• 보건행정학회지
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• 제15권2호
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• pp.1-15
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• 2005

The aim of this study was to compare medical cost of hospice care and that of conventional care during the last year of life, and identify factors that influenced the cost. From January to August 2003 592 terminal cancer patients receiving care from 5 hospice care units and 2 hospice care teams in general hospitals were enrolled to case group. Two hundreds and seventy two terminal cancer patients receiving conventional care from 7 general hospitals were enrolled to hospital-based control group, and 1,636 terminal cancer patients from 122 general hospitals located in same regions with the 7 hospitals were enrolled to community-based control. We used characteristics and medical cost from data of National Health Insurance Cooperation. Total medical cost per beneficiary in cases was about 10 millions won, 14.5 millions in hospital-based controls and 11.1 millions in community-based controls. The hospice care saved $45\%$ over the last year of life compared with hospital-based controls (p<0.0001). Saving of inpatient cost account for approximately $80\%$ of saving per beneficiary. Hospice care saved $29\%$ of medical cost per hospitalization day compared with hospital­based controls and $17\%$ compared with community-based controls (p<0.0001). Multiple regression analyses showed that hospice care significantly saved the medical cost. This study suggest that hospice care save medical cost compared with hospital-based control and community-based control. Most of saving of inpatient cost account for approximately $80\%$ of saving of medical cost.

• 한국의료질향상학회지
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• 제9권1호
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• pp.34-51
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• 2002

Background : The purpose for this study is to develop a critical pathway of bullectomy for spontaneous pneumothorax patients. Methods : For this study a conceptual framework of critical pathway was developed through a review of the literature including five critical pathways which are currently being used in USA, and opinions of the critical pathway development team members at Y university hospital. In order to identify the service contents required by these patients and to draw up a preliminary critical pathway, 33 cases of medical records of patients who had received bullectomy for spontaneous pneumothorax between September, 2000 to August, 2001 at the Respiratory Center of Y university hospital in Seoul was analyzed. Results : In order to test the clinical validity of the preliminary critical pathway, it was applied to ten patients who had received bullectomy for spontaneous pneumothorax from October, 2001 to December, 2001. The average discharge day was 4.89th post operation day, six patients discharged on the fourth post operation day which was the expected day, one patients discharged one day earlier than the expected day, one patient discharged three days later than the expected day, and one patient discharged six days later than the expected day. There were variances between the critical pathway and the actual practice. The variances came from tests, medications, and treatments. One item that showed variance in clinical applications was complemented, and three items were decided not to be corrected for the final determination of the critical pathway. Conclusion : This critical pathway is applicable to the care of patients with bullectomy for spontaneous pneumothorax, but it needs more clinical applications to grasp varied variances.

• 아동학회지
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• 제26권1호
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• pp.123-135
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• 2005

This study examined conditions and influential factors of psycho-behavioral adjustment in abused children who had been returned home after out-of-home care. Subjects were selected nationwide from the Center for the Prevention of Child Abuse. Subjects were 54 cooperative children selected from among 126 returned children : they were older than 11 years of age and had experienced more than one day in out-of-home care between January 2002 and December 2003. Findings were: (1)children had such psychological adjustment symptoms as withdrawal, depression, or anxiety, rather than symptoms of misdeeds and aggression. (2) Level of self-esteem and re-abuse were the great influential factors in psycho-behavioral adjustment. This result shows that the processes of out-of-home care and returning home remain important issues for abused children.

• Journal of Trauma and Injury
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• 제36권4호
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• pp.337-342
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• 2023

