Background: Regular doctor visits are vital for hypertension patients, especially for who have never received hypertension medication or non-pharmacologic therapy. This study purposed to study factors affecting outpatient visits for patients diagnosed with hypertension. Methods: This study included 59,009 respondents with hypertension over 30 from 2019 Community Health Survey data. Outpatient visits were defined by having hypertension treatments such as medication or non-pharmacologic therapy. Logistic regression was used to examine the factors affecting outpatient visits using SAS ver. 9.3. Results: 57,081(96.73%) patients with hypertension were identified as those having a outpatient visit for hypertension treatments, whereas 1,928(3.27%) patients did not have visits. Patient's characteristics such as gender, age, periods of hypertension, education level, perception of the blood pressure, hypertension management education, place of living, body mass index, depression and diabetes were found to have statistically significant relationship with the outpatient visits. Practical Implications: There is a need to select patients with high blood pressure who are unlikely to visit for hypertension treatments based on the study results. For those, establishing a personalized management plan such as health education and counseling programs will be helpful for the successful implementation of national chronic disease management program.
This study was carried out to understand the general conditions about management of hypertension and the differences in opinions between the Eastern-Western Nursing Sciences. In this context, this study was aimed to find out a possible integration of the Eastern-Western Nursing Sciences for the management of hypertension and to suggest a distinct frame of Korean nursing intervention method which is unique for the hypertensive patients by combining two hypertensive management systems originated from the Western type, "mainly classified by stage", and the Eastern type, "typically classified by form" as they are identified in the literature. From the research literature including both domestic and foreign, this study identified that exuberance of Yang of the Liver form mainly appeared to the patient who is at a border hypertension or the first stage of hypertension, Deficiency of Yin of the Liver and Kidneys form mostly appeared to the first stage and the second stage of Hypertension and Deficiency of the both of Yin and Yang form appeared to the third stage of Hypertension. These unifications of the types of Hypertension classified by stages and forms suggest the possibility not only of integration of the Eastern-western Medicine but also of establishment for the intervention of specific nursing management which is the united Eastern-western Nursing Science for the Hypertension. Hence, the new frame for the nursing management of Hypertensive patient is suggested as follows : 1) In case of the exuberance of Yang of the Liver form, as classified by form which is categorized to the border Hypertension or the first stage of Hypertension, nursing intervention should include general therapy, cooking meal and neutral care to restrain the condition of the exuberance of Yang of the liver. 2) In case of the deficiency of Yin of the liver and the Kidneys form, as classified by form which is categorized to the second stage of Hypertension, nursing intervention should include both the general and drug therapy and their use in combination with cooking meal and neural care to restrain the condition of the deficiency of Yin of the Li ver and Kidneys. 3) In case of the deficiency of both of Yin and Yang form, as classified by form which is categorized to he third stage of Hypertension should include both the general therapy and drug therapy and their use in combination with cooking meal and neural care to restrain the condition of deficiency of the both of Yin and Yang. In addition, using this basic frame of Hypertensive management, a specific way of nursing intervention, which is suitable for exuberance of Yang of the Liver form, deficiency of Yin of the Liver and Kidneys form, and deficiency of both of the Yin and Yang form and classified by Korean herbal medicine related to hypertension, should be pursued continuously in the future.
This study attempts to analyze medical service factors associated with patients' satisfaction, and its difference between inpatients and outpatients in A medium-sized hospital located in rural area. Questionaries have been collected from 411 patients of 96 inpatients and 315 outpatients. The survey was carried out for 4 weeks, from August 20, 2011. The study found that hospital awareness was only factor related to patients' satisfaction in inpatients. In the case of outpatients, several factors were related to patients' satisfaction. They are included qualified health care providers, infirmary accommodations, staff kindness, hospital awareness, and convenient procedure of treatment and admission. Based on the findings, it is desirable to differentiate the strategy in improving patients' satisfaction between patient type; either inpatient or outpatient to being competitive.
Context aware environment u-health service is to provide health service with recognition of a computer. The computer recognizes that a patient can contact real life in many context. Context aware environment service for recommend have to definition of context data and service recommendations related to factors shall be identified. In this paper, Context aware environment of u-health service will be provide context data related to identifies recommendations factors using multivariate analysis method and recommendations factors creation to decision tree, association rule based decision model. health service recommend for significantly context data can be distinguish through recommendation factors of identify. Also, context data of patient can know preference factors through preference decision model.
