• Journal of the Korean Dietetic Association
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• v.16 no.4
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• pp.378-396
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• 2010

The objectives of this study were to explore hospital foodservice management and to investigate conditions related to health insurance coverage of inpatient meals. A questionnaire was distributed to the nutrition departments of 44 hospitals in Seoul on July 2009. The average kitchen area was 0.5 $m^2$, and centralized distribution systems were in place. Partition walls from contamination zones, separate work tables to prevent cross-contamination, exclusive areas for preparing tube feeding, and split carts with refrigerated and convection heat settings were largely used in tertiary hospitals. Most dietitians did meal rounds (93.2%) and surveyed for patient satisfaction (86.4%). The major theme of QI (Quality Improvement) was menu management (31.8%). The health insurance fees for meals were (won)4,938.9 for a general diet, (won)5,199.8 for a therapeutic diet, (won)4,067.0 for tube feeding, (won)9,950.0 for sterilized diet, and (won)18,383.4 for diets not covered by health insurance. The prices for general and therapeutic diets were significantly lower in hospitals compared to tertiary or general hospitals (P<0.001). The cost composed of 48.3% food, 44.0% labor and 7.7% overhead for general diets and 47.9%, 44.5% and 7.6% for therapeutic diets. In the case of health insurance coverage for patient meals, the number of items applied to general diets averaged 2.8 out of 4 and for therapeutic diets it averaged 1.9 out of 3. To reform the health insurance coverage system for patient meals, it is urgent that the qualified level of patient meals is presented from a national viewpoint, and monitoring should be performed consistently by developing the evaluation tools.

• Journal of the Ergonomics Society of Korea
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• v.26 no.3
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• pp.91-100
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• 2007

The purposes of this research are to survey work-related risk factors of musculoskeletal disorders(MSDs) in various departments and tasks at general hospitals in non-manufacturing sectors, and to use basic data derived from the survey results in preventing work-related MSDs in hospital workers. Investigation started in March of 2006 and continued for 6 months in 220 general hospitals at Seoul, Incheon, Kyeongi, and Kangwon area. Investigators visited and interviewed workers in hospitals to identify the presence of tasks of musculoskeletal burden, the investigation results of ergonomic risk factors required by the Occupational Safety and Health Law, statistical analysis from questionnaire for musculoskeletal symptoms, and major departments and tasks that have such risk factors. Twenty-seven percents of hospitals finished the investigation of ergonomic risk factors, and 69% did not do the investigation while remained 4% did not have such factors in their hospitals. The rank order of major departments that had such musculoskeletal burdens was kitchen rooms of 143, managing departments/computer rooms/dispensaries of 137, physical treatment rooms of 109, nursing departments of 96, radiological and clinical laboratories of 63. Eighteen hospitals that did not hold legal duties by the section 148 of labor minister decree practiced prevention programs of MSDs according to the labor-management cooperation. Nursing departments ranked in the first place for the numbers of musculoskeletal symptoms of 438. Managing departments/computer rooms/dispensaries, kitchen rooms, and medical treatment departments held 127, 52 and 45 symptoms, respectively. The magnitude order of physical symptom areas followed shoulder of 185, backs and waist of 166, hand wrists of 120, necks of 110, and legs/feet of 106. The departments and jobs that had major work-related ergonomic risks were patient transporting, central supplying, patient nursing (moving patients into wheel-chairs, changing of patient posture and sheet alteration), manual transporting, operation, and managing/computer departments.

• The Korean Society of Law and Medicine
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• v.20 no.1
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• pp.109-132
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• 2019

Recently, medical accidents related to surgical procedures have increased. In addition, the media reported that some of these accidents were involved in health crimes. Patient-advocate groups have called for mandatory establishment and management of CCTV in operating rooms. There is a lot of discussion among the interested parties, so it is necessary to review the relevant laws and regulations. The purpose of this study is to identify the characteristics of CCTV in operating rooms and to review legislations related to establishment and management of the CCTV in operating rooms. Medical institutions use CCTV for management of facilities and patient safety and install it in operating rooms optionally. The Constitution guarantees the privacy and the privacy of correspondence of every citizen, but it can be limited by the law for public welfare. Currently, however, there is no existing law about establishment and management of the CCTV in operating rooms and it can be defect of legal system. Under the current legislations, it is likely that the Self-determination can be violated due to the characteristic of healthcare provider when CCTV is mandatorily installed in operating room. In addition, the regulations on access and leakage of confidential information known by operator are insufficient. So that, the safety of the visual data might be threatened. Furthermore, unless the period and the place of storage of the visual data are clearly defined, it is highly unlikely to meet the original purpose of patient safety and prevention of medical accidents. This study is meaningful as there is few previous study on this topic although the need for legal review about this is growing and several bills are being proposed. It is expected that the results of this study can be utilized as basic data for enactment or amendment of the laws and regulations about establishment and management of CCTV in operating rooms.

