• 가정간호학회지
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• 제6권
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• pp.33-45
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• 1999

The purpose of this study was to develop a basic framework and criteria for evaluation of quality care provided to patients with the attributes of disease in the home care nursing field, and to provide measurement tools for home health care in the future. The study design was a developmental study for evaluation of hospital-based HCN(home care nursing) in Korea. The study process was as follows: a home care nursing study team of College of Nursing. Yonsei University reviewed the nursing records of 47 patients who were enrolled at Yonsei University Medical Center Home Care Center in March, 1995. Twenty-five patients were insured at that time, were selected from 47 patients receiving home care service for study feasibility with six disease groups; Caesarean Section (C/S), simple nephrectomy, Liver cirrhosis(LC), chronic obstructive pulmonary disease(COPD), Lung cancer or cerebrovascular accident(CVA). In this study, the following items were selected : First step : Preliminary study 1. Criteria and items were selected on the basis of related literature on each disease area. 2. Items were identified by home care nurses. 3. A physician in charge reviewed the criteria and content of selected items. 4. Items were revised through preliminary study offered to both HCN patients and discharged patients from the home care center. Second step : Pretest 1. To verify the content of the items, a pretest was conducted with 18 patients of which there were three patients in each of the six selected disease groups. Third step : Test of reliability and validity of tools 1. Using the collected data from 25 patients with either cis, Simple nephrectomy, LC, COPD, Lung cancer, or CVA. the final items were revised through a panel discussion among experts in medical care who were researchers, doctors, or nurses. 2. Reliability and validity of the completed tool were verified with both inpatients and HCN patients in each of field for researches. The study results are as follows: 1. Standard for discharge with HCN referral The referral standard for home care, which included criteria for discharge with HCN referral and criteria leaving the hospital were established. These were developed through content analysis from the results of an open-ended questionnaire to related doctors concerning characteristic for discharge with HCN referral for each of the disease groups. The final criteria was decided by discussion among the researchers. 2. Instrument for measurement of health statusPatient health status was measured pre and post home care by direct observation and interview with an open-ended questionnaire which consisted of 61 items based on Gorden's nursing diagnosis classification. These included seven items on health knowledge and health management, eight items on nutrition and metabolism, three items on elimination, five items on activity and exercise, seven items on perception and cognition, three items on sleep and rest, three items on self-perception, three items on role and interpersonal relations, five items on sexuality and reproduction, five items on coping and stress, four items on value and religion, three items on family. and three items on facilities and environment. 3. Instrument for measurement of self-care The instrument for self-care measurement was classified with scales according to the attributes of the disease. Each scale measured understanding level and practice level by a Yes or No scale. Understanding level was measured by interview but practice level was measured by both observation and interview. Items for self-care measurement included 14 for patients with a CVA, five for women who had a cis, ten for patients with lung cancer, 12 for patients with COPD, five for patients with a simple nephrectomy, and 11 for patients with LC. 4. Record for follow-up management This included (1) OPD visit sheet, (2) ER visit form, (3) complications problem form, (4) readmission sheet. and (5) visit note for others medical centers which included visit date, reason for visit, patient name, caregivers, sex, age, time and cost required for visit, and traffic expenses, that is, there were open-end items that investigated OPD visits, emergency room visits, the problem and solution of complications, readmissions and visits to other medical institution to measure health problems and expenditures during the follow up period. 5. Instrument to measure patients satisfaction The satisfaction measurement instrument by Reisseer(1975) was referred to for the development of a tool to measure patient home care satisfaction. The instrument was an open-ended questionnaire which consisted of 11 domains; treatment, nursing care, information, time consumption, accessibility, rapidity, treatment skill, service relevance, attitude, satisfaction factors, dissatisfaction factors, overall satisfaction about nursing care, and others. In conclusion, Five evaluation instruments were developed for home care nursing. These were (1)standard for discharge with HCN referral. (2)instrument for measurement of health status, (3)instrument for measurement of self-care. (4)record for follow-up management, and (5)instrument to measure patient satisfaction. Also, the five instruments can be used to evaluate the effectiveness of the service to assure quality. Further research is needed to increase the reliability and validity of instrument through a community-based HCN evaluation.

