• Journal of Korean Clinical Nursing Research
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• v.18 no.2
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• pp.317-328
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• 2012

Purpose: This study was done to provide oncology nurses systemic guidelines designed to perform telephone counseling in outpatient settings treating patients with chemotherapy. Methods: Symptoms which are frequently questioned were identified through case reports recorded by 4 clinical nurse specialists from January 4 to December 31. 2010. Fifteen clinical experts and two hemato-oncologists reviewed the developed draft. Their opinions were synthesized to arrive at consensus on the ideal guidelines. This process confirmed content validity. The two hemato-oncologists also verified the face validity. Results: The six symptoms which were most frequently asked about were identified through 4,644 case reports and concerned pain, fever, skin alteration, nausea/vomiting, stomatitis and diarrhea. Evidence-based telephone triage guidelines for the 6 major symptoms in patients receiving chemotherapy were developed. Conclusion: These guidelines will help oncology nurses from novice to expert incorporate evidence-based telenursing into their practice.

• The Journal of Korean Physical Therapy
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• v.30 no.6
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• pp.239-245
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• 2018

Purpose: This study was to identify international classification of functioning, disability and health (ICF) categories that could be linked conceptually to disability of arm, shoulder and hand (DASH) items and short form of health survey 36 (SF-36) items for persons with shoulder pain. Methods: Linkage between each item in DASH and SF-36 and the categories in the ICF were assessed. The linking process was performed by ten health professionals following the linking rule. One hundred four patients with shoulder pain were enrolled from 12 private clinic outpatient departments and participated in this study. Pearson correlation coefficients were used to assess the relationships between each scale item and the linked ICF code. Results: Thirty DASH items were able to be linked to 30 ICF codes, whereas the 36 items in SF-36 were only linked to 17 ICF codes. General health items included in SF-36 could not be linked to a relevant ICF concept. There was a high correlation between the two measurement tools and the linked ICF codes, DASH and its ICF code list (r =0.91), SF-36-Physical Health and its code list (r =-0.62), and SF-36-Mental Health and its code list (r =-0.72). Conclusion: The results suggest that concepts within each item in DASH can be linked to ICF codes for patients with shoulder pain, however, the concepts in the SF-36 items had limited linkage to ICF codes. The shoulder-specific functional tool, DASH can be expressed with ICF codes and, therefore, its use can promote data standardization and improve communication between professionals.

• Journal of Korean Clinical Nursing Research
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• v.28 no.1
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• pp.23-33
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• 2022

Purpose: This study aimed to identify the relationships among disease severity, anxiety, depression, social support, unpleasant symptoms and self-care among patients with atrial fibrillation based on the unpleasant symptom theory, and to examine the mediating effects of unpleasant symptoms. Methods: A cross-sectional study was conducted. The participants were 216 patients with atrial fibrillation who were being followed up on an outpatient basis at a university hospital in Seoul. Data were collected from November 1, 2020 to June 30, 2021, using self-report questionnaires. Data were analyzed using IBM SPSS/WIN 27.0 and PROCESS macro with 95% bias-corrected bootstrap confidence interval(CI). Results: The average age of participants in this study was 66.0years. Disease severity (β=10.19, p<.001) and depression (β=1.53, p<.001) had significant positive relationships with unpleasant symptoms. Also, unpleasant symptoms (β=-0.03, p=.006) had a negative relationship with physical activity, which is a subscale of self- care. Social support (β=0.06, p<.001) was positively related with physical activity. Unpleasant symptoms showed a mediation effect in the relationship between disease severity and physical activity (Bias corrected bootstrap CI -0.65, -0.04). Depression had an indirect effect on physical activity that was mediated by unpleasant symptoms (Bias corrected bootstrap CI -0.11, -0.00). Conclusion: The findings of this study suggest that integrated strategies including physical, psychological, and social factors should be considered to promote self-care in patients with atrial fibrillation.

