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The Results of Gastric Cancer Surgery during the Early Stage of a Training Hospital (설립 초기의 수련 병원에서의 위암 수술 성적)

  • Kim, Kun-Young;Yoo, Moon-Won;Han, Hye-Seung;Yun, Ik-Jin;Lee, Kyung-Yung
    • Journal of Gastric Cancer
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    • v.8 no.4
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    • pp.244-249
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    • 2008
  • Konkuk University Hospital (KUH), which opened in September 2005, is currently categorized as a secondary hospital. Early on after its establishment, the surgical residents and nurses were relatively inexperienced in the treatment of stomach cancer. Therefore, the quality of surgery for stomach cancer at KUH may be different from that of the existing large-scale tertiary hospitals. The purpose of this study is first to investigate the clinicopathological characteristics of the gastric cancer patients at the KUH, and second to compare our morbidity & mortality rates with those of previous studies, and we also analyzed the risk factors of morbidity at the early stage of a training hospital. Materials and Methods: This study retrospectively collected the clinicopathological characteristics and the post-operative morbidity rates and mortality rates with using the electronic medical records of all the patients who went under a gastric cancer operation at KUH from September 2005 to April 2008. Results: The total number of gastric cancer patients who underwent operation was 201. The morbidity rate and death rate at KUH were 10.4% and 0.5%, respectively. The morbidity has increased with an older age. The other variables had no influence on morbidity. Conclusion: The morbidity rate, death rate and the clinicopathological characteristics of gastric cancer patients at KUH were similar to those of the previous reports. We found that age is the main factor affecting the morbidity rate after stomach cancer surgery. For further surgical qualification of stomach cancer surgery at KUH, it is necessary to collect the survival data of patients who undergo stomach cancer surgery.

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Comparison between Subjective and Actigraphic Measurement of Sleep in Psychiatric Inpatients (주관적 수면평가와 활동기록기를 이용한 수면평가의 비교 - 정신과입원환자를 대상으로 -)

  • Jeong, Hyun-Ghang;Lee, Moon-Soo;Ko, Yong-Hoon;Lim, Se-Won;Kim, Seung-Hyun;Jung, In-Kwa;Joe, Sook-Haeng
    • Korean Journal of Psychosomatic Medicine
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    • v.18 no.1
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    • pp.30-39
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    • 2010
  • Objectives:Assessment of sleep disturbance is an essential part of the diagnostic criteria used for several psychiatric disorders. Change in sleep patterns over time may indicate response to treatment. In clinical practice, sleep is usually evaluated subjectively by patient self-report. This study was aimed to compare subjective sleep assessment with objective sleep measurement by actigraphy in psychiatric inpatients. Methods:A total of 32 psychiatric inpatients were studied. Patients were asked to wear a wrist actigraphy for three consecutive days and nights and to fill out a sleep log each morning. The severity of depression and anxiety was evaluated according to Beck Depression Inventory and State-Trait Anxiety Inventory on the first day of the study. The subjective level of satisfaction with quality of sleep was also evaluated according to visual analog scale. Nurses assessed sleep at one hour interval between 10:00 PM and 6:00 AM for three consecutive nights. Results:There was statistically significant difference of sleep latency between patient's sleep log and acti-graphic measurement. Nursing reports were more consistent with actigraphic measurement than sleep log. Interestingly, subjectively poor sleepers show no significant difference in sleep parameters compared with those of good sleepers. Subjectively poor sleepers report longer sleep latency than that of actigraphic assessment. The discrepancy between subjective and objective assessment of sleep latency was significantly correlated with scores of Beck Depression Inventory and State-Trait Anxiety Inventory. Conclusion:These results show that there are discrepancies between subjective and objective assessment of sleep. The discrepancy of sleep assessment could be influenced by severe depression and anxiety. Especially objective sleep measurement is needed to assess sleep in psychiatric inpatients with severe depression or anxiety and the subjectively poor sleepers for more reliable measurements.

