• Journal of agricultural medicine and community health
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• v.24 no.2
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• pp.315-329
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• 1999

Recently, dissatisfaction with aspects of health care has been complemented by directly at complaints such as informal, formal and litigation. But some people take action and other not in spite of feeling of dissatisfaction. This study was to investigate an accounts of patient's disagreement with doctor's care from a community sample, and make a distinction between felt disagreement and disagreement actions. This study was done in six hundred forty residents in Sungjoo County of Kyungbuk Province and Nonman city of Chungnam Province. The questionnaires of interview included sociodemographic data, health status data, a nature of patient's disagreement with doctor and actions taken following or during the disagreement episode. Approximately sixteen percent of sample reported a disagreement, and nine percent reported action taken following or during the disagreement episode. Age, educational attainment, income and area were significantly related with experience of disagreement episode in univariate analysis. In people who experienced the disagreement episode, nearly forty-one percent reported on disagreement about the diagnosis related, twenty-eight percent reported doctor-patients relationship related, twenty percent reported treatment related, and eleven percent reported prescription drug related. In people who experienced actions taken following or during the disagreement episode, nearly fifty-four percent acted as 'sought a second opinion or visit other doctor', thirty-six percent acted as 'verbally challenged the doctor', thirty-two percent acted as 'stopped prescribed treatment or medication', twenty-nine percent acted as 'made repeat visits to the same doctor', twenty-five percent acted as 'eventually left and changed doctor'. Results of multivariate analysis, age, marital status, have or haven't chronic disease, and general satisfaction with health service were significantly related with experience of disagreement episode and marital status was significantly related with experience of actions taken following or during the disagreement episode. This study is experimental and exploratory trial about a relationship between patient's disagreement with doctor and actions taken following or during the disagreement episode in some community of Korea. We find that patient's disagreement with doctor and actions taken following or during the disagreement episode is latent in our community. We suggest that the relationship between felt disagreement and disagreement action is more complicated and worthy of further study.

• Clinical and Experimental Reproductive Medicine
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• v.48 no.3
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• pp.198-202
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• 2021

Considerable disagreement exists regarding whether endometrial polyps should be removed before attempting natural pregnancy and before pregnancy via intrauterine insemination (IUI) or in vitro fertilization (IVF). Through a literature review, we obtained information on the impact of endometrial polyps and polypectomy on fertility outcomes. Several observational studies have suggested that women with unexplained infertility may benefit from endometrial polypectomy for a future natural pregnancy. A few studies reported benefits from endometrial polypectomy in infertile women who plan to undergo IUI. However, no strong evidence supports polypectomy as a way to improve the pregnancy rate in infertile women who plan to undergo IVF or polypectomy during controlled ovarian stimulation for IVF. Although no studies have defined criteria for the polyp size that should be removed in infertile women, clinicians should be aware that small endometrial polyps (<10 mm) sometimes regress spontaneously. Endometrial polypectomy is currently justified in patients with repeated IVF failure, but more studies are needed to verify that endometrial polypectomy itself will eventually increase the pregnancy rate. Although several mechanisms by which endometrial polyps exert a negative effect on fertility have emerged, there is no consensus about the proper management of endometrial polyps in infertile women. Therefore, the management of endometrial polyps should be individualized depending on the patient's situation and clinician's preference.

• Korean Journal of Veterinary Research
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• v.58 no.3
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• pp.131-136
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• 2018

Blood pressure (BP) measurement plays a pivotal role in veterinary medicine for diagnosing cardiovascular disorders and monitoring anesthesia of animals. Although indirect BP measurement has been widely applied to monitor BP because of its convenience and non-invasiveness, it is still unclear whether indirect BP measurement is compatible with direct BP measurement in minipigs. In addition, the effect of animal posture during BP measurement is not well understood in minipigs despite its importance to cardiovascular performance. Therefore, both systolic and diastolic arterial BPs in minipigs were measured via femoral artery catheterization for direct BP measurement and using a compressive cuff as an indirect BP measurement under the dorsal or right lateral recumbent postures. Numerical values were processed by the Bland-Altman method to calculate the bias ${\pm}$ SD and the limits of agreement (LOA). In accordance with the American College of Veterinary Internal Medicine guidelines, the results between direct and indirect BP measurements were determined as apparent disagreements in both systolic and diastolic arterial BPs under all postures because of large bias ${\pm}$ SD and wide LOA. The results of the present will help prevent misinterpretation of the anesthetized patient's condition during monitoring of BP by indirect measurement.

