• Journal of Hospice and Palliative Care
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• v.16 no.3
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• pp.145-154
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• 2013

This study was performed to evaluate the existing pain assessment methods including the tools developed for use with nonverbal older adults with dementia, and to suggest recommendations to clinicians based on the evaluations. Computerized literature searches published after year 2000 using databases - Google scholar, RISS, KoreaMed, Medline, ScienceDirect, CINAHL - were done. Searching keywords were 'pain', 'pain assessment', and 'cognitive impairment/dementia'. The pain assessments for non-communicative dementia patients who are unable to self-report their pains are often made using the assessment tools relying on the observation of behavioral indicators or alternatively the strategy of surrogate reporting. While several tools in English version and only one in Korean are suggested for the pain assessments based on the observation of behavioral indicators, none are commonly used. In this review, we selectively evaluated those tools known to show relatively higher degree of validity and reliability for nonverbal older adults with dementia, namely, CNPI, DOLOPLUS 2, PACSLAC, PAINAD, and DS-DAT. It is hoped that the present review of selected tools for assessing pain in those vulnerable population and the general recommendations given be useful for clinicians in their palliative care practice. And future studies should focus on enriching the validation of the useful tools used to observe the nonverbal patient's behavioral indicators for pain in Korean.

• Journal of Life Science
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• v.24 no.9
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• pp.1030-1038
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• 2014

Platelet products are used to treat hemorrhagic or platelet dysfunction diseases. Plateletpheresis involves collecting the platelet components of blood using an apheresis blood-collection system. Various indicators are available for evaluating the qualities of the apheresis platelets. The productivity of platelet collection is evaluated through both the collection efficiency and collection rates. Platelet storage quality can be evaluated in vitro using several indicators, including visual appearance, metabolic activities, volume, platelet count, white blood cell count, microparticles, and various platelet activation markers. Platelet activation markers have been used as indicators of storage quality in various studies. Post-transfusion platelet quality can be evaluated based on the corrected count increment and the percentage of platelet recovery. Although various studies have investigated the aspects of plateletpheresis, no article has systemically presented assessments of the platelet products obtained from different plateletpheresis devices. The present study provides a review of plateletpheresis, including the specifics of the process, the types of devices employed, the platelet quality, the overall efficacy, and the evaluation indicator qualities. Furthermore, the differences in functionality among the different apheresis devices are discussed. Although adverse reactions to the citrate anti-coagulant have been reported, apheresis processing may provide a safer option for donors who are at a high risk for presyncopal or syncopal reactions related to whole blood collection.

• The korean journal of orthodontics
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• v.50 no.6
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• pp.363-372
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• 2020

Objective: To develop a standardized instrument to measure the level of cognition for orthodontic treatment in adults, and verify its reliability and validity for assessing perceptions of orthodontic treatment in adults. Methods: A total of 406 adults aged 19-64 years were surveyed by an internet research system. A tool was developed through the instrument development and verification stages. The data were analyzed by correlation analysis, exploratory factor analysis, confirmatory factor analysis, and Cronbach's α test. Results: The instrument consisted of 11 items covering four factors related to orthodontic treatment. Three items were related to general perception, four described the perception of the treatment for adults, two related to the treatment effects, and two related to the retention of orthodontic treatment. In the reliability test, Cronbach's α was 0.845 for the 11 items. In assessments for individual components, Cronbach's α was 0.764 for the general perception of orthodontic treatment, 0.705 for the perception of this treatment for adults, 0.707 for the effects of the treatment, and 0.701 for the retention of orthodontic treatment. Finally, a measurement instrument for the perception of orthodontic treatment in adults was designed to assess the 11 items on a four-point Likert scale. Conclusions: This study developed a standard measurement instrument for assessing the perception of orthodontic treatment in adults. The proposed instrument will enable additional studies on the influence of an adult's perception of orthodontic treatment on the decision to undergo treatment.

