• The Korean Journal of Rehabilitation Nursing
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• v.16 no.1
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• pp.1-8
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• 2013

Purpose: This study aimed to identify the effect of individualized education on stroke patients' post-discharge anxiety and self-care compliance. Methods: It was a pretest-posttest design with non-equivalent groups. A total of 32 hospitalized stroke patients in experimental group were given individualized education three times at one day before, the day of and one week after discharge. Data were analyzed using descriptive statistics, t-test and $x^2$-test. Results: The scores of anxiety at posttest were $45.66{\pm}9.58$ in control group and $35.44{\pm}8.21$ in the experimental group. Self-compliance scores were $44.00{\pm}7.99$ in control and $61.06{\pm}7.69$ in the experimental group. These indicate that anxiety score is significantly lower (t=-4.58, p<.001), and self-compliance score is significantly higher (t=8.70, p<.001) in experimental group. Conclusion: If stroke patients receive a relevant individualized education, it could help reduce their anxiety. Also it would be useful to maintain and improve their self-care compliance after discharge.

• The Journal of Internal Korean Medicine
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• v.38 no.2
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• pp.118-124
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• 2017

Objective: This study describes the case of a patient with a left basal ganglia (BG) infarct who had made almost a complete recovery upon discharge from the hospital in 2014 but who was re-admitted after 31 months with a worsened hemiplegic gait. Methods: The patient had undergone no rehabilitation treatment in the 31 months since his discharge. When the patient was re-admitted to our hospital in 2017, stance and gait data were collected on the patient using a treadmill gait analysis system. In addition, the patient underwent a manual muscle test (MMT) evaluation, and his Motricity index (MI) and modified Barthel index (MBI) scores were recorded. After rehabilitation for one month, the patient was reassessed, and the results were compared to those on the day of re-admission and those recorded in 2014. Results: Compared to the 2014 evaluation results, the patient's stance parameters and gait parameters had worsened at re-admission. However, there was no significant change in the patient's MMT grade or MI and MBI scores in comparison to the results of the 2014 evaluation. After one month of rehabilitation, the patient was re-evaluated again, but there was no significant change in comparison to the evaluation results at re-admission. Conclusion: Some of the stroke patients who have passed six months since the onset of their stroke may require ongoing rehabilitation although the functions of them is almost recovered. Because there is a possibility that recovered functions get worse again without any rehabilitation for a long time. And once the recovered functions get worse, re-recovery of them is not easy.

• Physical Therapy Korea
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• v.31 no.1
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• pp.48-54
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• 2024

Background: Promoting patients' safe return home at discharge and reducing length of stay in hospital is key for Restorative Rehabilitation Institution (RMI). Objects: This study was designed to identify the factors influencing the return to home and length of stay among various factors. Methods: A total of 120 stroke patients (76 males and 44 females) who were hospitalized in an adult inpatient unit of a RMI for more than 2 months were retrospectively analyzed for this study (multivariate logistic regression analyses, p < 0.001). As predictor variables for assessing the return to home and length of stay, demographic data (sex, age, duration between onset and admission, length of stay, caregiver after discharge, occupation after discharge, reason for discharge, and household type after discharge) were collected. Additionally, following measurements were selectively collected from patient's medical records: scores of Mini-Mental State Examination Korean version (K-MMSE), modified Barthel Index Korean version (K-MBI), Berg Balance Scale and Functional Ambulation Category were obtained at admission and discharge. Results: The K-MMSE at admission and K-MBI at discharge were found to be the predictors of return to home. Additionally, K-MBI at admission influenced the length of stay. Conclusion: This study suggests cognitive functioning at admission and the level of activities of daily living at discharge predicted the return to home and length of stay.

• Journal of Korean Clinical Nursing Research
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• v.23 no.3
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• pp.376-387
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• 2017

Purpose: This study was to systematically review the contents and effects of nurse-led transitional care programs for discharged patients from hospital to home. Methods: Randomized controlled trials published between 2005 and 2015 were searched in Pubmed, Embase, Cochrane(Central Register of Controlled Trials) and CINAHL. Data were analyzed using Cochrane Review Manager(Revman) software 5.3. Results: Nine studies were selected and analyzed. Patient assessment, education and discharge planning were included in pre-discharge phase. Referring, communication and care planning were performed by nurses in transition phase. Home and phone visits, monitoring and multidisciplinary advices were included in post-discharge phase. Various outcome measures such as hospital utilization(30 days readmission and emergency department visit), quality of life, and cost were used to identify effectiveness of nurse-led transitional care programs. 30 days readmission(OR=.73, 95% CI 0.54, 0.98; p=.03) and emergency department visit(OR=.67, 95% CI 0.50, 0.88; p=.005) were statistically significant in meta-analysis. However, participant blinding was not done in seven studies which put at the risk of performance bias. Conclusion: The results indicated that nurse-led transitional care program is effective in reducing unnecessary hospital utilization. Nevertheless, small sample size and risk at performance bias are the limitation of this study. Thus, we suggest that well-designed randomized controlled trials need to be conducted.

