• Journal of Korean Neurosurgical Society
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• 제29권12호
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• pp.1620-1627
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• 2000

Objectives : DAMA cases were analyzed to examine what the main casual factors of DAMA were and how to deal with these cases effectively in hospital with the DAMA interdisciplinary team including medical social worker whose role is to perform psycho-social assessment, family counsel, to evaluate family's DAMA need. Patients and Methods : The content analysis of medical record and social work record were reviewed in 37 cases referred by medical doctor to DAMA team. These cases were reported by patients' self discharge request or family's request for discharge from September 1998 to February 2000. The DAMA team consists of Assistant Director of Hospital as team leader, medical staff in-charge, social worker, QI nurse, other staff members who are not involved in direct treatment for patient, and administrative clerk. Results : The results of content analysis are as follows : 1) The most causal factors of DAMA consist of combination of more than 2 factors. 2) The major decision-maker is revealed to be son and daughter of patient. 3) In 59.4% of cases, family was not informed of patients' prognosis, alternatives, the consequence of DAMA at all. 4) In cases of DAMA report, the rapid intervention of social worker is carried out. Conclusion : In this study, we propose the interdisciplinary team approach to make decision legitimately and ethically for DAMA. The suggestions from this study are as follows : 1) To deal with DAMA case properly, the interdisciplinary team approach should be considered. 2) The criteria for DAMA case should be formed carefully. For the explicit selection of DAMA case, preliminary system for high-risk patient screening is recommended. 3) The medical social worker is available for the psycho-social problems of the patient once family members. For the effective family counselling, discharge planning and nursing home placement, the participation of medical social worker should be mandatory.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.723-726
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• 2013

Background: Breast cancer is worldwide the most common cancer in women and is a major public health problem. Genes with high or low penetrance are now clearly implicated in the onset of breast cancer, mostly the BRCA genes. All women in families at high risk of breast cancer do not develop tumours, even when they carry the familial mutation, suggesting the existence of genetic and environmental protective factors. Several studies have shown that consanguinity is linked to a decreased or an increased risk of breast cancer, but to the best of our knowledge, there is no study concerning the association between consanguinity and the occurrence of tumours in women with high risk of breast cancer. The objective of this study was to examine whether parental consanguinity in families with genetic predisposition to breast cancer affect the risk of siblings for having this cancer. Materials and Methods: Over a six-year period, 72 different patients with a histological diagnosis of breast or ovarian cancer from 42 families were recruited for genetic counselling to the Department of Medical Genetics, Rabat. Consanguinity rate was determined in cases and compared to the consanguinity rate in the Moroccan general population. Results: Consanguinity rates were 9.72% in patients and 15.3% in controls, but the difference was statistically not significant (p>0.001) and the mean coefficient of consanguinity was lower in breast cancer patients (0.0034) than in controls (0.0065). Conclusions: Despite the relatively small sample size of the current study, our results suggest that parental consanguinity in Moroccan women might not be associated with an altered risk of breast cancer. Large scale studies should be carried out to confirm our results and to develop public health programs.

• 한국임상약학회지
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• 제32권1호
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• pp.27-36
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• 2022

Background: Medication-related problems (MRPs) frequently occur during the discharge period. Elderly patients, particularly, are at high risk for these problems due to polypharmacy and the use of potentially inappropriate medications. The purpose of this study was to build and implement collaboration between general hospital and community pharmacies to address MRPs among high-risk elderly patients before/after discharge. Methods: This retrospective study was conducted between June and December of 2020. The inclusion criteria were patients with aged ≥65 years; residents of Jeonju; discharged from Jeonbuk National University hospital; either on medication of exceeding 10 medications (or high-risk medications) after hospitalization through the emergency room, or having severe illness. Patients received medication reconciliation and counselling by hospital pharmacists before discharge and home-visit pharmaceutical care as follow-up by community pharmacists after discharge. Results: Twenty-two patients agreed to home-visit pharmaceutical services. Fifteen and 11 patients completed the first and second home-visit pharmaceutical care service, respectively. Forty-two MRPs were identified in 15 patients. The types of high-frequency MRPs were incorrect administration of drug, adverse drug reactions, medication non-compliance, drug-drug interactions, lifestyle modifications, and expired medication disposal. After consultation with the pharmacist, 34 out of 42 MRPs were resolved. Conclusions: Transitional care for high-risk elderly patients before and after discharge was successfully built and implemented through a collaboration between general hospital and community pharmacies. This study suggests that home-visit pharmaceutical services may have positive effects on the safe use of drugs during the transition period; however, additional research is needed to expand on these findings.

