• Archives of Plastic Surgery
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• v.48 no.3
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• pp.295-304
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• 2021

Clinical photography is an essential component of patient care in plastic surgery. The use of unsecured smartphone cameras, digital cameras, social media, instant messaging, and commercially available cloud-based storage devices threatens patients' data safety. This paper Identifies potential risks of clinical photography and heightens awareness of safe clinical photography. Specifically, we evaluated existing risk-mitigation strategies globally, comparing them to industry standards in similar settings, and formulated a framework for developing a risk-mitigation plan for avoiding data breaches by identifying the safest methods of picture taking, transfer to storage, retrieval, and use, both within and outside the organization. Since threats evolve constantly, the framework must evolve too. Based on a literature search of both PubMed and the web (via Google) with key phrases and child terms (for PubMed), the risks and consequences of data breaches in individual processes in clinical photography are identified. Current clinical-photography practices are described. Lastly, we evaluate current risk mitigation strategies for clinical photography by examining guidelines from professional organizations, governmental agencies, and non-healthcare industries. Combining lessons learned from the steps above into a comprehensive framework that could contribute to national/international guidelines on safe clinical photography, we provide recommendations for best practice guidelines. It is imperative that best practice guidelines for the simple, safe, and secure capture, transfer, storage, and retrieval of clinical photographs be co-developed through cooperative efforts between providers, hospital administrators, clinical informaticians, IT governance structures, and national professional organizations. This would significantly safeguard patient data security and provide the privacy that patients deserve and expect.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2021.05a
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• pp.641-643
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• 2021

The Internet of Things (IoT) connects all markets and industries, enabling new business models for a variety of services and service providers. The Internet of Medical Things (IoMT) not only accelerates medical advances, but also enables treatment with a more human approach. In addition, it improves treatment methods and quality of precision medical care through data, enables timely treatment, and improves operational productivity of medical institutions through a simplified workflow. However, since the medical field directly affects human health and life, securing security has become an issue above all else, and is a target for hackers trying to exploit it. Therefore, in this study, IoMT technology and security threats and countermeasures in the medical field are analyzed.

• Journal of Korean Neurosurgical Society
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• v.65 no.3
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• pp.370-379
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• 2022

Abusive head trauma (AHT) is the most severe form of physical abuse in children. Such injury involves traumatic damage to the head and/or spine of infants and young children. The term AHT was introduced to include a wider range of injury mechanisms, such as intentional direct blow, throw, and even penetrating trauma by perpetuator(s). Currently, it is recommended to replace the former term, shaken baby syndrome, which implicates shaking as the only mechanism, with AHT to include diverse clinical and radiological manifestations. The consequences of AHT cause devastating medical, social and financial burdens on families, communities, and victims. The potential harm of AHT to the developing brain and spinal cord of the victims is tremendous. Many studies have reported that the adverse effects of AHT are various and serious, such as blindness, mental retardation, physical limitation of daily activities and even psychological problems. Therefore, appropriate vigilance for the early recognition and diagnosis of AHT is highly recommended to stop and prevent further injuries. The aim of this review is to summarize the relevant evidence concerning the early recognition and diagnosis of AHT. To recognize this severe type of child abuse early, all health care providers maintain a high index of suspicion and vigilance. Such suspicion can be initiated with careful and thorough history taking and physical examinations. Previously developed clinical prediction rules can be helpful for decision-making regarding starting an investigation when considering meaningful findings. Even the combination of biochemical markers may be useful to predict AHT. For a more confirmative evaluation, neuroradiological imaging is required to find AHT-specific findings. Moreover, timely consultation with ophthalmologists is needed to find a very specific finding, retinal hemorrhage.

• Journal of Korean Academy of Nursing
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• v.54 no.1
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• pp.93-105
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• 2024

Purpose: The study aimed to understand the semantic structure and nature of the disease experience of kidney transplant recipients with kidney graft failure by applying phenomenological research methods. Methods: Data were collected between February and September 2021 through individual in-depth interviews with 12 kidney transplant recipients with kidney graft failure. Colaizzi's phenomenological analysis was used to analyze the meaning of the participants' illness experiences. Results: 5 theme clusters and 15 themes were derived. The five theme clusters are as follows: (1) First transplant giving me a second life; (2) Body and mind becoming sick again; (3) Waiting for a re-transplant with hope and worry; (4) Life supported by gratefulness; (5) Having control over my own life. Conclusion: This study shows that kidney transplant recipients with kidney graft failure experience physical and psychological difficulties during the long disease period and require help from many people, including family members, friends, colleagues, and health care providers, to overcome their difficulties.

