• Therapeutic Science for Rehabilitation
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• v.9 no.1
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• pp.56-68
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• 2020

Objective : This study introduces domestic and overseas systematic assessment tools that can identify eating problems of dementia patients based on abnormal behavior observations and turns them into Korean through the verification of content placement by expert groups. Methods : Three types of assessment tools were selected for final development in Korean version through several meetings based on a wide range of relevant literature searches. The 3 selected assessment tools were first translated by the researchers, and a 9-person expert team was used to verify the Content Validity Index. Results : The EBS content equivalence calculation shows that all 6 questions and 1 response item had a CVI value 0.9, and all items were included in Korean EBS without modification. The EdFED content equivalence calculation showed that all 11 questions had CVI value 0.9, which was included in the Korean edition of EdFED without modification. The content equivalence calculation of the FDI showed that all 19 questions had a CVI of 0.8 or higher, and all items were included in the Korean version of the FDI without modification of the item. Conclusion : Korean versions of the EBS, EdFED and FDI, which are based on behavioral observation and diet tools for people with dementia, have been developed. Early determination of problems related to diet in dementia patients and providing proper intervention through observational Korean version assessment tools is vital in terms of strengthening patient nutrition and reducing caregivers' burden.

• Korean Journal of Adult Nursing
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• v.13 no.1
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• pp.123-135
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• 2001

The purpose of this study is to analyze the structural pattern of nurses' pain management with patients who experience pain. As a research method, the Q methodology, which is useful for an objective view of a highly abstract concept, was applied. The data collecting activity of this study was from August, 21st, 2000 to November, 24th 2000. The Q-population, the previous thesis and a literature review were done. Questions about pain management by the nurse on the patients, caregivers, nursing students, doctors, nurses, and others were asked in documentary work and in-depth interviews. In all, 223 units of the Q-population were formed, and the last 35 units of the Q-population were extracted. The data on the P-sample was collected from 41 nurses who worked in the medical and surgical units of a hospital that belonges to C university in Seoul. The research results were constituted in 3 types. Type I was the 'pattern of judging by objectivity'. The statement on which most of the people highly agreed for those patterns was shown by 'If patients said that they are suffering from pain, we sufficiently performed an assessment about the etiology, location, duration and degree'. For type I, the same pain was found in different locations according to the patients, so the etiology of the pain should be identified first place. Since ways of coping are different according to pain etiology, it was thought that it is important to assess sufficiently the pain etiology, location, duration, and degree. Therefore, when patients complain of pain, the pain etiology should be identified and assessed; according to the result, pain management should be performed systematically. Type II was the 'pattern of accepting by subjectivity'. The statement on which most of the people highly agreed for those patterns was shown as 'If patients said that they are suffering from pain, the medical treatment should be performed rapidly and speedily.' For type II, when the patient complains of pain, treatment should be performed quickly in order to prevent the condition getting worse, and it is thought that activity is a reasonable duty. Further, by trying to show empathy after pain is admitted and by understanding and coping rapidly with the pain of patients, an attitude which matched the altruistic morals of nurses is being shown. Type III was the 'pattern of worrying about', and the statement on which most of the people highly agreed for those patterns was shown is 'When there is a pain, to help patients to tolerate the pain to the highest degree.' In type III, the pain is a subjective expression, so there is a difference according to every individual. Therefore, actually if there is no measurement of pain, it could be exaggerated so nurses should help patients to tolerate it to the utmost. Even if there is a way to remove pain without an analgesic drug, nurses were reluctant to perform pain management as they possibly could. Through these research results, pain management of nurses was classified in 3 types, and structural characteristics in each type were discovered. Based upon the characteristics according to the type, an individualized pain management intervention strategy should be established and the follow up work performed.

• Journal of Preventive Medicine and Public Health
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• v.42 no.4
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• pp.251-260
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• 2009

Objectives : To estimate the annual socioeconomic costs of stroke in Korea in 2005 from a societal perspective. Methods : We identified those 20 years or older who had at least one national health insurance (NHI) claims record with a primary or a secondary diagnosis of stroke (ICD-10 codes: I60-I69, G45) in 2005. Direct medical costs of the stroke were measured from the NHI claims records. Direct non-medical costs were estimated as transportation costs incurred when visiting the hospitals. Indirect costs were defined as patients and caregivers productivity loss associated with office visits or hospitalization. Also, the costs of productivity loss due to premature death from stroke were calculated. Results : A total of 882,143 stroke patients were identified with prevalence for treatment of stroke at 2.44%. The total cost for the treatment of stroke in the nation was estimated to be 3,737 billion Korean won (KRW) which included direct costs at 1,130 billion KRW and indirect costs at 2,606 billion KRW. The per-capita cost of stroke was 3 million KRW for men and 2 million KRW for women. The total national spending for hemorrhagic and ischemic stroke was 1,323 billion KRW and 1,553 billion KRW, respectively, which together consisted of 77.0% of the total cost for stroke. Costs per patient for hemorrhagic and ischemic stroke were estimated at 6 million KRW and 2 million KRW, respectively. Conclusions : Stroke is a leading public health problem in Korea in terms of the economic burden. The indirect costs were identified as the largest component of the overall cost.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.11 no.2
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• pp.91-98
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• 2017

