• Title/Summary/Keyword: Improvement of statistics quality

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An Effect of Muscle Strength Training Program on Muscle Strength, Muscle Endurance, Instrumental Activities of Daily Living and Quality of Life in the Institutionalized Elderly (노인의 근력강화운동이 일상생활기능 및 삶의 질에 미치는 효과)

  • Kim, Hee-Ja;Hong, Yeo-Shin
    • Research in Community and Public Health Nursing
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    • v.6 no.1
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    • pp.55-73
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    • 1995
  • An Effect of Muscle Strength Training Program on Muscle Strength, Muscle Endurance, Instrumental Activities of Daily Living and Quality of Life in the Institutionalized Elderly Recent statistics shows that the aged are the fastest growing segment of our population by increasing life span. The age group of over 60 shows multiple health problems and the most serious handicapping problem of these. are related to the changes in muscular skeletal system. With aging, people lose. their muscle mass and muscle strength resulting from biological changes and physical inactivity. Studies documented a 30-50% loss of muscle mass in an advanced age and thus, ordinary life activities can be seriously affected due to weakened muscle strength. Preservation of muscle strength of lower limb is especially important in the aged. Since it is readily affected from reduced physical activity in old age, sometimes to the detriment of moving or walking. So muscle strength exercise program designed for the elderly to improve leg muscle strength and leg muscle endurance. The research design used was nonequivalent control group pretest - protest design. The purposes of this study were to test the effect of muscle strength exercise program utilizing Leg Press on muscle strength, muscle endurance, instrumental activities of daily living(IADL), cognitive perceptual variables and quality of life. Forty nine subjects participating in this study consisted of twenty four male and twenty five female. Twenty four experimental group subjects were selected from C-institution in Chung Buk province, and twenty five control group subjects were selected from O-institution in Chung Nam province. The mean age of subjects was 72.8 years. Muscle strength training program utilizing Leg Press for the experimental group was carried out three times a week for 9 weeks. The data was collected from August, 1993 to October, 1993. Data were analyzed with $X^2-test$, t-test, ANCOVA test, Kruskal Wallis 1-Way ANOVA test using SPSS PC program. Results were obtained as follows : 1) The experimental group showed significantly higher scores on muscle strength (leg lift strength, back lift strength and grip strength) and muscle endurance than control group after the experiment $\ulcorner$F=52.35(p=.001), F=54.07(p=.001), F=6.97(p=.011), F=18.17(p=.001)$\lrcorner$ 2) Experimental group were significantly higher scores on IADL than control group(F=7.51, p=.009). 3) Experimental group showed significantly higher scores on economical state and self esteem aspects of the quality of life scale than control group $\ulcorner$F=10.59(p=.002), F=6.97(p=.011)$\lrcorner$. But there were no differences in emotional state, physical and functional state and relationship with reatives in the quality of life between groups. 4) Scores on IADL showed a significant difference with the level of muscle strength and muscle endurance $\ulcornerx^2=7.73(p=.025),\;x^2=8.86\;(p=.011)\lrcorner$ 5) Scores on self esteem and physical and functional state aspects of the quality of life scale showed a significant difference with the level of IADL $\ulcornerx^2=11.39(p=.003),\;x^2=9.02(p=.011)\lrcorner$. 6) Scores of experimental group after the experiment in cognitive perceptual variables (perceived benefit on exercise, perceived health status, self efficacy, emotion on exercise) were significantly higher than those of control group $\ulcorner$F=32.09(p=.001), F=5.07(p=.029), F=20.63 (p=.001), F=30.38(p=.001)$\lrcorner$. As a result of this study, the effect of strength training exercise program with Leg. Press had improved muscle strength, muscle endurance, IADL, and the perception of self esteem, physical and funtional state, and economical state. Thus strength training program could be beneficially applied for the prevention of disablity and promotion of health and wellbeing in the aged easily and safely. The subjects in the experimental group have maintained their exercises till six months after the cessation of the experiment. This seem to illustrate that changes in cognitive perceptual variables and the improvement in health status have reinforced motivation for the continuation of voluntary exercises. A further study is necessary to determine the factors affecting maintainance of muscle strength exercise and to assess the effect of weight training program on bone density.

