• Title/Summary/Keyword: Diagnosis-related group

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Cross Mapping of Standardized Nursing Diagnoses and Problems with NANDA-I in 4 Tertiary Hospitals (표준화된 간호진단 및 문제와 NANDA-I 교차분석: 4개 상급종합병원 사례를 중심으로)

  • Song, Mi Ra;Shim, So Yun;Kim, Dae Sung;Lee, Kyung Soon;Lee, Yu Na;Won, Mi Suk
    • Journal of Korean Clinical Nursing Research
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    • v.26 no.3
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    • pp.374-384
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    • 2020
  • Purpose: To explore the scope and method of applying standardized nursing terminologies to nursing diagnosis and problems used in nursing practice. Methods: A descriptive study was done with a retrospective analysis of the nursing records of 141,420 patients that were hospitalized in 4 tertiary hospitals. The nursing diagnosis and problems collected from the records were standardized, and the standardized nursing diagnosis and problems cross mapped with NANDA-I, confirmed in a nursing focus group. Results: 65 (67.7%) of the 96 standardized nursing diagnosis and problems were equal with NANDA-I and included in the 10 domains of NANDA-I. Among 86 nursing diagnosis and problems excluded from the cross mapping with NANDA-I, the 63 terms (73.3%) related to surgery/procedure were the most common. Conclusion: It is meaningful that multi-tertiary hospital nursing diagnosis and problems were standardized and cross mapping with standard nursing terminologies was performed. As for the method of applying standardized nursing terminologies in nursing practice, it is appropriate to use several standardized nursing terminologies complementarily.

Age Differences in Signs and Symptoms of Patients with Temporomandibular Disorders

  • Jo, Jung Hwan;Park, Ji Woon;Kim, Ji Rak;Seo, Hyong Duk;Jang, Ji Hee;Chung, Jin Woo
    • Journal of Oral Medicine and Pain
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    • v.40 no.2
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    • pp.55-62
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    • 2015
  • Purpose: The aims of this study were to evaluate the differences in subjective symptoms, clinical characteristics, distribution according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) subgroup, psychological profile of TMD patients, and to identify the prevalence and trend according to age. Methods: A total of 1,052 patients (261 men and 791 women; mean age, $34.40{\pm}15.73$ years) who visited the Orofacial Pain Clinic of the Department of Oral Medicine, Seoul National University Dental Hospital complaining of TMD symptoms of were evaluated. All patients were questioned for medical history, clinical symptoms and contributing factors. Clinical examination and patient grouping based on RDC/TMD was conducted. Radiographies were taken. The Korean version of RDC/TMD axis II and Symptom Checklist-90-Revision (SCL-90-R) were administered to evaluate pain-related disability level and psychological status of the patients. Results: Prevalence peaked in the 20-year-old age group. There were more women than men in all groups. The highest T-score among SCL-90-R dimensions was somatization in each group, except for teenagers who showed the highest T-score in interpersonal sensitivity. The 30-year-old age group showed the highest distribution of high disability based on the graded chronic pain scale. Age was positively associated with pain intensity (r=0.100), number of positive muscles on palpation (r=0.137) and negatively associated with maximum mouth opening (r=-0.168). Conclusions: Subjective symptoms and clinical characteristics of TMD patients show distinct tendencies according to different age groups. Treatment should be customized and personalized according to age for efficient symptom resolution and patient satisfaction.

Effects of Copper Reduction on Angiogenesis-Related Factors in Recurrent Glioblastoma Cases

  • Jazayeri, Shima;Feli, Alireza;Bitaraf, Mohammad Ali;Dodaran, Masoud Solaymani;Alikhani, Mazdak;Hosseinzadeh-Attar, Mohammad Javad
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.10
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    • pp.4609-4614
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    • 2016
  • Purpose: To evaluate the therapeutic effects of copper reduction on angiogenesis-related factors in patients with glioblastoma multiforme treated by gamma knife radiosurgery. Materials and Methods: In the present block randomized, placebo-controlled trial, fifty eligible patients with a diagnosis of glioblastoma multiforme who were candidates for gamma knife radiosurgery were randomly assigned into two groups to receive daily either 1gr penicillamine and a low copper diet or placebo for three months. The intervention started on the same day as gamma knife radiosurgery. Serum interleukin-6 (IL-6), tumor necrosis $factor-{\alpha}$ ($TNF-{\alpha}$), vascular endothelial growth factor (VEGF) and copper levels were measured at baseline and after the intervention. The serum copper level was used as the final index of compliance with the diet. In order to control probable side effects of intervention, laboratory tests were conducted at the beginning, middle and end of the study. Results: The patients had a mean age and Karnofsky Performance Scale of 43.7 years and 75 respectively. Mean serum copper levels were significantly reduced in intervention group. Mean survival time was 18.5 months in intervention group vs. 14.9 in placebo group. VEGF and IL-6 levels in the intervention group were also significantly reduced compared to the placebo group and $TNF-{\alpha}$ increased less. Conclusions: It seems that reducing the level of copper in the diet and dosing with penicillamine leads to decline of angiogenesis-related factors such as VEGF, IL-6 and $TNF-{\alpha}$. Approaches targeting angiogenesis may improve survival and can be used as a future therapeutic strategy.