• Research in Community and Public Health Nursing
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• v.33 no.4
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• pp.357-371
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• 2022

Purpose: This study aims to investigate factors related to long-term length of stay (LOS) of patients with chronic diseases in Korean veterans hospitals. Methods: The subjects were 196 elderly patients with chronic disease staying in the hospital for more than 10 days, Data were collected by the survey of patients with structured questionnaires and medical records review by nurses from July 15 to August 10, 2019. Collected data were analyzed using t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression. Results: The present and desired LOS were 37.78±32.66 days and 60.87±45.95 days, respectively. Factors affecting hospital LOS were found to be main disease (genitourinary) (p<.001), assistance in activities of daily living (p<.001), area of hospital (p<.001), payment of medical fees (p=.026), hospital satisfaction (p=.036) and the explanatory power of these variables was 26.4%. The most common health problems that need to be solved after discharge were symptom alleviation and health promotion. These problems can be solved using community-based facility services or visiting medical-welfare services (especially home care nursing). Conclusion: In order to reduce hospital LOS, the following measures are required: personalized self-management education, provision of transportation services for dialysis therapy of inactive patients, linking patients with visiting medical-welfare services including home care nursing and mobile healthcare services, operation of the case management system including the notice of the discharge date at admission, interim check of patient status, and connecting the patient with community resources or transferring the patient to long-term care facilities at discharge.

• Journal of Korean Clinical Nursing Research
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• v.22 no.2
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• pp.194-204
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• 2016

Purpose: The purpose of this study was to identify physiological functional status and unmet care needs among patients with chronic pulmonary disease, colorectal cancer, and strokes after discharge. Methods: A crosssectional study was conducted with 224 patients diagnosed with aforementioned diseases from January to July in 2014 in two different tertiary hospitals in Seoul and its suburban area. Physiological functional status and unmet care needs were collected using Karnofsky Performance Status (KPS) Scale and Problems After Discharge Questionnaire-English version(PADQ-E) respectively. Data were analyzed using SPSS/WIN 21.0 program. Results: Patients with chronic pulmonary disease and colorectal cancer showed a low level of physiological functional status (mean: 77.20 and 77.60 out of 100 respectively) and a high level of unmet care needs (mean 2.23 and 2.63 out of 4 respectively). Stroke patients showed a high level of unmet care needs in the category of 'counseling', 'physical complaints', and 'instructions'. Physiological functional status was significantly associated with unmet care needs in all three patient groups and it showed a significant effect on unmet care needs in patients with stroke. Conclusion: The results showed that patients after discharge were still having insufficient functional status and various unmet care needs. The results of this study suggest a development of nursing care service for patients with chronic diseases after discharge.

• Journal of Korean Public Health Nursing
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• v.4 no.1
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• pp.25-35
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• 1990

This study examined the evaluation of the information effects of the teaching on knowledge and daily activities of open heart surgery patients between 2 and 6 weeks after discharge. The subject was 29 patients being taught with teaching materials at discharge as experimental group, 20 patients who received no education as control group among the patients who had undergone open heart surgery in S.N.U.H. And research method was non-equivalent control group non-synchronized quasi-experimental design. As the tool of this study, 30 items of knowledge measurement scale which was extracted among the content of teaching materials to evaluate the effect of education and 28 items of which were designed to measure the daily activities of patients with myocardial infarction for the estimation of the degree of observance in daily activities were used. For data analysis, frequency, t-test, Pearson's correlation coefficient and Cronbach's $\alpha$ were used. The result were as follows; 1. Informations given through teaching materials were effective for increasing the knowledge of the patient with open heart surgery. The knowledge of patients increased to the top level (p<0.05) in 2 weeks after discharge. In control group, the knowledge level of patients did not increase after discharge. 2. The knowledge level daily activity of the experimental group was somewat higher than that of the control group, but there was no significant difference. The score .of the experimental group was 69.66 in 6 weeks after discharge much less than the top level score 112. 3. The correlation between knowledge and daily activities was not significant, suggesting the fact that the increase of knowledge did not influence the daily activities significantly. Recommendation was suggested that; 1) Further studies might be .needed with the increasing numbers of the subjects. 2) Daily activities of the patients with open heart surgery should be investigated for long term period until they recovered normal activities.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.1
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• pp.62-66
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• 2013

