Objectives: The study aimed to compare the indicators of infrastructure of the whole country with those of Busan through National Medical Care Psychiatric (hospital level) Quality Assesment and to provide the basic evidence for presenting vision and strategies of mental health policy. Methods: National Medical Care Psychiatric (hospital level) Quality Assesment Data was used from 2011 to 2015. A total of 8 indicators were analyzed including facility and workforce. Results: The median value of the capacity per ward was decreasing with years both whole country and Busan. The number of beds out of total inpatient occupancy was improved over the years. There was no clear change in the number of inpatients per toilet in the hospitalized ward, but the indicator was decreasing obviously. Therefore, the median value of whole country and Busan was same with 10.2 in 2015. Conclusions: We confirmed that indicators for infrastructure were improving in a generally positive change over the years. The infrastructure is related to the patient-centered treatment environment, and the workforce is related to the quality of care. Therefore, the structural area should be continuously evaluated and improved.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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제24권3호
/
pp.141-150
/
2013
Objectives : The objective of this report is to identify the utilization of hospital school service during hospitalization among patients in their childhood and adolescence with psychiatric disorders. Methods : We retrospectively reviewed the medical record of child and adolescent psychiatric who were hospitalized during March 2009 through October 2012. We compared the one-year successful schooling and outpatient follow up rate between users and nonusers of the inpatient hospital school service. The hospital schooling experiences of the users were investigated upon follow-up visits to the outpatient clinic. Results : Sixty-three students received hospital school service during hospitalization among total 122 child and adolescent inpatients. Hospital school participants showed a significantly higher school reentry rate (61.9%) than non-participants (40.7%). However, there was no difference on follow up rate between the two groups. More than 60% of the 22 interviewed participants expressed an above-average level of satisfaction about hospital school service. Conclusion : Many patients with mental illness experience difficulty in receiving school education during treatment. That induces deterioration in disease, academic failure, poor social skills, low self-esteem, economic difficulties, and future job opportunities. The results of this study emphasize the importance of hospital school service and offer useful guidance for hospital school operation.
Park, Suin;Park, Sohee;Lee, Young Joo;Park, Choon-Seon;Jung, Young-Chul;Kim, Sunah
대한간호학회지
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제50권3호
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pp.333-348
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2020
Purpose: The present study investigated the association between nurse staffing and health outcomes among psychiatric inpatients in Korea by assessing National Health Insurance claims data. Methods: The dataset included 70,136 patients aged 19 years who were inpatients in psychiatric wards for at least two days in 2016 and treated for mental and behavioral disorders due to use of alcohol; schizophrenia, schizotypal and delusional disorders; and mood disorders across 453 hospitals. Nurse staffing levels were measured in three ways: registered nurse-to-inpatient ratio, registered nurse-to-adjusted inpatient ratio, and nursing staff-to-adjusted inpatient ratio. Patient outcomes included length of stay, readmission within 30 days, psychiatric emergency treatment, use of injected psycholeptics for chemical restraint, and hypnotics use. Relationships between nurse staffing levels and patient outcomes were analyzed considering both patient and system characteristics using multilevel modeling. Results: Multilevel analyses revealed that more inpatients per registered nurse, adjusted inpatients per registered nurse, and adjusted inpatients per nursing staff were associated with longer lengths of stay as well as a higher risk of readmission. More adjusted inpatients per registered nurse and adjusted inpatients per nursing staff were also associated with increased hypnotics use but a lower risk of psychiatric emergency treatment. Nurse staffing levels were not significantly associated with the use of injected psycholeptics for chemical restraint. Conclusion: Lower nurse staffing levels are associated with negative health outcomes of psychiatric inpatients. Policies for improving nurse staffing toward an optimal level should be enacted to facilitate better outcomes for psychiatric inpatients in Korea.
