• Title/Summary/Keyword: Continuing Medical Education

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Metabolic Syndromes Improvement and Its Related Factors among Health Checkup Examinees in a University Hospital (일개 대학병원 건강검진 수진자의 대사증후군 호전과 관련요인)

  • Jo, Mal-Suk;Suh, Soon-Rim;Kim, Keon-Yeop
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.6
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    • pp.147-156
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    • 2016
  • The purpose of this study was to identify the factors associated with the improvement of metabolic syndrome, and provide basic data for the health management of clients. The subjects were 280 adults who were diagnosed with metabolic syndrome in 2013, and who were examined from January 2013 to December 2014. The data were analyzed by descriptive statistics, t-test, ${\chi}^2$-test, and logistic regression analysis with SPSS WIN 18. The change rate from 3 to 2 risk factors was 60.6% among those clients whose metabolic syndrome improved. The improvement group showed a decrease in their waist circumference, systolic blood pressure, triglycerides and increase in their HDL cholesterol in 2014 compared to 2013, as well as decreased drinking, increased exercise, proper calorie, protein and carbohydrate uptake, and increased consumption of a lipid lowering agent. Exercise, calorie uptake and maintenance of an oral hypoglycemic drug influenced the improvement of the metabolic syndrome. In conclusion, it is necessary to have an intervention program including exercise enhancement and diet modification and to reinforce the health education for continuing health management.

Physical Therapist's Understanding and the Usage of Assessment Tools for Children With Delayed Development and Cerebral Palsy (발달지연 아동 및 뇌성마비 아동의 평가실태와 물리치료사들의 평가에 대한 인식도 조사)

  • Park, Hey-Jeong;Yi, Chung-Hwi;Cho, Sang-Hyun;Kwon, Hyuk-Cheol
    • Physical Therapy Korea
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    • v.7 no.1
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    • pp.1-21
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    • 2000
  • The purposes of this study were to research the current state of evaluation of children with delayed development and cerebral palsy and determine pediatric physical therapists' knowledge of assessment tools and their use. The subjects were 130 pediatric physical therapists (general hospitals, university-related hospitals, rehabilitation centers, etc.). Data was obtained from August 24, 1999 to October 18, 1999 by means of a survey questionnaire. The results were as follows: 1. The current state of pediatric physical therapist evaluation of children with delayed development and cerebral palsy. 1) Tools used to assess functional areas of children with cerebral palsy were: subjective description format-128 (47.1%); the GMFM-58 (21.3%); facility-generated tool-51 (18.8%); and DDST-15 (5.5%). 2) Tools used to assess developmentally delayed children were: subjective description format-121 (50.6%); the GMFM-43 (18.0%); facility-generated tool-41 (17.2%); and DDS T-14 (5.9%). 3) After their college or university study, therapists who had attended lectures on evaluation were 113 (86.9%); 13 (10.0%) therapists had not attended any lectures on evaluation 2. Test scores of physical therapists' professional knowledge of evaluation procedures: high (more than 36 points)-74 (56.9%); moderate (18~35 points)-39 (30.0%); and low (below 17 points)-none. 1) For therapists treating cerebral palsied children, 73 (65.2%) were in the high range, 39 (34.8%) were in the moderate range and none were in the low range. 2) For therapists treating children with delayed development, 71 (65.7%) were in the high range, 37 (34.3%) were in the moderate range and none were in the low range. Although the general degree of professional knowledge of evaluation was quite high, there was a lack of variety in the assessment tools used With a large number of therapists depending on subjective description. Possible reasons for the low rate of objective asses sment tool use: 1) Poor clinical environment: too many clients and lirnited treatment time. 2) Lack of any medical insurance fee category for specific assessment tools. 3) Lack of continuing education opportunities in pediatric evaluation skills during or after either college-based (3 year) or university-based (4 year) education programs. Based on the study results, provision of more extended educational opportunities would promote the use of a greater variety of objective assessment tools by pediatric physical therapists.