• Journal of Korean Foot and Ankle Society
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• v.16 no.2
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• pp.87-93
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• 2012

Fractures located at the metaphyseal/diaphyseal junction at the base of the fifth metatarsal were first described by Sir Robert Jones in 1902. However, ever since, there has been disagreement and debate regarding the diagnosis, classification, pathomechanics, the incidences, and potential causes of delayed unions and nonunions, and the optimal method of treatment. It appears to be widely agreed that proximal fractures of the metaphyseal/diaphyseal region of the fifth metatarsal are prone to delayed union or even nonunion. Several classifications of proximal fifth metatarsal stress fractures have been devised. Torg et al. classified fractures involving the proximal part of the diaphysis of the fifth metatarsal into three types. The Torg classification is a good grading system that can be used to determine the type of surgery needed as well as for the prediction of prognosis. The ''plantar gap'' might add to the decision-making process for surgery and improve the prediction of patient prognosis. In addition, the new classification using 'plantar gap' might be used for classification of fifth metatarsal stress fracture. Fifth metatarsal stress fractures can be treated conservatively or surgically, and excellent results have been reported for surgery with rapid recovery in athletes. Intramedullary screw fixation has become a popular form of fixation for fifth metatarsal stress fractures. Bone grafting presents the problems of a longer recovery time and additional skin incision for harvesting. The modified tension band wiring is an useful and simple option for surgical treatment of challenging fifth metatarsal stress fractures.

• The Journal of the Korea Contents Association
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• v.14 no.5
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• pp.224-234
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• 2014

This study designed to nursing student's image of professional nurse before clinical practice using Q-methodology. Using Q-methodology, 43 nursing student sorted 34 statements selected professional nurse type. The statement positions on the sorting continuum were scored from +4(representing the highest level of agreement) through 0(at the neutral position on the continuum) through -4(representing the highest level of disagreement). Factor analysis of the data was undertaken using PC QUANL software to determine if any patterns were discernible. The three factors extracted eigenvalues greater than 1.0 and explained approximately 53.94% of the variation in responses(41.63, 7.41 and 4.9% respectively). The categories were labeled 'Nightingale's nursing philosophy type', 'Consideration of patient type' and 'Self-development type'. Twenty-two students who located to factor 1 "Nightingale's nursing philosophy type". Eleven students who located to factor 2 "Consideration of patient type". Three students sho located to the factor 3 "Self-development type". The significant differences found in the subjective structure of nursing student's image of professional nurse. The study results can be utilized in both an effective nursing education and clinical practice.

• Journal of Korean Medical Science
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• v.33 no.52
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• pp.347.1-347.11
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• 2018

Background: Smartphone addiction has recently been highlighted as a major health issue among adolescents. In this study, we assessed the degree of agreement between adolescents' and parents' ratings of adolescents' smartphone addiction. Additionally, we evaluated the psychosocial factors associated with adolescents' and parents' ratings of adolescents' smartphone addiction. Methods: In total, 158 adolescents aged 12-19 years and their parents participated in this study. The adolescents completed the Smartphone Addiction Scale (SAS) and the Isolated Peer Relationship Inventory (IPRI). Their parents also completed the SAS (about their adolescents), SAS-Short Version (SAS-SV; about themselves), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). We used the paired t-test, McNemar test, and Pearson's correlation analyses. Results: Percentage of risk users was higher in parents' ratings of adolescents' smartphone addiction than ratings of adolescents themselves. There was disagreement between the SAS and SAS-parent report total scores and subscale scores on positive anticipation, withdrawal, and cyberspace-oriented relationship. SAS scores were positively associated with average minutes of weekday/holiday smartphone use and scores on the IPRI and father's GAD-7 and PHQ-9 scores. Additionally, SAS-parent report scores showed positive associations with average minutes of weekday/holiday smartphone use and each parent's SAS-SV, GAD-7, and PHQ-9 scores. Conclusion: The results suggest that clinicians need to consider both adolescents' and parents' reports when assessing adolescents' smartphone addiction, and be aware of the possibility of under- or overestimation. Our results cannot only be a reference in assessing adolescents' smartphone addiction, but also provide inspiration for future studies.

