• Journal of Korean Academic Society of Home Health Care Nursing
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• v.11 no.1
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• pp.5-13
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• 2004

The home health care industry has grown rapidly and can be expected to continue to grow in the foreseeable future. Home health care refers to the practice of nursing applied to clients with a health condition in the clients place of residence. clients and their designated care givers are the focus at home health nursing practice. The goal of care is to initiate. manage and evaluate the resources needed to promote the clients optimal level of well-being and function. Nursing activities necessary to achieve this goal may warrant preventive maintenance and restorative emphases to prevent potential problems from developing. Many project program were suggested home health care model for Korea's health care system and policy direction for expansion and establishment of home health care .But the aim of this paper is to provide on overview for theoretical frame work in home health care. Theories and conceptual frameworks or models are important nursing because they define and guide the boundaries of professional practice and identify key nurse-patient-caregiver relationships that emerge with caring. Following is the research with an investigation of the literature review in the University of Arizona international medline database, In conclusion, are as followers: First, many nursing theorists have had a tremendous impact on nursing practice. the following highlights those nursing theorists that are particularly helpful in understanding home health care. 1. Florence Nightingale : Our earliest theoretical legacy. Nightingale's believes are reflected in basic infection control practice such as hand washing and infectious waste disposal and are key nursing interventions in home care. 2. Martha Roger's :Science of unitary human beings theory. Rorger's believed that the focus of shared. non invasive healing modelities is the human environmental field rather than direct physical care. These modelities continue to evolve as our awareness (reflecting greater diversity, faster rhythms, motions, and ways of knowing) transcends time and space, allowing individuals to get in touch with their integral nature of unbroken wholeness. On people as ever changing energy fields have special relevance in home care especially with hospice and palliative care applications. 3. Madeline Leininger's; Transcultural nursing theory. Home care nurses move through a variety of communities and often care for patients from different cultural back grounds. Therefore Leininger's work has a good that with home care because home care nursing practice is very culturally focused. 4. Dorothea Orem's : Self care deficit theory. Orem's theory views care as something to be performed by both nurses and patients. The role of the nurse is to provide education and support that help patients acquire the necessary activities to perform self-care. Orem's theory is foundational to have care because it begins to truly acknowledge the role of the patient in managing his or her own health. which is referred to as self-care. 5. Margaret Neuman's; Health as expending consciousness theory. Neuman believes that health compasses disease and reflects an underlying pattern of person-environment interaction. A key application of 'Neuman's work to home care is for nurses to understand that health and illness do not necessarily exist at opposite ends of a continuum. 6. Jean Watson's: Theory of human caring. Watson's theory of human caring in nursing proposes human caring as the moral ideal of nursing. Nurses participate human caring to protect, enhance and preserve humanity by assisting individuals to fing meaning in illness. pain and existence and to help others gain self knowledge. self control. and self healing such thinking lends richness to theory development. as well as clinical practice in home care. Second, Robin Rice : Dynamic self determination for self care. (A theoretical framework for home care) Dynamical self determination for self care can be useful to home care nurses in a variety of ways. As research tool it can be reflected in the interview process when the home visit. The home care nurse's role is that of facilitator of patient self-determination for self care through numerous strategies. including patient education and case management.

• Korea Journal of Hospital Management
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• v.8 no.1
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• pp.112-134
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• 2003

The purpose of this study is to analyze the consumer's expectation before the health care service and the consumer's satisfaction after it. The participants of the study are inpatients in a general hospital located in Seoul. The resources were collected from the self-administration questionnaire survey run parallel with face to face interview. In order to measure the degree of the consumer's expectation, 349 samples were collected from the first questionnaire survey on the date of admission to the hospital. The second questionnaire survey was carried out on the date of discharge to the hospital with the participants responding to the first questionnaire survey. There are 154 samples collected from this survey. The results from the analysis of these resources are as follow. First, the survey shows that one of the highest consumers' expectations was about the generosity, kindliness and sincerity from the staff at the hospital, specially from doctors. Second, according to the analysis of the factors affecting the expectations of the consumers, with regard to path of admission to a hospital relating to patient's features, outpatient who gets into a hospital expected good medical care much more than the other patients. In regard of doctor's features, patients usually and highly expect good medical care from doctors who have good carrier and much experience. Third, according to the second questionnaire survey, what patients are satisfied most with is about the generosity and sincerity from staff at a hospital, especially from doctors and their gem attitudes. The results from survey show that the differences among the degree of consumers' satisfaction are very variable, depending on surrounding environments and facilities. The only fact that expectation didn't meet with satisfaction appeared to the case about technology and skill of medical care and the case about updated medical skills and equipments. Fourth, comparing the degree of expectation with the degree of satisfaction of consumers, correlative analysis was concerned significantly and specifically about the part of overall cleanliness relating to facilities and surrounding environments, the items about medical examination and test plan procedure relating to skill of medical care, professional specialties and convenience for procedure, and the items about satisfying explanations and concern about patients from doctors relating to staff's generosity and sincerity. Fifth, the analysis of the factors affecting the degree of how much patients are satisfied with shows that relating to sociodemographical features, patients are not satisfied with the case when the time and process of medical treatment are getting longer. It is surveyed that consumer were satisfied with the motivation to visit a hospital and the insurance type in patient's feature and so were the medical department and the factor of the degree of the expectation in disease's feature. Sixth, according to analysis based on the survey, patients would join again a hospital when they get satisfaction from the medical care and also they want to come again regarding to doctor's capability. For example, when doctors are old, have a good carrier and much experience, patients would come again. As seen from the above, consumers are usually satisfied with the medical treatment more than that they expected before. They would intend to use again when they get satisfaction from the medical care provided at a hospital. Patients and consumers highly expect good attitude as well as capacity from medical doctors and they are also generally satisfied with those things. Therefore, in order to increase the degree of consumer's satisfaction and their intention to come again, the hospital staff would have to commit themselves to achieve high quality service continuously and would have to make an effort to offer the finest quality service.