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An Analysis of Nursing Decision Tasks, Characteristics, and Problems with Decision Making (환자 간호에 대한 간호사의 의사결정 내용과 특성 및 의사결정 장애요인에 관한 분석)

  • 최희정
    • Journal of Korean Academy of Nursing
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    • v.29 no.4
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    • pp.880-891
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    • 1999
  • The purpose of this study was to describe nursing decision tasks, their characteristics, and problems associated with decision making. The subjects were 32 nurses who had at least one-year nursing experience and worked on medical-surgical units or intensive care units(ICU). They were asked to describe their decision making experiences in patient care situations and to identify the characteristics of each decisions. They were also asked to describe perceived problems associated with decision making in nursing. The responses on nursing decision tasks and problems were analyzed with content analysis and the decision characteristics were identified by statistical analysis of variance. It was found that there were 16 nursing decisions which are as follows : decisions related to interpreting and selecting appropriate strategies for pain management(6.6%) ; decisions related to providing emotional support (0.7%) ; decisions related to explaining the patient's condition and rationale for procedures(1.1%) ; decisions related to assisting patients to integrate the implications of illness and recovering into their lifestyles(2.9%) ; decisions related to detecting significant changes In patients and selecting appropriate intervention strategies (17.2%) ; decisions related to anticipating problems and selecting preventive measures(4.2%) ; decisions related to identifying emergency situations(0.4%) ; decisions related to effective management of patient crisis until physician assistance becomes available(2.8%) ; decisions related to starting and maintaining intravenous therapy(2.6%) ; decisions related to administering medications(8.1%) ; decisions related to combating the hazards of immobility(7.3%) : decisions related to treating wound management strategies(5.5%) ; decisions related to relieving patient discomfort(13.9) ; decisions related to selecting appropriate strategy according to the changing situation of the patient(18.2%) ; decisions related to selecting the best strategy for patient management(5.3%) ; and decisions related to coordinating, ordering, and meeting the various needs of the patient (3.1%). The nurses reported the fellowing problems in decision making : difficulties due to lack of knowledge and experience (18.6%) ; uncertainty and complexity of decision tasks(15.2%) ; lack of time to make decisions(2.9%) ; personal values which conflict with other staff(15.7%) ; lack of selection autonomy(30.0%) ; and organizational barriers(7.6%). Continuing education programs and decision support systems for frequent nursing decision tasks can be established on the basis of these results. Then decision ability in nurses will increase through the education programs and decision support systems, and then quality of nursing service will be better.

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Pre-hospitalization Advanced Airway Management Using The KING LTS-DTM and the LMA ProSealTM (LTS와 LMA를 이용한 병원 전 전문 기도 관리 연구)

  • Choi, Uk-Jin;Shim, Gyu-Sik
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.12
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    • pp.5893-5900
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    • 2012
  • It is very critical to promptly maintain airway of cardiac arrest cases or serious traumatic cases. The purpose of this study is to compare intubation rate, successful rate and pre-/post-education self-confidence between laryngeal tube (LTS) and proseal laryngeal mask (PLMA), so that it may contribute to improving the ability of 119 emergency team - a pivotal role in pre-hospitalization process - to carry out advanced airway management. In order to achieve the purpose, total 60 paramedics (Class I) who worked for incumbent 119 emergency team were asked to join a practical experiment and were also divided into two groups (LTS group: 30 people, PLMA group: 30 people). In details, they were all asked to take 3 sessions of practice (5 minutes per session) using dummy model to quantitatively measure the time and success/failure of intubation and the change of their self-confidence. As a result, it was found that there were statistically significant differences in the time of intubation between LTS and PLMA group (p=.000), but there was no significant difference in the rate of successful intubation between these two groups, and self-confidence of two groups tended to significantly increase after experiment (p=.000). Conclusively, if it is necessary to promptly apply intubation to traumatic cases with immobilized cervical vertebral and lingual edema, LTS can be useful as an effective means of intubation. And it is expected that continuing intubation training using LTS will improve the ability of emergency team to perform advanced airway management for traumatic cases.