Purpose: This study aimed to compare the resting energy expenditure (REE) measured using indirect calorimetry with that estimated using predictive equations in severe trauma patients to determine the appropriate caloric requirements. Methods: Patients admitted to the surgical intensive care unit between January 2020 and March 2023 were included in this study. Indirect calorimetry was used to measure the patients' REE values. These values were subsequently compared with those estimated using predictive equations: the weight-based equation (rule of thumb, 25 kcal/kg/day), Harris-Benedict, Ireton-Jones, and the Penn State 2003 equations. Results: A total of 27 severe trauma patients were included in this study, and 47 indirect calorimetric measurements were conducted. The weight-based equation (mean difference [MD], -28.96±303.58 kcal) and the Penn State 2003 equation (MD, - 3.56±270.39 kcal) showed the closest results to REE measured by indirect calorimetry. However, the REE values estimated using the Harris-Benedict equation (MD, 156.64±276.54 kcal) and Ireton-Jones equation (MD, 250.87±332.54 kcal) displayed significant differences from those measured using indirect calorimetry. The concordance rate, which the predictive REE differs from the measured REE value within 10%, was up to 36.2%. Conclusions: The REE values estimated using predictive equations exhibited substantial differences from those measured via indirect calorimetry. Therefore, it is necessary to measure the REE value through indirect calorimetry in severe trauma patients.

• 아동학회지
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• 제28권6호
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• pp.201-215
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• 2007

This study examined cortisol patterning in 160 children(79 boys, 81 girls; aged 4-5) attending twelve childcare centers in Seoul and Kyunggi Province. Saliva samples for the assay of cortisol were collected twice a day at 10 : 30 am and 3 : 30 pm. Saliva samples were collected again within a week after the first collection. Data were analyzed with descriptive statistics and multiple regression analysis. The cortisol level of the afternoon showed neither increase nor decrease compared to morning. Regression analysis indicated that time children spent at childcare centers accounted for increased afternoon cortisol levels; that is, higher levels of afternoon cortisol were associated with more hours per day at childcare centers.

• 대한영양사협회학술지
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• 제4권2호
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• pp.225-234
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• 1998

Nutrition during childhood is essential for growth and maintenance of health. Good food habits developed during the childhood will contribute both to the healthy growth and the prevention of the degenerative disease of later life. Both parents and the providers in child care centers play an important role for children's good eating behavior. Therefore all child care programs should achieve recommended standards for meeting children's nutritional and educational needs in a safe, sanitary, and supportive environment to promote the healthy growth and development of children. The purposes of this study were to evaluate the foodservice management practices and assess the needs for a Central Production Unit by contacting the child care center' providers. This approach was achieved using a variety of qualitative and quantitative information including the general foodservice management practices and the needs for a Central Production Unit. An indepth face-to-face interview with structured-questionnaires was undertaken at 32 representative child-care centers in Seoul. Statistical data analysis was done using the SAS program for descriptive analysis and ANOVA. The number of national/public and private sectors were 11 respectively, followed by 10 licensed home day-care centers. Total average number of children in child-care centers was 54.3 $\pm$48.5. The foodservice productivity index in child-care centers was 4.8 minutes per meal for public child care centers, 6.0 for private child-care centers, and 9.8 for home child care centers. Home child care centers were found to have the lowest productivity index which indicated inefficient foodservice practice. The important factors in group purchasing were menus(39.6%) or close distance(39.6%) > type of foodservice operation(32.8%) > total number of meals(19.9%) > food costs(16.2%) in order. Average score of the efficiency for central food production in child-care centers was 3.80 $\pm$0.84 out of 5.

• 기본간호학회지
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• 제23권1호
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• pp.61-72
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• 2016

Purpose: Purpose of this retrospective study was to investigate cognitive function, physical function, and problematic behaviors of elders who attended dementia daycare centers, and to identify reasons why they stopped using the center. Methods: Participants were 176 elders, 60 years or over, attending one of four dementia daycare centers in Incheon. Data were collected from center documents. Results: Mean age was 80.5 years. When admitted to the centers mean scores for the mini-mental status examination, activity of daily living, and instrumental activity of daily living (IADL) were 12.31, 9.53, and 25.09 respectively. Participants received day care service for an average of 17.98 months. The reasons for leaving the center were worsening dementia and health (40.2%), and problematic behaviors (20.1%). Conclusion: Results show that elders began to use day care services when their cognitive function and IADL had declined considerably. As the ultimate goal of dementia daycare service is to delay the worsening of cognitive capability and decreases in activities daily living, the effect of the service can be maximized when the service is provided as early as possible in the course of progressively severe dementia. Active promotion should be exerted in the community to encourage early use of this service.

