• Journal of Preventive Medicine and Public Health
• /
• v.57 no.3
• /
• pp.260-268
• /
• 2024

Objectives: Regional disparities in cardiovascular care in Korea have led to uneven patient outcomes. Despite the growing need for and access to procedures, few studies have linked regional service availability to mortality rates. This study analyzed regional variation in the utilization of major cardiovascular procedures and their associations with short-term mortality to provide better evidence regarding the relationship between healthcare resource distribution and patient survival. Methods: A cross-sectional study was conducted using nationwide claims data for patients who underwent coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), stent insertion, or aortic aneurysm resection in 2022. Regional variation was assessed by the relevance index (RI). The associations between the regional RI and 30-day mortality were analyzed. Results: The RI was lowest for aortic aneurysm resection (mean, 26.2; standard deviation, 26.1), indicating the most uneven regional distribution among the surgical procedures. Patients undergoing this procedure in regions with higher RIs showed significantly lower 30-day mortality (adjusted odds ratio [aOR], 0.73; 95% confidence interval, 0.55 to 0.96; p=0.026) versus those with lower RIs. This suggests that cardiovascular surgery regional availability, as measured by RI, has an impact on mortality rates for certain complex surgical procedures. The RI was not associated with significant mortality differences for more widely available procedures like CABG (aOR, 0.96), PCI (aOR, 1.00), or stent insertion (aOR, 0.91). Conclusions: Significant regional variation and underutilization of cardiovascular surgery were found, with reduced access linked to worse mortality for complex procedures. Disparities should be addressed through collaboration among hospitals and policy efforts to improve outcomes.

• Journal of agricultural medicine and community health
• /
• v.27 no.1
• /
• pp.51-64
• /
• 2002

This study was aimed to provide the basic data for the development of effective educational program by reflecting the opinions of the visiting health service workers. The subjects were 144 visiting health service workers in Gwangju and Jeollanam-do area who responded the mail questionnaire. The data were collected from June to July, 2001 using questionnaire composed of the education need, knowledge by subjective appraisal, and experience of education. The major findings of this study were as follows: 1. The number of respondents who received at least one education within recent three years were 43(29.9%) at the central level, 57(39.6%) at the provincial level and 53(36.8%) at the district level. The satisfaction with education was higher at the central level than at the provincial and district level. 2. Knowledges by subjective appraisal on the 'chronic degenerative diseases management' and 'health promotion' was relatively high. while that of 'rehabilitation' was low. 3. The knowledge by subjective appraisal of visiting health service was related with experience of education and license status. The knowledge was higher in registered nurses than in nurse aids. The curricula related to increased level of knowledge of visting health service workers were 'elderly health care', 'rehabilitation' and 'psychiatric-mental health nursing' educations at the central level 'continuing education for the community health practioners' and 'psychiatric-mental health education' at the provincial level and 'elderly health care', 'rehabilitation' 'psychiatric-mental health' and 'acute diseases control' educations at the district level. 4. The respondents preferred elderly health management as the contents of education, officer group education as the method of education, province(30.4%) as the main body of education, exercise and practice as the form of education, 2-3 times per year as the frequency of education, and 3-5days as the period of education. The findings of this study could suggest that future education program should be planned to increae the knowledge level of visiting health service workers by reflecting their educational need.

