• Journal of Korean Biological Nursing Science
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• v.19 no.2
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• pp.86-97
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• 2017

Purpose: Postoperative nausea and vomiting (PONV) is very common among postoperative orthopedic surgical patients with patient-controlled analgesia (PCA), especially for narcotics. Therefore, the purpose of this study was to investigate the effects of an evidence-based PONV management protocol on nursing and patient outcomes. Methods: A methodological study was conducted to develop PONV protocol and a quasi-experimental study to evaluate the effectiveness of protocol. The preliminary PONV protocol was drawn by conducting a systematic review and by reviewing clinical guidelines and best practice recommendations. Validation of the content was done by expert clinicians, and the clinical applicability was evaluated by staff nurses and patients. The effect was evaluated in clinical outcomes associated with PONV and nursing outcomes. Results: In the experimental group, the occurrence of vomiting (z= 2.147) was significantly decreased, the maintenance PCA (${\chi}^2=4.212$) and the satisfaction of patients (z= 5.007) were significantly higher. In the outcomes of nurses, the PONV knowledge of nursing care (z = 3.791), awareness (z = 2.982) and self-efficacy (z= 2.745) were higher in the experimental group. The attitude towards evidence-based nursing practice (z= 2.446) was significantly positive. Conclusion: The results show that an evidence-based approach to the implementation of PONV care is effective in improving patient clinical outcomes and quality of care.

• Journal of Preventive Medicine and Public Health
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• v.34 no.1
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• pp.55-60
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• 2001

Objectives : The SERVQUAL scale is based on gap theory, which suggests the difference between consumers' expectations and the quality of the medical service actually received. However, problems in the implementation of the SERVQUAL scale have been identified by several researchers. Some researchers have proposed a simple performance-based measure (SERVPERF) or au exportation-controlled performance-based measure(Non-Diff) as alternatives to the SERVQUAL scale. On the basis of the theoretical concerns discussed, we examined the capability of each of the three scales(SERVQUAL, Non-Diff, SERVPERF) to explain variations in consumer satisfaction. Methods : Data was gathered from a self-administered questionnaire in a 430 bed hospital. Questionnaires evaluating medical services were distributed to 180 ambulatory patients. A total of 167 usable questionnaires were gathered. The questionnaire was composed of 10 expectation, performance and expectation-controlled performance items. In addition, overall satisfaction and purchase intention were measured. Results : Compared with the SERVQUAL scale, the Non-Diff and SERVPERF scales better explained the observed variations in consumer satisfaction(SERVOQUAL, $R^2=0.29;\;Non-Diff,\;R^2=0.51;\;SERVPERF,\;R^2=0.48$) and purchase intention(SERVQUAL, $R^2=0.22;\;Non-Diff,\;R^2=0.33;\;SERVPERF,\;R^2=0.34$). Conclusion : The maier conclusion from our study is that the Non-Diff and SERVPERF scales are more efficient in assessing consumer satisfaction than the SERVQUAL scale. Therefore we suggest that consumer satisfaction he measured by the Non-Diff or SEVPERF scales.

• The Transactions of The Korean Institute of Electrical Engineers
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• v.61 no.9
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• pp.1350-1357
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• 2012

Medical system for personal health management recently changes its paradigm from hospital service to self home care based on ubiquitous technology for healthcare anywhere at any time. The present study developed a wireless bio-signal measurement system for patients to self manage pulmonary disease and benign prostate hyperplasia(BPH), both of which are chronic diseases with increasing frequency in modern society. Velocity-type respiratory air flow transducer adapted to develop respiratory module for pulmonary disease management was simplified in structure to measure uni-directional flow since most important diagnostic parameters are evaluated on the expiratory flow signal only. Standard weight measurement technique was introduced to obtain urinary flow signal for BPH management. Three load cell signals were acquired for averaging to minimize noise, followed by accuracy evaluation. Transmission and receiver modules were also developed with user program for wireless communication. Averaged relative errors were 2.05 and 1.02% for respiratory volume and maximal flow rate, respectively, and the relative error was 2.17% for urinary volume, demonstrating that both modules enabled very accurate measurements. Wireless communication distance was verified within 15m, long enough for home care application. The present system allows the user to select a necessary measurement module on a particular health demand and to immediately provide the self-test results, thus better quality health care would be possible.

