• Title/Summary/Keyword: Clinical statistics

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A Study of the Chief Complaints of Pediatric Outpatients (소아과(小兒科) 외래(外來) 환자(患者)의 주소증(主訴證)에 관한 고찰(考察))

  • Song, In-Sun;Shin, Ji-Na;Shin, Youn-Guo
    • The Journal of Pediatrics of Korean Medicine
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    • v.16 no.2
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    • pp.69-81
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    • 2002
  • The Purpose of this study was to collect statistics of pediatric problems, and so to investigate the new effective oriental medicine treatments in pediatric disease and its clinical applicability. The Study was composed of 698 new patient who had been treated at the pediatric unit in th Dong Sea Oriental Medical Hospital for 1 year, from 1 September 2001 to 31 October 2002, and aged between 0 and 18 years. The Chief complaints and their care-givers. Result: 1. In the study, male children are 403 and female children are 295. So the sex ratio between male and female is 1.37 : 1. 2. In age distribution, 0-3 years : 317(45.4%), 4-6 years : 148(21.2%). 7-9 years 98(14.0%), 10-12 years: 66(9.5%), 13-15 years : 40(5.7%), 16-18 years 29(4.2%). 3. The chief complaint according to systemic division was Respiratory diseases covers 30.1%, Digestive diseases covers 20.8%, Physique diseases covers 10.6%. 4. The Respiratory diseases tended to increase in autumn and appeared mostly in the age group between 0 and 9 years. The Digestive diseases increase in summer and appeared mostly in the age group between 10 and 12 years. The physique diseases increase in winter and appeared mostly in he age group between 13 and 18 years. 5. Most of patient came to the hospital from diseases such as common cold, weakness, dyspepsia, atopic dermatitis, rhinitis, take a easy cold, short stature, sweating, Bell's palsy, abdominal pain, etc. Conclusion : 1. The chief complaint In pediatric diseases that needed an oriental medical treatment was mainly the disease that tends to take long time and the weakness, and appeared frequency in respiratory and digestive disease. 2. The oriental medical treatment was still preferred as a way to improve the weakness by patients, rather than a way to overcome their disease. in particular, the study shows that the oriental medical treatment should be emphasized in terms of preventing the disease. 3. The new disease, which were developed with change of human life and environment, should be investigated as a new fie of oriental medical treatment.

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Affecting Factors of Insulin Resistance in Obese Children and Adolescents (소아 및 청소년 비만증에서 인슐린 저항성에 미치는 요인)

  • Kim, Duk Hee;Eun, Ho Seon;Choi, In Kyung;Kim, Ho Seung;Cha, Bong Soo;Kim, Dong Kee
    • Clinical and Experimental Pediatrics
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    • v.48 no.10
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    • pp.1076-1081
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    • 2005
  • Purpose : Insulin resistance is the most important risk factor linked to the development of impaired glucose tolerance(IGT), diabetes mellitus and cardiovascular diseases in childhood and adolescent obesity, The purpose of this study was to see whether insulin resistance of obese adolescent is higher than that of obese children. and to analyze gender difference and affecting factors of insulin resistance. Methods : Of the 9,837 school children from 5 to 16 tears old, 92 obese children and 187 adolescent, underwent a two-hour oral glucose tolerance test and plasma glucose, insulin, lipid profiles, leptin and high sensitive C-reactive protein(hs-CRP) were measure. Results : Plasma insulin levels of female were higher compared to those of males during oral glucose tolerance test(P<0.05). Four(4.3%) in obese children and twenty five(13.3%) in obese adolescents met the criteria of IGT. Female, leptin, adiponectin and triglyceride concentrations were strongly correlated with homeostatic model assessment insulin-resistance(HOMA-IR) by multiple linear regression analysis(P<0.05). Conclusion : Obese adolescents might have higher insulin concentrations compared to obese children and obese girls higher insulin concentrations than obese boys. Obese boys and children with impaired glucose tolerance have higher insulin concentrations than those with normal glucose tolerance. HOMA-IR was significantly correlated with female, plasma leptin, adiponectin and triglyceride concentrations.