• Physical Therapy Rehabilitation Science
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• v.10 no.4
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• pp.387-397
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• 2021

Objective: The purpose of this case study was to investigate selective region high-frequency diathermy at trigger points with therapeutic exercises on pain, function, balance and gait in older patients with degenerative knee osteoarthritis (DKO). Design: A case report. Methods: The patient who participated in this study was a 71-year-old woman, who had been diagnosed with moderate osteoarthritis with grade II Kellgren & Lawrence grading scale. The intervention consisted of selective region high-frequency diathermy at trigger points, with hip and knee stretching and strengthening exercises. The participant was given assessments before and after every intervention session using the Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), the Timed Up and Go test (TUG) and the 10 Meter Walk Test (10MWT). The participant performed the intervention 18 times for a total of 30 minutes each. Results: As a result of this study, the patient VAS decreased to 3 points, and the WOMAC decreased to 53 points. In addition, the TUG decreased to 3.25 s and the 10MWT decreased to 1.14 s. Conclusions: The results of this study suggest that selective region high-frequency diathermy at trigger points with therapeutic exercises may be an effective intervention to decrease pain, improve knee function, balance and gait in patients with DKO. The selective region high-frequency diathermy with therapeutic exercises may be feasible and provide potential benefits for rehabilitation of DKO.

• Korean journal of aerospace and environmental medicine
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• v.29 no.2
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• pp.67-71
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• 2019

The health of licence holders (flight crew members and air traffic controllers) is recognized as an important element of aviation safety. The medical emergency symptoms that occur during the flight duty period without prior notice can interfere with human performance capabilities and threaten aviation safety. To prevent this, ICAO has been required to conduct a periodic medical assessment process of licence holders including routine analysis of in-flight incapacitation events and medical findings during medical to identify areas of increased medical risk and continuous reevaluation of the medical assessment process to concentrate on identified areas of increased medical risk. The supply and demand of licence holders have become a major issue due to the increase in air traffic around the world, and the pilot retirement age has been extended to 65 years. But, there is no significant change in the aviation medical assessments process. The follow up of the result of medical examination discovered through aviation medical examination is a very important part, but it has not been properly implemented, and the sick leaves and medical inflight incapacitation reporting system should be improved. The management of health risk factors for licence holders must be implemented to prevent aircraft accidents or aviation safety problems caused by health problems. In this paper, we propose the development plan and concrete improvement plan of the health risk management system of licence holders in Korea in terms of aviation safety.

• Journal of Korean Academy of Nursing
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• v.28 no.1
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• pp.117-131
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• 1998

The purpose of this study was to develop a critical pathway for case management for patients who have received Coronary Artery Bypass Graft (CABG) because of Ischemic Heart Disease(IHD) which is a factor of rising medical expenses. For this study. a conceptual framework was developed through a review of the literature including six critical pathways which are currently being used in USA. In order to identify the overall service contents required by these patients and to draw up a preliminary critical pathway, 30 cases of medical records of patients who had CABG because of IHD between January, 1995 to June. 1996 at the Cardiovascular Center of Yonsei Medical Center in Seoul were analyzed. An expert validity test was done for the preliminary critical pathway and clinical validity test was also done using seven IHD patients with CABG between November 11 and 23, 1996. After these processes. the final critical pathway was developed. The results of this study are summarized as follows : 1. The vertical axis of the critical pathway includes the following eight items : tests, nutrition, medications, consultations, activity, assessments, treatments, education discharge planning and the horizontal axis includes the time from the start of hospitalization to discharge. 2. Analysis of the 30 medical records indicated that the average length of stay was 20.2days with the average length of stay from hospitalization day to operation day being 6.2 days, and the average length of stay from operation day to discharge day was 13. 9 days. Analysis of the service contents showed that the horizontal axis of the preliminary critical pathway was set from hospitalization to the 14th post operation day and the vertical axis was set to include eight items, the contents which ought to have occurred, according to the time frames of the horizontal axis. 3. As a result of the experts validity, it was found that among the total of 571 items. there was over 83% agreement for 482 items, less than 83% for 89 items, which were then deleted and a revision of the critical pathway was done. 4. A clinical validity test was done using seven IHD patients with CABG. During the process, three patients were deleted because they were out of the criteria the investigator set. Finally, four patients were used. The result of study indicated that only one patient was discharged on the tenth post operation day, which was one day later than the expected day. Three patients were discharged later than the expected day from three days to nine days. All the cases progressed on schedule until the operation day and the first post operation day, but from the second post operation days, there were differences between the critical pathway and the actual practice. The differences came from tests, assessments, and treatments. 5. On the basis of the results of the clinical validity test. the following revisions in the final critical pathway were made : the transfer from ICU to step down ward would be the second post operation day, and the transfer to a general ward, the fifth post operation day, for patients who complained of lack of sleep from the fifth post operation day to discharge, a sleeping pill would be prescribed, skin observations would be performed routinely from immediately after the operation until the third post operation day, and would continue if there was a sign of skin injury on the fourth post operation day, and assessment of chest pain would be done from the third post operation day, and the “stairs climbing” item, expected to be done on the ninth post operation day would be deleted. In conclusion, this critical pathway is partially applicable to the care of patients with CABG but there are some parts needed to be further investigated.

