• Title/Summary/Keyword: Outcome indicator

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Nursing outcomes of inpatient on level of nursing staffing in long term care hospitals (요양병원 간호인력 확보수준에 따른 입원환자의 간호결과)

  • Kim, Eun Hee;Lee, Eunjoo
    • Journal of the Korean Data and Information Science Society
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    • v.26 no.3
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    • pp.715-727
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    • 2015
  • This study was conducted to explore the impact of nursing staffing on inpatient nursing outcomes in long term care hospitals. A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals. Patients per RN was a significant indicator of foley catheter ratio in high risk group and low risk group. Patients per RN&NA was a significant indicator of decline in ADL for patients with dementia, non dementia, urinary incontinence and new pressure ulcer development in the high risk group. The average nursing outcome of inpatient in high grade was higher than that low grade in long care hospital. This higher level of nursing staffing and the higher the grade shown a positive effect on the nursing outcomes of the inpatient. We therefore recommend modifying the above nurse staffing policy so as to make it more effective in improving nursing outcomes.

Call for an Open Discussion on Empirical Viability of Causal Indicators

  • Kim, Gi Mun;Shin, Bong Sik;Grover, Varun;Howell, Roy D.;Kim, Ki Joo
    • Journal of Korea Society of Industrial Information Systems
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    • v.22 no.6
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    • pp.71-84
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    • 2017
  • Over the past decade, we have witnessed Serious Debates in MISQ and Other Journals Between Two Camps that have Differing Views on the use of Causal Indicators to Measure Constructs. There is the Camp that advocates Causal Indicators (ADVOCATE) and the Camp that opposes Their Usage (OPPONENT). The Debates have been primarily centered on the OPPONENT's Argument that the Meaning of a Latent Variable is determined by its Outcome Variables. However, Little Effort has been made to Validate the ADVOCATE's Dispute (Against the OPPONENT's Arguments) that the Meaning of a Latent Variable is decided by its Causal Indicators if there is no Misspecification. Our Study precisely examines the Integrity of the Argument. For this, we empirically examine how the two Primary Psychometric Properties-Comprehensiveness and Interrelationship-of Causal Indicators Influence Theory Testing between Latent Variables through Three Different Tests (i.e., Comprehensive Test, Interrelationship Test, and Mixed Test). Conducted on Two Different Datasets, Our Analysis Consistently Reveals that Structural Path Coefficients are Hardly Sensitive to the Changes (i.e., Misspecification) in the Properties of Causal Indicators. The Discovery offers Important Evidence that the Sound Theoretical Logic of a Causal Model is not in Sync with the Empirical Mechanism of Parameter Estimation. This Underscores that a Latent Variable Formed by Causal Indicators is empirically an elusive notion that is Difficult to Operationalize. As Our Results have Significant Implications on the Integrity of Numerous IS studies which have conducted Theory or Hypothesis Testing Using Causal Indicators, we strongly advocate Open Discussions among Methodologists regarding Our Findings and Their Implications for Both Published IS Research and Future Practices.

Expression of C4.4A is a Potential Independent Prognostic Factor for Patients with Gastric Cancer

  • Cheng, Da-Qing;Gu, Xiao-Dong;Li, Zhen-Yang;Xiang, Jian-Bin;Chen, Zong-You
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.9
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    • pp.3895-3899
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    • 2014
  • C4.4A, a metastasis-associated gene, encodes a glycolipid-anchored membrane protein which is overexpressed in several human malignancies. However, there are few data available on C4.4A expression and its relationship with progression in gastric cancer. Our study was designed to explore the expression of C4.4A in gastric cancer and to correlate it with clinical outcome. C4.4A expression was studied by quantitative real-time RT-PCR and immunohistochemistry for assessment of correlations with clinicopathological factors. C4.4A mRNA expression was significantly up-regulated in gastric cancer as compared with noncancerous tissue (p<0.05)., being observed in 107 (88.4%) of the 121 gastric cancer cases by immunohistochemistry. We found that the expression of C4.4A mRNA was correlated with size of the tumor, depth of invasion, lymph node metastasis, distant metastasis and TNM stage. Moreover, patients with overexpression of C4.4A has a significantly worse survival (p<0.05). Further multivariable analysis indicated that the expression of C4.4A was an independent prognostic indicator for gastric cancer (p<0.05). In conclusion, overexpression of C4.4A correlates with metastatic potential of gastric cancer and C4.4A could be a novel independent prognostic marker for predicting outcome.

