• Journal of East-West Nursing Research
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• v.20 no.2
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• pp.112-120
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• 2014

Purpose: The purpose of this study was to compare the differences in characteristics, lactation problems, knowledge, and adaptation of breastfeeding between users and non-users of a lactation clinic. Methods: The descriptive study design was utilized using self-report questionnaires. 446 breastfeeding mothers participated in this study. Data were collected from lactation clinics, postpartum care centers, mother's culture centers, public health centers, pediatrics and obstetrics & gynaecology outpatient clinics in Seoul, Gyeonggi province, and Chungcheongnam province from August 20 to September 30, 2011. The questionnaires to measure lactation problems, knowledge and adaptation of breastfeeding were used. Data were analyzed using SPSS ver. 18.0 for Windows. Results: There was statistically significant differences in the breast feeding problems(t=5.71, p<.001) and breastfeeding knowledge(t=2.87, p=.004) between users and non-users of a lactation clinic. Conclusion: The results of this study may provide a foundation to develop nursing intervention for mothers in breastfeeding, and an evidence to expand the role of nurses as breastfeeding specialists.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.3
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• pp.227-236
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• 2021

Background: Emergencies in outpatient clinics are rare. However, potentially catastrophic events can be challenging to manage due to a variety of factors, including limited equipment and staff. The purpose of this quality improvement project was to improve the staff knowledge and familiarity with critical performance elements for emergencies encountered in the setting of a periodontics clinic. Methods: Emergency cognitive aids tailored to the clinic's resources were created for anaphylaxis, airway obstruction, and sublingual hemorrhage. The project pre-post-test repeated measures design evaluated the effectiveness of cognitive aids using a combination of hands-on simulation, written knowledge assessments, and self-efficacy surveys. Training sessions and simulations were provided to the clinic's existing care teams made up of a periodontist and two dental assistants with an anesthetist who was present for simulations involving sedation. Due to the small sample size (N = 14) and non-normal distribution, all metrics were evaluated using non-parametric statistics. Results: Significant improvements were found in knowledge assessment (-2.310, P = 0.021) and self-efficacy (-2.486, P = 0.013) scores when retention after a training session before and after the introduction of cognitive aid was compared. The mean simulation scores and times improved steadily or reached maximum scores during the project progression. Conclusion: Training sessions before and after cognitive aid introduction were effective in improving knowledge, self-efficacy, and simulation performance. Future projects should focus on validating the process for creating contextualized cognitive aids and evaluating the effectiveness of these cognitive aids in larger samples.

• Korean Institute of Interior Design Journal
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• v.17 no.1
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• pp.120-129
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• 2008

It requires great efforts to satisfy all functional characteristics of the rehabilitating treatments space for the specialized clinic for the elderly as the rehabilitating scope for treatment of the clinic has become more specialized and sectionalized. The specialization of the clinic for the elderly is saliently different in terms of rehabilitation treatment. The changed concept of rehabilitation for the elderly means that it places great importance in helping the elderly in their day-to-day life through a short-term or outpatient treatment, not a long term stay at hospital for retreat. The rehabilitation space in the clinic is essential in that it provided environment for efficient space placement in varied location. Thus, this study has been researched on 6 clinics for the elderly. It is because the space will have a variety of functions, which will be for the sake of the effective rehabilitation treatment of those aged patients who use that medical facilities, and not only for the physical therapy. It could have been designed to accommodate and realize not only the physical well-being, but also psychological, social and spiritual integrity for a variety of treatments, with which as the basis, this study theorizes the characteristics of the essential elements and the specialization factors by extracting spatial element through theoretical investigation. In conclusion the study here proposes the planned guideline for the rehabilitation treatment space to be designed inside the specialized clinic for the elderly, with renewed awareness of the importance on the spatial element in a recently established clinic.

• Tuberculosis and Respiratory Diseases
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• v.71 no.4
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• pp.271-277
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• 2011

Background: A chronic obstructive pulmonary disease (COPD) assessment test (CAT) has recently been developed as a short and simple method for assessing the quality of life in COPD patients. The object of this study was to assess the usefulness of the Korean version of the CAT for assessing COPD patients in an outpatient clinic. Methods: The study included 60 COPD patients in a stable state from an outpatient clinic. The authors investigated the frequency of acute exacerbation during aprevious year through reviewing medical records. We evaluated the spirometry test, a 6-min walk distance test, and obtained the MMRC dyspnea scale, the Korean version of the CAT, and the BODE index at the time of visit. To assess the usefulness of the CAT, correlations between the CAT and other methods were evaluated. Results: The mean age of patients was $68.3{\pm}8.6$ years and 95% of patients were male. There was a significant correlation between the CAT score and $FEV_1%$ (r=-0.323, p=0.012), the frequency of acute exacerbation (r=0.292, p=0.024), the MMRC dyspnea scale (r=0.554, p<0.001), the BODE index (r=0.380, p=0.003), and 6 MWD (r=-0.372, p=0.004). The mean CAT score increased according to the GOLD stage (stage 1, $10.7{\pm}4.5$; stage 2, $13.1{\pm}7.9$; stage 3, $16.3{\pm}6.2$; stage 4, $16.5{\pm}14.8$; p=0.746). Conclusion: The CAT was shown to be useful for the assessment of COPD severity. Therefore, the CAT is an easily applied and simple method for assessing COPD severity in an outpatient clinic.