This study is an attempt to analyze the physical load by the type of the nursing tasks at the neurosurgical ICU nurses through the quantitative analysis of the working postures by the type of the nursing tasks with the OWAS(Ovako Working Postures Analysis System). Data collection was conducted through the video recording of the 13 nurses working at the neurosurgical ICU. For the analysis of the work postures by the type of the nursing tasks, and were interviewed regarding the subjective degree of the difficulties with the work postures related to the tasks. Collected data was analyzed through the WinOWAS program. The results were as follows : AC3 or AC4 tasks among the 18 nursing tasks types are "occupied bed making and change of the patient gown", "back massage", "suction", "elimination management", "change of position", "adjustment of bed", "helping the patient to move","measurement of CVP"and "measurement of urine volume". It appears that these tasks are harmful to the musculoskeletal system and the improvement or change of the work is required. The results stated above indicate that improper working postures during the nursing tasks influence the musculoskeletal system. Therefore, making use of assistant devices for the improvement of the working environment at the nursing tasks, based on human technological diagnoses, is required regarding the duty types with massive work pressure known to be harmful to the musculoskeletal system among those performed by the nurses. And there is a need of the education about the employment and maintenance of the vocational back pain prevention.
Purpose: As the care of surgical patients becomes increasingly complex and catheter-based techniques are more frequently applied, the pattern of iatrogenic vascular injuries may be increasing. Major vascular injuries can jeopardize a patient's life or limb survival. The purpose of this study was to examine the current etiology and prognosis for iatrogenic vascular injuries. Methods: We reviewed medical records of 29 cases of iatrogenic vascular injury that were treated Seoul National University Bundang Hospital between October 2003 and October 2008. We studied clinical variables including demographics, cause of injury, clinical presentations, management and prognosis. Results: The mean age was 60.8 years (range: 25-86), and the male to female ratio was 1.9 : 1. The causes of injuries were operation related complication in 18 cases (62.1%), endovascular intervention and diagnostic angiography in 11 cases (37.9%). The types of vascular injury were partial severance in 14 cases, pseudoaneurysm in 8, arteriovenous fistula (AVF) in 3, thrombosis in 2, complete severance in 2. Especially, device related complication including percutaneous closing device were occurred in 9 and the others came from inadvertent physician's procedure. Primary repair were done in 12 cases, end-to-end anastomosis in 5, interposition graft in 4, ligation in 2, patch angioplasty in 1, peudoaneurysm excision and arteriorrhaphy in 1, hematoma evacuation in 1, and endovascular repair in 3. There were 2 cases of mortality, one of them due to hemorrhagic shock and the other due to septic shock. Conclusion: Proper selection of treatment modalities should be important to have better outcome according to the type of injury as well as anatomical location. Each physician should be familiar to new device as well as patient's topographical feature. Immediate referral to vascular specialist is also essential to reduce morbidity.
Ropper, Alexander E.;Huang, Kevin T.;Ho, Allen L.;Wong, Judith M.;Nalbach, Stephen V.;Chi, John H.
Neurospine
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v.15
no.4
/
pp.338-347
/
2018
Objective: Patients with extradural spine tumors are at an increased risk for intraoperative cerebrospinal fluid (CSF) leaks and postoperative wound dehiscence due to radiotherapy and other comorbidities related to systemic cancer treatment. In this case series, we discuss our experience with the management of intraoperative durotomies and wound closure strategies for this complex surgical patient population. Methods: We reviewed our recent single-center experience with spine surgery for primarily extradural tumors, with attention to intraoperative durotomy occurrence and postoperative wound-related complications. Results: A total of 105 patients underwent tumor resection and spinal reconstruction with instrumented fusion for a multitude of pathologies. Twelve of the 105 patients (11.4%) reviewed had intraoperative durotomies. Of these, 3 underwent reoperation for a delayed complication, including 1 epidural hematoma, 1 retained drain, and 1 wound infection. Of the 93 uncomplicated index operations, there were a total of 9 reoperations: 2 for epidural hematoma, 3 for wound infection, 2 for wound dehiscence, and 2 for recurrent primary disease. One patient was readmitted for a delayed spinal fluid leak. The average length of stay for patients with and without intraoperative durotomy was 7.3 and 5.9 days, respectively, with a nonsignificant trend for an increased length of stay in the durotomy cases (p=0.098). Conclusion: Surgery for extradural tumor resections can be complicated by CSF leaks due to the proximity of the tumor to the dura. When encountered, a variety of strategies may be employed to minimize subsequent morbidity.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.47
no.1
/
pp.20-24
/
2021
Objectives: The aim of this study was to evaluate the profile of patients on antiresorptive therapies for cancer treatment and assess presence of oral lesions, oral hygiene status, and knowledge regarding medication-related osteonecrosis of the jaw (MRONJ). Materials and Methods: This was an observational cross-sectional study that evaluated patients treated with antiresorptive medication at a single cancer hospital. Clinical data were collected and oral examination was performed to assess patient oral health. Results: From July 2017 to December 2018, 90 patients were assessed; 64 were female and 26 were male, and the mean age was 61 years. The most common drug was an intravenous bisphosphonate, zoledronic acid. Among the 90 patients, 47 presented with some type of oral disease, isolated or associated. Among these 47 patients, 9 patients (10%) developed osteonecrosis. Oral hygiene was evaluated, and most patients, with or without MRONJ, presented with regular to poor condition. Regarding patient knowledge of the risks of MRONJ and the risks associated with dental surgery, 60% stated that they were not aware of the risks. Conclusion: Identifying the profile of patients and their needs facilitates not only the preventive process, but also the emergence of new therapeutic options. Our study shows that most patients are weakened both by metastatic disease and antineoplastic treatment as well as by issues associated with aging because most were over 60 years of age. Collectively, this information should be considered for management of preventive and therapeutic measures.