Efforts to Improve the E-Learning Center of the Korean Society of Radiology: Survey on User Experience and Satisfaction (대한영상의학회 이러닝 센터 발전을 위한 노력: 대한영상의학회 회원 설문조사)

  • Yong Eun Chung;Hyun Cheol Kim
    • Journal of the Korean Society of Radiology
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    • v.83 no.6
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    • pp.1259-1272
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    • 2022
  • Purpose As part of ongoing efforts to improve the current e-learning center, a survey was conducted regarding user experience and satisfaction to identify areas of improvement. Materials and Methods Radiologists (n = 454/617) and radiology residents (n = 163/617) of the Korean Society of Radiology were asked to answer a survey via email. The questionnaire asked for basic user information as well as user experiences relating to the e-learning center, such as workplace, frequency of use, overall satisfaction levels, reasons for satisfaction or dissatisfaction, and other suggestions for improvement. Results Annual members and all members of the e-learning center reported above average satisfaction levels of 67% and 42%, respectively. Approximately 30% of respondents viewed e-learning center lectures more than 5 times a month, with residents having a particularly high usage frequency. There was a high demand for additional lectures covering more diverse specialties (e-learning for annual members only: n = 28/97, e-learning for all members: n = 72/166), a smoother and more convenient searching platform/interface (n = 37/97 and n = 58/166, respectively), and regular content updates. In addition, many of the members suggested the addition of user-friendly functions such as playback speed control, a way to save viewing history, as well as requests for improved system stability. Conclusion Based on survey results, the educational committee plans to continue its efforts to improve the e-learning center by increasing the quality and quantity of available lectures, and increasing technical support to improve the stability and convenience of the e-learning digital system.

Prevalence of Chronic Obstructive Pulmonary Disease in Korea: The Result of Forth Korean National Health and Nutrition Examination Survey

  • Hwang, Yong-Il;Yoo, Kwang-Ha;Sheen, Seung-Soo;Park, Joo-Hun;Kim, Sang-Ha;Yoon, Ho-Il;Lim, Sung-Chul;Lee, Shin-Yup;Park, Jae-Yong;Park, Seoung-Ju;Seo, Ki-Hyun;Kim, Ki-Uk;Lee, Sang-Yeub;Park, In-Won;Lee, Sang-Do;Kim, Se-Kyu;Kim, Young-Kyoon;Lee, Sang-Min;Han, Sung-Koo;Kim, Yu-Na;Cho, Yu-Mi;Park, Hye-Jin;Oh, Kyung-Won;Kim, Young-Sam;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.5
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    • pp.328-334
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    • 2011
  • Background: Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality throughout the world and is the only major disease that is continuing to increase in both prevalence and mortality. The second Korean National Health and Nutrition Survey revealed that the prevalence of COPD in Korean subjects aged ${\geq}45$ years was 17.2% in 2001. Further surveys on the prevalence of COPD were not available until 2007. Here, we report the prevalence of spirometrically detected COPD in Korea, using data from the fourth Korean National Health and Nutrition Survey (KNHANES IV) which was conducted in 2007~2009. Methods: Based on the Korean Statistical Office census that used nationwide stratified random sampling, 10,523 subjects aged ${\geq}40$ years underwent spirometry. Place of residence, levels of education, income, and smoking status, as well as other results from a COPD survey questionnaire were also assessed. Results: The prevalence of COPD (defined as forced expiratory volume in 1 sec/forced vital capacity <0.7 in subjects aged ${\geq}40$ years) was 12.9% (men, 18.7%; women, 7.5%). In total, 96.5% of patients with COPD had mild-to-moderate disease; only 2.5% had been diagnosed by physicians, and only 1.7% had been treated. The independent risk factors for COPD were smoking, advanced age, and male gender. Conclusion: The prevalence of COPD was 12.9% in the KNHANES IV data. Most patients with COPD were undiagnosed and untreated. Based on these results, a strategy for early COPD intervention is warranted in high risk subjects.

Determination of Cost and Measurement of nursing Care Hours for Hospice Patients Hospitalized in one University Hospital (일 대학병원 호스피스 병동 입원 환자의 간호활동시간 측정과 원가산정)