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Evaluation of Current Coding Practices in 3 University Hospitals (3개 대학병원의 주 진단 코딩사례 평가)

  • Seo, Sun Won;Kim, Kwang Hwan;Pu, Yoo Kyung;Suh, Jin Sook;Seo, Jeong-Don;Park, Woo-Sung;Yoon, Seok Jun;Lee, Young Sung;Lee, Moo-Sik;Chung, Hee-Ung
    • Quality Improvement in Health Care
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    • v.9 no.1
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    • pp.52-64
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    • 2002
  • Background : Coding of principal diagnosis is essential component for producing reliable health statistics. We performed this study to evaluate the current practice of principal diagnoses determination and coding, and to give some basic data to improve coding of principal diagnosis. Method : Nineteen medical record administrators (MRAs) of 3 university hospitals participated in coding principal Dx. from August 1, 2001 to August 31, 2001. From each hospital, 10 medical records of patients with high frequency disease were selected randomly. Each 10 medical records were grouped into three (A. B, C). Then, these 30 medical records were given to each MRAs for coding. At the same time questionnaire was given to each of them. Questions were to prove how they decide and code the principal diagnosis among many current diagnoses; how they decide and code the principal diagnosis when they see irrelevant diagnosis recorded as the principal diagnosis in medical record, when only tentative diagnoses were recorded without final diagnosis, and when different diagnoses were recorded in different sheets of same record. Agreement of coding among 3 hospitals were compared and survey results were analysed with SAS 6.12. Results : Agreement of coding was found in medical records 5-6 of each 10 medical records. Causes of disagreement were as follows. Difference of clinician's opinion from each hospital; mixed use of guideline from KCD-3 and guideline from DRG; difference in 4th digit classification according to the absence of pathology report in the medical record; difference of abbreviations among hospitals. 57.9% of MRAs selected the principal diagnosis recorded by physician, 42.1% of MRAs decided principal diagnosis after consulting to KCD-3 guideline. When there were difficulties in determining the principal diagnosis, 42.1% of MRAs decided principal diagnosis after discussion with the physician, 26.3% after discussion with fellow MRAs. Conclusion : There were differences in codings among hospitals. To minimize the difference, we suggest the development of disease-specific guidelines for coding in addition to the current general guideline such as KCD-3. To do this, Coding Clinic which can produce guidelines is needed.

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Profile and Outcome of Management of Brain Tumours in Kaduna Northwestern Nigeria

  • Danjuma, Sale;Dauda, Happy Amos;Kene, Aghadi Ifeanyi;Akau, Kache Stephen;Jinjiri, Ismail Nasiru
    • Journal of Korean Neurosurgical Society
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    • v.65 no.5
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    • pp.751-757
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    • 2022
  • Objective : Tumours of the brain are a rare occurrence accounting for approximately 2% of all neoplasms in adults. Few studies have been done in Nigeria on the profile of brain tumours. The aim of this study is to determine the profile of brain tumours in general and determine the change in Kanofsky Performance Score (KPS) after treatment. Methods : This is a prospective hospital-based study in Kaduna. All consecutive patients over 18 years of age with diagnosis of brain tumours from January 2016 to December 2019 were included in the study. Demographic and clinical data was collected using a proforma during the study. Patients who received treatment were followed up for 12 months. The primary outcome data was the difference in the quality of life as measured by KPS at the point of first contact and at 1-month after treatment and at 12-month follow up. Data obtained was analysed with SPSS version 25.0 for Windows. Descriptive statistics was done to determine the profile. Paired t-test at 95% confidence interval was done to check for significant correlation between the mean KPS. Results : A total of 39 consecutive patients were included in the study. There was a slight male preponderance with a M : F of 1.17 : 1. Meningioma and metastasis were more common in females while gliomas and pituitary tumours were more common in males. The mean age of patients was 49.8 years and standard deviation of 11.8 years. Pituitary tumours were the most common tumours. The most common location of the tumour was frontal lobe followed by the pituitary gland. The mean duration of symptoms before neurosurgical consultation was 38 weeks. The most common presenting symptoms of patient with brain tumour was headache. The quality of life improve compare to the baseline in 81% of patient at discharge and at 1 year follow up. The overall mortality rate was 25.6%. Conclusion : The most common brain tumour in our study is pituitary tumour. Most patients present late. The most common presenting symptoms is headache. There is significant improvement in the KPS of patients following treatment. The overall mortality rate at 1-year post treatment is 25.6%.

