• Korean Journal of Biological Psychiatry
• /
• v.19 no.4
• /
• pp.172-178
• /
• 2012

Data from clinical studies are needed for psychiatrists to make quick and scientific decisions based on the best available evidence in clinical settings. Various methods of clinical studies are useful for clinicians to have reliable answers to unmet clinical needs. Although randomized controlled trials may provide high-quality information about major issues, well-designed, naturalistic and observational studies often give us unbiased explanation for real-world phenomena. Adequate selection of clinical variables and appropriate number of participants are key factors of well-designed clinical studies. Statistical methods can add an extra dimension to initial design of clinical studies. Given ethical issues in clinical studies on psychiatric disorders, special regards should be paid to participants' ability to provide informed consents. New strategies of clinical studies need to be developed to meet clinical needs and protect the rights and welfare of study participants.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.7
• /
• pp.3317-3320
• /
• 2016

Purpose: To assess the success rates of two step loop electrosurgical excision procedure (LEEP) compared with conventional cold conization procedures for decreasing positive surgical margins. Materials and Methods: This study was conducted on 70 patients who underwent colposcopic evaluation in Zeynep Kamil Women and Children's Health Training and Research Hospital between 2013-2015 with indications of CIN 2/3 or persistent CIN 1 for more than 2 years. The study included age matched groups of patients with similar histopathololical lesions who underwent cold conization (n=40) or LEEP (N=30). Results: Comparison of tissue characteristics between the two groups revealed significantly higher deepest depth and lower volume of tissue removed by the two step LEEP. Ectocervical positivity rate was similar between groups (1/39 versus 0/29, P>0.05), while endocervical surgical margin positivity rate was significantly higher in the cold conization group (9/39 versus 0/29, P<0.05). Surgical margin positive cases were significantly older than the cases with negative margins (P<0.05). Conclusions: Two step LEEP made it easier to reach the squamocolumnar junction in the endocervical region with lower blood loss and applicability in office settings. Our study suggests to use two step approach in cases with high grade and glandular CIN.

• Journal of Hospice and Palliative Care
• /
• v.23 no.2
• /
• pp.44-54
• /
• 2020

Purpose: The purpose of this study was to analyze the experiences of acute care hospital nurses' on spiritual care with focus group interviews. Methods: Data were collected from 24 nurses recruited from one acute-care hospital in a southern province of Korea. Six focus groups were assembled considering age and religion. All interviews were recorded and transcribed. Data were analyzed using qualitative content analysis. Results: Five categories with 14 sub-categories emerged: 1) ambiguous concept: confusing terms, an additional job; 2) assessment of spiritual care needs: looking for spiritual care needs, not recognizing spiritual care needs; 3) spiritual care practices: active spiritual care, passive spiritual care ; 4) outcomes of spiritual care: comfort of the recipient, comfort of the provider; and 5) barriers to spiritual care: fear of criticism from others, lack of education, lack of time, space constraints, and absence of a recording system. Conclusion: Participants perceived spiritual care as an uncertain concept. Some participants recognized it as a form of nursing care, and others did not. They practiced spiritual care in acute-care settings according to their personal perceptions of spiritual care. Therefore, in order to perform spiritual nursing in acute-care hospitals, it is a priority for nurses to recognize the concept of spiritual nursing accurately. It is also necessary to prepare a hospital environment suitable for the provision of spiritual care.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.16 no.2
• /
• pp.156-161
• /
• 2012

Purpose : IRMA method for the experimental reagents, as set out in the manual settings for doing and reporting the test results should, in principle. But many of the reagents allows for the setting of the plot does not have a lot of information. Depending on the angle setting of the table make a difference in test results and what settings are best suited to investigate. Materials and Methods : The hospital has Boramae DREAM10, Cobra, SR-300's using the Immunotech TSH reagents have been compared with the measurements. Since then there using EXCEL calculation of the equipment compared with the measurement. Results : In the comparison between each piece of equipment 1.SR-300: DREAM 10 y = 1.1376x - 0.046 (LOG-LOGIT), 2.SR-300: COBRA y = 1.0985x + 0.042 (LOG-LOG) 3.DREAM10: COBRA y = 0.965x + 0.0887 (LOG-LOG) was the result. In all charts the same X, Y axis, X values were good in general when you have. Linear-Logit value of Cobra Dream10 and Excel tends to match the calculated values provided. Conclusion : Is to guide the B / max, B / Total Logit Y axis of the chart is set to draw a look at the value equation when the X-axis LOG a high concentration are disadvantages rising urgently toward the slope. Linear-Logit plots close to the straight line has a curve. If you have a chart to guide on setting AS setting and therefore, set to guide the absence of information on the need to set up the experiment are thought to pass through.

