• Journal of Korean Academy of Nursing
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• v.40 no.1
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• pp.110-118
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• 2010

Purpose: To develop outcome indicators of urinary incontinence to measure quality of care in long term care hospitals in Korea. Methods: The draft indicators of urinary incontinence were developed from a literature review and clinical expert panel. A survey of medical records of 280 patients in 20 hospitals was conducted to test inter-rater reliability. Statistical analysis was done to test risk adjustment criteria, variation between hospitals, and stability of indicators, using assessment data from 77,918 patients in 623 hospitals. Results: The inter-rater reliability of items was high (Kappa range: 0.66- 0.92). Severe cognitive impairment (odds ratio [OR]: 3.15, confidence interval [CI]: 3.03-3.26) and total mobility activities of daily living (ADLs) dependency (OR: 4.85, CI: 4.72-4.98) increased the prevalence of urinary incontinence, thus they proved to be significant criteria to stratify high and low risk groups. The prevalence for low risk showed more substantial variation than the high risk group. The indicators were stable over one month. Conclusion: This study demonstrated the feasibility of outcome indicators of urinary incontinence. Improving the reliability of the patient assessment tool and refining the indicators through validation study is a must for future study.

• Journal of Oriental Neuropsychiatry
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• v.16 no.2
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• pp.223-231
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• 2005

The purpose of this study was to investigate the clinical application of relaxation training and oriental medical treatment to the SimDamHeoGup(心膽虛怯) type of ChilJungGuQiJung(七情九氣證) patient. In this case, a male patient, 31 years old, who lost his job two months ago, complained of the tension of body and anxiety. We treated the patient with relaxation training and oriental medical treatment such as herbal medicine, acupuncture treatment and aroma therapy. And we diagnosed his state SimDamHeoGup(心膽虛怯) type of ChilJungGuQiJung(七情九氣證), so we prescribed HaChuBoSimTang(夏朮補心場) for patient. In result, the patient’s tension of body and anxiety was improved, so he could recover his confidence slowly. Conclusionally, relaxation training and oriental medical treatment could be effective method to treat the patient of adjustment disorder with the tension of body and anxiety.

• Clinical and Experimental Pediatrics
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• v.57 no.2
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• pp.79-84
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• 2014

Purpose: Overweight can be defined by the body mass index (BMI) and is likely associated with an increased cardiovascular disease risk. However, waist circumference (WC), a central adiposity index, may be a better indicator of cardiovascular disease risk. Studies comparing the effects of BMI and WC on cardiovascular risk factors, such as high blood pressure (BP), are rare in adolescents. Methods: We analyzed the correlations of BMI and WC with BP in 3,363 Korean adolescents (aged 10-19 years), using data from the Korean National Health and Nutrition Examination Surveys (2009-2011). Results: Systolic BP (SBP) in both sexes and diastolic BP (DBP) in boys were higher in the high BMI (>85th percentile) and high WC (>90th percentile) groups. High BMI and high WC were positively correlated with high SBP (>90th percentile) in both sexes, and high DBP (>90th percentile), in boys. BMI maintained its positive associations with SBP, DBP, high SBP, and high DBP in the normal weight ($BMI{\leq}85th$ percentile) and overweight (BMI>85th percentile) groups in both boys and girls, as well as in all subjects of both sexes, even after adjustment for WC. However, WC did not correlate with SBP, DBP, high SBP, or high DBP after adjustment for BMI in any group in either sex. Conclusion: In Korean adolescents, BMI correlated better with BP and high BP levels than WC. Further, BMI was positively associated with BP and high BP in the normal weight group as well as in the overweight group.