Applicability of Appropriateness Evaluation Protocol and Delay Tool (적절성 평가지침과 이유목록의 적용 가능성 평가)

  • Shin, Youngsoo;Kim, Yong-Ik;Kim, Chang-Yup;Kim, Yoon;Kim, Eun Gyung;Song, Yun Mi;Lee, Young Seong
    • Quality Improvement in Health Care
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    • v.1 no.1
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    • pp.96-108
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    • 1994
  • Background: An appropriate use of hospital beds can improve productivity of hospital significantly. The authors' previous study revealed that approximately one third of Korean hospital bed days and one sixth of admissions were inappropriately used, when it was measured by Appropriateness Evaluation Protocol(AEP) and Delay Tool modified into Korean situation by the authors. This study aims to evaluate applicability of the instruments in a new hospital. More specifically the study aims to measure appropriateness of the instruments used by newly trained nurse reviewers at a new hospital setting. Methods: In order to evaluate applicability of these instruments, agreement rates of the scores recorded by newly trained nurse reviewers with by skilled nurse reviewer and also compared with the scores recorded by physician's implicit decision were assessed. Agreement rates were derived from concurrent application of AEP and Delay Tool to 52 admissions and 104 patient days from internal medicine, pediatrics, and general surgery of one university hospital. Overall agreement rate, specific nonacute agreement rate, and kappa statistics were used to indicate level of agreement. Results: Overall agreement rates on appropriateness between newly trained nurse reviewers and skilled nurse reviewer were 100% in admission and 98% in bed days. Overall agreement rates on reason for inappropriateness between newly trained nurse reviewers and skilled nurse reviewer were 96% in admission and 91% in bed days. Overall agreement rates between newly trained nurse reviewers and physician reviewer were 86% in admission and 87% in bed days. Conclusion: Results indicated that AEP and Delay Tool were applicable to a new hospital in detecting inappropriate utilization of beds and reasoning of the inappropriateness. These instruments could contribute to enhance efficiency of hospital use, through continuous monitoring of level of inappropriate hospital use at national or individual hospital level.

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A Study on the Patient Satisfaction Survey at the General Hospitals in Korea (국내 종합병원 환자만족도 조사현황 분석)

  • Lee, Sunhee;Kim, Ji In;Cho, Woohyun;Lee, Jijeon
    • Quality Improvement in Health Care
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    • v.5 no.1
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    • pp.42-57
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    • 1998
  • Background : It is increasing the concern for patient satisfaction as a customer information. This study was planned to investigate the activities related to patient satisfaction survey at the Korean hospitals. Methods : We performed the nationwide survey on 235 general hospitals by using the self-administrated checklist from Sep. 9 to Oct. 9, 1996. The response rate were 50.2%. We analyzed the descriptive statistics and chi-square test by SAS software on 118 hospitals. Results : First of all, 62.7% of study hospitals showed to conduct the patient satisfaction survey, and most of hospitals which did not conduct it had a plan to do it within 5 years. The reason that hospitals did not conduct satisfaction survey was due to a lack of administrator's interest or adequate questionnaire form. Second, the bigger, public and being more located in the big city or opened more than 10 years, the more hospitals conducted the patient satisfaction survey. Also, patient satisfaction survey was mainly handled by planning dept. or administrative team. Third, most hospitals had their own way of making questionnaires without proving reliability and validity. The results of the survey were applied to hospital management timely, and were mostly reported to top manager level. Most CEO concerned about the results of satisfaction survey. Fourth, the staffs in charge of survey had problems such as skill related to data analysis and development of questionnaire and they suggested that this problems could be solved through inducing the implementation of the survey results on hospital management, support for the development of standardized questionnaires and increasing the top manager's interests. Fifth, most questionnaires composed of lots of questioning items on hospital equipments and environment, and kindness of hospital employee to patients. Conclusions : Although this study had some limitations in generalization due to low response rate in big hospitals, it is meaningful to find the present state and the problems related to patient satisfaction survey of the general hospitals. We can conclude that there are increasing the concern for patient satisfaction survey among the hospitals nationwide, and it can be needed for technical support related to development of survey tool or method.

