• Korea Journal of Hospital Management
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• v.26 no.1
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• pp.55-70
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• 2021

Purpose: The purpose of this study was to examine the influencing factors of the patient leaning phenomenon in tertiary hospitals. Based on the results of this study, we intended to find implications for improving the problems of the delivery system imbalance in tertiary hospitals caused by patient leaning phenomenon. Methodology/Approach: Qualitative studies were conducted, using focus group interviews and in-depth interviews. The focus group interviews were conducted for 12 users of tertiary hospitals by 2 groups. And in-depth interviews were conducted for 6 tertiary hospital managers. This was considered to be the most effective approach to gather diverse and in-depth information about the influencing factor of patient leaning phenomenon in tertiary hospitals. Findings: In focus group interviews, the reason for choosing tertiary hospitals was the reliability of the hospital(physician, reputation, etc.). And the effect of the policy to strengthen coverage of National Health Insurance and private medical insurance was relatively small. In other words, we found that the individual's desire to receive medical services suitable for one's health status and disease condition was the biggest factor, rather than the cost and policy factors. Practical Implications: We suggested that the appropriate medical care provision should be strengthened according to the role and function of medical institutions. In addition, the education system needs to be reorganized to activate the referral program, expand community medical capabilities, and foster quality primary medical care.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.3
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• pp.109-117
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• 2022

Objectives To compare the therapeutic effect of ultrasound guided soyeom pharmacopuncture therapy and unguided soyeom pharmacopuncture therapy on cervical facet joint of patient who have cervical pain caused by traffic accidents. Methods The study was planned as a retrospective study that analyzes the patient's medical records. We analyzed medical records of 20 patients with acute cervical pain caused by traffic accidents from April 1, 2022 to May 31, 2022. 10 patients (Group A) were treated ultrasound guided soyeom pharmacopuncture therapy on cervical facet joint, 10 patients (Group B) were treated unguided soyeom pharmacopuncture therapy on cervical facet joint. We used visual analogue scale (VAS) and neck disability index (NDI) to evaluate improvements in cervical functions and pain, five point Likert scale to estimate patient's satisfaction. We used the IBM SPSS Statistics version 25 program (IBM Co., Armonk, NY, USA) for statistical analysis. Results Group A showed a significant decrease in the VAS on the 5^th day of the soyeom pharmacopuncture therapy (p=0.001). However, there was no statistically significant difference of VAS between two groups (p=0.142). Group A showed significant decrease in the NDI on the 5^th day of the therapy (p=0.002). Also, there was statistically significant difference on NDI between two groups (p=0.018). Difference of five point Likert scale between two groups was not statistically significant (p=0.407). Conclusions In patients of acute cervical pain caused by traffic accidents, ultrasound guided soyeom pharmacopuncture therapy on cervical facet joint showed significant efficacy on reduction of neck disability compared with unguided therapy.

• Archives of Plastic Surgery
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• v.51 no.2
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• pp.202-207
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• 2024

Background Ingrown toenail is a common condition that results in chronic pain, recurrent infections, and difficulty in performing daily activities. Our aim is to compare two surgical methods for the treatment of ingrown toenails: wedge resection with curetting versus wedge resection curetting followed by electrocauterization of the nail bed. Methods A prospective, comparative study that included 130 patients with ingrown toenails. All patients had stage II or III disease. We divided the participants into two groups according to the type of surgery and all patients were followed up for 6 months. The outcomes measured were the incidence of postoperative bleeding and infection, recovery time, patient satisfaction, and recurrence rate 6 months after surgery. Results Of the 130 patients included, 59 (45.4%) underwent excision and curetting of the nail matrix (group 1) and 71 (54.6%) underwent excision, curetting, and electrocauterization of the nail matrix (group 2). The postoperative infection rates were 20.3 and 4.2% in the first and second groups, respectively (p = 0.004). Patient satisfaction was 76.3% among the first group, while 91.5% of patients in the second group were satisfied with the results of surgery. Six months postoperatively, recurrence rates were 25.4 and 4.2% in the first and second groups, respectively (p = 0.001). Conclusion Wedge excision and curettage, followed by electrocauterization of the ingrown toenail is a safe treatment modality with a high success rate, that is evident by a lower recurrence rate, and greater patient satisfaction, with no effect on postoperative pain score or recovery time.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.25 no.1
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• pp.19-27
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• 2023