Development and Application of a Computerized Nursing Process Program for Orthopedic Surgery Inpatients - NANDA, NOC, and NIC Linkages - (정형외과 입원환자를 위한 간호과정 전산프로그램 개발 및 적용 - 간호진단, 간호결과, 간호중재 연계 -)

  • Kim, Hye-Suk
    • Journal of Korean Academy of Nursing
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    • v.35 no.6
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    • pp.979-990
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    • 2005
  • Purpose: The purpose of this study was to develop and to apply the NANDA, NOC, and NIC (NNN) linkages into a computerized nursing process program using the classification systems of nursing diagnoses, nursing outcomes and nursing interventions. Method: The program was developed with planning, analysis, design and performance stages. The program was applied to 117 patients who were admitted to orthopedic surgery nursing units from January to February, 2004. Results: Thirty-five of fifty-three nursing diagnoses were identified. Five nursing diagnoses in order of frequency were: Acute pain $(28.4\%)$, Impaired physical mobility $(15.6\%)$, Impaired walking $(8.7\%)$, Chronic pain $(5.5\%)$ and Risk for disuse syndrome $(5.0\%)$. The nursing outcomes of the 'Acute pain' nursing diagnosis tended to have higher frequencies (cumulative) in order of Pain management $(95.2\%)$, Comfort level $(35.5\%)$ and Pain level $(17.7\%)$. The nursing interventions of the 'Acute pain' nursing diagnosis tended to have higher frequencies (cumulative) in order of Pain management $(71.0\%)$, Splinting $(24.2\%)$ and Analgesic administration $(17.7\%)$. In comparison of outcome indicator scores between before and after the intervention according to the 61 nursing outcomes, the mean scores of 52 outcome indicators after the intervention were significantly higher than before the intervention. Conclusion: It is expected that this program will help nurses perform their nursing processes more efficiently.

Tumor Interstitial Fluid Pressure in Patients with Head and Neck Cancer (두경부 악성 종양 조직내 간질액 압력)

  • Cho Moon-June;Kim Jae-Sung;Lee In-Tae;Kim Jun-Sang;Jang Ji-Young;Kim Ki-Hwan
    • Korean Journal of Head & Neck Oncology
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    • v.16 no.1
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    • pp.9-13
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    • 2000
  • Objectives: To determine the tumor interstitial fluid pressure(TIFP) in patients with head and neck cancerand predict radiotherapy outcome.Materials and Methods: In 12 biopsy proven primary head and neck cancer patients with accessible by direct inspection and palpation, and of sufficient thickness(>1cm) to permit accurate needle placement, we measured TIFP at cervical lymph node before and during radiotherapy using a modified wick-in-needle technique. Tumor size was measured clinically and radiologically. Results: The mean preradiotherapy TIFP was 23.4mmHg. Preradiotherapy TIFP had significant relationship with tumor size(p=0.0009). Preradiotherapy TIFP was not different between complete response group and partial or less response group(p=0.114). Radiotherapy outcome was not different between group with above and group with below average TIFP(p=0.09). Conclusion: The mean TIFP was elevated with 23.4mmHg before radiation therapy. Preradiotherapy TIFP had significant relationship with tumor size. It is not definitive that TIFP could be prognostic indicator of radiation response.