  • Kim, Kyeong-Uoon
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.3
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    • pp.389-404
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    • 2000
  • This study was designed to determine the cost and measurement of nursing care hours for hospice patients hostpitalized in one university hospital. 314 inpatients in the hospice unit 11 nursing manpower were enrolled. Study was taken place in C University Hospital from 8th to 28th, Nov, 1999. Researcher and investigator did pilot study for selecting compatible hospice patient classification indicators. After modifying patient classification indicators and nursing care details for general ward, approved of content validity by specialist. Using hospice patient classification indicators and per 5 min continuing observation method, researcher and investigator recorded direct nursing care hours, indirect nursing care hours, and personnel time on hospice nursing care hours, and personnel time on hospice nursing care activities sheet. All of the patients were classified into Class I(mildly ill), Class II (moderately ill), Class III (acutely ill), and Class IV (critically ill) by patient classification system (PCS) which had been carefully developed to be suitable for the Korean hospice ward. And then the elements of the nursing care cost was investigated. Based on the data from an accounting section (Riccolo, 1988), nursing care hours per patient per day in each class and nursing care cost per patient per hour were multiplied. And then the mean of the nursing care cost per patient per day in each class was calculated. Using SAS, The number of patients in class and nursing activities in duty for nursing care hours were calculated the percent, the mean, the standard deviation respectively. According to the ANOVA and the $Scheff{\'{e}$ test, direct nursing care hours per patient per day for the each class were analyzed. The results of this study were summarized as follows : 1. Distribution of patient class : class IN(33.5%) was the largest class the rest were class II(26.1%) class III(22.6%), class I(17.8%). Nursing care requirements of the inpatients in hospice ward were greater than that of the inpatients in general ward. 2. Direct nursing care activities : Measurement ${\cdot}$ observation 41.7%, medication 16.6%, exercise ${\cdot}$ safety 12.5%, education ${\cdot}$ communication 7.2% etc. The mean hours of direct nursing care per patient per day per duty were needed ; 69.3 min for day duty, 64.7 min for evening duty, 88.2 min for night duty, 38.7 min for shift duty. The mean hours of direct nursing care of night duty was longer than that of the other duty. Direct nursing care hours per patient per day in each class were needed ; 3.1 hrs for class I, 3.9 hrs for class II, 4.7 hrs for class III, and 5.2 hrs for class IV. The mean hours of direct nursing care per patient per day without the PCS was 4.1 hours. The mean hours of direct nursing care per patient per day in class was increased significantly according to increasing nursing care requirements of the inpatients(F=49.04, p=.0001). The each class was significantly different(p<0.05). The mean hours of direct nursing care of several direct nursing care activities in each class were increased according to increasing nursing care requirements of the inpatients(p<0.05) ; class III and class IV for medication and education ${\cdot}$ communication, class I, class III and class IV for measurement ${\cdot}$ observation, class I, class II and class IV for elimination ${\cdot}$ irrigation, all of class for exercise ${\cdot}$ safety. 3. Indirect nursing care activities and personnel time : Recognization 24.2%, house keeping activity 22.7%, charting 17.2%, personnel time 11.8% etc. The mean hours of indirect nursing care and personnel time per nursing manpower was 4.7 hrs. The mean hours of indirect nursing care and personnel time per duty were 294.8 min for day duty, 212.3 min for evening duty, 387.9 min for night duty, 143.3 min for shift duty. The mean of indirect nursing care hours and personnel time of night duty was longer than that of the other duty. 4. The mean hours of indirect nursing care and personnel time per patient per day was 2.5 hrs. 5. The mean hours of nursing care per patient per day in each class were class I 5.6 hrs, class II 6.4 hrs, class III 7.2 hrs, class IV 7.7 hrs. 6. The elements of the nursing care cost were composed of 2,212 won for direct nursing care cost, 267 won for direct material cost and 307 won for indirect cost. Sum of the elements of the nursing care cost was 2,786 won. 7. The mean cost of the nursing care per patient per day in each class were 15,601.6 won for class I, 17,830.4 won for class II, 20,259.2 won for class III, 21,452.2 won for class IV. As above, using modified hospice patient classification indicators and nursing care activity details, many critical ill patients were hospitalized in the hospice unit and it reflected that the more nursing care requirements of the patients, the more direct nursing care hours. Emotional ${\cdot}$ spiritual care, pain ${\cdot}$ symptom control, terminal care, education ${\cdot}$ communication, narcotics management and delivery, attending funeral ceremony, the major nursing care activities, were also the independent hospice service. But it is not compensated by the present medical insurance system. Exercise ${\cdot}$ safety, elimination ${\cdot}$ irrigation needed more nursing care hours as equal to that of intensive care units. The present nursing management fee in the medical insurance system compensated only a part of nursing car service in hospice unit, which rewarded lower cost that that of nursing care.