• The Journal of Korean Physical Therapy
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• 제5권1호
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• pp.47-60
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• 1993

This study was conducted to investigate the changes diseases of physical therapy patient. Through the analysis, of total 2,902 cases in one university hospital and one general hospital in Taegu, of which 1,619 cases for 1989 and 1,283 cases for 1981. The physical records were analyzed in terms of sex, age, pattern in PT diseases, fee, and medical department of PT. The international classification of Diseases, 9th revision was used fer the study. Major results are as follows : 1. The ratio of male me female nae 1.51 to 1 in 1989, 1.53 to 1 in 1991. The proportion of the elderly over 60 was $15.6\%$ in 1989, $22.0\%$ in 1989. And the age groups of 50-59 years ranked the first an years. 2. As to the PT patients of medical department, Orthopaedics$(50.3\%)$, Neurosurgery$(28.1\%)$. Neuromedicine$(8.0\%)$. Plastic surgery$(4.4\%)$, and Dentry$(3.2\%)$ in that order in 1989. On the other hand, Orthopaedics$(51.2\%)$, Neurosurgery$(22.1\%)$, Neuromedicine$(9.6\%)$, Plastic surgery$(6.5\%)$, and Internal medicine$(6.5\%)$ in that order in 1991. 3. No significant difference was observed by season of PT patients, but winter (December, January and February) ranked the first all years. 4. No significant difference was observed changes in diseases as for the 56 international classification of diseases of PT patients, Diseases of the musculoskeletal system and connective tissue occupied the largest proportion all years. Fractures increased from $21.4\%$ in 1989, $24.5\%$ in 1991. On the other hand, Diseases of the nervous system remarkably increased from $8.9\%$ in 1989, $19.7\%$ in 1991.

• 한국화재소방학회:학술대회논문집
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• 한국화재소방학회 2012년도 춘계학술발표회 초록집
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• pp.190-193
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• 2012

The tools that classify the severity of patients based on the prediction of mortality include APACHE, SAPS, and MPM. Theses tools rely crucially on the evaluation of patients' general clinical status on the first date of their admission to ICU. Nursing activities are one of the most crucial factors influencing on the quality of treatment that patients receive and one of the contributing factors for their prognosis and safety. The purpose of this study was to identify the goodness-of-fit of CPSCS of critical patient severity classification system(CPSCS) and Glasgow coma scale(GCS) and the clinical usefulness of its death rate prediction. Data were collected from the medical records of 187 neurological patients who were admitted to the ICU of C University Hospital. The data were analyzed through $x^2$ test, t-test, Mann-Whitney, Kruskal-Wallis, goodness-of-fit test, and ROC curve. In accordance with patients' general and clinical characteristics, patient mortality turned out to be statistically different depending on ICU stay, endotracheal intubation, central venous catheter, and severity by CPSCS. Homer-Lemeshow goodness-of-fit tests were CPSCS and GCS and the results of the discrimination test using the ROC curve were $CPSCS_0$,.734, $GCS_0$,.583, $CPSCS_{24}$,.734, $GCS_{24}$,.612, $CPSCS_{48}$,.591, $GCS_{48}$,.646, $CPSCS_{72}$,.622, and $GCS_{72}$,.623. Logistic regression analysis showed that each point on the CPSCS score signifies1.034 higher likelihood of dying. Applied to neurologically ill patients, early CPSCS scores can be regarded as a useful tool.

• 전기학회논문지
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• 제65권7호
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• pp.1236-1241
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• 2016

Cancer has been the most frequent in Korea, and pathogenesis and progression of cancer have been known to be occurred through various causes and stages. Recently, the research of chromosomal and genetic disorder and the research about prognostic factor to predict occurrence, recurrence and progress of chromosomal and genetic disorder have been performed actively. In this paper, we analyzed DNA methylation data downloaded from TCGA (The Cancer Genome Atlas), open database, to research bladder cancer which is the most frequent among urinary system cancers. Using three level of methylation data which had the most preprocessing, 59 candidate CpG island were extracted from 480,000 CpG island, and then we analyzed extracted CpG island applying data mining technique. As a result, cg12840719 CpG island were analyzed significant, and in Cox's regression we can find the CpG island with high relative risk in comparison with other CpG island. Shown in the result of classification analysis, the CpG island which have high correlation with bladder cancer are cg03146993, cg07323648, cg12840719, cg14676825 and classification accuracy is about 76%. Also we found out that positive predictive value, the probability which predicts cancer in case of cancer was 72.4%. Through the verification of candidate CpG island from the result, we can utilize this method for diagnosing and treating cancer.

• 한국보건간호학회지
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• 제14권1호
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• pp.147-160
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• 2000

This study was carried out to investigate awareness and attitude of monitors in 206 small sized industries in Seoul and Kyeonggi area toward the occupational health programs using a specially prepared questionnaire. The industries had been running Government-Funded Subsidiary Program since 1998. The questionnaire was designed to be self-administered by respondents. Data were collected for two months from November to December, 1998. Major results are as follows: 1. Between two groups of industries, there were no significant differences in classification, scale, methods of production, existence of trade union, but in type of working pattern and facility ownership there were significant differences. 2. Between two groups of monitors, there were no significant differences in gender, age, marital status, rank, years of education, but in duration of working there was a significant difference. 3. In awareness and attitude of monitors toward their activities and occupational health programs, there was no significant difference by groups of industries, but a significant difference by type and scale of industry, gender, age, years of education 4. It was found that newly subsidized industries were more necessary to provide education programs on occupational health than old industries, and there was a significant difference between two groups of industries in the contents of education needed. In conclusion, it is desirable that the government should develop specific training programs for monitors on occupational health to provide them practical knowledge and specific skills which monitors can apply to their specific situation, and implement the training programs and continue Government-Funded Subsidiary Program for years until small scale industries would have been able to develop and keep their own health management system spontaneously.

