• Title/Summary/Keyword: Patient assessment

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Reliability and Validity of the Assessment Tool for Measuring Communication Skills in Nursing Simulation Education (시뮬레이션 교육에서 간호학생의 의사소통능력 측정도구의 신뢰도와 타당도 검증)

  • Yang, Hee Mo;Hwang, Seon Young
    • Korean Journal of Adult Nursing
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    • v.28 no.1
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    • pp.95-105
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    • 2016
  • Purpose: This study was conducted to test whether Health Communication Assessment Tool (HCAT) developed by Campbell et al. in 2013 can be applied to assess Korean nursing students' communication skills in simulation education. Methods: The content validity of the Korean version of HCAT (K-HCAT) was evaluated through expert's assessment and a principal component analysis was conducted for testing construct validity. The convergent validity was tested by measuring relationship between the K-HCAT and those of existing communication assessment tool for standardized patient instruction. The evaluation was done by surveying 154 senior students from four different nursing colleges. Results: The K-HCAT was condensed into 15 items from the original 22 HCAT items. Four factors were extracted from the principal component analysis; factor loadings ranged from .50 to .83; cumulative explained variance was 62.65%. Four factors were entitled as 'relationship building', 'empowering', 'empathy/response', and 'education/feedback'. Cronbach's ${\alpha}$ for sub-dimensions ranged from .73 to .84. An evaluation of convergent validity showed that the scores of the K-HCAT were moderately correlated with those of an assessment tool for standardized patient instruction. Conclusion: The K-HCAT can be used as an effective tool for assessing nursing students' communication skills in various kinds of simulation educations Further research is needed to test the consistency of the K-HCAT.

Medical Service Variation of Urinary Incontinence Surgery and Uterine Polypectomy Using a Multilevel Analysis (다수준 분석을 이용한 요실금수술과 자궁폴립제거술의 의료서비스 변이)

  • Kim, Sang Me;Ahn, Bo Ryung;Kim, Jeong Lim;Lee, Hae Jong
    • Health Policy and Management
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    • v.30 no.1
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    • pp.82-91
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    • 2020
  • Background: This study investigates the influence factors of medical service variations using medical charge and the length of stay (LOS) for urinary incontinence surgery and uterine polypectomy. Methods: The National Health Insurance claims data and Medical Resource Report by the Health Insurance Review & Assessment Service in 2016 were used. Frequency analysis, one-way analysis of variance, and Bonferroni post-hoc tests were executed for each surgery. A multilevel analysis was executed to assess the factors to the medical charge and LOS for each surgery in patient, doctor, and hospital level. Results: Fifty-two point eight percent of urinary incontinence surgery and 87.1% of uterine polypectomy were distributed in general and tertiary hospitals. Among three levels, the patient level variation was 61.5% or 77.2% in medical charge and 93.9% or 96.3% in LOS, respectively. The doctor level variation was 29.6% or 22.6% in medical charge and 0.6% or 0.0% in LOS, respectively. The institution level variation was 8.9% or 0.2% in medical charge and 5.5% or 3.7% in LOS, respectively. Number of other disease and organizational type were main factors that affected the charge and LOS for urinary incontinence surgery and uterine polypectomy. Conclusion: Medical service variations of the urinary incontinence surgery and uterine polypectomy were the largest for the patient level, followed by doctor level for the medical charge, and the institution level for the LOS.

An analysis of Korean Medicine treatment pattern for the development of Korean-medicine health literacy assessment tool (한의약 건강정보이해력 평가도구 개발을 위한 한의 진료 패턴 분석)

  • Park, Jeong-Su
    • Journal of Society of Preventive Korean Medicine
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    • v.22 no.2
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    • pp.33-40
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    • 2018
  • Objectives : Health literacy can affect medical results. This study aimed to detect to the modify point of health literacy assessment tools. Methods : The general Korean Medicine service procedure was recorded and categorized. The participants were in- or out-patient of Korean Medical hospital. Written informed consents were obtained. Results : A total of 20 patients participated, with nine males and eleven females. The chief complaints were pain, growth, cerebral infarction sequela, dyspepsia, diarrhea, feeling of helplessness, mental stress, postpartum symptoms, and menstrual disorder. The Korean Medicine service were categorized into collecting patient information, relationship building, and treatment. Terms used in the service embraced general medical terms and Korean Medical terms. Conclusions : The Korean-medical health literacy assessment tool should incorporate western-eastern combined treatment and Korean medical terms.

Nutrition Intervention in a Gastric Cancer Patient With Gastrectomy for 12 Months: A Case Report

  • So Young Youn;Bo Eun Kim;Eun Mee Kim
    • Clinical Nutrition Research
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    • v.12 no.1
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    • pp.1-6
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    • 2023
  • Gastrectomy is the most effective method of treating gastric cancer, but it is commonly associated with weight loss, nutritional deficiencies, and the increased risk of malnutrition due to post-surgery complications, including gastric stasis, dumping syndrome, malabsorption, and maldigestion. Malnutrition is a risk factor for postoperative complications and poor prognosis. To prevent it and guarantee a quick recovery after surgery, continuous and individualized nutrition intervention should be performed both before surgery and postoperatively. The Department of Dietetics at Samsung Medical Center (SMC) performed nutritional status assessment before gastrectomy, initial nutritional assessment within 24 hours of admission, description of therapeutic diet after surgery, nutrition counselling before discharge, and nutritional status assessment and individual nutrition counselling after 1, 3, 6, and 12 months from surgery. This is a case report of a patient who underwent gastrectomy as well as intensive nutrition intervention in SMC.

