• Journal of Korean Public Health Nursing
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• v.6 no.2
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• pp.11-20
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• 1992

The major goal of caring the elderly is not to cure the patient, but rather to improve or maintain the individual functional ability. With the aged population increases, there is increasing consensus among health care workers about the importance of developing a tool to measure and evaluate the health status of the elderly. As many writers is pointing out, care of the elderly embraces the spectrum of physical-social-psychological problems and an enormous number of variables could be introudeced into the health worker's routine measurement. But such an expansive approach to measurement could have disadvantages. The purpose of this study is to introduce the measurement tools of physical functioning, perhaps the most important measure required in long-term care, which are separated into three categories of measures; general physical health, ADL, IADL. It is important that all health workers who provide care to the elderly incorporate the concepts of functional health status into the routine assessments. And continuous study about reliability and validity is needed to apply those foreign tools to Korea.

• Journal of Digital Convergence
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• v.18 no.11
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• pp.559-569
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• 2020

This study was conducted to examine relationships among job environment, psychological work demand, fatigue, musculoskeletal symptoms, then to investigate the factors influencing musculoskeletal symptoms of care workers in long-term care hospitals. A total of 128 care workers recruited from three long-term care hospitals in S city. Self-reported questionnaire survey was conducted from April to May, 2020. The results were as follows: The musculoskeletal symptoms of the care workers were the sum of the frequency of symptom occurrence, duration of symptoms, and intensity of pain in the three parts of the shoulder, hand/wrist/finger, and waist. The average score was 11.41±9.50 points out of 42. According to the hierarchical regression analysis, their musculoskeletal symptoms were significantly influenced by working department(β=.18, p=.034), psychological work demand(β=.21, p=.013) and fatigue(β=.25, p=.003), explained 21.6% of the total variance(F=6.87, p<.001). Based on our results, in order to reduce musculoskeletal symptoms of care workers in nursing hospitals, it is necessary to develop and apply an intervention program that can reduce psychological work demand and fatigue in consideration of the severity of the patient in charge.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2009.05a
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• pp.337-340
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• 2009

Wireless tele-home-care application gives new possibilities for ECG (electrocardiogram) monitoring system with wearable biomedical sensors. Thus, continuously development of high convenient ECG monitoring system for high-risk cardiac patients is essential. This paper describes to monitor a person's ECG using wearable approach. A wearable belt-type ECG electrode with integrated electronics has been developed and has proven long-term robustness and monitoring of all electrical components. The measured ECG signal is transmitted via an ultra low power consumption wireless sensor node. ECG signals carry a lot clinical information for a cardiologist especially the R-peak detection in ECG. R-peak detection generally uses the threshold value which is fixed thus it bring errors due to motion artifacts and signal size changes. Variable threshold method is used to detect the R-peak which is more accurate and efficient. In order to evaluate the performance analysis, R-peak detection using MIT-BIH databases and Long Term Real-Time ECG is performed in this research. This concept able to allow patient to follow up critical patients from their home and early detecting rarely occurrences of cardiac arrhythmia.

• Journal of Korean Critical Care Nursing
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• v.2 no.2
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• pp.18-27
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• 2009

Purpose: This study is to provide effective care to each individual with myocardial ischemia by finding out how the patient's knowledge related to the disease and anxiety level affect his/her compliance of patient role behavior. Methods: The subjects of study were 100 patients diagnosed as ischemic heart disease at a university hospital located in Gyeonggi Province. The data were collected from May 19, 2008 to August 30, 2008. A cross-sectional descriptive survey was done using a structured questionnaires. Results: The average score of knowledge level about myocardial ischemia was $22.24\pm5.07$(out of 31), anxiety level was $54.68\pm9.15$(out of 80), and compliance of patient role behavior was $34.28\pm6.00$(out of 50). A significant correlation between the patient's level of knowledge and his/her compliance of patient role behavior was found(r=0.239 p=0.017). The patients who are females, singles, without occupation, have a long term being diagnosed, under-educated, tend to be excellent in their compliance. Conclusion: The patient with a higher level of knowledge is better in his/her compliance of patient role behavior. Therefore, it is suggested that we need to develop nursing intervention to increase knowledge level as well as consistent educational support.

