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Remote Cardiac Rehabilitation With Wearable Devices

  • Atsuko Nakayama;Noriko Ishii;Mami Mantani;Kazumi Samukawa;Rieko Tsuneta;Megumi Marukawa;Kayoko Ohno;Azusa Yoshida;Emiko Hasegawa;Junko Sakamoto;Kentaro Hori;Shinya Takahashi;Kaoruko Komuro;Takashi Hiruma;Ryo Abe;Togo Norimatsu;Mai Shimbo;Miyu Tajima;Mika Nagasaki;Takuya Kawahara;Mamoru Nanasato;Toshimi Ikemage;Mitsuaki Isobe
    • Korean Circulation Journal
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    • v.53 no.11
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    • pp.727-743
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    • 2023
  • Although cardiac rehabilitation (CR) has been shown to improve exercise tolerance and prognosis in patients with cardiovascular diseases, there remains low participation in outpatient CR. This may be attributed to the patients' busy schedules and difficulty in visiting the hospital due to distance, cost, avoidance of exercise, and severity of coronary disease. To overcome these challenges, many countries are exploring the possibility of remote CR. Specifically, there is increasing attention on the development of remote CR devices, which allow transmission of vital information to the hospital via a remote CR application linked to a wearable device for telemonitoring by dedicated hospital staff. In addition, remote CR programs can support return to work after hospitalization. Previous studies have demonstrated the effects of remote CR on exercise tolerance. However, the preventive effects of remote CR on cardiac events and mortality remain controversial. Thus, safe and effective remote CR requires exercise risk stratification for each patient, telenursing by skilled staff, and multidisciplinary interventions. Therefore, quality assurance of telenursing and multi-disciplinary interventions will be essential for remote CR. Remote CR may become an important part of cardiac management in the future. However, issues such as cost-effectiveness and insurance coverage still persist.

The Role of Health Educators for the Prevention of Suicide in the Elderly Population in Gangwon-do (강원도 노인인구의 자살 예방을 위한 보건교육사의 역할)

  • Si-Kyoung Lee
    • Journal of the Health Care and Life Science
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    • v.10 no.1
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    • pp.61-68
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    • 2022
  • Korea's suicide rate is 23.0 people per 100,000 OECD standard population (as of 2017), the highest among OECD member countries, 2.1 times higher than the OECD average of 11.2. The suicide rate in Gangwon-do is the fourth highest in the country and the number of suicides is 507, with a suicide rate of 26.1 per 100,000 people. As basic data for reducing the suicide rate in Gangwon-do, the National Statistical Office, National Health Statistics, Community Health Survey, Health Insurance Corporation DB, Mental Health Case Management System (MHIS), and previous studies were analyzed in relation to suicide. Based on this, it is intended to provide basic data for reducing the suicide rate in Gangwon-do and to provide basic data for the design and use of an effective social intervention model.

The Effect of Infection Control Education Program on Infection Control Knowledge and Infection Control Performance of Visiting Nursing Nursing Assistant Trainees (감염예방 교육프로그램이 방문간호 간호조무사 교육생의 감염관리 지식과 감염관리 수행도에 미치는 영향)

  • Seong-Mi Yu;Jeong-Hyeon Kong;Hee-Kyung Kong
    • Journal of the Health Care and Life Science
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    • v.11 no.1
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    • pp.127-133
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    • 2023
  • The purpose of this study is to develop an infection control education program for visiting nursing assistant trainees and to verify its effectiveness. Data were collected using a structured questionnaire from 56 visiting nursing assistant trainees, and data were analyzed by applying frequency analysis, mean and standard deviation and t-test with the SPSS WIN 21.0 program. After applying the infection control program, the knowledge and performance of the subjects before and after education increased statistically significantly. In this way, it is necessary to continuously develop infection control education and programs to improve the level of infection control knowledge and performance of visiting nursing assistants.

