• Title/Summary/Keyword: Nursing cost

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Effectiveness of Deep Breathing Exercise for Postoperative Pulmonary Complications Prevention: A Systematic Review (수술 후 폐 합병증 예방을 위한 심호흡 운동의 효과에 대한 체계적 고찰)

  • Lee, Worlsook;Yang, You Lee;Oh, Eui Geum
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.21 no.4
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    • pp.423-432
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    • 2014
  • Purpose: This study was done to evaluate effectiveness of deep breathing exercise as a postoperative intervention to prevent pulmonary complications. Methods: A search of databases from 1990 to 2012 was done including MEDLINE, EMBASE, CINAHL, Cochrane Library and eight Korean databases. Ten studies met eligibility criteria. Researchers trained in systematic review, independently assessed the methodological quality of selected studies using the Cochrane's risk of bias tool. Data were analyzed using RevMan 5.2 program. Results: Among ten RCTs in four studies, deep breathing exercise was compared with an instrument using interventions such as incentive spirometry, in the other four studies deep breathing exercise was compared with non-intervention, and in last two studies bundles of interventions including coughing and early ambulation were assessed. A significant difference was found between deep breathing exercise group and non-intervention group. The odds ratio (OR) of occurrence of pulmonary complications for deep breathing exercise versus non-intervention was 0.30. However, there was no significant difference between deep breathing exercise group and incentive spirometry group (OR=1.22). Conclusion: Deep breathing exercise is vital to improving cost-effectiveness and efficiency of patient care in preventing postoperative pulmonary complications. For evidence-based nursing, standardized guidelines for deep breathing in postoperative care should be further studied.

A study of the Consumer's Satisfaction and the Marketing Strategies of a General Hospital (일 종합병원의 소비자 만족과 마케팅 전략에 관한 연구)

  • Lee, Mi-Aie
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.1
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    • pp.25-40
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    • 2001
  • As the medical market has gradually changed from supplier-centered market to consumer-centered one, it makes hospital managers seek the consumer's satisfaction and the various marketing strategies for survival. Under the these changes, this study was accomplished to measure the consumer's satisfaction about the medial services which a general hospital provided, to identify the marketing strategies that a general hospital could establish for survival. For these purposes, a questionnaire was developed and distributed to 200 patients in general units and 100 patients in oriental units of a general hospital in Seoul. Among them, 163 reponses in general units and 71 reponses in oriental units were turned out to be useful. they were used for final analysis. The results of the survey were as follows : First, among all items of medical services which the hospital provided, patients were most satisfied by nursing services. Second, to Improve the hospital's medical service quality, it was very important for hospital staffs to be courtesy and to explain about a process of treatment or care sufficiently. Third, to decrease cost of medical service, it was very important to develop the various items and premiums of medical insurance especially in field of oriental medicine. Fourth, to make people come to the hospital easy, it was very important of fully utilize the public transportation such as subway. Fifth, to make hospital's image good, it was very important to develop well-prepared public relationship and to continuously provide the diverse medical service in the community.

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Application and Developmental Strategies for Community-Based Injury Prevention Programs of the International Safe Communities Movement in Korea

  • Bae, Jeongyee;Cho, Joonpil;Cho, Seong-il;Kwak, Minyeong;Lee, Taehyen;Bae, Christina Aram
    • Journal of Korean Academy of Nursing
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    • v.45 no.6
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    • pp.910-918
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    • 2015
  • Purpose: Safety of humans is an important factor that affects health overall, and injuries are one of the major public-health problems in the world. The purposes of this study were to describe the International safe Community movement which contributes to the injury prevention and safety promotion all over the world, and to identify out the application and developmental strategies for Korea. Methods: A review was done of previous research, reviews, and reports on the history, concepts, basic principles, and recommendations for actions of the Safe Community. Results: For this study, the application strategies of the International Safe Community movement in Korea were examined to deduce the strengths of the safe Community program. Community-based injury prevention work according to the International Safe Community model is a successful and cost-effective way of reducing injuries in the community. Conclusion: Through the International Safe Community program, communities are able to realize a healthy community and achieve improved quality of lives for the people, which is the ultimate objective of the Safe Community model. In addition, it will contribute to the economic vitalization and gain through energy and enhancement of productivity of people.