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Assessment of the Activities of General Physicians in Health Subcenters and a Scheme to Improve the Training Program (보건지소 공중보건 일반의사의 업무수행정도와 수련개선방안)

  • Park, Jung-Han;Chun, Byung-Yeol;Woo, Kuck-Hyeun
    • Journal of Preventive Medicine and Public Health
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    • v.19 no.2 s.20
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    • pp.193-202
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    • 1986
  • The activities of general physicians (GPs) in health subcenters and their competency for clinical skills were assessed to develop a scheme to improve the training program. One hundred-twenty GPs in southern four provinces (Kyungpook, Kyungnam, Chunpook, Chunnam) were randomly selected and 97 were interviewed between January 9 and February 10, 1984. Of the 97 GPs, 86 provided all the information we requested. Average number of patient visits per health subcenter in a day was 30-40 in the demonstration project area for the class II medical insurance whereas it was 3-4 visits in other area. The interviewees were asked to rate their competency in 63 clinical skills. The skills in which over 50% of the interviewees rated themselves competent were only 12 items including IM injection, IV injection, wound dressing, etc. Less than 10% of the interviewees rated themselves competent in such skills as maternal health care, emergency medical care, preventive and promotive health services. Most part of the training program of the NIH for the GPs were not applicable to their field work as the training contents were unrealistic. Clinical training at a local general hospital was of great help in 38.8% and the rest of training was not much helpful as the training was inadequate due to lack of trainer or indifference of the trainer. For more effective training of the GPs, the training program of the NIH should be modified to be more realistic and utilize competent field workers as the instructors. It may be more effective if the training is carried out at several local centers. Ideal length of the clinical training for the GPs is 4 months. A pocketbook should be developed that includes specific skills to master during the clinical training and require the trainer to confirm the achievement. The Ministry of Health and Social Affairs should provide the training hospitals with a training guideline and evaluate the training activities and make sure that the training hospital has specialist for each of the 4 major clinical departments. The Ministry of Health and Social Affairs should provide the GPs with a continuing education to assist the problem solving in the field and motivate them to actively carry out the health program. A province may be divided into several regions and a supervisory committee may be organized with specialists in each region. The committee may hold a meeting for the GPs periodically and respond to the specific questions of the GPs by mail.

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A study on the level of codependency among social work related professionals and its effect on their burnout: Focusing on moderating effects of Sex-role attitude (사회복지종사자의 공동의존성과 소진에 관한 연구 : 성역할태도의 조절효과를 중심으로)

  • Jang, Gyeongho;Yoon, Kyeonga;Shim, Woochan
    • Korean Journal of Social Welfare Studies
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    • v.47 no.1
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    • pp.29-56
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    • 2016
  • The purpose of this study is first, to explore the level of codependency among social work related professionals since codependency of professionals in the field has not been explored much in Korea. Second purpose is to examine whether codependency affects the level of burnout. Last purpose is to examine moderating effects of the Sex-role attitude on the relationship between codependency and burnout. Data were collected from the 11th of December in 2014 until the 28th of February in the following year. Self-administered questionnaires were distributed to care professionals practicing in social work institutions in Daejeon City and Choongcheong province, via email and mail. In addition, surveys were administered at several continuing education training venues. Instruments used for this study include CODAT(Codependency Assessment Tool) developed by Hughes-Hammer and colleagues in 1998, MBI(Maslach Burnout Inventory) developed by Maslach and Jackson in 1981, and SRA(Sex Role Attitude) developed by Osmond and Maryin in 1975. In total, 368 surveys were used for final analysis. The results include that gender did not have statistically significant relationship with the overall codependency, however, male showed statistically higher score than female in one of subscales of codependency called hiding oneself. Workers in the residential settings showed higher level of codependency than those in non-residential settings, especially in the subscale of Other focus or Self-neglect. Codependency showed a strong relationship with Burnout. Among the five-factor structure of the CODAT, Medical problem, Low Self-worth and Family of Origin showed strong relationship with the Burnout score. And the moderating effects of Sex-role Attitude showed a statistically significant relationship between codependency and burnout. Conservative sex-role attitude amplified the level of burnout on the relationship between codependency and burnout. Based on the result, educational and policy implications were made in order to prevent burnout among social work related professionals.