• Title/Summary/Keyword: Long-term care Hospital

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Effectiveness of porcine-derived xenograft with enamel matrix derivative for periodontal regenerative treatment of intrabony defects associated with a fixed dental prosthesis: a 2-year follow-up retrospective study

  • Kim, Yeon-Tae;Jeong, Seong-Nyum;Lee, Jae-Hong
    • Journal of Periodontal and Implant Science
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    • v.51 no.3
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    • pp.179-188
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    • 2021
  • Purpose: Due to the difficulty of the hygienic care and sanitary management of abutment teeth and subpontic areas associated with fixed dental prostheses (FDPs), intrabony defects occur and accelerate due to the accumulation of plaque and calculus. This study aimed to evaluate the efficacy of regenerative periodontal surgery for intrabony defects associated with FDPs. Methods: The study inclusion criteria were met by 60 patients who underwent regenerative treatment between 2016 and 2018, involving a total of 82 intrabony defects associated with FDPs. Periodontal osseous lesions were classified as 1-, 2-, and 3-wall intrabony defects and were treated with an enamel matrix derivative in combination with bone graft material. The changes in clinical (pocket probing depth [PPD] and clinical attachment level [CAL]) and radiographic (defect depth and width) outcomes were measured at baseline and at 6, 12, and 24 months. Results: Six months after regenerative treatment, a significant reduction was observed in the PPD of 1-wall (P<0.001), 2-wall (P<0.001), and 3-wall (P<0.001) defects, as well as a significant reduction in the CAL of 2-wall (P<0.001) and 3-wall (P<0.001) intrabony defects. However, there was a significant increase in the CAL of 1-wall intrabony defects (P=0.003). Radiographically, a significant reduction in the depth of the 3-wall (P<0.001) defects and a significant reduction in the width of 2-wall (P=0.008) and 3-wall (P<0.001) defects were observed. The depth decreased in 1-wall defects; however, this change was not statistically significant (P=0.066). Conclusions: Within the limitations of the current study, regenerative treatment of 2- and 3-wall intrabony defects associated with FDPs improved clinical and radiological outcomes. Additional prospective studies are necessary to confirm our findings and to assess long-term outcomes.

Updated guidelines for prescribing opioids to treat patients with chronic non-cancer pain in Korea: developed by committee on hospice and palliative care of the Korean Pain Society

  • Minsoo Kim;Sun Kyung Park;Woong Mo Kim;Eunsoo Kim;Hyuckgoo Kim;Jun-Mo Park;Seong-Soo Choi;Eun Joo Choi
    • The Korean Journal of Pain
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    • v.37 no.2
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    • pp.119-131
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    • 2024
  • There are growing concerns regarding the safety of long-term treatment with opioids of patients with chronic non-cancer pain. In 2017, the Korean Pain Society (KPS) developed guidelines for opioid prescriptions for chronic non-cancer pain to guide physicians to prescribe opioids effectively and safely. Since then, investigations have provided updated data regarding opioid therapy for chronic non-cancer pain and have focused on initial dosing schedules, reassessment follow-ups, recommended dosage thresholds considering the risk-benefit ratio, dose-reducing schedules for tapering and discontinuation, adverse effects, and inadvertent problems resulting from inappropriate application of the previous guidelines. Herein, we have updated the previous KPS guidelines based on a comprehensive literature review and consensus development following discussions among experts affiliated with the Committee on Hospice and Palliative Care in the KPS. These guidelines may assist physicians in prescribing opioids for chronic non-cancer pain in adult outpatient settings, but should not to be regarded as an inflexible standard. Clinical judgements by the attending physician and patient-centered decisions should always be prioritized.