• Health Policy and Management
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• v.20 no.4
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• pp.19-44
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• 2010

This study was conducted to investigate the changes in patterns of Daegu- and Gyeongbuk-based patients' use of medical care facilities located in Seoul. The 'Patient Survey' data issued by the Ministry of Health and Welfare for 2002, 2005, and 2008 were used. Among all discharged patients residing in Daegu and Gyeongbuk, 133,456 who used medical facilities in Daegu, Gyeongbuk, and Seoul were selected. Among patients residing in Daegu, 2.2% used medical facilities in Seoul in 2002, 3.7% in 2005, and 3.5% in 2008. The corresponding rates among patients living in Gyeongbuk were 5.6%(2002), 7.1%(2005), and 7.3%(2008). Regarding the ICD-10 disease groups, the use of medical facilities in Seoul by patients residing in either Daegu or Gyeongbuk increased in 2005 right after the introduction of the KTX high-speed train service, covering various disease groups, but decreased again in 2008. 'Neoplasm' cases, however, showed a progressive rising trend during the years studied. Multivariate data analysis for the three years showed that sex, age, payment type, hospital type, residence, year, and disease groups were all significantly associated with the utilization of medical facilities in Seoul. The major results are : First, use of medical facilities in Seoul by Gyeongbuk patients was 2.4-fold higher than that by Daegu patients, but with respect to 2005 and 2008 vs. 2002, use of medical facilities in Seoul by Daegu resident patients' showed a larger increase than that by Gyeongbuk's patients. Second, for patients residing in the two regions, use of medical facilities in Seoul was highest for 'congenital malformations, deformations and chromosomal abnormalities', followed by 'neoplasms'. Third, for patients residing in the two regions, general hospitals comprise the primary factor in the use of medical facilities in Seoul. The study shows that local medical facilities should individually exert more efforts to improve the quality of their medical services. Relevant authorities should likewise help these facilities develop their own unique services and respective specialization.

• The Korean Journal of Emergency Medical Services
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• v.19 no.2
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• pp.7-17
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• 2015

Purpose: This study aimed to compare the effects of rescue ventilation maneuvers on the quality of two-rescuer cardiopulmonary resuscitation (CPR). Methods: We implemented mouth to mouth (MMV), mouth to pocket mask (MPV) and bag-valve mask ventilation (BMV) maneuvers. Each team of two-nurses was randomized to perform three consecutive sessions of two-rescuer CPR by using three artificial ventilation maneuvers. Results: The subjects were 26 teams of nurses (female: 96.2%, male: 3.8%, age: 26.6 years). Failed ventilation was more frequent in BMV ($2.23{\pm}2.21$, p <.001) than MMV ($0.31{\pm}0.74$) and MPV ($0.38{\pm}0.64$). BMV had more compressions per minute ($93.7{\pm}5.7$) than MMV ($87.0{\pm}7.2$, p = .001) and shorter total compression pause time ($46.1{\pm}5.8sec$) and compression pause fraction ($23.3{\pm}2.2%$) than MMV ($54.8{\pm}10.3sec$, p = .001, $25.5{\pm}3.5%$, p = .001, respectively) and MPV ($53.1{\pm}7.1sec$, p =. 006 and $25.8{\pm}2.6%$, p = .006, respectively). Conclusion: In our simulation study, BMV reduced the compression pause time and increased the number of compressions per minute, thus indicating CPR provided to patients was effective. However, considering the high rate of ventilation failure, we recommend periodic training.

• Health Policy and Management
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• v.31 no.1
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• pp.35-45
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• 2021

Background: As a descriptive study targeting 2,068 cancer patients as men of national merit in 2013, this study aims to provide the basic data for systematizing the early diagnosis and treatment of cancer by comparatively analyzing the 5-year survival rate. Methods: This study researched the survival of cancer patients through Electronic Medical Record and Patriots-Veterans Qualification Program, targeting 2,068 newly-diagnosed cancer patients verified in five veterans hospitals and consigned management system. This study verified differences between general characteristics of cancer patients as men of national merit and analyzed their survival rate. Results: The cancer patients as men of national merit were super-aged as their average age was 72.5. In the analysis of general characteristics of five major prevalent cancers, there were statistically significant differences according to age, region, cancer diagnostic path, differentiation, diagnostic method, treatment method, SEER stage, and survival period, except for the types of the man of national merit (p<0.001). The whole survival rate of cancer patients as men of national merit was 50%. The 5-year survival rates of predisposing cancers were shown as prostate cancer (79%), colorectal cancer (64%), gastric cancer (57%), liver cancer (32%), and lung cancer (12%). In the cancer diagnostic path, all the predisposing cancers showed the highest survival rate in medical examination. In the treatment method, the surgery showed the highest survival rate. The cancer patients as men of national merit showed a lower survival rate than the general cancer patients of Korea. Conclusion: It would be needed to guarantee the honorable and happy life through health recovery as special treatment of contribution and sacrifice of super-aged men of national merit by increasing the cancer survival rates through regular checkup, early diagnosis, and high-quality treatment system that could have important effects on the survival rate according to the occurrence of cancers.