• Journal of Acupuncture Research
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• v.26 no.6
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• pp.121-132
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• 2009

Objectives : To evaluate the current status of East-West combination treatment in joint disorders. Methods : The medical records of patients who visited the Joints & Rheumatism Center at the Kyung Hee East-West Neo Medical Center from April 2006 to June 2009 were evaluated. The general characteristics of patients who underwent combination treatment, trend in number of cross-system referrals, and disorders and involved body regions of patients referred to the Eastern medical hospital from the Western medical hospital were initially assessed. 6 major disorders were found from the initial scanning. The trend in number of cross-hospital referrals, number of visits to the Eastern medical hospital, current status of combination treatment, treatment modality, and reason for cross-system referral was evaluated. Results : 1. 1510 patients were referred from the Eastern medical hospital to the Western medical hospital, and 1065 patients were referred from the Western medical hospital to the Eastern medical hospital. First visit patients reached a peak at the second quarter of 2007 and fourth quarter of 2006 respectively, and have steadily decreased from then on. Referrals of female patients were twice as common as male patient referrals. Patients in their sixth or seventh decade of life were most commonly referred, and more outpatients were referred compared to inpatients. 2. Patients with knee joint disorders were most commonly referred from the Western medical hospital to the Eastern medical hospital, followed by hip, shoulder, ankle, wrist, and elbow joint disorders. The most common disorders for each of the above regions in referred patients were knee osteoarthritis, avascular necrosis of the hip, adhesive capsulitis, and ankle strain and sprain. The generalized disorders rheumatoid arthritis and ankylosing spondylitis followed. 3. Patients referred to the Eastern hospital received approximately 3 to 10 Eastern medical treatment sessions. 45 percent remained on constant combination treatment, and 98 percent of referred patients received acupuncture treatment. Conclusions : In regard to the number of patients and duration of combination treatment, combination treatment was successfully performed for knee osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis, while it was not so for avascular necrosis of the hip, adhesive capsulitis, and ankle strain and sprain. Further research on this subject is required.

• Journal of Veterinary Clinics
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• v.23 no.3
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• pp.349-354
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• 2006

A 9-month-old, female Miniature Pinscher(MP) dog weighing 1.97kg was presented because of periodic syncopal episode for 5 months. This case was diagnosed as primary dilated cardiomyopathy based on respiratory distress history, weak femoral pulse, generalized cardiomegaly, pulmonary edema, marked dilation of left atrium(LA) and left ventricle(LV), decreased wall thickness of LV and interventricular septum(IVS), increased EPSS in echocardiography, and young age of onset in the absence of other cardiovascular disorders. The patient was stabilized by application of diuretics(Furosemide, 2 mg/kg, SC, q 1 hr) and venodilator(Nitroglycerine patch, 0.5 mg/kg, q 12 hrs). Clinical signs were improved with medical management of positive inotropic vasodilator(Pimobendan, 0.2 mg/kg, PO, q 12 hrs) and angiotensin-converting enzyme(ACE) inhibitor(benazepril, 0.5 mg/kg, PO, q 12 hrs), potassium gluconate gel(2 mEq/dog, PO, q 12 hrs) and, L-carnitine(50 mg/kg, PO, q 12 hrs). The dog still maintains stable clinical status 10 months after the first visit. We report the rare case of DCM in small breed dog, which corresponds to the diagnosis and treatment of typical DCM in large breed dog.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.11 no.1
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• pp.11-23
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• 2016