Erratum: Correction of Text in the Article "Prasugrel-based De-Escalation of Dual Antiplatelet Therapy After Percutaneous Coronary Intervention in Patients With STEMI"

  • You-Jeong Ki;Bong Ki Lee;Kyung Woo Park;Jang-Whan Bae;Doyeon Hwang;Jeehoon Kang;Jung-Kyu Han;Han-Mo Yang;Hyun-Jae Kang;Bon-Kwon Koo;Dong-Bin Kim;In-Ho Chae;Keon-Woong Moon;Hyun Woong Park;Ki-Bum Won;Dong Woon Jeon;Kyoo-Rok Han;Si Wan Choi;Jae Kean Ryu;Myung Ho Jeong;Kwang Soo Cha;Hyo-Soo Kim;HOST-RP-ACS investigators
    • Korean Circulation Journal
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    • v.52 no.6
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    • pp.483-484
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    • 2022

Discontinuation of antiplatelet therapy after stent-assisted coil embolization for cerebral aneurysms

  • Tae Gon Kim
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.2
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    • pp.132-142
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    • 2023
  • Objective: Dual antiplatelet therapy (DAPT) is usually temporarily used after stent-assisted coil embolization (SACE), and is commonly converted to mono antiplatelet therapy (MAPT) for indefinitely. In this study, we aimed to find the possibility of discontinuing MAPT, and to determine the proper period of DAPT use. Methods: We used the Standard Sample Cohort DB dataset from the National Health Insurance Sharing Service. Among approximately 1 million people in the dataset, SACE was performed in 214 patients whose data this study analyzed. The relationship between discontinuation of antiplatelet therapy and intracranial hemorrhage or cerebral infarction was analyzed using multiple logistic regression, considering all confounding variables. The survival rate according to the continuation of antiplatelet therapy was obtained using Kaplan-Meier analysis, and the difference in survival rate according to the continuation of antiplatelet therapy was verified using the log-rank test. The hazard ratio according to continuation of antiplatelet therapy was obtained using the Cox proportional hazards model. The analysis was conducted by applying the same statistical method to the duration of DAPT use. Results: Among 214 patients who underwent SACE, 50, 159 and five patients continued, discontinued and did not use antiplatelet therapy (except at the time of procedure), respectively. In multiple logistic regression analysis, discontinuation of antiplatelet agents (including aspirin) and the period of DAPT use did not affect the occurrence of intracranial hemorrhage or cerebral infarction, considering various confounding factors. In the survival analysis according to the continuation of antiplatelet agents, patients who continued to use antiplatelet agents had a higher survival rate than those in other groups (p=0.00). The survival rate was higher in the rest of the group than in the group that received DAPT for three months (p=0.00). Conclusions: Continuation of antiplatelet agents or the period of DAPT use did not affect the occurrence of intracranial hemorrhage or cerebral infarction. Considering the survival rate, it would be better to maintain at least three months of antiplatelet therapy and it might be recommended to continue DAPT use for 12 months.

Awareness and Need as Factors in an Incremental Oral Health Care Program for Korean Adults (일부 성인의 계속구강관리프로그램 인식과 요구도)

  • Jang, Ho-Yeol;Lee, Su-Ryeon;Lee, Yun-Ji;Lee, Soo-Bin;Lee, Ha-Neul;Lee, Hye-Bin;Hwang, Soo-Jeong
    • Journal of dental hygiene science
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    • v.16 no.6
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    • pp.442-448
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    • 2016
  • Dental caries and periodontal disease are considered to be chronic, but can be prevented through an incremental oral health program covering all ages. The National Oral Health Program for adults provides oral health exam and scaling, and is covered by national health insurance for those over 20 years of age in Korea. The aim of this study was to collect basic data for developing an oral health program for adults by identifying factors related to awareness and need. The data were obtained by convenience sampling of 303 subjects. The use of dental plaque disclosing agents affected tooth brushing frequency, toothbrushing time and use of oral auxiliary devices. Education on toothbrushing methods affected toothbrushing time and use of oral auxiliary devices. Of those surveyed, 93.1% replied that an incremental oral health program for adults was needed, and 68.0% intended to participate. In a regression model, the factors that had an effect on the perceived need for an oral health program were education level, use of oral hygiene auxiliary devices, and toothbrushing time, and the factors affecting intent to participate were education for prevention of periodontal disease and the use of oral hygiene auxiliary devices. The subjects stated that the following oral health programs were needed: an oral bacteria exam (74.3%), toothbrushing education (71.6%), a bad breath exam (69.3%), education on use of oral hygiene auxiliary devices (46.9%), a dental plaque exam (42.9%) and a saliva exam (37.6%). Oral health education appears to be an important factor for participation in an incremental oral health program.

