• Journal of Oral Medicine and Pain
• /
• v.35 no.4
• /
• pp.265-273
• /
• 2010

Understanding patients' expectation for health visits and providing appropriate care may increase patients' satisfaction with health care, leading to more positive treatment outcome. The study aimed to investigate expectations of the patients with temporomandibular disorders (TMD) at their first visit to university-based orofacial pain clinic and to evaluate any relation with duration of pain, presence of previous treatment, pain severity and pain interference. Inclusion criterion was patients aged over and 18 years old and diagnosed as TMD during 3 months' period from Aug to Nov 2010. They were asked to complete the questionnaires for patients' expectation and the Brief Pain Inventory (BPI) at waiting room prior to consultation. 322 TMD patients participated in the study(M:F=1:1.5, mean age=36 years old). The study indicated that the most important top 3 expectations were 'cure of pain', 'understanding their problem' and 'doctor-patient communication' in order. This finding was not affected by gender, duration and previous treatment history but affected by sub-category of TMD and BPI pain severity and pain interference. 'Pain relief' and 'understanding their problems' were relatively highlighted in the patients with muscle disorders and combination (joint-muscle) disorders of TMD than those with joint disorders who wanted communication and further investigation relatively more (p=0.000). While expectation for pain relief was expected more with increase of pain severity and interference, patients with mild level of pain severity and interference expected communication and further investigation relatively more (p=0.000, 0.017, respectively). Based on the results of the study, though pain relief was the primary concern for TMD patients suffering from pain, their satisfaction with care may be increased by explanation for etiology and mechanism of TMD to make them understand their problems better and doctor-patient communication and collaborative decision-making for treatment. Importance of patient-centered consultations and availability of written material or web sites for patient information should be stressed out.

• Journal of Korean Academy of Nursing
• /
• v.20 no.2
• /
• pp.227-248
• /
• 1990

The study was conceived in relation to a concern over the growing gap between the needs of chronic patients and the availability of care from the current health care system in Korea. Patients with agonizing chronic pain, discomfort, despair and disability are left with helplessly unprepared families with little help from the acute care oriented health care system after discharge from hospital. There is a great need for the development of an alternative means of quality care that is economically feasible and culturally adaptible to our society. Thus, the study was designed to demonstrate the effectiveness of home heath care as an alternative to bridge the existing gap between the patients' needs and the current practice of health care. The study specifically purports to test the effects of home care on health expenditure, readmission, job retention, compliance to health care regime, general conditions, complications, and self-care knowledge and practices. The study was guided by the operations research method advocated by the Primary Health Care Operations Research Institute(PRICOR) which constitutes 3 stages of research : namely, problem analysis solution development, and solution validation. The first step in the operations research was field preparation to develop the necessary consensus and cooperation. This was done through the formation of a consulting body at the hospital and a steering committee among the researchers. For the stage of problem analysis, the Annual Report of Seoul National University Hospital and the patients records for last 5 years were reviewed and selective patient interviews were conducted to find out the magnitude of chronic health problems and areas of unmect health care needs to finally decide on the kinds of health problems to study. On the basis of problem analysis, the solution development stage was devoted to home care program development asa solution alternative. Assessment tools, teaching guidelines and care protocols were developed and tested for their validity. The final stage was the stage of experimentation and evaluation. Patients with liver diseases, hemiplegic and diabetic conditions were selected as study samples. Discharge evaluation, follow up home care, measurement and evaluation were carried out according to the protocols of care and measurement plan for each patient for the period of 6 months after discharge. The study was carried out for the period from Jan. 1987 to Dec. 1989. The following are the results of the study presented according to the hypotheses set forth for the study ; 1. Total expenditures for the period of study were not reduced for the experimental group, however, since the cost per hospital visit is about 4 times as great as the cost per home visit, the effect of cost saving by home care will become a reality as home care replaces part of the hospital visits. 2. The effect on the rate of readmission and job retention was found to be statistically nonsignificant though the number of readmission was less among the experimental group receiving home care. 3. The effect on compliance to the health care regime was found to be statistically significant at the 5% level for hepatopathic and diabetic patients. 4. Education on diet, rest and excise, and medication through home care had an effect on improved liver function test scores, prevention of complications and self - care knowledge in hepatopathic patients at a statistically significant level. 5. In hemiplegic patient, home care had an effect on increased grasping power at a significant level. However. there was no significant difference between the experimental and control groups in the level of compliane, prevention of complications or in self-care practices. 6. In diabetic patients, there was no difference between the experimental and control groups in scores of laboratory tests, appearance of complications, and self-care knowledge or self -care practices. The above findings indicate that a home care program instituted for such short term as 6 months period could not totally demonstrate its effectiveness at a statistically significant level by quantitative analysis however, what was shown in part in this analysis, and in the continuous consultation sought by those who had been in the experimental group, is that home health care has a great potential in retarding or preventing pathological progress, facilitating rehabilitative and productive life, and improving quality of life by adding comfort, confidence and strength to patients and their families. For the further studies of this kind with chronic patients it is recommended that a sample of newly diagnosed patients be followed up for a longer period of time with more frequent observations to demonstrate a more dear- cut picture of the effectiveness of home care.