• Korea Journal of Hospital Management
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• v.7 no.1
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• pp.105-120
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• 2002

In the United States, the prospective payment system(PPS), under which diagnosis related groups (DRGs) are used to reimburse hospitals for the care of Medicare patients since 1983, Study results showed that the PPS is having a major impact on the quantity of services especially of hospital length of stay. The PPS has increased the likelihood that a patient will be discharged home in an unstable condition and the use of nursing homes or long term care facilities increased. Still, it is insufficient to conclude that the PPS has decreased the Medicare total expenditure, but relatively sufficient to conclude that the quality of care hasn't changed. The maintenance of the quality resulted from the systemic "check-and-balance" composed of three factors; (1) The doctors are reimbursed based on the fee-for-service system, (2) hospitals contact with doctors under the attending system, and (3) there are some public hospitals. In Korea, the reimbursement for hospitals and doctors are not divided, the hospitals have doctors as employees, and 90% of hospitals are private. These differences may weaken the "check-and-balance" existing in the U.S. system. And there are few long term care facilities and the diagnostic coding system using in pilot test are not suitable for Korean situation. In conclusion, for successful implementation of the DRG payment system in Korea, the government should establish the "check-and-balance" system in the health sector to make sure the quality of care before the implementation.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.9
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• pp.167-174
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• 2019

The propose od this study was to examine the extent of using physical restraint on elderly patients (over 65 years old) and who were patients in long-term care hospitals. The data was collected, from March 3 2018 to March 29 2018, from the electronic nursing records by using a recording tool, and clinical observation was also used for assessing the use of physical restraint and the related factors. Descriptive statistics, Pearson correlation coefficients and logistic regression were then performed. The usage rate for physical restraints in long-term care hospital was 83.7%, and the most common type of physical restraint was side rails. The use of physical restraints showed a positive correlation with the fall risk scores and a negative correlation with the MMSE. Logistic regression analysis showed that the Fall Risk Score (OR=1.02, 95% CI=1.01~1.03), MMSE (OR=0.94, CI=0.88~0.99) and the use of medical devices (OR=0.80, 95% CI=0.65~0.98) were related with using physical restraints. Therefore, it was confirmed that physical restraint was used in cases of a high risk of falling, severe cognitive impairment and the use of complex and fragile medical devices to treat the patient. Clinical nursing practice should be changed so that treatment alternatives can be applied for elderly patients rather than using too many physical restraints.

• International journal of advanced smart convergence
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• v.11 no.2
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• pp.194-204
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• 2022

This study is a one-group pretest-posttest design to evaluate the effect of problem-based learning (PBL) for patient safety on self-leadership, patient safety competencies, and reflective thinking of nursing students. The research was conducted from March 2 to April 15, 2022, in which 57 nursing students participated. PBL for patient safety was examined in a total of 8 sessions in the order of motivation, problem identification, task performance planning, problem-solving methods, summary and solution, presentation, and evaluation. The following topics of patient safety were selected for each team: nursing records, high-alert medication, medication error and intravenous fluid regulation, blood transfusion care, fall, bedsore, infection control, and pain management. We provided feedback on the learning process and outcomes of nursing students. According to the results, self-leadership showed a statistically significant improvement in self-expectations (t=2.60, p=0.01), goal setting (t=2.84, p<0.01), self-reward (t=3.32, p<0.01), and self-criticism (t=2.32, p=0.02). Patient safety competencies showed a statistically significant improvement in patient safety knowledge (t=13.05, p<0.001) and patient safety skills (t=4.87, p<0.001) but not in reflective thinking. The results prove that PBL for patient safety is an effective teaching-learning strategy to improve self-leadership and patient safety competencies. Future studies must develop and validate specific and long-term teaching-learning methods to improve reflective thinking.