An Alternative Method for a Rapid Urease Test Using Back-table Gastric Mucosal Biopsies from Gastrectomy Specimen for Making the Diagnosis of Helicobacter pylori Infection in Patients with Gastric Cancer (위암 환자의 헬리코박터 파이로리 감염 진단에 있어서 위절제술 직후 생검된 위점막 조직을 이용한 신속 요소 분해 효소 검사법 도입의 의의)

  • Kim, Sin-Ill;Jin, Sung-Ho;Lee, Jae-Hwan;Min, Jae-Seok;Bang, Ho-Yoon;Lee, Jong-Inn
    • Journal of Gastric Cancer
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    • v.9 no.4
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    • pp.172-176
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    • 2009
  • Purpose: The rapid urease test is a rapid and reliable method for diagnosing Helicobacter pylori infection. However it requires gastric mucosal biopsies during endoscopy, and the test is not covered by national health insurance for patients with gastric cancer. So, we introduced an alternative method for a rapid urease test using back-table gastric mucosal biopsies from gastrectomy specimen. Materials and Methods: Ninety gastric cancer patients underwent an anti H. pylori IgG ELISA test and gastrectomy. Just after gastrectomy, two gastric mucosal biopsies from the prepyloric antrum and lower body of the gastrectomy specimen were taken from the back table in the operative room, and these were fixed immediately with the rapid urease test kit, and the color change was monitored for up to 24 hours. In this study, H. pylori infection was defined as positive when the serology or rapid urease test showed positive results. Results: The positive rate of the rapid urease test and serology was 91.1% and 77.8%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of the rapid urease test and serology were 94.3 and 80.5%, 100 and 100%, 100 and 100%, and 37.5 and 15%, respectively. The accuracy of the rapid urease test was higher than that of serology (94.4 vs. 81.1%, respectively). The rapid urease test showed a higher rate of detecting H. pylori infection than that of serology (McNemar's test, P=0.019). Conclusion: The result of the rapid urease test using back-table gastric mucosal biopsies from a gastrectomy specimen is comparable to the reference data of the conventional rapid urease test using gastric mucosal endoscopic biopsies. Therefore, it can be an alternative diagnostic method for H. pylori infection.

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Unmet Medical Service Needs in Family Caregivers of Terminal Cancer Patients (말기암환자 가족간병인의 미충족 의료 분석)

  • Shin, Woong Jae;Hwang, Sun Wook;Hwang, In Cheol;Choi, Youn Seon;Lee, Yong Joo;Kim, Young Sung;Shin, Ji Sung;Choi, Young Ho;Rim, Da Won;Kim, Han Sook
    • Journal of Hospice and Palliative Care
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    • v.19 no.2
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    • pp.163-169
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    • 2016
  • Purpose: The unmet medical service needs of caregivers critically influence their caring for terminal cancer patients, but not much research has been done in this regard. Thus, the purpose of this study is to investigate the association between caregivers' characteristics and their unmet medical service needs. Methods: The survey was conducted with 109 family caregivers of terminal cancer patients admitted to four hospice units. The data were collected from March 2014 through December 2014 using a structured questionnaire. The unmet medical service needs were measured using 14 items which were adopted and modified by authors. Results: Seven areas of unmet medical service needs were shown to be significant. A well-educated group showed stronger needs for counsel about cancer screening and complementary-alternative medicine and health supplement food. A never-smoked group was identified with less need for sexual dysfunction counsel. Counsel about family and personal relations was more necessary for current drinkers and current workers, and less necessary for the married. Insurance counsel was more needed for a no-religion group. Occupation counsel was less necessary for healthy patients. Financial support was less necessary for the married group. Conclusion: Based on the results, it is highly recommended to further investigate the unmet medical service needs of family caregivers for terminal cancer patients and causes of the unmet needs.

