• 융합경영연구
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• 제4권3호
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• pp.7-11
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• 2016

The purpose of this study is to examine the long term care insurance system that has been 9 years and to understand issues arose during settlement of the insurance system in accordance with provision of solutions to increase the quality of elders' long term care service. Also, the study is aiming at providing contribution to both satisfaction of customers and workforces at the field along with achievement of the primary goal that the elders' care service policy was aiming at. To achieve the purpose of the study, authors gathered and analyzed reports and literatures from books published domestically, governmental open data and statistical data related to policy on long term care service insurance for elders to examine current problematic issues of long term care insurance and to explore ways to improve by having case studies of advanced countries. The result of this study shows that there are differences in the way how participants of the programs react to registering to insurance of program for supporting elderly persons' social activities and employment despite Korean government is operating the programs along general guidance for the programs as a standardized guideline.

• Korean Circulation Journal
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• 제53권9호
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• pp.594-605
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• 2023

Acute myocardial infarction (AMI) is a major cause of morbidity and mortality in the Asia-Pacific region, and mortality rates differ between countries in the region. Systems of care have been shown to play a major role in determining AMI outcomes, and this review aims to highlight pre-hospital and in-hospital system deficiencies and suggest possible improvements to enhance quality of care, focusing on Korea, Japan, Singapore and Malaysia as representative countries. Time to first medical contact can be shortened by improving patient awareness of AMI symptoms and the need to activate emergency medical services (EMS), as well as by developing robust, well-coordinated and centralized EMS systems. Additionally, performing and transmitting pre-hospital electrocardiograms, algorithmically identifying patients with high risk AMI and developing hospital networks that appropriately divert such patients to percutaneous coronary intervention-capable hospitals have been shown to be beneficial. Within the hospital environment, developing and following clinical practice guidelines ensures that treatment plans can be standardised, whilst integrated care pathways can aid in coordinating care within the healthcare institution and can guide care even after discharge. Prescription of guideline directed medical therapy for secondary prevention and patient compliance to medications can be further optimised. Finally, the authors advocate for the establishment of more regional, national and international AMI registries for the formal collection of data to facilitate audit and clinical improvement.

• Journal of Gynecologic Oncology
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• 제29권6호
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• pp.83.1-83.10
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• 2018

Objective: We aimed to propose a set of quality indicators (QIs) based on the clinical guidelines for cervical cancer treatment published by The Japan Society of Gynecologic Oncology, and to assess adherence to standard-of-care as an index of the quality of care for cervical cancer in Japan. Methods: A panel of clinical experts devised the QIs using a modified Delphi method. Adherence to each QI was evaluated using data from a hospital-based cancer registry of patients diagnosed in 2013, and linked with insurance claims data, between October 1, 2012, and December 31, 2014. All patients who received first-line treatment at the participating facility were included. The QI scores were communicated to participating hospitals, and additional data about the reasons for non-adherence were collected. Results: In total, 297 hospitals participated, and the care provided to 15,163 cervical cancer patients was examined using 10 measurable QIs. The adherence rate ranged from 50.0% for 'cystoscope or proctoscope for stage IVA' to 98.8% for 'chemotherapy using platinum for stage IVB'. Despite the variation in care, hospitals reported clinically valid reasons for more than half of the non-adherent cases. Clinically valid reasons accounted for 75%, 90.9%, 73.4%, 44.5%, and 88.1% of presented non-adherent cases respectively. Conclusion: Our study revealed variations in pattern of care as well as an adherence to standards-of-care across Japan. Further assessment of the causes of variation and non-adherence can help identify areas where improvements are needed in patient care.

• 대한한방부인과학회지
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• 제18권3호
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• pp.139-151
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• 2005

Purpose : 1. To analyze the cognition and realities of postpartum care and to aid the spread of oriental medicine in postpartum care. 2. Get a basic guideline of postpartum care home and O.M.D.'s role model of postpartum care. Methods : We studied the cognition and realities of postpartum care with questionnaire from May 2005 to July 2005, in postpartum care home at Gangdong-gu and Seocho-gu. 147 puerperants answered us. Results : Puerperants pay postpartum care for without regard to economic state. 59.2% of 147 puerperants replied that the reason of postpartum care at postpartum care home is for systematic care. Important selection guidelines of postpartum care home are expertness at infant and puerperant management. We can find that 78.2% of 147 puerperants will visit oriental medical clinic for postpartum care and 61.2% of 147 puerperants will take herb-medicine. Conclusion : Puerperants has well-expectation in postpartum care by oriental medicine. There is much room for extension of oriental medical province in postpartum care. So continuous publicity activities about oriental medical postpartum care are required.

