During acute stages of hospitalized stroke patients, family caregivers face many challenges. They often experience emotional distress, social isolation, and financial constraints. However, the burden of caregiving of stroke patients in acute stages has never been studied properly. The purpose of this study was to investigate the factors related to the caregivers' burden with acute stroke. The subjects were 123 acute stroke patients and their caregivers who were admitted to neurology and neurosurgery units at Dan Kook University Hospital in Chung-Nam area. An interview was performed with the use of standardized questionnaire which included data pertaining to the patients/caregivers characteristics, caregiver burden (Modified Zarit's Burden Scale), and social support (Personal Resource Questionnaire). Our results showed that the mean burden score was 3.11, indicating high level of burden. Among the sub-domain scores, financial burden was the highest. In univariate analysis, the factors related to caregiver burdens were: inability to communicate between patients and caregiver(p<.001); low cognitive function of the patients(p<.001); low level of ADL(p<.001); the gender of caregiver(p<.001); the current employment status of caregivers(p<.01); the presence of social support for caregiver(p<.001); and the availability of alternative caregivers(p<.001). In multiple regression analysis, social support for family caregivers (87%), low level of patient's cognition (2%), availability of 2nd caregiver (1%), and gender of caregiver (female, 0.4%) were significant explanatory factors of overall burden. The caregivers' burden in acute stages during hospitalization following stroke was high. Recognition of high levels of caregivers' burden and those relating factors affecting caregiver burden may allow us to develop different nursing strategies to unload the level of burden for caregivers in acute stages of stroke.
Background: Tobacco control and cessation interventions are among the most cost effective medical interventions but health systems in low resource countries lack the infrastructure to promote prevention and cessation among tobacco users. Workplace settings have the potential to provide opportunities and access for tobacco prevention interventions. Methods: This is a single group study evaluating tobacco use prevention and cessation through a structured three stage intervention program for tobacco users comprising education on harmful effects of tobacco, oral cancer screening and behavior therapy for tobacco cessation at the worksite. Results: All the 739 workers who were invited participated in tobacco awareness program and were screened for oral pre cancer lesions. 291 (39.4%) workers were found to be users of tobacco in some form. Education, gender and alcohol use (p<0.0001) were some of the factors associated with tobacco user status. The prevalence of clinical oral precancer lesions among tobacco users was 21.6%. Alcohol consumption (p<0.001), the type of tobacco consumed (p<0.018), personal medical history of chronic diseases (p<0.007) and combined use of alcohol and tobacco (p<0.001) were some factors found to be associated with presence of oral pre cancer lesions. Conclusion: An integrated approach for worksite based tobacco use prevention with oral cancer screening program showed good acceptance and participation and was effective in addressing the problem of tobacco consumption among the factory workers.
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.
Journal of The Korea Institute of Healthcare Architecture
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v.25
no.3
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pp.7-14
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2019
Purpose: The purpose of this research is to find out week and strong aspects in LEED categories based on achieved scores earned by LEED-HC(Healthcare) v.2009. Methods: The LEED-HC scorecards of 88 healthcare projects are analyzed. The analysis are focused on relationship between achieved scores, LEED categories and achieved levels. This relationship was presented by graphs and charts. Results: 1) Compare to LEED-NC, in LEED-HC, sub-categories related to public health are added. The scores are added in Energy Atmosphere and Indoor Environmental Quality. 2) Achieve scores in Sustainable Site are high and one in Energy Atmosphere and Indoor Environmental Quality are low at all levels. 3) Scores which was lost in Energy Atmosphere are recovered in Material Resource and Sustainable Site in order to keep its level. 4) Since most of scores in Energy Atmosphere are under EAc1 Optimize energy performance sub-categories, it is important to achieve more score in Optimize Energy Performance Sub-Categories to gain a higher level. Even if LEED-HC has more score in Energy Atmosphere, this is a hard to achieve scores in that categories. It is important to review Energy Atmosphere categories and its points for improvement. Implications: This study will provide basic database in order to establish Korean green building rating system for hospital.
Purpose: Repeated hospitalization could be a proxy of unnecessary or preventive admission in South Korea where barriers to hospitalization are relatively low. This study aimed to estimate the current status of repeated hospitalization due to ambulatory care sensitive conditions (ACSC) in South Korea. Methods: Using the National Health Information Database, repeated hospitalization databases were constructed in units of episodes for patients who had been admitted more than twice between January 2017 and December 2018. The number of hospitalizations, total in-hospital days, and total medical expenditure were calculated and compared by patient characteristics in both of the entire patient group and the ACSC patient group. Results: Of total hospitalization episodes, 26.6% reported repeated admission, and 6.7% of repeated hospitalization was due to ACSC. A total of 183,110 patients with ACSC had been admitted an average of 2.9 times and spent an average of KRW5,630,118. In other words, KRW1,309 billion had been spent for repeated hospitalization due to ACSC. The scale of medical expenditure was relatively large in the highest and lowest socioeconomic status. Conclusion: Repeated hospitalization for ACSC can be considered a simple and intuitive indicator when assessing unnecessary hospitalizations or evaluating healthcare policy.
Poverty directly affects health and well-being, The poor population has a higher rate of chronics illness. higher infant morbidity and motality rates. shorter life expectancy. more complex health problems. and greater physical limitations resulting from chronic disease. In order to activate primary health care for the poverty in urban area the following measures should be taken : 1. Health center must be expended or establish subhealth center. 2. Health center must monitor neighbour's workplace's health management for their working population. 3. Health centers must do active home visiting nursing care for the urban-poor. 4. Health center must carry out flexible problem-centered practice according to the area. 5. For the urban-poor's health care must have organization of the health center & practice according to community's characteristics. 6. Public health care must be closely connected with welfare. 7. For the health care of the urban-poor must demand active community participation. 8. Health center is closely connected with Community hospital. 9. Active management of public health resource system is demanded.
