This study was to assess the effects of a recovery oriented integrated rehabilitation program on cognitive social function, rehabilitation motivation, and mental health recovery. This program is involved motivation enhancement program with 4 subprograms composed of cognitive rehabilitation, emotion management, vocational rehabilitation, family education program. The subjects were 34 patirents with schizophrenia who had been hospitalized at National Mental Hospital on local area. The study was a non-equivalent control group non-synchronized design with two groups, an experimental group(18 patients) and a control group(16 patients). The collected data were analyzed using SPSS 12. 0. The results of the data show that there was not a significant increase in the symptom, cognitive and social function. But there was a significant increase in readiness of rehabilitation(maintenance, p=.027) and mental health recovery (p=.039). Short term recovery oriented integrated rehabilitation programs in inpatient settings are more available for motivation of rehabilitation and mental health recovery than symptom reduction or functional improvement. Therefore there should be more efforts to create more recovery oriented service provision in clinical settings.
Kim, Woorim;Nam, Chung Mo;Lee, Sang Gyu;Park, Sohee;Kim, Tae Hyun;Park, Eun-Cheol
Health Policy and Management
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v.29
no.4
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pp.513-522
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2019
Background: South Korea operates a Medical Aid (MA) program targeting selected low-income individuals to ensure medical service delivery to the disadvantaged while enhancing self-sufficiency of work-capable beneficiaries. However, as reasons behind welfare exits are diverse and do not always infer poverty relief or the provision of appropriate levels of health care services, this study aimed to investigate the association between changes in MA status and health care utilization. Methods: This study used the 2006 to 2015 National Health Insurance claims data. The impact of changes in annual MA status on health care utilization (yearly number of outpatient visits, inpatient visits, length of stay, and emergency department [ED] visits) was investigated using the generalized estimating equation model. Results: In 117,943 adult subjects aged 20 to 64, compared to the 'MA to MA' group, the 'MA to MA exit' group showed general decreases in utilization (outpatient visits: β=-3.93, p<0.0001; hospital admissions: relative risk [RR], 0.87; 95% confidence interval [CI], 0.83-0.91; length of stay: β=-3.64, p<0.0001; ED visits: RR, 0.83; 95% CI, 0.77-0.90). Similar patterns were found in the 'MA exit to MA exit' group (outpatient visits: β=-5.72, p<0.0001; admissions: RR, 0.91; 95% CI, 0.87-0.94; length of stay: β=-5.87; p<0.0001; ED visits: RR, 0.81; 95% CI, 0.75-0.88). Likewise, in 74,747 older adult subjects aged 65 or above, the 'MA to MA exit' group showed reduced levels of utilization (outpatient visits: β=-1.51; p=0.0020), as well as the 'MA exit to MA exit' group (admissions: RR, 0.92; 95% CI, 0.89-0.95; length of stay: β, -5.45; p<0.0001; ED visits: RR, 0.90; 95% CI, 0.83-0.97). Conclusion: MA exit was associated with general decreases in health care utilization. Utilization patterns of individuals with experiences of receiving MA benefits should be monitored to promote the ideal use of health care services while preventing potential financial barriers present in accessing medical care.
Purpose: The Assessing Care Of Vulnerable Elders project has developed indicators for the quality of the end-of-life (EOL) care. However, family members of cancer patients may have a different view on the quality indicators (QIs) established by health care experts. We evaluated the QIs from the family members' perspective. Methods: The information used in this study was gathered by surveying family members of cancer patients who were admitted to the inpatient hospice ward in Korea. A cross-sectional anonymous questionnaire was distributed to 120 potential respondents from July to October 2009. We included 69 responses in this study (effective response rate, 57.5%). Statistical analysis was performed by using SPSS for Win ver. 14.0, with independent t-test and Pearson's chi-square test. Results: Among QIs for good hospice care, families agreed the most on "Medical examination by the palliative care team or specialist" (88.4%) and "Dying in the family's presence" (88.4%). They agreed the least on "Discussing cardiopulmonary resuscitation with patients" (15.9%). Among QIs for bad hospice care, "Occurrence of fall or pressure ulcer are undesirable" showed the highest agreement rate (94.2%). The lowest agreement rate was 11.6% on "Dying in the hospital is undesirable." In addition, women, patients who were aware of their prognoses, and people with a high socioeconomic status tended to agree more on the QIs. Conclusion: Patients' families did not agree on some of the QIs recommended by previous studies. Family members' characteristics were related to their opinions on QIs.
