• Title/Summary/Keyword: Health recognition

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Predictability of Impending Events for Death within 48 Hours in Terminal Cancer Patients (말기암환자에서 임박사건 간 48시간 임종예측도 비교)

  • Hwang, In-Cheol;Choi, Chung-Hyun;Kim, Kyoung-Kon;Lee, Kyoung-Shik;Suh, Heuy-Sun;Shim, Jae-Yong
    • Journal of Hospice and Palliative Care
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    • v.14 no.1
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    • pp.28-33
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    • 2011
  • Purpose: Recognition of impending death is crucial not only for efficient communication with the caregiver of the patient, but also determination of the time to refer to a separate room. Current studies simply list the events 'that have already occurred' around 48 hours before the death. This study is to analyze the predictability of each event by comparing the time length from 'change' to death. Methods: Subjects included 160 patients who passed away in a palliative care unit in Incheon. The analysis was limited to 80 patients who had medical records for the last week of their lives. We determined 9 symptoms and 8 signs, and established the standard of 'significant change' of each event before death. Results: The most common symptom was increased sleeping (53.8%) and the most common sign was decreased blood pressure (BP) (87.5%). The mean time to death within 48 hours was 46.8% in the case of resting dyspnea, 13.6% in the ease of low oxygen saturation, and 36.9% in the case of decreased BP. The symptom(s) which had the highest positive predictive value (PV) for death within 48 hours was shown to be resting dyspnea (83%), whereas the combination of resting dyspnea and confusion/delirium (65%) had the highest negative PV. As for the most common signs before death within 48 hours, the positive PVs were more than 95%, and the negative PV was the highest when decreased BP and low oxygen saturation were combined. The difference in survival patterns between symptoms and signs was significant. Conclusion: The most reliable symptoms to predict the impending death are resting dyspnea and confusion/delirium, and decline of oxygen saturation and BP are the reliable signs to predict the event.

Occupational Stress of Hospital Workers (병원종사자의 직업성 스트레스에 관한 연구 - 서울시내 500병상 이상 병원종사자를 중심으로 -)

  • Lee, Woo-Cheon
    • Korea Journal of Hospital Management
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    • v.3 no.1
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    • pp.1-33
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    • 1998
  • The purpose of this thesis is to study theoretical access to the methods that have been used for the research of occupational stress, thereby providing management methods of occupational stress of hospital workers. With a stress model of hospital workers set up from the viewpoint of organization management, 929 sets of questionnaires were collected from intern doctors, resident doctors, nurses, nursing aides, pharmacists, medical technicians, workers in patient affairs(reception and medical insurance workers), administrators and clerks from the 8 hospitals in Seoul with more than 500 beds. Upon variance analysis, correlation analysis and regression analysis of the collected questionnaires, this work examined how differences in stress caused by specific occupations and formulated a method of stress management for the hospital workers. The results are as follows. 1) If some duties of the nurses suffering from role-overloaded stress are transferred to the nursing aides dissatisfied with insufficient role, the two grunting groups can be satisfied at the same time. It is also necessary to transfer some jobs of the overloaded workers in patient affairs to the administrators, or the other way around. To reduce stress of conflict and ambiguity of role caused by the obscure division of roles between the workers, the role of each occupation should be delineated and the clear division of roles should be translated into action strictly according to that delineated. 2) Stress of inefficiency of organization from which the student doctors suffer can be relieved by management of participation. If they have access to the process of decision-making in general hospital affairs and consequently their understanding and the autonomy of job performance are promoted, such stress will be reduced. 3) To cope with stress of career development from which nurses, medical technicians, administrators, workers in patient affairs suffer, it is necessary to establish whether they have a chance to revive their careers, whether there are any ways of remotivation for less contributive workers, and whether they encourage each other to develope their careers. If they are given a chance to develope their careers, such stress will be relieved. 4) Pharmacists, suffering from stresses of living and personal relations, have strong cohesive power among themselves and organize a well-integrated team; thereby reducing the stress of personal relations and increasing productivity. 5) For administrators and student doctors confined to lesser social supports and for nurses and workers in patient affairs whose recognition of stress and job satisfaction are affected by social supports, emotional and informational supports for job performance help alleviate an individual's mental, and physical stress. 6) In addition to the above-mentioned stress-management methods, if an organizational coping strategy is provided according to the types of stress from the general viewpoint of the whole group of hospital workers, it would be of great help to managing stress. For example, the redesign of jobs, the management of objective, the improvement of working environment, the formation of an autonomous working group and various working plans can be set up for those who suffer from stress related to inappropriate role, while career counseling and development of career process can be provided for those dissatisfied with career development. Participation in the process of decision-making and the restructuring of the organization are needed for those who suffer from stress of malfunctioning organization, whereas creation of a supportive organizational atmosphere is desired for those who feel stressed due to personal relations. As well, such organizational coping strategies. as the increase of welfare facilities, seminars and educational programs and provision of health-promotion facilities can be provided.