A study on the use of Alternative Therapies for Cancer Patients Undergoing Chemotherapy (항암화학요법제 투여 중인 암환자의 대체요법 이용실태 및 의사결정요인)

  • Oh, Hyo-Sook;Park, Hyeoun-Ae
    • Asian Oncology Nursing
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    • v.4 no.1
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    • pp.5-15
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    • 2004
  • Purpose: This study was conducted to examine utilization of alternative therapies and understand decisional criteria related to use of alternative therapies among chemotherapy patients. Method: Data were collected from 165 cancer patients through the use of questionnaire and interviews at the chemotherapy treatment rooms of two general hospitals located in Seoul. Result: Sixty point six percent of subjects after cancer diagnosis have experience of using alternative therapies and 39.4% were still using alternative therapies. On the average the patients used alternative therapies for 9.4 months and they paid 483,000 Won per month for alternative therapies. Decisional criteria related to use of alternative therapy were curability, social group influence about alternative therapy, confidence in alternative therapy, present symptoms, and who decide on the use of alternative therapy. These variables in the alternative therapy group were statistically different from those of the hospital treatment only group. Conclusion: Utilization rate of alternative therapy among chemotherapy patients is high and cost burden is heavy. Thus, they need to be educated about utilization of alternative therapy by nurse and medical personnel.

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Study of the Relation between Palpation of the Jeonjung(膻中, $CV_{17}$) and Autonomic Nerve System by Heart Rate Variability (심박 변이도 분석을 통한 전중혈(膻中穴) 압진(壓診)과 자율신경실조의 상관성 연구)

  • Ha, Seon-Yun;Cho, Seong-Yeun;Jang, Jin-Young;Kim, Yong-Suk;Nam, Sang-Soo
    • Journal of Acupuncture Research
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    • v.26 no.5
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    • pp.57-63
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    • 2009
  • Objectives : Since the Front Points are treated as response zone, it can be used for the diagnosis and treatment of disease in viscera and bowels. Jeonjung($CV_{17}$) is the Front Point of SIMPO, it is related with cardiovascular, neuro-psychiatrical disease in aspect of Oriental Medicine. This research is for clarifying relations with palpation of the Jeonjung($CV_{17}$) and autonomic nerve system by comparing HRV and SRI(Stress Reaction Index). Methods : This study was proceeded for three months, from June 2009 to September 2009. Among 31 healthy volunteers, 13 subjects who complained the pressure pain around Jeonjung($CV_{17}$) are classified pressure pain group and 18 subjects who had no pain around Jeonjung($CV_{17}$) as normal group. All subjects had their HRV(SA-2000E: Medicore Co..Ltd. Korea) and SRI measured at visit. We studied the difference of HRV between two groups.(Statistics by Student t-test, p<0.05) Results : LF normalization of the pressure pain group were significantly higher than those of the normal group. HF normalization of the pressure pain group were significantly lower than those of the normal group. Compared with those of the normal group, total SRI of the pressure pain group were low but it's not significant. Conclusions : The results of HRV of the pressure pain group show that pressure pain around Jeonjung($CV_{17}$) is related to mental stress and autonomic disturbance.

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A STUDY ON USEFULNESS OF THE REFERENCE LINE IN DIAGNOSIS OF THE FACIAL ASYMMETRY (안모비대칭의 진단용 기준선의 유용성에 관한 연구)

  • Ryu, Sung-Ho;Chang, Hyun-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.3
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    • pp.266-273
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    • 2005
  • Purpose: To assess the relationship between soft tissue reference line and hard tissue reference line using the standardized photographs and the posteroanterior cephalometric radiographs(P-A)in facial asymmetric patients and to compare the differences of angular measurement between normal group and asymmetry group. Methods: Normal group consisted of 44 persons with normal occlusion and normal facial morphology. Asymmetry group consisted of 90 patients with facial asymmetry. Standardized facial photographs and P-A were taken in all subjects. The horizontal reference lines were bipupillary line in photographs and latero-orbitale line in P-A respectively. The vertical reference line were the line from the midpoint of horizontal reference line perpendicularly. Angular measurement of otobasion canting, lip canting, nose deviation, chin deviation, and maxillary deviation were compared and analyzed in photographs. And angular measurement of mastoid canting, mandibular canting, nose deviation, chin deviation, and maxillary deviation were compared and analyzed in P-A. Results: 1. The variables of photographs and P-A were significantly related in the asymmetry group. 2. Significant differences between all variables except for PT2 and PA2 were shown in the asymmetry group and between PT1 and PA1, PT3 and PA3 in the normal group respectively. 3. Comparison measurement scores of angular difference between control group and experimental group concerning each variable showed significant difference except for PA1. Conclusions: Soft tissue components may not compensate for underlying skeletal imbalance in nose deviation and chin deviation. The horizontal reference lines in photographs were significant related with the P-A, but angular variables between the two studies show significant differences. Therefore, we do not recommend use photography in the assessment the facial asymmetry as complemented in the P-A.