• Journal of Hospice and Palliative Care
• /
• v.2 no.1
• /
• pp.36-45
• /
• 1999

Purpose : Cancer, one of the major causes of death in Korea, tends to become chronic due to the rapid development of diagnostic and therapeutic methods. As a result, the number of home-based cancer patients is in the increasing trend. However, on account of the insufficiency of continuous and comprehensive cancer patient management system, a number of cancer patients are left in a defenseless state. This study was designed for need assessment of home-based cancer patient to establish the community-based health care system for the comprehensive and continuous health care service to improve the quality of life of cancer patients and reduce rare burdens of their families. Methods : Through making a survey for needs assessment toward the health care service, the 455 respondents among home-based cancer patients answered the given enquetes to analyze the management status and problems of home-based cancer patients Results : 1) Unsatisfaction rates of pain control is 25.5 percent for mild cases, 46.5 percent for severe cases. 2) According to the needs assessment of home-based cancer patients, most of the respondents want to receive economical support, alleviation for the pain and symptoms, and the information of health care and consultation. So these needs account for the main contents of the home-based cancer patient management plan. 3) In the aspect of the satisfaction rate for basic care need, most items account for $20{\sim}30%$ of satisfaction. And the proportion of need for special case is under 5%, satisfaction rate for special care need is about 50% of satisfaction. So the home-based cancer patients are not being cared sufficiently. Conclusion : According to the result of need assessment, many home-based cancer patients received inadequate pain and symptom management. And Satisfaction rate for basic and special care need is low. So development of comprehensive and continuous health care service to improve the quality of life of cancer patients and reduce care burdens of their families is very necessary.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.13 no.1
• /
• pp.93-97
• /
• 2009

Purpose: Recognize circulation work system and fixing work system's merits and demerits that is enforced in operation of PET/CT center in sudden increase recently. Wish to estimate connectivity degree of individual exposure dose and PET/CT working that is managed periodically through this and look for operation efficiency of PET/CT center. Materials and Methods: (1) Find interrelationship of length of service to be individual exposure dose and PET/CT through TLD interpretation. Specially, evaluate on the basis of data of 2.5 years until 2 quarters 2006~2008 year that show patient increase rapidly the latest. (2) Recognize what countermeasure is evaluating problems happened at circulation work system and fixing work system. Results: Patient examination's number was 14,674 items until 2 quarters 2006~2008 year, and the $^{18}F$-FDG average injection amount was 461.5 MBq. 2 people of 10 radiotechnologist did fixing work PET area and GAMMA area each, and 8 people did circulation work of 3 times for 2.5 years. Average exposure dose that PET area and Gamma area's circulation men in service receive was 1.32 mSv, and PET area men in services came out average 0.825 mSv high than Gamma area men in services. Nurse's exposure dose is 0.28 mSv, and next 2 reason is conjectured. One is contact with patient that medicate $^{18}F$-FDG injection, and another is consultation about patient's next time schedule after examination end. Although exposure dose's amount is not much, is expected to consider continuation work possibility by exposure dose in case is a nurse with pregnancy possibility. Also, $^{131}I$-isotope therapy area's radiotechnologist that use capsule appeared by 0.12 mSv and a nuclear medicine doctor appeared by exposure dose that is less of 0.11 mSv. Conclusions: In case do PET/CT center circulation work after a long time, connoted danger that most men in service is consecutiveness deficiency of business and individual exposure dose increase at early 1 month. Specially, way for individual exposure dose's decrease should be considered. Also, need to evaluate abhorrent work form for efficient work system introduction, and enforce circulation and fixing work suggestion suitable shift working. Finally, must make normalized business guide and so on to prevent circulation work people's business efficiency decline.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.14 no.2
• /
• pp.33-37
• /
• 2010

