• Korean Journal of Clinical Pharmacy
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• v.31 no.2
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• pp.145-152
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• 2021

Background: The Life-Sustaining Treatment Decision-Making Act has allowed anyone aged 19 or older to sign an Advance Directive not to receive life-sustaining treatment when they are in the 'death process'. Recently, the Korean Pharmaceutical Association announced to raise awareness of the Advance Directive to the general public through community pharmacies across the country. This study aimed to investigate the public's willingness to accept pharmacist's consultation regarding the Advance Directive and to present future directions to pharmacists Methods: This cross-sectional questionnaire study using 16-items was conducted in adults, Study subjects were recruited by convenience sampling method during August 5-15, 2020. Results: Of 460 respondents, 51.7% were younger than 30-year-old and 58.7% were not in the healthcare field in terms of job or major. 60.2% knew about the Advance Directive and 81.7% agreed the necessity to sign when healthy. 50.0% had the willingness to consult with pharmacists on the Advance Directive for well-dying and 80.4% preferred verbal explanation together with written information. Simple linear regression analysis results showed a significant relationship between trust in pharmacists or satisfaction with pharmacist's communication and willingness to use pharmacist' consultation on the Advance Directive (1-point increases in values measured on a five-point scale are associated with 0.464 and 0.486 increases, respectively.) Conclusion: This study suggests that pharmacists need to improve the public's trust and communication capability to satisfy with public's demands on well-dying service.

• Korean Journal of Psychosomatic Medicine
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• v.1 no.1
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• pp.14-24
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• 1993

The author discussed present problems and future prospects of psychosomatic medicine in clinical, educational, research, and social aspects. In general, psychosomatic field. particularly. consultation-liaison(C-L) psychiatry in Korea seems to remain on early developmental phase. However, positive change in the general publics' and societal view of psychiatry, specialization of medicine and development of medical technology, implementation of delivery system in medical care could contribute to development of this field. In future, clinically, liaison activity will be more activated. and this field will be developed as main subspecialty of psychiatry. In addition. C-L psychiatry will be subspecialized. and prevention and humanization of medical care could be more emphasized. In education. the main place of education for medical students and psychiatric residents will be changed from closed ward to general ward in which consultation-liaison activity can be performed. In research. consultation liaison model suitable for Koreans will be developed and studies on disease mechanism will be more promoted. In social aspects, this field could influence the general publics' view of psychiatry and change the whole areas of medicine and society toward integration. In order to achieve these goals, medical insurance system and cost relevant to C-L activity should be essentially improved.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.1
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• pp.34-41
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• 2021

Objectives : The purpose of this study is to investigate the characteristics of depressive patients who admitted to general hospital. We examined the clinical characteristics of patients who were referred to the Department of Psychiatry as depressive symptoms, according to the type of consultation request, and comparing 'with re-consultation' and 'without re-consultation' groups. Methods : We performed a retrospective chart review of 4,966 inpatients who were referred to the Department of Psychiatry from August 2005 to December 2011. Results : For about 6 years, among the inpatients referred for psychiatric consultation, a total of 647 patients were referred for depressive symptoms, accounting for 13.82% of the total consultations. The average age of depressive patients was 58.6 years, which was higher than the average of 56.4 years of overall patients. Among the depressive patients, 275 patients were included in 'with re-consultation' group and there was no statistically significant difference when comparing 'with re-consultation' group and 'without re-consultation' group. However, there was a difference in the tendency of the two groups in the type of consultation request. 'With re-consultation' group was in the order of frequency of consultation type 3-2-1, whereas the 'without re-consultation' group was in the order of frequency of consultation type 2-3-1. Conclusions : The group of inpatients who were referred for depressive symptoms in general hospital showed the largest proportion of the group of patients referred to the Department of Psychiatry. 'With re-consultation' group had a higher rate of re-consultation due to the occurrence of new symptoms after hospitalization compared to 'without re-consultation' group. Therefore, doctors in each department and psychiatrists should pay attention to the depressive symptoms of inpatients and actively discuss treatment plans to improve the quality of medical services, identify risk factors, and make efforts to intervene early if necessary.