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Analysis of Intervention Studies for Married Immigrant Women (결혼 이주여성 대상 중재연구 분석)

  • Kim, Tae Im;Kim, Ji Young;Choi, Sun Mi;Jung, Gye Hyun
    • Research in Community and Public Health Nursing
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    • v.24 no.2
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    • pp.172-184
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    • 2013
  • Purpose: The purpose of this study is to analyze the intervention studies for married immigrant women. Methods: Based on inclusion criteria, 45 articles published from 2006 to 2011 were reviewed and analyzed. Results: Among the total amount of studies, 77.8% have been conducted since 2009; and 46.7% of them were for a master's thesis, 11.1% were for a doctoral thesis, and 42.2% were journal articles. Most of them were quantitative research (77.8%) and 71.1% were conducted in urban areas. The most frequently conducted intervention was art therapy (35.6%), whereas 6.7% was health education. In total, 104 outcome indicators were used with 57 (54.8%) in the mental health domain, 29 (27.9%) in the social health domain, and 18 (17.3%) in the physical health domain. The most commonly used outcome indicator was self-esteem (23.2%), and the next, in the order of frequency, included self-efficacy (23.2%), acculturative stress (21.4%), and depression (10.7%). Conclusion: Most intervention studies were conducted to support the sociocultural adaptation of married immigrant women, while few intervention studies were conducted to support the health of married immigrant women. To promote the health and quality of life of married immigrant women, many health related intervention programs should be undertaken.

Transcranial Doppler and Cerebrospinal Fluid Flow Study in Normal Pressure Hydrocephalus

  • Lee, Hui-Keun;Hu, Chul;Whang, Kum;Kim, Hun-Joo
    • Journal of Korean Neurosurgical Society
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    • v.39 no.1
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    • pp.20-25
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    • 2006
  • Objective : The authors analyze prospectively the result of transcranial doppler[TCD] in normal pressure hydrocephalus and compared its cerebral blood flow parameters to radionuclide cerebrospinal fluid[CSF] flow study, postoperative brain computed tomography[CT] findings and clinical outcome, and studied the relationship between cerebral hemodynamics and clinical performance. Methods : Twenty five patients with hydrocephalus undertook pre- and post-operative TCD but only preoperative CSF flow study was performed. Mean flow velocity[Vm], pulsatility index[PI] and resistance index[RI] were assessed through TCD and changes in ventricle size and cortical gyral atrophy were checked through brain CT. Results : Postoperative hydrocephalus showed an increase in Vm[ACA P=0.037, MCA P=0.034], decrease in PI[ACA P=0.019, MCA P=0.017] and decrease in RI [ACA P=0.017, MCA P=0.021] compared to preoperative TCD parameters in the postoperative improvement group. In the postoperative improvement group, postoperative TCD parameters correlated with CSF flow study grade [Vm : $R^2=-0.75$, PI : $R^2=0.86$, RI : $R^2=0.78$] and ventriculocranial ratio change correlated with PI change [$R^2=0.73$]. The convexity gyral atrophy and initial TCD parameters showed close relationship to outcome. Conclusion : PI and RI can be used as an indicator of post operative prognosis, and with the addition of CSF flow study values, can also be used as a tool to predict pre-op and post-op patient status and successful shunt surgery.

Preventing Varus Deformity in Senile Patients with Proximal Humerus Fractures and Poor Medial Support