• Journal of Home Health Care Nursing
• /
• v.10 no.1
• /
• pp.5-14
• /
• 2003

Recently, there has been an increasing need for long-term care and comprehensive health care services in community settings. The Ministry of Health and Welfare introduced the Hospital-Based Home Nursing Care Program in 2000. Before this initiative, there was a Home Nursing Demonstration Center, affiliated with the Seoul Nurse Association, had offered home nursing services with the financial support from the local government. since 1993, the Center's nursing staff has been engaged in a general hospital in an effort to provide home nursing care services within Korea's health care system. The purpose of this study was to analyze and identify characteristics of community-based home nursing care supplied by a community-based home nursing team engaged in a general hospital. Also. visit nursing care services provided by public health centers were evaluated in terms of accessibility and supply versus demand, to enhance the accessibility of low-income patients living in Seoul to home nursing care services. Data were collected from home nursing insurance reimbursement claims submitted by the community-based home nursing care team from March 1 to October 30 in 2001 and a questionnaire survey on home-visit nursing services of 25 public health centers in Seoul. The subjects consisted of 197 patients and 12 public health centers. The result were as follows. First, medical institution's community-based home nursing care program was better in technical quality than health-center-based home-visit nursing care. In addition. the pattern of the subject patients was similar to that of hospital-based home nursing care program. Second, there was a high demand for community-based home nursing care while only a small number of home-visiting nurses served at public health centers in Seoul. As a result, many patients could not receive adequate care. Finally, we suggest that community-based home nursing care program should be introduced in the national health system to meet the at-home care needs of severely ill low-income patients. Furthermore, to better utilize home nursing and visit-nursing care resources and offer continued care for patients in community settings, an efficient referral network should be built among related institutions. This would require improvement of reimbursement system and amendment of the law related to health insurance system and community-based home nursing care services.

• Health Policy and Management
• /
• v.16 no.3
• /
• pp.1-18
• /
• 2006

The organizational effectiveness of hospital in various environmental fluctuations is a large and complex problem. Hospital CEO leadership characteristics may be a critical determinant of employees' job satisfaction and turnover intention. Several empirical studies on transformational leadership found that transformational leadership behaviors were positively related to workers' job satisfaction and turnover intention. Very little research related to this subject has been done in health care settings in Korea. The author explores the relationship between hospital CEO leadership style and its effect on job satisfaction and turnover intention among the all staffs of general hospital. The relationship of hospital CEO leadership style to employees' job satisfaction was investigated using the Bass's leadership paradigm of transformational and transactional leadership. The Multifactor Leadership Questionnaire(MLQ) and the index of job satisfaction and turnover intention were completed by 493 hospital employees(doctors, nurses, hospital administrators, technicians, and assistants). The findings show a similar trend to the previous studies. Hospital CEO leadership behaviors and employee outcomes were significantly correlated. Correlations showed a significant positive relationship between those hospital CEO exhibiting a transformational leadership style and the job satisfaction of their staffs. The results of multiple regression analysis indicate that the effect of charisma in transformational leadership behaviors is more higher than other variables. Transformational leadership style may be a more effective strategy and have a greater effect on staff outcomes, attitudes and behaviors. The findings of this study reveal implications for efficient hospital management and the importance of understanding relationship between hospital CEO's leadership style and subordinate behaviors in the context of CEO's desirable role and function for hospital strategy planning and future direction.

• The Korean journal of internal medicine
• /
• v.39 no.3
• /
• pp.477-487
• /
• 2024