Objective: The purpose of this study was to determine the efficacy of a 3D-printed aneurysm simulation model (3DPM) in educating patients and improving physicians' comprehension and performance. Methods: This prospective study involved 40 patients who were diagnosed with unruptured intracranial aneurysms (UIAs) and scheduled for surgical clipping or endovascular coiling and randomly divided into two groups (the 3DPM group and the non-3DPM group). The 3DPM was used in preoperative consultation with patients and intraoperatively referenced by surgeons. The patients, 7 neurosurgical residents, and 10 surgeons completed questionnaires (5-point Likert scale) to determine the usefulness of the 3DPM. Results: Patients in the 3DPM group had significantly higher scores in terms of their understanding of the disease (mean 4.85 vs. 3.95, p<0.001) and the treatment plan (mean 4.85 vs. 4.20, p=0.005) and reported higher satisfaction during consultation (5.0 vs. 4.60, p=0.036) than patients in the non-3DPM group. During patient consultation, 3DPMs were most useful in improving doctor-patient communication (mean 4.57, range 4-5). During clipping surgery, the models were most useful in assessing adjacent arteries (mean 4.9, range 4-5); during endovascular coiling, they were especially helpful in microcatheter shaping (mean 4.7, range 4-5). Conclusions: In general, 3DPMs are beneficial in educating patients and improving the physician's performance in terms of surgical clipping and endovascular coiling of UIAs.

• Journal of Korean Academy of Nursing Administration
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• v.2 no.1
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• pp.57-72
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• 1996

Provision of better nursing care to patients is a difficult but important task. The first problem for nursing quality improvement is development of evaluation tool for the quality of nursing care. This study tries to develop a patient care tool for patients with chronic renal failure. This study as a procedural evaluation of patient care, tries to show what, how, at what order to provide care to patients with chronic renal failure. This study is divided into process of development of tool, its reliability and validity. Among process of development of tool is focal group, small expert group and expert evaluation group. To develop approprieteness of tool, nurses working is four major hospitals is Seoul were selected. To evaluate the credibility of subjects, 19 patient who were hospitalized and discharged within 3 months were selected. The period for collecting data for reliability and valiability evaluation was between Sept. 20 to Oct. 18, 1995. The development process of this study is as follows ; 1. Make preliminary list of the tool by focal group consisting of 8 clinical nurses. 2. Modify and add preliminary list by 4 expert nursing panel. 3. Calculate content validity of the tool by 23 nursing expert panel of judge. 4. Verity relability and validity of the tool. 5. Finalize an evaluation tool for the quality of nursing care in chronic renal failure patient. The result of this study were as follows ; 1. Development of evaluation tool for the quality of nursing care in chronic renal failure. 1) The evaluation of this study was developed 5 standards, 28 criteria. and 130 indicators 2) Nursing care evaluation scores for chronic renal failure patients were average 68.8. 2. Verity reliability and validity of the tool. 1) 5 standards were divided into 4 point scale and according to 28 creteria, indicators of standard were 3.72 and of criteria were 3.77 2) Inter - rater reliability (consentaneity score) of the tool by pearson correlation coefficient betwwen rates were r= .72, r= .75 and interreliabilities by single - facet crossed design were r= .96. 3) The alpha coeffecient relating to internal consistency was .7259 over 27 items of 28 criterias of developed tool. Through this study, I'm sure that the developed tool for the quality of patient care in chronic-renal failure patient will show the way of more improvement of the quality of nursing care and effective nursing intervention.