Comparison of Effectiveness between Two Different Protocols of Treatment of IV γ-globulin in Idiopathic Thrombocytopenic Purpura (특발성 혈소판 감소성 자반증에서 정주용 감마 글로불린의 투여 방법에 따른 효과 비교)

  • Jang, Jae Ho;Lee, Moonsouk;Park, Mira;Choeh, Kyuchul
    • Clinical and Experimental Pediatrics
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    • v.46 no.4
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    • pp.358-362
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    • 2003
  • Purpose : Several methods of IV ${\gamma}-globulin$(IVG) infusion are effective in the treatment of autoimmune disease, including idiopathic thrombocytopenic purpura(ITP). But it is not known which method is more effective in the treatment of ITP. The effectiveness of these two methods of IVG infusion was studied in terms of platelet recovery rate, side effects and recurrence rate. Methods : Forty seven patients with acute ITP in the department of pediatrics, Eulji University Hospital from January 1995 to June 2001 were enrolled. We assesssed the treatment effects of 47 patients blindly selected; IV ${\gamma}-globulin$ 2 g/kg/day in one day(treatment group A, n=25), 400 mg/kg/day in five days(treatment group B, n=22). Results : Treatment group A increased platelet count more rapidly on the 2nd, 4th and 6th day of treatment than treatment group B. Side effects like fever, chill and vomiting were more frequent in treatment group A than treatment group B. The platelet count on the sixth day of treatment showed a greater increase in the cases which had side effects than in the cases which did not. There was no difference between the two groups in the recurrence rate. Conclusion : IV ${\gamma}-globulin$ 2 g/kg/day in one day increases platelet count more rapidly than 400 mg/kg/day in five days, and is favorable for the prevention of a severe hemorrhagic episode like early intracranial hemorrhage.

Relationships among Emotional Labor, Fatigue, and Musculoskeletal Pain in Nurses (간호사의 감정노동, 피로 및 근골격계 통증의 관계)

  • Lee, Eun-Yeon;Kim, Ju-Sung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.1
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    • pp.351-359
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    • 2017
  • This study examined emotional labor, fatigue, and musculoskeletal pain in hospital nurses. The study sample included 235 hospital nurses. The data were collected by questionnaire and analyzed with descriptive statistics, t-test, ANOVA, Scheffe test, Pearson's correlation coefficients, and multiple regression.The average emotional labor score was 3.27, and of fatigue was 2.04. The musculoskeletal pain score was 4.43. Emotional labor and fatigue are significantly positively associated with musculoskeletal pain(r=.180, p=.006; r=.278, p<.001). Emotional labor was positively associated with the degree of fatigue(r=.353, p<.001). The significant predictors of musculoskeletal pain for nurses were physical fatigue(${\beta}=.324$, p<.001) and gender(female)(${\beta}=.171$, p=.009), explaining 13.7% of the variance in musculoskeletal pain(F=16.271, p<.001). The results suggest that engaging in emotional labor related to nursing tasks increases the risks of fatigue and musculoskeletal pain. Therefore, it is important to develop a management program to relieve the emotional labor, fatigue, and prevent musculoskeletal pain for clinical nurses.

The Factors Affecting advanced Beginner-Stage Nurse's Intention of Retention (상급초보 간호사의 재직의도 영향요인)