• Journal of Hospice and Palliative Care
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• v.9 no.2
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• pp.93-100
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• 2006

Purpose: This study was designed to understand the doctor's attitude toward hospice and palliative care for terminal cancer patients. Methods: Specialists who work at general hospital were surveyed with questionnaires about hospice and palliative care for terminal cancer patients. The questionnaires comprise 17 items. The data were statistically analyzed. Results: Eighty one doctors responded. Their median age was 35 years old. Thirty six doctors (44.4%) were from internal medicine. The median of specialist's experience was 4 years. Forty three respondents (53.2%) have rarely examined and treated cancer patients even a week. Thirty seven respondents (45.6%) knew the exact definition of hospice and palliative care. Eighty respondents (98.8%) felt that hospice and palliative care is necessary, and 91.2% of them responded the necessity of palliative medicine specialist. As to the question 'Do you positively referred terminal cancer patient to hospice and palliative care?', 55 respondents (67.9%) responded 'Yes' and 22 (27.2%) 'No'. Among the 'Yes' respondents 17 (30.9%) had an experience of hesitation for referring patients to hospice and palliative care; the most common reason was the disagreement of family members (6, 35.3%). As for the reasons of responding 'No', 6 doctors (27.2%) did so because of their 'feeling of abandoning the patients' and the other f for the 'lack of information on the referral procedure for hospice and palliative care'. Thirty seven specialists (45.7%) thought it is most desirable for the patients to have hospice and palliative care for 3 months before death. Fifty eight specialists (71.6%) responded that hospice and palliative care help controlling the patient's psychological symptoms before all. Conclusion: While most doctors recognize the need of hospice and palliative care for patients with terminal ranter, their attitude toward hospice and palliative care was rather reserved. We suggest that continuing education, information and promotion for hospice and palliative care should be provided for doctors.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.1
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• pp.259-263
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• 2015

Background: In the field of cancer, the ICD-10 coding convention is based on the site of a neoplasm in the body and usually ignores the morphology, thus the same code may be assigned to tumors of different morphologic types in an organ. Nowadays, all general (provincial) and center hospitals in Thailand are equipped with the hospital information system (HIS) database. Objective: This study aimed to find the characteristics and magnitude of agreement represented by the positive predictive value (PPV) of provisional cancer diagnoses in the HIS database in Pattani Hospital in Thailand in comparison with the final cancer diagnosis of the ICD-10 codes generated from a well established cancer registry in Songklanagarind Hospital, the medical school hospital of Prince of Songkla University. Materials and Methods: Data on cancer patients residing in Pattani province who visited Pattani Hospital from January 2007 to May 2011 were obtained from the HIS database. The ICD-10 codes of the HIS computer database of Pattani Hospital were compared against the ICD-10 codes of the same person recorded in the hospital-based cancer registry of Songklanagarind Hospital. The degree of agreement or positive predictive value (PPV) was calculated for each sex and for both sexes combined. Results: A total of 313 cases (15.9%) could be matched in the two databases. Some 222 cases, 109 males and 113 females, fulfilled the criteria of referral from Pattani to Songklanagarind Hospitals. Of 109 male cancer cases, 76 had the same ICD-10 codes in both hospitals, thus, the PPV was 69.7% (95%CI: 60.2-78.2%). Agreement in 76 out of 113 females gave a PPV of 67.3% (95%CI: 57.8-75.8%). The two percentages were found non-significant with Fisher's exact p-value of 0.773. The PPV for combined cases of both sexes was 68.5% (95%CI: 61.9-74.5%). Conclusions: Changes in final diagnosis in the referral system are common, thus the summary statistics of a hospital without full investigation facilities must be used with care, as the statistics are biased towards simple diseases able to be investigated by available facilities. A systematic feedback of patient information from a tertiary to a referring hospital should be considered to increase the accuracy of statistics and to improve the comprehensive care of cancer patients.