• 한국병원경영학회지
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• 제23권4호
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• pp.81-86
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• 2018

Purposes: The purpose of this study is to argue that the taxation system for non-for-profit medical institution in Korea should be revised and that the basic direction should be to expand tax exemption like the US. Methods: We analyzed the US context of taxation policy for non-for-profit medical institutions and compared the US and Korean situation. Findings: In the United States, for-profit or non-for-profit medical institutions eternities are the most important criteria for hospital classification. Basically, full tax-exemption has been applied for non-for-profit medical institutions. The reason why many hospitals maintain their status as non-for-profit are following. First, the American society places great importance on the social responsibility and role of non-for-profit hospitals. Second, maintaining the status of non-for profit medical institutions is financially beneficial while maintaining good social reputation. The most powerful financial incentives are tax deductions and tax deductions for donations. Practical Implications: How will the taxation system for medical institutions in Korea be reformed in the future? First, if Korean government do not allow for-profit medical institutions, Korean government should consider implementing a full tax exemption system suitable for non-profit medical institutions like the US. Second, there are many variation in taxation for non-for-profit medical institution according to their legal positions. Therefore, current taxation system should be revised. Third, the reorganization of such taxation system should be in a direction that can finally encourage community benefit activities of medical institutions of nonprofit hospitals.

• 기본간호학회지
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• 제3권2호
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• pp.153-169
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• 1996

This study was designed to identify, describe and classify orientations of cancer patient's family members to death and to identify factors related to their attitudes on death. Death to the male is understood as a comprehensive system and believed to be highly subjective experience. Therefore attitude on death is affected by personalities. As an attempt to measure the subjective meaning toward death, the unstructured Q-methodology was used. Korean Death Orientation Questonaire prepared by Kim was used. Item-reliability and Sorting-reliability were tested. Forty five cancer patients' family members hospitalized in one university medical center in Seoul were sampled. Sorting the 65 Q-itmes according to the level of personal agreement ; A forced normal distribution into the 11 levels, were carried out by the 45 P-samples. The demographic data and information related to death orientation of the P-sample was collected through face to face in depth interviews. Data was gathered from August 30 till September 22, 1995. The Z-scores of the Q-items were computed and principal component factor analysis was carried out by PC-QUANL Program. Three unique types of the death orientation were identified and labeled. Type I consists of twenty P-samples. Life and death was accepted as people's destiny, They firmly believed the existence of life after life. They kept aloof from death and their concern was facing the and of the life with dignity, They were in favor of organ donation. Type II consists of Nine P-Samples. They considered that death was the end of everything and did not believed the life after life. They were very concerned about the present life. Type III consists of Sixteen P-samples. They regarded the death as a natural phenomena. And they considered that the man is just a traveller and is bound to head for the next life which is believed to be free of agony, pain or darkness. They neither feared death nor its process. Their conserns were on the activities to prepare themselves for the eternal-life after death. Thus, it was concluded that there were three distinctiven type of attitudes on death among cancer patient family members, and their death attitudes were affected by demographic and socio-cultural factors such as sex, education, and religion.

• 지역사회간호학회지
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• 제6권2호
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• pp.259-274
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• 1995

The study is to grasp the problems related to operation of Maternity clinic of public health centers in seoul and needs for public health of community in relation to consumers and providers in order to improve efficiency of community public health for mothers and children. Four pregnancy woman, who receive medical care at the maternity clinic of M public health centers in seoul and understand the purpose of this study, and one nurse who works at the were the objects of this field study. Participating observation and intensive interviews were conducted to collect data. All of them were performed as necessary from time to time since December, 1994, and not during a specific period. Through an data analysis in the order of sector analysis and classification analysis, the data were classified into specific patterns and the results are the following; 1. All of the subjects were using both private hospitals and public clinics, but managing activities prior to delivery were not carried out in accordence with theories for those activities. 2. The subjects showed two types of response to utilizing maternity clinic. they answered that the advantages of the clinic were 'short waiting time for medical treatment', 'medical treatment by female doctors' and 'economical benefit.' Meanwhile, they gave negative response to the problems of 'non-implementation of delivery' 'uncleanness and insufficient facilities', 'limited time of treatment', 'lack of expertise' and 'want of public health education for materity.' 3. Problems related to operation of maternity clinic were 'lack of experts', 'irrational facility structure' and 'absolutely lack budget'. In terms of the status of managing the subjects, 'programs only aimed at attaining the central-government-assigned objects' and 'limited management before and after delivery by non-implementing delivery' were pointed out to be problems. Regarding public health education before delivery and PR relations, 'superficial public health education for maternity' and 'absence of PR programs' were named. In planning and evaluation, 'absence of autonomous planning and evaluation by the clinic itself' was a major problem in operating the clinic. 4. 'Substantial health education and PR', 'supplementation of facilities and eqipment', 'development' and supply of demanded service by the subjects', 'implementation of autonomous programs', and 'reinforcement of supplementary education' were presented as alternatives for efficient opration of maternity clinics.

