Kim, Young-Im;Jung, Hye-Sun;Lee, Chang-Hyun;Kim, Gum-Sook;Park, Jung-Young
Research in Community and Public Health Nursing
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v.11
no.2
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pp.411-422
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2000
The purpose of this study is to identify the difference of emergency care conditions where the nurse is posted in the 119 relief squard or not. The data composed a total of 777 cases of emergency activity of one police stand in Seoul during March, June. September and December in 1998. The results of this study were as follows: 1. The age of the subjects was 20-60 age 54.3%, over 60 age 35.4% with an average age of 50.2. Among them men were 55.0%, the unemployed were 60.8%. The place of the occurrence of an accident was the house, 49.7% and the cause as illness was 59.6%. 2. The main symtom was pain the 36.2% the main consciousness state was alert 76.9%: The state of the patients as chronic was 59.6%. 3. The consulting hospital of the 119 relief squad as a third medical center was 79.9%. The distance to the medical center as less than 5 km was 77.2%, and an average transfer distance was 5.38 km. The cases of doctor guided emergency care was 0.9%, the cases that had posted nurses in 119 relief squads was 48.6%. 4. The case of the best emergency care operation was difficulty in breathing, 62.1% and the second was unconsciousness, 46.1 %. The more serious the consciousness state, the higher the rate of emergency care operation. There wasn't any difference in emergency care operation concerning transfer distance. 5. The cases that had the posted nurses was 19.1%, the cases of no nurse was 11.7% among the cases of emergency care operation during transfering; the cases that had posted nurses had the higher emergency care operation. (p<0.05). Airway maintenance was 14.8% in cases that had the posted nurses, while in the cases of no nurse, 10.9%; and oxygen inspiration was 16.0% in cases that had the posted nurses while in the cases of no nurse 7.6% (p<0.01); spinal fixation was 6.6% in cases that had the posted nurses while in the cases of no nurse 4.6%(p<0.05). With these results, we can conclude that the cases that had the posted nurse showed higher emergency care operation.
Journal of the Korean Institute of Illuminating and Electrical Installation Engineers
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v.20
no.6
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pp.49-54
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2006
The X-ray unit developed by this study is to diagnose emergency cases which is too far from a hospital and to classify the patients. We have to use the X-ray in a ambulance or the scene of an accident where we cannot use the AC220 outlet because of the distance from a hospital as well. The X-ray unit developed has a characteristics as follows. First of all, as the unit has a condenser in itself where there is no electric supply, we can use the X-ray inspector in a mountain area or a island. Second, we can detect by digital detector the information taken by X-ray from DC 12[V] electricity and store as a form of file. A control circuit can secure the reliability of the X-ray unit by using the Pic16F84A X-ray and provide various functions. The X-ray unit which suits remote emergency system can be efficiently used for the emergent cases who is too far from a doctor and a hospital or in the situation where it is difficult to diagnose, transcribe and treat simultaneously.
There will be many changes in job consciousness and job satisfaction due to changes in various job fields and social interests, and it is necessary to manage them efficiently for the organization to continue to grow. By analyzing factors influencing job satisfaction by occupation, the study intended to provide the necessary data for an efficient management plan. 400 Employees working at S tertiary hospital in Seoul from April 1st to April 15th, 2015 were targeted. An analysis of the validity and reliability of the influencing factors was conducted, and the allied health profession which showed the highest level of satisfaction in overall job satisfaction and influencing factors were identified. It was found that achievement, compensation and working environment in the medical doctor profession, achievement, compensation and job stability in the nursing profession, achievement and working environment in the allied health profession, achievement, interpersonal relationships, working environment, and job stability in the administrative profession, were the main influencing factors for job satisfaction. It can be seen that not only motivation factors but also hygiene factors affect job satisfaction. To increase the level of satisfaction, it is judged that systematic management of hygiene factors as well as motivation factors is necessary.