• Journal of Korean Society of Industrial and Systems Engineering
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• v.39 no.2
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• pp.82-87
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• 2016

As contemporary society has become more complicated, specialized, and segmented, people are experiencing more diverse types of stress. In particular, while several factors associated with job stress have been examined among nurses, who belong to a professional group, the existing research has made no quantitative assessments of stress that reflect temporal differences in individuals. Therefore, the aim of this study is to understand the effects of job stress on alpha-amylase with regard to the working hours of nurses, to assess the variations in jobs stress over time, and provide basic data to improve the quality of nursing services. Ninety nurses working in three shifts in general, emergency, and intensive care wards of a university hospital in D City participated in this study. Salivary alpha-amylase (SAA) was extracted and analyzed at two-hour intervals from 07:00 to 15:00 from nurses on the day shift and from 23:00 to 07:00 from those working the night shift. The SAA level was highest between 23:00 and 01:00 for nurses in general wards ($mean{\pm}S.D.\;39.00{\pm}14.88$) and between 11:00 and 13:00 for those in both intensive care units and emergency wards ($mean{\pm}S.D.\;67.50{\pm}62.93$ and $mean{\pm}S.D.\;39.67{\pm}35.96$, respectively). The characteristic variation in SAA was significant between 23:00 and 01:00 (p < 0.01) and for those in their fifties or older (p < 0.01). The activation ratio of alpha-amylase, a stress reactant, showed an increase when the sympathetic nervous system was activated by mental stress; in addition, job stress was manifested with the effect of awakening at different time segments and at different ages among the nurses. With the aim of raising the level of service based on the nurses maintaining their mental health, it is necessary to focus sharply on the time segment for critical control and to conduct repetitive studies to determine the divisions of eustress critical values as well as to expand the population.

• Journal of Korean Public Health Nursing
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• v.6 no.1
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• pp.32-45
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• 1992