• Journal of The Korean Society of Integrative Medicine
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• v.12 no.2
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• pp.65-76
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• 2024

Purpose : This study aimed to develop and validate a reliable tool, the Korean physical therapists' work environment scale (K-PTWES), for assessing the work environment of Korean physical therapists. The study also sought to examine the validity and reliability of the instrument. Methods : This methodological study involved the development and testing of the measurement tool. The conceptual framework was established through a literature review and in-depth interviews with clinical physical therapists. A total of 40 meaningful statements emerged from this process, leading to the generation of 29 primary items. Following a content validity test, 29 items were selected for the preliminary tool. Data were collected from 220 physical therapists across various job roles and unit types, such as outpatient and inpatient physical therapy rooms in domestic hospitals, with more than one year of experience. The final analysis included data from all 220 physical therapists. Results : Varimax rotated principal component analysis was employed for validities, revealing four factors: organizational support, working system, sustainable development, and relationship with coworkers, explaining a total variance of 54.97 %. The Cronbach's α coefficient for the final tool was .939, indicating high reliability. Conclusion : In this study, we developed a measurement tool reflecting the characteristics of the Korean physical therapists' work environment scale (K-PTWES). Our findings highlight the tool demonstrated both validity and reliability. Utilizing this tool is expected to contribute to understanding the work environment of Korean physical therapists and fostering a healthy work environment. Based on our findings, we recommend, firstly, conducting research on the work environment and related factors of physical therapists working in diverse settings using the K-PTWES. Secondly, future studies should focus on validating the tool's criterion-related validity, as it was not addressed in this research.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.12
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• pp.381-393
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• 2016

This was a qualitative study to explore and better understand the adaptation experience and processes of peoples with fibromyalgia syndrome (FMS), as well as to develop a substantive theory using the grounded theory method. There were 13 patients (12 females and 1 male) who received FMS treatment from Rheumatic Medicine outpatient department of one general hospital. The data were collected through an in-depth interview between January and May of 2014. Transcribed interview contents were analyzed by the grounded theory method of Corbin and Strauss (2008). As a result, a total of 98 concepts, 26 sub-categories, and 10 categories were identified through the open coding process. The process of adaptation experience showed 4 steps: perception of uncertainty and limited condition, evaluation of self-control possibility and determinations of expectations of life, searching and trying of strategies, as well as self-regulation. The 4 types of adaptation experience were expansionary, complacently, effusively and withering. The 'protective self-regulation' theory was derived from the core category of 'learning to self-regulation method'. Patients with FMS has repeatedly attempted these strategies of protective self-regulation in order to gain stability from uncertainty and limited condition of the disease. Based on these results, it is necessary to develop an educational program for patients and families which has appropriate nursing intervention strategies in accordance with the types of adaptation.

• Journal of muscle and joint health
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• v.4 no.2
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• pp.197-220
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• 1997

The lack of a comprehensive theory describing the mechanism of adaptation scientifically has been one of the limiting factors for the development of nursing intervention of patients with chronic illness. Since Roy's theory provides the general conceptual framework depicting adaptation process with structural stimuli and control mechanism, it is appropriate to understand the process of adaptation. But in Roy's theory, the propositions about cognator and regulator as control mechanisms are not clearly defined. For this reason, most of the previous researches applying the Roy's theory have disregarded the study of cognator and regulator. For the patients with chronic illness such as rheumatoid arthritis, it was reported that adaptation states were different for the same stimuli due to the difference of the control mechanism. Moreover in nursing it is important to identify the control mechanism which can be and must be intervened by nurses. It was the Lazarus and Folkman's theory that proposed the control mechanism. They suggested that individual differences in the reaction against the perceived stress are due to the difference in appraisal and coping. Therefore, the synthesis of Roy's and Lazarus and Folkman's propositions might help to clearly understand the mechanism of adaptation. From this point, a theoretical framework has been developed and tested. The subjects were the 297 patients who had been diagnosed rheumatoid arthritis and attended the outpatient clinic. A hypothetical prediction model of adaptation was tested by the covariance structure analysis with PC-LISREL 7.13. As a result, the overall fit was good($x^2$=78.83, p=0.00 ; GFI=0.96 : AGFI=0.90 ; RMR=0.04) for the hypothetical model. In the final model added GA(5, 1), the overall fit was increased ($x^2$=57.82, p=0.003 ; GFI=0.97 ; AGFI=0.93 : RMR=0.036). Except the fact that illness symptoms affected physical adaptation directly, it was supported that focal and contextual stimuli affected physical and psychosocial adaptation through appraisal and coping. Therefore, it was asserted that the synthesis of two theory's propositions was appropriate. So this model would be useful for the theoretical framework in the nursing practice. And this study synthesizing and testing the theory might contribute to establish nursing's scientific base.

