• The Korean Journal of Health Service Management
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• v.13 no.3
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• pp.163-172
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• 2019

Objectives: With the rapidly increasing incidence of cancer worldwide, it has become important for health care professionals to both provide care for cancer patients and to address the challenges faced by family caregivers of cancer patients. This study aims to identify the factors affecting depression among cancer patients' family caregivers. The results of this study suggest the need to propose programs for family caregivers as well as cancer patients. Methods: Participants were 219 caregivers who were informed of the study purpose and agreed to participate. Data were analyzed using t-tests, one-way ANOVA, Scheffe's test, Pearson correlation coefficients, and multiple stepwise regression with the SPSS/WIN 25.0 program. Results: The mean score for depression among cancer patients' family caregivers was $1.57{\pm}.40$ (range: 0-3). Depression was significantly different based on age, relationship with the patient, education, occupation, cancer recurrence, care days per week, financial burden, site of cancer, and health status. Analysis using multiple regression showed that model 1 showed 16% of the factors predicting depression among cancer patients' family caregivers (F=6.16, p<.001) including occupation, recurrence, and health status of the caregiver. Model 3, which included additional burnout, showed 37% of the factors predicting depression (F=12.36, p<.001). Conclusions: These results suggest that it is necessary to develop programs for prevention and management of depression among cancer patients' family caregivers.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.22 no.3
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• pp.178-187
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• 2009

Background : Atopic dermatitis is chronic exzemaous dermatitis and the recurrence rate of atopic dermatitis is high. Many patients are suffering from pruritus. Objective : This study compared ambulatory care with hospitalization for atopic dermatitis treatment of one patient, and investigated the effect of Oriental medicine program for atopic dermatitis patients during short term hospitalization. Method : We treated a 5 year-old boy with uncontrollable atopic dermatitis by ambulatory care and hospitalizaion. Herbal medication and herbal dressing was done samely during ambulatory care and hospitalization. Intensive life management, education for compliance was done only during hospitalization. Results : Even though he had been treated for 5 months by ambulatory care, he still suffered from severe itching, erythema, oozing and insomnia. Admission duration was 10 days. During admission, the SCORAD scores and subjective scores were decreased rapidly. Conclusion : We concluded that effects of the treatments can be different due to compliance of the patient and in that view the short term hospitalization program could be more helpful than ambulatory care for uncontrollable atopic dermatitis patients.

• Quality Improvement in Health Care
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• v.19 no.2
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• pp.14-34
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• 2013

Objectives: The purpose of this study is to provide comprehensive information of qualification systems of developed countries needed to establish our national system for QI(Quality improvement) specialists. Methods: All articles related to any applicable domestic or foreign countries' laws, operational status, and detailed programs for professional qualification system of QI were reviewed. Result: In the United States, a non-profit organization, Healthcare Quality Certification Commission (HQCC) has set the policies, procedures and standards in the field of health care quality. And qualification system of CPHQ (certified professional in healthcare quality) has been operated in order to authenticate the qualifications in the field of quality management. IBQH(international Board for quality in healthcare), a qualification system of experts in the United Kingdom, was designed to assist the qualification of professionals to improve the quality of healthcare. In addition, Health Research Center of Feinberg School of Medicine in Northwestern University has been operating Master's and doctoral degree programs in the field of the quality of care and patient safety and IHI (institute for healthcare improvement) open school was operating a professional training course related to the quality of care and patient safety. Conclusion: Quantity and complexity of information of the quality of care and patient safety have been increased. For reform of the health care system, a special training course of the expertise and leadership are needed. So far, there is no national professional certification courses in our nation. Therefore essential job skill should be acquired individually. For systematic and effective quality improvement activities, the educational and certification system with professional development model are needed.