• Child Health Nursing Research
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• v.3 no.1
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• pp.83-98
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• 1997

The purpose of this study were to find out the practical way to enlarged child-raising knowledge and to enhance their satisfaction with out-patient care by evaluating how effectively the education is done by nurses for mothers with ill-child and how their satisfaction with out-patient care changed. This study was designed as a Nonequivalent Control Group study. The subjects studied were consisted of the experimental and control group. Each consisted of 50 mothers with ill-child in pediatric department at one university hospital in Seoul. The period of this study is from May 20, 1996 to J one 28, 1996. The first data were collected from both of experimental and control groups in which mothers with ill-child come to the hospital for the first time. After this being done, the experimental group had been educated by the planned program and then the second data were collected from them. On the contrary, as for the control group, there had been no education and the second data were col looted on the same method. The data analysis was done by SPSS program. The results of this study are as follow, 1 The child-raising knowledge level of mothers with education was higher than that of with no education. (t=18.84, df=49, p=0.000) 2. The satisfaction with out-patient care level of mothers with education was higher than that of no education. (t=10.51, df=49, p=0.000) Based on these results, I suggest as follow, 1. The research on the patients and their family should be made not only in pediatric department, but in every out-patient department. 2. For more effective education, it is required for all out-patient nurses to research the education demand of patients and their family. 3. To increase the effect of education, there must be the consultation room in out-patient department. 4. The meetings with the mothers with ill-child of the same illness have to be established and periodical education must be executed. 5. Audio-visual education programs like video tapes are needed to make use of waiting time for the medical treatment. 6. On-line consulting programs are needed.

• Journal of Korean Academy of Nursing
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• v.19 no.1
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• pp.40-62
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• 1989

This study was conducted to measure the effects of clinical application of a Nursing Diagnosis Protocol. The dependent variables were the degree of patient's satisfaction and the degree of nurse's satisfaction with the nursing activity. Analysis of the effect of the use of the nursing diagnosis protocol was based on the nursing record. The subjects for this study were 61 nurses(experimental group 31, control group 30) and 155 patients (experimental group 55, control group 100) on four internal medicine wards in K University Hospital in Seoul. Data collection was done from August to October 12,1988. The results obtained in this study can be summarized as follows, 1, Effect of the clinical application of the nursing diagnosis protocol. 1) The first hypothesis ; “nurses who use the nursing diagnosis protocol will have higher degrees of satisfaction than those who use traditional methods” was rejected (t＝.54, df＝58, p＝.59). 2) The second hypothesis ; “patients nursed by nurses using the nursing diagnosis protocol will have higher degrees of satisfaction than those nursed with traditional methods” was supported(t＝1.93, df＝154, p＝.05). 3) The third hypothisis : Major hypothesis ; “the nursing records of the experimental group, who used the nursing diagnosis protocol, will be more detailed than those of the control group” was supported (t＝6.40, df＝79.90, p＝.000). (1) The first subhypothesis ; “The recorded data collection of the experimental group will be more detailed than that of the control group” was rejected (t＝1.79, df＝118, p＝.07). (2) The second subhypothesis ; “The recorded patient's problem statement of the experimental group will be more detailed than that of the control group”, was supported. (3) The third subhypothesis ; “The nursing record of the experimental group will be more convenient for implementation than that of the control group” was supported. 2. Factors related to the nurse's degree of satisfaction with protocol. 1) No general characteristics(age, religion, education level, duty career, present duty career) were related to the nurse's degree of satisfaction. 2) Variables related to the nurse's degree of satisfaction were “satisfaction as a nurse” and “consider nursing as lifelong job” (t＝-2.6, df＝13.22, p＝.02, t＝2.41, df＝23.85, p＝.02). 3. Factors related to the patient's degree of satisfaction. 1) General characteristics related to the patient's degree of satisfaction with nurses using the protocol were age, educational level, and being married.(F＝5.17, df＝3/153, p＝.00, t＝ -2.39, df＝154, p＝,01, f＝5.91, df＝2/153, p＝.00) 2) The variables previous hospitalization, duration of hospitalization, the hospital unit presence of a relative, medical insurance, or medical diagnosis were not related to the patient's degree of satisfaction. 1. The experimental group's nursing record was more detailed than the control group's record with regard to the physical and psychological state of the patients. As noted above, the experimental group nurses, who use a nursing diagnosis had protocol were less satisfied than the control group who used traditional methods of the recording, but experimental group patients had a higher degree of satisfaction than the control group patients. The nursing records of experimental group, using the nursing, diagnosis protocol was more detailed than that of the control group. If the nursing diagnosis protocol is used in clinical nursing practice, the quality of nursing care may be improved.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.3 no.2
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• pp.37-42
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• 2008