• Anxiety and mood
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• v.15 no.2
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• pp.61-67
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• 2019

Objective : This study aimed to investigate the general process from the symptom onset to the psychiatric treatment in Korean panic patients and the effect of improved public awareness on it. Methods : This study has a retrospective design. The subjects were the new patients with panic disorder who visited the psychiatric outpatient clinic in twelve university-affiliated hospitals all across Korea. The medical chart was reviewed retrospectively and the data were collected including chief complaints of symptoms, recent stressors, the time to visit the psychiatric outpatient clinic, and visit of other departments and diagnostic approaches for their symptoms. Results : A total of 814 participants were included in the study. The most common department other than psychiatry the panic patients visited were cardiology (28.3%), general internal medicine (16.0%) and neurology (11.4%). The most frequently used diagnostic tests were a echocardiography (17.9%), 24-hour Holter monitoring (11.2%), and brain MRI (8.2%). Only 37.3% of participants visited psychiatric clinic directly. About 80% of participants visited psychiatric department within 1 year after their first panic symptoms and it took $13.8{\pm}13.7weeks$ on average. Comparing before and after 2012, the number of participants increased who visit directly the psychiatric clinic without visiting other departments (p=0.002) and without visiting emergency room (p<0.001). Conclusions : Our results suggest that a substantial number of patients visit departments other than psychiatry when they experience first panic symptoms. However, most patients begin psychiatric treatment within 1 year after their first symptoms and the number of patient are increasing who visit psychiatric department directly without visiting other departments.

• Journal of Sasang Constitutional Medicine
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• v.8 no.1
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• pp.247-294
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• 1996

By means of the statistical data which has been collected with newly revised QSCC made use of the outpatient group examined at Kyung-Hee Medical Center and an open ordinary person group, the author proceeded statistical analysis for the validation study of the revised questionnaire itself. First, check the accurate discrimination rate by performing discriminant analysis on the statistical data of the patient group. And next, sought T-score by applying the norms gained in process of standadization of the open ordinary person group to the Sasang scale score of the outpatient group and investigated the distinctive feature between the subpopulations which was devided in the process of multivarite cluster analysis. The result was summarized as follows ; 1. The validity of the questionnaire was established through the fact that the accurate discrimination rate the ratio between predicted group and actual group was figured out 70.08%. 2. At the profile analysis the response to the relevant scale showed notable upward tendency in each constitutional group and therefore it seems to be pertinent in the field of constitutional discrimination. 3. In the observation of the power of expression through the profile analysis of each constitutional group the Soyang group demonstrated the most remarkable outcome, the Soeum group was the most inferior and the Taieum group revealed a sort of dual property. 4. What is called the group of seceder out of three subpopulation of each constitutional group distinguished definitely from the contrasted groups at the point of the distinctive profile feature and the content is like following description. (1) The seceder group of Soyang-in showed considerably passive disposition differently from general character of ordinary Soyang group and an appearance attracting the attention is that they demonstrated comparatively higher response at Soeum scale (2) The seceder group of Taieum-in gained low scores in general that informed the passive disposition of the group and the other way of the general property of Taieum group which showed accompanied ascension in Taiyang-Taieum scales they demonstrated sharply declined score at Taiyang scale (3) The seceder group of Soeum-in demonstrated distinctive property similar to the profile feature of Soyang group and it notifies that the passive property of Soeum group was diluted for the most part. According to the above result, the validity of newly revised questionnaire has been proven successfully and the property of seceder groups could be noticed to some degree through the profile analysis on the course of this study. The result of this study is expected to use as a research materials to produce next edition of the questionnaire and it is regarded that further inquisition about the difference between the seceder group and the contrasted group is required for the promotion of the questionnaire as it refered several times in the contents of the main discourse.