Purpose: This study was conducted to examine the effects of uncertainty, social support, and sick role behavior on health-related quality of life in patients with peripheral arterial disease. Methods: This study is a descriptive research using self-reporting questionnaire. Data were collected from 167 patients with peripheral arterial disease. Measurement tools were Multidimensional Scale of Perceived Social Support(MSPSS), Mishel's Uncertainty in Illness Scale (MUIS), Sick role behavior measurement tools and SF-36 Version I. The data were analyzed using descriptive statistics, correlation, and regression analysis by using SPSS/WIN 24.0. Results: Factors that significantly influenced physical health-related quality of life were age (β=-.19, p=.010), monthly income (β=.17, p=.027), uncertainty (β=-.29, p<.001), and exercise and rest (β=.28, p<.001) that all together accounted for 32.6% of the variance. Factors that significantly influenced mental health-related quality of life were monthly income (β=.20, p=.015), drinking (β=.17, p=.040), uncertainty (β=-.24, p=.001), and exercise and rest in sick role behavior (β=.26, p=.003) that all together accounted for 18.2% of the variance. Social support was an insignificant factor on physical and mental health-related quality of life. Conclusion: To improve the health-related quality of life of people with peripheral arterial disease, it is necessary to develop a systematic nursing intervention program including a strong support system, education, strategies for alcohol abstinence, and exercise and rest therapy.
Purpose : To grasp the mental burden for legal responsibility that rescue members have in the performance of job. Method : Questionnaire was presented to rescue members serving in 2 direct control safety centers of fire station located in Seoul, Daejon, Incheon, Kwangju, Busan, Daegu and Ulsan. Results : 1. Questioned whether they have mental burden for legal responsibility while performing job on the site, the rescue members responded : very burdensome in 38.0%, burdensome in 56.0%, moderate in 4.5%, not burdensome in 1.0%, no burden at all in 0.5%. 2. Questioned on the first aid treat for which they have the most mental burden, the rescue members responded : intubation into trachea laryngeal mask airway(LMA) in 40.4%, automatic external defibrillator in 16.3%, securing vein providing sap(medicine) in 10.8%, basic cardiopulmonary resuscitation in 7.2%, eliminating foreign matters inserted into body in 5.4%, stanching external bleeding and treating injury in 5.4%, fixing extremities and spine by using splint in 1.8%, measuring the symptom of vitality in 1.2%, providing oxygen in 0.0%. 3. Questioned whether experiencing legal problem or firm petition(complaint) raised by patient while serving as rescue members, they responded : experiencing a complaint in 41.6%, experiencing no complaint in 58.4%. Asked to indicate the stress level in the scale of which they suffered when lawsuit or firm petition was raised, 0(weak)-10(strong), they answered 8.8 in average. 4. Questioned whether 119 rescue members put the legal responsibility in case that they cause damage to patients intentionally in performing, they responded to the inquiry 3.66 in average(of 5.00). It represented meaningful differences (F=2.874, p=.024) whether they had license or not. 5. In future, legal action will raise against the rescue member by 99% because of people's rights improvement(63.1%), high expectations for the rescue system(29.5%), non-licensed rescue members(5.1%). Conclusion : It was found that the rescue members had severe mental burden for advanced life support which was investigated to have low enforcement rate in the preceding research, for instance, intubation into trachea securing vein management by using automatic external defibrillator. To improve the qualitative level of rescue service in the fire fighting, it may be required to construct the environment that eliminates the mental burden of rescue members for legal responsibility.
Objectives: To conduct and report the results of a public health promotion program in Korean medicine (KM), namely the KM Visiting Care Service for Solitary Elderly, from November 2018 to April 2019. Methods: Six elderly people living in a rural area received the KM visiting care service, twice a week, for four months. This service consisted of acupuncture, auriculotherapy, and supportive counseling to manage their musculoskeletal pain, cognitive impairment, and/or depression. The changes of symptoms were assessed using Numeric Rating Scale (NRS), Korean version of Mini-Mental State Examination for Dementia Screening (MMSE-DS), Korean version of Montreal Cognitive Assessment (MoCA-K), and Geriatric Depression Scale-Short form Korean (GDS-SF-K). Results: Through the 4-months KM visiting care service, the overall subjects' NRS-rated pain decreased slightly. Most showed improvement in MMSE-DS and/or MoCA-K, except one subject who was diagnosed with Alzheimer's disease. Depression assessed by GDS-SF-K showed improvement in a few subjects who were unable to walk independently. Satisfaction assessed through survey was generally high in all subjects. Conclusions: This KM Visiting Care Service for Solitary Elderly may help improve the pain and cognitive function of frail solitary elderly in rural areas. However, the protocol need to be improved to optimize the effect.