Objective : Due to the implementation of vaccinations and the development of therapeutic agents, the coronavirus disease 2019 (COVID-19) pandemic that started at the end of 2019 has entered a new phase. As a result, neurosurgeons should reconsider the way they treat their patients. As the COVID-19 situation prolongs, the change in neurosurgical emergency patients according to the number of confirmed cases is no longer clear. Outpatient treatment by telephone was permitted according to government policy. In addition, visits to caregivers in the intensive care unit were limited. Methods : The electronic medical records of patients who had been treated over the phone for a month (during April 2020, while the hospital was closing) were reviewed. Meanwhile, according to the limited visits to the intensive care unit, a video meeting was held with the caregivers. After the video meeting, satisfaction was evaluated using a questionnaire. Results : During April 2020, 1021 patients received non-face-to-face care over the telephone. Among the patients, no critical medical problem occurred due to non-face-to-face care. From July 2021 to December 2021, 321 patients were admitted to the neurosurgical intensive care unit and 107 patients (33.3%) including their caregivers agreed to video visits. Twice a week, advance notice was given that access would be made through a mobile device and the nurse explained to caregivers how to use the mobile device. The time for the video meeting was approximately 20 minutes per patient. Based on the questionnaire, 81 respondents (75.7%) answered that they agreed, and 26 respondents (24.3%) answered that they strongly agreed that was easy to communicate through video meetings. Fifty-two (48.6%) agreed and 55 (51.4%) strongly agreed that they were easy to understand the doctor's explanation. For overall satisfaction with this video meeting, three respondents (2.8%) gave 4/5 points and 95 respondents (88.8%) gave 5/5 points, and nine (8.4%) gave 3/5 points. Their reason was that there was not enough time. Conclusion : In situations where patient visits are limited, video meetings through a mobile device can provide sufficient satisfaction to caregivers. Telemedicine will likely become common in the near future. Health care professionals should prepare and respond to these needs and changes. Therefore, establishing a system with institutional support is necessary.
On the viewpoint of Nae-Kyung and Ju-Yeok, the Seok-Kok's Pu-Yang-Non and other oriental medical doctor's Po-Eum-Eok-Yang, Pu-Yang-Eok-Eum theory which are on the basis of the Kun-Shin-Sang-Wha theory of Nae-Kyung and Myung-Mun theory of Nan-Kyung were compared and studied. The results were as follows : 1. Ju-Yeok and Nae-Kyung said the South is Fire. And explained it as the chief object of life activity by likening to king or saint. And said the North is Water. but didn't mentioned that there exists Fire. The activity of Kun-Wha is regarded as the the chief object of life activity and the Shin-Su can be vatalized by receiving the Shim-Kun-Wha. Therefore, the Seok-Kok's opinion that Shang-Wha is the Fire received by Shin-Su matchs the theory of Nae-Kyung and Nan-Kyung. 2. The Kidney(Shin) in Nae-Kyung means Puk-Bang- Han-Su(The North Cold Water) which has two characters, charging and discharging, ascending and descending. The paragrap "Kam-Ga-Seub(坎加習)" in Ju-Yeok means Puk-Bang-Su(The North Water) which also has two characters, charging and discharging, ascending and descending. The beginning and the end. And One Eum and Two Yang of Ri Sign of divination(離卦) cannot be divided into Su-Jang and Wha-Jang, the same as that, One Yang and Two Eum of Kam Sign of divination(坎卦) is Puk-Bang-Han-Su which cannot be divided into Shin and Myung-Mun. The theory of Choa-Shin-Woo-Myung-Mun of Nan-Kyung is the result that the Shin which has two characters is regarded as two organs. Therefore, from the viewpoint of Nae-Kyung and Ju-Yeok, the Seok-Kok's opinion that the Shin is the Puk-Bang-Han-Su which charges from the right and discharges to the left is more proper. 3. For the first time, the right kidney(Woo-Shin) defined as Myung-Mun in the Nan-Kyung and it is trailblazing theory which dosen't exist in the Nae-Kyung. But from the viewpoint of Nae-Kyung, Myung-Mun-Shang-Wha which some oriental medical doctors thought importantly is considered as Shim-Po which is in charge of the order of Shim(心命). 4. The rush of heat to the upper part(上熱) is raised by blind acting of Shang-Wha which exists in the lower part. This theory is on the basis of the Myung-Mun-Shang-Wha theory of Nan-Kyung. The theory that Wha is in the Shin(Kidney) doesn't exist and only the theory exists that the fever happens by the Kun-Wha not going down but ascending in the Nae-Kyung. Therefore the Shang-Wha blind acting theory of the lower part is not coincided with the theory of Nae-Kyung. 5. When the Vital power(陽氣) is blocked by bad tendencies(邪氣) like uncontrolled joy and anger or too much cold and heat etc, the trapped heat(鬱熱) or Ascending Shang-Wha apper, so Vital power itself cannot have blind activity or excess. Therefore, the theory of oriental medical doctors that the remaining vital power is the fire(氣有餘便是火) cannot be materialized. 6. On the basis of the Woo-Shin-Myung-Mun theroy, oriental medical doctors attached importance to Shin-Eum and Shin-Yang. So they emphasized on Ja-Eum-Gang-Wha or On-Bo-Shin-Yang for curing the Fire. Contrarily, On the viewpoint of siding with the vital power which is the Good and repressing the bad tendency which is the Bad, and another viewpoint that when the vital power which is Shim-Kun-Wha moves through the body consistently and fills up the body, then the enery and blood can be made, the Seok-Kok's theory is coincided with the theory of Nae-Kyung.
