• Journal of Hospice and Palliative Care
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• v.2 no.2
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• pp.138-143
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• 1999

Accurately estimating survival times in terminal cancer patients is very difficult for palliative care clinicians. But a reasonably accurate estimate of survival would permit the medical team to : Plan the ideal therapeutic strategy between overtreatment and too early discontinuation of specific therapy. Answer any questions asked by the patient or family. Organize adequate assistance for the patient concerned. Decide on the eligibility of the patient for clinical trials and whether to begin a treatment, the effects of which will not be immediate. This case was a 79 year-old male patient with colon cancer. He complained of dry mouth, anorexia, weight loss and showed KPS $40{\sim}50$ on admission day. 40 days later he died. To improve patient/family quality of life, it is necessary to improve the ability to estimate accurately a patient's length of survival.

• Quality Improvement in Health Care
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• v.2 no.1
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• pp.118-124
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• 1995

Background: Clinical indicators are objective measures of process or outcome of patient care in quantitative terms. This study aims to review the medical records of patients who 'return to operating room during the same admission', which is one of the critical clinical outcomes, and describe the result by unplanned reoperation rate. Methods: Computerized patient registry was used for selecting subject conditions. For medical records retrieved, two nurse evaluators identified the presence of explicit reoperation planning in medical records. Results: Overall reoperation rate was 2.8% and unplanned reoperation rate 1.3%. The main category of reoperation cause was the postoperative bleeding. Duration of stay from previous operation to reoperation of the unplanned group, 12.7 days, was shorter than that of the planned(p< .05). The differences did not reach statistical significance in age, sex and length of stay. Conclusion: Results suggested that unplanned reoperation rate was lower than 'threshold' level other institutions had established. However, this result could become comparable only after management of medical records would be improved and risk adjusted.

• Journal of Korean Biological Nursing Science
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• v.15 no.4
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• pp.193-201
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• 2013

Purpose: The purpose of the study was to evaluate the effect of the immediate postoperative nutritional status and calorie adequacy on clinical outcomes in liver transplant recipients. Methods: A total number of 99 patients who received liver transplants were recruited from a tertiary university hospital. Demography, subjective global assessment, clinical outcomes and calorie adequacy were evaluated through personal interviews, electronic medical records and dietary records. Anthropometric measures, body mass index and percent of ideal body weight were also obtained. Results: At admission to the Surgical Intensive Care Unit (SICU), the triceps skinfold thickness and mid-arm muscle circumference were significantly lower in the malnourished group than in the well-nourished group (p<.05, respectively). In the clinical outcomes, transfusion of red blood cells, mechanically ventilated hours, length of stay in the Intensive Care Unit (ICU), length of stay in the hospital, and prothrombin time were significantly higher in the malnourished group than in the well-nourished group (p<.05, respectively). The mechanically ventilated hour was significantly higher in the group with less than 50% of their required energy intake (p<.05). Conclusion: Therefore, it is important to assess the nutritional status of immediate postoperative patients. Furthermore, studies on nutritional interventions are urgently needed to provide adequate nutritional care for patients in ICUs.

• Journal of Korean Academy of Nursing
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• v.43 no.2
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• pp.287-295
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• 2013

Purpose: The purpose of this study was to identify vancomycin-resistant enterococcus (VRE) colonization rate in patients admitted to the intensive care unit (ICU), associated risk factors and clinical outcomes for VRE colonization. Methods: Of the 7,703 patients admitted to the ICUs between January, 2008 and December, 2010, medical records of 554 VRE colonized and 503 uncolonized patients were reviewed retrospectively. To analyzed the impact of colonization on patients' clinical outcomes, 199 VRE colonized patients were matched with 199 uncolonized patients using a propensity score matching method. Results: During the study period, 567 (7.2%) of the 7,703 patients were colonized with VRE. Multivariate analysis identified the following independent risk factors for VRE colonization: use of antibiotics (odds ratio [OR]=3.33), having bedsores (OR=2.92), having invasive devices (OR=2.29), methicillin-resistant Staphylococcus aureus co-colonization (OR=1.84), and previous hospitalization (OR=1.74). VRE colonized patients were more likely to have infectious diseases than uncolonized patients. VRE colonization was associated with prolonged hospitalization and higher mortality. Conclusion: Strict infection control program including preemptive isolation for high-risk group may be helpful. Further research needs to be done to investigate the effects of active surveillance program on the incidence of colonization or infection with VRE in the ICU.