Background/Aims: Risk factors for progression to critical illness in hospital-acquired coronavirus disease 2019 (COVID-19) remain unknown. Here, we assessed the incidence and risk factors for progression to critical illness and determined their effects on clinical outcomes in patients with hospital-acquired COVID-19. Methods: This retrospective cohort study analyzed patients admitted to the tertiary hospital between January 2020 and June 2022 with confirmed hospital-acquired COVID-19. The primary outcome was the progression to critical illness of hospital-acquired COVID-19. Patients were stratified into high-, intermediate-, or low-risk groups by the number of risk factors for progression to critical illness. Results: In total, 204 patients were included and 37 (18.1%) progressed to critical illness. In the multivariable logistic analysis, patients with preexisting respiratory disease (OR, 3.90; 95% CI, 1.04-15.18), preexisting cardiovascular disease (OR, 3.49; 95% CI, 1.11-11.27), immunocompromised status (OR, 3.18; 95% CI, 1.11-9.16), higher sequential organ failure assessment (SOFA) score (OR, 1.56; 95% CI, 1.28-1.96), and higher clinical frailty scale (OR, 2.49; 95% CI, 1.62-4.13) showed significantly increased risk of progression to critical illness. As the risk of the groups increased, patients were significantly more likely to progress to critical illness and had higher 28-day mortality. Conclusions: Among patients with hospital-acquired COVID-19, preexisting respiratory disease, preexisting cardiovascular disease, immunocompromised status, and higher clinical frailty scale and SOFA scores at baseline were risk factors for progression to critical illness. Patients with these risk factors must be prioritized and appropriately isolated or treated in a timely manner, especially in pandemic settings.

• International Journal of Advanced Culture Technology
• /
• v.6 no.3
• /
• pp.211-215
• /
• 2018

Ventilator-associated pneumonia (VAP) is a lung infection that develops in patients receiving mechanical ventilation. VAP contributes to about 50% of hospital-acquired pneumonia in ICU settings. One of the recommendation of the Institute of for Healthcare Improvement ventilator bundle is HOB elevation. HOB elevation affects shearing forces and makes higher risk for pressure injury development. Pressure injury (PI) is localized damage to the skin over a bony prominence. PI prevention guidelines recommend that HOB positioning should be lower to reduce risk for PI development which contradicts VAP prevention guidelines for the HOB between 30 and 45 degrees for ICU patients. This presents a care dilemma and tension. The purpose of this study was to perform a secondary data analysis using cumulative electronic health record data in order to determine the association of HOB elevation with VAP and PI in ICU patients. A secondary data analysis was conducted to determine whether HOB elevation is associated with VAP and PI. HOB elevation was not likely to be associated with VAP prevention whereas it was likely to be related to PI development. This is somewhat contrary to popular data and publications. Prospective cohort study is desired to inform us in an evidence-based fashion what actually is optimal HOB elevation for ventilated patients in ICU settings.

• The Journal of Korean Academic Society of Nursing Education
• /
• v.20 no.4
• /
• pp.606-616
• /
• 2014

Purpose: This study compares differences between male and female nursing students in terms of the level of stress experienced during clinical practice settings, stress coping mechanisms and clinical competency. Method: The study population was nursing students who had taken a clinical practice course at one of five general hospitals in city D. Data were collected from September 15 to October 15, 2013 through a structured self-administered questionnaire survey given to 319 subjects (156 male students, 163 female students) enrolled in a statistical analysis course. Results: Male nursing students experienced lower stress levels during clinical practice and higher clinical competency than female students. In terms of stress coping mechanisms, male students were significantly more active than female students in deploying coping strategies. Among all students, students with higher clinical practice stress and concomitant stress coping scores exhibited higher clinical competency. Conclusion: Noticeable differences between male and female nursing students in terms of stress levels arising in the course of clinical practice, stress coping strategies, and clinical competency were revealed. However, further identification of specific stressful situations for male and female nursing students and subsequent management of clinical training circumstances are required.

• Korean Journal of Occupational Health Nursing
• /
• v.22 no.4
• /
• pp.285-294
• /
• 2013

Purpose: This study aimed to explore professional autonomy, nursing work environment, and clinical decision making ability and to determine predictors of clinical decision making ability among clinical nurses. Methods: A cross-sectional design was used in this study and 263 clinical nurses were selected from advanced-level hospitals with over 500 beds located in D metropolitan city. Independent t-test, ANOVA, Pearson's correlation coefficients and hierarchical multiple regression analyses were done with the SPSS/WIN 20.0 program. Results: Clinical nurses reported moderate levels of professional autonomy, nursing work environment and clinical decision making ability. Marital status, professional autonomy and nursing work environment accounted for 25% of variance in clinical decision making ability required in various clinical settings. Importantly, being married, higher level of professional autonomy, and greater satisfaction with work environment were significantly associated with better decision making ability. Conclusion: Findings indicate that improving the quality of decision making in the healthcare settings requires awareness of the multiple effects of individual, occupational and environmental features. Nurses' ability to make effective clinical decisions may rely on personal characteristics, the degree of autonomy in their job, and nurses' satisfaction with their work environment.