• 임상간호연구
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• 제16권3호
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• pp.175-186
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• 2010

Purpose: Delirium can be a highly prevalent symptom in intensive care units but it may still be under-recognized despite its relation with inclined morbidity, mortality, cost, and readmission. Therefore, this study aimed to develop a protocol that covers risk factors and non-pharmacological interventions to prevent delirium in ICU patients. Methods: This study was conducted using methodological design, and it followed the Scottish Intercollegiate Guideline Network (SIGN) guideline development steps: 1) the scope of protocol was decided (population, intervention, comparison, and outcomes); 2) guidelines, systematic reviews, and protocols were reviewed and checked using methodology checklist; 3) the level of evidence and recommendation grades was assigned; 4) the appropriateness of recommendations was scored by experts; 5) the final protocol & algorithm was modified and complemented. Results: The evidence-based delirium prevention protocol was completed that includes predisposing factors, precipitating factors and recommendations with evidenced grades. Conclusion: This protocol can be used as a guide nurses in screening patients with high risk factors of delirium as well as in intervening the patients non-pharmacologically to prevent delirium.

• 대한한방부인과학회지
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• 제22권4호
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• pp.173-186
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• 2009

Purpose: 1. To analyze the satisfaction and cognition of postpartum care and to aid the spread of oriental medicine in postpartum care. 2. Get a basic guideline of O.M.D's postpartum care. Methods: We studied the satisfaction and cognition of postpartum care with questionnaire from January 2009 to August 2009, who was treated in ○○ Oriental Medical Postpartum care center during 2 weeks. 61 puerperants answered us. Results: 1. In choosing Postpartum care center, puerperants concerned about new born infants' care(50.8%) and treatment for discomfort after delivery(27.86%). 2. 22 puerperants(36.6%) had a positive view in folk remedy for postpartum care and 34 puerperants(55.73%) thought it would be good to eliminate edema and loose weight. 3. Most of puerperants(80.32%) chose oriental medical postpartum care because they wanted to receive oriental medical treatment. 4. 5 puerperants(8.19%) were very satisfied with oriental medical postpartum care than other type of postparum care which they experienced at first delivery. 47(77.04%) were satisfied, 2(3.27%) were unsatisfied and no one was very satisfied. 5. To the questionnaire about the effect of strength recovery, lochia excretion, edema limination, increasing amount of breastmilk, reducing arthralgia, about 36.8% puerperants showed positive view. 6. The positive view about Acupuncture, cupping, moxibustion, herbal treatment was, respectively, 90.16%, 49.18%, 73.77%, 86.88%. Conclusion: Puerperants were satisfied with oriental medical postpartum care and had positive cognition in oriental medical treatment. There is much capability for extension of oriental medicine in postpartum care. So continuous concern, systemic development and publicity about oriental medical postpartum care are required.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제26권3호
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• pp.7-16
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• 2020

Purpose: As communicable disease, COVID-19, pandemic strikes over the world, it is critically bewared that air travel possibly be a major pass way to deliver the infectious disease virus. Especially the airplane could be an unique environment to cultivate the virus spreaders. In order to keep the continuous safe airway as well as the industry, related international associations and organizations have been published the guidelines for the prevention and control the infectious disease through the all aspects of aviation. By reviewing the guidelines, focusing on the in-flight infection prevention and control, this study would not only inform a summary of the international guidelines but also provide an essential and general consideration for related research or guideline study. Methods: Guidelines of 5 major countries are reviewed, which has been seriously influenced by COVID-19 : U.S., Canada, E.U., Australia and China. The items of the guidelines are re-categorized as its similarity and structure by applicable cases. Results: The result of this study shows that each guideline seems to share a major structure and issue such as identifying sick traveler, sick passenger care, and cleaning even though that of China has a different since it used to consider the flight conditions based on 3 levels of infection risk. For sick passenger care, the guidelines includes crew safety, service level, sick passenger isolation, and cleaning. Implications: A published guideline as a public manual could be to prevent and control the in-flight infection efficiently and promptly. It also could provide a confidence of knowledge and educate for all users to prepare the in-flight emergency as well.

