• 가정과삶의질연구
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• 제17권1호
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• pp.73-86
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• 1999

The aim of this study is to suggest theoretical foundations on which hospital employees could estimate medical care services not in the position of providers but consumers. For this purpose this study compares satisfaction of providers but consumers. For this purpose this study compares satisfaction of patients with medical care service with that of hospital employees. 287 patients and 261 employees in three university hospitals in Daegu were selected as samples of investigation and asked questions. Statistical analysis was taken using SAS package. The result of this study are as follows. 1) Among the five fields of medical services patients and hospital employees have different views in doctor hospital staff(except doctor) treatment system availability service but parking service 2) Hospital employees overestimate the level of medical care services compared with patients 3) Demographical variables make a difference in medical satisfaction 4) In satisfaction-evaluation after r ceiving treatment medical system service is influential variables in both patients and hospital employees. And in patient group doctor service is following variables while availability and parking service is influential variables in employees.

• 한국임상보건과학회지
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• 제3권2호
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• pp.361-371
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• 2015

Purpose. The purposed of this study was done to DNR attitude and terminal care performance among hospital nurses. Methods. The participants were 207 nurses working in hospital nurses in D and G cities. Data on DNR attitude and terminal care performance were collected via questionnaire between April 2015 and July 2015. Data analysis was done with SPSS 12.0 program and included one-way ANOVA, independent t-test, and Pearson correlation. Result. DNR attitude of participants in this study were shown to have high levels (DNR attitude: M=32.64/60, SD=6.14). Terminal care performance of participants in this study were shown to have poor levels (physical M=20.72/32, SD=3.77, psychological M=20.26/32, SD=3.85, spiritual M=9.62/24, SD=3.65). The attitude of the hospital nurse was significantly different according to the marital status. The terminal care performance was significantly different according to experience of terminal care. The DNR attitude by nurses was positively correlation to physioloical terminal care performance(r=.137, p<.049) but the relationship between the psychological terminal care performance( r=.016, p=.815) and spiritual terminal care performance showed no correlation(r=-.099, p=.157). Conclusion. The results of this study indicate that it is necessary to increase DNR attitude and to encourage terminal care performance among hospital nurses.

• 가정∙방문간호학회지
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• 제12권1권
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• pp.41-69
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• 2005

Purpose: This study was performed to evaluate the outcomes of the home care nursing program conducted jointly by thirty two catholic churches and C hospital in Seoul. Method: The subjects included 173 patients who registered for the program during a 4 month-period from November 1, 2004 to February 28, 2005 and received home care services for more than 4 times and 32 professional nurses participating in the program. Using the concept of medical outcome study (MOS), the structure, process, outcome elements were analyzed. Result: 1) A Catholic homecare nursing center and nurses of the C hospital played a central role in providing nursing care, and each church operated its own vehicle from its own office. Home care nurse's job satisfaction was 2.8 out of total score of 4. The major illness was cerebrovascular disease including stroke followed by skeletomuscular disease including degenerative arthritis cancer, and diabetes. Among reasons for accessing the home care nursing program, hypertension management was most prevalent. More than half of the registration was done through catholic churches. Most people who referred the patient to the program was through the church. Most patients received home care nursing 1-2 times a week for 30 to 60 minutes in average and the most frequent type of service provided was basic nursing. 3) The most frequent reason for terminating home care services was death. The change in PPS(Palliative Performance Scale) level from the time of registration and after 4 visits was the same in 45%, decreased in 30%, and improved in 25%. Patient satisfaction was very high, showing 3.4 out of total score of 4. Conclusion: These results proved that the home care nursing program was highly appreciated by subjects and nurses were providing professional care. Thus the two parties involved in the program were actively supporting the program to fulfill their mission. However, several areas needed to be improved such as relating with local community, relating with family doctor, and issue of improving the working conditions for home care nurses.