  • Kim, Yang-Sin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.4
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    • pp.221-228
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    • 2018
  • The purpose of this study was to identify advanced beginner-stage nurse's intention of retention. Data were collected from May 1 to June 30 of 2017 using a structured questionnaire. Participants consisted of 150 nurses with 13 to 36 month clinical careers at a hospital located in D, C and K city, Korea. Data were analyzed by descriptive statistics, t-test, ANOVA, Scheffe's test, Pearson's correlation coefficients and multiple regression, using IBM SPSS WIN 20.0. The average score was 3.34 (${\pm}0.53$) for ego resilience, 2.28 (${\pm}0.44$) for sense of calling, 3.88 (${\pm}0.58$) for teamwork, 3.36 (${\pm}0.42$) for organizational culture, and 5.27 (${\pm}1.38$) for retention intention. Retention intention was positively correlated with ego resilience (r=0.211, p<0.05), sense of calling (r=0.338, p<0.001), teamwork (r=0.284, p<0.001) and organizational culture (r=0.215, p<0.01). Regression analysis revealed that sense of calling and teamwork explained 11.4% (${\beta}=0.284$, p<0.001) and 4.2% (${\beta}=0.212$ p<0.001) of the retention intention of advanced beginner-stage nurses, respectively, and these variables together explained 15.6% of the retention intention of advanced beginner-stage nurses. The results of this study will improve retention intention of advanced beginner-stage nurses and facilitate development a management program and execution strategy that helps improve sense of calling and teamwork, especially that of friendly social orientation and mutual cooperation.

The analysis of medical care behaviors influencing New Diagnosis-Related Groups (DRG) based payment - focused on hospitalized patients with medical illness (신포괄수가에 영향을 미치는 의료행태 요인 분석 - 내과 입원환자 중심으로)

  • Lee, Kyunghee;Wi, Seung Bum;Kim, Suk Il;Choi, Byoong Yong
    • Korea Journal of Hospital Management
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    • v.25 no.2
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    • pp.45-56
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    • 2020
  • Purpose: The purpose of this study is to investigate medical care behaviors influencing accuracy of the payment based New diagnosis-related groups (DRG) compared to fee for service (FFS) in hospitalized patients with medical illness. Methodology: In order to estimate the difference in medical costs between New DRG and FFS depending on medical care behaviors, medical records and hospital claims data (n=4,232) were utilized, which were collected from a single public hospital during the first-half of 2018. Data were analyzed by descriptive statistics, t-test, chi-square test, and multivariate binary logistic regression. Findings: The average difference in medical costs between New DRG and FFS were KRW 506,711±13,945 with incentives and KRW -51,506±12,979 without incentives, respectively. Forty-four point two percent (44.2%, n=1,872) of total subjects were shown to have negative compensation in overall medical costs with New DRG compared to the costs with FFS. Medical care behaviors that affected on the negative compensation were the presence of severe bed sores on admission, medical consultations, death, operations, medications and laboratory or imaging tests with unit price over KRW 100,000, hospital-acquired complications or underlying comorbidities, elderly patients (≧65 years), and hospitalized for more than average inpatient days defined by New DRG (p<0.001). The difference in average medical cost between New DRG and FFS for a group with mild illness was KRW -11,900±10,544, whereas it was KRW -196,800±46,364 for a group with severe illness (p<0.0001). Practical Implications: These findings suggest that New DRG payment model without incentives may incompletely cover the variation of medical costs in real clinical practice. Therefore, policy makers need to consider that the current New DRG reimbursement should be focused and refined to improve accuracy of payment on medical care resources utilized in severe and complex medical conditions.

The Role of Exposure Assessment of Humidifier Disinfectant (HD) in the Program to Monitor HD Associated Health Problems (가습기 살균제 건강영향 모니터링에서 환경노출조사의 역할)