• Journal of Korean Academy of Nursing
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• v.47 no.1
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• pp.14-24
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• 2017

Purpose: The purpose of this study was to construct and test a hypothetical model of self-management in patients with hemodialysis based on the Self-Regulation Model and resource-coping perspective. Methods: Data were collected from 215 adults receiving hemodialysis in 17 local clinics and one tertiary hospital in 2016. The Hemodialysis Self-management Instrument, the Revised Illness Perception Questionnaire, Herth Hope Index and Multidimensional Scale of Perceived Social Support were used. The exogenous variable was social context; the endogenous variables were cognitive illness representation, hope, self-management behavior, and illness outcome. For data analysis, descriptive statistics, Pearson correlation analysis, factor analysis, and structural equation modeling were performed. Results: The hypothetical model with six paths showed a good fitness to the empirical data: GFI=.96, AGFI=.90, CFI=.95, RMSEA=.08, SRMR=.04. The factors that had an influence on self-management behavior were social context (${\beta}=.84$), hope and cognitive illness representation (${\beta}=.37$ and ${\beta}=.27$) explaining 92.4% of the variance. Self-management behavior mediated the relationship between psychosocial coping resources and illness outcome. Conclusion: This research specifies a more complete spectrum of the self-management process. It is important to recognize the array of clinical resources available to support patients' self-management. Healthcare providers can facilitate self-management through collaborative care and understanding the ideas and emotions that each patient has about the illness, and ultimately improve the health outcomes. This framework can be used to guide self-management intervention development and assure effective clinical assessment.

• Korean Parent-Child Health Journal
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• v.4 no.1
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• pp.19-34
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• 2001

The childbearing process is not only a biological phenomenon of a woman who gives birth to a child but also a sociocultural phenomenon which is reflected on her value, belief in the sociocultural context according to social change and acculturation. The familial relation and sociocultural context in the multigravidas are more complex and intermingled than in the primigravidas. The purpose of this ethnographic research study was to explore the experience of identity from the first trimester of pregnancy to the third trimester of pregnancy in the Korean multigravidas and to understand deeply the perspectives of pregnant women reflected on Korean sociocultural values, beliefs, norms and familial culture. The participants of 10 pregnant women in Seoul, Korea were observed for 10 months from January to October 2000 and interviewed in their homes and comfortable place. Data analysis was accomplished 'line by line method' and significant concepts were classified according to themes, categories, and domains. The results of this study were as follows : The participants experienced 4 categorized subjects : understanding the oneself - mother to be, performing the dual role, drifting the emotion, and living disheartened during pregnancy. The participants were showed universality and diversity pattern in the self understanding process. The universal pattern were 'mother to be' showing maturation, life along family and priority on motherhood between being a mother and a woman. The diverse pattern were taking the dual role in working mothers having the higher self actualized value and personal identity rather than maternal identity, drifting emotion in resigned mothers, and living disheartened in mothers who have two daughters and no son. In conclusion, the Korean multigravidas experienced womanhood as well as motherhood through the self understanding process with familial connections during pregnancy. Therefore it is suggested that if the harmony and the balance between a mother and a woman is accomplished, the woman will lead a healthy and high quality of life. Also, this study sought to confirm the sociocultural factors affecting during pregnancy in the perspectives of the women with children. Therefore, the health care providers have to divert their attention from biomedical perspectives to biocultural perspectives integrating bio-psycho-sociocultural aspects of pregnant women in a clinical setting.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.1
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• pp.22-26
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• 2017