Purpose: In the early stage of using PET/CT, it was used to damper revision but recently shows that CT with MDCT is commonly used and works well for an anatomical diagnosis. This hospital makes the accuracy and convenience more higher in the diagnosis and evaluate of coronary heart disease through concurrently running myocardial perfusion SPECT examination, myocardial PET examination with FDG, and CT coronary artery CT angiography(coronary CTA) used PET/CT with 64-slice. This report shows protocol and image based on results from about 400 coronary heart disease examinations since having 64 channels PET/CT in July 2007. Materials and Methods: An Equipment for this examination is 64-slice CT and Discovery VCT (DVCT) that is consisted of PET with BGO ($Bi_4Ge_3O_{12}$) scintillation crystal by GE health care. First myocardial perfusion SPECT with pharmacologic stress test to reduce waiting time of a patient and get a quick diagnosis and evaluation, and right after it, myocardial FDG PET examination and coronary CTA run without a break. One-stop evaluation protocol of ischemic heart disease is as follows. 1)Myocardial perfusion SPECT with pharmacologic stress: A patient is injected with $^{99m}Tc$-MIBI 10 mCi and does not have any fatty food for myocardial PET examination and drink natural water with ursodeoxcholic acid 100 mg and we get SPECT image in an hour. 2)Myocardial FDG PET: To reduce blood fatty content and to increase uptake of FDG, we used creative oral glucose load using insulin and Acipimox to according to blood acid content. A patient is injected with $^{18}F$-FDG 5 mCi for reduction of his radiation exposure and we get a gated image an hour later and get delay image when we need. 3) Coronary CTA: The most important point is to control heart rate and to get cooperation of patient's breath. In order to reduce a heart rate of him or her below 65 beats, let him or her take beta blocker 50 mg ~ 200 mg after a consultation with a doctor about it and have breath-practices then have the examination. Right before the examination, we spray isosorbide dinitrate 3 to 5 times to lower tension of bessel wall and to extension a blood wall of a patient. It makes to get better the shape of an anatomy. At filming, a patient is injected CT contrast with high pressure and have enough practices before the examination in order to have no problem. For reduction of his radiation exposure, we have to do ECG-triggered X-ray tube modulation exposure. Results: We evaluate coronary artery stenosis through coronary CTA and study correlation (culprit vessel check) of a decline between stenosis and perfusion from the myocardial perfusion SPECT with pharmacologic stress, coronary CTA, and can check viability of infarction or hibernating myocardium by FDG PET. Conclusion: The examination makes us to set up a direction of remedy (drug treatment, PCI, CABG) because we can estimate of effect from remedy, lesion site and severity. In addition, we have an advantage that it takes just 3 hours and one-stop in that all of process of examinations run in succession and at the same time. Therefore it shows that the method is useful in one stop evaluation of ischemic heart disease.

• Research in Community and Public Health Nursing
• /
• v.13 no.1
• /
• pp.182-196
• /
• 2002

The purpose of this study was to provide the basic resources for developing a parish nursing program. We did this by investigating what demands were made on the parish nursing service by the parishes or churches under review. The subjects of this study were 96 pastors located throughout the City of Busan. NP (New paragraph) $\gg$ We conducted our research by utilizing a modified version of the study created by Hwang (2000) and by using the help of prior research and professionals gathered from the parish nurse questionnaire by Djupe (1990). The data in this study were collected from July 1 to Oct. 31, 2001, using the questionnaire method. The Data were analyzed by: (a) frequency: (b) percentage: (c) mean: (d) standard deviation, and x^2-test$ with SPSS/PC program. The study has found the follows: 1. For subjects making demands on the parish nursing service, 95.8% were in need of using the services of parish nurses. On the demands of parish nursing service for the subjects, 95.8% the necessity of parish nursing services. And they answered by their intention of asking for parish nursing service practice. 2. Of the subjects under review, 71.9% were part-time workers and 28.1% were full-time employees 71.9% of part time and 28.1% of full times duty. In terms of the method of pay for work, 41.8% were pay free or freelance while 51.2% were on salary. And engagement intention of parish nurse as preacher was 88.5%. 3. The demand for nursing services in various categories were as follows. (a) hospice care: (4.02 1.11), (b) health screening: (3.98 1.09), (c) home visiting: (3.97 1.16), (d) group health education: (3.81 1.12), (e) organization of volunteer groups: (3.75 1.12), (f) individual health education: (3.75 1.14), (g) advice on choosing hospital or hospital consultation: (3.69 1.21) and (h) individual counseling: (3.51 1.31). 4. In terms of the specific services rendered by parish nurses. our study found that services were needed for the following: physical symptom management; preparation before death in spiritual preparation for death, blood pressure check in health examination, home visiting where the patient makes phone call, management of chronic disease in group health education, disease management in individual health education, advice on choosing hospital, or hospital consultation: and physical problems in individual counseling. 5. With respect to whether there was a correlation between what church a pastor came from and the types of demands made, there was NO significant difference found. 6. In relation to the characteristics of the subjects and their church and the hope demands (duty pattern and method of payment and engagement intention of parish nurse as preacher) for parish nurses, these had non significant differences. In conclusion, the perception of parish nursing service is very high. Moreover, we found that there is a great demand for well ordered parish nursing services to promote the health of each congregation. Before doing so, it would be better to make things known and to consider the relevant characteristics shown in the researched results.