• Research in Community and Public Health Nursing
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• v.32 no.4
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• pp.566-577
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• 2021

Purpose: This study aimed to determine the correlation between job performance difficulties and job satisfaction that novice health teachers experienced in a new school environment, and provide the basic data necessary for policy development. Methods: Data were collected from 196 novice health teachers without in-service training program for the qualification of 1st grade and with less than four years of work experience in Korea. The self-report questionnaire consisted of general characteristics, perception of difficulties in job performance, and job satisfaction. The data were analyzed using the x² test, t-test, ANOVA, and Pearson's correlation coefficient. Results: Novice health teachers had the most difficulty in health education during their job performance, whereas teachers without hospital clinical experience encountered difficulties in health management. Those with less than two years of teaching experience or no experience of being contract health teachers had higher job performance difficulties. The results revealed that the lack of experience in performance at a school site had a considerable influence on the difficulty in job performance. In terms of job satisfaction, novice health teachers had the highest satisfaction with status recognition and the lowest satisfaction with their tasks in charge. Additionally, as the difficulty in job performance increased, job satisfaction decreased. Conclusion: The study results indicated the need for training to provide novice health teachers with sufficient experience in job performance before being placed in a school. The provision of support to respond to difficulties in job performance will improve job satisfaction and contribute not only to the development of novice health teachers, but also to the improvement of the quality of school health.

• Journal of Korean Physical Therapy Science
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• v.29 no.1
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• pp.1-14
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• 2022

Background: The legal and academic definitions of manual therapy in domestic and foreign countries are reviewed, and problems and improvement plan of manual therapy are established through comparative analysis of the current status and system of manual therapy in Korea and abroad. Design: Review. Methods: In this study, the development direction of manual therapy in Korea was derived by analyzing the definition, application status, and service system of domestic and foreign manual therapy. Results: Firstly, it lays the foundation for a more comprehensive national health promotion by solving problems arising from the current unclear definition of manual therapy. Secondly, the subject of manual therapy is a physiotherapist but the subject of claiming non-benefit costs is a doctor, moreover illegal manual therapy by an unqualified or non-professional who is not a physiotherapist is being carried out in the medical field. Thirdly, in order to provide quality physiotherapy services (manual therapy) under a cooperative relationship between medical staff and physiotherapists, it is appropriate that physiotherapist have a clear "prescription" or "request" by a doctor. Fourth, there is no provision for the preparation of medical records in the current Medical Technicians Act, and this causes safety accidents of patients during manual treatment. Conclusion: As described above, the current manual therapy in Korea is being performed indiscriminately without a clear interpretation, resulting in various problems. I think it is necessary to lay the foundation for institutional and legal re-establishment of manual therapy through additional research on manual therapy in the future.

• The Journal of Internal Korean Medicine
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• v.43 no.4
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• pp.720-737
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• 2022

Objectives: To compare the effectiveness and safety of East Asian traditional medicine treatments (EATMT) versus conventional management in patients following heart valve replacement surgery. Methods: We searched several databases, including the Korean Studies Information Service System, PubMed, China National Knowledge Infrastructure, and Citation Information by NII. The search range included randomized controlled trials from each first issue until June 27, 2021. Two review authors independently extracted the data. We assessed the risk of systematic errors by evaluating risk domains using the "Risk of bias" tool. Results: We included 5 trials in the review. In the EATMT, the investigators reported significant improvements in reshaping of the heart structure: left ventricular end diastolic diameter (MD -4.43, 95% CI -6.06 to -2.79; 130 participants; 2 studies; high evidence). Comparisons with usual care revealed a significant decrease in gastrointestinal complications rate (OR 0.30, 95% CI 0.20 to 0.47; 503 participants; 2 studies; high evidence). We assessed 4 studies as having a low risk of bias and 1 study as having a high risk of bias. Conclusion: This systematic review suggests that East Asian traditional medicine interventions may be effective in preventing and alleviating complications, but we found evidence of important trade-offs between known benefits and known adverse effects in cardiac dysfunction and inflammation following heart valve replacement. Consequently, additional high-quality studies should be conducted.

• Journal of Oriental Neuropsychiatry
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• v.32 no.4
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• pp.337-343
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• 2021

Objectives: To investigate effectiveness and satisfaction of applying critical pathway (CP) to Hwa-byung outpatients. Methods: Subjects were 32 outpatients who were diagnosed with Hwa-byung between January 1 and 2021 to October 31, 2021. Among these patients, 18 patients were applied with CP and 14 patients received treatment without applying CP. Their medical records and administration records were retrospectively analyzed. Data were analyzed by mean, standard deviation, and t-test using SPSS 26.0 program. Results: Mean total treatment period significantly decreased in the CP group compared with the non-CP group. Medical expenses were classified by treatment period, per visit, and patient charges per type of visit. When analyzed specifically by detailed items, there was a decreasing tendency in total medical expenses, uncovered medical expenses, and patient charges but an increasing tendency in covered medical expenses, although some of these changes were not statistically significant. Satisfaction score increased in the CP group compared with the non-CP group in general, although not all increases were statistically significant. Conclusions: Applying CP may contribute to the reduction of medical expenses and improvement of medical service quality. Further research on the development of CP for various diseases and the application of CP under various circumstances is needed.