Purpose: I-131 is a radioisotope widely used for thyroid gland treatments. The physical half life is 8.01 and characterized by emitting beta and gamma rays which is used in clinical practice for the purpose of acquiring treatment and images. In order to reduce the recurrence rate after surgery in high-risk thyroid cancer patients, the remaining thyroid tissue is either removed or the I-131 is used for treatment during relapse. In cases of using a high dosage of radioactive iodine requiring hospitalization, the patient is administered dosage in the hospital isolation ward over a certain period of time preventing I-131 exposure to others. By checking the radiation amount emitted from patients before discharge, the patients are discharged after checking whether they meet the legal standards (50 uSv/h). After patients are discharged from the hospital, the contamination level is checked in many parts of the ward before the next patients are hospitalized and when necessary, decontamination operations are performed. It is expected that there is exposure to radiation when measuring the ward contamination level and dose check emitted from patients at the time of discharge whereby the radiation exposure by health workers that come from the patients in this process is the main factor. This study analyzed the correlation between discharge dose of patients and ward contamination level through a variety of factors such as renal functions, gender, age, dosage, etc.). Materials and Method: The study was conducted on 151 patients who received high-dosage radioactive iodine treatment at Soon Chun Hyang University Hospital during the period between 8/1/2011~5/31/2012 (Male: Female: 31:120, $47.5{\pm}11.9$, average dosage of $138{\pm}22.4$ mCi). As various factors expected to influence the patient discharge dose & ward contamination such as the beds, floors, bathroom floors, and washbasins, the patient renal function (GFR), age, gender, dosage, and the correlation between the expected Tg & Tg-Tb expected to reflect the remaining tissue in patients were analyzed. Results: In terms of the discharge dose and GFR, a low correlation was shown in the patient discharge dose as the GFR was higher (p < 0.0001). When comparing the group with a dosage of over 150mCi and the group with a lower dosage, the lower dosage group showed a significantly lower discharge dose ($24{\pm}10.4uSv/h$ vs $28.7{\pm}11.8uSv/h$, p<0.05). Age, gender, Tg, Tg-Tb did not show a significant relationship with discharge dose (p> 0.05). The contamination level in each spot of the treatment ward showed no significant relationship with GFR, Tg, Tg-Tb, age, gender, and dosage (p>0.05 ). Conclusion: This study says that discharge of the dose in the patient's body is low in GFR higher and Dosage 150mCi under lower. There was no case of contamination of the treatment ward, depending on the dose and renal association. This suggests that patients' lifestyles or be affected by a variety of other factors.

• Journal of Korean Academy of Nursing
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• v.40 no.4
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• pp.599-609
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• 2010

Purpose: The purpose of this study was to develop and evaluate a transitional care program for patients discharged from military hospitals. The study consists of two phases: developing the program and evaluating its effectiveness. Methods: The conceptual framework used to guide the development of the program was Meleis's transition theory. A quasiexperimental design was employed for this study. Participants were recruited from patients discharged from one military hospital, 72 in the control group and 56 in the experiment group. Data were analyzed using SPSS WIN 12.0 program with chi-square, Fisher's exact test, independent t-test, and mixed model. Results: Participants in the transitional care program reported promoting a positive personal condition, and more healthy patterns of response in the first week after being discharged and a smoother discharge transition. Conclusion: The transitional care program developed for discharge patients from military hospital promoted discharge readiness and promoted smooth discharge transition.

• Journal of Preventive Medicine and Public Health
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• v.45 no.4
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• pp.259-266
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• 2012

Objectives: This study aims to determine the risk factors predicting rehospitalization by comparing three models and selecting the most successful model. Methods: In order to predict the risk of rehospitalization within 28 days after discharge, 11 951 inpatients were recruited into this study between January and December 2009. Predictive models were constructed with three methods, logistic regression analysis, a decision tree, and a neural network, and the models were compared and evaluated in light of their misclassification rate, root asymptotic standard error, lift chart, and receiver operating characteristic curve. Results: The decision tree was selected as the final model. The risk of rehospitalization was higher when the length of stay (LOS) was less than 2 days, route of admission was through the out-patient department (OPD), medical department was in internal medicine, 10th revision of the International Classification of Diseases code was neoplasm, LOS was relatively shorter, and the frequency of OPD visit was greater. Conclusions: When a patient is to be discharged within 2 days, the appropriateness of discharge should be considered, with special concern of undiscovered complications and co-morbidities. In particular, if the patient is admitted through the OPD, any suspected disease should be appropriately examined and prompt outcomes of tests should be secured. Moreover, for patients of internal medicine practitioners, co-morbidity and complications caused by chronic illness should be given greater attention.