• Tuberculosis and Respiratory Diseases
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• 제83권4호
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• pp.257-267
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• 2020

Patients with chronic obstructive pulmonary disease receive a range of treatments including but not limited to inhaled bronchodilators, inhaled and systemic corticosteroids, supplemental oxygen, and pulmonary rehabilitation. Pulmonary rehabilitation is a multidisciplinary intervention that seeks to combine patient education, exercise, and lifestyle changes into a comprehensive program. Programs 6 to 8 weeks in length have been shown to improve health, reduce dyspnea, increase exercise capacity, improve psychological well-being, and reduce healthcare utilization and hospitalization. Although the use of pulmonary rehabilitation is widely supported by the literature, controversy still exists regarding what should be included in the programs. The goal of this review was to summarize the evidence for pulmonary rehabilitation and identify the areas that hold promise in improving its utilization and effectiveness.

• Journal of Korean Biological Nursing Science
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• 제21권4호
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• pp.292-299
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• 2019

Purpose: The purpose of this study was to determine whether poor preoperative nutritional status in elderly patients exhibited a negative influence on postoperative clinical outcomes. Methods: The medical records of 645 elderly patients were examined retrospectively. The patients had undergone major surgery between January 2017 and January 2018. Their nutritional status was measured using the Nutritional Risk Screening 2002. The data were analyzed using the chi-squared test, the Mann-Whitney U test, logistic regression, linear regression, Cox proportional hazards regression, and the Kaplan-Meier analysis. Results: Preoperative malnutrition was found in 73 patients (11.3%). Poor preoperative nutritional status was significantly associated with pressure ulcers, length of hospitalization, discharge to patient care facilities rather than home, and mortality rate at three months. Conclusion: Preoperative malnutrition in elderly patients was associated with negative postoperative clinical outcomes. These results indicate that an effective nutritional program before surgery can lead to a more rapid postoperative recovery.

• Journal of Preventive Medicine and Public Health
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• 제11권1호
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• pp.41-48
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• 1978

To examine the result of the government Medical Aid Program which began in January, 1977 as a part of social security policy implementation, all the medical records of the clients and official statistics in the year were analysed. The specific objectives this study pursues include the magnitudes and patterns of morbidity and utilization, and the characteristics of clients. One Korean rural area, Koje county was selected as the study area and subsequently all the clinics and hospitals assigned to work out the Aid Program are the subjects for the survey. A brief summary of the sutdy results as follows: a. The clients of Koje county are 6.4% of the total population in the area, more than the average percentage of the clients in Korea. It reflects on low level of economic status of the residents of the area. b. The population structure of the clients indicates that the large proportions of young and old age group are overwhelming, while the middle age group share very small portions. c. The utilization rates for primary care are 2.0 persons, 11.6 visits and 22.6 treatment days per 100 persons per months. Annual hospitalization is rated as 13.7 cases and 164 days per 1,000 persons, The utilization rates are slightly lower than those expected rates during planning period but eventually become higher than those of general population in rural Korea. d. The factors which influence the utilization rates are identified with client group (low income vs indigent), age and sex. e. The utilization pattern for primary care demonstrates seasonal variation similar to the pattern of general rural population in the low income group, but none in the indigent group. f. The most common diseases revealed at the primary care clinics are the acute respiratory infection (26.9%), acute gastritis (10.8%), skin and subcutaneous infection (6.8%). The cases of acute conditions are outnumbered than the cases of chronic condition. 8. The clinics, hospitals and other related health institutions are well cooperated in dealing health care services in their own capacities. Considering the above results Medical Aid Program generated satisfactory results at least in the utilization aspect.

• 가정∙방문간호학회지
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• 제18권2호
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• pp.88-98
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• 2011

Purpose: This study was done to develop and test a maternal role strengthening program based on home care nursing. Methods: A quasi-experimental design was employed. Changes in the variables(maternal identity and confidence of maternal role) were evaluated to test the effects of the developed program. Participants were first-time mothers receiving home care nursing from S Medical Center following normal spontaneous vaginal delivery(experimental group 29; control group 29). Data collection was conducted from December 2008 to February 2009. $X^2$-test, Fisher's exact test and t-test were used to analyse the data. Results: Hypothesis 1, that the experimental group receiving this program would experience a stronger maternal identity than the control group, was supported(t=-7.990, p=<.001). Hypothesis 2, that the experimental group would have higher confidence in their maternal role than the control group, was also supported(t=-10.109, p=<.001). Conclusion: The maternal role strengthening program based on home care nursing developed in this study was found to be an effective means of improving maternal identity and confidence of maternal role. As these traits are developed once the baby is born, active nursing programs which provide continuous training and demonstrations to mothers are needed prior to hospitalization and following hospital discharge.