• Korean Journal of Psychosomatic Medicine
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• v.13 no.1
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• pp.49-59
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• 2005

Objectives: This clinical study investigates the status of psychiatric consultation from 2001 to 2003 at Maryknoll General Hospital, located in Busan to evaluate the characteristic patterns of current psychiatric consultation and to contribute for further data of consultation study. Methods : The subjects of this study were hospitalized at Maryknoll General Hospital from 1 January, 2001 to 31 December, 2003, who were referred for psychiatric consultation during hospitalization. This study was analysed demographic data, reason for referral, psychiatric diagnosis by patient's chart and psychiatrist's report retrospectively. Results : 1) The psychiatric consultation rates was 1.72%. 2) There was 47.8% in referral among the age group over 60 years, especially the age group over 70 years was 20.3%. 3) The most frequent referral source was department of internal medicine(72.5%). 4) The frequency of psychiatric consultation was the highest at March and the lowest at December. 5) The reasons of psychiatric consultation, according to frequency, were affective change, somatic symptom without abnormal finding. And drug intoxication. alcohol problem were increased. 6) Somatoform disorder was the most common psychiatric diagnosis followed by depressive disorder, organic mental disorder. The diagnosis of somatoform disorder, depressive disorder, alcohol dependence were increased, but anxiety disorder, organic mental disorder were decreased. 7) Pharmacotherapy was the most recommendation, and diagnostic procedure and psychotherapy were increased. Conclusion : In review of consultation referral subjects, the referral rate was 1.72%. The consultation referral of the old(over 60 years) was 42.8%, and annually increased. The most frequent request source was from department of internal medicine. The reasons of consultation referral was the most due to affect change. The recommendation of pharmacotherapy was the most numerous. and psychotherapy was increased annually. Further studies warranted on geriatric psychiatric consultation, pattern change of consultation.

• Korean Journal of Clinical Pharmacy
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• v.11 no.1
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• pp.1-6
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• 2001

This research is conducted to evaluate the clinical and economic benefits from therapeutic drug monitoring(TDM) service on vancomycin in a tertiary general hospital. Total 99 pairs of steady state peak and trough concentrations of vancomycin were obtained from 73 patients. To see the clinical benefits, the appropriateness of vancomycin dosing before TDM was evaluated. In 72 pairs of vancomycin blood concentrations obtained prior to TDM consultation, $47.2\%$ of the cases had reached within therapeutic range. Serum vancomycin levels in patients with $40{\leq}CLcr<60$ (ml/min) were higher and than the levels in patients with 40>CLcr and $60{\leq}CLcr$ (ml/min). Dose reduction rate in patients with creatinine clearance $40{\leq}CLcr<60$ (ml/min) were also significantly higher than those of compared groups ($61.5\%$, p=0.0138). Serum vancomycin concentrations were re-obtained from 21 patients who received modified dose through TDM service. Ninety percent (19/21cases) of them were within the target therapeutic range. For the evaluation of economic benefits from TDM consultation, estimated cost savings were calculated in those patients. The total drug saving were 586 vials in 21 patients. The calculated mean cost saving from the drugs was 314,570 won (range: $11,273\sim473,466)$ per patient. The study revealed that TDM service for vancomycin is necessary because empirical dosing is not effective for obtaining therapeutic drug level, especially patients with mild renal insufficiencies. The cost saving from TDM is also beneficial for the patients.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2014.05a
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• pp.323-325
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• 2014

SNOMED CT is a standard clinical terminology which is to efficiently record, manage and utilize clinical records during clinical processes. However, huge expressive power of SNOMED CT makes it difficult to select appropriate terms during short consultation hours. In addition, true meaning of a written record using the terminology may be misunderstood or even distorted since one clinical meaning could be expressed in a variety of ways. This paper analyzes such known problems in a database point of view, and presents effective selection methods of similar terminologies to mitigate the problem.