Background & Object: Basic daily activity screening tool such as the Modified Barthel Index (MBI) has been used commonly in rehabilitation clinic and community based rehabilitation setting. Previous studies have shown the significant relations between the level of daily activities and driving ability on stroke or elderly people. However, there is a lack of studies to investigate the usefulness of MBI on prediction of driving ability for stroke patient. This study was to predict driving abilities of stroke survivor using Korean version Modified Barthel Index (K-MBI). Methods: A sample of 48 patients with stroke in rehabilitation hospital was recruited. All participants were tested level of basic daily activities using K-MBI. The driving ability of participants was tested using virtual reality driving simulator. The predictive validity was calculated of the K-MBI among pass or fail group of driving simulator test using receiver operating characteristics curves. Results: The cut-off score of >86.5 on the K-MBI is proper sensitivity to predict on driving performance ability. Conclusion: This pilot result offers clinical reference to therapists and caregivers for reasoning on driving recommendation period during rehabilitation stage of stroke survivors. Further studies need to identify prediction using real on-road test in a large population group.

• Journal of the korean academy of Pediatric Dentistry
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• v.42 no.2
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• pp.158-163
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• 2015

General anesthesia (GA) for dental care in handicapped patients is necessary to facilitate the provision of safe, efficient, and effective quality treatment. The aims of this study were to determine the anesthetic characteristics of handicapped patients in need of dental treatment in these day care units, and to establish for plan to provide better services. 325 patients who had outpatient general anesthesia from January 2005 to March 2014 were assessed for this study. Patients' distribution and treatment patterns were examined. The proportion of male patients (202, 62.2%) was higher than female patients (123, 37.8%) and the largest group of patients were 5 to 10 years old (85, 26.2%). The reasons for general anesthesia included mental and physical disabilities (207, 63.7%), behavior management (84, 25.8%), parent needs (14, 4.3%), and so on. Restorative treatment was the most common procedure with the average of 4.2 teeth treated per one patient and 43 (13.2%) patients underwent general anesthesia for dental treatment more than once. To expand and improve access to the dental care of the disabled, improvement of the health care system, enhancement of their training for dental care by professionals, and enlarging caregivers'understanding of the importance of oral care in the early stages are required.

• The Journal of the Korea Contents Association
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• v.22 no.2
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• pp.794-802
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• 2022

This retrospective study was to investigate the characteristics of unplanned readmission and factors affecting readmission within 30 days of discharge in patients who underwent heart valve surgery through electronic medical records. The participants were 423 unplanned re-hospitalization within 30 days after heart valve surgery at a tertiary hospital in Seoul from January 2018 to August 2019. A total of 48 patients (11.3%) were unplanned readmissions, and the most common causes were atrial fibrillation in 13 cases (27.1%) and pain at the surgical site in 13 cases (27.1%). Other causes were: 10 cases (20.8%) of warfarin inappropriate treatment concentration, 7 cases of general weakness (14.6%), 5 cases of hypotension (10.4%), 4 cases of pericardial effusion (8.3%), 3 cases of surgical wound infection (6.3%), 3 cases of hemorrhage (6.3%), 3 cases of high fever (6.3%), and 1 case of cerebral infarction (2.1%). Variables influencing readmission were history of cancer (OR = 2.60, 95% CI 1.13-6.03, p = .025) and the patients who went to a home rather than a hospital after discharge (OR = 2.91, 95% CI 1.33-6.36, p = .008), as a type of valve surgery, mitral valve valvuloplasty had a higher readmission rate than aortic valve replacement (OR = 1.21, 95% CI 1.21-4.98, p = .012). In order to reduce unplanned readmissions, an tailored education program is needed to enable patients and caregivers to manage their comorbid chronic diseases before discharge and assess risk factors for readmission in advance.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.6
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• pp.5-18
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• 1999

This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.