A study for the factors on choosing hospitals and patients satisfaction between Geriatric Hospitals and General Hospitals (노인병원과 종합병원의 선택요인 및 환자만족도 분석)

  • Yoon, Seo-Jung;Yu, Seung-Hum;Kim, Young-Hoon;Lee, Ji-Jeon
    • Korea Journal of Hospital Management
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    • v.9 no.2
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    • pp.46-75
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    • 2004
  • This research anticipated on acknowledging the inpatients factors in choosing which hospital for the geriatric hospital and general hospital they would prefer to go to the analization of different factors in patients satisfaction, and the relation between satisfactory standards and the patients intentions on recommendation or re-visiting the hospital. The statistical data was based upon the 359 question and answer papers that were done by inpatients that were hospitalized in two geriatric hospitals and two general hospitals, and the methods used for analyzing were frequency, t-test, factor analysis, and hierarchical multiple regression. The results are as follows. 1. The factors on choosing hospitals between geriatric hospital and general hospitals were different. The priority for the geriatrics was kindness, and then considerate nursing, and the reliance of treatment. The patients of general hospitals looked first for reliance of treatment, reputation and history of the hospital, and the kindness of the staff. The kindness of the staff, good nursing, and easy procedures were the primary factors of choosing geriatric hospital. 2. The four primary factors in choosing which hospital patients would go to were the predominance of the facilities, kindness and convenience, the reliance and proximity of medical treatment, and recommendation. The patients in the geriatric hospital first looked for kindness and convenience, second the reliance and proximity of medical treatment, third predominance of facilities, and last recommendation. The general hospitals main priority was the reliance and proximity of medical care, second predominance of facilities, kindness and hospitality, and last recommendation. 3. The satisfaction rate was higher in the geriatric hospital compared to general hospitals, but the satisfactory of factors were very similar. Patients in the geriatric hospital were pleased with the hospital staffs kindness, quick nursing and the improvement of inconvenient matters, and clear diagnosis of the doctors. The general hospital patients were satisfied with the hospital staffs clear explanation and accurate diagnosis 4. The analysis in the satisfactory factors turned out to be the environment of the hospital, kindness of the staff, and convenience. Both the patients of the geriatric hospital and general hospitals were very pleased with the kindness of the hospital staff. Ranking second and third was convenience and service for the geriatric hospital, and environment of the hospital and convenience for the general hospital. 5. According to a rank of multiple recurrent analysis of the patients satisfaction and the intention of re-visiting in addition to intention of solicitation, in the case of a geriatric hospital, when the intention of re-visiting is the dependent variable, the first stage shows that the less insurance the patient has, the higher was the intention of re-visiting. In the second stage, the more satisfied the patient is of the staffs kindness, the higher was the intention of re-visiting. Further more, when the intention of solicitation is the dependent variable, the first stage shows that not all the independent variables were significant, but the second stage shows that the more satisfied the patient is of the staffs kindness and the hospital along with the medical treatment expenses, the higher was the intention of solicitation. 6. In the first stage of a rank of multiple recurrent analysis of the satisfaction of the general hospital and the intention of re-visiting, not all the variables were significant, but in the second stage, all the satisfaction by factors were significant. Moreover, when the intention of solicitation was the dependent variable, the first stage shows not all the variables were significant, but in the second stage, all the satisfaction by factors were significant. That is to say, in the case of a general hospital, the satisfaction of the hospital and the medical treatment expenses were high, and the more satisfied the patient is of the hospitals environment and the staffs kindness, the intention of re-visiting and the intention of solicitation was higher.