• Quality Improvement in Health Care
• /
• v.5 no.2
• /
• pp.258-276
• /
• 1998

This study was conducted to justify the "prescribed shelf life" currently used in Samsung Medical Center and give recommendations based on scientific data to adopt for safe and cost-effective storage times for sterile goods Since the early 1970's, predetermined expiration dating policy has been used in Korea on all in-house sterilized products like any other countries; six months for the supplies wrapped in polyethylene peel pouches and two weeks for the rest. Recently, however, the studies suggest that current standards for preserving the sterility can be changing. It looks like we unnecessarily have too-short expiration date of sterilized supplies, that is far from being cost effective. Certainly, this research is an exciting project, especially in Korea, and will be leading and contributing to the paradigm shift of the conservative concept of shelf life for sterile supplies in Korean healthcare facilities. The major goal of this study was placed on the measurement of the recontamination time in packs wrapped in all kinds of wrapping materials used in S.M.C and stored in various conditions for periods ranging from three months to six months, and then develop a practical standard of "shelf life" based on the analyzed data. Objectives: To measure and compare the recontamination time of sterile packs among wrapppers and storage conditions, and develop a practical standard for the shelf life and storage conditions of sterile products. Samples and Method: The sterile integrity was investigated of the total 1,440 sterile sample packs containing gauze strip($1.5cm{\times}0.5cm$) we prepared and wrapped in nine wrapping materials (randomized reprocessed linens, linens reprocessed 99 times, linens reprocessed 120 times, new kraft paper, used kraft paper, new nonwoven fabrics, 6-time reprocessed nonwoven fabrics, new polyethylene peel pouches, used polyethylene peel pouches), and stored in four locations(closed cabinet of one of the typical wards, open shelf of one of ICUs, open shelf of separate storage room in ER, open shelf in OR), for three to six months, respectively in 1998. Each type of packs were opened weekly and the gauze strips inoculated into Brewer's thioglycollate broth at $35^{\circ}C$ for seven days. Results: There was no growth found for any types of the pack and storage conditions studied. Discussion: This study was conducted in an attempt to identify the possibility of extending the current shelf life for sterile goods we use in a sense of cost effectiveness. The findings suggest that we could extend our expiration dates, that means we can save a lot of materials and personnel time meeded for resterilizing, outdating, recleaning, wrapping, and reshelving. Then it will initiate a great reform in the field of healthcare in Korea, and now we are looking forward to this valuable revolution. We are going to continue this study and take all steps need to apply this new concept to our practice, and then trying to extend to other hospitals.

• Journal of Hospice and Palliative Care
• /
• v.12 no.3
• /
• pp.147-156
• /
• 2009

The purpose of this study was to assess the level of resilience to burnout and work satisfaction of hospice volunteers. Methods: Participants included 235 regular volunteers at hospice facilities of two university hospitals and four general hospitals located in Busan. The study instruments were the scale of resilience to burnout and work satisfaction. The scale of resilience to burnout consisted of six dimensions (professional competency, accomplishment and worthiness, firm belief and value about their profession, good teamwork, support by their agency, and individual resources) and 31 items which were rated on a 5-point Likert scale, whereas the scale of work satisfaction consisted of 6 items which were rated on a 5-point Likert scale. Data were analyzed by descriptive statistics, t-test, ANOVA, Tukey and Pearson's correlation coefficient. Results: The mean score of resilience to burnout and work satisfaction of participants were 3.59 and 3.69, respectively. The highest and lowest scores of resilience to burnout were individual resources (3.81) and accomplishment and worthiness (3.36). There were significant differences in resilience to burnout scores, depending on religion, health status, type of hospice facilities, and period of volunteer experience. There were significant differences in work satisfaction scores, depending on gender, religion, education level, health status, and type of hospice facilities. Conclusions: Continuous education and efficient management need to be developed to improve the level of resilience to burnout and work satisfaction of hospice volunteers.

• Journal of Digital Convergence
• /
• v.18 no.7
• /
• pp.317-330
• /
• 2020

The purpose of this study was to compare lifestyle, dietary habit, health attitude and self-efficacy among chronic schizophrenia with upper gastrointestinal disease and chronic schizophrenia to improve lifestyle, dietary habit and health attitude, in each mental health care facilities field, it was attempted to provide basic data to search for alternatives to increase self-efficacy. This study surveyed them from February 20^th to April 30^th in 2019 for data collection. Data were analyzed using Chi-square test, Independent t-test and ANCOVA with SPSS/WIN 22.0. The sociodemographic factor of age and education, the lifestyle factors of carbonated drink and physical activity intensity, the dietary habit factors of overeat, snack, late night meals and fatty food, the other factor of self-efficacy show statistically significant differences among groups. The study provides meaningful data in finding distinctive features of Upper Gastrointestinal Disease among Group with Chronic Schizophrenia. The results indicate that need to develope a variety of intervention methods to promote lifestyle and dietary habit and to enhance self-efficacy of chronic schizophrenia.

