• 간호행정학회지
• /
• 제13권3호
• /
• pp.311-320
• /
• 2007

연구 목적: 사례 관리(CM) 환자 만족도 측정에 관한 연구 결과를 고찰하여 사례관리 실무에서 활용할 수 있는 근거를 제공하고자 한다. 연구 방법: MedLine, CINAHL에서 주요용어로 case management, care management, 주제어로 patient satisfaction, client satisfaction을 이용해 문헌 검색을 실시하였다. 연구 결과: 만족도에 대한 개념은 관련 연구가 매우 부족하며, 서로 다른 이론적 접근을 하고 있으므로 그 측정에 어려움이 있다. 신뢰할 만한 만족도 측정을 위해서는 설문 문항을 서술하는 여러 가지 방법들, 측정 척도의 종류, 만족도에 영향을 미치는 혼란변수들을 주의 깊게 고려하여야 한다. 만족도는 사례관리 연구에서 흔히 측정되는 성과이지만 대부분의 관련 연구에서 사례관리의 특징이 반영된 측정 도구를 사용하지 않고 있었다. 따라서 본 논문은 다섯 개의 사례관리 만족도 측정 도구를 제시하고 그 특징을 소개하였다. 또한, 간호성과분류체계(The Nursing Outcomes Classification)에 제시된 만족도 측정항목들 중 사례관리와 관련이 높은 약 40%의 항목들을 발견하였다. 결론: 사례관리 만족도 측정 도구가 매우 부족하므로 표준 사례관리 측정도구 개발이 시급하다. 한편 사례관리사들은 만족도 측정에 대한 이해를 높이고 기존 연구 결과를 활용함으로써 보다 정확한 사례관리 만족도 평가가 이뤄지도록 노력해야 한다.

• 한국임상약학회지
• /
• 제28권4호
• /
• pp.300-307
• /
• 2018

Objective: As the demands of healthcare environment change, it is necessary to advance human health care by improving students' essential competencies including knowledge, skills, abilities, inter-professional collaboration and patient centered care. This study identified long term accomplishment and improvement of the essential competencies in clinical pharmacy practice education (CPPE) at Korean hospitals over time. Methods: This study was conducted for pharmacy students who completed CPPE evaluation related to tertiary hospitals and secondary hospitals located in Seoul and Gyeonggi-do regional area from 2014 to 2018. Results: Over the past 5 years, overall results of student evaluation on the essential competencies in CPPE at both tertiary and secondary hospitals showed a decreasing trend or did not change. Essential competency in CPPE at tertiary hospitals had been identified as superior on 'Learn clinical knowledge in the treatment of diseases' to secondary hospitals [average number of students (%): 210 (72.9%) vs 68 (68.0%)]. On the other hand, essential competencies in CPPE at secondary hospitals had been identified as better at 'inter-professionals collaborative teamwork and direct patient care' than tertiary hospitals [average number of students (%): 64 (64.0%) and 56 (56.0%) vs 121 (42.0%) and 90 (31.3%)]. A total of 176 (61.1%) students in tertiary hospitals and 66 (66.0%) in secondary hospitals evaluated that 'patient-centered care' education was good. Conclusion: In tertiary hospitals, all six essential competency outcomes have not been improved, whereas four essential competency outcomes showed an increasing trend in secondary hospitals. It will be necessary to develop outcome-based CPPE education program to better reflect the essential competencies.

• Healthcare Informatics Research
• /
• 제24권4호
• /
• pp.346-358
• /
• 2018

Objectives: The association between obstructive sleep apnea (OSA) and mortality or serious cardiovascular events over a long period of time is not clearly understood. The aim of this observational study was to estimate the clinical effectiveness of continuous positive airway pressure (CPAP) treatment on an outcome variable combining mortality, acute myocardial infarction (AMI), and cerebrovascular insult (CVI) during a follow-up period of 15.5 years ($186{\pm}58$ months). Methods: The data set consisted of 978 patients with an apnea-hypopnea index (AHI) ${\geq}5.0$. One-third had used CPAP treatment. For the first time, a data-driven causal Bayesian network (DDBN) and a hypothesis-driven causal Bayesian network (HDBN) were used to investigate the effectiveness of CPAP. Results: In the DDBN, coronary heart disease (CHD), congestive heart failure (CHF), and diuretic use were directly associated with the outcome variable. Sleep apnea parameters and CPAP treatment had no direct association with the outcome variable. In the HDBN, CPAP treatment showed an average improvement of 5.3 percentage points in the outcome. The greatest improvement was seen in patients aged ${\leq}55$ years. The effect of CPAP treatment was weaker in older patients (>55 years) and in patients with CHD. In CHF patients, CPAP treatment was associated with an increased risk of mortality, AMI, or CVI. Conclusions: The effectiveness of CPAP is modest in younger patients. Long-term effectiveness is limited in older patients and in patients with heart disease (CHD or CHF).

