• Journal of the Korean housing association
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• v.19 no.4
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• pp.79-87
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• 2008

Snoezelen, multi-sensory stimulation, provides stimulation through the visual, aural, tactile, olfactory, gustatory and proprioceptive senses. Its aim is to be a relaxing, feeling of safety, novelty and stimulation with no expectations for performance. Agitated behavior of people with dementia causes significant problems and distress for cares. The objective of this research study was to test the effects of Snoezelen room on physical and verbal agitated behaviors of people with dementia. Four patients participated five sessions in Snoezelen room of 'F' dementia care facility in Sweden. Assessment instrument was basically used Cohen-Mansfield Agitation Inventory-Short Form to be rated by caregivers on a 5-point frequency scale. Pre-trial and post-trial assessments were carried out during $27^{th}$ Aug.-$27^{th}$ Sept. 2007. Result shows that Snoezelen room has some short-term positive effect on agitated behavior even though there was a considerable variation individuals responded. This result adds to the increasing evidence that Snoezelen could be a therapeutic environment for the elderly with dementia. Further research study, with larger number of participation, and a control group is required to establish more scientific evidence of Snoezelen effects on health outcome.

• 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.

• The Journal of the Korea institute of electronic communication sciences
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• v.12 no.3
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• pp.515-524
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• 2017

The aim of this study was investigated the effect of self-exercise based on health care application on upper extremity function and daily living, satisfaction in patients with stroke. This experiments were participated in thirty patients with stroke. All subjects allocated that randomized each fifteen patients in experimental and control groups. Subjects of both group received the conventional rehabilitation therapy during 30 min/day, 5 for week, for 4 weeks. Additionally, experimental group performed that self-exercise based on health care application, supervised under caregivers, during 30 min/day. Additionally, control group conducted only self-exercise supervised under caregivers, during 30 min/day. The outcome measures were the JHFT(: Jebsen-Taylor Hand Function Test), FMA(: Fugl-Meyer Assessment), K-MBI(: Korean Modified Barthel Index), VASS(: Visual Analog Satisfaction Scale). In results of study. Two groups showed significant improvements after intervention in all tests(p<.05). In comparison of change score between both group, experimental group showed greater significant improvements than control group in JHFT(p<.05). The experimental group was significant higher than control group in VASS(p<.05). We suggested that self-exercise based on health care application can have a positive effects of the improvements of hand function and satisfaction than usual self-exercise in patients with stroke.

• 한국노년학
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• v.29 no.1
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• pp.37-50
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• 2009

The purpose of the present study was to develop a community-based intensive health care program for the community dwelling elderly to strength their functional status and to verify the effect on their geriatric syndrome. A one-group pretest-posttest design was used for the study. A total of 69 frail elderly, who lived in the area within 20 minutes by car, were committed themselves to the day care center(Sangikjae), and had the ability of verbal communication were selected from G city in Kyunggi province. The participants completed a set of questionnaires to measure the sub-score of frailty, fall, urinary incontinence, malnutrition, and mild cognitive disorder domain, using the Otasha-Kensin through the physical examinations and interviews. After 4 weeks of intervention, the outcome was measured to evaluate the effects of the program, and the data obtained were analyzed using descriptive statistics, paired t-test and McNemar test. The results showed that the sub-score of frailty, fall, urinary incontinence, and malnutrition domain were statistically significantly decreased after intervention except those of urinary incontinence and mild cognitive disorder domain, implying that the risk of frailty, fall, and malnutrition was decreased. These findings indicated that community-based the intensive health care program is effective for relieving geriatric syndrome of the community dwelling elderly.

• Journal of the Korean Data and Information Science Society
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• v.26 no.3
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• pp.715-727
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• 2015

This study was conducted to explore the impact of nursing staffing on inpatient nursing outcomes in long term care hospitals. A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals. Patients per RN was a significant indicator of foley catheter ratio in high risk group and low risk group. Patients per RN&NA was a significant indicator of decline in ADL for patients with dementia, non dementia, urinary incontinence and new pressure ulcer development in the high risk group. The average nursing outcome of inpatient in high grade was higher than that low grade in long care hospital. This higher level of nursing staffing and the higher the grade shown a positive effect on the nursing outcomes of the inpatient. We therefore recommend modifying the above nurse staffing policy so as to make it more effective in improving nursing outcomes.

• Child Health Nursing Research
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• v.9 no.3
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• pp.285-293
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• 2003

Purpose: This study was conducted to identify behavioral items for Korean infants under 24months by naturalistic observation. These items will be the basis for developmental scale for Korean infants. Method: Data were collected by observing and interviewing fifty one infants and their mothers during the period from November 15 to December 14, 2003. Raw data in descriptive form were obtained by unstructured naturalistic observation, and were reformed to behavioral items through discussion with professors in pediatric nursing and experienced nurses in child care department. Also, behavioral items were classified into five developmental areas. Result: Total number of behavioral items was two hundreds and thirty eight. 52 items for motor development, 66 items for personal-social, 40 items for hearing and speech, 41 items for eye-hand coordination, and 39 items for performance. Conclusion: This is meaningful that fundamental items for Korean developmental scale for infants were identified by observing behaviors of Korean infants. On the basis of these items, average age will be calculated for passing each item by testing Korean infants. We hope to develop Korean infant developmental scale as a final outcome in the future research.