• 한국임상약학회:학술대회논문집
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• 2007.12a
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• pp.181-181
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• 2007

• Korean Journal of Psychosomatic Medicine
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• v.21 no.2
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• pp.114-121
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• 2013

Objectives: The aim of this study was to know differences of characteristics between presenile and senile patients who were consulted to the department of psychiatry during medical-surgical admission. Methods: The demographic and clinical data obtained from the medical records of psychiatric consultation in the presenile inpatients with age 50 to 64 years(N=162) and those of the senile inpatients with age over 65 years(N=171) were reviewed and compared. Results: 1) The most common chief complaints for psychiatric consultation in presenile patients were somatic symptoms, anxiety and sleep disturbance in order, while cognitive decline, clouded consciousness and depressed mood were most common in senile patients with statistical significance. 2) The most frequent psychiatric diagnoses after consultation in presenile patients were delirium, mood disorder and substance use disorder in order, while delirium, mood disorder and major neurocognitive disorder were most frequent in senile patients with statistical significance. 3) There were no significant difference in numbers of physical illnesses, while numbers of therapeutic drugs for them were more in senile patients. Conclusions : Our study found significant differences between presenile and senile patients on psychiatric symptoms and diagnoses in geropsychiatric consultation. Therefore, more subdivided age-specific approach seems to be needed for the geropsychiatric consultation activities.

• Journal of Korean Clinical Health Science
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• v.4 no.1
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• pp.504-509
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• 2016

Purpose. This study aims to present basic data to develop programs suitable to the characteristics of elderly people through a meta-analysis of effectiveness of variables related to psychological effects of programs of elderly people conducted in past 15 years. Methods. The analysis subjects are total 229 articles related to the psychological effects of programs for elderly people and submitted for master or doctor degrees or published in academic journals. CMA2 is used for the analysis. Results. The results of this study shows lower variables of the psychological effect promoting factor group that are highly effective for Life Satisfaction, Self-Efficacy, Self-Respect and Self-Integration and lower variables of suppressing factor group that are highly effective for Loneliness, Tension, Weakness, Anger and Depression. For the effect scale of psychological effect promoting factors, Arts is shown to be the highest followed by Exercise, Consultation, Recollection, Others and Recreation in order. For the effect scale of suppressing factors, Consultation is shown to be the highest followed by Recollection, Arts, Exercise, Others and Recreation) in order. Conclusions. This study has its own meaning for establishing integrated factors of psychological effects of programs for elderly people and presenting realistic data for planing programs suitable for various desires of elderly people.

• Korean Journal of Clinical Pharmacy
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• v.32 no.4
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• pp.303-312
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• 2022

Objective: The purpose of the study was to analyze the difference in the importance and performance of the educational content of the community pharmacy practice and find the factors that influence it. Methods: A 5-point Likert scale questionnaire asked about the importance and performance of the pharmacy practice education items to community pharmacy preceptors, current students, and professors. Data were analyzed using Microsoft office 365 Excel and IBM SPSS 21.0. Results: A total of 117 people participated. The averages of importance and performance were 4.34±0.34 and 3.71±0.45, respectively. Except for the computational entry of prescriptions and medication history, the average score for the importance of all educational items was statistically significantly higher than the one for performance. Importance Performance Analysis (IPA) identified over-the-counter medication counseling, over-the-counter drug selection consultation, pharmacy management, adverse drug reaction monitoring, and understanding and implementation of drug use evaluation as the items that needed focused effort. Borich's needs were highest in the adverse drug reaction monitoring. Conclusions: Overall, high importance and low performance indicate a need for improvement in community pharmacy practice education. Since the demand for education was high in over-the-counter medication counseling, adverse drug reaction monitoring, and OTC drug selection consultation, various supports are urgently needed to strengthen pharmacy practice education in this area in the future.