Effects of a Progressive Walking Program on Physical Activity, Exercise Tolerance, Recovery, and Post-Operative Complications in Patients with a Lung Resection (점진적 걷기프로그램이 폐절제술 환자의 신체활동량, 운동능력, 회복력 및 합병증 발생에 미치는 효과)

  • Kim, Inah;Lee, Haejung
    • Journal of Korean Academy of Nursing
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    • v.44 no.4
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    • pp.381-390
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    • 2014
  • Purpose: The purpose of this study was to identify the effects of a Progressive Walking program (PW) on physical activity, exercise tolerance, recovery, and post-operative complications for patients with a lung resection. Methods: A nonequivalent control group non-synchronized design was utilized and 37 participants with a lung resection (22 for control group, 15 for experimental group) were recruited at A university hospital from December 2012 to August 2013. The PW consisted of preoperative education, goal setting, and feedback, provided to the experimental group, and usual care to the control group. Data were analyzed using the SPSS WIN 18.0. Results: A higher proportion of patients in the experimental group showed adequate levels of physical activity (p=.001), shorter period of chest tube retention (${\leq}7$ days; p=.011), and shorter stay in the hospital (${\leq}10$ days; p=.036) than patients in the control group. Patients in the experimental group reported longer 6-minute walking distance (p=.032) and lower levels of dyspnea (p=.049) than patients in the control group. The PW did not influence the occurrence of pulmonary complications. Conclusion: The findings of this study suggest that the PW could be a useful strategy for improving patients' post-operative health and reducing cost after lung resection.

The Effects of Comprehensive Education Program on Anxiety, Uncertainty and Athletic Performance of Patients undergo Spinal Nerve Block (척추 신경차단술 환자를 위한 포괄적 교육 프로그램이 불안, 불확실성 및 운동수행에 미치는 효과)

  • Kim, Seon Hee;Lee, Eun Sook
    • Korean Journal of Adult Nursing
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    • v.29 no.2
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    • pp.143-153
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    • 2017
  • Purpose: Purpose of the study was to identify the effect of the Comprehensive Education Program (CEP) on intra-procedure anxiety, post-procedure uncertainty and athletic performance of back strengthening of patients undergo spinal nerve block (SNB). Methods: The participants (experimental group=33, control group=33) were recruited from a university hospital in G metropolitan city. Data were collected from July to November 2015. The experimental group was individually provided with a booklet/motion picture about the SNB and back strengthening exercise training before the SNB. This group also received a leaflet about back strengthening exercise post SNB. The Anxiety-Visual Analog Scale (A-VAS), the Mishel adapted uncertainty scale and newly created knowledge scale/athletic performance checklist were utilized as our study tools. Results: Intra-procedure anxiety score (F=25.70, p<.001), post-procedure uncertainty score (F=82.56, p<.001), post-procedure knowledge score (F=14.63, p<.001) and athletic performance rate of back strengthening (p=.003) of the experimental group showed statistically significant differences in comparison with the control group. Conclusion: This CEP is a cost and time-effective intervention for patients who undergo spinal injections, so it should be actively utilized as an educational management strategy in outpatient.

Predictors of Human Papillomavirus Vaccination in Female University Students (여대생의 인유두종바이러스 예방접종 예측요인)

  • Park, Jeong-Sook;Lee, Eun-Joo
    • Women's Health Nursing
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    • v.17 no.4
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    • pp.346-358
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    • 2011
  • Purpose: The purpose of this study was to identify predictors of HPV (Human papillomavirus) vaccination among female university students. Methods: The participants in this study were 1,486 female university students. Data were collected using self-administered questionnaire from september 1, 2010 to June 30, 2011. Data were analysed using descriptive statistics, t-test, $x^2$-test and logistic regression. Results: The rate of HPV vaccination was 7.2%. Factors that influence HPV vaccination included residential region, smoking experience, family history of cervical cancer, experience having heard about the HPV vaccination, awareness that HPV is a sexual disease, HPV knowledge, perceived seriousness, perceived benefit and perceived barrier in health beliefs. Conclusion: The results suggest a need to increase HPV vaccination campaigns to increase awareness of HPV vaccination. University and health care facilities should provide health education emphasizing perceived seriousness and perceived benefits. Also, the national health insurance corporation should consider addressing cost issues as a barrier to HPV vaccination.

Development of a Critical Pathway for Patients with Uterine Artery Embolization (자궁동맥색전술 환자를 위한 표준진료지침 개발)