Objectives : One of the most important cause of spondylolisthesis is it's epidemiological structure and L5's stability takes a significant role. The purpose of this study is to assess the difference of the Tuffier's line among of Spondylolythesis patients. Methods : We analyzed the Anterior view of lumbar spine checked at erect position on 60 patients who had been diagnosed as spondylolythesis. We investigated the Tuffier's Line on X-ray film. Results and Conclusions : Age distribution was 15 to 66 and the average was 47.81. Men were 19 cases(31.6%) and women were 41 cases(68.4%). Compared to men, women were more exposed to spondylolisthesis and for the age distribution, 50's showed the biggest portion. Group of normal people showed proportion of 14.3% at L4, 44% at L4/5 and 41.7% at L5 each. And group of patients showed proportion of 48.4% at L4, 35% at L4/5 and 51.6% at L5 each. Comparing these results, significance probability was 0.004(<0.05) which was significant. As the results of comparing the relation between L4/5 and L5/S1 patients, Normal group showed average of 3.33 which were close to L4/5. When there are spondylolisthesis at L4/5, averege was 3.33, placed at lower part of the vertebra body. When there are spondylolisthesis at L5/S1, averege was 3.566, placed between lower part of the veterbra body of L4 and L4/5. The p value of Normal group and L4/5 spondylolisthesis patient group was 0.022(p<0.05) which was significant. But the p value of Normal group and L5/S1 spondylolisthesis patient group was 0.0239 which was not significant. Also p value of L4/5 spcndylolisthesis patient group and L5/S1 spondylolisthesis patient group was 0.721 which was also not significant.

• The Journal of Internal Korean Medicine
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• v.40 no.3
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• pp.369-389
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• 2019

Objectives: This study aimed to analyze the correlation between Ryodoraku diagnosis and three pattern identification questionnaires, namely, Spleen Qi Deficiency, Stomach Qi Deficiency, and Food Retention in functional dyspepsia (FD) patients. Methods: Forty FD patients who met the Rome IV diagnostic criteria for FD participated in this study. The Ryodoraku test was conducted, and three pattern identification questionnaires were filled up by all patients. The average Ryodoraku score was called total average (TA), and the scores on the Ryodoraku points were measured. The degree of Spleen Qi Deficiency, Stomach Qi Deficiency, and Food Retention was assessed by Spleen Qi Deficiency questionnaire (SQDQ), Scale for Stomach Qi Deficiency pattern (SSQD), and Food Retention Questionnaire (FRQ). Results: The TA scores in the SQDQ patient group were lower than those in the SQDQ control group (p=0.091). The TA scores in the SSQD patient group were higher than those in the SSQD control group (p=0.651). The TA scores in the FRQ patient group were lower than those in the FRQ control group (p=0.851). The scores on the LH5, RH5, and RH6 points were significantly lower in the SQDQ patient group than in the SQDQ control group. However, no significant difference was found in the Ryodoraku scores among the other groups. Conclusions: The results suggest that the low TA and low Ryodoraku scores on the LH5, RH5, and RH6 points could be a quantitative indicator to diagnose Spleen Qi Deficiency in FD patients in a simpler manner. Larger studies on the Ryodoraku test in FD patients, the health control group, and other pattern identification groups are required.

• YAKHAK HOEJI
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• v.54 no.6
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• pp.507-521
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• 2010

Training for asthma patients by professionals has been highly emphasized for patients' self-management. In the present study, three standardized training sessions targeting hospital pharmacists were performed. On the basis of the number of training sessions taken, a non-educated group (CG), an once-educated group (NG), and a twice more-educated group (IG) were allocated. The most frequent errors of using an inhalant were shaking before the use in MDI while taking breathe out before inhaling in the case of DPI, and the total average number of errors were the biggest for CG and the smallest in IG. On comparison in the number of the four symptoms of asthma according to the level of seriousness, it was revealed that the total average number was the biggest in CG and the smallest in IG. In the level of awareness regarding the contents of training for patients, patients over 50 tended to answer that they were aware of education contents, and particularly in mouth rinsing and the use before/after a meal, significant similarity was examined. Regular asthma patient training performed by hospital pharmacists appeared to reduce errors in the inhaler usage, increase the quality of life of an patient, and help a patient remember the contents of the training. Especially among patients over 50, it was found to be more effective and retraining of more than two sessions was requisite.