• The Korean Journal of Health Service Management
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• v.3 no.1
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• pp.33-46
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• 2009

In order to analyze possible effects of senior hospital selection factors and service satisfaction on senior hospital patients' revisit of senior hospital, this study surveyed guardians of total 204 patients hospitalized in major 4 senior hospitals in Busan. As a result, this study came to the following conclusions: First, it was found that guardians considered appropriateness of medical treatment cost as the biggest factor of choice, which was followed by kindness of doctor and hospital employees, locational accessibility (traffic convenience), and doctor's medical capacity. Second, the factor analysis about patients' satisfaction showed that the influential factors consisted of satisfaction at medical staffs, satisfaction at nursing and care, and satisfaction at facilities. Third, there was not significant difference in the overall impression of hospital and the intention of revisit depending upon sociological variables. Fourth, satisfaction at nursing and care and satisfaction at facilities had significant effects on better satisfaction at overall impression of hospital, and it was noted that the shorter admission period and the less complaint led to the higher intention of revisit. Therefore, it is necessary to improve satisfaction at medical staffs, nursing and care, and facilities rather than patients' own sociological characteristics.

• Journal of Korean Public Health Nursing
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• v.33 no.1
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• pp.59-72
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• 2019

Purpose: Nursing homes are a type of residential care that provide diverse services such as planned activities, convalescent care, skilled nursing and memory care. Nursing homes are good facilities for old people with dementia to improve their quality of life. On the other hand, the subjectivity toward nursing homes can vary to greater or lesser degrees. The purpose of this study was to identify the subjective attitudes and viewpoints toward nursing homes in undergraduate nursing students. Methods: The Q methodology, which is a research method to study the people's subjectivity, was used. The 40 Q-statements selected from each of 43 participants were classified into the shape of a normal distribution. The data collected were analyzed using the QUANL program. Results: Three types of subjectivity toward nursing homes emerged: 'Type I, in terms of usage of nursing homes-hesitative perspectives;', 'Type II, in terms of running of nursing homes-progressive perspectives;', and 'Type III, in terms of admission to nursing homes-constructive perspectives'. Conclusion: The findings of this study suggest that nursing intervention programs should be developed for the three types. The study results will lead to further research.

• Korea Journal of Hospital Management
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• v.6 no.1
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• pp.107-119
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• 2001

There has been pointed out that a great portion of hospitalized patients stay in hospitals longer than necessary, often even after the completion of necessary care. This causes that hospital resources are not used efficiently. In order to identify underlying forces in postponing inpatients' discharge, this study aimed to investigate reasons for long-term stay of patients admitted in general hospitals. A total of 135 patients, who were staying at 7 general hospitals in Inchon and Kyonggi-Do for more than 60 days, were surveyed with a self-administered questionnaire between April 3 and April 10, 2000. Medical reasons including incompleteness of necessary care, difficulty in receiving outpatient-based care, and being under physical therapy were the most significant factors associated with long-term stay, followed by the lack of familial resources to take care of patients after discharge. Financial problems such as inability to pay for hospital bills were not significant factors influencing long-term stay. Regression analyses were conducted for medical reasons, familial resources, and financial problems, respectively. It was shown that receiving physical therapy and the number of admission in the past were significant predictors for medical reasons. The lack of familial resources as a reason for long-term stay had a positive relationship with the degree of need for aid in daily living. It may be recommended for the hospitals to cope with administrative problems due to the patients' long-term stay, considering the reasons of it, and their characteristics. And also, institutional efforts like vitalizing the home care service systems by hospitals as the continuing care after discharge should be needed.