• 임상간호연구
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• 제18권2호
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• pp.183-195
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• 2012

Purpose: This study was performed to identify the variations of nursing care cost depending on nursing care requirement and calculate nursing care cost per one day and one care requirement point. Methods: Nursing care requirement was measured by classifying 3,855 patients according to KPCS-1(Korean Patient Classification System for nurses-1). Nursing care cost was calculated from personnel expenses and nursing care requirement. Nursing cost factors were identified by multiple regression analysis. Results: Average nursing cost per patient per day was 33,588 won, Average nursing care cost per 1 patient classification score was 3,558 won. The nursing cost per 1 patient classification score was different depending on the types and levels of the hospitals. The 4th patient classification group revealed the highest nursing care cost. Nursing cost factors included the number of beds in the hospitals, seniority, number of nurses and first grade in nurse personnel accreditation ($adj-R^2$ 74.0%. p<.05). Conclusion: Nursing care requirements expressed by patient classification scores don't directly correlate with nursing care cost. Further research is needed to evaluate validity and reliability for refining KPCS-1 and to apply variable criteria to nurse personnel accreditation.

• 한국의료질향상학회지
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• 제11권1호
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• pp.72-83
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• 2004

• 중환자간호학회지
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• 제4권2호
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• pp.27-38
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• 2011

Purpose: The purpose of this study was to examine the effect of tooth-brushing oral care on oral health and ventilator-associated pneumonia of patients in Intensive Care Unit (ICU). Methods: A total of 74 participants were recruited from a medical, surgical, or neurosurgical ICU at S Hospital in Seoul, Korea, from September of 2010 to January of 2011. An experimental group (n= 36) received oral care with tooth-brushing while a control group (n=38) received oral care with cotton ball and gauze. In both group, the oral care was done three times a day at least one minute for 7 days. Oral health was examined by the Modified Oral Assessment Guide before the intervention and each night. Results: There is no difference between the groups in aspect of passage of time (p = .603), interaction between time and intervention (p =.300), the performance intervention (p = .766), and the incidence of VAP (p = .486). Conclusion: The effect of oral care with tooth-brushing on oral health and VAP was not different from that of usual oral care in ICU. However, further study is necessary due to high attrition in this study.

• Tuberculosis and Respiratory Diseases
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• 제82권2호
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• pp.102-117
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• 2019

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrosing interstitial pneumonia, which presents with a progressive worsening dyspnea, and thus a poor outcome. The members of the Korean Academy of Tuberculosis and Respiratory Diseases as well as the participating members of the Korea Interstitial Lung Disease Study Group drafted this clinical practice guideline for IPF management. This guideline includes a wide range of topics, including the epidemiology, pathogenesis, risk factors, clinical features, diagnosis, treatment, prognosis, and acute exacerbation of IPF in Korea. Additionally, we suggested the PICO for the use of pirfenidone and nintendanib and for lung transplantation for the treatment of patients with IPF through a systemic literature review using experts' help in conducting a meta-analysis. We recommend this guideline to physicians, other health care professionals, and government personnel in Korea, to facilitate the treatment of patients with IPF.

• Journal of Hospice and Palliative Care
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• 제24권1호
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• pp.26-35
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• 2021

Purpose: The purpose of this study was to determine the effects of awareness of good death and end-of-life care attitudes on end-of-life care performance in long-term care hospital nurses. Methods: This study used a cross-sectional study design. The participants were 147 nurses working at six long-term care hospitals with more than 200 beds in B city, South Korea. Data were collected using self-reported questionnaires, and analyzed with descriptive statistics, the t-test, analysis of variance, Pearson correlation coefficients, and multiple stepwise regression analysis using IBM/SPSS 26.0 for Windows. Results: The participants' awareness of good death, end-of-life care attitudes, and end-of-life care performance were positively correlated. The factors affecting end-of-life care performance were age, education level, awareness of good death, and end-of-life care attitudes; these variables explained 19.0% of end-of-life care performance. Conclusion: In order to improve long term care hospital nurses' end-of-life care performance, continuing education and training should be provided regarding awareness of good death and end-of-life care attitudes.