  • Park, Soyoung;Park, Ju-Hyun;Lee, Seunghee;Jang, Woo-Sung;Kim, So-Yeon;Park, Jihoon;Mun, Eunchan;Lee, Yesung;Kim, Hyunil;Kim, Hyeong-Cheol;Park, Dong-Uk
    • Journal of Environmental Health Sciences
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    • v.46 no.2
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    • pp.224-231
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    • 2020
  • Objective: The objectives of this study are to update the information on the characteristics of humidifier disinfectant (HD) usage with HD associated health problems and to discuss the role of HD exposure assessment in the national program to monitor health problems in patients with HD associated diseases. Method: A total of 201 HD associated patients who registered to undergo clinical examination at Kangbuk Samsung Hospital was interviewed to acquire their responses regarding several HD use characteristics, including type of HD brands used, HD use duration, average daily HD use hours, and the volume of the room in which HD was used. The responses of the HD associated patients to HD use-related questions were compared between responses in the lung injury investigation and this study. Results: The responses of HD associated patients in this study were found to be different from those in the lunginjury investigation. In particular, some of the patients who had not answered in the lung-injury investigation were able to answer thanks to assistance from the investigator in this study. For their responses regarding the name of the most commonly used HD brand, the number of patients who did not answer (N=11) was reduced to eight in this study. Significant changes in the responses of study subjects to questions related to HD use were achieved through the interview in this study. Conclusion: This study found significant changes in the responses regarding HD use characteristics. HD exposure assessment should be included in the program in order to allow surveillance of HD associated health problems.

Effects on the Thermal Changes of the Ankie Region Following Acupuncture on Wu-Hu (오호혈(五虎穴)이 족과부(足踝部) 체표온도변화(體表溫度變化)에 미치는 영향(影響))

  • Kim, Hyun-Jung;Byun, Jae-Young;Ahn, Soo-Gi;Lee, Geon-Mok;Park, Yong-Hyun;Kim, Kyung-Sik
    • Journal of Acupuncture Research
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    • v.18 no.1
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    • pp.40-49
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    • 2001
  • Background and Purpose : There have been many studys about the relationship between the meridians and the acupoints of the twelve meridians, but no study about the extra points. To verify Dong-Shi acupoints, a kind of extra points, we studied the effects on the thermal changes of the ankle region following acupuncture on the Wu-Hu. Object and Methods : This study was researched into clinical statistics for 45 healthy normal students. The object was divided into two groups. One was the control group and the other was the acupuncture group. The acupuncture group was divided into two groups ; ACU-up : The class of ascent thermal change among acupuncture group. ACU-dn : The class of descent thermal change among acupuncture group. First, in the control group, we took a picture at the ankle region(BL60, BL62, GB40, ST41) without any stimulation with the Digital Infrared Thermal Imaging System and did after 10 minutes respectively. Second, in the acupuncture group, we took a picture without any stimulation and then acupuncture on Wu-Hu and took a picture after 10 minutes in the same way respectively. Results : 1. In the control group, average thermal change of BL60, BL62, GB40 and ST41 was decreased(about $0.2^{\circ}C$) after 10 minutes. 2. The skin temperature of all measured parts was significantly lower in the ACU-dn group after 10 minutes. 3. There were no significant differences of thermal change between the control and the acupuncture group, between the control and ACU-up group after 10 minutes. Conclusion : This result indicated that the acupuncture on the Wu-Hu was effective at the ankle region. And so the more study is needed continuously.

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Report of the 3rd Japan-Korea Workshop on Acupuncture and EBM;Protocol development for the acupuncture trial on the osteoarthritis of the knee