• 지역사회간호학회지
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• 제10권1호
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• pp.70-79
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• 1999

This study attempts to encourage the development of a rehabilitation delivery system as a substitute service for hospitalization such as a community based intermediate facility or home health care. We need substitute services for hospitalization to curtail the length of stay for inpatients due to car accidents. It focused on developing an estimation for early discharge based on a detailed statement of treatment from medical records of 109 inpatients who were hospitalized at General Hospital in 1997. This study has three specific purposes: First, to find the mean length of stay and mean medical expenditure. Second, to estimate the mean of early discharge from the mean length of stay. Third, to analyize the income effect per bed from early discharge. In order to analyze the length of stay and medical expenditure of inpatients the author conducted a micro and macro-analysis with medical expenditure records. To estimate the early discharge we examined with a group of 4 experts decreases in the amount of treatment after surgery, in treatments, in tests, in drug methods. We also looked their vital signs, the start of ROM exercise, the time removel, a patient's visitations, and possible stable conditions. In addition to identifing the income effect due to an early discharge, the data was analyzed by an SPSS-PC for windows and Excell program with a regression analysis model. The research findings are as follows: First, the mean length of stay was 47.56 days, but the mean length of stay due to early discharge was 32.26 days. The estimation of early discharge days was shown to depend on the length of stay. The longer the length of stay, the longer the length before discharge. For example, if the patient stayed under 14 days the mean length of stay was 7.09 while an early discharge was 6.39, whereas if the mean length of stay was 155.73, the early discharge time was 107.43. The mean medical expenditure per day of car accident patients was found to be 169,085 Won, whereas the mean medical expenditure per day was shown to be in a negative linear form according to the length of stay. That is the mean expenditure for under 14 days of stay was 303,015 Won and the period of the hospitalization of 15 days to 29 days was 170,338 Won and those of 30 days to 59 days was 113,333 Won. The estimation of the income effect due to being discharged 16 days was around 2,350,000 Won with a regression analysis model. However, this does not show the real benefits from an early discharge, but only the income increasing amount without considering prime medical cost at a general hospital. Therefore, we need further analysis on cost containments and benefits incending turn over rates and medical prime costs. From these research findings, the following suggestions have been drawn, we need to develop strategies on a rehabilitation delivery system focused on consumers for the 21st century. Varions intermediate facilities and home health care should be developed in the community as a substitute for shortening the length of stay in hospitals. In home health care cases, patients who want rehabilitation services as a substitute for hospitalization in cooperation with private health insurance companies might be available immediately.

• Child Health Nursing Research
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• 제8권1호
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• pp.97-109
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• 2002

This study was conducted to understand the degree and contents of stress which the mothers of high-risk infants can be experienced from the hospitalization of ICU for their new borns, and thus to offer the basic program to he nursing intervention program for these. Subjects were the 171 mother of hospitalized newborn in NICU of 1 University Hospital in Busan from June, 20, 2001 to September, 15, 2001, who agreed to take part in this study. The instruments used in this study were Parental Stressor Scale:NICU(PSS:NICU) developed by Miles et al. The questionnaire has 4 dimensions and 45 items ; sight and sounds of NICU(5 items), babies' appearance and behavior nursing intervention(19 items), parental role alteration and relationship with their baby(10 items), health team communication(11 items). The data was analysed as average, frequency, Standard Deviation, t-test, ANOVA, Pearson correlation coefficient by use of SPSS/PC+. The results of this study are as follows ; 1. The total perceived stress level score of mothers of high-risk infants was slightly high(3.44±0.71). The highest scored dimension was 'appearance and behavior of the baby'(4.06±0.80), and next were 'relationship with their baby and parental role change'(3.55±0.98), 'sight and sounds of NICU'(3.22±1.01), 'communication with health team'(2.93±0.91). 2. The total perceived stress level score was significantly correlated with birth weight (F=2.35, p<.05). 3. In sight and sounds of NICU, the perceived stress level score was significantly correlated with nursing in the incubator(t=2.28, p<.05) and birth weight(t=2.26, p<.05). In summary, information about physical environment of NICU, birth weight and nursing in the incubator must be included in nursing intervention program of mother's of high-risk infants in reducing the patents stress level. And, it is suggested that there need to find the coping mechanism of mother of high-risk infants.