• Asian Pacific Journal of Cancer Prevention
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• 제17권5호
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• pp.2611-2617
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• 2016

Background: Medication errors are common but most often preventable events in any health care setup. Studies on medication errors involving chemotherapeutic drugs are limited. Objective: We studied three aspects of medication errors - prescription, transcription and administration errors in 500 cancer patients who received ambulatory cancer chemotherapy at a resource limited setting government hospital attached cancer centre in South India. The frequency of medication errors, their types and the possible reasons for their occurrence were analysed. Design and Methods: Cross-sectional study using direct observation and chart review in anmbulatory day care unit of a Regional Cancer Centre in South India. Prescription charts of 500 patients during a three month time period were studied and errors analysed. Transcription errors were estimated from the nurses records for these 500 patients who were prescribed anticancer medications or premedication to be administered in the day care centre, direct observations were made during drug administration and administration errors analysed. Medical oncologists prescribing anticancer medications and nurses administering medications also participated. Results: A total of 500 patient observations were made and 41.6% medication errors were detected. Among the total observed errors, 114 (54.8%) were prescription errors, 51(24.5%) were transcribing errors and 43 (20.7%) were administration errors. The majority of the prescription errors were due to missing information (45.5%) and administration errors were mainly due to errors in drug reconstitution (55.8%). There were no life threatening events during the observation period since most of the errors were either intercepted before reaching the patient or were trivial. Conclusions: A high rate of potentially harmful medication errors were intercepted at the ambulatory day care unit of our regional cancer centre. Suggestions have been made to reduce errors in the future by adoption of computerised prescriptions and periodic sensitisation of the responsible health personnel.

• 한국보육지원학회지
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• 제12권5호
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• pp.17-45
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• 2016

This study aimed to investigate the effect of a young children's happiness program in relation with the Nuri curriculum on young children's happiness and self-esteem. Study subjects included 37 children aged 5 (experimental group 20, comparative group 17) enrolled in A day care center and D day care center located in K district, Seoul. As for the research procedure, an experiment was conducted 48 times in 18 weeks, and the experimental group carried out the children's happiness program linked with the Nuri curriculum. In contrast, the comparative group conducted general activities focusing on the subjects according to the Nuri curriculum. Study results show that there was a significant difference amongst 9 sub-domains related to young children's happiness (health, emotion, immersion, recognition and achievement, parent-child relationship, teacher-child relationship, peer relationship, spirituality, life satisfaction) and 3 sub-domains related to self-esteem (start and spirit of independence, sociality emotionality, academic achievement). Results of this study prove that the children's happiness program in relation with the Nuri curriculum is effective for increasing young children's happiness and self-esteem, and could be used as preliminary data for the possibility of a happiness program in early childhood education settings and happiness education in the future.

• 한국간호교육학회지
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• 제13권1호
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• pp.114-122
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• 2007

Purpose: This study was aimed at evaluating the effects of Music Therapy for the autistic children. Method: The subjects of this study consisted of 3 autistic children who were trained in an Attachment Promotion Therapy Program for 6 months. The Children were all males and 4years 9months, 3years 1 month, and 3years 8month each, and diagnosed with Autism by Child and Adolescent Psychiatrists. Data was collected by using video-taping methods(ADOS, Fagot's Interactive Behavior Code), an interview and observational methods(SMS). Music Therapy intervention was done once a week for 6 months. Data was gathered by quantitative and qualitative analysis. Result: This study showed that the Autism Diagnostic Observation Scale and Social Maturity Quotient(SQ) much improved after the Music Therapy After the Music Therapy, the Interactive Behavior Code : Gaze, Gesture for the communication, Verbal language, Laughing/Smile, and Normal play behaviors increased more than before the intervention. As the results show, the child's behavior became more positively responsive, playful, and attentive to others. Conclusion: This study suggests that Music Therapy might be an effective intervention for autistic disorder children in order to decrease autistic symptoms and increase joint attention behavior.