• Child Health Nursing Research
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• v.20 no.2
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• pp.113-122
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• 2014

Purpose: Purposes of this study were to identify the level of parental fever phobia and to investigate the relationship between level of parental concern about fever and related variables. Methods: Participants were 151 parents of children who visited a pediatric outpatient clinic. A selfreported structured questionnaire was used for data collection and data were analyzed using descriptive statistics and ${\chi}^2$-test. Results: Almost half of participants defined a minimum temperature for fever as $37.8^{\circ}C$ and a minimum temperature for high fever as $38.9^{\circ}C$. About 75% of participants identified harmful effects of fever as seizure and brain damage, were 'very worried' about fever, measured their child's temperature every hour or less, provided tepid massage and woke children to give antipyretics during febrile illness. There were significant relationships between level of parental concerns about fever and prior experience of febrile seizures, and/or being parents of a single child. Conclusion: Results indicate that fever phobia is prevalent among parents. Further studies are needed to develop and evaluate childhood fever management educational programs for parents. Considering health care providers as a primary information resource about fever management, health care providers should play a vital role to reduce parental unrealistic concerns about fever.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.2
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• pp.77-83
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• 2015

Background: To prepare for possible emergency situations during dental treatment, it is helpful to know how often and what kinds of emergencies may arise. This study set out to evaluate the incidences, causes, treatments, and outcomes of emergency situations in the outpatient clinic of a dental teaching hospital in Korea. Methods: We retrospectively reviewed the records of patients who had experienced an emergency situation and emergency response team activated in a selected outpatient clinic between November 2004 and November 2013. Specific information about the emergency cases was collected, including the patient characteristics and the frequency, types, treatments, and outcomes of the emergency situations. Results: We identified 35 instances of emergency situations in 2,890,424 patients (incidence = 0.012 per 10,000 outpatients). The number of cases was as follows: 10 (28.6%) in the Department of Periodontics, 10 (28.6%) in the Department of Oral and Maxillofacial Surgery, 6 (17.1%) in the Department of Oral and Maxillofacial Radiology, 4 (11.4%) in the Department of Prosthodontics, 2 (5.7%) in the Department of Conservative Dentistry, 2 (5.7%) in the Department of Pediatric Dentistry, and 1 (2.9%) in the Department of Orthodontics. Three (8.6%) of the emergency situations arose before treatment, 22 (62.9%) during treatment, 7 (20.0%) after treatment, and 2 (5.7%) in a patient's guardian. Conclusions: In accordance with the growing elderly population and more aggressive dental procedures, the number of emergency situations may increase in the future. We recommend that clinicians keep in mind airway management and the active control of emergency situations.

• Journal of Society of Preventive Korean Medicine
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• v.19 no.1
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• pp.95-107
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• 2015

Objective : To use and its affecting factors of patients' outpatient treatment that have single and multiple chronic illnesses Method : We used the 2011 study by the Ministry of Health and Welfare, "Report on Usage and Consumption of Korean Medicine." This report was conducted on outpatients and inpatients that visited Korean traditional medicine, from August 25th, 2011, to September 30th, 2011. Our research was based on 1729 patients with chronic diseases aged 30 and over who received outpatient treatment during the last three months. Results : There were 1365 patients with non-complex chronic diseases, while there were 364 patients with complex chronis diseases. Patients had 1 - 8 chronic diseases, and the average number (standard deviation) was 1.26 (0.59). There were statistically significant differences by sex(P<0.0001), age(p=0.0045), marriage (p=0.0060), education level(p<0.0001), income level(P=0.0063), and types of health insurance(p=0.0023). The diseases most common among patients with non-complex chronic diseases were: low back pain, arthritis, gastrointestinal disorder, frozen shoulder, side effects from motor accidents, high blood pressure, fracture, stroke, diabetes, cancer, atopic dermatitis, and asthma. The diseases most common among patients with non-complex chronic diseases were: arthritis+low back pain, low back pain+gastrointestinal disorder, low back pain+side effects from motor accidents, low back pain+frozen shoulder, arthritis+gastrointestinal disease, gastrointestinal disease+frozen shoulder, arthritis+low back pain+gastrointestinal disease, high blood pressure+arthritis, arthritis+low back pain+frozen shoulder, arthritis+fracture, and arthritis+side effects from motor accidents. There were statistically significant differences among the usage of medical clinics by: frequently used clinic (p<0.0001), number of treatment (p<0.0001), the cost of outpatient treatment (p=0.0073), the satisfaction rate (p=0.0171), whether the clinic is the preferred clinic (p=0.0040). In model 1, men than women, people who had local benefits instead of type 1 medical aid, and patients with complex chronic diseases were more likely to use Korean medical clinics. In model 2, men than women, people who had local benefits than people with types 1 and 2 medical aids, people who went to pharmacies and Korean medicine pharmacies than people who went to hospitals, people who went to get treatment 1-10 times than people who visited 11-20 times and more than 41 times, and people who spent less than ten thousand Korean won than people who spent 1 to 2 million Korean won, and people without complex chronic diseases were more likely to use Korean medical treatment. Conclusion : There were differences in sociodemographic characteristics and the usage of medical clinics between patients with non-complex chronic diseases and patients with complex chronic diseases. Among patients with complex chronic diseases, women, patients with types 1 and 2 medical aid, patients who used Korean medical clinics, patients who were treated 11-20 times and more than 41 times, and patients who spent 1 million to 2 million Korean won on outpatient treatment used less treatment than patients with non-complex chronic diseases. However, patients with complex chronic diseases used pharmacies and Korean medicine pharmacies more.

• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.2
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• pp.93-97
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• 2012

Background: Some disabled patients show insufficient cooperation during dental treatment, and general anesthesia in an outpatient setting can be successfully administered. To minimize post-anesthetic complications is an essential issue, and strict discharge protocols are required for the safety of the patients. Post-anesthetic follow-ups using telephone calls can be applied to improve the quality of the outpatient care system. The authors evaluated the post-operative condition of patients after dental treatment under general anesthesia. Methods: Total 143 patients and their caregivers included in this study. The patients received general anesthesia for dental treatment in Seoul National University Dental Hospital, Clinic for Persons with Disabilities from July, 2011 to April, 2012. Telephone calls were given to the patients or their caregivers to collect information about the patients' systemic condition and anesthesia-related complications. Results: Among 131 patients with responses of telephone calls, 87 patients (66.4%) reported no discomfort, while 44 patients (33.6%) presented post-anesthetic complications. A total of 20 patients reported mild fever, 10 patients had vomiting, and 7 patients had sore throat. Other complications included nausea, fatigue, nasal bleeding, skin sore, and body rash. Among the patients with the history of epilepsy, 63.6% showed post-anesthetic discomfort or complication (P = 0.027, ${\chi}^2$ test). Conclusions: One third of dental patients who received general anesthesia due to insufficientcooperation complained discomfort after discharged from outpatient anesthetic care.

• Archives of Plastic Surgery
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• v.40 no.6
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• pp.711-714
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• 2013

Background The most common cause of skin graft failure is the collection of blood or serous fluid underneath the graft. In our study, we describe the use of silicone tube for tie-over dressing to secure the skin graft margins with the aim of decreasing loss of the skin graft, particularly in grafting of deep wounds. Methods Between March 2008 and July 2011, we used this technique in 17 patients with skin defects with depths ranging from 3.5 to 8 mm (mean, 5.5 mm). First, the skin graft was sutured with 3/0 silk suture material from its corners. Then, a silicone round drain tube was sutured with 3/0 absorbable polyglactin 910 over the margins of the graft. Finally, long silk threads were tied over the bolus dressing, and the tie-over dressing was completed in the usual fashion. Results The mean follow-up was 7 months (range, 2-10 months) in the outpatient clinic. Graft loss on the graft margins due to hematoma or seroma was not developed. The results of adhesion between the graft and wound bed peripherally was excellent. Conclusions In our study, we suggest that use of a silicone tube for additional pressure on the edges of skin grafts in case of reconstruction of deep skin defects.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.1
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• pp.5-10
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• 2015

Background: Patients were subjected to post-discharge follow-up (by telephone) in order to investigate the potential complications of outpatient general anesthesia or deep sedation that could develop in disabled dental patients discharged from the hospital. The ultimate aim of this study was to establish an appropriate response measure for such complications. Methods: The caregivers of 79 disabled patients who underwent dental procedures under general anesthesia at our outpatient clinic were interviewed over telephone. Necessary care instructions were provided during the phone calls when required. The patient satisfaction level regarding the telephonic follow-up care was surveyed by additional telephone calls. Results: Most of the patients did not suffer any serious complications; however, some reported fever and bleeding. The data obtained in this study can be utilized towards the development of caregiver education pertaining to the ambulatory general anesthesia of dental patients with disabilities. Conclusions: Additionally, we hope that the findings of this study will help minimize the effects of complications experienced by disabled dental patients undergoing ambulatory general anesthesia, as well as increase the overall patient satisfaction level.