Effects of a Multifaceted Pediatric Delirium Education Program for Pediatric Intensive Care Unit Nurses on their Delirium Knowledge, Self-confidence in Delirium Nursing, and Delirium Assessment Accuracy: A One Group Pretest-Posttest Design (소아중환자실 간호사를 위한 다면적 소아 섬망 교육프로그램이 섬망 지식, 섬망 간호에 대한 자신감, 섬망 사정 정확도에 미치는 효과: 단일군 전후설계)

  • Nam, Song Yi;Choi, Su Jung;Oh, Sa Rang;Chio, Ji Eun;Park, Ki Young
    • Journal of Korean Critical Care Nursing
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    • v.16 no.1
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    • pp.56-70
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    • 2023
  • Purpose : This study aimed to identify the effects of a multifaceted pediatric delirium education program for pediatric intensive care unit (PICU) nurses on their delirium knowledge, confidence in delirium nursing, and delirium evaluation accuracy. Methods : This study used a one-group pretest-posttest design. The participants were 50 nurses in two units of the PICU at S General Hospital in Seoul. All participants took a 1-hour lecture with case-based practice for the first two weeks, and received feedback as they applied the program to clinical practice over the next two weeks. Test measures were completed before and after the four week intervention period for all participants. The delirium evaluation accuracy was measured using the Korean version of the Cornell Assessment of Pediatric Delirium. Data were analyzed using the chi-square and paired t-tests. Results : After the Pediatric Delirium Education Program, nurses' delirium knowledge (x2=11.65, p =.001), confidence in delirium nursing (t=9.71, p<.001), and delirium evaluation accuracy (t=6.07, p<.001) improved significantly. Conclusions : Pediatric delirium education programs for PICU nurses were effective. For active application of the program in clinical practice in the future, various cases of childhood delirium and specific strategies for each subject must be developed. To achieve this, long-term intervention and research for multiple organizations are required.

No benefit of hypomethylating agents compared to supportive care for higher risk myelodysplastic syndrome

  • Sohn, Sang Kyun;Moon, Joon Ho;Lee, In Hee;Ahn, Jae Sook;Kim, Hyeoung Joon;Chung, Joo Seop;Shin, Ho Jin;Park, Sung Woo;Lee, Won Sik;Lee, Sang Min;Kim, Hawk;Lee, Ho Sup;Kim, Yang Soo;Cho, Yoon Young;Bae, Sung Hwa;Lee, Ji Hyun;Kim, Sung Hyun;Song, Ik Chan;Kwon, Ji Hyun;Lee, Yoo Jin
    • The Korean journal of internal medicine
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    • v.33 no.6
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    • pp.1194-1202
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    • 2018
  • Background/Aims: This study evaluated the role of hypomethylating agents (HMA) compared to best supportive care (BSC) for patients with high or very-high (H/VH) risk myelodysplastic syndrome (MDS) according to the Revised International Prognostic Scoring System. Methods: A total of 279 H/VH risk MDS patients registered in the Korean MDS Working Party database were retrospectively analyzed. Results: HMA therapy was administered to 205 patients (73.5%), including 31 patients (11.1%) who then received allogeneic hematopoietic cell transplantation (allo-HCT), while 74 patients (26.5%) received BSC or allo-HCT without HMA. The 3-year overall survival (OS) rates were $53.1%{\pm}10.7%$ for allo-HCT with HMA, $75%{\pm}21.7%$ for allo-HCT without HMA, $17.3%{\pm}3.6%$ for HMA, and $20.8%{\pm}6.9%$ for BSC groups (p < 0.001). In the multivariate analysis, only allo-HCT was related with favorable OS (hazard ratio [HR], 0.356; p = 0.002), while very poor cytogenetic risk (HR, 5.696; p = 0.042), age ${\geq}65years$ (HR, 1.578; p = 0.022), Eastern Cooperative Oncology Group performance status (ECOG PS) 2 to 4 (HR, 2.837; p < 0.001), and transformation to acute myeloid leukemia (AML) (HR, 1.901; p = 0.001) all had an adverse effect on OS. Conclusions: For the H/VH risk group, very poor cytogenetic risk, age ${\geq}65years$, ECOG PS 2 to 4, and AML transformation were poor prognostic factors. HMA showed no benefit in terms of OS when compared to BSC. Allo-HCT was the only factor predicting a favorable long-term outcome. The use of HMA therapy did not seem to have an adverse effect on the transplantation outcomes. However, the conclusion of this study should be carefully interpreted and proven by large scale research in the future.