• Journal of Korean Academy of Nursing
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• v.27 no.2
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• pp.289-302
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• 1997

The main purpose of this study was to identify the effects of integrated stress management program on the stress symptoms of psychophysiological patients. especially patients with peptic ulcer. The study employed a quasi-experimental design using two different experimental groups. The samples in the integrated stress management program participated in autogenic training with biofeedback. discussions on effective coping method. cognitive. behavioral, and emotional management. They were also provided with an educational booklet on stress management and an tape on progressive muscie relaxation. Each session lasted one hour and the program consisted of seven sessions over four weeks. The other group was only given an tape on progressive muscle relaxation. The data were collected from May 20 to september 25, 1996. A total 47 patients from one university hospital located in Seoul participated, experiment group 1(integrated stress management training) had 23 subjects and experiment group 2(progressive muscle relaxation training) had 24 subjects. The effects of these programs were measured by the stress symptom scale developed by Kogan(1991) which was translated by Lee(1992) and the healing status of the ulcer evaluated by a physician. The data were analyzed using Chi-square test, t- test, ANOVA, repeated measure ANOVA. The result are as follows : 1. The integrated stress management group reported a significantly lower stress symptom score than the group given the progressive muscle relaxation only. 2. The integrated stress management group showed a significantly improved ulcer status as compared to the group given a progressive muscle relaxation only. In conclusion, it was found that the integrated stress management program was more effective in decreasing self-reported stress and physiological symptoms among patients with peptic ulcer as compared to the progressive muscle relaxation group. Based on this finding, the following suggestions can be made. 1. It is necessary to broaden the scope of nursing practice for psychophysiological patients so nurses can include stress management as part of patient care. 2. It is necessary to develop stress management program for other patients whose symptoms are known to be related to stress. 3. It is necessary to replicated this study with a larger sample in different settings.

• Journal of Preventive Medicine and Public Health
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• v.26 no.2 s.42
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• pp.293-309
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• 1993

With expanded and extended coverage of the national medical insurance and fast growing health care expenditures, appropriateness of health service utilization and quality of care are concerns of both health care providers and insurers as well as patients. An accurate patient classification system is a basic tool for effective health care policies and efficient health services management. A classification system applicable to Korean medical information-Korean Diagnosis Related Groups (K-DRGs)-was developed based on the U.S. Refined DRGs, and the performance of the developed system was assessed in this study. In the process of the development, first the Korean coding systems for diagnoses and procedures were converted to the systems used in the definition of the U.S. Refined DRGs using the mapping tables formulated by physician panels. Then physician panels reviewed the group definition, and identified medical practice patterns different in two countries. The definition was modified for the differences in K-DRGs. The process resulted in 1,199 groups in the system. Several groups in Refined DRGs could not be differentiated in K-DRGs due to insufficient medical information, and several groups could not be defined due to procedures which were not practiced in Korea. However, the classification structure of Refined DRGs was retained in K-DRGs. The developed system was evaluated fur its performance in explaining variations in resource use as measured by charges and length of stay(LOS), for both all and non-extreme discharges. The data base used in this evaluation included 373,322 discharges which was a random sample of discharges reviewed and payed by the medical insurance during the five-month period from September 1990. The proportion of variance in resource use which was reduced by classifying patients into K-DRGs-r-square-was comparable to the performance of the U.S. Refined DRGs: .39 for charges and .25 for LOS for all discharges, and .53 for charges and .31 for LOS for non-extreme discharges. Another measure analyzed to assess the performance was the coefficient of variation of charges within individual K-DRGs. A total of 966 K-DRGs (87.7%) showed a coefficient below 100%, and the highest coefficient among K-DRGs with more than 30 discharges was 159%.

• The Korean Society of Law and Medicine
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• v.9 no.2
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• pp.209-229
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• 2008

When we are totalizing the lawsrelated to the medical, as the Laboratory medical testing is a kind of the medical act, it is the regulation that the medical technologist can analyze the specimen using in vitro diagnostic devices and diagnosticdrugs under the guidance of doctor or dentist from a corresponding medical institution and can report through verification and interpretation. However, in real medical fields, 'the guidance of doctor' is seriously in-sufficient or even the person who is not the medical technologist is executing. Furthermore the cases that produce inspection results with devices or reagents which are not validated nor approved have been frequently occurred. The result of Laboratory medical testing derived from this procedure can become the important information for the disease control of a country, and also can be decisive to the definite diagnosis and the prognostic monitoring about the patient disease. In spite of its significant medical act to be applicable to an unique proof with the related expert appraisal result in the medical mal-practice lawsuit, our reality in which the quality control is not properly working due by the costs and the labor shortage related to the Laboratory medical testing is quietly in bad condition. Even from now, the government should recognize the significance of the Laboratory medical testing and must achieve more strict administrative management as well as the law maintenance.

