• Journal of Hospice and Palliative Care
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• 제12권2호
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• pp.49-55
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• 2009

상부 위장관 스텐트 삽입술은 근치적 수술이 불가능한 상부 악성 종양에 의한 상부 위장관 협착 환자의 폐쇄 증상 완화를 위한 보존적 치료로서 확립되었으며 내시경 개발 기술이 발달하고 임상 경험이 축적됨에 따라서 여러 상부 위장관 질환에서 스텐트 삽입술을 보다 편리하고 안전하게 시행할 수 있게 되었다. 그러나 스텐트 삽입술 이후에는 동통, 출혈, 천공과 같은 조기 합병증이나 스텐트 일탈, 스텐트 폐쇄 등의 후기 합병증이 발생할 수 있으므로 사후 관리 또한 중요하다.

• Tuberculosis and Respiratory Diseases
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• 제78권4호
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• pp.416-418
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• 2015

Mycobacterium shinjukuense is a novel species of nontuberculous mycobacteria (NTM) that was first reported in Japan in 2011. It is a slow-growing NTM pathogen that can cause chronic pulmonary infections. There are only a few reported cases of M. shinjukuense infections, all of which are from Japan. We reported a case of chronic lung disease caused by M. shinjukuense. The organism was identified by 16S rRNA, rpoB, and hsp65 gene sequencing. To the best of our knowledge, this was the first confirmed case of lung disease caused by M. shinjukuense outside of Japan.

• 대한간호학회지
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• 제36권1호
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• pp.103-113
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• 2006

Introduction: It is important to understand the nature of the identity through the live experiences of Home Care Nurse Practitioner(HCNP) because the role identity of a professional is constructed by continuous social interactions, This study aims to understand the construction of the role identity of HCNP. Method: Data was collected from 12 hospital based HCNPs. This study involved two focus group discussion sand four in-depth individual interviews. The main question was 'what is the role of HCNP?' The debriefing notes and field notes were analyzed using consistent comparative data analysis method. Result: First, Home care (He) is a small clinic. HCNP brings it to home to provide various services. Second, HC is the real nursing and HCNP is the 'genuine' nurse who actualizes the essence of nursing in practice. Third, HC is empowering activity to promote self-care ability of the patients and their caregivers. Forth, HC is like the dish-spinning required high-level mastery and HCNP is an expert who provides the most appropriate services to the patients. Conclusion: HCNPs have the role identity as a highly qualified professional who delivers services from hospital to home, actualizes the essence of nursing in practice, empowers the patients and their caregivers to have self-efficacy to recover, and offers the most appropriate nursing care.

• Tuberculosis and Respiratory Diseases
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• 제84권4호
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• pp.317-325
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• 2021

Background: Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are significant public health issues in the world, but the epidemiological data pertaining to HAP/VAP is limited in Korea. The objective of this study was to investigate the characteristics, management, and clinical outcomes of HAP/VAP in Korea. Methods: This study is a multicenter retrospective cohort study. In total, 206,372 adult patients, who were hospitalized at one of the 13 participating tertiary hospitals in Korea, were screened for eligibility during the six-month study period. Among them, we included patients who were diagnosed with HAP/VAP based on the Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) definition for HAP/VAP. Results: Using the IDSA/ATS diagnostic criteria, 526 patients were identified as HAP/VAP patients. Among them, 27.9% were diagnosed at the intensive care unit (ICU). The cohort of patients had a median age of 71.0 (range from 62.0 to 79.0) years. Most of the patients had a high risk of aspiration (63.3%). The pathogen involved was identified in 211 patients (40.1%). Furthermore, multidrug resistant (MDR) pathogens were isolated in 138 patients; the most common MDR pathogen was Acinetobacter baumannii. During hospitalization, 107 patients with HAP (28.2%) had to be admitted to the ICU for additional care. The hospital mortality rate was 28.1% in the cohort of this study. Among the 378 patients who survived, 54.2% were discharged and sent back home, while 45.8% were transferred to other hospitals or facilities. Conclusion: This study found that the prevalence of HAP/VAP in adult hospitalized patients in Korea was 2.54/1,000 patients. In tertiary hospitals in Korea, patients with HAP/VAP were elderly and had a risk of aspiration, so they were often referred to step-down centers.

• 한국주거학회:학술대회논문집
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• 한국주거학회 2006년도 추계학술발표대회 논문집
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• pp.420-425
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• 2006

By considering research trend how flow of elderly welfare policy of Japan, which experienced an aging society already, has changed and developed and characteristic of living environment, this study has its purpose to offer basic data to be helpful for finding out direction of Korean future elderly care facility. Way of study worked with only Special Nursing Home and Group Home where elderly with dementia mainly lived among researches of elderly welfare facility published in proceeding of Architecture Planning Engineering of Japan from Jan, 1990 to Sep, 2006. And the number of example of analysis was total 69. The result was classified by year, facilities, and keyword and this study has its focus on discussion of space planning element requested as living environment.

