• Title/Summary/Keyword: Hospital Management

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Small Bowel Intussusception in Children: Spontaneous Resolution vs. Surgical Intervention (소아에서 소장형 장중첩증; 자연 정복과 수술적 치료의 비교)

  • Park, Mi-Ran;Lim, Mi-Sun;Seo, Jeong-Kee;Ko, Jae-Sung;Chang, Ju-Young;Yang, Hye-Ran;Lim, Yoon-Joung;Kim, Woo-Sun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.2
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    • pp.128-133
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    • 2010
  • Purpose: Intussusception is one of the most common causes of an acute abdomen in infancy. The majority of pediatric cases of intussusception are of the ileocolic type and usually idiopathic. Small bowel intussusception is rarely diagnosed in children, and few cases have been reported. The purpose of this study was to determine the clinical features and causes of small bowel intussusception in children. Methods: We retrospectively reviewed the clinical and radiologic findings of 21 children with small bowel intussusception who were admitted to Seoul National University Children's Hospital between March 2005 and January 2010. Results: The clinical presentation of small bowel intussusception included abdominal pain or irritability (85%), vomiting (23%), fever (14%), bloody stools (14%), and abdominal masses (4%). Six patients required surgical management. Ultrasonography showed that the mean diameter of the lesions and mean thickness of the outer rims were 1.6${\pm}$0.7 and 1.7${\pm}$1.8 mm, respectively. Eleven lesions were located in the left abdominal or paraumbilical regions. Children who underwent surgical management were older than children with transient small bowel intussusception (mean age, 51 vs. 109 months). The mean diameter of the lesions and mean thickness of the outer rims were greater in the surgically-managed group. The location of intussusception was not significantly different between the two groups. Conclusion: Small bowel intussusception was spontaneously reduced in a large number of pediatric patients. However, sonographic demonstration of larger size, older age, and pathologic lead point warrant surgical intervention.

Analysis of characteristics affecting the score-groups by supervisor and subordinate rating (하향평가와 상향평가 결과에 영향을 미치는 특성 분석)

  • Shin Ki Soo;Cho Woo Hyun;Park Young Yo;Jung Sang Huyk;Lee Hye Jean
    • Health Policy and Management
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    • v.15 no.1
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    • pp.97-117
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    • 2005
  • This study was designed to compare the differences m results of supervisor and subordinate rating. Data was collected from personnel evaluation and subordinate rating results for middle managers(n=68) in hospital from 3rd January to 20th March in 2004. Supervisor rating consisted of performance, ability and attitude evaluation. Subordinate rating consisted of leadership, ability and attitude evaluation. Collected data included sociodemographic characteristics, work department, work level, years of work, years at present level and whether working in a patient serving department. The difference of standardized supervisor and subordinate rating score was used to define groups as 'higher in supervisor rating group'. Groups were defined in total score, ability score and attitude score. Main results were as follows: 1. In total score, sectional chiefs were apt to be 'higher in subordinate rating group' while chief clerks were apt to be 'similar group' or 'higher in supervisor rating group'. Staffs in patient serving department were likely to be 'higher in supervisor rating group' and staffs in non-patient serving department were likely to be 'higher in subordinate rating group'. All these results were statistically significant. 2. In ability score, there were no statistically significant differences in age, sex, years of education, work department, work level, years of work and whether working in a patient serving department among 'higher in supervisor rating group', 'similar group' and 'higher in subordinate rating group'. 3. In attitude score, staffs in the department of medical affairs and the department of administration were apt to be 'higher in subordinate rating group'. Staffs in the department of nursing were apt to be 'higher in supervisor rating group'. Staffs in a patient serving department were likely to be 'higher in supervisor rating group' and staffs in a non-patient serving department were likely to be 'higher in subordinate rating group'. All these results were statistically significant. 4. Logistic analysis about total score showed that sectional chiefs had higher Odds Ratio(OR) to be in 'higher in subordinate rating group'. Staffs in a non-patient serving department had higher OR to be in 'higher in subordinate rating group'. Both these results were statistically significant. 5. Logistic analysis about ability score showed that sectional chiefs had higher OR to be in 'higher in subordinate rating group'. Staffs in a non-patient serving department had higher OR to be in 'higher in subordinate rating group'. These results were not statistically significant. 6. Logistic analysis about total score showed that sectional chiefs had higher OR to be in 'higher in subordinate rating group', but the difference was not statistically significant. Staffs in a non-patient serving department had significantly higher OR to be in 'higher in subordinate rating group'. In conclusion, there is no clear superiority between supervisor and subordinate rating in personnel evaluation. It would be better to use a mixed model. It's also suggested to use an intervening rate of application or scores considering work levels and work department in personnel evaluation. These results would be helpful for hospitals planning a supervisor and subordinate rating system for personnel evaluation.