• Journal of Chest Surgery
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• v.27 no.12
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• pp.989-994
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• 1994

Between January 1986 and August 1993, 11 patients underwent surgical repair of ventricular septal defect [VSD] complicated with myocardial infarction. The ages of patients were ranged from 22 years to 83 years with a mean of 64 years. There were 8 male and 3 female patients. The preoperative cineangiograms of all patients were reviewed to measure both ventricular function and to evaluate coronary artery disease. The mean time interval between occurance of VSD and operation was 13 days. The operations were performed as soon as possible if there were hemodynamic derangement. Postmyocardial infarction VSD were repaired simultaneuously with coronary artery bypass graft in 3 patients, repaired with left ventricular aneurysmectomy in 6 patients, with left ventricular thrombectomy in 1 patient and with mitral valve chordae repair in 1 patient. There was no early death [within 30 days]. There were 6 postoperative complications; one with perioperative myocardial infarction, two with recurred VSD on postoperative 1 and 6 days respectively, two with lower leg embolism associated with intraaortic balloon pump insertion, one with wound infection. Of the complicated patients, 1 patient with lower leg embolism performed left above ankle amputation. Among two patients with recurred ventricular septal defect, one patient is doing well without problem. On follow up echocardiogram, the residual VSD was occluded completely. However another patient was with recurred VSD died 3 months after the operation because of congestive heart failure. Of the long term survivors, all patients are in NEW YORK Heart Association functional Class I or II. Although number of patients were small, our results of surgical closure of postmyocardial infarction VSD were favored to the others. Moreover, seven patients with preoperative cardiogenic shock among 11 were performed early operation after diagnosis of ventricular septal rupture. All of the patients were survived and doing well during the follow up period. Therefore early diagnosis with aggressive preoperative care with intraaortic balloon pumping and early operation seems to be very important for prevention of deterioration of vital organ.

• YAKHAK HOEJI
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• v.49 no.6
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• pp.449-458
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• 2005

There have been rapid changes in the pharmaceutical environment after the separation of Dispensing and Prescribing practice. In the early stage of this system, outpatients had few options to choose their pharmacies due to various obstacles. Under these circumstances, this study on the defection tendency of long-term care patients was performed through the analysis of outpatients who quit visiting a pharmacy nearby general hospital. PowerBuilder ver 9.0 program was used to extract significant data, and SPSS package was employed for statistic analysis. 3,308 outpatients who visited a pharmacy nearby hospital for a month (in January, 2004) were studied. Patients' sex, age and location of residence, the class of medical insurance, the characteristic type of medication (powder, split form, medication for external use/injection), waiting time, disease (department) were considered as variable factors. It turned out that the patient revisit ratio was 80.8$\%$ and the patient defection ratio was 32.4$\%$. As was expected, those factors mentioned above influenced on the revisit and defection ratio considerably. In terms of patient factors, it proved that there was no relationship among sex, location of residence, the class of medical insurance and revisit (defection) ratio. Only age factor influenced the ratio; the older, the higher revisit ratio and the less defection ratio. In respect of dispensing factors, there were obvious relationships among the factors and the ratio: bill (money they had to pay individually), waiting time, number of medications, splitting of tablets, unit price of drug and revisit (defection) ratio showed significant relationship. The result of this study revealed an aspect of outpatients' behavior and it could be used as a reference for better patient service and customer relationship management.

• Korean Journal of Occupational Health Nursing
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• v.32 no.4
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• pp.174-184
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• 2023

Purpose: The purpose of this study was to examine the impact of the working environment on person-centered care for home visiting dementia caregivers. Methods: Participants in this study were 146 caregivers, with the least 6 months of experience working at visiting care centers in Busan, and used a total of 133 questionnaires suitable for analysis. Data were collected from June 9 to July 20, 2023, and were analyzed using descriptive statistics, t-test, ANOVA, pearson's correlation coefficients, and multiple linear regression using IBM/SPSS 27.0. Results: As a result of multiple linear regression analysis, organizational factors (β=-.37, p<.001), job-related factors (β=-.27, p=.001), and religion (β=.18, p<.013) were factors affecting person-centered care of home visiting dementia caregivers, and working environment explained 37% (F=10.63, p<.001) of person-centered care. Conclusion: Based on the results of this study, the exploration of strategies to improve the working environment will be necessary in order to increase person-centered care for home visiting dementia caregivers.