  • Kim, Young-Kyu;Kang, Suk-Woong;Kim, Jin-Woo
    • Clinics in Shoulder and Elbow
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    • v.19 no.4
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    • pp.216-222
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    • 2016
  • Background: We investigated the effectiveness of fibular strut allograft augmentation of proximal humerus fractures to prevent varus deformity in patients over the age of 65 years with insufficient medial support. Methods: We analyzed the clinical and radiological outcomes of locking plate fixation with adjunct fibular strut allograft augmentation in 21 patients with proximal humeral fractures. The inclusion criteria were age (65-year-old or older); presence of severe medial comminution; inadequate medial support; and those who could participate in at least a one year follow-up. The average age was 76.4 years. We analyzed each patient's Constant score, our indicator of clinical outcome. As radiological parameters, we analyzed time-to-bone union; restoration of the medial hinge; difference between the immediately postoperative and the last follow-up humeral neck-shaft angles;; and anatomical reduction status, which was assessed using the Paavolainen method. Results: A successful bone union was achieved in all patients at an average of 11.4 weeks. We found that the average Constant score was 74.2, showing a satisfactory outcome. The average difference in the humeral neck-shaft angles between the immediately postoperative time-point and at the final follow-up was $3.09^{\circ}$. According to the Paavolainen method, the anatomical reduction was rated excellent. The medial hinge was restored in 14 of 21 patients. Although we did not find evidence for osteonecrosis, we found that a single patient had a postoperative complication of screw cut-out. Conclusions: Fibular strut allografting as an adjunct treatment of proximal humeral fractures may reduce varus deformity in patients with severe medial comminution.

Health Outcome Prediction Using the Charlson Comorbidity Index In Lung Cancer Patients (Charlson Comorbidity Index를 활용한 폐암수술환자의 건강결과 예측에 관한 연구)

  • Kim, Se-Won;Yoon, Seok-Jun;Kyung, Min-Ho;Yun, Young-Ho;Kim, Young-Ae;Kim, Eun-Jung;Kim, Kyeong-Uoon
    • Health Policy and Management
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    • v.19 no.4
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    • pp.18-32
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    • 2009
  • The goal of this study was to predict the health outcomes of lung cancer surgery based on the Charlson comorbidity index (CCI). An attempt was likewise made to assess the prognostic value of such data for predicting mortality, survival rate, and length of hospital stay. A medical-record review of 389 patients with non-small-cell lung cancer was performed. To evaluate the agreement, the kappa coefficient was tested. Logistic-regression analysis was also conducted within two years after the surgery to determine the association of CCI with death. Survival and multiple-regression analyses were used to evaluate the relationship between CCI and the hospital care outcomes within two-year survival after lung cancer surgery and the length of hospital stay. The results of the study showed that CCI is a valid prognostic indicator of two-year mortality and length of hospital stay, and that it shows the health outcomes, such as death, survival rate, and length of hospital stay, after the surgery, thus enabling the development and application of the methodology using a systematic and objective scale for the results.

Role of CD10 Immunohistochemical Expression in Predicting Aggressive Behavior of Phylloides Tumors

  • Tariq, Muhammad Usman;Haroon, Saroona;Kayani, Naila
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3147-3152
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    • 2015
  • Background: Phylloides tumors are rare breast neoplasms with a variable clinical course depending on the tumor category. Along with histologic features, the role of immunohistochemical staining has been studied in predicting their behavior. Objectives: Our aim was to evaluate the role of CD 10 immunohistochemical staining in predicting survival, recurrence and metastasis in phylloides tumor. We also evaluated correlations of other clinicopathological features with overall and disease-free survival. Materials and Methods: CD10 expression was studied in 82 phylloides tumors divided into recurrent/metastatic and non-recurrent/non-metastatic cohorts. The Chi-square test was applied to determine the significance of differences in CD10 expression between outcome cohorts. Uni and multivariate survival analyses were also performed using log-rank test and Cox regression hazard models. Results: All 3 metastatic cases, 5 out of 6 (83.3%) recurrent cases and 37out of 73 (50.7%) non-recurrent and non-metastatic cases expressed significant (2+ or 3+) staining for CD10. This expression significantly varied between outcome cohorts (p<0.03). Tumor category and histological features including mitotic count and necrosis correlated significantly with recurrence and metastasis. A significant decrease in overall and disease free survival was seen with CD10 positivity, malignant category, increased mitoses and necrosis. Neither CD10 expression nor any other clinicopathologic feature proved to be an independent prognostic indicator in multivariate analysis. Conclusions: CD10 immunohistochemical staining can be used as a predictive tool for phylloides tumor but this expression should be interpreted in conjunction with tumor category.