• Tuberculosis and Respiratory Diseases
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• 제82권3호
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• pp.251-260
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• 2019

Background: Beyond its current function as a rescue therapy in acute respiratory distress syndrome (ARDS), extracorporeal membrane oxygenation (ECMO) may be applied in ARDS patients with less severe hypoxemia to facilitate lung protective ventilation. The purpose of this study was to evaluate the efficacy of extended ECMO use in ARDS patients. Methods: This study reviewed 223 adult patients who had been admitted to the intensive care units of 11 hospitals in Korea and subsequently treated using ECMO. Among them, the 62 who required ECMO for ARDS were analyzed. The patients were divided into two groups according to pre-ECMO arterial blood gas: an extended group (n=14) and a conventional group (n=48). Results: Baseline characteristics were not different between the groups. The median arterial carbon dioxide tension/fraction of inspired oxygen ($FiO_2$) ratio was higher (97 vs. 61, p<0.001) while the median $FiO_2$ was lower (0.8 vs. 1.0, p<0.001) in the extended compared to the conventional group. The 60-day mortality was 21% in the extended group and 54% in the conventional group (p=0.03). Multivariate analysis indicated that the extended use of ECMO was independently associated with reduced 60-day mortality (odds ratio, 0.10; 95% confidence interval, 0.02-0.64; p=0.02). Lower median peak inspiratory pressure and median dynamic driving pressure were observed in the extended group 24 hours after ECMO support. Conclusion: Extended indications of ECMO implementation coupled with protective ventilator settings may improve the clinical outcome of patients with ARDS.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1998년도 제50차 추계 학술대회 연제집
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• pp.151-154
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• 1998

• 보건행정학회지
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• 제10권3호
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• pp.1-18
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• 2000

This study was conducted to find medical care utilization pattern and to examine the affecting factors on medical facilities utilization using Andersen's medical care service behavioral model. Three hundreds and five public officials with detected disease through the health examination in 1998 were surveyed using self-administered questionnaire. And 230 data were available and analyzed. The results of this study were summarized as follows: Among variables of predisposing factors, knowledge for disease, confidence about periodic health examination program in health insurance, and the attitude toward medical utilization in the usual showed significant relations with the medical utilization. Other variables were not related with the medical utilization. Variables of enabling factors did not show significant relations with the medical utilization. Recognition of family members for detected disease had significant relations with the medical utilization. Among variables of need factors, absence caused by detected disease was significantly related with the medical utilization. The number of non-occupational diseases detected, but untreated people were 75(32.6%) of total subjects, mainly because detected diseases seemed insignificant to them. With multiple logistic regression analysis, the significant variables having an effect on the medical facilities utilization were 'knowledge for disease', 'attitude toward medical utilization in the usual', 'recognition of family members for detected disease' and 'experience of absence caused by detected disease'. On considerations of above findings, counselling for detected disease and its treatment, health education for individuals and program for family support promotion are needed for health management of public officials with diseases detected in health examination.

• 임상간호연구
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• 제16권3호
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• pp.157-174
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• 2010

Purpose: This study aims to develop, verify, and suggest outcome indicators for advanced practice nurses (APNs) in order to clarify their usefulness. Methods: To develop outcome indicators, the following methods were applied: reviewing literature intended to identify preliminary outcome indicators; surveying outcome indicators currently used for APNs and collecting the opinions from representatives of the professionals in clinical practice; verifying the content validity of preliminary outcome indicators by professionals and verifying the preliminary outcome indicators with 252 APNs. Results: Suggested outcome indicators are categorized into 84 items in total. Of these, the number of outcome indicators commonly appearing across disciplines was 18, mostly related to satisfaction and education. A majority of other outcome indictors exhibiting high relevance to individual disciplines are associated with care, including critical care (19 items), oncologic care (9 items) and emergency care (10 items). Conclusion: As the outcome indicators identified in this study are available to demonstrate the usefulness of APNs, it is recommended that future studies need to select and use appropriate outcome indicators according to characteristics and conditions of the discipline under examination. In addition, it is necessary to validate whether the suggested outcome indicators reflect adequately the practices of APNs.

• Journal of Preventive Medicine and Public Health
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• 제52권3호
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• pp.200-204
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• 2019

On September 12, 2018, President Jae-In Moon announced the Comprehensive Plan for Lifelong Care for People with Developmental Disabilities, with representatives from the associated government branches (Ministry of Health and Welfare, Ministry of Education, and Ministry of Employment and Labor) in attendance. The goals of this plan are to provide health, medical, rehabilitative, special education, and social welfare services according to the life-stages of the affected individuals; to reduce parental pressure; to promote social interventions; and to enhance community-level participation in order to create a 'welfare society in harmony.' However, in order for the plan to succeed, additional efforts must be made in the following areas. First, an epidemiological survey is needed to understand the scale, prevalence, and incidence of developmental disabilities and to establish an evidence base to support policy development. Second, accurate definitions of developmental disabilities must be established in order to avoid policy discrimination based on impairment type and age. Third, personal evaluations to assess disabled individuals' unmet needs and customized service designs to deliver those needs are required. Fourth, the plan must fulfill the goals of accessibility and fairness that the government intends to provide. Fifth, the government should consider an integrated financial support system and to propose a detailed plan for monetary distributions. Finally, an integrated system that links health, medical, employment, educational, and welfare services must be constructed.