• Journal of Gastric Cancer
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• 제9권3호
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• pp.117-127
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• 2009

목적: 의료진은 암 환자들에게 적절한 건강 관련 정보를 제공함으로써 암 환자들이 자신의 질병과 치료에 대한 불확실한 상황을 극복하여 스스로 건강을 관리하는 것을 도울 수 있다. 효과적으로 정보를 제공하기 위해서는 환자가 실제 알고자 하는 정보 내용을 파악하는 것이 필요하다. 본 연구에서는 위암 수술 후 환자의 정보 요구 경향을 확인하고자 하였다. 대상 및 방법: 위암 수술 후 환자로, 2008년 11월 18일 삼성서울병원 위암센터에서 주관한 '위암 환자의 날' 행사에 참여한 대상자에게 설문지를 배부하여 직접 작성하도록 하였고, 수집된 190명의 설문지를 분석하였다. 설문 도구는 검사, 치료, 예후, 추후 관리, 성 생활, 위암 관련 정보 영역과 7개의 단일 문항의 총 37개 문항으로 구성되었다. 결과: 정보 요구는 예후, 치료 기간 동안 스스로 할 수 있는 건강 관리 방법, 추후 관리, 위암 관련 정보, 치료, 검사 등의 순으로 높게 나타났다. 문항별로 살펴보면, 예후, 식이, 치료 중의 건강 관리와 관련한 문항에서 높은 정보 요구를 보였다. 대상자의 연령이 젊을수록 검사, 치료, 성 생활, 위암 관련 정보 영역의 정보 요구가 높았다. 결론: 기존에 축적된 병원의 치료 결과 및 예후 자료에 근거한 객관적인 예후 관련 정보를 교육 프로그램에 반영하고 암 환자 및 보호자가 이해하기 쉽도록, 그리고 치료 과정에 적극적으로 참여할 수 있도록 적절한 정보를 전달하여야 할 것이다.

• 한국농촌간호학회지
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• 제4권1호
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• pp.13-21
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• 2009

Purpose: This study was done to investigate the prevalence and related factors of Clonorchis Sinensis for inhabitants of the Han riverside area and to identify knowledge related to Clonorchis Sinensis and intended behavioral changes to decrease risk of infection. Method: The data were collected from December 16, 2008 to January 10, 2009. Participants were 555 people who responded to a questionnaire. Frequency, percentage, $X^2$-test, and t-test were used to analyze the data. Results: The prevalence of Clonorchis Sinensis was 7.9% in this population. Related factors for Clonorchis Sinensis were gender (male=10.8%, female=3.6%, p=0.002) and smoking (p=0.007). but habits related to ingestion of alcohol and raw fish were not significant. As for knowledge of Clonorchis Sinensis, the Clonorchiasis group had a mean score of 10.09 $({\pm}3.95)$ of a possible 17 compared to a score of only 8.27$({\pm}4.60)$ for the negative group (p=0.011). The intended behavioral change related to risk of infection, according to presence of infection or not, was significant (p=0.004). Conclusion: These results suggest that Clonorchiasis is still highly endemic in all risk areas such as the Han riverside, indicating that it is necessary to set up effective management programs for patient care and prevention of Clonorchis Sinensis.

• 동의생리병리학회지
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• 제16권5호
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• pp.1075-1078
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• 2002

Objective: The management for the stroke should ,given as soon as possible to be effect. But Patients with stroke symptoms commonly delay many hours before seeking medical attention. We evaluated the factors which are related to the time of hospital arrival after acute stroke. Method: Data were obtained from 317 patients admitted to our hospital within 72 hours of stroke onset. We assessed demographic variables, stoke subtype. referral routes. history of previous stroke, level of consciousness, distance from the place where stroke occurred to hospital, and the time interval between onset of stroke and arrival at the hospital. Results: Mean patient age was 65.99±9.57 years. The mean time interval between onset of stroke and hospital arrival was 17.26±18.69 hours and 128 (40.38%) patients arrived within 6 hours. The patients whoes stoke subtype was infarction, who arrived our hospital by way of other hospital, who had no suffered from previous stroke and who showed no impairement of consciousness was arrived at the hospital late(p<0.05). Conclusion: The majority of patients arrive at the hospital after prolonged delays for multiple reasons, and patients with milder symptoms, for whom treatment might be more effective, were less likely to arrive in time for therapy. Our study suggest that effective education about stroke to the patients and public would be highly necessary.