• Quality Improvement in Health Care
• /
• v.27 no.2
• /
• pp.57-72
• /
• 2021

Purpose: At present, there are a variety of serious patient safety incidents related to problems in health information technology (HIT), specifically involving electronic medical records (EMRs). This emphasizes the need for an enhanced electronic medical record system (EMRS). As such, this study analyzed both the nature of and potential to prevent incidents associated with HIT/EMRS based on data from the Korea Patient Safety Reporting and Learning System (KOPS). Methods: This study analyzed patient safety incidents submitted to KOPS between August 2016 and December 2019. HIT keywords were used to extract HIT/EMRS incidents. Each case was reviewed to confirm whether the contributing factors were related to HIT/EMRS (HIT/EMRS-related incidents) and if the incident could have been prevented (HIT/EMRS-preventable incidents). The selected reports were summarized for general clarity (e.g., incident type, and degree of harm). Results: Of the 25,515 obtained reports, 2,664 incidents (10.4%) were HIT-related, while 2,525 (9.9%) were EMRS-related. HIT/EMRS-related incidents were the third largest type of incident followed by 'fall' and 'medication incidents.' More than 80% of HIT/EMRS-related incidents were medication-related, accounting for approximately one-third of the total number of medication incidents. Approximately 10% of HIT/EMRS-related incidents resulted in patient harm, with more than 94% of these deemed as preventable; further, sentinel events were wholly preventable. Conclusion: This study provides basic data for improving EMR use/safety standards based on real-world patient safety incidents. Such improvements entail the establishment of long-term plans, research, and incident analysis, thus ensuring a safe healthcare environment for patients and healthcare providers.

• 한국노년학
• /
• v.30 no.4
• /
• pp.1281-1292
• /
• 2010

This study was performed to identify older adults' self-reported difficulties in understanding and utilizing health information and their relationships with health status and to investigate the differences between age groups and among education levels. Data were collected from July 1 to August 31 in 2007 from older adults in senior centers located in Daegu, Kyungpook, and Busan area. A total of 103 subjects participated in the study. The level of understanding health information in older adults was 50 on average (possible score 15-75). The most difficult items to understand were patient educational materials, written information provided by health care providers, and medical forms. The lower level of difficulty in utilizing health information was associated with better physical and mental health status. There were differences in their self-reported difficulties between the young-old and the old-old as well as among different education levels. Health care providers may need to tailor educational materials and medical forms to the cognitive ability of older adults under the consideration of their age and education levels.

• Journal of Korean Society of Occupational and Environmental Hygiene
• /
• v.24 no.4
• /
• pp.528-535
• /
• 2014

Objectives: This study compares the differences of fit factors before and after training on the N95 mask. The results will be utilized to suggest the need of providing effective training on respirator use. Methods: A total of 49 study subjects were tested, comprised of nurses from a general hospital and undergraduate nursing students from a medical school. Anthropometric measurements of face length and face width were compared with the NIOSH(National Institute for Occupational Safety and Health) panel. Fit factors(FF) were measured with TSI Portacount Pro+8038 before and after on-site training regarding the proper use of respirators. The FF pass/fail criterion was set at 100. Results: Two subjects(4.1 %) passed the fit test before training on use of the N95. However, 36(73.5%) of the 49 passed the test after training. Overall the FF(GM(GSD)) was 13.4(3.2) before training, but improved to 106.6(2.1) after training, which was statistically significant. These findings suggest the efficacy of educational intervention, and the performance of the direct on-site training proved to be better than that of the traditional educational methods. Conclusions: This study showed the effect of on-site training of the N95 respirator among health care workers(HCW). Therefore, providing effective training on the use of N95 for HCWs before their work assignments will greatly reduce exposure to harmful agents. It is recommended that fit testing be mandated to check for adequate protection being provided by the given respirators.