Purpose: This study was conducted to identify the perception regarding palliative care among Korean doctors and referral barriers toward palliative care for terminal cancer patients. Methods: Between May and June 2010, 477 specialists mainly caring cancer patients using a web-based, self-administered questionnaire. Results: A total of 128 doctors (26.8%) responded. All respondents (100%) deemed palliative care a necessary service for terminal cancer patients. More than 80% of the respondents agreed to each of the following statements: all cancer centers should provide palliative care service (80.5%); all terminal cancer patients should receive concurrent palliative care along with anti-cancer therapies (89.1%) and caring for terminal cancer patients requires interdisciplinary approach (96.9). While more than 58% of the respondents were satisfied with their performance of physical and psychological symptoms management and emotional support provided by patient's family members, 64% of the responded answered that their general management of the end-of-life care was less than satisfactory. Doctors without prior experience in referring their patients to palliative care specialists accounted for 26.6% of the respondents. The most common barrier to hospice referral, cited by 47.7% of the respondents, was "refusal of patient or family member", followed by "lack of available palliative care resources" (46.1%). Conclusion: Although most doctors do recognize the importance of palliative care for advanced cancer patients, comprehensive and sufficient palliative medicine, including interdisciplinary cooperation and end-of-life care, has not been put into practice. Thus, more active palliative consultation or referral is needed for effective care of terminal cancer patients.
Pixel values of contrast enhanced computed tomography (CE-CT) images are randomly changed. Also, the middle liver part has a problem to segregate the liver structure because of similar gray-level values of a pancreas in the abdomen. In this paper, an automatic liver segmentation method using a partial histogram threshold (PHT) algorithm is proposed for overcoming randomness of CE-CT images and removing the pancreas. After histogram transformation, adaptive multi-modal threshold is used to find the range of gray-level values of the liver structure. Also, the PHT algorithm is performed for removing the pancreas. Then, morphological filtering is processed for removing of unnecessary objects and smoothing of the boundary. Four CE-CT slices of eight patients were selected to evaluate the proposed method. As the average of normalized average area of the automatic segmented method II (ASM II) using the PHT and manual segmented method (MSM) are 0.1671 and 0.1711, these two method shows very small differences. Also, the average area error rate between the ASM II and MSM is 6.8339 %. From the results of experiments, the proposed method has similar performance as the MSM by medical Doctor.