• The Journal of Korean Physical Therapy
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• 제3권1호
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• pp.39-58
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• 1991

This study was carried out to recognize the understanding of high school teachers about physical therapist during September in 1988, The study population was comprised of 511 high school teachers who had lived in Seoul and Kyunggi Province. Mate teachers were $56\%$ and the rest of them were females. In age distribution $45.4\%$ of them belonged to the 3rd decade, in religion $36.2\%$ of them were Christians, and in their carrier $45.8\%$ of them were less then 5 years. The results obtained were as follows. 1. The high school teachers who knew about department of physical therapy is amounted to $62.6\%$ in male and $49.8\%$ in female. The high school teachers ($41.7\%$ in male and $38.6\%$ in female) considered that students aptitude was the most important thing to keep in mind in counselling those who wished to become physical therapists. There were difference in opinion between male and female teachers as to the counselling criteria (p<0.05). 2. The high school teachers who knew that the students would beemployed in sport center and health clubs after graduation amounted to $24.3\%$ in males and in general hospital to $27.1\%$ in female. There was significant difference in the knowledge for their field of employment between male and female teachers (p<0.05). 3. As to the effectiveness of the physical therapy, $41.3\%$ of male and $29.8\%$ of the female teachers responded to 'satisfactory', but indicating no statistical difference both sexes. 4. As for the attitude of physical therapiest, $43\%$ of them answered that kindness and service devotion were the prerequisite for them. There were statistical difference between male and female teachers in concepts about attitude (p<0.05). To the social level of physical therapist, majority of the teachers thought that physical therapist belong to moderate level in social class. 5. Those who considered that the physical therapy was necessary means for treatment of trauma amounted to $73\%$. The reason why teachers thought that physical therapy was not necessary was that it required too long period of time for the treatment. 6. Those who knew fully the job of physical therapist amounted to $55\%$ and the 55. $9\%$ knew that physical therapists work only at hospitals as the therapist and the rest of them misunderstood the job of physical therapist. 7. As for the academic background to be qualified as physical therapist, $76.2\%$ of them said that graduation of Junior College was required, $12.9\%$ graduation of Senior College and the rest of them had no ideas at all. There was no statistical difference between male and female teachers.

• 지역사회간호학회지
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• 제12권2호
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• pp.361-374
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• 2001

This study was done to identify a status of home visiting project as a community health nursing system, that was the organization. personal who have age, educational background, marital status, position, experience of the home visiting in the public sectors in part of Seoul. Kyonggi, Kang-won area, It was done to provide basis data for the development of effective visiting nurses project in the health sectors, where was Health Centers in urban and rural. Branch of Health Center in rural and Health posts. The question airs were distributed 352 public health workers who working place was 118 health workers in 12 health centers in Seoul. 56 public health workers among 39 health center and other public health sectors in Kyonggi and 178 public health workers among health center and health care sectors. Data collected from October to December. 2000. The analysis by SAS system with F test, percentage and frequency. The major result were as follows. The general characteristics of the respondent show that most of them were graduates from community college and RN-BS with broadcast that they had not completed CPHN course but only two health workers have trained for the visiting nurses project. As for their grade in the position, the most of health workers have seventh level and the other CHP were above sixth level in the health care post that in the government structure. This indicates that workers do not have great authority in decision making, the most period of works in the position was one and two years indicating that they change jobs frequently. On an average their clinical experience was 4.11 years which is ideal for the total service. As for preparation of staff for home visiting workers education on visiting nurses program have to receive short term or longer term training course for strong emphasis. The analysis showed that public health visiting workers responds about active job performance that based on an area, approach of acting by districts, education and position are shown statistically significant difference between acceptance of the visiting nursing job show the same as well as visiting nurses project. Special concerns for visiting Nursing care spread came to burden, many of activity carry out main solution is covered the health problem connective support system needs of quality and quantity which out health problem. As 71.1% of visiting health service held on the poor population was under the guardianship of the law, but people who health insurance wide application under law shown a tendency to increase gradually. The general characteristics of the patients showed 56.2% of female on average of age was 66.1 years old, they have health problem was the most of 47.6% of high blood pressure and stroke, the other and as a problem that economics, which is complex welfare with out health problem. Community health care service should be combined health and social work program. The form of delivery of visiting health care given the most guide and education with counselling and support. (33.6%) Among the six category of visiting care service shown statistically significant difference and next is fundamental care, remedy care with priority.