  • Jang, Jun-Hyouk;Kenji, Kawakita;Hahn, Seo-Kyung;Park, Hi-Joon;Lee, Seung-Deok;Kim, Yong-Suk;Norihito, Takahashi;Toshiyuki, Shichidou;Kazunori, Itoh;Eiji, Sumiya;Eiji, Furuya;Hitoshi, Yamashita;Hiroshi, Tsukayama
    • Journal of Acupuncture Research
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    • v.23 no.6
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    • pp.239-254
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    • 2006
  • The 3rd Japan-Korea Workshop on Acupuncture and EBM was held at Kanazawa on June $16^{th}$. From Korea team, 4 papers were presented. Dr. Hahn introduced a new approach of data analysis on series of n-of-1 trials using the Bayesian statistics. It offered important information for the future n-of-1 trials. Dr. Park clearly demonstrated the significance of various sham devices proposed and stressed the importance of research questions when we choose the control intervention in RCT. Dr. Lee reported the results of survey in Korean Medical Doctors (KMD) for their point selection and techniques to the distal and local points. Dr. Kim presented the results of face to face survey on the KMD with 28 items for acupuncture treatment on the knee OA. Finally, a draft of protocol was introduced by Dr. Kim. The title was "multi-center, a randomized, single blinded, two arms, parallel-group study to compare the effectiveness and safety of 'individualized acupuncture' and 'standardized minimal acupuncture' in Korean and Japanese patients with knee osteoarthritis (Phase IV)". From Japan team, 7 speakers presented their comments and proposals on the protocol. Dr. Takahashi introduced several issues regarding n-of-1 trials and pointed out the importance of obtaining generalizability from n-of-1 trials. Dr. Shichidou pointed the importance of research design, selection of outcome measures and reduction of biases. Dr. Itoh presented the results of point selection for the knee OA based on the literature survey. Dr. Sumiya introduced several differences between KMD and Japanese acupuncturists based on the questionnaire used in KMD survey. Dr. Furuya demonstrated a result of press tack needle and its sham device on shoulder stiffness. Dr. Yamashita introduced the results of literature survey regarding adverse events occurred by acupuncture on knee OA. Dr.Tsukayama stressed the importance of responsibility of Institutional Review Board (IRB) for the conduction of clinical trials. After several issues were discussed, the need of continued meeting for final protocol development was agreed, then the workshop was closed.

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Korean Nurses Knowledge Concerning Vaginal Birth After Cesarean(VBAC) and its Educational Material (제왕절개 기왕력이 있는 질 분만(VBAC)에 관한 간호사의 인식정도와 교육안)

  • Park Sang-Ju;Choi Kyung-Sook
    • The Journal of Korean Academic Society of Nursing Education
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    • v.5 no.2
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    • pp.267-284
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    • 1999
  • The purpose of this study are 1. Evaluate the degree of knowledge of Vaginal Birth After Cesarean(VBAC) of Korean nurses. 2. To gather and develop educational material for VBAC. The sample was surveyed Korean Nurses knowledge about VBAC, from November 1998 through March 1999. For the data analysis, the SPSS computer program percentage and frequency were used for descriptive statistics. The x2 and the t-test were used to compare the results of the two sample groups. Open questions asked in the survey were sorted out by content, then displayed in chart form. For the education material, the Internet was the main source of information. Information on the Internet was provided by professional doctors and prenatal educational nurses. The results of the survey are as follows: 1. Out of 97 Nurses 15.3% answered that cesarean deliveries do not need to be performed after previous cesarean sections : however. 46.4% answered that cesarean sections must be performed after previous cesarean sections. 2. Of the nurses surveyed 14% had no knowledge or had never heard of VBAC. 3 Nurses did not have questions from patients concerning VBAC was 34.7%. This led to the conclusion that patients either do not have knowledge about VBAC or patients have no interest in the trial of labor. 4, Nurses indicated that their information about VBAC originated from other people's experiences (31%), Nursing School (25%), Media information (9%), and through literature review (6%). This data led to the conclusion that the knowledge about VBAC may not be extensive enough to counsel and guide patients who are willing to endure the trial of labor. 5. Nurses preferred hospital education programs to develop their knowledge concerning VBAC. Based upon survey, the conclusion was made that General Nurses and Maternity Nurses did not have knowledge about VBAC success rates and the possibility of a trial of labor. In order for nurses to help patients make decisions concerning VBAC, nurses have to gam more knowledge through hospital educational programs. Further more, the study suggests that through hospital educational programs, the possibility and importance of VBAC must be emphasized to nurses who work in maternity areas. Second, through prenatal educational programs, the possibility and importance of VBAC must be explained and emphasized to patients who had previous cesarean sections. Third, the clinical pathways of VBAC need to be developed. Fourth, each hospital needs to develop multi-disciplinary teams, consis-ting of obstetricians, risk management/quality management, staff registered nurses, and the director for perinatal services. This team can review cesarean section rates and help to increase the practice of VBAC.

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