• Journal of Korean Academy of Nursing
• /
• v.24 no.3
• /
• pp.448-460
• /
• 1994

This study was conducted to investigate risk factors for senile dementia as well as care givers' stresses and thier needs for nursing care. It was done using a retrospective survey. A convenience sample or In senile dementia patients and l20 nor-mal elders in a rural area was used. The tools used in the study were the MMSE-K(Mini-Mental State Examination-Korea) for dementia screening test and a questionaire developed by the research team. Data were collected through home visits by Com-munity Health Practitioners. Data were analyzed using descriptive statistics, T-test, and Chi-square test. The findings are as follows : 1. There were significant differences in age, marital status, and religions between the two groups. 2. There was a significant difference in smoling behavior between the two groups. 3. There was a significant difference in past his-tory of cancer between groups. 4. There was a significant difference in past and present elderftmily relationship between the two groups. 5. There were significant differences in intellectual activities, assuming major role in family and seeking other's help in daily life troubles between the two groups. 6. There were significant differences in stress factors such as child problem, family conflict, health problem and illegal behavior between the two groups. 7. The major problems out by families in caring for dementia patient were catastrophic reactions, dirtiness, mood change, devouring and tremor. The most serious problems faced by families was dirtiness. with catastrophic reactions, sleep distrubance, changeableness, and a suspcio-usness following. The care givers expressed chronic fatigue, anxiety, tension, depression, disorder in daily life, shamefulness, blame from neighbours and guiltiness. 8. There is need for geriatric hospitals, nursing homes, burden sharing, and counselling or education for family care givers. A replicate study in the urban area is recommended to validate the findings of this study. To explore the impact of stress in life and ‘han’ on senile dementia, a qualitative study is recommended.

• The Journal of the Korea institute of electronic communication sciences
• /
• v.12 no.1
• /
• pp.229-236
• /
• 2017

The Nursing Care Integrated Service is an inpatient service provided in a ward equipped with all kinds of professional nursing services, nursing environment improvement, and patient safety management through team nursing staff placement through appropriate nursing staff placement. The subjects of the study were 92 patients who agreed to understand and participate in the research purpose as the inpatient ward of a general hospital in Gyeonggi Province, for the study method, frequency, percentage, mean, standard deviation, t-test, ANOVA were applied using SPSS/WIN 21.0 program and the post test was Scheffe test. In addition, the correlation between nursing satisfaction and service evaluation was analyzed by Pearson's correlation. This paper is meaningful in that it reaffirms the importance of satisfaction and presents basic data for improving the quality of service of nursing care integrated service ward inpatients.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.15 no.1
• /
• pp.31-39
• /
• 2017

Purpose: Despite the clinical and socio-economic impact of acute poisoned patients, many of the treatments are not standardized in Korea. Moreover, no formal training that is specifically focused on clinical toxicology exists. Rather, training and education are conducted case by case in various institutions. This study was conducted to develop a standardized simulation-based clinical toxicology training curriculum for healthcare providers. This program will focus on specific assessment and treatment of critical toxicology patients, specifically those who have been poisoned with organophosphate. Methods: The study was performed using a pre- and post-design to determine the effects of implementation of this program. The study was conducted at eight different urban teaching hospitals in a simulated room in the clinical area. The study was targeted to 19 groups composed of emergency residents and nurses. Simulation-based learning was conducted for each group. Results: All 19 groups achieved the minimum passing score of 75%. Implementation of the program led to improved performance rates for overall management and cooperative moods competency (p<0.01). Inter-rater agreement between the two evaluators was excellent. In general, the participants thought the program was realistic and were able to recognize and improve the competencies needed to care for organophosphate poisoned patients. Conclusion: Simulation-based learning is an effective educational strategy that can be applied to improving and understanding proper care for rare but critical patients. This program was effective at improving team performance and cooperative moods when managing an organophosphate poisoned patient in the Emergency Department.

• Asian Oncology Nursing
• /
• v.4 no.2
• /
• pp.110-123
• /
• 2004

The purpose of this study was to develop a clinical pathway for the allogeneic bone marrow transplantation donor. For this study, a conceptual framework was developed through a review of the literature including six steps which are using in Jones Hopkins Hospital. USA. The researcher reviewed 129 medical re-cords of donor who had bone marrow donation between January 2002 to January 2004, to identify the overall service contents required by these patients and to make a preliminary clinical pathway. A content validity test was done for the preliminary clinical pathway, a professional group screened 51 medical re-cords and adopted with 3 hospitalization days as the clinical pathway framework. In the fifth step, clinical pathway test was also done to 7 donors from April 28th to July, 2004. After these processes the final clinical pathway was developed. The results of this study are as follows: 1. The vertical axis of the clinical pathway Includes the following 9 items: vital signs, nursing assessment, activity, diet, intervention, medication, test, consultation and patient teaching. The duration of the horizontal axis was 3days from admission to discharge 2. Analysis of the 129 medical records indicated that the average length of stay was 3 4 days. The medical performance according to the vertical axis in the preliminary clinical pathway consisted of 51 items After clinical validity test, it steel consisted of 51 items in the final form. 3. Clinical Validity test was done to 7 bone marrow donors. During these process, The first patient was deleted because he was out of the criteria the investigate set and 6 patients were used, finally The result of this study indicated all of 7 donors were discharged on expected day. 4. Clinical pathway enables to improve the quality of care, multidisciplinary team work It also helps nursing bone marrow donor, effective education to donor or medical member. The results of this study suggest that clinical pathway may be able to improve the quality of nursing care for bone marrow transplantation donors.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.23 no.2
• /
• pp.83-89
• /
• 2023