A Study on the Job Activities of the Emergency Nurses (응급실 근무 간호사의 업무분석)

  • 김광주;이향련;김귀분
    • Journal of Korean Academy of Nursing
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    • v.25 no.4
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    • pp.709-728
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    • 1995
  • The job related activities of sixty nine nurses, working in the emergency rooms of three university hospitals, were analyzed for six days according to preestablished checklist of nursing activities ; the frequency of these activities and the amount of time spent in each specific nursing activity. The established checklist was monitored every five minutes for the duration of the duty autu, thus producing 414 items of data. The data were not gathered on consecutive days but over the period of one month from May 6, 1994 to June 5, 1994. The following conclusions are derived from analysis of the data : 1. Twelve categories of nursing activities were obtained : The primary activity was communication related to the patient and all information pertaining to the patient. Other activities included maintaining the patient's record, observation and assessment of the patient, cooperation with other medical personnel, management of equipment and drugs, procedure and treatment, specimen collection, consultation and education for the patient, including drug management and personal hygiene and any other relevant education to the patient's condition. 2. The average frequency of categorized nursing activity can be classified as follows : communication related to patient was the highest at 17.6 times. The next was maintaining the patient's record at 17.3 times. The observation and assessment occurred 16.9 times. Consultation and education for patients and family, 8 times, medication, 5.7 times, and procedures and treatments, 6 times. 3. The average time required for each activity was as follows : 230.1 minutes (or maintaining the patient's record, 204.9 minutes for communication related to the patient, 199.2 minutes for observation and assessment, 71.2 minutes for medication, 66 minutes for consultation and education of the patient and family, and 51.8 minutes for procedures and treatment. 4. The most demanding nursing activity in the emergency room for the nurse was answering questions from the patient's family, maintaining communication between the medical staff, maintaining and reviewing the patient's charts, writing prescriptions and monitoring 1. V. infusion rates. 5. The most time consuming nursing activities for the emergency room nurse include maintaining and following the patient's charts, communication between the medical staff, answering questions from the patient's family, observation of the patient and relaying all of the appropriate patient information to the incoming nurses during a shift change. 6. The F-test was administered to measure the required time for the categorized nursing activities according to day, evening, and night-shift nurses. There were significant differences (p<.05) in specimen collection, observation and assessment, cooperation between medical staffs, personal hygiene, communication related to patient, education and re-search. Posterior multiple comparison test showed that specimen collection, cooperation between medical staffs and personal hygiene were mostly done by the evening-shift nurses. Also most observations and assessments were done by the night-shift nurses. Education and communication to patients were done by day-shift nurses. Thus there were significant difference between shifts for the main nursing activities. So there should considev a reallocation of the duty of nurses on each shift. 7. The F-test also indicated that there wes a similarity in time duration for procedures and treatments and for cooperation between medical staff and nurses in all three hospitals. However, the remaining categories of nursing activities also showed a significant difference between the three hospitals. This indicated that there were differences in each emergency room that influence time for each categorized nursing activities and this should be given more consideration. Recommendations : 1. A seasonal difference should be considered in the activities of nurses in the emergency room and a comparative analysis should be carried out to deter-mine seasonal differentiation. 2. A study on more objectively measurable nursing activities should be administered as well as one determining the subjective responds towards nursing activities in the emergency room.

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Stress and Psychological Status between a Stroke and a Fracture Patient's Caregivers (뇌졸중환자와 골절환자 보호자의 스트레스 및 심리상태)

  • Jung, Jaehun
    • Journal of The Korean Society of Integrative Medicine
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    • v.7 no.4
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    • pp.213-222
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    • 2019
  • Purpose : The purpose of this study was to compare stress and psychological status between a stroke and a fracture patient's caregivers. Methods : Data was collected from September to December 2018 and participants of this study were 60 stroke and 61 fracture patient's caregivers. Stress was evaluated with the Global Assessment of Recent Stress scale-Korean Version and psychological status was measured with the Symptom check List-90-Revision. Results : The stroke patient's caregivers scored significantly higher than the fracture patient's caregivers in stress relevant to interpersonal, change in relationship, sickness or injury, financial, change/no change in routine (p<.05). The stroke patient's caregivers scored significantly higher in somatization, interpersonal sensitivity, depression, anxiety, paranoid ideation, and psychoticism than the fracture patient's caregivers (p<.05). Conclusion : It was found that the severity of mental health in the stroke patient's caregivers is necessary to develop a customized mental health improvement program for stroke patient's caregivers.