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Analysis and Application of Nursing Management Practicum Case Simulation for Developing Performance-Centered Education (성과중심 교육과정 개발을 위한 간호관리실습 사례시뮬레이션 적용 및 내용 분석)

  • Lim, Ji Young;Ko, Gug Jin
    • The Journal of the Korea Contents Association
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    • v.17 no.9
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    • pp.235-254
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    • 2017
  • The purpose of this study was to develop a nursing management case simulation (NMCS) framework based on the five components of nursing management process and to apply it to clinical nursing practice of nursing college students. The subjects of this study were NMCS reports submitted by the 4th grade 105 nursing students of an university. The research tool is a simulation framework for nursing management practice. It reflects the brainstorming and debriefing process used in the previous simulation exercise based on the five elements of planning, organization, human resource management, directing and control of the nursing management process respectively. As a result of the study, 32 nursing management cases were found to have 79.6% correct rate, 11.6% concept error rate, and 5.6% classification error rate in the first brainstorming and debriefing process for the five components of nursing management process. On the other hand, in the second brainstorming and debriefing process, 94.6% correct rate, 0.0% concept error rate, and 4.4% classification error rate. Based on these results, the NMCS framework developed in this study can be applied to the nursing management theory and practice course of nursing college students as well as simulation based job training and maintenance educations for clinical nurses. Therefore, we propose follow-up studies in various clinical nursing settings and a longitudinal cohort study to investigate the effect of nursing management job skills of nursing college students after graduation.

Investigation about the Actual Prevention of Infection and Vaccination against B-type Hepatitis among Dental Workers in Daegu (대구지역 치과 의료기관 종사자의 B형간염 예방접종 및 감염관리 실태)

  • Eun, Jeong-Hwa;Bae, Ji-Young
    • Journal of Korean society of Dental Hygiene
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    • v.5 no.2
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    • pp.219-233
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    • 2005
  • This study was conducted on 185 workers at 73 dental clinics and university hospitals in Daegu to investigate the actual prevention of infection and vaccination against B-type hepatitis among dental workers. 1. According to the result of medical examination, only 35 out of 144 (24%) dental clinic workers had periodic health examination while 7 out of 9 (78%) university hospital workers did. 2. In a survey on vaccination against B-type hepatitis, 52 workers aged 29 or younger (96.3%), 38 dental hygienists (51.9%) and 44 dental workers at dental clinics (81.5%) have not had any vaccination against B-type hepatitis. The rest appeared to have had vaccination or be aware that they had antibody against B-type hepatitis without having to have any vaccination. 3. According to the result of a survey on the existence of antibody by job, 42 (56%) of dental hygienists, 15 (20%) of assistant nurses, 12 (16%) of medical assistants and 6 (8%) of dental technicians did not know whether or not they had antibody. This suggests that all types of dental workers except dental hygienists have low awareness of whether or not they have antibody. 4. In a survey on the relation between general characteristics of subjects and the sterilization of dental equipment, alcohol disinfection of high speed handpiece and low speed handpiece was most common among dental workers aged 29 or younger, and all of those aged over 40 used autoclave. By position, alcohol disinfection was used most commonly for high-speed handpiece. antiseptic solution deposition for disposable suction lips, and autoclaving for impression. By workplace, dental workers at university hospitals used autoc1aving most frequently for high/low speed handpiece while those at dental hospitals and dental clinics used alcohol disinfection most frequently and even some respondents replied that they did not disinfect. For metal cups, workers at dental clinics and dental hospitals did not use any sterilizing method while those at university hospitals used autoclaving. For disposable suction tips, workers at dental clinics used antiseptic solution deposition and those at dental hospitals used alcohol disinfection but some respondents replied that they did not disinfect. For metal suctions and impression trays, autoclaving was most common in all workplaces but some dental clinics replied that they did not disinfect impression trays. According to work experience, alcohol disinfection was most common for high/low speed handpiece. For disposable suction tips, dental workers with 3 years' or shorter work experience, those with 3~6 years' experience and those with 9~12 years' experience used antiseptic solution deposition most commonly, and many of those with 6~9 years replied that they did not disinfect. The results of this study stated above suggest that systematic education is necessary for all dental workers for enhancing th eir awareness of B-type hepatitis and the prevention of infection. Moreover, dental workers are required to make efforts to prevent infection with B-type hepatitis voluntarily and actively.

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The Actor Effect and the Partner Effect of Family Interaction and Self-esteem on Depression of Parents in School Age: Analysis of Actor-Partner Interdependence Model (학령기 부모의 우울에 대한 가족 상호작용과 자아존중감의 자기효과와 상대방효과: 커플관계분석을 활용하여)

  • Han, Jeong Won
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.8
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    • pp.231-239
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    • 2017
  • This study was conducted to provide basic data about the depression of parents with school-aged children by identifying the actor and partner effects of family interaction and self-esteem on depression among parents with school-aged children. Data on 1,475 pairs from the Wave 7 Panel Study on Korean Children were analyzed by using the SPSS 18.0 program and the AMOS 18.0 program. From the analysis of a hypothetical model, parents' family interaction exerted an actor effect on self-esteem. Mother's family interaction and self-esteem exerted an actor effect on depression; however, the partner effect on father's depression was not statistically significant. Father's family interaction and self-esteem exerted an actor effect on depression; however, the partner effect of father's family interaction on mother's depression was not statistically significant, and only father's self-esteem exerted a partner effect on mother's depression. The study results are as follows. First, the affecting factors of depression in school-aged parents, which are directly related to the depression of the child, were identified and the basic data of nursing intervention for the parents'. It is expected that clinical nurses will be used as data to convey professional knowledge to control parents' depression.