• Tuberculosis and Respiratory Diseases
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• 제80권3호
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• pp.296-303
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• 2017

Background: Acute respiratory distress syndrome (ARDS) is related to high mortality and morbidity. There are no proven therapeutic measures however, to improve the clinical course of ARDS, except using low tidal volume ventilation. Metformin is known to have pleiotropic effects including anti-inflammatory activity. We hypothesized that pre-admission metformin might alter the progress of ARDS among intensive care unit (ICU) patients with diabetes mellitus (DM). Methods: We performed a retrospective cohort study from January 1, 2005, to April 30, 2005 of patients who were admitted to the medical ICU at Seoul National University Hospital because of ARDS, and reviewed ARDS patients with DM. Metformin use was defined as prescribed within 3-month pre-admission. Results: Of 558 patients diagnosed with ARDS, 128 (23.3%) patients had diabetes and 33 patients were treated with metformin monotherapy or in combination with other antidiabetic medications. Demographic characteristics, cause of ARDS, and comorbid conditions (except chronic kidney disease) were not different between metformin users and nonusers. Several severity indexes of ARDS were similar in both groups. The 30-day mortality was 42.42% in metformin users and 55.32% in metformin nonusers. On multivariable regression analysis, use of metformin was not significantly related to a reduced 30-day mortality (adjusted ${\beta}-coefficient$, -0.19; 95% confidence interval, -1.76 to 1.39; p=0.816). Propensity score-matched analyses showed similar results. Conclusion: Pre-admission metformin use was not associated with reduced 30-day mortality among ARDS patients with DM in our medical ICU.

• 한국의료질향상학회지
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• 제15권2호
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• pp.93-103
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• 2009

문제: 억제대 적용에 대한 구체적 적용 지침 없이 의례적으로 억제대를 사용함으로 인해 환자들의 신체적 또는 정신적 안전을 위협할 수 있다. 목적: 완전 진정 상태 이거나 근력이 약하여 발관 능력이 없는 환자에 대한 예방적 적용, 바빠서 환자를 볼 수 없는 경우, 간호사 본인의 판단이 없이 타인의 요구에 따르는 등의 불필요한 억제대 적용이 증가하는 원인을 파악하여 중환자실의 특수성에 맞는 억제대 적용 및 제거 지침을 마련하고자한다. 의료기관: 인천광역시에 소재한 의과대학 소속병원의 집중치료실 질 향상 활동: 불필요한 억제대 적용에 영향을 미치는 요인을 선정하여 개선활동 수행. 개선효과: 억제대 적용에 대한 중환자실 간호사에게 미치는 영향을 보면 태도 정도 p=0.09(p<0.1), 올바른 수행 능력은 p=0.005(p<0.05)로 통계적으로 유의한 것으로 나타났다. 지식 정도 p=0.172(p<0.05) 통계적으로 유의 하지는 않지만 모든 항목이 개선 활동 전 에 비해 2,3차 개선 활동 후에 향상 한 것으로 나타났다. 개선 활동 전에 8.1%였던 간호 기록, 0.7%였던 간호 중재, 0%였던 의사 처방율이 3차 개선 활동 후 3가지 모두 100% 달성되었다. 이는 억제대 적용율 감소 및 부적절한 억제대 적용율은 유의하게 감소 하였다. 교훈: 중환자실 간호사의 억제대 적용에 대한 태도, 지식, 올바른 간호 수행 능력은 지속적으로 재평가 되어지고, 교육내용은 좀 더 나은 간호 제공을 위하여 개발되어져야 할 것이다. 억제대 적용 기준과 제거 기준을 Check List 하여 객관성의 유지를 위한 개선 활동은 계속적으로 Feedback 되어야 할 것이다.