Evaluation of the Adequacy of Pain Management in the Admitted Cancer Patients (입원중인 암환자에 대한 통증관리의 적절성평가 - 한 3차 의료기관 내과 전공의를 대상으로 -)

  • Kim, Kuk-Hyoe;Jang, Won-Il;Joh, Yo-Han;Choi, In-Sil;Park, Sook-Ryun;Lee, Sang-Yoon;Kim, Jee-Hyun;Kim, Do-Yeun;Lee, Se-Hoon;Kim, Tae-You;Bang, Yung-Jue;Kim, Noe-Kyeong;Heo, Dae-Seog
    • Journal of Hospice and Palliative Care
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    • v.4 no.2
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    • pp.137-144
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    • 2001
  • Purpose : Pain is the most serious symptom that cancer patients experience. About $60{\sim}90%$ of advanced cancer patients and four million patients worldwide, according to the WHO statistics, are reported to suffer from cancer pain. Although about $70{\sim}80%$ of the pain could be controlled according to the pain control principles, to our regret, only $30{\sim}40%$ are managed appropriately. This research was aimed to (1) investigates the prevalence of pain among cancer patients, (2) compare patients' perception of pain with physician's recognition and (3) evaluate appropriateness of the doctor's prescription of analgesic. Materials and Methods : Patients with advanced or terminal cancers admitted at department of internal medicine of Seoul National University Hospital for at least 7 days were enrolled. A questionnaire for the patients and the physicians in charge were given and the answers were compared for each other. We also examined their medical records and the physician's orders. Results : Total 59 patients were enrolled. Among them, 43 patients answered the questionnaire, and 27 patients (62.8%) suffered hem cancer pain. The survey also showed that physicians underestimated the severity of pain, overlooked frequently analgesic prescription principle, and that as the patients' pain became severe, the less adequate was pain managements. Conclusion : For cancer patients, pain was frequently overlooked, and treatment still inadequate. Based on this evidence, it seemed that more active practice and education about evaluation and management of cancer pain are needed.

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Relations between the Emotional Labor and Depression Symptoms of Female Workers in Cosmetics Sales - With a focus on spiritual resilience - (화장품 판매직 여성근로자의 감정노동과 우울증상과의 관련성 -정신적 회복탄력성을 중심으로-)

  • Jung, Myung-Hee;Kim, Hyun-Joo
    • Journal of the Korean Applied Science and Technology
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    • v.35 no.1
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    • pp.1-11
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    • 2018
  • The purposes of this study were to examine the depression level of sales workers at a cosmetics company in South Korea and investigate the effects of emotional labor, job stress, and resilience on their depression symptoms. A structured questionnaire was distributed to 189 workers at the cosmetics company to assess their general characteristics, diseases diagnosed by the doctor, depression, emotional labor, job stress, and resilience. Univariate analysis and multiple logistic regression analysis was conducted to examine connections among depression symptoms, emotional labor, job stress, and resilience. The findings show that the depression symptom rate of the cosmetics sales workers was 32.3%. The multiple logistic regression analysis results of the high risk group in depression symptoms show that depression had significant relations with resilience(OR : 3.84, CI : 1.68-8.77), diseases diagnosed by the doctor(OR : 3.82, CI : 1.73-8.47), emotional disharmony(OR : 2.51, CI : 1.06-5.96), and job demand(OR : 2.12, CI : 0.93-4.85). The low risk group of emotional labor was corrected in age, doctor's diagnosis, and job stress with the reference value to analyze connections with depression symptoms according to the degree of resilience. The analysis results show that depression symptoms increased by 2.35 times(CI : 0.73-7.53) when they had high emotional labor and good resilience, by 3.74 times(CI : 1.17-11.97) when they had low emotional labor and bad resilience, and by 10.39 times(CI : 3.34-32.28) when they had high emotional labor and bad resilience. These findings raise a need to run a program to increase resilience, reduce emotional disharmony through emotional labor management, and take health management measures to control physical illness and lower job stress so that cosmetics sales workers can manage their depression symptoms.