An important role of community health nurses in health centers is to solve community health problems found through data collection methodology which has been used to identify the health needs of the community, diagnose the health problems and to plan health programs suitable for the health problems. Also community health nurses must be prepared to know the community health needs and to participate in the planning process. Since 1956 when the health center law was established, community health nurses have really implemented only the services which the government has asked them to do. This has kept them busy enough. But these days as society is in rapid change, community health nurses should have the flexibility to deal with the social change and demands that are unique to their community each which has different health needs and demands. So community health nurses need to identify what community health problems exist in their particular communities. The purposes of this study were as follows. 1) To explore the suitability of the health programs which the government has asked the community health nurses to do for their own communities and if these programs are not suitable, to explore the reasons why. 2) To explore the degree to which the community health nurses have the ability to identify health problems in their own communities and activate the community diagnostic process. 3) To identify the degree that the community health nurses have the ability to implement plans related to community diagnosis. 4) To find out how much data related to community health problems, the community health nurses have and how they are utilizing it. 5) To measure the community health nurses self-confidence concerning diagnostic activities for community health. The study subjects were 454 Community Health Nurses working in Health Centers in Seoul, Korea. The period of data collection was 6 days(Nov. 9th 1991-Nov. 15th 1991). A questionnaire used for data collection was composed of three different items; general characteristics, community health diagnostic activities and self-confidence in performing diagnostic activities. The results of the study are as follows. First, over one third of the respondents replied that the government required activities for their communities are not appropriate. Of these activities the most frequent reply $(51.2\%)$ indicated that many of the activities in the community were inappropriate to the actual situation. Further, $25\%$ of the replies indicated that many activities were only administratively oriented and as such not appropriate. Second, $49.8\%$ of the respondents replied that they had done general assessments and had a general idea of the health problems of their community. Effective solutions to health problems could be found with an increase in health personnel and management ability according to $41.5\%$ of the respondents. Third, to the question as to whether they had ever independently implemented a plan towards solving community diagnosed problems, $52\%$ of nurses replied 'never', $40\%$ 'occasionally' but only $7.5\%$ replied that they did it frequently. Actually there was very little done even in the basic work of collecting the necessary data. Fourth, when asked how much of basic information they had collected that might be used in community diagnosis activity, of 26 items in 5 areas, there was hardly one for which complete data had been collected. Fifteen percent did have data on the geographical aspects of their area, housing distribution and types of housing, while $17.8\%$ knew the frequency with which the health center was used. Concerning community resources, even with a list of community resources, only $12.3\%$ had data on any of these resources, and this data was incomplete. Further, information about social work institutions, and facilities was also incomplete, only $14.2\%$ of the respondents had any data and even it was incomplete; that is, in general, the nurses did not have this information. Fifth, concerning the confidence of the community health nurse in their ability to carry out community diagnoses activities, $60\%$ replied that they were very or at least nominally confident, indicating that although they were not doing community diagnostic activities they felt they could do so, as they were carrying out home visits and program planning as part of their official duties. The following recommendations are made based on the results of this study. First; since the community health nurses have a high perception of the need for community diagnostic activities and. high confidence in their ability to carry out this activity and high percentage of respondents replied that with a little training they could do this even better it is recommended that community diagnostic activity training be included in the continuing education program for community health nurses. Second, in order for the Community Health Nurses to successfully solve the health problems of their respective community they reported to a need to increase the number of health personnel, improve the facilities and the system of managing their work. Considering this, it is recommended that ways be sought to remedy these deficits.

• Health Policy and Management
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• v.12 no.2
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• pp.23-42
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• 2002

The purpose of this study was to analyze the results of 133 studies related to patient compliance published between 1980 and 2001 and to assess the effectiveness of intervention on compliance by using meta-analysis. We collected the existing literatures by using web and manual search 'patient compliance', 'sick role behavior', 'major clinical disease', and 'intervention' as key words and by reviewing content of journals related to medicine, nursing and public health. The compliance interventions were classified by theoretical focus into educational, behavioral, and affective categories within which specific intervention strategies were further distinguished. The compliance indicators broadly represent five classes of compliance-related assessments: (1) health outcomes (eg, blood pressure and hospitalization), (2) direct indicators (eg, urine and blood tracers and weight change), (3) indirect indicators (eg, pill count and refill records), (4) subjective report (eg, patients' or others' reports), (5) utilization (appointment making and keeping, use of preventive services). Quantitative meta-analysis was performed by MetaKorea program which was developed for meta-analysis in Korea. Among the 133 articles, 10 studies were selected through the qualitative meta-analysis process, and then only 6 studies were selected for the quantitative meta-analysis finally. The interventions produced significant effects for all the compliance indicators with the magnitude of common effect size (4.1192) than the non-intervention group in a random effect model. The largest effects were each study for patient of hypertension using health outcome such as blood pressure (0.4679) and diabetes mellitus using direct indicator such as glucose level in blood and urine (0.7753). These results suggest that strategic interventions showed clear advantage for improvement of patient compliance compared with non-intervention group.