• 재활간호학회지
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• 제4권2호
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• pp.207-218
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• 2001

This study was carried out to find out the basic data required to plan and develop Rehabilitation Day Care Program for the stroke survivor's family in Korea. The subjects comprised of 92 stroke survivor's family who discharged from 4 hospitals in Seoul during the past 2 years. The data were collected from August 3, 1998 to September 18, 1998, through interviews with questionnaires about general characteristics, activities of daily living, depression and service need of rehabilitation day care program at the outpatient clinics by trained nursing graduates. Data were analyzed with descriptive analysis, Pearson's correlation analysis, and Stepwise multiple linear regression analysis using SPSS/WIN 10.0 program. The results obtained are as follows; 1. The mean score of the general need of rehabilitation day care program of stroke survivor's family was 3.10(range 1-4). The highest need among the service categories of the rehabilitation day card program was self-care and restorative activities category(3.30), and health services referral category, recreation category, psychosocial activities category in order. The needs of each category are as follows. In the health services referral category, the need for dental examination and medical examination were highest, followed by the need for physical therapy and occupational therapy. In the psychosocial activities category, the need for family counselling was highest. In the self-care and restorative activities category, the need for ROM exercise training was highest, followed by bowel training, and ambulation training. 2. The need of family for rehabilitation day care program service displayed a correlation with the level of education, ADL, and the level of depression, and a reverse correlation with age, illness intrusiveness, depression, knowledge, subject and object burden and relationship with stroke survivors. 3. The stepwise multiple linear regression analysis revealed following results. For the need for rehabilitation day care program service, 22.6% of the variance was initially explained by level of family's knowledge about caring method for stroke survivors, 8.8% was the level of subjective burden and 5.4% was relationship with stroke survivors. In conclusion, above characteristics should be considered to develop stroke survivors' rehabilitation day care program.

• 한국보건간호학회지
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• 제14권2호
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• pp.246-259
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• 2000

The purpose of this study was to assess the provided home health care services and to evaluate the patient's satisfaction level of received home health care services. Well trained two home health care nurses interviewed with 138 respondents who received home health care by Keimyung University Hospital from January 1st to August 31st 1999. The results were summarized as follows : 1) Among 138 respondents, $55.8\%$ were mail and $44.2\%$ were female and $70.3\%$ of them were over sixty years old. Respondents main family care givers were spouse$(53.6\%)$, daughters and sons$(36.2\%)$ and parents$(7.2\%)$. 2) $60.2\%$ of cancer patients received home health care services, $23.3\%$ of cerebral­cardiovascular patients, $7.5\%$ of endocrine disorder patients, $2.3\%$ of those who have indwelling foley catheter patients, $1.5\%$ of those who have respiratory problems and others$(5.2\%)$. 3) $88.1\%$ of respondents were satisfied with the number of home visits they received. $50.5\%$ of respondents' were received 1 to 3 times of home visits by home health care nurse per month. $48.6\%$ of respondents answered they were introduced by attending doctors or nurses to home health care services. $55.8\%$ of respondents answered registration to home health care services was simple and easy. $97.4\%$ of respondents answered home health care payment system was adequate. $64.9\%$ of respondents answered the cost of home health care per visit was adequate and comfortable. 4) Health education, counselling, physical assessment was provided to most of the patients. Those who suffered with cerebral-cardiovascular disease was needed hands on direct care most of all. The least home health care service provided was medication. 5) The satisfaction measurement tool was composed with 13 items and 3 score scale. The mean score of satisfaction on provided home health care services was 2.67 out of 3. Among 13 items. 'home health care service was kind enough' was highest(2.84). 'nurse use precise word to understand and communicate'. 'nurse gave home visiting notice ahead of time and kept the home visiting promise on time' was 2.83. 'whenever I need home health care nurse I can give a call and meet the nurse' was lowest 2.41. Special Home Health care programs such as comprehensive hospice care programs for elders over sixty years old should be organized. Adequate and standardized home health care payment system should be developed as soon as possible. In korean family situation. when family members are getting sick and stay at home. family members were taking care of the patients. special program such as counselling family members are needed.