A study on the analysis of production-related key performance indicator affecting business positioning of machinery manufacturers (중소기계제조업의 사업포지셔닝에 영향을 미치는 생산관련 핵심성과지표에 관한 연구)

  • Cheong, Hae-Sock;Yoo, Woo-Sik
    • Journal of the Korea Safety Management & Science
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    • v.14 no.2
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    • pp.221-228
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    • 2012
  • This paper analyzed twenty-six production-related KPI(Key Performance indicator) factors of business diagnosis, such as personnel, equipment, materials, operations and quality affecting company business competition to 186 small machinery manufacturers in 2010. Also, we explained the concept of Business Positioning and divided research subjects into four Business Positioning Groups formed break-even point ratio & fixed cost ratio to sales and then we compared between the 4 groups using Logistic Regression analysis by SAS statistical software package. The objective of this study is two-fold. The first is to find out production-related KPI factor of superior Business Positioning Group. The second is to suggest improvement ways for small manufacturers in order to get better profitable Business Positioning.

Prevalence and Related Risk Factors of Delirium in Intensive Care Units as Detected by the CAM-ICU (CAM-ICU로 평가한 중환자실의 섬망 발생률과 섬망 발생 위험요인)

  • Choi, Su Jung;Cho, Yong Ae
    • Journal of Korean Clinical Nursing Research
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    • v.20 no.3
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    • pp.406-416
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    • 2014
  • Purpose: Screening of delirium using delirium assessment tools could promote delirium detection, however, there is lack of report about regular delirium assessment in Korea. This study was intended to describe the prevalence and related risk factors of delirium in intensive care unit (ICU). Methods: The Confusion Assessment Method for the ICU (CAM-ICU) data which were evaluated by nurses in ICUs was obtained through retrospective chart review. Data were analyzed using descriptive statistics, Chi-square test, t-test, Mann-Whitney U test, and stepwise logistic regression. Results: Delirium was evaluated in 125 patients. The incidence rate of delirium was 27.2% with a high prevalence of hypoactive delirium compared to hyperactive delirium (61.8 vs. 38.2%). Those with delirium were older, had hypertension, stayed longer in hospital, receiving ventilator support, had more number of catheters, had low serum protein and albumin level. Delirium incidence also varied according to diagnosis. Age, diagnosis of gastrointestinal disease, and application of ventilator were the significant risk factors for the incidence of delirium. Conclusion: Routine delirium screening is important for early detection of delirium. Identification of high-risk group and running delirium prevention programs could improve early recognition of delirium in ICU.

Inpatient care focused strategy and convergence performance in hospitals (병원의 입원 진료 집중화 전략과 융합적 운영 성과)

  • Yoo, Hai-Won
    • Journal of the Korea Convergence Society
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    • v.7 no.4
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    • pp.59-66
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    • 2016
  • This study analyzed the relationship between the convergence performance in hospital. This study examined previous research and calculated centralized index using diagnosis related groups. In addition, multiple regression analysis was used based on LOS in order to understand the effect of focused strategy which quality of medical inpatient service. The centralized level was examined by analyzing national inpatient sample data using 'Internal Herfindahl-Hirshman index' This study is significant because it reviewed medical inpatient service quality by measuring hospital centralized level which has been rarely studied before Korea.

Refinement and Evaluation of Korean Diagnosis Related Groups (한국형진단명기준환자군의 개선과 평가)

  • 강길원;박하영;신영수
    • Health Policy and Management
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    • v.14 no.1
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    • pp.121-147
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    • 2004
  • Since the pilot program for a DRG-based prospective payment system was introduced in 1997, the performance of KDRGs has been one of hotly debated issues. The objectives of this study are to refine the classification algorithm of the KDRGs and to assess the improvement achieved by the refinement. The U.S. Medicare DRGs version 17.0 and the Australian Refined DRGs version 4.1 were reviewed to identify areas of possible impro-vement. Refined changes in the classification and result of date analyses were submitted to a panel of 48 physicians for their reviews and suggestions. The refinement was evaluated by the variance reduction in resource utilization achieved by the KDRG The database of 2,182,168 claims submitted to the Health Insurance Review Agency during 2002 was used for evaluation. As the result of the refinement, three new MDCs were introduced and the number of ADEGs increased from 332 to 674. Various age splits and two to four levels of severity classification for secondary diagnoses were introduced as well. A total of 1,817 groups were defined in the refined KDRGs. The variance reduction for charges of all patients increased from 48.2% to 53.6% by the refinement, and from 65.6% to 73.1% for non-outlier patients. The r-square for length of stays of all patients was increased from 28.3% to 32.6%, and from 40.4% to 44.9% for non-outlier patients. These results indicated a significant improvement in the classification accuracy of the KDRG system.