• Korean Journal of Adult Nursing
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• v.28 no.1
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• pp.1-12
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• 2016

Purpose: The purpose of this study was to test a Winningham's psychobiologic entropy model (PEM) on cancer related fatigue (CRF) among patients with solid tumors. Methods: Participants consisted of 213 patients with solid tumors recruited from December, 2012 through June, 2013, in a university hospital, in Hwasun, South Korea. Primary symptoms, adjustment, physical activity, status of nutrition and fatigue were measured using structured questionnaires. Collected data were analyzed using SPSS 21.0 and AMOS 21.0 programs. Results: The modified model tested provided a reasonable fit to the data ($x^2=65.80$ [df=30, p<.001], TLI=.92, CFI=.95, RMSEA=.08, SRMR=.07). Primary symptoms (dyspnea, anxiety, depression and insomnia) had direct positive effects on CRF. Adjustment and status of nutrition showed indirect negative effects on CRF. However, the impact of physical activity was not significant. These variables explained 49.2% of the variance of CRF among solid tumor patients. Conclusion: The findings demonstrate that the tested model explain some CRF among solid tumor patients and warrant future research considering the cancer-related clinical factors of the given population.

• Clinical and Experimental Pediatrics
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• v.64 no.3
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• pp.96-102
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• 2021

This study aimed to investigate the effect of maternal smoking during pregnancy (MSDP) on the risk of bone fractures in the offspring through a systematic review and meta-analysis. The PubMed, Web of Science, and Scopus databases were systematically searched for relevant articles published through July 2019. According to heterogeneity, the pooled risk ratio (RR) and odds ratio (OR) and their corresponding 95% confidence interval (CI) were obtained using fixed or random effects models. The heterogeneity and quality of the included studies were assessed by the I-squared (I²) statistic and the Newcastle-Ottawa scale, respectively. Sensitivity analyses were performed to test the effect of MSDP misclassification on the results. The review of 842 search records yielded 5 studies including 8,746 mother-child pairs that were included in the meta-analysis. Pooling adjusted effect measures showed that MSDP was not associated with a later risk of bone fractures in the offspring (pooled RR, 1.15; 95% CI, 0.84-1.58; I²=66.8%; P=0.049). After the adjustment for misclassification, MSDP may be associated with a 27% increased risk of bone fracture (pooled OR, 1.27; 95% CI, 1.00-1.62; I²=0%; P=0.537). After the adjustment for misclassification, MSDP is associated with an increased risk of bone fractures among children whose mothers smoked during pregnancy.

• Clinical and Experimental Pediatrics
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• v.59 no.12
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• pp.471-476
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• 2016

Purpose: Chest radiography is often performed on patients hospitalized with typical clinical manifestations of bronchiolitis. We aimed to determine the proportion of subjects with pathologic chest radiographic findings and the clinical predictors associated with pathologic chest radiographic findings in young children admitted with the typical presentation of bronchiolitis. Methods: We obtained the following data at admission: sex, age, neonatal history, past history of hospitalization for respiratory illnesses, heart rate, respiratory rate, the presence of fever, total duration of fever, oxygen saturation, laboratory parameters (i.e., complete blood cell count, high-sensitivity C-reactive protein [hs-CRP], etc.), and chest radiography. Results: The study comprised 279 young children. Of these, 26 had a chest radiograph revealing opacity (n=24) or atelectasis (n=2). Multivariate logistic regression analysis showed that after adjustment for confounding factors, the clinical predictors associated with pathologic chest radiographic findings in young children admitted with bronchiolitis were elevated hs-CRP level (>0.3 mg/dL) and past history of hospitalization for respiratory illnesses (all P<0.05). Conclusion: The current study suggests that chest radiographs in young children with typical clinical manifestations of bronchiolitis have limited value. Nonetheless, young children with clinical factors such as high hs-CRP levels at admission or past history of hospitalization for respiratory illnesses may be more likely to have pathologic chest radiographic findings.

• Korean Journal of Clinical Laboratory Science
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• v.38 no.2
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• pp.141-146
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• 2006