• 한국보건간호학회지
• /
• 제34권3호
• /
• pp.416-428
• /
• 2020

Purpose: This study identified socioeconomic factors affecting the health status of Korean adults. Methods: Secondary data from 12,921 adults aged 19 to 64 old in the 7th Korean National Health and Nutrition Examination Survey were used. The participants' health status was measured using the indicators that included health behaviors (smoking, high-risk drinking, strength exercise, and aerobic physical activity) and health outcomes (metabolic syndrome, and subjective health status). Results: For all health behaviors and health outcomes, gender, age, educational level, and income were common affecting factors. Regarding health behaviors, the employment status was related to smoking, high-risk drinking, strength exercise, and aerobic physical activity. The marital status was related to high-risk drinking, strength exercise, and aerobic physical activity. The household type was related to smoking. The residential area was related to smoking, high-risk drinking, and aerobic physical activity. For health outcomes, the household type was related to obesity, and subjective health status; residential area was related to obesity. Conclusion: This study presented basic data for assessing the differences in health status. The characteristics of the affecting factors to health status should be considered, depending on the health behaviors and health outcomes.

• 대한물리치료과학회지
• /
• 제16권3호
• /
• pp.67-74
• /
• 2009

Background: Various functional factors should be incorporated during assessment and intervention for patient rehabilitation. Stable respiratory function is one of required factors for functional restoration. To maximize respiratory physical therapy intervention outcome, it is required to understand clinical features of respiratory diseases and physical therapy approaches. Methods: Previous studies were systematically reviewed through computerized search. Methodological qualities of selected studies were evaluated and the levels of recommendations were determined. Results: Assessment for respiratory pattern and thoracic mobility is of importance to improve cardiopulmonary fitness during physical reconditioning. Application of optimal therapeutic protocol can increase thoracic mobility and respiratory function. Interdisciplinary communication is critical during rehabilitation for respiratory patients. Health care provider should have professional knowledge and experience for cardiopulmonary fitness and obligation to endeavor for patients' respiratory rehabilitation. It is necessary to standardize therapeutic intervention, and rehabilitative respiratory exercise should be applied to confirm the effects of intervention. Conclusion: Respiratory diseases that may reduce patients' quality of life and cardiopulmonary fitness should be resolved through physical therapy approaches. Through conducting research, effect of evidence-based and patients' function-oriented intervention can be determined.

• Journal of Preventive Medicine and Public Health
• /
• 제56권2호
• /
• pp.111-127
• /
• 2023

Objectives: Pre-pregnancy diet has an important role in preparing for healthy generation. However, evidence on this issue has been scarce. A scoping review synthesising current evidence will support the demand to map 'what has been researched' on pre-pregnancy diet and maternal and child health. Methods: Systematic search was performed using PICOS (Population, Intervention, Comparison, Outcomes, and Study design) framework in electronic databases. Articles were screened for eligibility, summarized, and the quality was assessed using the National Institute of Health assessment tool. The review structure complies with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guide. Results: Forty-two articles were included after full-text screening. Twenty-five studies were in high-income countries (HICs), six in each upper-middle income, five in lower-middle income countries (LMICs), and one in low-income countries (LIC). Based on the regions: North America (n=16), Europe (n=5), South America (n=4), Australia (n=4), Asia (n=5), Middle East (n=2), and sub-Saharan Africa (n=1). The two-most observed diet-related exposures were dietary pattern (n=17) and dietary quality (n=12). The most assessed outcome was gestational diabetes mellitus (n=28) and fetal and newborn anthropometry (n=7). The average quality score±standard deviation was 70±18%. Conclusions: Research related to pre-pregnancy diet is still concentrated in HICs. The context of diet may vary; therefore, future research is encouraged in LMICs and LICs context, and Mediterranean, South-East Asia, Pacific, and African regions. Some maternal and child nutrition-related morbidity, such as anemia and micronutrient deficiencies, have not been discussed. Research on these aspects will benefit to fill in the gaps related to pre-pregnancy diet and maternal and child health.

• 한국전문물리치료학회지
• /
• 제27권4호
• /
• pp.233-240
• /
• 2020

Background: Cross-culturally adapted questionnaires may not be comparable to their original version. Objects: To examine concurrent validity of two health-related quality of life (HRQOL) instruments for the Korean versions of EuroQOL-5 Dimension (EQ-5D) and the abbreviated version of the World Health Organization Quality of Life (WHOQOL-BREF) instrument. Methods: A total of 139 cancer survivors from two rehabilitation institutes was recruited. All participants were registered for palliative rehabilitation care. Both instruments were concurrently administered by health care providers following the second bout of the rehabilitation cares. Rasch partial credit model and Spearman's correlation analysis were used to investigate: 1) dimensionality, 2) hierarchical item difficulty, and 3) concurrent validity using correlations between two instruments. Results: For the WHOQOL-BREF, all items except negative feeling, pain, dependence of medical aid, were found to be acceptable, while all items of EQ-5D were acceptable. There was an evidence of negative correlations between EQ-5D and 4 domains of WHOQOL-BREF. Two correlations were strong (EQ-5D vs. physical health domain, ρ = -0.610, 95% CI = -0.716 to -0.475) and moderate (EQ-5D vs. psychosocial domain, ρ = -0.402, 95% CI = -0.546 to -0.236). Other two correlations were weak (EQ-5D vs. social relationship and environmental domains, ρ = -0.242, 95% CI = -0.401 to -0.075 and ρ = -0.364, 95% CI = -0.514 to -0.207, respectively). Item difficulty calibrations of the two measurements were ranged from -0.84 to 0.86 for the EQ-5D and -1.07 to 1.06 for the WHOQOL-BREF. Conclusion: The study provides some supports for the concurrent validity of the two Korean versions of HRQOL instrument, with evidences of weak to strong correlations between the EQ-5D and four domains of the WHOQOL-BREF applied to various cancer survivors. Additionally, the cancer survivors appeared to have more of a tendency to view the EQ-5D items as being slightly more challenging than the WHOQOL-BREF items.