Purpose: It is important to identify problems in elders' health through health examination as a part of health service for elders and to execute health education so that elders have appropriate abilities to manage and protect themselves. This study was attempted to assess the need of health education in the elderly and to analyze factors affecting the need of health education. Method: The participants in this study were 354 elderly people living independently in the Jeju Special Self-Governing Province of Korea, and a questionnaire survey was conducted through personal interviews from June 25 to July 26, 2007. The methodology was a descriptive study. Data were collected and analyzed using SPSS Win 12.0. Results: As for the contents of education, elders preferred most the area of 'prevention and management of elderly diseases.' Detailed education contents preferred by elders were the prevention of accidents, diet habits, exercise and weight management, mental health and stress management, complementary and alternative therapies, management of drinking and smoking, etc. Conclusion: According to elders' concerns and needs, systemic health education for the elderly should provide right health knowledge, health maintenance, health promotion and setting of appropriate health education.
The coronavirus disease 2019 (COVID-19) pandemic has profoundly impacted all aspects of undergraduate, postgraduate, and continuing medical education. Only the focus of medical education-care for patients and communities-has remained an integral part of all of the above sectors. Several challenges have been experienced by learners and educators as the education and training of future doctors has continued in the midst of this crisis, including the cancellation of face-to-face classes and training, reduced patient encounter opportunities, fairness issues in online assessments, disruption of patient interview-based exams, reflections on the role of doctors in society, and mental health-related problems linked to isolation and concerns about infection. In response to these disruptions, educators and institutions have rapidly deployed educational innovations. Schools have adopted educational strategies to overcome these challenges by implementing novel education delivery methods in an online format, providing clinical experiences through simulation or telehealth methods, introducing online assessment tools with formative purposes, encouraging learners' involvement in nonclinical activities such as community service, and making available resources and programs to sustain learners' mental health and wellness. During the COVID-19 pandemic, educators and institutions have faced drastic changes in medical education worldwide. At the same time, the quantitative expansion of online education has caused other problems, such as the lack of human collaboration. The long-term effects of the COVID-19 pandemic on medical education need to be studied further.
In Vol. 31, No. 3, our journal prepared three review articles, an original paper, and two case reports. First, as COVID-19 continues for a long time, aviation workers, including pilots, are also experiencing mental problems such as depression. Therefore, we have compiled the basic principles for improving the mental health of pilots. Next, it is difficult to properly perform cardio-pulmonary resuscitation (CPR) when a cardiac arrest situation occurs in an aircraft. Moreover, in the context of the COVID-19 pandemic, CPR is more difficult because medical staff and other passengers may also be exposed to infections. Therefore, we have summarized the principles of CPR on board and ways to perform CPR while keeping the safety of medical staff and other passengers in the COVID-19 situation. The sudden change of gravity caused by space travel has various effects on the human body, and among them, the effect on the immune system is profound. Therefore, we reviewed the research methods to study the effect of gravity on the immune system and the results. In addition, we analyzed the demographic characteristics and health status of immigrant visa applicants who intended to immigrate to the United States over the past five years. Next, through two case reports, we reported cases of determining physical fitness for aviation service in patients who recovered after receiving appropriate treatment for chronic myeloid leukemia or renal cell carcinoma.
Purpose: Mood disorders such as depression and bipolar disorder are a major mental health problem in college students. We investigate the prevalence of depression and bipolar disorder and the relevance of risk factors for these mood disorders among one college freshmen. Methods: The subjects were 2,865 college students who entered one university located in Seoul and Ansung in 2009. We used BDI (Beck Depression Inventory) for depression assessment and K-MDQ (Mood Disorder Questionnaire) for bipolar disorder assessment. Demographic and socioeconomic factors were measured by questionnaire. Height, weight, blood pressure, total cholesterol, complete blood cell count, and liver function test data were obtained by physical examination for freshmen. Chi-square test and multiple logistic regression were performed to analyze the possible risk factors for depression and bipolar disorder. Results: With different BDI cutoff value, 16 and 21, the prevalence of depression was 8.7% (male: 7.6%, female: 10.1%) and 2.4% (male: 2.5%, female: 2.3%), separately. 'Low economic status', 'urban birth place', and 'low grade at entrance' were significantly associated with depression. Using the original cutoff criterion, defined as clustering of 7 or more symptoms that caused moderate or severe problems, the prevalence of bipolar disorder was 1.3% (male: 1.4%, female: 1.1%). The risk factor of bipolar disorder was academic fields (art fields). Conclusion: Depression and bipolar disorder are common disease in college freshmen. Therefore, Campus-based mental health service program is needed to help with prevention of and early intervention of these mood disorders.
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