• Health Policy and Management
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• v.24 no.2
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• pp.120-127
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• 2014

Background: Since December 2010, online computerized prospective drug utilization review (pDUR) has been implemented in Korea. pDUR involves the review of each prescription before the medication is dispensed to the individual patient. The pDUR is performed electronically by Health Insurance Review & Assessment Service (HIRA), which is a Korean governmental agency, and then HIRA provides medical institutions and pharmacies with information that can be helpful to them in preventing potential drug problems such as drug/drug interactions or ingredient duplication. The aim of this study was to assess the impact of the Korean pDUR implementation on the proportion of drug-drug interactions (DDIs) using claims data from HIRA. Methods: A before-after comparison of the prevalence of DDIs between prescription was conducted, using HIRA administrative claims data of medical institution from January 2010 to December 2011. The analysis unit was the prescription issued and pairs before and after. The main outcome measures were the proportion of DDIs within- (control group) or between- physician encounters. To examine the difference, a paired t-test was applied. Results: We found that DDIs proportion between prescription decreased significantly (t=3.04, p=0.0026) after the implementation of pDUR, whereas there is no significant reduction within prescription (t=1.15, p=0.2518). With respect to the prevalence of DDIs between drug groups, the most dramatic reduction was occurred between 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors and anti-fungal agents. Conclusion: It seems effective that giving a direct feedback to prescribers by a prospective DUR. Further research is needed to assess the impact of DUR to final outcomes such as hospitalization.

• Journal of Korean Academy of Nursing Administration
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• v.20 no.1
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• pp.117-127
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• 2014

Purpose: In order to provide a systematic and standardized treatment course for MVD patients, a critical pathway (CP) program was developed and the results of its long term application were analyzed. Methods: This was a methodological study. The CP was established and applied to 75 (step I) and 1,216 (step II). Another group of 56 with similar features was used as a control group. Results: The application of CP turned out to be useful in many regards: the rate of hearing loss was reduced from 1.8% to 0% (step I) and 0.5% (step II), and low cranial nerve palsy was reduced from 1.8% to 1.3% and 0.7%, respectively. The length of hospitalization decreased by 2.56 days (25.2%) for step I and 3.05 days (30.0%) for step II. Days of ICU stay were reduced by 7.9% and 1.8%. The total cost per patient was reduced by 14.8% (step I). The cost per day was increased by 13.7% and 52.4%. An increase in the patient satisfaction index was noted, as shown in the ICU information guide (p=.002). Conclusion: The development and application of CP was found to improve the quality of medical treatment and the efficacy of hospital management in MVD patients. Well organized and efficient system and multidisciplinary teamwork are the key component of the successful application of CP.

• Quality Improvement in Health Care
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• v.12 no.1
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• pp.92-102
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• 2006

Background : Most hospitalized children will experience physical pain as well as psychological distress. Painful procedure can increase anxiety and fear of pediatric patients and their parents who do not have understanding logical of their disease and hospitalization. This study attempted to identify pain reduction in related to therapeutic intervention by age and environmental improvement. Methods : A total of 194 hospitalized children and their parents were investigated. Data collection period was 3 months from March to May 2004. Four instruments were used to collect the data : Faces Pain Rating Scale(FPRS), Heart rate, Oxygen saturation and Pain behavioral check list. The data were analyzed by a SPSS program and tested x2-test, t-test, ANCOVA. Results : 1. Age from 0 to 3, the Heart rate, FPRS, Oxygen saturation and Pain behavioral check list were significantly different in theraputic intervention group when compare to control group. 2. Age from 4 to 6, FPRS, Oxygen saturation and Pain behavioral check list were significantly different in theraputic intervention group when compare to control group. But the heart rate were not significantly different when compare to control group. 3. Age from 7 to 9, FPRS and Pain behavioral check list were significantly lower in therapeutic intervention group when compare to control group but Heart rate and Oxygen saturation were not significantly different when compare to control group. Conclusion : The results of this study concludes that most children experience acute pain during IV therapy and it can be reduced by age specific therapeutic intervention and by change of surrounding environment.

• KIEAE Journal
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• v.15 no.2
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• pp.27-35
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• 2015