• Quality Improvement in Health Care
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• v.4 no.1
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• pp.104-114
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• 1997

Background : Hospitals(Health care providers) are under tremendous pressure to meet consumer demands in order to compete in the rapidly changing health care arena. Through evaluating patient satisfaction, hospitals(health care providers) can learn what the consumer Wants from the health care system. Timely feedback is necessary. The purpose of this study is to evaluate patients' hospital experience and satisfaction using telephone interview and to study the usefulness for telephone interview at assessing patient satisfaction. Method : The 846 patients who were discharged from September 17, 1996 to October 11, 1996 were targeted were telephoned. The informations gathered telephone survey were processed by computer and analyzed for the patient satisfaction, contributing factors. Result : The 846 patients who were discharged from September 17, 1996 to October 11, 1996 were called and 197 patients(23.3%) were successful interviewed. 51.3 percent of respondents were male and mean age is 39 years mean LOS(length of stay) is 13 days and 110(56.1%) patients were admitted by outpatients clinic. The mean calling-time is 5.5 minutes. There is no significant difference between interviewers(telemarketer) in patients satisfaction. Seven telephone interviews are possible by interview a day. There in no significant difference between groups in patients satisfaction in length of stay, path of admission, the interval between discharge and interview. 97.5 percent of respondents were satisfied with telephone interview and 81.7% were satisfied with overall satisfaction and 79.4 % of respondents were good response in interviewers' conclusion. Of six variables that were found to be correlated with telephone interview and eight variables correlated with overall hospital satisfaction, a multiple logistic regression analysis revealed that two most important variables which are significantly correlated with telephone interview are to meet doctors, not ask tediously then three variables which are with overall satisfaction are doctors explain, subject response, convenient facilities. Conclusion : The patients interviewed are satisfied with telephone interview. Telephone interview is good method for assessing patient satisfaction, making high levels of patient satisfaction and for hospital marketing.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.6
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• pp.3832-3840
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• 2014

The rapidly aging population is also increasing the number of dementia patients rapidly. Studies have revealed the early signs of slowing progress. Therefore, dementia patient safety, continuous care, daily living, and health care are becoming more important. In this paper, a smart home care system using smart phones and Bluetooth communication technology was used to monitor the state of dementia patients of based on the results of grading dementia, health care of the dementia patients at home and provide for the safety of the system using motion sensors and gas leak sensors to respond to various emergency situations, such as fire, gas leak protection, and loitering. Using this system, the patient can stay longer in their home due to the nature of Korean culture before admission, while reducing the family's economical, physical and psychological burden and allowing the consultation of specialists through the system by building a database of individuals and providing professional service and specialty care referral agencies through the link.

• Journal of Korean Critical Care Nursing
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• v.13 no.3
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• pp.62-74
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• 2020

Purpose : This study aimed to investigate the prevalence and risk factors of mental health problems in patients discharged from the intensive care unit (ICU). Methods : This was a secondary analysis study using data from a multicenter prospective cohort of post-ICU patients. We analyzed data of 311 patients enrolled in the primary cohort study who responded to the mental health questionnaire three months after the discharge. Anxiety and depression were measured on the Hospital Anxiety-Depression Scale, and post-traumatic stress disorder (PTSD) was measured on the Posttraumatic Diagnostic Scale. Results : The prevalence of anxiety, depression, and PTSD in patients at three months after ICU discharge were 25.7%, 17.4%, and 18.0%, respectively, and 7.7% of them experienced all three problems. Unemployment (OR=1.99, p=.033) and unplanned ICU admission (OR=2.28, p=.017) were risk factors for depression, while women gender (OR=2.34, p=.009), comorbid diseases (OR=2.88, p=.004), non-surgical ICUs (trauma ICU: OR=7.31, p=.002, medical ICU: OR=3.72, p=.007, neurological ICU: OR=2.95, p=.019) and delirium (OR=2.89, p=.009) were risk factors for PTSD. Conclusion : ICU nurses should proactively monitor risk factors for post-ICU mental health problems. In particular, guidelines on the detection and management of delirium in critically ill patients should be observed.