The purpose of this study was to explore the influence of credibility of health information (CHI) source and e health literacy (eHL) on health information orientation (HIO) of parents of hospitalized children. Convenience sampling method of 109 parent whose children were admitted in a children's hospital in D city was used. The hierarchial regression model with general characteristics and characteristics of children for step 1 and eHL and CHI for step 2 against HIO was statistically significant (F=8.22, p<.001). And this model could explain 40% of HIO ($R^2$=.40). Especially, eHL (${\beta}$=.54, p<.001) and CHI (${\beta}$=.21, p=.008), subjective health perception (${\beta}$=.19, p=.016), and age (${\beta}$=-0.15, p=.048) were identified the influencing factors on HIO. Based on these findings, to foster the HIO of parents of inpatient children, credible health information should be given to these population and a approach with eHL enhancement should be considered. And further research that is to explore the way to enhance the eHL should be carried out to suggest the practical application
This research was designed to compare the health condition and the quality of life of the elderly inpatients with those of the normal elderly people. The subjects of study were 482 elderly inpatients and 304 normal elderly people. The research was conducted in July and August using the instrument WHOQOL. The results of the research are as follows: For the level of health, it was recognized that male was healthier than female, having higher the education, living in the city rather than in the rural, keeping the normal life than being in the hospital. There were little difference in the past medical histories of the elderly inpatients and the normal elderly people. As to the diseases currently under the treatment, there were some difference between the elderly inpatients and the normal elderly people but the tendency was similar in the kinds and the frequencies. As to the recognition for the quality of life between the elderly inpatients and the normal elderly people based on the records reflected on each of the domains of WHOQOL, the normal elderly people more positively recognized in the overall quality of life and the following domains: physical, psychological, level of independence, and spirituality/religion/personal beliefs. The normal elderly people more positively recognized especially in the level of independence domain (mobility, activities of daily living, dependence on medication or treatments, working capacity). In the social relationships domain only the sexual activity was significant and the normal elderly people more positively recognized. The elderly inpatients showed the correlation of over 0.5 in the overall quality of life and the following domains: environment, social relationships, physical, psychological, level of independence. It was over 0.6 in the physical domain and the domains of psychological and level of independence. and the psychological domains of level of independence and social relationships. For the points of overall quality of life, it had no correlation with hospitalization but the health condition, residential district, occupation, and taste exerted a significant effect. As a result of separate analyses of the elderly inpatients and the normal elderly people, the health condition and the age only were the common variable which would exercise a significant effect. Besides, the primary factors which would exercise the quality of life were the occupation and taste for the elderly inpatients, and the residential district and source of income for the normal elderly people. In conclusion, it is first and foremost important to improve the standard of health for the overall quality of life for the elderly people, regardless of hospitalization. Therefore, a plan must be urgently drawn up for revitalization of the health promoting projects for the elderly people and the public health projects for the elderly people, and the investment must be increased for settlement of health problems of the elderly people.
Purpose: The Hospice Oriented Medical Record (HOMR) was developed for assessing the pain and symptoms of terminal cancer patients. Methods and Results: The HOMR consists of an instruction for users and 2 assessment pages which include the graph showing vital signs (temperature, blood pressure, pulse, respiration rate and pain score), current problem lists, performance status, laboratory data, pain characteristics and management, sedation score, associated symptoms and drug side effects, etc. Pilot study was performed in the inpatient Hospice Care Unit in Guro Hospital, Korea University Medical Center. Because an one-week progress data was recorded in HOMR as a flow sheet, the patient's condition and pain control status could be seen at a glance. Conclusion: The HOMR is useful for assessing the terminal cancer patients because it is simple and convenient to use. Further research is needed before it can be universally used in the clinical settings.