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The Critical Factors on Improvement of Medical institution Competitiveness (의료기관 경쟁력 향상에 영향을 미치는 핵심 요인)

  • Yeom, Jae-Kwang;Kang, Chang-Yeol
    • Korea Journal of Hospital Management
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    • v.12 no.1
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    • pp.1-30
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    • 2007
  • The study carried out a survey with employees of hospitals located in Daejeon, Chungnam, and Chungbuk from Sep. 12 to Sep. 30, 2005 in order to derive primary elements that affect the improvement of hospital's competitiveness. The study investigated and analyzed the employees' recognition on the change of competitive environment caused by the change of medical environment. The study also analyzed the elements that affect the hospital's competitiveness and the competitive strategies of the hospitals. The conclusion of this study can be summarized as follows. 1. Summary 1) Most of the employees responded that there is a rival in the competitive environment and the competitive is intense. Especially when the employees are married, live in urban areas, have an education level of university graduate or are managers, they tend to think the competitive is very intense. Also, they said that the competitive is based upon the quality of medical service. They mentioned the element that has the biggest effect on the competitiveness is the element of medical consumer and they recognized that the medical services in university and general hospitals have more competitiveness than the one-department hospitals. 2) It was investigated that the medical technique service has the most effect on the hospital's competitiveness. Also, the external service of medical techniques also has a large effect on the hospital's competitiveness. 3) When they were asked for the factors that affect the patients' decision on selecting a hospital, most of them responded "capability and technique of the medical staffs." Also, they said that "sufficient explanation from doctors" and "special center and clinic" are the factors that have big effects on the patients' decision. 4) In the SWOT analysis, most of them responded that the strength is the hospital's characteristics and the weakness is insufficient and obsolete equipment. They said the opportunity is the demands for professional medical service and the risk is the intense competitive among the hospitals. 5) In the SWOT strategy, they emphasized the strategy that uses the opportunity and the strength and the strategy that uses the opportunity while overcoming the weakness. 6) As for the basic competition strategy, most of them thought of the strategy of professionalizing the medical service most importantly. Next, they focused on the strategy of distinct service and the strategy of lower prime cost. 2. Conclusion 1) Because service competition between hospitals is happening seriously, need competitiveness security through right awareness transfer and satisfaction upgrade about medical consumer. 2) For medical technique service upgrade that equip Hospital's competitiveness but affects most, must solidify the countermeasure because professionalizing the medical service and newest medical technique induction should be achieved first, and compose task force for the external service of medical techniques improvement. 3) To improve SWOT of hospital, opportunity and the strength strategy choice that rescue hospital's characteristics heightening professionalizing the medical service level is fancied. 4) As for the basic competition strategy, will have to try in phase triangular position of hospital which is trusted medical level upgrade and excellent manpower security and finance independence through upgrade. The study was only done with hospitals in Daejeon, Chungnam and Chungbuk. Also, it is a study from the side of suppliers of medical service so there are limitations. However, the significance of the study is to present the basic data for improvement of hospital's competitiveness by examining the importance of medical techniques and external service of medical techniques that are the main effects on the improvement of hospital's competitiveness.

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A Study of the Department of Dental Hygiene and Dental Laboratory Technology Student's Demand for the Credit Bank System (학점은행제(치위생과, 치기공과)를 이용한 학사학위 취득에 관한 요구도 조사)

  • Yu, Ji-Su
    • Journal of dental hygiene science
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    • v.7 no.3
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    • pp.153-159
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    • 2007
  • To investigate requirements for the process of credit bank system in life-long education institutions attached to colleges, this research was conducted with seniors at the departments of dental hygiene and dental laboratory technology, in the health line of the specific College from March 26 to April 15, 2007, followed by analysis using an SPSS/WIN 12.0 program, obtaining the following results. 1. 89.7% of the respondents had a plan to take a bachelor's degree and 56.1% of whom had such a plan for the purpose of personal development (p<0.05). 2. 73.5% of the respondents preferred the credit bank system in a lifelong education institution attached to a college to take a bachelor's degree. 3. 34.8% presented the greatest advantage of taking a bachelor's degree through the credit bank system that they could take a degree in a short period of time while 33.8% presented the most serious disadvantage that they might low social recognition. 4. As for requirements for the process of operating the credit bank system, 80.3% regarded required subjects for the major as appropriate basic ones. 79.9% regarded it as proper that filling more than 20 credits made it possible to take a degree. 5. As directions for improving the system, it was found that the students was thinking that strict academic record management is needed, and the degrees from the system must be recognized equally to those in regular colleges, social awareness in those degrees should be enhanced, and also credits assigned to cultural subjects should be reduced, and the limitation in the number of credits being able to be obtained in one center should be removed.