Objectives : The purpose of this study was to investigate the characteristics and visiting patterns of traffic accident outpatients Methods : In this study, we reviewed the medical charts of 2,048 traffic accident patients who visited Jaseng Hospital of Korean Medicine from January 1st, 2012 to December 31st, 2012. Results : In the distribution of gender and of age patients, the male percentage was 52.3% and the majority of patients were in their thirties(47.2%). In the distribution of the patient's initial visit, most patients visited our clinic from Monday to Wednesday. By monthly distribution, the more patients visited the clinic at the latter half of the year. In the duration of treatment, 1,389 patients(67.8%) finished treatment within four weeks. The most frequently cited sites of pain were neck(82.0%), followed closely by low back(74.0%). In the access route, 746 patients(36.4%) visited our traffic accident clinic as a first choice for primary treatment. We referred patients for radiologic examination in 159 patients(7.9%), of which the exams were mainly lumbar spine MRIs(3.6%) and cervical spine MRIs(2.8%). The most frequent diagnosis were herniated nucleus pulposus. Conclusions : This study shows that most of the patients who visited the traffic accident clinic of a Korean Medical Hospital presented neck and low back pain, and the majority showed improvement without surgical treatment. Following the increasing minor injury rate caused by traffic accidents, we expect the role of Korean Medicine Hospital to become more prominent.

• Pediatric Infection and Vaccine
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• v.13 no.2
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• pp.180-185
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• 2006

Invasive Pseudomonas infections most often occur in the immunocompromised patients and are associated with high mortality rate. Rarely this disease may develop in healthy infants and children. We report two cases of invasive Pseudomonas aeruginosa infections that were diagnosed in otherwise healthy infants. The first case was a previously healthy 5-month-old infant with ecthyma gangrenosum and septicemia. She presented with fever, swelling of left periorbital area and multiple erythronodular skin lesions. Each skin lesion formed a black eschar surrounded by an erythematous areola over time. Cultures of blood, urine and discharge from skin lesions grew P. aeruginosa. On the day of visit, she showed pancytopenia which was normalized after 10 days. The patient responded well to the management with ceftazidime and tobramycin. The other case was a previously healthy 9-month-old infant with community-acquired pneumonia. He was referred from an outside hospital with fever and cough. Chest x-ray revealed pneumonic infiltrations on both lower lungs with pleural effusion on the right side. Cultures of blood and pleural fluid grew P. aeruginosa. Chest CT performed on the ninth day demonstrated pneumatoceles, lung abscess and necrosis of lung parenchyma. He was managed with ceftazidime and amikacin for 50 days. No residual pulmonary complications were noted during the three month follow-up. Laboratory results to evaluate immunologic defects of phagocytic cells, complement components and T- and B-lymphocytes were all within normal range in both patients. It should be kept in mind that Pseudomonas can be, though uncommon, a cause of community-acquired invasive infections in the previously healthy infants.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.5
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• pp.20-31
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• 1998

The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to examine the validity of it. For these, home care nursing study team of College of Nursing, Seoul National University has studied home care nursing system since September, 1996, and has operated home care center since August, 1997. This study has been supported by the Korean Sience Foundation. We organized Committee of rules, and Clinical specialist consultant group for more efficient running of the home care center. In nursing station, research assistant controlled general work, and 5 home care nurses were hired for home visiting. We developed the Standards for operations, that included criteria for clients, central supply system of nursing materials, central management of nursing care cost, advertisement, patient referral system, and so forth. In our center, 108 patients enrolled, and neurologic disorders including cerebrovascular accident, and cancer were the most prevailing diseases. We tried to overcome the limitations of hopital -based home care, and to provide more accessible, efficient, safe, and stable home care nursing. Therefore, we were referred clients from patients and families, public health care center, industries, as well as from hospitals. Meanwhile, we developed home care recording system and assessment-intervention algorithm for various diseases for quality control and standardization. Also, we did continuing education, and tried to detect problems and to find solutions by regular meeting between the committee of rules and home care nurses. As the results of this study, several limitations of operation were found. First, it was difficult to manage and communicate with the doctor in the emergency situation, Second, we spent too much time for trasnsportation, because only five nurses covered all areas of Seoul and nearby cities. Third, preparation for special care of home care nurses were lacked. Forth, criteria for termination of care and frequency of home visit were ambiguous. Fifth, some difficulties were found in retrospective payment system. And finally, interconnection with home care machinery company were needed. Strategies for solving these problems were suggested.