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Analysis the of User's Needs for Developing a Mobile Health Based Lifestyle Care Application for Health Promotion among the Elderly (장노년층 건강증진을 위한 모바일 헬스 기반 라이프스타일 케어 앱의 사용자 요구도 분석)

  • Park, Kang-Hyun;Won, Kyung-A;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.9 no.3
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    • pp.23-34
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    • 2020
  • Objective : Recently, the demand for wearable mobile devices for the monitoring and improvement of one's health and quality of life is increasing. Therefore, the purpose of this study is to analyze the need of potential users in order to develop mobile health based and lifestyle care application for the elderly. Methods : Participants who lived in their community and used a mobile phone were recruited. Finally, a total of 84 participants completed the survey. Data were analyzed using descriptive statistics and a t-test, which was carried out with SPSS version 25.0. Results : The application functions that users deemed important for a lifestyle care app were the number of daily steps, physical activity, blood pressure, sleep, nutrition and participation in activity. Interestingly, there was a significant difference in the importance given to the app function of participation in activities between age groups. Conclusion : This study investigated the need and preferences of potential users of health and lifestyle care application for the promotion of health among the elderly. The, findings obtained from this study could be a valuable resource for the development of lifestyle care application.

Predictors of Psychological Happiness in Leisure Sports Participant - Focusing on Amateur Baseball Clubs - (여가스포츠 참여자의 심리적 행복감 예측요인 - 사회인 야구를 중심으로 -)

  • Suh, Hae-Joo;Kim, Ja-Ok;Kim, Ja-Sook;Kim, Hack-Sun;Park, A Young
    • Journal of Digital Convergence
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    • v.16 no.1
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    • pp.409-420
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    • 2018
  • This is a convergence study to investigate the factors affecting the psychological happiness of leisure sports participants(social baseball club) and to present a strategy for effective program development. The subjects of this study were 151 participants of social baseball clubs in J-do area and collected data by self-reported questionnaire. Data were analyzed by descriptive statistics, t-test, ANOVA, correlation analysis and stepwise multiple regression analysis. The results of this study were the explanatory power was 54.1% with psychological happiness, quality of life, self-efficacy. As a result, it was confirmed that strengthening interpersonal relationship ability, positive reinforcement of self-efficacy, and quality of life were important for improvement of psychological happiness. and in the future, it is necessary to study repeatedly to confirm the influence of psychological through objective measurement.

Prioritizing Themes Using a Delphi Survey on Patient Safety Theme Reports (환자안전 주제별 보고서의 주제 우선순위 설정: 델파이 조사를 통한 분석)