A Study on Differences of Opinions on Home Health Care Program among Physicians, Nurses, Non-medical personnel, and Patients. (가정간호 사업에 대한 의사, 간호사, 진료관련부서 직원 및 환자의 인식 비교)

  • Kim, Y.S.;Lim, Y.S.;Chun, C.Y.;Lee, J.J.;Park, J.W.
    • The Korean Nurse
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    • v.29 no.2
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    • pp.48-65
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    • 1990
  • The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

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Oral health knowledge level on oral care and elder oral hygiene care of the nursing home staff in long-term care facilities (노인요양시설 요양보호사의 구강관리 및 노인구강위생관리에 따른 구강보건지식 수준)

  • Kim, Kyung-Min;Park, Young-Nam;Lee, Min-Kyung;Lee, Jung-Hwa;Yoon, Hyun-Seo;Jin, Hye-Jung;Kim, Hye-Jin
    • Journal of Korean society of Dental Hygiene
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    • v.14 no.5
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    • pp.723-730
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    • 2014
  • Objectives : This research was conducted to investigate geriatric care workers' oral care, and the oral care conditions of residents of elder care facilities in relation to workers' knowledge of oral care. Methods : A survey was conducted from November 2011 to February 2012 with geriatric-care workers in elder care facilities located in Busan and other areas of Gyeongsangnam-do. Results : With regard to their oral self-care practices, 52.5% of the geriatric workers "brushed their teeth from top to bottom" and 58.1% brushed their teeth 3 times a day. Further, 52.0% did not use any oral care products, while 36.5% used Mouthrinese. The workers who brushed their teeth in their own ways or from top to bottom had significantly higher oral care knowledge scores than those who brushed from left to right (p<.05). Concerning oral hygiene care for residents, 72.6% of the geriatric workers recommended that elders visit dentists for oral care, 96.6% helped elders oral wash their teeth every day, and 54.7% used oral care products for the elders. The workers who did not recommend visits to dental clinics scored slightly higher than those who did (p<.05). Additionally, those who did not help elders oral wash their teeth scored significantly higher than those who did (p<.05). Except for oral wash to recuperated old man and recommendation of visiting the dentist, relation between oral care and knowledge about oral health and oral hygiene care is plus mutual relation. Conclusions : To manage the accuracy and quality of oral care work performed by geriatric care workers in elder care facilities, enhancing standard training and education on oral care is necessary. Providing systematic, regular education on such knowledge and practices would also be essential.

Insurance Claims Review and Assessment Task Effects on the Insurance Claims Reviewer and Evaluator in Hospitals (병원 급 보험심사자의 업무 특성에 따른 효과 분석)

  • Lee, Ko-Eun;Kim, Kyung-Hwa
    • The Korean Journal of Health Service Management
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    • v.11 no.1
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    • pp.27-42
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    • 2017
  • Objectives : This study analyzes the characteristics of hospital organization structures, insurance claims reviews and assessment tasks and their effects on hospitals in Pusan. Methods : The data for this study were collected through interview and self-administered surveys in 109 hospitals. The study included only - hospitals with a minimum of 50beds and excluded those providing only dental, psychiatric, or long-term care. Results : The findings of this study state that the number of beds has an influence on the organizitional structure. Conclusions : Hospital managements should seek human resources management(the insurance claims reviewer and evaluator) schemes that take into account the characteristics of the medical institution. In addition, insurance claims review and assessment tasks in hospitals require considerable knowledge and experience, and hospitals should be equipped with staff that have the relevant expertise. Therefore, to further deepen knowledge, comprehensive training should be continuously carried out in order to produce specialists in claims review and assessment.