• Journal of Families and Better Life
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• v.18 no.3 s.47
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• pp.171-187
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• 2000

The purpose of this study is to research high school students' stressful life events, to examine effects of SES, psychological environments, stress coping methods on stress. Data were collected by 965 high school students in Cheon-buk. Data were analyzed with the frequency, percentage, factor analysis, reliability, ANOVA test, Multiple Regression in use of SPSS WIN 7.5 Program. The main results are as follow: 1. High school students; stressful life events are ① comparingㆍinterferenceㆍscolding ② having a bad at their study. ③ educational environments ④ ability ⑤ apearance. Peoples stressed me are ① her(him)self ② friend and ③ teacher. Stress coping behaviors are it's ① speak ill a person. ② listen to the music. ③ sleep. ④ be patient. ⑤ keep still or take breath deeply. 2. SES, Psychological Environments, Stress Coping Methods are related to stress. Especially hopeless in future, parental not affections and parental interference are related to stress highly. Also the stress by sex discrimination are related to gender intimately. 3. Effects of SES, Psychological Environments, Stress Coping Method on high school students' stress are very different. So it must to be differentiated the support on the high school students' stress.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.973-978
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• 2016

Background: Between October 2012 and February 2015, 25 patients with metastatic colorectal cancer (mCRC) (mean age, $57.0{\pm}12.1years$) were granted access to aflibercept via the Aflibercept Named Patient Program at four centers. Materials and Methods: Here we reported the initial experience of aflibercept / FOLFIRI in combination. We evaluated treatment-related adverse events (AEs), progression-free survival (PFS) and overall survival (OS). Results: The majority of the patients experienced gastrointestinal toxicity (grade 1-2), with diarrhea (52%), mucositis (52%), and nausea/vomiting (20%) being largely observed. Neutropenia (16%) and febrile neutropenia (8%) were common grade 3-4 hematological events. Aflibercept-related toxicity was managed as per practice guidelines. No grade 5 event was reported. Median PFS was 6.12 months (95% CI, 4.80-7.20) and OS was 12 months (95% CI, 9.80-14.18). The partial response (PR), stable disease (SD), and progressive disease (PD) rates were 25% (95% CI: 23.4-27.0), 37.5% (95% CI: 31.6-43.3), and 37.5% (95% CI: 22.5-52.5), respectively. Conclusions: Aflibercept/FOLFIRI can be administered safely in a second line setting to Malaysian patients with mCRC, as the AEs experienced were generally reversible and manageable. The safety and efficacy outcomes were consistent with those observed in Western populations.

• Journal of Korean Society of Industrial and Systems Engineering
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• v.35 no.4
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• pp.33-40
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• 2012

Dentists are known to be highly exposed to the musculoskeletal disorders (MSD). The present study investigated the prevalence of MSD among Korean dentists and association between their MSD and physical workload. In addition, detailed causes related to the physical workloads were identified in dental operation, and needs for improvement of dental instrument and environment were collected from Korean dentists. The standardized Nordic questionnaire was used to survey body troubles and three types of questionnaires were made to investigate the physical workloads, causes of the physical workloads and improvement priority of dental equipments, respectively. A total of 104 Korean dentists were participated in the survey. Neck trouble (82%) was the most prevalent in Korean dentists, and shoulder (68%) and low back trouble (56%) followed, while low back trouble was reported to be most frequent in previous studies. The body troubles were related to the physical workload of the corresponding body parts, although they were not associated with personal characteristics. Most Korean dentists selected 'to keep direct view inside patient's mouth' and 'no support of the hand with dental instruments' as the causes of awkward and strenuous work postures. They wanted design improvement for some equipment in their operating room such as operating light and arrangement of workplace.

• Journal of Oriental Neuropsychiatry
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• v.24 no.3
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• pp.211-228
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• 2013

Objectives : This report describes the diagnostic and therapeutic procedures of Collaborative Practice between Korean Traditional Medicine and Western Medicine for two dementia patients. Furthermore, through these cases, we suggest a model of collaborative practice between Korean traditional medicine and western medicine for the treatment of dementia. Methods : Two patients suffering from several symptoms related to dementia received collaborative practice between Korean traditional medicine and western medicine. Physicians of deparment which paient first visit interviewed patient and patient's guardians, discussed the symptoms and the status of the patient. Since then, the medical team made a differential diagnosis based on the results of brain imaging, hematology, urine test. and apprehended the status of dementia by the neuropsychological test. Korean traditional physicians examined the physical symptoms and identified the pattern of dementia in Korean traditional medicine. Following this, they decided on the method of acupuncture, moxibustion, cupping and herbal treatment. Western physicians decided on the type of medication after consideration of the patient's other medical conditions. Every intervention was decided by both Korean traditional physicians and western physicians after discussion. The medical team provided education on dementia and counseled the guardians. They also wrote the paper for using the long-term care insurance for the aged. Results : Two patients showed no improvement on the neuropsychologic and activity of daily living tests. However, the patients' subjective physical symptoms were improved. The collaborative practice between Korean traditional medicine and western medicine improved the patients' and guardians' satisfaction. Conclusions : Through these cases, we propose a model of collaborative practice between Korean traditional medicine and western medicine for dementia categorized diagnosis-test, treatment, prevention, management. More specifically, we supplement qigong and psychotherapy which was inadequate in these cases.