  • Park, Jeong Yun;Shin, Eun-Jung;Kim, Rhieun;Kim, Sukyeong;Park, Choon-Seon;Park, Taezoon;Choi, Yun-Kyoung;Heo, Young-Hee
    • Quality Improvement in Health Care
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    • v.28 no.1
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    • pp.45-54
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    • 2022
  • Purpose: The study aims to identify the theme list and priority criteria of patient safety theme reports in South Korea. Methods: The survey was conducted twice, and the importance of each criterion and theme was measured on a nine-point scale using the Delphi technique by a panel of 19 patient safety experts. The criteria included severity, universality, preventability, and organizational-social impact. Descriptive statistics such as frequency, percentage, mean, standard deviation, median, and interval quartile range were used to analyze the data. Results: The parameters were assigned a weighted average of 35% for severity, 20% for universality, 30% for preventability, and 15% for organizational-social impact, respectively. The final top three rankings were surgery safety, blood transfusion safety, and medication safety. In addition to expert opinion, for the theme that is selected based on the priority ranking, one to five sub-topics can be derived from the theme based on the priority ranking, societal demands, or the yearly priority list of patient safety incidents. Conclusion: It is recommended that the official patient safety center distribute the report in the form of a summary that can be utilized nationwide at medical institutions, government institutions, and other places. Updates, as well as accumulated theme reports, will serve as the baseline data for the proposal of the system and for the policy designed to implement and improve institutions' safety practices as a standard of domestic patient safety practice guidelines.

An Evaluation and Management Strategy of Environmental Zone for Improving Air Quality in the Seoul Metropolitan Area (수도권 도심 대기질 개선을 위한 환경지역의 운영전략 및 평가에 관한 연구)

  • Choi, Kee Choo;Lee, Kyu Jin;Ahn, Seong Chae;Shin, Kang Won
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.29 no.6D
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    • pp.693-702
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    • 2009
  • In the Seoul metropolitan area (SMA), transportation sector is the largest source of air pollutant emissions. Of the total amount of air pollutant emissions in the SMA, about 52% of the particulate matter emissions and 59% of the nitrogen oxide emissions are from superannuated heavy diesel vehicles. To lessen the air pollutant emissions from superannuated heavy vehicles in the SMA, this study devised several strategies for operating Environmental Zone (EZ) program, which requires superannuated heavy diesel vehicles to install reduction equipments as well as restricts them entering part of the SMA, and evaluated the effects of different strategies on air pollution in the SMA. By using the Korean traffic statistics, an evaluation has been made of six EZ scenarios, which were devised by different target areas and vehicles. The results showed that the EZ program with retrofitting a DPF (Diesel Particulate Filter) equipment to 7-year-old heavy diesel vehicles and early scrapping of pre-1998 heavy diesel vehicles is the most efficient alternative in terms of air pollution reduction. In addition, the results showed that the magnitude of air pollution reduction increases when implementing the EZ program to all entering superannuated heavy diesel vehicles to the SMA rather than registered ones in the SMA.

Annual Analysis on Quality Attributes and Customer Satisfaction in School Foodservice (연차별 학교급식 품질 속성 및 전반적인 만족도 분석)

  • Yi, Bo-Sook;Yang, Il-Sun;Park, Moon-Kyung
    • Journal of Nutrition and Health
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    • v.42 no.8
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    • pp.770-783
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    • 2009
  • The school foodservice was quantitatively extended by policy of government all the while. There was carried out the survey of customer satisfaction about school foodservice by the ministry of education, science, and technology since 2006 years. Therefore, the purpose of this study was to grasp an improvement of the scores of school foodservice' quality attributes and satisfaction as compared with the preceding year by respondents and school type (elementary school, middle school, and high school). An annual survey was practiced to respondents (students, parents, and faculty) on september 2007 years and 2008 years in 16 cities and provinces. The statistics was analyzed to descriptive analysis and t-test for SPSS 12.0. The scores of school foodservice' quality attributes and overall customer satisfaction were almost increased to students, parents, and faculty and especially, big elevation in middle school. There was big increased the quality attributes such as 'providing information on foodservice', 'pleasant foodservice environment', 'kindness offered by employee' in elementary school, middle school, and high school to total respondents. An overall satisfaction in school foodservice was improved from 69.2 score to 71.9 score. On students, scores of overall satisfaction was increased from 72.9 to 74.0 as students of elementary school and from 61.5 to 65.8 as students of middle school (p < .001). Therefore, for improvement and development of school foodservice, there should be a necessary for an operator of school foodservice and an office of education to make an effort.