Vagal nerve stimulation (VNS) has been proposed as a possible way to improve the control of refractory epilepsy. We report the effects following VNS treatment in patients with refractory epilepsy. Seventeen patients with a mean age of 12.8 years, ranging from 5 to 29 years, underwent the implantation of vagal nerve stimulation (Cyberonics, Houston, TX). We reviewed the clinical findings before and after VNS in seizure frequency, number of antiepileptic drugs (AED), and quality of life (QOL). All of the patients had intractable seizures, eleven of the patients had additional medical complications, three had hippocampus atrophy, one had encephalomalacia, five had encephalitis, one had pachygyria, and one had schizencephaly. Thirteen patients had symptomatic partial epilepsies, three patients had Lennox-Gastaut syndrome and one had cryptogenic partial epilepsy. The mean follow up duration was 35 months. The mean reduction of seizure frequency compared with baseline before VNS was 26.1% after 3 months (p<0.005), 41.9% after 6 months (p<0.001), 46.9% after 1 year (p<0.001), and 53% at the latest follow-up (p<0.001). Twelve patients showed an improvement of QOL such as mood, language, alertness, expression, and motor function. The most common side effects were transient hoarseness or voice change or cough, which was detected in six patients (35%) and wound infection in one patient (5%). This study has shown a good anti-seizure effect of VNS, decrease in seizure frequency and improvements in QOL. We concluded that VNS is a beneficial therapy in refractory epilepsy with a non-resectable epileptic focus. Further studies should be focused on the prediction of unresponsiveness and the adjustment of VNS parameters for maximum efficacy in patients with various medical histories.

• The Journal of the Korean life insurance medical association
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• v.26
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• pp.31-39
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• 2007

Background and main issue: In the Korean insurance market, an outstanding issue is the decrease of margin of risk ratio. This affects the solvency and profitability of insurance companies. Insurance medicine, which has been developed in Western countries, is so-called medical risk selection or medical underwriting. Medical risk selection is based on clinical follow-up study and mortality analysis methodology. Unfortunately, there have been few clinical follow-up studies, and no intercompany disease analysis system is available in the Korean insurance market. In practice, we use underwriting guidelines, which were developed by some global reinsurance companies. However, these guidelines were developed under clinical follow-up studies performed abroad. So, we cannot rule out underestimation of excess mortality factors such as mortality ratio, excess death rate, and life expectancy. It is necessary to perform medical assessment in claims administration. Comparing the insured's statement by medical records with products' benefit according to this procedure, we can make sound claim decisions and participate in the role of sound underwriting. We can call this scientific procedure as the verification of medical claims review. Another area of medical claims review is medical counsel for claims staff. Result: There is another insurance medicine in addition to medical risk selection. Independent medical assessment by medical records of insured is medical claims review. Medical claims review is composed of verification and counsel.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.1 no.1
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• pp.61-71
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• 2006

Objectives : To introduce Total Body Modification(TBM) technique system developed by Dr. Victor Frank DC, DO, ND through combining chiropractic manipulation with osteopathy, acupuncture meridian system, and naturopathy based on his long-time clinical experiences and insights. Methods : After investigating the art, philosophy and science of TBM thechnique, and applying TBM practice under private clinical situation, we compared It with Chuna Korean manual medicine and oriental medicine system. Results : This system deals with correcting human body's functional physiology to potentiate in a favorable manner. TBM uses a neuromuscular reflex test and body access meridian points to tap into the body's biocomputer and read functional programs. Corrections are usually made by means of special respiratory spinal adjustment, cranial, soft tissue, or specific joint manipulation. Conclusions : We found similarities between TBM and Chuna system in the view of Korean Traditional meridian concept. The special combinations and sequences of various alarm points and associated points have clinical effects on the treatment of chronic spinal subluxation pattern. This suggests TBM has significance In the point of the future evolution of Chuna manual medicine in Korea.

• Women's Health Nursing
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• v.17 no.5
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• pp.484-490
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• 2011

Purpose: This study was aimed to investigate the impact of job stress on low back symptoms among Clinical nurses (CNs) in university hospital. Methods: A total of 322 CNs employed in a hospital in Seoul were interviewed by a well-trained interviewer using the structured questionnaire. Data collected for this study includes demographics, social and work characteristics, low back symptoms, and job stress. To test the impact of job stress on low back symptoms, we used multiple logistic regression analysis. Results: The prevalence of low back symptoms was 25.8% in this study. Low back symptoms differed significantly by factors, such as physical work burden, past history of injury and work duration. Also low back symptoms differed significantly by organizational system among independent variables of job stress. In a multiple logistic regression analysis, the odds ratio of organizational system to low back symptoms was 2.07 after an adjustment. Conclusion: This study showed that organizational system among job stress was a significant variable in explaining low back symptoms. We suggest the improvement of organizational system category as a preventive strategy for low back pain in CNs working in hospital.