• 생물정신의학
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• 제14권1호
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• pp.5-13
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• 2007

Objectives : Depression disturbs the individual life from the loss of productivity to suicide. Furthermore the whole society is also influenced by depression in social and economic areas. Many scientific treatment methods are known to be effective in depression. But in reality more than half of patients with depression prefer self help treatment rather than medically based treatment. For the patients with mild depression and primary physicians, it is reasonable to provide the evidence based self care including self help or alternative treatment. This study is supported by the Korean Health 21 R&D Project for the Depression Center to establish the Korean treatment guideline for depression. Methods : The members of Depression Center including the authors attended the workshops where the methods of evidence based medicine such as literature search, quality evaluation of the articles, making the level of evidence were educated. The professional librarians helped the authors for get the searched articles. Among the total of 354 abstracts of systemic review and 300 abstracts of random controlled trials, 3 systemic reviews and 2 random controlled trials were the main structure of evaluation. Result : Among the 37 self care methods known to be effective for depression, 11 kinds of methods were worth of evaluation. The first step for the self care of mild depression is to use St. John's wort, exercise, bibliotherapy, and light therapy in depression during winter season. Acupuncture, negative ion therapy, massage, relaxation technique are known to be efective with evidence. Music therapy, hypnotherapy, and aromatherapy are known to be effective but until now the evidences is insufficient and further evaluations are needed. Conclusion : Among 11 listed self-care methods, several methods need more evidence especially in Korean situation. Exercise is the most recommendable evidence based self care method in Korea nowadays. St. John's wort is effective with evidence, but it is not the OTC drug in Korea, so it is not recommendable now. For the bibliotherapy, there is no book such as "Feeling Good" in Korea. Only the introductory book about depression is available. Publishing the self help book based upon cognitive behavioral approach or psychodynamic approach is needed. Light therapy is practiced in a few clinics, but not self-help style. Exposure to the sunlight is recommended in the level of commen sense. These self care methods are for the mild patient. Moderate to severe patients with depression should seek the professional treatment.

• 한국실내디자인학회논문집
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• 제24권3호
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• pp.165-175
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• 2015

Korean medical welfare facilities for the elderly provide the conveniences to care geriatric illness such as dementia and stroke. The medical welfare facility categorizes elderly care facilities, nursing homes, and geriatrics hospitals based on the Korean welfare of the aged act. The government makes an effort to secure feed rate and finances of medical welfare facilities. However, the qualitative improvement of facilities is inadequate. The purpose of this study is to analyze the conditions and problems of existing facilities using an environmental evaluation and to discuss the improvement direction related to the daycare centers for the elderly. The method of this study is literature review and field survey. Firstly, we analyzed the previous studies to develop the tool, evaluating the environment of day care centers for the old. Secondly, the items of environmental evaluation are deduced. Thirdly, we select the facilities to conduct field survey and analyze the results of field survey. Lastly, We discussed the problems and improvement directions through the results. It is judged that this study is an useful as the basic guideline to strengthen the minimum legal standards of day care center for the elderly due to the suggestion of insufficient environmental evaluation items.

• 한국식품조리과학회지
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• 제7권4호
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• pp.111-118
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• 1991

The purpose of this study was to evaluate nutritional adequacy and microbiological quality of foods served in day-care centers, and to provide basic information and guidelines for the development of computerized standardized recipes and microbiological quality control program. Assessment was conducted for four day-care certers selected from each of the four groups categorized in the basic survey. Nutritional balance and amount of consumption of the food was calculated and microbiological analysis was conducted. The results of the study showed the followings: the nutritional assessment of food served in day-care centers indicated that energy and nutrients contents of foods were below the recommended level (RDA/3), except the case of a university day-care center; the percentage of leftovers for soups and vegetables was high, but that for a la carte was low; fecal coliform was not found in any of samples, however, the number of coliform in the salted Korean radish and salad was higher than guideline for microbial acceptability; the number of coliform checked from the surface of the cutting board was higher than acceptable level in most day-care centers.