The Rate of Diagnostic Agreement and Concordance Ratings on Psychiatric Recommendation in Consulted Delirious Cases (자문의뢰된 섬망환자에 대한 진단 일치율과 정신과 의견의 반영도)

  • Oh, Eung-Seok;Nam, Jung-Hyun;Kim, Seok-Hyeon;Park, Yong-Chon;Kim, Sung-Mok
    • Korean Journal of Psychosomatic Medicine
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    • v.9 no.2
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    • pp.174-181
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    • 2001
  • Objectives : The author investigated the rate of diagnostic agreement between consultants and consultees and concordance ratings on the consultees' recommendation to examine the interactive collaborativeness and find the factors that influence the reflectiveness on treatment. Methods : The subjects were 54 patients with delirium selected from 583 cases referred from other departments who were admitted to Hanyang University Kuri Hospital from July 1, 1995 to Dec. 31, 1997. The information on demographic data, diagnostic impression, symptoms, management before consultation, psychiatric recommendation, management after consultation, diagnoses at the referring departments and the psychiatric department on delirium was obtained by medical records and consultation papers retrospectively. The reflectiveness of the psychiatric recommendation was divided into complete concordance, partial concordance, and nonconcordance and among them the complete and partial concordance were considered for concordance. The reflectiveness was compared among all the departments and between medical unit and surgery unit. Results: The rate of diagnostic agreement on the cause of delirium was highest(85.7%) in organic brain syndrome and lowest in general medical condition(0%). There was no statistically significant differences between medical unit and surgery unit. Neither differences were there among all the departments. In comparing symptoms affecting the reflectiveness, it was 73.5% in impulsive and aggressive behavioral changes, whereas 40.0% in behavioral changes. Reflectiveness of psychiatric recommendation showed higher scores in the case of behavioral changes. The cases of sleep problem showed higher scores of reflectiveness. When these two symptoms of behavioral change and sleep problem were compared as one factor, the results suggested that there were significant differences. The cases with both two symptoms showed 80% in reflectiveness, and the cases with only one symptom or no symptoms showed 44.8% in reflectiveness. There were no statistical significances between concordance ratings and symptoms such as disturbance of consciousness, disorientation, and hallucination that cannot be easily evaluated at the referring departments. Conclusions : The rate of diagnostic agreement on the cause of delirium was highest in the case of organic brain syndrome in which lesions can be easily recognized. The factors that influence the reflectiveness of psychiatric recommendation were behavior changes and sleep disorders in the symptoms of evaluated cases.

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Improvement of Knowledge, Self-Efficacy and Self-Care Behaviors among Diabetic Patients participated in the Education Program of Sejong Center for Hypertension and Diabetes Management (당뇨병 환자 교육에 따른 지식, 자기효능감 및 자기관리행위의 변화: 세종특별자치시 고혈압·당뇨병 등록교육센터 등록자를 중심으로)

  • Jung, Jin-Gyu;Chung, Eun-Young;Kim, A-Ryeon;Park, Hyun-Jin;Kim, Yun-Jung;Ban, Young-Hwa;Kim, Jong-Sung;Yoon, Seok-Joon;Kim, Soon-Young;Ahn, Soon-Ki;Nam, Hae-Sung
    • Journal of agricultural medicine and community health
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    • v.42 no.4
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    • pp.234-243
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    • 2017
  • Objective: This study was aimed to evaluate the effectiveness of the diabetes education program implemented in a community hypertension and diabetes education center. Methods: Participants were thirty nine diabetic patients who received the education program in the center from May 2014 through May 2015. The education program consisted of two sessions for 2 days (45 minutes per session) regarding clinical information, nutrition and exercise for type 2 diabetes patients. Initially, they were assessed for general characteristics, knowledge on diabetes, self-efficacy and self-care behaviors. Reassessment was performed on their knowledge and self-efficacy directly after the program, and on self-care behaviors at 12 weeks after the program. Results: The mean score of diabetes knowledge was significantly increased from $5.27{\pm}2.10$ to $8.21{\pm}1.20$ (p<0.001) between before and after the program. The self-efficacy score was also significantly increased from $6.88{\pm}1.72$ to $8.16{\pm}1.47$ (p<0.001). The self-care behavior score was significantly increased from $3.59{\pm}1.89$ before the program to $4.35{\pm}1.29$ (p<0.001) at 12 weeks after the program. Conclusion: The diabetes education program may be effective on the improvement of knowledge, self-efficacy and self-care behaviors in type 2 diabetic patients.