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A Study on the Environmental Condition and Safety in Dental Radiography Room (치과방사선 촬영실의 환경 및 안전성에 관한 연구)

  • Park, Il-Soon;Lee, Kyung-Hee
    • Journal of Korean society of Dental Hygiene
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    • v.4 no.1
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    • pp.49-64
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    • 2004
  • This study is designed to conduct a questionnaire research into the safety control and the actual condition of radiography by working with dentistry belonging to university hospitals, dental hospitals and dental clinics for three months ranging from August, 2003 to October, 2003. The researcher came to the following conclusions. 1. The research on the current condition of possessed radiational equipment shows that 61.2 percent of the subjects had one intraoral radiation medicine and that 70.1 percent of the subjects had more than one extraoral radiation medicine and that 37.3 percent of the subjects had more than one digital radiation medicine. 2. Most of intraoral radiography (82.1%) was conducted by dental hygienists, and 7.5 percent of intraoral radiography was conducted by nurse aids. On the other hand, most of extraoral radiography (76.6%) was conducted by dental hygienists and digital radiography was conducted by dental hygienists(60.6%), dentists(32.0%) and radiographer(80.0%). 3. The less-than 1-meter-long distance between cone and the radiographer accounted for 44.8 percent. And the more-than 1.6-meter-long distance accounted for no more than 13.4 percent. The exposure time per standard film which was adjusted to each part accounted for 71.6 percent. Fixing the film on the part of healthy patients accounted for 76.1 percent. Fixing the film of elderly patients and children patients by the radiographer accounted for 43.3 percent. 4. The average daily photographing frequency of standard films stood at six to ten pieces(31.3%), and the average weekly photographing frequency of bitewing films stood at less than one piece(47.8%), and the dentistries where bitewing films were not employed accounted for 25.4%. The subjects whose average weekly photographing freqeuncy of occlusal films stood at less than a piece accounted for 59.7 percent. The dentistries whose average weekly photographing frequency of pediatric films stood at one to five pieces accounted for 41.8 percent. In case of panorama & cephalo, one to five pieces on a weekly average accounted for 36.2 percent. The dentistries whose average daily photographing frequency of digital radiation medicine stood at less than 1 piece accounted for 40.0 percent. 5. The research on the use of protective clothes shows that pregnant ·women only accounted for 31.3 percent. In regard to the use of protective clothes in case of the radiographers fixing films, the cases where no protective clothes were employed accounted for 88.1 percent. The reason was said to he attributable to the trouble related to wearing the clothes(54.2%). 6. The survey on the measurement of exposure dose shows that the cases where no measurement was made accounted for 76.1 percent. As far as the measurement methods of exposure dose was concerned, the employment of film badge accounted for 68.8 percent. The subjects turned out to conduct measurement of exposure dose every third month, which accounted for 43.8 percent. The barriers to the measurement of measurement of exposure dose were attributable to the recognition that a little amount of exposure dose need not be measured(29.9%). 7. The survey on the distinction of radiation rooms and clinic rooms reveals that the cases where radiation rooms exclusively existed accounted for 67.2 percent. 43.3 percent of the subjects turned out to have only one protective garment, and 49.3 percent of the subjects proved to conduct a periodical checkup of radiational equipment. The survey on the examination certificates of radiational generators and protective facilities indicates that 80.6 percent of the subjects had the certificates. The research also shows that the subjects with the marks indicating the radiational areas accounted for 70.1 percent. And trustees turned out to handle developing solutions and fixing solutions.