Factors Influencing Health-related Quality of Life in Patients with Coronary Artery Bypass Graft (관상동맥우회술 대상자의 건강관련 삶의 질 영향요인)

  • Kim, Jiyoung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.5
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    • pp.164-172
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    • 2016
  • The purpose of this study was to determine the relationships among the social support, depression, and health-related quality of life and the factors affecting the health-related quality of life in patients with coronary artery bypass graft (CABG). The subjects consisted of 134 patients who had received CABG from S general hospitals in Seoul, Korea, and the results were analyzed using the SPSS Win 21.0 program. The physical component summary (PCS) was significantly different depending on the age (F=4.616, p=.004), gender (t=3.657, p<.001), education (F=7.688, p=.001), current job (t=-4.363, p<.001), spouse (t=-3.065, p=.003), and underlying disease (F=3.078, p=.030) of the subjects. There were differences in the scores for the mental component summary (MCS) according to their gender (t=2.243, p=.027) and monthly income (F=2.821, p=.041). A significant negative correlation was found between social support and depression (r=-.415, p<.001). Social support had a statistically significant positive correlation with the MCS (r=.261, p=.002). Significant negative correlations were found between depression and the PCS (r=-.459, p<.001) and MCS (r=-.554, p<.001). The depression and underlying disease accounted for 36.7% of the variance in the PCS. The depression accounted for 34.1% of the variance in the MCS. Based on these results, nurses should develop nursing intervention programs for patients who have undergone CABG which take into consideration their depression.

Different Patterns of Behavioral and Psychological Symptoms of Dementia and Caregiver Burden according to Dementia Type in Nursing Home Residents (요양시설 치매노인의 치매유형에 따른 행동심리증상 특성과 간호제공자의 업무 부담감)

  • Gang, Min-Suk;Choi, Hyun-A;Hyun, Jin-Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.5
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    • pp.459-469
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    • 2016
  • The purpose of this study was to examine different patterns of behavioral and psychological symptoms of dementia (BPSD) and caregiver burden according to dementia type. Data were collected from June 2014 to December 2014 from five nursing homes. In all, 214 patients [131 patients with Alzheimer's disease (AD) and 83 patients with Vascular dementia (VD)] were included in the study. BPSD and caregiver burden data were examined using NPI-NH (Neuropsychiatric Inventory Nursing Home Version). According to the results, both the AD and VD group showed the highest frequency in apathy/indifference and the frequency of anxiety, elation/euphoria, and irritability/lability was significantly higher in the AD group than in the VD group. The difference in total BPSD composite scores between the AD and VD groups was not significant but agitation/aggression was significantly higher in the AD group than in the VD group. The mean score for caregiver burden was significantly higher in the AD group than in the VD group, particularly in agitation/aggression. In conclusion, BPSD differed according to dementia type, and nurses should provide specific interventions to control BPSD; a program to reduce caregiver burden according to dementia type is also needed.

A Comparison Research on the Expected Satisfaction and Actual Satisfaction on VOC of one General Hospital (서울소재 일개 종합병원의 CRM에 대한 기대만족도와 실제만족도 비교와 VOC활용)

  • Ma, Yeon-Ji;Kim, Jeong-Ah;Park, Seung-Woo;Oh, Eun-Hwa;Moon, So-Young;Rhee, Hyun-Sill
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.3
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    • pp.1146-1152
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    • 2010
  • The Korean healthcare industry is rapidly changing along with the competition among hospitals. In the past, hospitals could make profit without designing competitive management strategies. Thus, they did not find importance in listening to customers' voices and identifying their wants. However, nowadays, the increasingly intense competition is encouraging hospitals to seriously consider competitive management strategies and Customer Relationship Management (CRM) activities to gain a competitive advantage and prosper. It tries to compare the expected satisfaction with the satisfaction of out-patient and in-patient and analysis of VOC(Voice of Customer). This survey was done from 27th, April, 2009 to 8th May and each 100 in-patients and out-patients. The paired t-test and descriptive analysis was used to analysis between before and after satisfaction. The result, the replied out-patients were the highest of I.M department, 43% and in-patients, surgery and other department are the highest each 22.0%. Nurses kindness is statistical significant in out-patients. Doctor, Nurse and staff's kindness and rounding service was statistical significant in in-patients. Totally, the satisfaction was lower than expected satisfaction, so the medical care institutions should analyst detailed the patient's satisfaction by VOC.