Personality Type Test(MBTI) of the Korean Bruxism Patients (한국 이갈이 환자의 성격 유형 검사(MBTI))

  • Lee, Hyun-Ae;Auh, Q-Schick;Jung, Kee-Taig;Chun, Yang-Hyun;Hong, Jung-Pyo
    • Journal of Oral Medicine and Pain
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    • v.33 no.1
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    • pp.41-48
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    • 2008
  • The focus of this study is to analyze the effect of stress on the health of bruxism patients using the MBTI system. The most common personality type will be identified among the bruxism patients and by understanding their personality & their handling of stress, more comprehesive and effective treatment plan can be constructed. The study will also conclude that the type of personality has big effect on the cause of bruxism, and that this will be considered in the treatment plan in this hospital. The result of the study is as follow. First, more bruxism patients were type I than type E. It can be suggested that this result is due to the introversive people maintaining their energy how within themselves, and private are less to likely to release there stress than the expressive people. Second, among the bruxism patients significantly more type T were found compared to type F. This implies the bruxism tend to follow principals, scientific and analysing during decision making rather than basing their decision an meanings, emotions and influences. Thirdly, more bruxism patients clarified into ST in comparison to non-bruxism patients. This is thought to be due to probable increased stress and anxiety following ST people's tendency to more strict and realistic thinking according to effectiveness, evidence-based and productivity. Fourth, the type IJ was the most of the bruxism patients. We can come to the conclusion that decision-oriented introversion people who have hard to change, a thoroughgoing preparation characters are likely to grind their teeth by their detailed characters. Fifth, the type IT was the most of the bruxism patients. Bruxism patients are usually influenced by spirit, easily hearted, awed of relationship and attention. So, their intensity of stress is much bigger because of their personality. The last, Type IS was the most of the bruxism patients. It means that introvert sensitive types who have characters of calm, passive but defence to other's emotion, also neutral, keep moderation, and have cold-heartedness are likely to grind their teeth frequently. In conclusion it is evident that bruxism patients have particular personality types. Precisive, analysing and introversive bruxism patients are expected to have higher sensitivities to stress.

An Effect of Aquatic Exercise Program with Self-help Group Activites and Strategies for Promoting Self-efficacy on Pain, Physiological Parameters and Quality of Life in Patients having Rheumatoid Arthritis. (자조집단 활동과 자기효능성 증진법을 이용한 수중운동 프로그램이 류마티스 관절염 환자의 통증, 생리적 지수 및 삶의 질에 미치는 영향)

  • Kim, Jong-Im
    • Journal of muscle and joint health
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    • v.1 no.1
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    • pp.1-30
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    • 1994
  • Rheumatoid arthritis is a chronic systematic disease with unpredictable course of exacerbation and remission, characterized by pain, joint deformity and reduced activity by joint limitation. The growing public awareness of the need for health management of chronic illnesses, provides impetus for nursing to demonstrate social effectiveness by active nursing intervention in this vast area in general, and with rheumatoid condition in particular. However, nursing interventions to date have not demonstrated its active participation in the management of chronic conditions. Nursing intervention for the patients having rheumatoid arthritis is one such area that needs to be studied intensively and to demonstrate their effectiveness empirically. The purposes of this study were two fold : first, to develop a comprehensive program that was intensified with therapeutic joint exercises in water, self-help group activities and utilization of self-efficacy promoting strategies : and secondly, to determine the effect of aquatic exercise program on pain, physiological changes and quality of life in the rheumatoid arthritis patients. Thirty five female subjects participating in this study were selected from outpatients in the Rheumatism Center, Hanyang University hospital. The period of data collection was from December, 1992 to March, 1993 in seoul and Taejeon. Subjects in Taejeon were assigned to the experimental group. The comprehensive aquatic exercise program for the experimental group was carried out three times a week for 6 weeks in regular swimming pool. Subjects in Seoul did not participated in the program, and treated as the control group. Data were analyzed with repeated measure MANCOVA, t-test, ANCOVA, percentage of change, Kruskal-Wallis 1-Way ANOVA using SPSS $PC^+$ program. Results were obtained as follows : 1) Scores on Korean pain scale, Numeric pain score, and RAI score of the experimental group were significantly lower than those of the control group (t=2.11, p=0.022 ; F=4.40, p=0.044 : t=3.10, p=0.002). 2) There was significant improvement in the physiological parameters (higher joint movement parameters, F=15.64, p=0.024 ; higher lean body mass, percentage of change=+12.2, lower body weight, t=1.01, p=0.026 : lower ESR, t=1.69, p=0.001) in the experimental group compaired with subjects In the control group. 3) There was significant improvement in the specific self-efficacy score through the comprehensive aquatic exercise program(t=2.73, p=0.011), but not in the general self- efficacy score(t=0.62, p=0.113). 4) The quality of life failed to show significant improvement in the experimental group as compaired with the control group (F=3.69, p=0.064). 5) In the experimental group, findings from additional analysis showed no significant difference in the specific self-efficacy between those who continued to aquatic exercise after completing 6 week program and those who stopped (X2=0.086, p=0.690). Therefore, adherence to aquatic exercise program for 6 weeks seem to be affected mainly by self-help group activities. An indepth study to delve into articulation of mechanisms affecting the effect of aquatic exercise program be recommended. A further study is necessary to determine the difference in the effect of group and individual aquatic exercise program, to assess factors affecting adherence to exercise for an extended length of time.