  • Chung, Kyung-Hee;Ko, Young-Sook;Lim, Jeong-Ah
    • Women's Health Nursing
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    • v.12 no.4
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    • pp.316-325
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    • 2006
  • Purpose: The purpose of this study was to develop a Critical Pathway for Uterine Artery Embolization patients. Method: There were 6 steps that were taken. Step 1 was selecting a diagnosis, and Step 2 was organizing a development team consisting of 7 experts. Step 3 analyzed the medical records, and Step 4 drew up a preliminary Critical Pathway. Step 5 tested the clinical validity of the preliminary Critical Pathway, and Step 6 developed the final Critical Pathway. Result: The contents of the medical practices observed in the medical records were investigated in seven areas: monitoring/assessment, treatment, medication, diet, activity, consults, and education/discharge plan; and a total of 73 items was identified. The validity of the 73 items was examined by a group of specialists. 68 items were adopted, 4 items revised, 1 item removed, and 1 item was added. Using the results, a preliminary Critical Pathway was drawn up. According to the results from examining the clinical validity of the preliminary Critical Pathway with five patients for five weeks, 3 items which showed discrepancy were revised and another 3 items were added. Then, the final Critical Pathway was completed. Conclusion: This Critical Pathway needs to be clinically applied and continuously to measure its effects in terms of the length of stay, cost.effectiveness, and the patients' and staffs' satisfaction.

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A study on the use of Alternative Therapies for Cancer Patients Undergoing Chemotherapy (항암화학요법제 투여 중인 암환자의 대체요법 이용실태 및 의사결정요인)

  • Oh, Hyo-Sook;Park, Hyeoun-Ae
    • Asian Oncology Nursing
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    • v.4 no.1
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    • pp.5-15
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    • 2004
  • Purpose: This study was conducted to examine utilization of alternative therapies and understand decisional criteria related to use of alternative therapies among chemotherapy patients. Method: Data were collected from 165 cancer patients through the use of questionnaire and interviews at the chemotherapy treatment rooms of two general hospitals located in Seoul. Result: Sixty point six percent of subjects after cancer diagnosis have experience of using alternative therapies and 39.4% were still using alternative therapies. On the average the patients used alternative therapies for 9.4 months and they paid 483,000 Won per month for alternative therapies. Decisional criteria related to use of alternative therapy were curability, social group influence about alternative therapy, confidence in alternative therapy, present symptoms, and who decide on the use of alternative therapy. These variables in the alternative therapy group were statistically different from those of the hospital treatment only group. Conclusion: Utilization rate of alternative therapy among chemotherapy patients is high and cost burden is heavy. Thus, they need to be educated about utilization of alternative therapy by nurse and medical personnel.

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Factors Related to Bone-density among Post-menopause Women (폐경여성의 골밀도 예측요인)

  • Lee, Myung-Ok
    • The Journal of Korean Academic Society of Nursing Education
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    • v.12 no.2
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    • pp.214-223
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    • 2006
  • Purpose: This study is to find the significant symptoms related to bone density, from which a cost-effective nursing diagnosis and intervention can be derived. Method: The research sample was 102 women, the sampling was designed by the researcher's convenience, and the subjects of the sample voluntarily participated in a questionnaire survey and measurements. The questionnaire asked socio-demographics, women' reproductive health symptoms, and the life style of the subject. Osteometer DTX-200 for bone density measure and a ruler for measuring spinal curvature were used. All the data were collected at the two public health clinics in a city in Korea. Result: The subjects' current and completed menopause ages, duration of menopause, degree of spinal curvature, BMI, frequency of parity and etc. showed significant correlations with bone density. However, only the degree of spinal curvature(p<.001, r=-.22) was found to be meaningful as a predicted factor for self diagnosis of bone density level. Conclusions: Since most of the subjects have not recognized the relationships between changes in spinal curvature and lowered bone densities, nurse needs to educate clients to get medical assistance to prevent from further bone density reduction by earlier finding of spinal curvature.

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Heart Failure Self-management Interventions: Evidence from Korean Patients

  • Kim, Jin-Shil;Yoo, Hye-Ra
    • Perspectives in Nursing Science
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    • v.8 no.2
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    • pp.148-155
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    • 2011
  • Purpose: The aims of this study were to (1) summarize the HF self-management interventions and (2) identify gaps and priorities for further investigation. Methods: A computer search of the literature over the past decade yielded 9 HF self-management studies. Six studies used non-experimental design; only 3 (33%) studies used quasi-experimental design which were included in this review. Results: The three pivotal HF self-management interventions studies were important because they highlight the positive effects of self-management compliance and other quality of life outcomes as well as discussing various issues. The informational booklet and telephone follow-up were the most common modalities in these interventions. The periodic telephone counseling offered in 2 studies effectively facilitated patient self-management compliance. There were some methodological flaws such as small sample sizes (range 8~21 in each group) and lack of experimental designs, long-term follow-up, and random group assignment. Additionally, the use of valid, reliable outcome measures is necessary to compare the effects of the interventions worldwide. Conclusion: More clinical evidence on HF self-management is needed using a larger sample size and the efficacy needs to be tested for various outcomes, including morbidity, mortality, and health care cost.

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