Arthroscopically Assisted Repair of Large to Massive Rotator Cuff Tears -The Role of Acromioplasty- (중범위 이상 회전근 개 파열 환자의 관절경적 봉합술 -견봉성형술의 역할-)

  • Lee, Kwang-Won;Kim, Kap-Jung;Lee, Hang-Ho;Kim, Byung-Sung;Kim, Ha-Yong;Choi, Won-Sik
    • Clinics in Shoulder and Elbow
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    • v.6 no.2
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    • pp.143-148
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    • 2003
  • Objectives: To analyze the postoperative functional outcome of shoulder in patients with arthroscopically assisted repair of large to massive rotator cuff tears with or without acromioplasty and role of acromioplasty. Materials and Methods: From June 1996 to June 2002, twenty six patients with large to massive rotator cuff tears were undergone arthroscopically assisted repair. Mean follow up was over one year. Fourteen were male and twelve were female. Mean age was 51 years old(39-66). Mean duration was 9 months. Acromioplasty was done in 14 cases concomitantly. They were divided into two groups. Group I: arthroscopic cuff repair with acromioplasty(14 cases). Group II: arthroscopic cuff repair without acromioplasty(12 cases). Each shoulder was evaluated at preoperative and final follow-up with Visual Analogue Scale(VAS), University of Pennsylvania Patient self-assessment of pain, University of Pennsylvania Patient self-assessment of function, ASES standardized shoulder assessment form, Simple Shoulder Test, UCLA score and range of motion(ROM). We analyzed the differences between the two groups. Shoulder ROM and acromioplasty were determining factors. Statistics was tested by correlation analysis and repeated measure ANOVA test. Results: At the final follow up, functional outcome and pain were improved but they had no statistical significance between the two groups(p>0.05). Combined procedure, acromioplasty, didn't affect on VAS. UCLA score, University of Pennsylvania Patient self-assessment of pain, University of Pennsylvania Patient self-assessment of function, ASf:S standardized shoulder assessment form and Simple Shoulder Test(p>0.05). In group II, forward flexion and abduction were statistically improved at the final follow up than in group I(p<0.05). Conclusions: It appears that arthroscopic repair is satisfactory procedure in patients with large to massive cuff tears. Combined procedure, acromioplasty, doesn't affect on postoperative functional outcome of shoulder.

Impact of public releasing of hospitals' performance on acute myocardial infarction outcomes (병원의 급성심근경색증 진료 결과 공개의 효과)

  • Eun, Sang Jun;Kim, Yoon;Lee, Eun Jung;Jang, Won Mo
    • Quality Improvement in Health Care
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    • v.17 no.1
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    • pp.69-78
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    • 2011
  • Objectives : The purpose of this study was to determine whether the published AMI report card could reduce in-patient mortality, 7-day after discharge mortality, and length of stay (LOS). Methods : Interrupted time-series intervention analysis was used to evaluate the impact of the report card for AMI care quality in November 2005 in terms of risk-adjusted in-patient mortality, risk-adjusted 7-day after discharge mortality, and DRGs case-mix LOS using the claim data of Health Insurance Review and Assessment Service. Results : Public disclosure of AMI care quality decreased risk-adjusted in-patient mortality and DRGs case-mix LOS by 0.00050% per month and 0.042 days per month respectively, however there was no effect on risk-adjusted 7-day after discharge mortality. Patterns of effect of public disclosure on AMI outcomes were a fluctuating pattern on risk-adjusted mortalities and a pulse impact for 1 month on DRGs case-mix LOS. Conclusions : We found the public disclosure of AMI care quality had decreasing effects on risk-adjusted in-patient mortality and DRGs case-mix LOS, but the size of the effect was marginal.

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Development of an Algorithm for Emergency Nursing Care of Dyspneic Patients (호흡곤란 환자 응급간호 관리를 위한 알고리즘 개발 연구)

  • Yang, Jin-Ju;Jang, Keum-Seong
    • Journal of Korean Academy of Nursing Administration
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    • v.15 no.4
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    • pp.491-505
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    • 2009
  • Purpose: This study was to develop an algorithm for emergency nursing care of dyspneic patients. Methods: This methodological study was done through reviews of medical records and literatures, checklists of emergency nursing care for dyspneic patients, interviews with nurses, and experts' validity. Results: Firstly, the initial assessment confirmed the identification of airway patency, accessory muscle usage, RR, $SpO_2$, v/s, skin color, and mental status. Immediate emergency care provided oxygen, checked ABG, EKG, and chest X-ray, established a semi-fowler position, maintained IV routes, administered medication orders, and conducted careful monitoring. Secondly, if the patient exhibited $SpO_2$ of less than 90%, the nurse considered the patient's condition to be aggravated. Thirdly, if the patient showed improvement of more than 90% $SpO_2$, the nurse administered secondary assessment and carried out specific nursing care. However, if the patient continuously showed $SpO_2$ of less than 80%, the nurse assisted the intubation and then executed ventilator therapy. Conclusions: This study suggests that the algorithm is an effective decision tool and utilizing the algorithm is expected to improve the emergency nursing care for dyspneic patients.

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