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Survey on Notion of Department of Ophthalmic Optics Students (안경광학과 학생들의 의식조사)

  • Kim, Hye-Dong
    • Journal of Korean Ophthalmic Optics Society
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    • v.13 no.3
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    • pp.13-17
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    • 2008
  • Purpose: The aim of the study is to provide for prospects of Department of Ophthalmic Optics. Methods: This study surveyed on notion in sunder of the frist grade 100 people, second grade 100 people, third grade 100 people in the third educational system of Department of Ophthalmic Optics. Results: 1. Recognition of beforehand information for Department of Ophthalmic Optic were investigated the highest rate at frist grade 40 people(40%) by ordinary, at second grade 42 people(42%) by ordinary and at third grade 34 people(34%) by low. 2. Goodness of fit of register for a course and content for Department of Ophthalmic Optic were investigated the highest rate at frist grade 54 people(54%) by ordinary, at second grade 51 people(51%) and at third grade 47 people(47%) by suitableness. 3. Satisfaction of choice for Department of Ophthalmic Optics were investigated the highest rate at frist grade 43 people(43%) by high, at second grade 45 people(45%) by ordinary and at third grade 41 people(41%) by high. 4. Consideration of instruction for Department of Ophthalmic Optic were investigated the highest rate at frist grade 55 people(55%), at second grade 60 people(60%) and at third grade 49 people (49%) by good. 5. Relationship of friend in Department of Ophthalmic Optics were investigated the highest rate at frist grade 40 people(40%), at second grade 50 people(50%) and at third grade 51 people(51%) by good. 6. Relationship a senior-younger men in Department of Ophthalmic Optics were investigated the highest rate at frist grade 47 people(47%), at second grade 50 people(50%) and at third grade 41 people(41%) by ordinary. 7. Prospects of future for Department Ophthalmic Optics were investigated the highest rate at frist grade 47 people (47%), at second grade 50 people(50%) and at third grade 45 people(45%) by ordinary. 8. Affairs after graduation of Department of Ophthalmic Optics were investigated the highest rate at frist grade 60 people(60%), at second grade 68 people(68%) and at third grade 66 people(66%) by optical shop. Conclusions: Satisfaction of choice for Department and Prospects of future for Department were investigated to be good as a whole.

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Principal component analysis in C[11]-PIB imaging (주성분분석을 이용한 C[11]-PIB imaging 영상분석)

  • Kim, Nambeom;Shin, Gwi Soon;Ahn, Sung Min
    • The Korean Journal of Nuclear Medicine Technology
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    • v.19 no.1
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    • pp.12-16
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    • 2015
  • Purpose Principal component analysis (PCA) is a method often used in the neuroimagre analysis as a multivariate analysis technique for describing the structure of high dimensional correlation as the structure of lower dimensional space. PCA is a statistical procedure that uses an orthogonal transformation to convert a set of observations of correlated variables into a set of values of linearly independent variables called principal components. In this study, in order to investigate the usefulness of PCA in the brain PET image analysis, we tried to analyze C[11]-PIB PET image as a representative case. Materials and Methods Nineteen subjects were included in this study (normal = 9, AD/MCI = 10). For C[11]-PIB, PET scan were acquired for 20 min starting 40 min after intravenous injection of 9.6 MBq/kg C[11]-PIB. All emission recordings were acquired with the Biograph 6 Hi-Rez (Siemens-CTI, Knoxville, TN) in three-dimensional acquisition mode. Transmission map for attenuation-correction was acquired using the CT emission scans (130 kVp, 240 mA). Standardized uptake values (SUVs) of C[11]-PIB calculated from PET/CT. In normal subjects, 3T MRI T1-weighted images were obtained to create a C[11]-PIB template. Spatial normalization and smoothing were conducted as a pre-processing for PCA using SPM8 and PCA was conducted using Matlab2012b. Results Through the PCA, we obtained linearly uncorrelated independent principal component images. Principal component images obtained through the PCA can simplify the variation of whole C[11]-PIB images into several principal components including the variation of neocortex and white matter and the variation of deep brain structure such as pons. Conclusion PCA is useful to analyze and extract the main pattern of C[11]-PIB image. PCA, as a method of multivariate analysis, might be useful for pattern recognition of neuroimages such as FDG-PET or fMRI as well as C[11]-PIB image.

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A Study on the Necessity Verification of Convex Probe Disinfection (Convex Probe 소독 필요성 검증에 관한 연구)