• 성인간호학회지
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• 제21권6호
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• pp.705-717
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• 2009

Purpose: The purpose of this study was to identify symptom clusters in patients with breast cancer and to investigate the associations among them with functional status and quality of life (QOL). Methods: A convenient sample of 303 patients was recruited from an oncology-specialized hospital. Results: Two distinct clusters were identified: A gastrointestinal- fatigue cluster and a pain cluster. Each cluster significantly influenced functional status and QOL. Based on these two clusters, we identified subgroups of symptom clusters using K-means cluster analysis. Three relatively distinct patient subgroups were identified in each cluster: mild, moderate, and severe group. Disease-related factors (i.e., stage, metastasis, type of surgery, current chemotherapy, and anti-hormone therapy) were associated with these subgroups of symptom clusters. There were significant differences in functional status and QOL among the three subgroups. The subgroup of patients who reported high levels of symptom clusters reported poorer functional status and QOL. Conclusion: Clinicians can anticipate that breast cancer patients with advanced stage, metastasis, and who receive mastectomy, and chemotherapy will have more intense gastrointestinal-fatigue or pain symptoms. In order to enhance functional status and QOL for patients with breast cancer, collective management for symptoms in a cluster may be beneficial.

• 한국의료질향상학회지
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• 제7권1호
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• pp.46-58
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• 2000

Background : Despite favorable effects of guidelines on patient care, guidelines often fail to achieve their objectives. Poorly implemented medical practice guidelines can produce only weak effects on the process of health care delivery. Therefore, we performed this study to investigate barriers related development of clinical practice guidelines. Methods : Cardiopulmonary resuscitation was selected as a target problem. Self questionnaires about management of cardiopulmonary resuscitation were developed by a researcher with advisory 8 experts. The questionnaires were designed as a unstructured methods. The data were collected from March 1 to May 31, 1999. A total 50 death case admitted inpatient to Inha University Hospital were subjected to evaluate the development and application of clinical practice guidelines for cardiopulmonary resuscitation. The data were examined by frequency, t-test with SPSS. Result : The article reviewed several common barriers that might limit successful implementation of guidelines in clinical practice, as illustrated by evaluating recommendations for cardiopulmonary resuscitation clinical practice guidelines. Some major problems with guidelines were characterized as follows (1) ethical problem : euthanasia, (2) occurrence on various emergency event and setting, (3) non-medical problems (4) unreliable of medical record etc. Conclusion : Careful analysis of guideline attributes, anticipated effect on medical care, and organizational factors revealed several barriers to successful guideline implementation that should be addressed in the design of future guideline-based interventions.

• 간호행정학회지
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• 제13권4호
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• pp.407-420
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• 2007

Purpose: The objective of this literature review study was to identify research's trends and methodological issues of cost analysis on nursing services. Methods: Researches which analyzed nursing services cost, were selected from journal articles and master or doctoral dissertation studies. The total numbers of the collected studies were 23. Results: The number of studies on nursing services cost has been increased rapidly since middle-1990. The 5 methodological frameworks to classify the cost analysis researches was found. 4 researches were using the traditional costing method. 6 researches were using the clinical patient classification systems. 4 researches were using the Korean Diagnosis Related Group (KDRG). 5 researches were using the Resource Based Relative Value Scale (RBRVS). 4 researches were using the Activity Based Costing (ABC). Conclusion: These results will be used to provide the basic data for developing a more refined cost analysis method on nursing services. For further studies, we will suggest that the consent criteria of cost items need to measure nursing services be developed and the conducting cost analysis on nursing services be networked a hospital's cost management system.