• Tuberculosis and Respiratory Diseases
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• v.78 no.4
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• pp.455-458
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• 2015

Excessive dynamic airway collapse (EDAC) is a disease entity of excessive reduction of the central airway diameter during exhalation, without cartilage collapse. An 80-year-old female presented with generalized edema and dyspnea at our hospital. The patient was in a state of acute decompensated heart failure due to pneumonia with respiratory failure. We accordingly managed the patient with renal replacement therapy, mechanical ventilation and antibiotics. Bronchoscopy confirmed the diagnosis of EDAC. We scheduled extubation after the improvement of pneumonia and heart condition. However, extubation failure occurred due to hypercapnic respiratory failure with poor expectoration. Her EDAC was improved in response to high flow nasal oxygen therapy (HFNOT). Subsequently, the patient was stabilized and transferred to the general ward. HFNOT, which generates physiologic positive end expiratory pressure (PEEP) effects, could be an alternative and effective management of EDAC. Further research and clinical trials are needed to demonstrate the therapeutic effect of HFNOT on EDAC.

• Health Policy and Management
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• v.26 no.1
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• pp.39-50
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• 2016

Background: This study examined patient and hospital factors related to long-stay admissions in long-term care hospitals (LTCHs) among older people in Korea. Methods: We analyzed health insurance claims data, entitlement data, and institutional administrative data from the National Health Insurance Service databases between 2010 and 2012. At the patient level, we compared characteristics of patients staying in LTCHs for over 180 days (the long-stay group) with those staying in LTCHs for less than 90 days during a calendar year. At the hospital level, we examined the general characteristics and staffing levels of the top 10% of hospitals with the highest proportion of patients whose length of stay (LOS) was 180+ days (the hospitals with long-stay patients) and compared them with the top 10% of hospitals with the highest proportions of patients whose LOS was less than 90 days (hospitals with shorter-stay patients). Results: The long-stay group accounted for about 40% of all LTCH patients. People in the group were more likely to be women, aged 80+, living alone, and experiencing more than two health conditions. Compared to the hospitals with shorter-stay patients, those with long-stay patients were more likely to be occupied by patients with behavior problems and/or impaired cognition, owned by corporate or local governments, have more beds and a longer period of operation, and deliver services with lower staffing levels. Conclusion: This study found long-stay older people in LTCHs and those in LTCHs with high proportions of long-stay older patients had several distinct characteristics compared to their counterparts designated in this study. Patient and hospital characteristics need to be considered in policies aiming to resolve long-stay admissions problems in LTCHs.

• Quality Improvement in Health Care
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• v.21 no.2
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• pp.40-56
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• 2015

Objectives: To outline overall duties of quality improvement (QI) performers within a health care organization, thus describing their key tasks, including task element-related frequency, importance and difficulty in enough detail. Methods: A DACUM (Developing A CurriculUM) workshop took place to outline overall job activities of QI performers. To examine the scope of their duty and task, we performed a questionnaire survey of 338 QI performers from 111 hospitals. Results: The results of our survey showed that for the task assigned to each QI performer, there were 10 duties, 31 tasks and 119 task elements. Respondents cited a project planning as the most frequent/important duty, and a research was the highest level of difficulty in their duty. They also said that the most frequent task was index management, the most important task was a business plan, and the highest level of difficulty was a practical application of QI research. QI performers added that the most frequent task element was receipt of patient safety reporting in patient safety system, the most important task element was an analysis for patient safety and its improvement, and the highest level of difficulty was a regional influence analysis related to the patient safety and its improvement. Conclusion: To ensure that QI performers play a pivotal role as a manager to better improve patient safety and the quality of health care services, proper training program for them should be developed by reflecting the results of our study.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.3
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• pp.506-512
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• 1998

The dentists often encouter a child who can not be treated with traditional behavior management technique. Mentally or physically handicapped child could receive proper dental care under general anesthesia. General anesthesia for dental care can be done in an outpatient surgery or inpatient surgery depending on the patient. In outpatient surgery, the patient is admitted and discharged the same day. Postoperative care and discharge procedure are abbreviated. Advantages of outpatient surgery are much less emotional disturbance of patients, reduced risk of nosocomial infection and less cost of treatment. A case of a physically handicapped patient treated under general anesthesia at Day Surgery Center is presented and the procedure and patient selection of outpatient surgery as well as its limitation is reviewed in this paper.