Purpose: Healthcare is on the whole a personal and critical service that consumer's use, whereas hospitalization is as a rule painful, because nature nurtures and Sun Light Luminosity for healthcare settings is considered healing. The performance and design of climate responsive buildings such as AKU requires a detailed study of attributes of climate both at micro as well as macro level. The therapeutic value of contact with nature through window view, greenery and landscape is calculated there. Method: A two prong strategy is been devised for this article, at micro level three typical morphologies are analysed by creating same environment of neighboring building on sun shading chart, radiation and temperature range. Since the analysis of local climate helps to determine the design strategies for hospital Healing Environment which is suitable for Karachi climate; in order to track the macro climatic behaviour, a considerable analysis of psychometrics chart for AKU Karachi are designed on Climate Consultant (CC) and analysed by Machine Learning. Climate Consultant proposes different design strategies suitable for Karachi. And on the other hand time wise illumination sources for clinical area which are then measured on psychrometric chart- according to singular space: multi patient admission, secondly: acute ambulatory ward, and tertiary: multi windowed space according to the mushrabiyah and sky light pattern. Result: Our findings support the hypothesis that windowed wall is 75-80% more healing wall; an accelerated evidence was found for healing at macro level if the form of the hospital is designed according to the climatologically preferences, whereas at micro level: the light resource becomes the staff attentiveness determinant. In Conclusion evidence was provided that the actual form of luminosity results consequently in satisfaction while light entering from several set of windows and other sources might be valued if design according to the healing environment. The data added on the sun shading chart to calculate rays entraining into space in patient room equal to 124416.21 Watts/ meter $m^2$ is calculated as precise healing rate-and is confirmed by questionnaire from patients belonging from each clinical stage having different illnesses.

• Journal of Korean Academy of Nursing Administration
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• v.8 no.2
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• pp.295-308
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• 2002

Purpose: The purpose of this quasi-experimental research is to develop the CP for primary THR patients and verify its effectiveness. Method: The CP is designed for both patients and medical employees to meet the 14-day-long hospitalization with an expert and clinical validity test, and the standardized orders are also created. 21 eligible subjects for the control group(with common care plan) and 27 subjects for the experimental group(with CP service) were assigned. Data were collected from questionnaires to evaluate patients' satisfaction level of nursing care and CP, investigation of physical complications, inspection of LOS(length of hospital stay) and hospital charges from April 2000 to February 2001 at K-hospital in Daegu. The collected data were analyzed by using the SAS program. Results: After implementation of CP, there was a statistically significant reduction in mean length of stay. The hospital charges have no considerable difference between two groups. Frequency of physical complications is reduced considerably. The experimental group scored much higher than the control group on the satisfaction level toward nursing care. And in the analysis of CP satisfaction questionnaires, many subjects have high satisfaction in items of 'I see the treatment process and hospital life', 'I feel that I am participating in my treatment process with health care staff'. The analysis of variances which cause a prolonged LOS supports that it's necessary to strengthen an evaluation of pre-operative outpatients' condition and link the home nursing care system in discharge for more shortening of LOS. Conclusion: The above results show that CP can have a positive impact on satisfaction level of inpatients with primary THR and the hospital.

• Korean Journal of Occupational Health Nursing
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• v.11 no.1
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• pp.44-51
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• 2002

Purpose: Surgical Site Infection(SSI) is the third most common cause of nosocomial infection, so that it results in serious socioeconomic impact such as extra hospitalization, mortality and health care cost. The aim of this study was to analyses the SSI that based on the degree of wound contamination and patient risk index after general surgery and to generate a reference data for the effective management and reducing SSI. Method: From July, 1999 to June, 2000, 1080 cases which presented with surgical site infection after general surgery at S hospital in chunchon city were included in this study. The data were collected by review of the medical records retrospectively. The collected data, in accordance with the test purpose, is analyzed by SPSS/PC+ program, using real numbers, percentage, $X^2$ test, Pearson's correlation and stepwise logistic regression. Result: The overall wound infection rate was 4.7%(51 cases out of 1,080). The infection rate of clean wounds was 1.4%. Surgical site infection rate for patient risk index scores of 0, 1, 2 and 3 was 1.9%, 8.0%, 13.1% and 20.0%, respectively and increased significantly according to patient risk index(p=.000). Sixteen of the fifty one(31.4%) surgical site infections were found during an outpatient visit after discharge. Multivariate analysis, identified two independent variables : duration of postoperation stay(p=.000), age(p=.037). The most frequent isolated organisms were Pseudomonas aeruginosa(21%) and Staphylococcus aureus(21%). Also Staphylococcus aureus were all MRSA(Methicillin Resistant S. aureus). Conclusion: In this study, SSI was analysed according to the degree of wound contamination and patient risk index after general surgery. The data that obtained from this study is expected that it would be available for surveillance and control of SSI.

• Journal of the Korean Data and Information Science Society
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• v.27 no.3
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• pp.773-789
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• 2016

This study was conducted to identify the sleep patterns and influencing factors of hospitalized elderly in a long-term care hospital. The sleep patterns of 142 subjects were recorded using Sleep Charts. The average sleep time of subjects was 10.7 hours a day (3.9 hours in daytime and 6.8 hours in nighttime). Sleep regularity among participants were 71.7% in all day (58.1% in day time and 80.5% in night time). The presence of dementia patients in the room (PDPR) has been identified to be a statistically significant predictor of all day sleep, and pain, PDPR, and physical function have been found to be a significant predictors of sleep regularity in all day among subjects. It suggested that elderly patients in a long-term care hospital do not slept well during night, which leads to increase in daytime sleep and decrease the quality of their sleep. Therefore, an intervention program should be developed to promote the quality of sleep among hospitalized elderly.