Purpose: The diagnosis of cow's milk (CM) allergy is a challenge. The Cow's Milk-related-Symptom-Score ($CoMiSS^{TM}$) was developed to offer primary health care providers a reliable diagnostic tool for CM related symptoms. The predictive prospective value of the $CoMiSS^{TM}$ was evaluated in three clinical trials. Methods: Pooled analyses of the three studies were conducted based on regressing the results of the month-1 challenge test on the month-1 $CoMiSS^{TM}$, adjusting for baseline $CoMiSS^{TM}$ using a logistic regression model. In addition a logistic regression model was also fitted to the month-1 challenge test result with the change in $CoMiSS^{TM}$ from baseline as a predictor. Results: Results suggest that infants having a low $CoMiSS^{TM}$ (median, 5) after 1 month dietary treatment free from intact CM protein have a significant risk of having a positive challenge test (odds ratio, 0.83; 95% confidence interval, 0.75-0.93; p=0.002). Pooled data suggest that the change in $CoMiSS^{TM}$ from baseline to month-1 can predict CM related symptoms as a confirmed diagnosis according to the challenge test at month-1. However, in order to validate such a tool, infants without CM related symptoms would also need to be enrolled in a validation trial. A concern is that it may not be ethical to expose healthy infants to a therapeutic formula and a challenge test. Conclusion: Pooled data analysis emphasizes that the $CoMiSS^{TM}$ has the potential to be of interest in infants suspected to have CM-related-symptoms. A prospective validation trial is needed.

• Journal of Digital Convergence
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• v.11 no.9
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• pp.221-228
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• 2013

The purpose of this study was to examine the effects of alcohol use, depression, and self-esteem on suicidal ideation of older adults. Community-dwelling older adults aged 65 years and older were recruited from three welfare centers. A total of 245 older adults was assessed with the Alcohol Use Disorder Identification Test-Korean (AUDIT-K), Geriatric Depression Scale Short Form-Korea Version (GDSSF-K), Self-Esteem Scale (SES), and Scale for Suicidal Ideation (SSI). Descriptive statistics, Pearson's correlation, independent t-test, one-way ANOVA, and multiple regression analysis were performed using the SPSS WIN 19.0 program. Higher depression, lower self-esteem, no religion, and poorly perceived health were statistically significant determinants of higher level of suicidal ideation in older adults. To prevent or reduce suicidal ideation of older adults, health care providers should consider the determinants identified in this study.

• Child Health Nursing Research
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• v.18 no.3
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• pp.150-156
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• 2012

Purpose: The main purposes of this study were to assess maternal-fetal attachment (MFA) of the expectant mothers of a fetus with a prenatal diagnosis of congenital heart disease (CHD) and to identify factors associated with MFA. Methods: The methodology was a cross sectional survey study using a self-administered questionnaire. Thirty pregnant women carrying a fetus with a prenatal diagnosis of CHD and 30 pregnant women with a normal fetus were enrolled in this study. The MFA Scale and PPS (The Prenatal Psychosocial Profile) were used to collect data. Data were analyzed using SPSS 20.0 Window version. Descriptive statistics, $X^2$-test and t-test were used to compare the two groups. The factors associated with MFA were identified by multiple regression analysis. Results: There was no significant difference between the two groups in MFA and social support from spouse was the only variable showing a significant difference. The model from the multiple regression analysis explained 33.8% of MFA for both groups. Conclusion: MFA of expectant mothers with a prenatal diagnosis of CHD and of mothers with a normal fetus were not significantly different. It is important that health care providers encourage expectant fathers to support the expectant mothers to increase MFA.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.1
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• pp.1-9
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• 2015

Eating behaviour disorder during early childhood is a common pediatric problem. Many terminologies have been used interchangeably to describe this condition, hindering implementation of therapy and confusing a common problem. The definition suggests an eating behaviour which has consequences for family harmony and growth. The recent Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition does not cover the entire spectrum seen by pediatricians. Publications are substantive but level of evidence is most of the time low. This purpose of this review is to clarify terminology of eating behaviour problems during early childhood; including benign picky eating, limited diets, sensory food aversion, selective eating, food avoidance emotional disorder, pervasive refusal syndrome, tactile defensiveness, functional dysphagia, neophobia and toddler anorexia. This tool is proposed only to ease the clinical management for child care providers. Diagnostic criteria are set and management tools are suggested. The role of dietary counselling and, where necessary, behavioural therapy is clarified. It is hoped that the condition will make its way into mainstream pediatrics to allow these children, and their families, to receive the help they deserve.