• Tuberculosis and Respiratory Diseases
• /
• 제85권1호
• /
• pp.47-55
• /
• 2022

Background: We evaluated the long-term effects of domiciliary noninvasive positive-pressure ventilation (NIPPV) used to treat patients with chronic obstructive pulmonary disease (COPD). Methods: Databases were searched to identify randomized controlled trials of COPD with NIPPV for longer than 1 year. Mortality rates were the primary outcome in this meta-analysis. The eight trials included in this study comprised data from 913 patients. Results: The mortality rates for the NIPPV and control groups were 29% (118/414) and 36% (151/419), suggesting a statistically significant difference (risk ratio [RR], 0.79; 95% confidence interval [CI], 0.65-0.95). Mortality rates were reduced with NIPPV in four trials that included stable COPD patients. There was no difference in admission, acute exacerbation and quality of life between the NIPPV and control groups. There was no significant difference in withdrawal rates between the two groups (RR, 0.99; 95% CI, 0.72-1.36; p=0.94). Conclusion: Maintaining long-term nocturnal NIPPV for more than 1 year, especially in patients with stable COPD, decreased the mortality rate, without increasing the withdrawal rate compared with long-term oxygen treatment.

• 한국응급구조학회지
• /
• 제15권2호
• /
• pp.27-42
• /
• 2011

Purpose: This study intended to improve quality of prehospital emergency care for trauma patients by figuring out its current situations and problems based on run-sheets and questionnaires of 119 emergency medical technicians (EMTs). Methods: This study conducted a research of 425 trauma patients transferred to the 3rd hospital in G-city by 119 ambulances from July 1, 2008 to June 30, 2009. We aslo utilized 114 copies with questionnaires of 119 EMTs working in J-province. The data were analyzed with SPSS 18.0. Results: There were 425 trauma patients including 272 men and 137 patients with traffic accident. When it comes to types of 119 EMTs who delivered cares to patients, there were 206 (48.5%) advanced EMTs, 101 (23.8%) basic EMTs, 50 (11.8%) nurses and 43 (10.2%) rescue education receivers. The most frequent measured vital sign was pulse rate (54.1%). Regarding assessment of systolic blood pressure, pulse rate and respiration rate, there were some significant differences in accordance with type of 119 EMTs. Among the 317 patients evaluated 'emergency' in field, 137 patients returned to their home. Prehospital emergency cares accounted for 861, around 2.0 treatments per a patient. In view of questionnaire, the 74.6% of 119 EMTs hoped supplement of man power for proper prehospital care to trauma patients. Conclusion: This study suggested that it is necessary to develop detailed guidelines for trauma patients so as to improve quality of trauma patient evaluation and prehospital care. Furthermore, improvement of emergency care systems will reduce mortality of trauma patients and lead to their good outcome.

• 대한한방내과학회지
• /
• 제37권4호
• /
• pp.645-652
• /
• 2016

Objectives: To compare the effects of Eastern-Western integrative medical care (EWIM) and Western single rehabilitation therapy (WSRT) on the functional recovery of stroke patients.Methods: Seventy-six stroke patients were recruited retrospectively. The participants were divided into two groups: EWIM and WSRT. Data on age, sex, stroke-related risk factors, stroke type, neurological deficits according to the National Institutes of Health Stroke Scale (NIHSS), elapsed time to the initiation of rehabilitation, duration from the onset to follow up, initial functional status, and function after therapy for 3 mon were obtained from a review of the patients’ medical records. Between-group differences in functional outcomes were analyzed before and after treatment using the functional ambulation category (FAC), Fugl-Meyer assessment (FMA), modified Barthel Index-Korean version (K-MBI), and Euro-Quality of Life-5 Dimension (EQ-5D).Results: At 3-mon poststroke, all the functional outcome measures had improved in both groups (P<0.05). However, the improvements were greater in the EWIM group, and the improvement was statistically significant in the K-MBI (P=0.048) and EQ-5D (P=0.042).Conclusions: With respect to activities of daily living and health-related quality of life, EWIM is a more effective stroke therapy than WSRT.