• 기본간호학회지
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• 제13권3호
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• pp.409-418
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• 2006

Purpose: This study was done to identify the process of change, decisional balance and self-efficacy corresponding to stage of exercise behavior based on the Transtheoretical model in patients with chronic arthritis. Method: The participants were 151 patients with chronic arthritis using an out-patient pain clinic and hospital in C city. The collected data were analyzed using ANOVA, Sheffe test and discriminant analysis with SPSS/WIN. Results: The patients were distributed as follows for each stage of exercise behavior 21.8% in the precontemplation stage, 26.5% in the contemplation stage, 25.2% in the preparation stage, 7.3% in the action stage, and 19.2% in the maintenance stage. Significant effects for stage of change were found for nine of the 10 processes of change and Pros, Cons, self-efficacy. Scores on these variables were found to increase across the stage of exercise behaviors from precontemplation to maintenance. Discriminant analysis revealed that self-efficacy and stimulus control, and reinforcement management were the major correlates of the stage of exercise behaviors. Conclusion: The findings of this study give useful information for exercise intervention, by using strategies of exercise for chronic arthritis patients in different stages of exercise behavior.

• 대한간호학회지
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• 제27권4호
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• pp.857-870
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• 1997

The purposes of this study were to describe 12 years of patient-related oncology nursing research in Korea, identifying various nursing interventions, and assesing the effectiveness of the interventions, through analysis and synthesis of the accumulated research papers. One hundred and seventy-nine studies were selected for this study and these were mostly descriptive in design (69.2%). Of the 179 studies, 25 met the criteria for meta-analytic treatment. Twenty-five experimental studies were found in theses and dissertations (68%), 92% used convenience sample, and the median sample size was 40. Subjects were predominantly in treatment and rehabilitation (76%). Most studies(68%) were not derived from a theory base, with only 8% reporting use of a nursing theory. Results of the meta-analysis are as follows. The effect size of the nursing intervention type was found to be significantly effective. The standardized mean difference ranged from a high positive of 2.55 to a low negative of -0.22. Direct personal nursing intervention method was more effective than indirect group method. Two nursing intervention methods were more effective than one. The greatest effect size was thyxical intervention. The greatest mean effect size was scalp hypothermia technique. Teaching was a frequent intervention after 1990, although a wide range of treatments were studied. Effect size of intervention for symptom management was largest in relieving pain. Effective intervention method for relieving anxiety was exercise.

• 대한통합의학회지
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• 제2권3호
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• pp.15-22
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• 2014

Backround : The paradigm of recent education has been shifting from existing style of professor-oriented, passive and rote teaching to learner-centered education. Rather than mere delivery of knowledge, today's idea of education uses various audiovisual media to let learners gain more problem-solving skills, judgment, cognitive thinking ability, and creativity to apply to real practice. Also, while current trends and change in policy ask for related industry to require practice-centered teaching learning model, Problem-Based Learning (PBL) is quite effective that it activates problem-solving skills as well as application of National Competency Standards (NCS). Purpose : The purpose of this study was to suggest a teaching learning model article as an approach to apply web-based PBL for patient & medical charge management practices. Discussion & Conclusion : This paper the cases on PBL and presents the teaching learning model on web-based PBL as an approach to applying web-based PBL, which fits Medical Information System Department that combines health-medical treatment and computer applications, to practical health administrative affairs.

• Journal of Chest Surgery
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• 제24권2호
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• pp.115-122
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• 1991

From April 1986 to December 1989, 25 infants under the age of 12 months with tetralogy of Fallot were operated on. Age ranged from 3 to 12 months[mean 8.9$\pm$4.9 months] and mean body weight was 7.8$\pm$ 2.6kg. All the patients were deeply cyanotic, 12 of them experienced anoxic spell. Transannular patch was laid down in 19 patients, in 7 of them monocuspid patch was utilized. Postrepair P RV/LV was measured at operation room in 17 patients[mean 0.48$\pm$0. 14]. Hospital mortality was 20Yo. Causes of deaths include right ventricular failure and low cardiac output. The mortality was closely related with patient`s age and body surface area at operation. Also higher mortality was noticed in patients having major associated anomaly or previous palliative operation, preoperative management with propranolol and transannular repair. 18 patients were followed up for 12 to 50 months with a mean follow-up time of 24 months after operation. There were no late deaths and late ventricular arrhythmia or congestive heart failure was not detected as yet. Redo operation was performed in one case because of residual pulmonic stenosis. Considering several advantages of early primary repair, primary repair of symptomatic infants with tetralogy of Fallot should be encouraged despite somewhat high mortality rate as yet and better results could be anticipated along with improvement of myocardial protection method and postoperative care.