Prevention of Pressure Ulcer using the Pressure Ulcer Risk Assessment Based on Braden Scale (Braden Scale에 기초한 욕창발생 위험군 선별도구를 이용한 욕창의 예방)

  • Oh, Deuk Young;Kim, Jee Hoon;Lee, Paik Kwon;Ahn, Sang Tae;Rhie, Jong Won
    • Archives of Plastic Surgery
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    • v.34 no.4
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    • pp.466-470
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    • 2007
  • Purpose: Active prevention is an essential component in reducing the development of pressure sores. For the high-risk patient group, following the certified pressure sore screening scale as well as educating the patient and the nurses who care for them can lead to optimal management of these patients. Applying a risk assessment scale along with a prevention strategy can reduce medical costs and length of stays at the hospital. The purpose of this study is to evaluate the efficacy of a new pressure sore risk assessment scale based on the universally recommended Braden scale and our prevention program. Methods: From June to August, 2003, our pressure ulcer risk assessment scale was applied to a total of 1882 patients admitted to the experimental group (intensive care unit, neurosurgery, general surgery, and oncology units). It was based on Braden scale. We analysed sensitivity, specificity, positive and negative predictive value and ROC curve to evaluate its efficacy. Pressure ulcer prevention program was composed of patient's education using protocol and specific nursing care. The incidence of pressure ulcers was also measured during the 3 months period, and those were compared to the control group of 1789 patients from March to May, 2002. Results: 118(6.27%) of the experimental group were high-risk with an incidence of pressure ulcers measuring 4 (0.21%). Sensitivity, specificity, positive and negative predictive value of our scale were 100%, 94%, 4%, 100%, respectively, and AUC(area under the curve) was 0.992. In the control group, the incidence of pressure ulcers was 11(0.61%). Statistical analyses using chisquared tests with a significance level of 5%, the results were such that ${\chi }^2=3.6482$(p=0.0561). The results proved to be statistically significant in borderline. Conclusion: The results from this study proved that pressure sore risk assessment scale based on Braden scale has an excellent efficacy, and shows that our pressure ulcer prevention program is partially effective in reducing pressure ulcer incidence.

Factors Affecting Users' Satisfaction with Order Communicating System (처방전달체계에 대한 사용자 만족도에 영향을 미치는 요인)

  • Kim, Chang-Yup;Ha, Bum-Man;Kang, Gil-Won;Kim, Byoung-Yik;Kim, Yong-Ik;Lee, Jin-Seok
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.4
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    • pp.436-448
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    • 2000
  • Objectives : To identify the factors affecting users' satisfaction with the Order Communicating System(OCS) and to highlight the factors important for the successful establishment of OCS. Methods : A Users Satisfaction survey was sent to 4,513 people, consisting of 1,503 doctors, 2,379 nurses, 255 pharmacists and 370 administrative workers in 16 hospitals which had introduced OCS. The response rate was 63.9%. Measurement of users' satisfaction was peformed with the instrument which was used in Doll's study. Some aspects of Doll's instrument were adjusted according to the aims of this study. The classifying sections of this survey included age, job and status classification, computer experience, OCS education, duration of daily OCS use, type of order entering, number of personnel in the Hospital Information System's department, cost of OCS, problem frequency, proportion of work managed by hand, OCS type, and Hospital establishment type. Results : There was a positive correlation between satisfaction level and managerial status throughout all job classifications. Irrespective of the importance of OCS education as a factor relating to users' satisfaction, the additional work load caused by OCS lowered users' satisfaction. Different factors affected users' satisfaction according to job and status classification. The composition of factors affecting the pharmacist and administrative worker satisfaction levels was simpler than that of the doctor and nurse levels. There were no statistically significant differences between the actual computer experience duration of daily OCS use and users' satisfaction with OCS. Conclusions : There was an understandable relationship between users' attitude to OCS and factors affecting users' satisfaction. The results of this study could be used as a basis for the successful expansion of the operation of OCS. But more detailed studies on users' satisfaction and further improvements of methodologies are required for the successful establishment of OCS.

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