Background: With advances in safety measures for anesthesia, conscious sedation has gained popularity in the field of dentistry and has become essential in dental practice worldwide. However, in Tanzania, intravenous (IV) sedation is rarely practiced in the dental field. Therefore, we report the establishment of sustainable IV conscious sedation in dental practices and subsequently train local OMS residents in Tanzania. Methods: In 2019, intravenous conscious sedation was initiated at the University Dental Clinic of the Muhimbili University of Health and Allied Science (MUHAS), Tanzania. During the preparatory phase of the program, local oral and maxillofacial surgeons (OMSs) were given a series of lecture notes that concentrated on different aspects of IV conscious sedation in dentistry. During the on-site training phase, an oral surgeon from the United States joined the OMSs for case selection, IV-conscious sedation procedures, and patient follow-up. Patients were recruited from existing patient records at the MUHAS Dental Clinic. Results: The first conscious IV sedation program in dentistry was successfully launched at the University Dental Clinic in Tanzania. The local team of OMSs was trained on the safe administration of sedative agents (midazolam or ketamine) to perform various minor surgical procedures in a dental office. Nine patients with different ages, body masses, and medical conditions benefited from the training. No complications were associated with IV conscious sedation in the dental office. Conclusion: This was the first successful "hands-on" training on IV conscious sedation provided to OMSs in Tanzania. It laid the foundation for the sustainable care of patients with special needs requiring oral health-related care in the country.

• 한국노년학
• /
• v.41 no.2
• /
• pp.197-215
• /
• 2021

This study aims to evaluate Person Centered Care practice and characteristics of care services in Korean long-term care facilities using Dementia Care Mapping as a tool. DCM, systematic observational evaluation tool for measuring dementia patients' QOL, was transformed into self-report rating scale. The process of transforming DCM into a scale of 34 items involves operationalization of DCM concepts and it's adaptation into Korean long-term care practices. Review by research team of Bradford university was added to maintain DCM concept and meaning in this scale. The scale with Cronbach alpha of .88 was surveyed on 343 care workers. Survey result shows PCC value practiced by them is 3.77(of 5 likert scale) and values on each categories of PCC reveal the characteristics of care in Korean facilities; attachment(4.02), comfort(3.95), inclusion(3.89), identity(3.67) and occupation(3.41). Dementia care in Korean facilities focuses on recipients'safety, comfort but lacks individualistic care and the meaningful and fulfilling occupation for patients. Looking at the organizational and individual factors influencing DCM values, the small facilities showed higher PCC values and there are no significant difference in PCC values between public and private facilities. Managers and care workers with career of 1~2 years showed higher PCC values compared to other career ranks and lengthes. This study suggests care practice should be centered on personhood of patients in long-term care facilities, for which introduction of unit care and education of PCC for service providers including support personnel are needed. DCM and Korean DCM scale developed in this study are suggested for the PCC-based assessment on care quality.

• Korean Journal of Radiology
• /
• v.23 no.7
• /
• pp.732-741
• /
• 2022

Objective: To determine the impact of dedicated subspecialized radiologists in multidisciplinary team (MDT) discussions on the management of lower gastrointestinal (GI) tract malignancies. Materials and Methods: We retrospectively analyzed the data of 244 patients (mean age ± standard deviation, 61.7 ± 11.9 years) referred to MDT discussions 249 times (i.e., 249 cases, as five patients were discussed twice for different issues) for lower GI tract malignancy including colorectal cancer, small bowel cancer, GI stromal tumor, and GI neuroendocrine tumor between April 2018 and June 2021 in a prospective database. Before the MDT discussions, dedicated GI radiologists reviewed all imaging studies again besides routine clinical reading. The referring clinician's initial diagnosis, initial treatment plan, change in radiologic interpretation compared with the initial radiology report, and the MDT's consensus recommendations for treatment were collected and compared. Factors associated with changes in treatment plans and the implementation of MDT decisions were analyzed. Results: Of the 249 cases, radiologic interpretation was changed in 73 cases (29.3%) after a review by dedicated GI radiologists, with 78.1% (57/73) resulting in changes in the treatment plan. The treatment plan was changed in 92 cases (36.9%), and the rate of change in the treatment plan was significantly higher in cases with changes in radiologic interpretation than in those without (78.1% [57/73] vs. 19.9% [35/176], p < 0.001). Follow-up records of patients showed that 91.2% (227/249) of MDT recommendations for treatment were implemented. Multiple logistic regression analysis revealed that the nonsurgical approach (vs. surgical approach) decided through MDT discussion was a significant factor for patients being managed differently than the MDT recommendations (odds ratio, 4.48; p = 0.017). Conclusion: MDT discussion involving additional review of radiology examinations by dedicated GI radiologists resulted in a change in the treatment plan in 36.9% of cases. Changes in treatment plans were significantly associated with changes in radiologic interpretation.