• 재활간호학회지
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• 제1권1호
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• pp.83-92
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• 1998

This study was designed to determine the outcomes of the team-based cardiac rehabilitation programs for patients with Ischemic Heart Disease(IHD) on their level of health behavior performance, anxiety, and quality of life. A total of 19 in-patients with IHD who have had PTCA treatment at G.Hospital in Inchon were selected as subject to data collection from 1 May 1998 to 30 Oct. 1998. The experimental group, consisting of 11 patients participated in the Hospital's cardiac rehabilitation program was compared with the non-rehabilitation control group of 8 patients. The experimental group has been trained on the cardiac rehabliltation programfor 120-150minute during hospitalization by a team consisted of four specialists, those are cardiologist, head nurse, dietian, and the author. Also individual follow-up training and interview were performed for the members of experimental group at their every visit to the Hospital after discharge. For all subjects, scores on health behavior performance, anxiety, and quality of life were collected two days and 12 weeks after PTCA treatment by questionnaire. The collected data were analyzed with the SPSS. The results of this study were summarized as follows : 1) The experimental group shows significant increase in health behavior performance score compared to the control group(-2.27, p=.022). 2) There was no significant difference between two group's anxiety scores (-.24, p= .803) and quality of life scores(-1.86, p= .061). 3) The correlation between health behavior performance and anxiety ( .07, p= .771), and that between health behavior performance and quality of life( .12, p= .621) respectively were not significant statistically. But the correlation between anxiety and quality of life were significant reversely ( .49, p= .032).

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제23권3호
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• pp.71-80
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• 2017

Purpose: At the moment prevention and treatment of animal related diseases is becoming a social concern as the demand for animal increases. Furthermore, The design of the veterinary medical teaching hospital are even more complex because they have to accommodate medical program for animal and education and research program for students. However, there are a few experience and useful guidelines for the planning of the veterinary medical teaching hospital. So it is not easy for the regional hub universities to work out the proper plan for the construction of the veterinary medical teaching hospital for their own. This study has been started in order to provide basic informations for the planning of Korean veterinary medical teaching hospital. Methods: Interview to veterinarian, intern and employee of the veterinary medical teaching hospital and Field surveys to veterinary medical teaching hospital in Korea have been conducted for the data collection. The drawings of three universities of veterinary medical teaching hospital have been analysed and diagramed. Results: The result of this study can be summarized into three points. The first one is that the veterinary medical teaching hospital spaces are divided into five areas (ambulatory care, central medical care, hospitalization, education and research, operations and support) and each area is divided independently and connected properly. The second one is that the veterinary medical teaching hospital differs from hospital in the detailed space plan in the sense that the animal is a patient. The third one is that each hospital has different operating practices and programs according to local conditions Implications: It is meaningful as a basic source of veterinary medical teaching hospital design in the future.

• Journal of Chest Surgery
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• 제57권4호
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• pp.390-398
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• 2024

Background: In this study, we examined the impact of a patient blood management (PBM) program on red blood cell (RBC) transfusion practices in cardiothoracic surgery. Methods: The PBM program had 3 components: monitoring transfusions through an order communication system checklist, educating the medical team about PBM, and providing feedback to ordering physicians on the appropriateness of transfusion. The retrospective analysis examined changes in the hemoglobin levels triggering transfusion and the proportions of appropriate RBC transfusions before, during, and after PBM implementation. Further analysis was focused on patients undergoing cardiac surgery, with outcomes including 30-day mortality, durations of intensive care unit and hospital stays, and rates of pneumonia, sepsis, and wound complications. Results: The study included 2,802 patients admitted for cardiothoracic surgery. After the implementation of PBM, a significant decrease was observed in the hemoglobin threshold for RBC transfusion. This threshold dropped from 8.7 g/dL before PBM to 8.3 g/dL during the PBM education phase and 8.0 g/dL during the PBM feedback period. Additionally, the proportion of appropriate RBC transfusions increased markedly, from 23.9% before PBM to 34.9% and 58.2% during the education and feedback phases, respectively. Among the 381 patients who underwent cardiac surgery, a significant reduction was noted in the length of hospitalization over time (p<0.001). However, other clinical outcomes displayed no significant differences. Conclusion: PBM implementation effectively reduced the hemoglobin threshold for RBC transfusion and increased the rate of appropriate transfusion in cardiothoracic surgery. Although transfusion practices improved, clinical outcomes were comparable to those observed before PBM implementation.

• 가정∙방문간호학회지
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• 제6권
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• pp.5-18
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• 1999

This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.