• The Korean Journal of Health Service Management
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• v.12 no.3
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• pp.1-11
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• 2018

Objectives: The purpose of this study is to evaluate patient experience assessment of inpatients, and to prepare measures to improve the quality level of medical services and guarante patient rights. Methods: The study was conducted among 199 patients admitted to hospitals and general hospitals in the metropolitan area. The analysis method used was crossover analysis, including a comparison of means, and logistic regression analysis. Results: The overall average score of satisfaction with healthcare service was 3.39 for nurses, 3.35 for hospitals and 3.42 for general hospitals. Age at the time of hospitalization affected satisfaction. The overall average score of healthcare service satisfaction was 3.09 for doctors, 3.14 for hospitals, and 3.04 for general hospitals. The factors affecting hospital satisfaction were gender and subjective health status. The factors affecting satisfaction in general hospitals were education, medical department, and hospitalization route. Conclusions: Hospitals should also introduce a systematic management system of general hospitals and strengthen the guarantee of the rights of patients who can improve the quality of medical care through positive communication between medical personnel and patients.

• Asian Oncology Nursing
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• v.12 no.1
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• pp.77-83
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• 2012

Purpose: This study was designed to describe outcomes of pain management, to identify pain intensity, pain management and barriers to pain management, and to test correlation among the variables in cancer patients who are registered in public health centers. Methods: By using a descriptive survey design, 3 instruments were used to collect data: the Numeric Rating Scale for pain, the Barriers Questionnaire-Korean version, and a one-item self-report tool about patient satisfaction. A sample of 190 patients with cancer was recruited from a public health center. Results: The mean rating for pain during the past 24 hours was mild and the mean score of barriers to pain management was 3.20. Patients were satisfied with pain management but they also had concerns it. A negative correlation was found among pain severity, pain relief and satisfaction of pain management. However, there was not significant correlation between the patient-related barriers to pain management and other variables. Conclusion: These results suggest that the intervention for cancer patients should focus not only on patient-related barriers to pain management, but also address health-care system related barriers.

• The Korean Nurse
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• v.36 no.3
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• pp.49-69
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• 1997

The urgent needs to establish hospice care systems in Korea arise from the following reasons: 0) a drastic increase in chronically ill patients with the increase of aged population: (2) rapid changes in living environment from the traditional habitation (e. g., Many Koreans living in apartment complexes, which is the most popular form of modern residence in recent years, prefer to die in the hospital.): the overall increase in patients with advanced cancer: (4) recent trends in early discharge of terminally ill patients from the limited hospital facilities to accomodate other medical insurance beneficiaries; (5) easy acceptance of euthanasia owing to the recent social atmosphere that belittles the dignity of human life; (6) medical and nursing care of AIDS patient in terminal stage; (7) and the problem associated with inhumane medical care system, overtreatment, and groundless fears against narcotics. Terminally ill patients were used to be treated in the hospital in the past. In these days, however, they are forced to have home cares with little assistance from the qualified medical personnel because of insufficient hospital facilities, which are even short for the need of emergency patients and provide priority cares to medical insurance beneficiaries with other acute problems. And yet, neither are there any administrative organizations nor systematic medical studies that deal with the level of terminally ill patient's need, their family's problems and resources of hospice care systems in Korea. Thus, most patients are not able to get appropriate medical care at the terminal stage of their lives. The objective of this study is to make comprehensive database for various hospice care organization currently in operation, link them through medical information system, and develop an easily accessible hospice care model that meets the need of most Korean people. Our survey results may be summarized as follows: Nationally there are 40 organizations that provide partial or full hospice care. However, these organizations are not linked to any formal medical service network. Furthermore, the objective of hospice care, care principles, personnel with appropriate training, educational programs, standard for care, costs, consulting service to patients' family members, the extent of medical care from professional staff members, status of hospice facility, and management of those institutions are neither clearly defined nor organized compared to the international hospice care standards. The surveys on patients of terminal stage. grouped in hospice and non-hospice care patients. reveal what they want visiting nursing care to help their pain control. psychological. social and spiritual demands. While the more than 90% of hospice care patients want to reduce their pains. the non-hospice care patients. in addition to their desire for pain control. demanded more psychological. social and spiritual helps as well. The results of this research could be utilized to 0) define the standard of hospice care. (2) provide the guidance for hospice medical care costs. (3) establish the database of hospice care systems. (4) develop softwares. (5) build communication network through Medinet. and (6) provide an organized visiting home nursing care system. These information should be a valuable resource to many medical staffs who are involved in cancer therapy. nursing care. and social welfare programs.