• Clinical and Experimental Pediatrics
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• v.51 no.2
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• pp.188-203
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• 2008

Purpose : Asthma is one of the most common chronic childhood disease. Education of asthmatic children and their families about asthma and its management may improve disease control, reduce symptoms, and improve school performance. The aim of the study was to evaluate the effects of an intensive asthma education program in asthmatic children and their families on outcome measure of asthma management behavior scale, knowledge about asthma, self efficacy scale and quality of life. Methods : Fifteen asthmatic children and their families were invited the intensive asthma education program which including allergen avoidance, management of asthma, correct use of the inhalation devices and control of exercise-induced asthma (study group). Fifteen asthmatic children and their families those who did not participate this program were served as control group. Participants were asked to complete a written questionnaire before and 3-month after the program. Results : After completing the intensive education program, significant improvement of the childrens asthma management behavior scale (27.1 vs. 32.2, P=0.011), belief and knowledge about asthma (14.2 vs. 17.9, P<0.001), self efficacy (47.9 vs. 49.7, P=0.091) and quality of life (79.6 vs. 88.6, P<0.001) was noted in the study group by measuring questionnaires. There are increasing tendencies in parental asthma management behavior scale and knowledge about asthma. Conclusion : This intensive asthma education program is effective in improving asthma control, self efficacy and quality of life of asthmatic children. This should serve as a national model for family-based programs for asthmatic children and their families.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.10 no.12
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• pp.3870-3878
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• 2009

The purpose of this study was to investigate 119 rescue party's violence experiences and to analyze their responses of violence experiences based on the pre-hospital emergency medical field. Data were collected from the self-administered survey of 226 rescue party in Jeollabuk-do area in Korea from January 1 through March 2, 2009. The data were analyzed by descriptive statistics and logistic regression analysis using SPSS Win 12.0. The results were as follows: first, all of 119 rescue unit in the pre-hospital emergency medical field reported that they got violence experiences more than once a week, and 62% of rescue team were exposed to physical violence. Patient's factors that caused violence were drug abuse or alcohol(56.2%), on the other hand rescue party's factors were shortage of human resources. Second, 42% of the respondents replied that they did not have any educational experiences for prevention and coping methods about violence within 5 years. 77.4% of those surveyed indicated that they wanted to receive specific educations which can prevent and cope with violence. Third, the mean value of total violent response scores was 2.53, and emotional response score was 3.2, social response score was 2.22, and physical response score was 2.17. Fourth, violent response score related to general characteristics proposed that physical(t=-2.08, p=o.38), emotional(t=-7.13, p=.006), and total responses(t=-4.764, p=.000) were statistically significant. And emotional(t=4.257, p=.000) and total responses(t=8.1330, p=.000) related to age were also statistically significant. Finally, among current tenure qualification scores, social response(t=9.987, p=.012) and total score(t=8.130, p=.000) were statistically significant. Between fire departments, violent response score suggested that physical(t=9.987, p=.000), emotional(t=2.433, p=.012), social(t=6.738, p=.000), and total score(t=5.943, p=.000) were statistically significant.

• Tuberculosis and Respiratory Diseases
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• v.49 no.5
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• pp.624-632
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• 2000

Background : Home ventilation can decrease hospital-acquired infection, increase physical activity, improve nutritional status, enhance quality of life, and reduce medical costs. The number of patient using home ventilators has been increasing, particularly in Europe and United States. Although the number of patients with home ventilation has been increasing in Korea, the current status of these patients is not well known. This study was undertaken to obtain basic information upon these patients in addition to evaluating any problems related to patients' home care in our country. Methods : A register of 92 patients with home ventilators in Seoul and Kyunggi Province were obtained from commercial ventilator supply companies. The patients were contacted by phone and 29 of them accepted our visit. Information concerning education about home care before discharge, equipment cost, and problems related to home care were documented. The mode and preset variables of the home ventilator were checked; tidal volume (TV), peak airway pressure, and oxygen saturation were measured. Results : There were 26 males (90%) and their mean age was 48.0 (${\pm}20.1$) years. The underlying diseases were : 21 neuromuscular disorders, 2 spinal cord injuries, 6 chronic lung diseases. Among the caregivers, spouses (n=14) predominated. Education for home care before discharge was performed primarily by intensive care unit nurses and the education for ventilator management by commercial companies. Twenty-five of the 29 patients had tracheostomies. Volume targeted type (VTT ; n=20, 69%) was more frequently used than the pressure targeted type (PTT). Twenty-three of the 29 patients purchased a ventilator privately, which cost 7,450,000 (${\pm}$3,290,000) won for a PTT, and 14,280.000 (${\pm}$3,130,000) won for a VTT. Total cost for the equipment was 11,430,000 (${\pm}$634,000) won. The average cost required for home care per month was 1,120,000 (${\pm}$1,360, 000) won. Conclusion : The commonest underlying disease of the patients was neuromuscular disease. The VTT ventilator was primarily used with tracheostomy. Patients and their families considered the financial difficulties associated with purchasing and maintaining equipment for home care an urgent problem. Some patients were aided by a visiting nurse, however most patients were neglected and left without professional medical supervision.