CARE OF POSTTRAUMATIC PAIN SYNDROME IN THE PSYCHIATRIC DISORDER PATIENT : REPORT OF CASES (정신 장애 환자에서 외상후 통증증후군의 관리 : 증례보고)

  • Oh, Ji-Hyeon;Yoo, Jae-Ha;Kim, Jong-Bae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.11 no.1
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    • pp.9-16
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    • 2015
  • Pain and sensory disorder resulting from injury to peripheral nerves of the face and jaws are a major source of patient dissatisfaction and suffering. The majority of patient who sustain injuries to the peripheral sensory nerves of the face and jaws experience a slow but orderly return of sensation that is functional and tolerable in quality, if not "normal". For many patients, however, the long-term effects are a source of aggravation, and for a few, a significant cause of suffering. Common complaints relate to reduced sensory information causing embarrassing food accumulations or drooling, biting a burning the lip or tongue, and difficulty in performing routine activities such as shaving and apply makeup. For some patients posttraumatic symptoms become pathological and frankly painful. The predominent pain components are (1) numbing anesthesia dolorosa pain, (2) triggered neuralgiaform pain, (3) burning, aching causalgiaform pain, and (4) phantom pain. This is a report of cases about posttraumatic pain syndrome associated with dental treatment in a psychologically disabled patient.

Effects of BSC Model's Non-financial Factors on Financial Performance in General Hospitals (종합병원의 비재무적 요인이 재무성과에 미치는 영향 - BSC 기법을 중심으로)

  • Yang, Jong-Hyun;Chang, Dong-Min
    • Korea Journal of Hospital Management
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    • v.16 no.3
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    • pp.57-74
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    • 2011
  • The purpose of this study is to analyze the relationship between the BSC model's non-financial factors such as learning and growth, internal process, customer and financial factor in general hospitals. To achieve research purpose, the data were collected from 293 employees of 5 hospitals using a standardized questionnaires which were constructed to include BSC model, and applied the structural equation modeling to examine the relationship between non-financial and financial factor. The results show that the learning and growth factor of the model has positive effects of the internal process and customer factor. The internal process and customer factor are strongly related to financial factor. Hospitals have to know non-financial factor which has positively relate to financial factor. Therefore, the results of this study help to enhance the health care center to become aligned and focused on implementing the long-term competitive strategy. This study proposes an effective performance indicators for general hospitals and it is expected to be likely to have positive influence upon enhancing services of general hospitals.

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Relationships of Activities of Daily Living and Body Image with Quality of Life in Stroke Patients: Mediating Effects of Interpersonal Relations (뇌졸중 환자의 일상생활 수행능력, 신체상이 삶의 질에 미치는 영향: 대인관계 매개효과 중심)

  • Kim, Minju;Park, Hyomin
    • Journal of muscle and joint health
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    • v.28 no.2
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    • pp.183-191
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    • 2021
  • Purpose: This study was conducted to identify factors associated with stroke patients' quality of life (QOL) and examine the mediating effects of interpersonal relations in the relationships of activities of daily living (ADL) and body image with QOL. Methods: In this study, 160 stroke patients were recruited from an outpatient clinic of a university hospital and rehabilitation clinic of a long-term care hospital. Participants completed a questionnaire which included sociodemographic characteristics, ADL, body image, interpersonal relation, and QOL. Descriptive statistics, t-tests, ANOVA, Pearson's correlation coefficients, multiple regression analysis, and process macro mediation analysis were conducted using SPSS. Results: The mean scores were 91.01 (range 6~100) for ADL, 61.19 (range 40~79) for body image, 87.53 (range 29~123) for interpersonal relations, and 186.67 (range 71~243) for QOL. Multiple regression analyses showed that ADL, body image, interpersonal relations, and participation in group activities after stroke were significantly associated with QOL among stroke patients (p<.05). There were no mediating effects of interpersonal relations in the relationships of ADL and body image with QOL (p>.05). Conclusion: This study showed that there is a need for physical, psychological, and social recovery to improve the QOL of stroke patients.