• Journal of Periodontal and Implant Science
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• v.28 no.3
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• pp.389-401
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• 1998

In this study, 21 patients diagnosed as adult periodontitis were divided into 4 groups. One quadrant with an average of 6mm deep pocket depth was chosen from each individual - Group A inserted tetra-cycline fiber after removing supragingival calculus while group RP had calculus removal and root planning alone. Group RP+A received combination of these treatments while group C received none. Plaque index, bleeding on probing, pocket depth, attachment level, and distribution of subgingival plaque were compared and evaluated among these groups at periods of first visit, 4th week and 8th week. The results were as follows ; 1. Plaque index and bleeding on probing improved after treatment and no significant difference was found between the groups. 2. When comparing the change in pocket depth between the groups, the use of tetracycline fiber showed significant reducton in pocket depth comparable to root planing. Combined therapy of tetracycline fiber and root planing showed synergistic effect in pocket depth reduction. 3. When comparing the change in attachment level between the groups, the use of tetracycline fiber showed significant increase in clinical attachment level comparable to root planing, but no synergistic effect was found in the combined therapy. 4. When comparing the change in the motile bacteria ratio between the groups, group RP and group RP+A showed significant decrease compared with control group. 5. There were no severe adverse effects from using tetracycline fiber, except for a few patient who experienced mild discomfort. In summary, the use of local adminstration of tetracycline fiber in adjunction to mechenical treatment can be effective for adult periodontitis.

• Korea Journal of Hospital Management
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• v.7 no.4
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• pp.172-192
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• 2002

The purpose of this study is to ascertain whether the effect of introduction of OCS(Order Communication System) to the hospital is satisfied or not comparing the anticipated effect with the actual effect. For this purpose, a domestic hospital which has introduced and has been operating OCS for several years was chosen. Based on the internal data of S Hospital prepared before introducing OCS, researcher has analyzed the basic direction, design standard and status of operation after the introduction of OCS, etc. After analyzing the status of operations of several departments using OCS and interviewing with the chiefs of pertinent departments, a survey form was designed. Actual survey and interviews were conducted by the researcher for weeks to know whether doctors, nurses, medical technicians and clerks of the patient management dept. were satisfied with OCS and to find if they have any recommendations to improve OCS. Based on the analysis of survey, the effect of OCS was evaluated whether it has satisfied the anticipated effectiveness. For the question if they feel convenient in using OCS, doctors, nursing staffs in charge of ward and the staffs of billing dept. has answered that they were all satisfied(100%). The answers for the same question were relatively high in the case of nurses in charge of outpatient and staffs of radiography. Of course, there have been some nurses and staffs who complained for the inconvenience. However, overall satisfaction was high on the average. Some common problems occurred after the introduction of OCS were frequent errors due to instability of OCS system, paralysis of function of hardware on data back-up system and redundant investment due to erroneous choice of DB program in setting DB. It was also pointed out that lack of computer education and low participation of medical staffs has resulted in failure of developing effective software. As a result, it has lowered the efficiency of OCS. For example, some works have to be done by hands even after OCS. Based on the result of this research, recommendations to maximize the effect of OCS were presented as follows. First, strong leadership of CEO and active cooperation of doctors are mandatory. Second, all the process of hospital work should be analyzed and be redesigned in more efficient ways. Third, OCS should be designed to be user-based system which can be used efficiently by all staffs of the hospital. Forth, prior to the operation of OCS, proper tests of the program and trainings of the pertinent staff are required. Fifth, prior to the selection of hardware, BMT(Bench Marking Test) should be conducted. Sixth, before introducing OCS, staffs in charge of OCS should visit many hospitals operating the OCS system and take their cases into account.

• Tuberculosis and Respiratory Diseases
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• v.69 no.6
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• pp.426-433
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• 2010

Background: Persistent cough has recently been found to be associated with Chlamydia pneumoniae infection. We aimed to investigate the infection rate of C. pneumonia in adult patients with chronic cough. Methods: We recruited 68 patients with persistent cough lasting in excess of 3 weeks, who visited Kangdong Sacred Heart Hospital from January 2005 to August 2005. On the first visit, chest and paranasal sinuses radiography, skin prick test of common allergens, and induced sputum samples for C. pneumoniae were performed in all of patients. Further evaluation for diagnosis included a methacholine provocation test and eosinophil counts in induced sputum. Results: The most common cause of chronic cough was upper airway cough syndrome (UACS) (26.5%), followed by eosinophilic bronchitis (20.6%) and cough variant asthma (16.2%). Idiopathic chronic cough was the cause in 33.8% of patients. The mean duration of cough was 11.7 months. C. pneumoniae was isolated by polymerase chain reaction (PCR) from one patient who had upper respiratory air way syndrome. Conclusion: Chlamydia pneumoniae appears to have a minor role as a cause of chronic cough in patients.