• Journal of Korean Academy of Nursing
• /
• v.3 no.1
• /
• pp.97-104
• /
• 1972

This study was designed to investigate differences in some aspects of value conceptions in fundamentals of nursing functions between nursing service personnel and nurse-educators. The purpose of the study was to identify the difference of value conceptions between the hospital nurses and school instructors, to contribute as a reference in strengthening the educational program in establishing nay hinder professional growth. The questionaries of this study were focused in the following aspects: 1) establishment of nursing service management system, 2) strengthening of the professionalization of nursing service, 3) hindrance in accomplishment of independent nursing functions, 4) communication skills in nurse-patient relationship, 5) activities directly related to nursing care planning, 6) communication skills in nurse-doctor relationship, 7) attitude towards taking responsibilities for patient- centered nursing approach, and 8) nursing educational approach towards preparation of professional competence in practicing independent nursing functions. 265 graduate nurses from 14 general hospitals and 88 nursing instructors from 18 schools, collegiate and diploma, were sampled. The main findings of the study were as follows; 1. Both groups responded highly in the lack of public recognition of nursing profession and hospital administrators support in establishment of nursing service management system. Further investigation is needed to define some relationship between the intrinsic and extrinsic factors which might give influence to the professional development. 2. while hospital nursing personnel responded on environmental pressure such as a heavy nursing load as the factor giving hindrance to independent nursing functions, the nurse educators responded highly on lack of nursing competence of individual nurses. An emphasis should be placed on the development of nursing interaction through professional education. If the professional model is not well established, nursing function will be limited to medical assistance. 3. 3. The patient-centered approach for nurse-patient communication had given positive respond for both group, tut lacks in team concept in problem solving process. There exist a social distance between nurses and other professional co-workers in the hospital hierarchy. 4. It was indicated that, as an intrinsic factor in the development of nursing service and nursing education, building up a philosophical basis is an utmost importance. This question is opened for further and extensive study to clarify whether existence of philosophical absence or philosophical stasis in nursing profession hinders the development.

• Journal of Korean Clinical Nursing Research
• /
• v.16 no.2
• /
• pp.127-140
• /
• 2010

Purpose: This study was performed to verify reliability and validity of Korean Patient Classification System for nurses(KPCS-1), to estimate nursing time conversion index, and to classify patients into groups according to KPCS-1 scores. Methods: KPCS-1 was revised from KPCS by a professional review team. Interrater reliability and construct validity of KPCS-1 were verified by data from 433 patients. Direct and indirect nursing time of 204 patients were measured by stopwatch observation and self reports for 24 hours. Nursing time conversion index was calculated. Results: KPCS-1 consisted of 12 area, 50 nursing activities, and 73 items. The interrater reliability was tested between two nurse group (r=.88, p<.001) and construct validity was verified according to medical department (F=10.97, p<.001) and patient pattern (F=5.54, p=.001). The correlation of nursing time and classification score was also statistically significant (r=.56, p<.001). The nursing time conversion index was 9.03 minutes per 1 classification score. The patients were classified into 4 groups by the classification scores. Conclusion: KPCS-1 can be a useful factor type patient classification system for general ward. Further study is needed to evaluate validity and reliability for refining KPCS-1 and to develop ways connecting the scores with nursing outcomes.

• Journal of Digital Convergence
• /
• v.19 no.4
• /
• pp.467-475
• /
• 2021

Purpose: When a patient with acute deterioration occurs in a ward, the decision to transfer to intensive care unit (ICU) is critical to improve the patient's outcomes. However, when available ICU resources limited, it is difficult to determine which of the deteriorating ward patients to transfer to the ICU. Therefore the purpose of this study was to identify risk factors in predicting deteriorating ward patients transferred to intensive care unit (ICU). Methods: We reviewed retrospectively clinical data of 2,945 deteriorating ward patients who referred medical emergency team. Data were analyzed with multivariate logistic regression. Results: The solid cancer that diagnosed at hospitalization (odds ratio[OR] 0.39; 95% confidence interval [CI] 0.32-0.47), when the cause of deterioration was respiratory problem (1.51; 95% CI 1.17-1.95), high MEWS (1.22; 1.17-1.28) and SpO2/FiO2 score (2.41; 2.23-2.60) were predictive of ICU transfer. Conclusion: These findings suggest that early prediction and treatment of patients with high risk of ICU transfer may improve the prognosis of patients.