This study was conducted to determine nutritional values of different sources of food residues(FR) released in autumn and to compare them with nutrient requirements on NRC standard feeding system of swine. Hospital or cafeteria FR contained more cooked rice and side dishes residues and less vegetable residues and fruit peel, resulting in higher energy and lower fiber contents, compared to apartment complex FR, which had opposite patterns to these results. Chemical composition between hospital and cafeteria FR was almost similar. Salt(NaCl) content was more than 9 folds of NRC swine requirement, but much lower than the maximum tolerant level. Essenial and non-essential amino acids profile was similar among FR sources. Hospital or cafeteria FR protein had a similar pepsin digestibility to soybean meal protein. Apartment complex FR protein, however, had a much lower pepsin digestibility. When NRC nutrient requirements are considered, FR in swine diets could satisfy requirements of protein and all the essential amino acids, 75${\sim}$111% of digestible or metabolizable energy, and most of the major and minor minerals. All the FR contained extremely low levels of toxic heavy metals, indicating that they are completely safe from these toxic substances. It was concluded that hospital or cafeteria FR could be a nutritionally excellent and balanced feed source for swine.
This study purported to acquire information necessary to improve the operational efficiency of general hospitals. It tried to determine major indices which represent managerial performance of general hospitals and to identify the managerial characteristics of general hospital which affect the major financial indices. 201 hospitals which were subject to standardization audit by the Korean Hospital Association were investigated and 80 hospitals were finally chosen for this study. Their financial and managerial data during the period between January 1991 and December 1991 were collected. Considering financial indices in this study were the ration of net income to total asset, income growth rate, and quick ration. The results of study are summarized as followings. First. The ration of net income to total assets and quick ration were highly related to managerial characteristics of general hospitals. Therefore, the standardization of three financial indices should be needed to systematically check the operational efficiency of general hospitals. Second, the sample hospitals can be classified as four groups on the basis of their financial indices' level. 4 of those hospitals(5.0%) showed high level of performance in terms of three financial indices and 27 of them(33.7%) showed that they are highly related to only two financial indices. 34 hospitals(42.5%) showed they have high level of relationship with only one indices and 15 hospitals(18.8%) showed very weak performance level with three indices. In addition, there is no hospitals to show mid-range level of managerial performance in relation to all three financial indices. Third, there is no significant relationship between three financial indices and the managerial characteristics of hospitals such as the number of beds, type of operation, location of hospitals, and etc. However, in the case of hospitals which have high level of managerial performance, they have more specialists and medical support personnel in comparison to low performance hospitals. They also have high level of bed occupancy rate and average length of stay(ALOS). In conclusion, the study showed the standardization of 3 financial indices are necessary to systematically evaluate the managerial performance of general hospitals and provide more accurate operational information for each hospital. To do so, it is necessary to focus on management side of hospital such as the effective human resource management and quality enhancement of medical treatment.
Purpose: The specific aims of this study was to find out the barrier to smoking cessation intervention in clinical practice among clinical nurses and compare them in high barrier group with those in the low barrier group. Method: The sample of this study consisted of 738 nurses practicing in general hospitals with over 400 beds throughout the country. The questionnaire was adopted from the 'Oncology Nurse's Tobacco Control Survey' used in the United Stated by Sarna et al.(2001). Result: Age, marital status, hospital experience, position were the variables related to the mean score of subjective resource insufficiency. The perception that the patient was not motivated to quit smoking was the most commonly identified barrier in low barrier group and the second most common barrier in high barrier group. Conclusion: Younger, with less clinical experience, single, staff nurses were the characteristics of nurses in the high barrier group. The smoking cessation educational program should be targeted to these populations. Further research is needed to develope strategies to reduce the perception associated with barriers in delivery of tobacco cessation interventions.
So, Kyeong A;Kim, Seon Ah;Lee, Yoo Kyung;Lee, In Ho;Lee, Ki Heon;Rhee, Jee Eun;Kee, Mee Kyung;Cho, Chi Heum;Hong, Sung Ran;Hwang, Chang Sun;Jeong, Mi Seon;Kim, Ki Tae;Ki, Moran;Hur, Soo Young;Park, Jong Sup;Kim, Tae Jin
Obstetrics & gynecology science
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v.61
no.6
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pp.662-668
/
2018
Objective This study was to identify the risk factors for cytological progression in women with atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesions (LSIL). Methods We analyzed data from women infected with the human papillomavirus (HPV) who participated in the Korean HPV cohort study. The cohort recruited women aged 20-60 years with abnormal cervical cytology (ASC-US or LSIL) from April 2010. All women were followed-up at every 6-month intervals with cervical cytology and HPV DNA testing. Results Of the 1,158 women included, 654 (56.5%) and 504 (43.5%) women showed ASC-US and LSIL, respectively. At the time of enrollment, 143 women tested positive for HPV 16 (85 single and 58 multiple infections). Cervical cytology performed in the HPV 16-positive women showed progression in 27%, no change in 23%, and regression in 50% of the women at the six-month follow-up. The progression rate associated with HPV 16 infection was higher than that with infection caused by other HPV types (relative risk [RR], 1.75; 95% confidence interval [CI], 1.08-2.84; P=0.028). The cytological progression rate in women with persistent HPV 16 infection was higher than that in women with incidental or cleared infections (P<0.001). Logistic regression analysis showed a significant relationship between cigarette smoking and cytological progression (RR, 4.15; 95% CI, 1.01-17.00). Conclusion The cytological progression rate in HPV 16-positive women with ASC-US or LSIL is higher than that in women infected with other HPV types. Additionally, cigarette smoking may play a role in cytological progression.
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