• Quality Improvement in Health Care
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• v.3 no.1
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• pp.104-124
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• 1996

Background : In these days, the health care organizations have concerned about customer-centered care in order to empower the competitiveness on the health care markets. The departments working for quality management of the hospitals have used health care quality indicators in terms of medical areas as well as service areas of the hospitals. However, there were insufficient efforts to develop the credible measurement to seek the customers' needs, their expectations and their satisfaction levels related to health care services because various kinds of challenges were in the process of scale development to measure customers' satisfaction in health care. The purpose of this study was to develop the satisfaction scale to health care services in a Korea health care organization and to test its tool with validity and reliability. Method : The concept of this tool was acceptability that one of the components of health care quality defined by Donabedian. Acceptability has the five dimensions of concept: Accessibility; Patient-Practitioner Relations; Amenities; Patient Preferences as to the effects of care; and Patient Preferences as to the costs of care. The Satisfaction Tool to Health Care Services was reviewed by expert panel with five researchers, including hospital managers and a professor related to quality management of the hospitals. As a result, the content validity index was .84 in the outpatient satisfaction tool. The inpatient satisfaction tool had .87 of the content validity index. The Satisfaction Tools to Health Care Services finally consisted of 44 items for outpatients/their families and of 60 items for inpatients/their families. Study subjects of the construct validity test were 479 outpatients/their families and 561 inpatients/their families who visited or admitted at a University hospital from July 1, 1996 through August 10, 1996. The data were examined by Factor Analysis with SPSS. Result : The items of Satisfaction tools for outpatients/their families were categorized by eleven factors with eigenvalue greater than 1.0 accounting for 64.2 percent of the variation in item scores. Also, the items of inpatient tool had eleven factors with eigenvalue greater than 1.0 accounting for 60.3 percent of the variation in item scores. The reliability of overall scale were .95 and .96 for the outpatients/their families satisfaction scores and inpatient/their families satisfaction scores. The internal consistency reliability with eleven factors was ranged from .30 to .94 for inpatients/their families. The Satisfaction Tool with eleven factors for inpatients/their families had internal consistency reliability ranged from .53 to .89. Conclusion : The Satisfaction Tools to Health Care Services focused on outpatients/their families and inpatients/their families developed in this study had a high reliability and the strong evidence of content validity and construct validity based on quality concept. Therefore, this tool would be utilized as a credible quality indicator of health care services to assess the quality problems and to monitor the quality improvement activities in Korean Health Care Organizations.

• Korea Journal of Hospital Management
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• v.7 no.4
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• pp.172-192
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• 2002

The purpose of this study is to ascertain whether the effect of introduction of OCS(Order Communication System) to the hospital is satisfied or not comparing the anticipated effect with the actual effect. For this purpose, a domestic hospital which has introduced and has been operating OCS for several years was chosen. Based on the internal data of S Hospital prepared before introducing OCS, researcher has analyzed the basic direction, design standard and status of operation after the introduction of OCS, etc. After analyzing the status of operations of several departments using OCS and interviewing with the chiefs of pertinent departments, a survey form was designed. Actual survey and interviews were conducted by the researcher for weeks to know whether doctors, nurses, medical technicians and clerks of the patient management dept. were satisfied with OCS and to find if they have any recommendations to improve OCS. Based on the analysis of survey, the effect of OCS was evaluated whether it has satisfied the anticipated effectiveness. For the question if they feel convenient in using OCS, doctors, nursing staffs in charge of ward and the staffs of billing dept. has answered that they were all satisfied(100%). The answers for the same question were relatively high in the case of nurses in charge of outpatient and staffs of radiography. Of course, there have been some nurses and staffs who complained for the inconvenience. However, overall satisfaction was high on the average. Some common problems occurred after the introduction of OCS were frequent errors due to instability of OCS system, paralysis of function of hardware on data back-up system and redundant investment due to erroneous choice of DB program in setting DB. It was also pointed out that lack of computer education and low participation of medical staffs has resulted in failure of developing effective software. As a result, it has lowered the efficiency of OCS. For example, some works have to be done by hands even after OCS. Based on the result of this research, recommendations to maximize the effect of OCS were presented as follows. First, strong leadership of CEO and active cooperation of doctors are mandatory. Second, all the process of hospital work should be analyzed and be redesigned in more efficient ways. Third, OCS should be designed to be user-based system which can be used efficiently by all staffs of the hospital. Forth, prior to the operation of OCS, proper tests of the program and trainings of the pertinent staff are required. Fifth, prior to the selection of hardware, BMT(Bench Marking Test) should be conducted. Sixth, before introducing OCS, staffs in charge of OCS should visit many hospitals operating the OCS system and take their cases into account.