• Research in Community and Public Health Nursing
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• v.15 no.1
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• pp.84-94
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• 2004

Purpose: The purpose of this study was to examine the health care management status of preschoolers depending on the children's characteristics. Methods: The sample of this study were 212 mothers of preschoolers attending Child Care Centers in three cities, Seoul, Daejon, and Suwon, in Korea. A self administered questionnaire developed by investigators was used to collect data from September 15 to October 31, 2002. Data was analyzed with SPSS 11.5 Win program. Results: 5.7% of the children had not completed their vaccination programs. Children who were second or later birth order showed less complete vaccination rates than firstborn babies. Children who had working mothers showed less complete vaccination rates than those whose mothers did not work. Among the various vaccinations, the DPT and MMR booster vaccination rates were the lowest. Home safety scores were higher when mothers have younger children. higher monthly incomes and reside in apartment type houses. Forty one(41%) of the preschoolers experienced accidents, and the accident rate was higher in boys and children with easy temperament. The most frequently experienced accident was laceration. Twenty eight point eight percent(28.8%) of the children experienced hospitalization because of various diseases. Most of the mothers perceived their children healthy. However, children who were second or third born were perceived less as healthy. Children in families with less monthly income were perceived as less healthy. Conclusions: This study provided basic data about preschoolers' health care management status focusing on vaccinations and accident rates. More attention should be paid to preschoolers' health and safety. Related factors found in this study should be considered when providing anticipatory guidance for parents.

• Journal of Korean Traditional Oncology
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• v.20 no.2
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• pp.37-49
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• 2015

Objectives : Retroperitoneal liposarcoma (RPS) is a rare solid tumor and has a high recurrence rate after surgery. New complementary and alternative medicine is required to manage symptoms of RPS and side effects of surgery, chemotherapy and radiation therapy. The purpose of this case report is to report two cases of reduction of side effects of surgery and radiation therapy in RPS treated with Wheel Balanced Therapy (WBT) which is a traditional Korean medicine treatment program for patients with cancer. Methods : Two patients with RPS were treated with WBT. Each of patients received personalized WBT schedule including acupuncture. The changes in clinical and laboratory findings were evaluated. Results : The symptoms of patients were improved after about 2 weeks hospitalization. Conclusions : This case report suggests that WBT has a potential to treat side effects of surgery and radiation therapy in patients with RPS. Further rigorous studies are necessary to investigate the therapeutic effects of WBT on RPS.

• The Korean Journal of Rehabilitation Nursing
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• v.1 no.1
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• pp.1-14
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• 1998

The purpose of this study was to identify the factors affecting family functioning of stroke patients. A descriptive survey research was conducted in which 65 stroke patients and their primary caregivers were conveniently sampled. Data were collected from July to September, 1998 through interviewing using a structured questionnare. The measuring instruments used were Barthel Index by Mahoney and Barthel(15 items), Quality of Relationship Scale by Archbold and Stewart(15 Items), Role Stress of Caregiver Scale by Yang(14 items), Situational Definition Scale by Lee(9 items), Family Hardiness Index by McCubbin, McCubbin. and Thompson(20 items), and Family Adaptability Cohesion Evaluation Scale(FACES-III) by Olson, Portner, and Lavee(20 items). The obtained data were analyzed using percentage, t-test, ANOVA, Duncan test, and Pearson coefficients correlation by SAS/PC program. The results were as follows; 1. Role Stress of Caregiver was not severe and Quality of Relationship was moderate. The level of Situational Definition of primary caregivers was not high but Family Hardiness and Family Functioning were rather high. 2. The following relationships between research variables and demographic characteristics of the primary caregivers of stroke patients were significantly different; occupation of caregiver between Quality of Relationship, occupation of caregiver between Situational Definition, family type between Role Stress, caregiving duration between Family Hardiness, caregiving duration between Family Functioning, and hospitalization days between Family Functioning. 3. The correlations between research variables were as follows; There was positively correlated between patient's ADL and Quality of Relationship. The relationship of the patient's ADL between Role Stress was negatively correlated. Quality of Relationship between Situational Definition, Family Hardiness, and Family Functioning were significantly correlated. The correlation of Situational Definition between Family Hardiness, and Situational Definition between Family Functioning were very high. As a result of these findings, Quality of Relationship, Role Stress, Situational Definition. and Family Hardiness were useful variables for identifying Family Functioning of stroke patients. It is important for the rehabilitation nurse to be knowledgeable about family functioning of stroke patients to promote rehabilitation process.