records, which includes clinicians, provider institutions, administrators, patient advocates, vendors, and health industry. In this paper, there are suggestions that provide a test bed, demonstration and specification of how standards such a IHE, HL7, ASTM can be used to provide an integrated environment.

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A BERGPT-chatbot for mitigating negative emotions

  • Song, Yun-Gyeong;Jung, Kyung-Min;Lee, Hyun
    • Journal of the Korea Society of Computer and Information
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    • v.26 no.12
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    • pp.53-59
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    • 2021
  • In this paper, we propose a BERGPT-chatbot, a domestic AI chatbot that can alleviate negative emotions based on text input such as 'Replika'. We made BERGPT-chatbot into a chatbot capable of mitigating negative emotions by pipelined two models, KR-BERT and KoGPT2-chatbot. We applied a creative method of giving emotions to unrefined everyday datasets through KR-BERT, and learning additional datasets through KoGPT2-chatbot. The development background of BERGPT-chatbot is as follows. Currently, the number of people with depression is increasing all over the world. This phenomenon is emerging as a more serious problem due to COVID-19, which causes people to increase long-term indoor living or limit interpersonal relationships. Overseas artificial intelligence chatbots aimed at relieving negative emotions or taking care of mental health care, have increased in use due to the pandemic. In Korea, Psychological diagnosis chatbots similar to those of overseas cases are being operated. However, as the domestic chatbot is a system that outputs a button-based answer rather than a text input-based answer, when compared to overseas chatbots, domestic chatbots remain at a low level of diagnosing human psychology. Therefore, we proposed a chatbot that helps mitigating negative emotions through BERGPT-chatbot. Finally, we compared BERGPT-chatbot and KoGPT2-chatbot through 'Perplexity', an internal evaluation metric for evaluating language models, and showed the superity of BERGPT-chatbot.

Association Between Cognitive Impairment and Oral Health Related Quality of Life: Using Propensity Score Approaches (인지기능과 구강건강관련 삶의 질의 연관성에 대한 연구: 성향점수 분석과 회귀모델을 중심으로)

  • Cha, Suna;Bae, Suyeong;Nam, Sanghun;Hong, Ickpyo
    • Therapeutic Science for Rehabilitation
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    • v.12 no.3
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    • pp.61-77
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    • 2023
  • Objective : This study analyzed the correlation between cognitive function and oral health-related quality of life (OHQoL). Methods : Demographic and clinical characteristics were extracted and utilized for subjects aged 45 years or older who participated in the 8th Korean Longitudinal Study on Aging in 2020. The dependent variable was the Geriatric Oral Health Assessment Index, and the independent variable was the level of cognitive function classified by the Mini-Mental State Examination scores. The analysis method used inverse probability of treatment weighting (IPTW). Then, the association between cognitive function and OHQoL was analyzed by multiple regression analysis. Results : Among the participants, 4,367 (71.40%) had normal cognition, 1,155 (18.89%) had moderate cognitive impairment, and 594 (9.71%) had severe cognitive impairment. As a result of analysis by applying IPTW, there was a negative correlation between the cognitive function group and OHQoL (normal vs. moderate: β = -2.534, p < .0001; normal vs. severe: β = -2.452, p < .0001). Conclusion : After propensity score matching, mild cognitive impairment showed a more negative association than severe cognitive impairment. Therefore, patients with cognitive impairment require oral health management education to improve OHQoL regardless of the level of cognitive impairment.

A Study of the Acculturation Meaning among Chinese-Chosun Residential Care Attendants in Long-Term Care Setting (조선족 간병인의 문화적응 경험에 관한 연구: 노인 간병서비스를 제공하는 조선족 여성을 중심으로)

  • Hong, Sae-Young;Kim, Gum-Ja
    • 한국노년학
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    • v.30 no.4
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    • pp.1263-1280
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    • 2010
  • The present study describes the acculturation meaning of 12 Chinese-Chosun residential care attendants(RCAs) who are currently working in long-term care settings for Korean older adults. Using a qualitative research method, the findings show that the acculturation process of Chinese-Chosun RCAs consists of three stages: entrance, conflict, and adaptation. In the initial stage, the assets of the social and cultural networks among their friends and relatives, who already settled down or employed as RCAs, provided more opportunities for being employed as a RCA. However, most Chinese-Chosun RCAs experienced a number of conflicts while they adapted to mainstream society and perform caregiving tasks. They perceived discrimination, heavy workload, prejudice, and homesick. Nevertheless, they appeared to adapt effectively to Korean society and working environments because they were aware of the various benefits of working as a RCA such as higher wage and more job openings compared to other jobs, a rapport with the patients and patients' families, flexible work hours, and pride as a caregiver. This type of qualitative groundwork will be an important precursor to the design, implementation, and evaluation of acculturation research for minority immigrant workers in the Korean social welfare system.