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A Study of Community Residents' Consciousness of Taking Herb Medicine (지역사회 주민의 한약복용에 대한 의식 조사 연구)

  • Kim Sung-Jin;Nam Chul-Hyun;Kang Young-Woo;Suh Ho-Suk;Jeon Bong-Cheon;Chang Young-Jin
    • Journal of Society of Preventive Korean Medicine
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    • v.6 no.1
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    • pp.15-35
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    • 2002
  • This study was conducted to provide basic data for policy of Oriental medicine by analyzing community resident's consciousness of taking herb medicine and its related factors. Data were collected from 1478 residents from March 2, 2001 to May 31, 2001. The results of this study are summarized as follows. 1) The rate of experience of taking herb medicine was 85.2%(88.2% of 'male'; 82.5% of 'female'). It appeared to be significantly higher in the groups of 'the married', 'housewife', and 'Buddhist'. As the age increased, so the rate of experience of taking herb medicine was significantly high. 2) In case of purpose of taking herb medicine, taking herb medicine as a restorative(66.8%) was much higher than taking it as a curative medicine. 3) 52.1% of the respondents satisfied with the effect of herb medicine. The groups of 'male', 'older age', 'residents in a big city', 'insurant in company', and 'the employed' showed significantly high rate in satisfying with herb medicine than the other groups. 4) According to the reason for preferring herb medicine, 36.7% of the respondents preferred herb medicine because the herb medicine was effective, while 27.8% preferred it because its side effect was low. 16.7% preferred it because persons around them recommended it. 5) 42.6% of the respondents did not want to take the herb medicine because the price of the herb medicine was high. Also 20.6% of the respondents did not want to take herb medicine because it is uneasy to take herb medicine. 15.8% did not want to take it because certain food should not be taken during the period of taking it. 9.4% did not want to take it because it tasted bitter. 6) In case of opinions on side effects of herb medicine, 40.8% of the respondents thinks that herb medicine is free from side effects, while 37.5% thinks that it causes side effects. There were significant difference in the opinions on side effects by sex, age, marital status, resident area, education level, occupation, and type of health insurance. 7) 60.7% of the respondents thinks the price of herb medicine is not resonable, while only 10.9% thinks it is resonable. 8) 45.2% of the respondents uses packs of decocted herbs although they think the packs of decocted herb are a little low effective because decocting herbs in home is bothersome. 45.2% uses packs of decocted herbs because they are convenient, being not related to the effect. 7.6% takes medicinal herbs after decocting them in a clay pot because they think the packs of decocted herbs have low effect. 51.9% does not know whether taking herb medicine in summer is effective or not because the effect is different according to their physical constitutions. 35.5% thinks that taking herb medicine is summer is effective because their physical stamina is weakened after sweated a lot, while 12.6% thinks that it is not effective because the effect of herb medicine disappears with sweat. 9) According to the level of satisfaction with Oriental medical care, the respondents marked $3.47{\pm}0.64$ points on the base of 5 points. It was significantly higher in the groups of 'male', 'the married, resident in a big city', 'highschool graduate', 'the unemployed', 'office clerk', 'growing up in a big city', 'insurant in region', and 'the middle class'. 10) According to the result of a regression analysis of factors influencing preference for herb medicine, the factors displayed significant difference by sex, age, education level, health status, and times of receiving Oriental medical care. As shown in the above results, the community residents satisfy with the effect of herb medicine. Therefore, the method of taking herb medicine without difficulty must be devised. The medicinal herbs in packages need to be included in health insurance coverage and resonable price of herb medicine must be set. Also, education program for community residents must be developed in order to provide right information in herb medicine. Therefore, related public authority, associations, and professionals must make efforts, forming organic cooperative system.

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