Kim, Haeng-Beom;Lee, Min-Ho;Lee, Soh-Young;Nam, Dong-Woo;Yang, Dong-Hoon;Choi, Yang-Sik;Park, Yeon-Chul;Koh, Hyung-Kyun;Lee, Yun-Ho
Journal of Acupuncture Research
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v.24
no.3
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pp.163-174
/
2007
Objectives : This study was designed to evaluate the effect of acupuncture on Heart Rate Variability(HRV) of patients with Parkinson's disease. Methods: Subjects were voluntarily recruited through newspaper and internet advertisement. All the subjects were confirmed as idiopathic Parkinson's disease by a neurologist. Patients were divided into three groups. Experimental group was acupunctured based on Sasang Constitution. Standard group was acupunctured on $LR_3$, $GB_{34}$ and $ST_{36}$. Control group was sham-acupunctured. Acupuncture was applied 2 times a week for four weeks by an oriental medical doctor at Kyung-hee Oriental Medical Hospital. The patients were assessed by HRV before and 4 weeks after the treatment. Results : The results were as follows 1. In experimental group, increase in SDNN, TP, LF, HF Nonn were statistically significant after 4 weeks compared to the pre-treatment. 2. In standard group, increase in SDNN, TP, LF were statistically significant after 4 weeks compared to the pre-treatment. 3. After 4 weeks of treatment SDNN, LF showed statistically significant cufferences among three groups. Conclusions : This study suggests that acupuncture treatment based on Sasang Constitution and other specific acupuncture treatment can be beneficial for patients with idiopathic Parkinson's disease. Further study on various acupuncture treatment for Parkinson's disease is required.
compensation is a major function of human resources management. The hospital industry is characterized by its remarkable labor intensity and human resource input by unit. That is why the hospital industry has a higher level of wage/cost ration. The issues of how much the hospital personnel's direct financial compensation amounts to and how the organizational and other factors generate compensation differentiation, are central problems for research in hospitals. But there have been few approaches to study staff compensation in hospitals, its magnitude and inter-hospital relative compensation amounts for the same personnel. A worker who moves from low-wage to a high-wage employer can usually increase his or her pay without change in job description. This means in the cases of same jobs, relative importance is different for each hospitals. The purpse of this study were to find the compensation levels of hospital personnel and to determine the factors affecting compensation levels of hospital personnel. The unit of analysis is the hospital and 145 hospitals were studied for nurse(RN), medical technoloist(MT), managerial personnel(MP) and 100 hospitals for medical doctor(MD). In this study the definitions of direct financial compensation are before tax, excluding employer's contriution and total annual remuneration received by the employee. Main findings of the research can be summarized as follows. 1. Direct financial compensation of hospital personnel are MD 45,056,000 won, RN 9,222,000 won, MT 9,513,000 won and MP 9,185,000 won in the starting year's employment in hospital. 2. According to determinants of hospital personnel compensations, there are no statistical significant variables to determine the level of MD's compensation. Wlith RN and MT's compensation level, the greater the patient revenue per 100 hospital beds, the higher the RN compensation and the tertiary hospital's compensation is much more than other types of hospitals. The location of hospital is another determinant factor for the MT's compensation level. Hospitals that are in the uban area have lower compensation level than rural area. There are the same results in MP with MT. Conclusions can be drawn from the results of the study. First, the wage differentiation of MD and other health personnel still remains and the differentiation existed in inter and intra job personnel of hospitals. Second, determinants of hospital personnel personnel compensation level are patient revenue, location, and type of hospital level.
Purpose: This study was conducted to investigate patients' characteristics and actual conditions of home-based services offered by a free-standing hospice center. Methods: A retrospective review was performed with the medical records of 75 patients who received home-based hospice care from a free-standing hospice center from January 2014 through December 2014. Results: Most patients (54.7%) were enrolled via self-directed referral. The reason for the service termination was death at home 25.3%, admission to a hospice ward 50.7%, hospitalization 22.6% and patients' refusal 2.7%. Seventy three patients had cancer, and two patients had ALS. Among all, 58.7% were in a dying phase, and 34.7% were almost completely bedfast at the time of their enrollment in this study. When they enrolled, the patients' physical symptoms were characterized as pain (89.4%), sleep disturbance (71.2%), urinary difficulties (35.8%) and defecation difficulties (47.8%). Among all, 77.4% terminated the home visit service within one month. The mean frequency of the home visits was 3.25 (${\pm}3.98$), and less than five in 82.7% of patients. The mean frequency of the phone service was 3.40 (${\pm}3.12$). The frequency of doctor's home visits was $1.21{\pm}0.79$ on average, and the figure increased when patients' conditions turned unstable. Conclusion: It is necessary to develop a home-based hospice care model with consideration of patients' characteristics and the actual service conditions delivered by free-standing hospice facilities.
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