  • Choi, Kwan-Yong;Yoo, Se-jong;Lee, Jun-ho;Hong, Sung-Yong
    • Journal of the Korean Society of Radiology
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    • v.13 no.2
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    • pp.193-200
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    • 2019
  • The study was conducted surveying ultrasound room workers on hospital infection awareness in Daejeon and Choong-chunng region. The contamination of ultrasonic probes used in clinical trials was measured using ATP, and the results were verified after using 70% alcohol sterilization. It was measured on the group's general characteristics and the specific categories such as academic background, job type, having professional certificate and infection education. After the examination, the gel removal and method, disinfection status of the probe and variable correlation analysis were performed to analyze the recognition of the ultrasonic probe disinfection. After examination in ultrasound room, it was found that towels were used the most for cleaning, and the gel container was not replaced for more than three months. After 70% alcohol disinfection, ATP contamination was reduced from $1055.4{\pm}944.2$ to $133.5{\pm}93.2$ and the result was analyzed to be statistically significant.(${\rho}<0.01$) The found bacteria were CNS, Gram positive bacillus, and Micrococcus specs. In order to solve this problem, 70% alcohol sterilization was applied and the bacteria were not detected after the treatment. The research shows that regular training on infection control and efforts to prevent infection are necessary, and that 70% alcohol is effective in disinfect the bacteria. Therefore, the medical institution should provide active hospital infection control education to improve the awareness of hospital infection among workers and contribute to the prevention of patient infection. It is also understood that proper use of the results of this study will help prevent infection by means of ultrasonic probes.

A Study on the Effect of Person-Job Fit and Organizational Justice Recognition on the Job Competency of Small and Medium Enterprises Workers (중소기업 종사자들의 직무 적합성과 조직 공정성 인식이 직무역량에 미치는 영향에 관한 연구)

  • Jung, Hwa;Ha, Kyu Soo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.14 no.3
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    • pp.73-84
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    • 2019
  • Despite decades of work experience, workers at small- and medium-sized enterprises(SME) here have yet to make inroads into the self-employed sector that utilizes the job competency they have accumulated at work after retirement. Unlike large companies, SME do not have a proper system for improving the long-term job competency of their employees as they focus on their immediate performance. It is necessary to analyse the independent variables affecting the job competency of employees of SME to derive practical implications for the personnel of SME. In the preceding studies, there are independent variable analyses that affect job competency in specialized industries, such as health care, public officials and IT, but the analysis of workers at SME is insufficient. This study set the person-job fit and organizational justice based on the prior studies of the independent variables that affect the job competency of SME general workers as a dependent variable. The sub-variables of each variable derived knowledge, skills, experience, and desire for person-job fit, and distribution, procedural and deployment justice for organizational justice, respectively. The survey of employees of SME in Korea was conducted from February to March 2019 by Likert 5 scales, and the survey was retrieved from 323 people and analyzed in a demonstration using the SPSS and AMOS statistics package. Among the four sub-independent variables of person-job fit, knowledge, skills and experience were shown to have a significant impact on the job competency, and desire was not shown to be so. Among the three sub-independent variables of organizational justice, deployment justice has a significant impact on job competency, but distribution and procedural justices have not. Personnel managers of SME need to improve the job competency of their employees by appropriately utilizing independent variables such as knowledge, skills, experience and deployment at each stage, including recruitment, deployment, and promotion. Future job competency modeling studies are needed to overcome the limitations of this study, which fails to objectively measure job competency.

A Study on the Problems of Eating Habits of Mordern People and Suggesting Alternatives to Overcome Diseases: A Review of the Five Blue Zones, Based on the Roma Linda Region in the USA (현대인의 식습관 문제점 인지와 발생 질병극복을 위한 대안 제시: 5대 블루존 중 미국 로마린다 지역을 중심으로)

  • Shin, Kyung-Ok;Je, Haejong
    • Journal of Korean Society of Neurocognitive Rehabilitation
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    • v.10 no.2
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    • pp.53-62
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    • 2018
  • The purpose of this study was to propose an alternative for the eating habits of modern people and coping with the diseases. The purpose of this study was to apply the principles of eating habits of people living in Roma Linda to modern dietary life and to help healthy life and prevent disease. The period of this study was from May 1, 2016 to February 28, 2018. Literature search was conducted using Pubmed and Korean academic web sites. Based on the recognition of wrong eating habits, we classify and classify diseases according to eating habits. A total of more than 100 papers were selected and 60 papers and a database were prepared. People living in Roma Linda have eight health principles. The Roma Linda practiced balanced nutritional intake, sufficient exercise, adequate water intake, sunlight, temperance (abstinence from alcohol etc.), fresh air, adequate rest, and trust in eating habits. People living in Roma Linda have a high intake of vegetables, fruits and nuts. People living in Roma Linda are educated about nutrition, and among them, there is a low prevalence of coronary heart disease and cancer, because they mostly do not smoke or drink alcohol. Unhealthy eating habits and dietary behavior are associated with many diseases. Many chronic, degenerative diseases are due to bad eating habits and stress. If you take good food habits of people living in the Roma Linda area and practice it steadily, it will have a great effect on disease prevention.