• 보건의료산업학회지
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• 제12권1호
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• pp.81-93
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• 2018

Objectives : This cross-sectional study aims to investigate the differences in general health status (GHS) and physical care burdens (PCB) of inpatient groups in long-term care hospitals (LTCH). Methods : The data of 228 patients were analyzed by integrating the electronic medical record (EMR) data of 2016, recorded by the nurses of hospitalized patients in the hospital. Results : There was a statistically significant difference in the GHS between the high-medical demand group and the other groups, but there was no difference in the GHS among other groups. The overall PCB was higher in the high-medical demand group than in the middle-medical demand, and cognitive impairment groups, but not in the problem behavioral group. Conclusions : The current classification of patient groups has shown limitations in terms of the basis of differential benefits of the groups. In particular, the PCB of the problem behavior group was not different from that of any group; hence, it should be adjusted through further study. To control the surge of medical care costs, it is necessary to improve the irrationality of the LTCH pay system in terms of the integration and continuity for elderly care.

• 대한간호학회지
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• 제20권1호
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• pp.61-78
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• 1990

The purpose of the present study is to confirm the interacting behavior between nurses and patients and other things concerned herewith. Subjects of investigation were : 42 nurses selected out of the average nurses who serve in hospital as nurses assigned to medical and surgical wards : and 42 male and female adult patients selected out of the average patients who were under the care of the nurse individuals and can make themselves understood verbally. A nurse and her patient were paired off for questioning. Materials for statistics were gathered by means of observaing interactions- - verbal and nonverbal - -of the chosen subjects for four hours every day from 7 : 30 a.m. through 7 : 30 p.m. between on July 15, 1988 and on Aug. 16, 1988. Classified by patterns, the materials observed and gathered were preliminarily analyzed by this researcher, and then reexamined in a full-fledged way by one professor, three nurses and three non - nurses. The researcher depended chiefly on Frequency, ANOVA, Pearson's Correlation Coefficient attached to SPSS Computer System for the process of gathered materials. The results of this investigations are follows 1) A total of 98 times' interactions between nurses and patients were provided during observation of 168 hours. 2) It took them the averaged 264.8 seconds(around 4.4 minutes) per a couple of subjects to interact between nurses and patients during observation of four hours. 3) The aim of interactions between nurses and patients appear that 29 times of injection amounted to 29.6% the most, 27 times of PO around to 27.6% the next most, 25 times of vital check to 25.5% the next most, 17 times of independent nursing works and round to 17.3% the least most. 4) As a result of qualitative analyzing the interactions between nurses and patients by the distinctive method of words were positively recognized in 19 cases with 45.2% and negatively in 23 cases with 54.8%. 5) A total of 2, 193 times. interaction behaviours between nurses and patients were provided. The frequency of these interaction behaviours took place l, 364 times with 62.2% to nurse, and 829 times with 37.8% to patients. 6) The classification of verbal and nonverbal interaction behaviour between nurses and patients indicated that it is amounted to 64.9% for verbal behaviour numbered 1, 423 and 35.1% for nonverbal one numbered 770. 7) The frequency of verbal behaviour between nurses and patients numbered 1, 423 in total. They took place 924 times to nurses and 499 times to patients, it can be also amounted to 64.9% and 35.1% respectively in percentagewise. 8) In interactions between nurses and patients, it turned out that the frequency of nurses' turns, which the present research discovered averaged 16.8 times for four hours, and the verbal behaviours by numbered 9.7 on an average. 9) Nonverbal behaviours between nurses and patients numbered 770 in total, it is assigned 440 times to nurse with 57.1% and 330 times to patients with 42.9%. 10) The investigation releases in formation that the frequency of verbal behaviours between nurses and patients was very much concerned with the age of patients(r＝0.422, p＜.01) and the number of patients one nurse has under her care(r＝-0.356, p＜.01). 11) It was found that were deep relationship of the number of a nurses turn with the patients age(r＝0.377, p＜.01) and the nurses burden of caring patients(r＝-0.372, p＜.01).