• Journal of Korean Academy of Nursing
• /
• v.3 no.1
• /
• pp.41-51
• /
• 1972

In this article, the writer attempted to study the followings: (1) mother's knowledge of milk feeding (including method of sterilization, formula and feeding) (2) reasons of artificial feeding (3) how much mothers are concerned about their artificial feeding infants (4) condition of growth and development of artificial feeding infants. As the object of study, 96 mothers with artificial feeding infants, who had consulted dep't of pediatrics of two Hospitals in Seoul (Korea Hospital and Med. College Woo Suk Hospital, Korea Uni.) and well baby clinic of the two Health Centers (Sung Dong and Dongdaemoon), were randomly sampled. The data were treated by the statistic method of chi-square and percentage, and come to the following conclusion. 1. Knowledge of milk feeding Sterilization: 70 percentages of mothers know about the milk sterilization (including bottle, nipple and instrument), but 55 percentages of them do not know the nipple sterilization correctly. Formula: 69 percentages of mothers follow the indicator or in accordance with doctor's directions, but 31 percentages do at their option by reasons that the baby often coughs up the milk, the baby is too small, the baby often has digestive troubles, or the baby grow fleshy heavily etc, except family economic problems. Feeding: only half of mothers know the correct feeding method, especially they do not know how to determine the heat degree of milk and how to bubble up the baby correctly. They just do feeding according to the accepted usages. 2. Reasons of artificial feeding Of the reasons of artificial feeding, 18 percentages were caused by infants and 82 percentages by mothers. Most of the reasons are mainly due to the lack of breast milk and sufficient supply of nourishments rather than mother's deficiency or mother's abnormality. 3. Mother's concern for artificial feeding infants Mothers who are sharply concerned for their artificial feeding baby's growth and development: 63%, mothers who made the baby (artificial feeding infant) routine vaccinated: 81%, mothers who ear anxious about the baby's future personality forming : 68%, mothers who care about the baby's condition of nourishment; 60%, mothers who are anxious about tile selection of baby's food; 54%. 4. The growth and development of artificial feeding infants compared with Korean average infants. The artificial feeding infants are above the Korean average infants in stature by 1.21 centimeters and in weight by 0.3 kilograms. Conclusion: It has been said that there is no better food for infant than the breast milk. However, the artificial feeding has been used for the supplement of nourishments and as substitute food for the breast milk. And this artificial feeding could give the married women the chance to act in society and more opportunity to develop themselves and to work for others at home and other fields. Considering these advantages, artificial feeding should not be exclusive, but preferably should be more improved and inquired positively. And even in artificial feeding, what is most important is that mothers should recognize the requirement and need of artificial feeding clearly and correctly, and they should be accustomed to the correct knowledge and skills of artificial feeding in order to practice it appropriately. In some degree, they should be properly trained in school education process.

• Journal of Korean Academy of Nursing
• /
• v.21 no.2
• /
• pp.150-167
• /
• 1991

The intent of this longitudinal descriptive correlational study is to investigate the change of the mother - infant interactions over the periods of one month, three months and six months of the infant's age. This study is also intended to explore the interrelationships among three major factors- the perception of pregnancy, the mother -infant inter-action and the maternal attitude. The samples participated are 36 pairs of mother and infant from two university hospitals in Seoul. A data collection was made, from October in 1988 to September in 1989, for each subject at five periods of time ; prenatal period (after 36 weeks in pregnancy), postpartum two or three days, one month, three months and six months of infant's age. The research tools used in this investigation are Mother - Infant Play Interaction Scale (MIPIS), Prenatal Self- Evaluation Questionnaire and Cohler's Maternal Attitude Scale. Some of the findings are as follows ; 1. There is a significant increase in the mother - infant interaction from one month to three months and six months of infant's age. The highest score of the mother - infant interaction during three periods is at the time of three months. 2. The primipara's mother -infant interaction is not affected by the demographic characteristics, such as age, education and vocation of mother, types of delivery, or sex of infant. 3. Among seven categories of the perception of pregnancy, the most positively perceived categories by primiparas are acceptance of pregnancy and identification of. a motherhood role : whereas the negative ones are preparation for labor, concern for well -being of self and baby, md fear of pain, helplessness and loss of control in order of negativity. 4. There is no significant relationship between the perception of pregnancy and the mother - infant interactions. 5. There is no significant change in the maternal attitude over the period of one month, three months, and six months of infant's age. 6. There is no significant relationship between the maternal attitude and the mother - infant interactions. 7, The significant relationships are (end between the perception of pregnancy and maternal attitude, especially in the categories of concern for well -being of self and baby, accetance of pregnancy, identification of a motherhood role, fear of pain, helplessness and loss of control, and relationship with husband. In conclusion, it is confirmed that primipara's mother-infant interactions change over time period, and that perception of pregnancy and the maternal attitude do not affect the mother-infant interactions despite a significat relationship between those two variables. The implications of this investigation include a suggestion that nurses need to teach and demonstrate to mothers how to care for and interact with their infants, with a view to improving the mother-infant interactions which can be obtained through the improvement of maternal sensitivity to their infants.