• Journal of Korean Academy of Nursing
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• v.8 no.1
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• pp.152-162
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• 1978

The desire to maintain health is increasing, consequently the role of nursing which has as one chief aim the solving of man′s basic problems is more and more important. Today, in spite of a growing concern about the nursing activities which nurses provide for individual human having specific needs, clinically in fact, it is questionable that individual′s expectation of nursing activities agrees with nurse′s performance of nursing activities. In this study the importance and agreement of the importance of the nursing activities during the hospitalized puerperal period as viewed by women in the puerperal period and by nurses caring for them, were assessed. The present study was undertaken in an attempt to furnish the basic data for expediting the progress of research activities in this area and further to be helpful in planning maternity nursing practice. The study population defined and selected was nurses (13) caring for women in the puerperal period and doing duty on obstetric & gynecologic ward at Y. hospital, and the women in puerperal period (39) as sum of 3 women selected by each nurse during the period of May 13th-June 4th 1976. The study data was collected by the direct interview method based on the questionnaire which the investigator made out. The study result was analyzed by percentage, t - test. The findings can be summarized as follows: 1. General characteristics of nurses doing duty on puerperal ward: a. Nurses′average age was 24.8 years old. b. 84.6% had educational background of 4 years of college. c. 69.2% had a religion. d. 53.8% were married. e. 53.8% had clinical experience of 1 year -3 years. f, 61.5% did duty on puerperal ward during 1 year -3 years. g. 46.2% desired to do duty on obstetric ? gynecologic ward. 2. General characteristics of the women who were studied during their puerperal period: a. Women′s average age was 26.4 years old. b. 79.5% had educational background above high school. c. 56.4% had a religion. d. 84.6% had living standard above medium. e. 89.7% had no occupation. f, 53,8% had previous hospitalization experience. g. 56.4% had previous delivery experience. 3. Examining the importance of 39 nursing activities during puerperal period selected by investigator, studied group of women considered that the most important nursing activity was "Record precisely about condition, medical treatment and nursing activity results etc". Nurses considered that the most important nursing activity was "Notice whether having pain and care for that". Both groups considered that the least important nursing activity was "Talk with her about topics such as news, hobbies, other interests". 4. Examining the importance of nursing activities in 4 specific categories, studied group of women considered that the most important nursing activity in physical nursing category was "Be sure of safety measure to prevent accidents, injuries", and nurses considered that the most important nursing activity was "Make her sleep and rest sufficiently". Studied group of women considered that the most important nursing activity in psychological category was "Explain about medical treatment and nursing activity ahead of time so she knows what to expect" , and nurses considered that the most important nursing activity was "Explain about puerperal period so she understands". Studied group of women considered that the most important nursing activity in relation to medical care was "Record precisely about condition, medical treatment and nursing activity results etc.", and nurses considered that the most important nursing activity was "Observing, cleaning and protecting the perineum" Studied group of women considered that the most important nursing activity in nursing category in preparation for discharge was "Instruct about personnel hygiene during puerperal period", and nurses considered that the most important nursing activity was "Instruct self-care to protect the perineum". 5. The analysis of this study showed a significant amount of disagreement computed by subtracting the nurse′s score from the patient′s score. Studied group of women put greater importance on physical nursing category, psychological nursing category, nursing in relation to medical care, than the nurses. These results were statistically significant at 0.01 level.