Gun Ho, Kim;Young Jun, Hwang;Min Jae, Kim;Kyoung Won, Nam
Journal of Biomedical Engineering Research
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v.44
no.1
/
pp.92-98
/
2023
Purpose: To propose a new infusion rate monitoring technique based on the 2D image marker tacking to improve patient safety by preventing syringe pump-related medication accidents due to decreased infusion rate control accuracy. Materials and Methods: The infusion rate of the syringe pump and drug residue in the pump-equipped syringe were monitored in real time by tracking the movement of the 2D image markers attached to the syringe pump. Results: The error rate between the set and the estimated infusion rates was 1.03, 0.66, 1.95, 0.23, and 1.05% when the infusion rate setting was 10, 20, 30, 40, and 50 mL/H, respectively. In addition, the error rate between the actual and the estimated drug residues was 1.04, 0.47, 0.60, 3.66, and 0.00% when the infusion rate setting was 10, 20, 30, 40, and 50 mL/H, respectively. Conclusion: Experimental results demonstrated that the proposed technique can increase the efficiency of the safety management system for seriously ill inpatients by decreasing a possibility of syringe pump-related medication accidents in hospitals.
This study evaluated the effect of diabetic group teaching programs in one university hospital in Seoul to predict when re-education would be needed. This study examined the patients’ knowledge at four points (before, directly after, three months and six months after the teaching program) and self-care performance related to diabetes twice (three months and six months after the teaching program). The subjects of the study were 24 admitted diabetic patients who participated in four-day teaching programs. Data were gathered from January to October, 1992 by means of an instrument developed from two diabetic knowledge tests which were equivalent in item differentiation and item discrimination coefficients. Collected data were analyzed by paired t-test, Pearson correlation, t and F tests. The results of study were as follows. 1. The analysis of the effect of the diabetic group teaching program and the duration of the effect of teaching. 1) The first hypothesis, that the diabetes knowledge score directly after the teaching program would be higher than before, was rejected (t=-1.40 ; p=.172). 2) The second hypothesis, that the diabetes knowledge score directly after teaching would be higher than three months later, was rejected(t= -4.27 ; p=.000). 3) The third hypothesis, that the diabetes knowledge score three months after teaching would be higher than six months later, was supported(t=2.43 : p=.020). 2. The relation of knowledge and self-care performance 1) The forth hypothesis, that the level of self-care performance related to diabetes three months later would be higher than six months later, was rejected( t=1.49 ; p=.146). 2) The fifth hypothesis, that the higher the diabetes knowledge, the higher the level of self-care performance, was rejected(r=.2086 ; p=.118). 3. The relation of diabetes knowledge and self-care performance according to demographic variables and structural variables of diabetes. 1) Diabetic knowledge scores varied according to the educational levels of the clients directly after the teaching. Three months after the teaching program higher educational levels and higher economic status were related to higher diabetic knowledge scores and men had higher knowledge scores than women. 2) Self-care performance scores of men were higher than those of women at three months and six months after the teaching program. 3) Before the diabetes teaching, the diabetic knowledge scores of subjects who had a diabetic patient in the family were higher than those who did not have patient in their family. Six months after the teaching, the diabetic knowledge scores of subjects who read the distributed books about diabetes were higher than those who did not read them. 4) No significance differences were found be-ween self-care performance and structural variables of dialetes. The results of this study indicated that the levels of diabetes knowledge and self-care performance incense of three months after the teaching program but decrease of six months. Reeducation would be needed between three and sir months. The investigator thinks that a study of the content and teaching methodology is needed to increase the education effect. The subjects want to hear patient histories of diabetic management. Group discussion would be helped after the teaching sessions.
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