• Journal of Korean Academy of Nursing Administration
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• v.17 no.3
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• pp.327-335
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• 2011

Purpose: The objective of this study was to analyze the effects of medical staffing level as bed-to-medical staff ratio on patient outcomes as length of stay (LOS) among hospitals in Korea. Methods: Two hundred and fifty one hospitals participated in the study between January and March 2008. Data for the study was requested by an electronic data interchange from the Health Insurance Review Agency in 2008. In data analysis, SPSS WIN 15.0 program was utilized for descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression. Results: The mean score for length of stay was 13.6 days. The mean of operating bed-to-nurse ratio was 7.93:1. The predicting factors for LOS were bed-to-nurse's aide ratio, bed-to doctor's ratio, severely ill patient rate, and hospital type. These factors explained 28.9% of the variance in patient outcomes. Conclusion: This study results indicate that the relationship between medical staffing level and patient outcomes is important in the improvement of the quality of patient care. Thus, improvements in the quality of the nurse practice environment could improve patient outcomes for hospitalized patients.

• Korean Medical Education Review
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• v.26 no.1
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• pp.41-47
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• 2024

The ultimate goal of career guidance is to help medical students develop a career plan that matches their personal characteristics, allows them to train in their desired subspecialty, and helps them to adapt well to medical practice after graduation. Gachon Medical School has designed a longitudinal career guidance program called GLORI (Gachon Longitudinal Orientation and Career Development), which is based on the outcome of each phase. The program consists of regular courses and portfolio-based career guidance from a mentor professor. In phase 2 (basic medical science), the "Career Seminar" course was developed. This course focuses on self-understanding through a psychological inventory, exploration of postgraduate career paths, and interviews with professors in specialties of interest. In phase 3 (the integration of basic and clinical science), the "Exploring Nonclinical Career Options" course was introduced. This course presents perspectives from doctors who have followed various pioneering career trajectories, including biomedical engineering, medical journalism, writing, public health, health care administration, the pharmaceutical and medical device industries, and other areas. All teaching methods were designed to encourage student participation. The assessment methods are assignment-based, including self-reflective reports and presentations. In addition, a portfolio-based career guidance program is implemented in phases 3 and 4 (clinical clerkship). It is expected that this case study will serve as a practical example for developing comprehensive career guidance programs for medical schools.

• Journal of Korean Medicine Rehabilitation
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• v.29 no.4
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• pp.89-100
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• 2019

Objectives We are going to analyze patient's medical and Korean medicine use trends after lumbar surgery, and examine the percentage of use of Korean medicine after surgery and its relevance to the medical care outcome after lumbar surgery. Methods Using 3% patients' sample data of the Health Insurance Review and Assessment Service, two groups were compared the treatment progress of the Korean Medicine treatment group and the untreated group after lumbar surgery by hierarchical logistic regression analysis. After hierarchical logistic regression analysis(including propensity scores), two groups were compared after lumbar surgery, the Korean Medicine treatment group within 50days and untreated group within 50days. Results Lumbar surgery was performed in 2750 patients in 2015. It was 3.72 that the risk(odds ratio) of finished treatment of patients treated without Korean Medicine, compared to patients with Korean Medicine. It was 0.12 that the risk of continuing treatment(odds ratio) of patients treated with Korean Medicine within 50 days, compared to patients treatment more than 50 days. Conclusions The ratio of Korean Medicine treatment after lumbar surgery was 14.8%. The group that did not have Korean Medicine showed a higher possibility of treatment termination than the group who did not. Among the groups treated with Korean Medicine, the early treatment group was more likely to end treatment than the late treatment group. Considering various situations in the medical environment, further studies such as prospective studies and long-term data analysis are considered to be necessary.

• Tuberculosis and Respiratory Diseases
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• v.83 no.4
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• pp.295-302
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• 2020

Background: Weaning failure is common in mechanically ventilated patients, and if ultrasound can predict weaning outcome remains controversial. The purpose of this study was to evaluate the diaphragmatic function (thickness and excursion) measured by ultrasound as a predictor of the extubation outcome. Methods: We included 62 mechanically ventilated patients from the chest intensive care unit in this study. Sixty-two patients who successfully passed the spontaneous breathing trial (SBT) were enrolled. The transthoracic ultrasound of the diaphragm was performed during an SBT to the assess diaphragmatic function (excursion and thickness), and they were classified into the successful extubation group and the failed extubation group. Results: There was a statistically significant increase in the successful extubation group in the diaphragmatic excursion and thickness fraction (p<0.001), a statistically significant negative correlation between the diaphragmatic function and the duration of the mechanical ventilation, and a statistically significant negative correlation between the diaphragmatic excursion and the Acute Physiology and Chronic Health Evaluation II. The diaphragmatic excursion cut-off value predictive of weaning was 1.25 cm, with a specificity of 82.1% and a sensitivity of 97.1% respectively, and the diaphragmatic thickness cut-off value predictive of weaning was 21.5%, with a specificity of 60.7% and a sensitivity of 91.2%, respectively. Conclusion: The diaphragmatic ultrasonography was found to be a promising tool for predicting the extubation outcome for mechanically ventilated patients.