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Availability of Oral Hygiene Devices for the Patients with Smoking in some Dental Clinics (일부 치과병원 흡연환자의 구강위생용품 이용도)

  • Jang, Kyeung-Ae;Seong, Mi-Gyung;Kang, Hyun-Kyung;Choi, Jung-Ok;Kim, Yoon-Sin
    • Journal of dental hygiene science
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    • v.8 no.1
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    • pp.7-12
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    • 2008
  • The purpose of this study is to improve the oral health after understanding the usage status of oral health items and to conduct active guidance for prohibition of smoking. The survey of 326 visitors for continuous oral health management in the dentist from April 2nd 2007 to May $20^{th}$ is accomplished. The data is handled from the SPSS 12.0 statistics program and we can get the results like below. 1. The number of people answering the usage of the smooth toothbrush is 64.5% which is higher in smoking peoples than in non-smoking ones (p < 0.001). Non-smoking people 61.4% answering '3 minutes more' per brushing their teeth is higher than smoking respondents. 2. The more used device is the interdental brush by non-smoking people 36.7% than smoking ones and the answer. 3. The percentage answering 'recommendation in the dentist' in the question about the motive using the oral health devices are nearly same in 69.6 % and 67.5% by non-smoking and smoking persons. The most reason not using these devices is 'don't know how to use this' and the number of smoking guys is 38.7% which is higher than that of non-smoking ones(p < 0.05). 4. The percentage of answering 'regular visiting the dentist', the method for oral health management is 28.3% in smoking parts and 35.3% in non-smoking ones which is slightly higher. From this study, the usage and the recognition of oral hygiene devices of the patient with smoking is a little bit lower than those of non-smoking patients and small difference is shown. So public relations of the effects and the necessity of the oral hygiene devices to all people have to be performed and the education and the activity prohibiting smoking are expanded by the dental hygienist based on the understanding of oral health when the patients are smoking or not.

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Nursing Professor's inspection and Status of Patient's Records and Informed Consent for Clinical Practice of Nursing Student in Korea and Japan (한·일 간호대학생의 임상실습 시 환자의 설명동의 및 기록관리와 지도실태)

  • Cho, Yooh-Yang;Kim, In-Hong;Yamamoto, Fujie;Yamasaki, Fujiko
    • Journal of agricultural medicine and community health
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    • v.31 no.1
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    • pp.35-46
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    • 2006
  • Objectives: In recently. the management and protection on individual information in patient's medical & nursing records have been very important, and that need a guideline. The purpose of this study was to investigate the status of using the patient's nursing records of nursing students in clinical practice, to find and discuss the patient's informed consent, and status of education and management concerned to patient's nursing records. Methods: This study used a mailing survey. data collected from September 24th to October 31th in 2002. The subject were 333 professors who are major in adult nursing, pediatric nursing, psychological nursing of 111 university of nursing department and nursing college. And then we received the survey mail from 103 professors that respondent rate was 30.9%. Results: The characteristics of study subjects showed 49.0% of university. 51.0% of college of nursing. 50.0% of the subjects practiced point the patient by oral approval in clinical practice. But when the decision of the patient was very difficult, 21.6% of the subjects take to informed consent from his or her families. During the clinical practice, 49.0% of the subjects were explain to patient about clinical practice and contents of the nursing student, only 7.8% of the subjects were explain to patient with nursing records. 52.0% of the subjects were took out records from the hospital, only 17.6% of the subjects had standard of the patient's informed consent and standard of handling practice records. 17.6%-92.2% of the subjects that educate and manage concern to patient's nursing records.

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