• Journal of Hospice and Palliative Care
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• 제12권1호
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• pp.5-13
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• 2009

목적: 본 연구는 국가암정보센터의 전화상담을 통해 말기 암 환자가족의 정보요구와 만족도 조사를 통해 말기 암 환자 간호의 질을 향상하고자 시도되었다. 방법: 2007년 6월부터 2008년 3월까지 국가암정보센터를 통해 문의한 말기 암 환자 가족 중 만족도 조사에 동의하고 실제 통화된 113명을 대상하였다. 결과: 1. 정보를 요구한 말기 암 환자 가족은 113명으로 가족 중 자녀(82명)와 배우자(8명)가 주로 이용하였고, 연령은 40대(40명)와 30대(36명)의 이용이 많았다. 가장 많은 질문은 치료방법 117건, 말기 암 환자의 관리 46건, 말기 암 환자의 생활은 27건, 임종과 수명예측 18건, 입원기관에 관한 정보 16건, 경제적 지원은 15건 으로 나타났다. 전화상담 서비스에 대해 전반적으로 높은 만족을 보였다. 전화상담 서비스를 알게 된 경위는 인터넷이 69%로 가장 많았고 상담 후 개선사항을 묻는 질문에 홍보가 부족하다는 대답이 10.6%로 가장 많았다. 결론: 이 연구의 결과를 통해 말기 암 환자 가족은 치료방법에 매여 있어 남은 삶의 질을 높일 수 있는 호스피스에 대한 인식이 적은 만큼 국가적 차원에서 매스미디어를 활용한 호스피스 홍보방안을 모색해야 한다.

• 한국산학기술학회논문지
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• 제13권11호
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• pp.5506-5511
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• 2012

본 u-웰니스는 병원 등 의료서비스 공급자 측과 개인에게 광범위하게 적용하는 개념으로, 공급 측의 u-피트니스, 화상 건강 상담 서비스 등과 함께 개인 측면의 스트레스 관리, 비만 관리, 운동량 체크 등을 포함하는 개념이다. 본 논문에서는 개인을 식별하는 인증장치로 사용자의 스마트폰을 사용하고 이 장치를 통해 체지방 분석, 건강관리 전문가의 처방기록을 받은 기록을 바탕으로 운동기구들과 Wi-Fi 통신을 통하여 운동량을 측정 및 관리하는 u-헬스케어 시스템을 설계하고 구현 하였다. 본 시스템은 건강관리 전문가의 처방을 통해 사용자의 최적화된 운동량을 처방 받아 효율적인 운동을 할 수 있도록 해준다. 또한 본 시스템은 체지방 측정기계와 전문가의 측정 결과를 수치화 하고 운동기구들의 이용 횟수 등을 데이터베이스로 구축하고 자동 스케줄 관리를 해준다.

• 대한영양사협회학술지
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• 제4권1호
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• pp.53-64
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• 1998

This study was performed to investigate the cost of nutrition counseling service at present and to suggest the guideline for the payment. Data were collected using questionnaires and the cost of counseling was expected by analyzing the time consumed and needed for nutrition counseling. The results were as follows; In the case of diabetes, mean time of nutrition counseling was 69.7$\pm$35.3min/case, but the dietitian asked 82.7$\pm$44.6min/case for counseling and in the cases of renal diseases, mean time of counseling was 64.3$\pm$24.1min/case and the time asked was 84.8$\pm$34.5min/case (P<001) It was found that time was not enough to educate or counsel the clients. The cost of counseling was not counted in 20.3% of the respondants and the mean nutrition counseling fee was 5,460.6$\pm$3,547.7won/case in in-patient. The group education fee was 6,168$\pm$2,813won/case. The estimations of the cost for nutrition counseling services using labor cost were 18,463.5won in case of diabetes and 18,463.5won/case for patients of renal disease and in group education 8,111.5won and 7,404.3won respectively.