This paper is to establish a basis for a dose reduction strategy by confirming correlations with the factors that may affect the radiation dose based on the dose records in low-dose chest CT and abdominal non-contrast CT. In order to find out the causes of unnecessary exposure, the correlation between seven factors (age, gender, height, weight, BMI, patient status [inpatient and outpatient], and use of dose modulation) and CT dose were identified. Logistic regression was used as the statistical analysis for correlation verification. In the low dose chest CT, as the higher values of height and BMI and dose modulation off were associated with lowering the risk exceeding Diagnostic Reference Levels(DRL) (odds ration<1, p<0.05). However, as woman compared to man and the higher values of weight were associated with highering the risk exceeding DRL (odds ration>1, p<0.05). In the abdomen CT, as dose modulation off were associated with lowering the risk exceeding DRL (odds ration<1, p<0.05). Therefore It is necessary to conduct research on the relationship between various factors affecting radiation exposure and patient radiation dose for reducing the dose.
Journal of the Korea Academia-Industrial cooperation Society
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v.20
no.2
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pp.228-234
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2019
This study was conducted to evaluate the usability of serious-game apps for robots that are being developed for hospitals to add familiarity to hospital life for hospitalized patients. We conducted a usability test of 10 experts and 12 elementary school students with inpatient experience. The usability evaluation of the developed apps was based on the professional (MARS) evaluation tool and the user (uMARS) evaluation tool. The results of the usability test of the serious game robot app were $3.67{\pm}0.342$ for professionals and $3.68{\pm}0.592$ for children. The expert group obtained the highest score in the aesthetics category, and the user group obtained the highest score in the functionality category. In the subjective comments, the experts pointed out the game layout and the consistency of the style. According to the children, the methods were easy to learn, and the screen movement was mainly described. Both groups received low ratings in terms of engagement through participation. This study will provide useful reference material when the functional game app is actually installed in the robot and the usability test is conducted again after the results obtained in this study are considered.
Journal of the Korea Academia-Industrial cooperation Society
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v.20
no.7
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pp.272-280
/
2019
This descriptive research study investigated the relationships between different degrees of family support, ego-resilience and employment volition of patients suffering from alcohol use disorder, and we identified the factors that had an influence on employment volition. This study used the survey research technique and structured questionnaires. The data was collected from 128 males (aged 20 years or older) and who had been diagnosed with alcohol use disorder. They had also undergone either inpatient hospital care or outpatient treatment. The data was analyzed using descriptive statistics, one-way ANOVA, Pearson's correlation coefficient and multiple regression analysis. The results of the study showed that family support had a value of 4.30, an ego resilience had a value of 2.37 and the employment volition had a value of 4.06. The results of the multiple regression analysis showed that there was statistically significant positive correlation between employment volition and ego resilience (${\beta}=-.314$, p<.01) and age (${\beta}=-.253$, p<.01), and the total explanatory power of these 2 factors was 16.3%. According to the results of this study, age-based approaches are needed to improve the employment volition of patients with alcohol use disorder. Additionally, the results of this study suggest that an ego resilience enhancement program be developed and implemented to help these patients.
Journal of the Korea Academia-Industrial cooperation Society
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v.22
no.2
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pp.539-547
/
2021
This study was conducted to identify the effects of knowledge of Advance Directives (AD) and the patient's perception of a peaceful death on their attitude toward the withdrawal of life-sustaining treatment and to provide basic data for the development of a nursing intervention program for activating self-determination in the withdrawal of life-sustaining support of patients. The subjects were 167 adult cancer patients who received outpatient or inpatient treatment, from September 15, 2019, to March 30, 2020. The data was analyzed by mean, standard deviation, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression by using SPSS 21.0. From the results, it was observed that the knowledge of AD was 8.87±2.46 out of 12, perception of a peaceful death was 2.87±0.42 out of 4, and attitude toward withdrawal of life-sustaining treatment was 3.46±0.49 out of 5. There was a positive correlation between knowledge of AD, perception of a peaceful death, and their attitude toward withdrawal of life-sustaining treatment. The influencing variables were the knowledge of AD, perception of a peaceful death, discussion with family on withdrawal of life-sustaining treatment, and explanation power was 16.0% (F=10.355, p<.001). Therefore, it is necessary to develop a program that would improve the perception of a peaceful death, increase the knowledge of AD to improve the patients' attitude toward the withdrawal of life-sustaining treatment. An intervention to assist a discussion between the patients and their families in advance would also be useful.
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