• Proceedings of the KOR-BRONCHOESO Conference
• /
• 1983.05a
• /
• pp.6.4-7
• /
• 1983

Hoarseness is the most common and early symptom in laryngeal diseases. A clinico - statistical analysis was performed on 228 cases with chief complaint of hoarseness at the department of otolaryngology, Jeonbug National University during the past 3 years from January 1980 to December 1980. 1) The number of the patient with hoarseness were 228 cases (2.3 %) among total outpatient of 10110 cases. 2) Among the 228 cases with hoarseness, male were 115 cases and female were 113 cases, so sex ratio was nearly same. 3) The underlying diseases causing hoarseness in order of frequency were acute laryngitis 43 cases (18.9 %), chronic laryngitis 36 cases (15.8 %), vocal nodule 30 cases(13.2 %), vocal polyp 30 cases (13.2 %), vocal cord paralysis 26 cases (11.4 %), laryngeal carcinoma 18 cases (7.9 %) and laryngeal tuberculosis 15 cases (6.6 %). There were other diseases of larynx in 30 cases (13.2 %). 4) The incidence of age distribution in order of frequency were 4th decade (26.8 % ), 3rd decade (18.9%), 5th decade (17.1 %), 2nd decade (15.8 %) and 6th decade (9.6 %). 5) The duration from onset to consultation in order of frequency were 11 days-1 month (22.8 %), 1 month-3 months(19.7%), 3 months -6 months (18.9 %), within 10 days (13.6 %), 6 months-l year (13.2 % ), 1 year -3 years(7. 9 %) and 3 years over. 6) The duration from onset to consultation for underlying diseases were as follows ; acute laryngitis was within 10 days, chronic laryngitis was 3 months - 6 months, vocal nodule was 1 month-3 months, vocal polyp was 3 months -1 year, vocal cord paralysis was 11 days -1 month. 7) Associated symptoms with hoarseness in order of frequency were sore throat (25 %), sputum (8.8 %), swallowing difficulty (7.9 %) and dyspnea (6.1 %). But 84 cases (36.8 %), there were no other symptoms except hoarseness.

• Korean Journal of Oriental Medicine
• /
• v.18 no.2
• /
• pp.65-89
• /
• 2012

Objective : In order to investigate and improve public Korean medical health service satisfaction level, this study was designed. Method : A questionnaire has been conducted on 212 patients who received treatments at six public health centers in the northern part of Gyeongbuk during 15 days between Sep. 24 and Oct. 8, 2011. Result : 1. An Investigation on the usage of herbal clinics in public health centers reveals that 63.7% have received three times or more medical treatments previously and 61.8% have had their illness treated at other medical institutions. In regard to illness 32.1% have had arthritis or muscle aches. 50.9% have taken insurance medication after having had treatments at the public health centers. 66% have assessed acupuncture and moxa cautery the most satisfying. 2. To a question regarding whether herbal health treatment costs higher than that of physician's, the highest response at 31.6% is 'No'. And to a question regarding whether herbal medicines administered at public health centers have more side effects than that of physician's, the highest response at 39.6% is 'No'. 3. To a question regarding whether herbal treatment of public health centers has little effect against acute disease, 48.1% of responses are 'Fair'. To a question regarding whether herbal treatments, when compared with physician's treatments, boost better recovery of patients, 48.1% of responses are 'Fair'. To a question regarding whether herbal medicine is unscientific, when compared with that of western medicine, 38.2% of responses are 'Fair', To a question regarding whether herbal medicine has faster effect on disease than western medicine, 41.0% of responses are 'Fair'. To a question regarding whether herbal medicine is more effective on disease prevention and promotion of health than disease treatment, 38.2% of responses are 'Fair'. And to a question regarding whether the lack of various types of physical therapy devices in herbal medicine, when compared with western medicine causes inconvenience in herbal treatment, 42.0% of responses are 'Fair'. Those responses take up highest portion at each questionnaire. 4. A comparative study between herbal treatments and physician's treatments has also been conducted. To questions regarding which one of the two considering types of disease is the better, responses are the latter accounted for 43.9% against 'Cancer', the latter accounted for 45.3% against 'Endocrine disorders', the former accounted for 30.7% against 'Psychiatric disorders', the latter accounted for 38.2% gainst 'Otolaryngological(ENT) disease', the former accounted for 47.6% against 'Post traumatic stress disorder', and the former accounted for 52.4% against 'Muscle-skeletal disease'. 5. An investigation on frequency of patients' visits via (p<0.05) of subjects show a statistically significant difference. 6. First, an investigation on frequency of reasons of medical treatments reveal that age, occupation, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of subjects taking insurance medicines after herbal health treatments reveal that monthly income (p<0.05) of subject shows a statistically significant difference. 7. First, an investigation on frequency of a claim that herbal treatments of public health center does not have great effect on acute disease reveals that age, education, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of analysis that herbal treatments has faster effect on disease compared with western treatments reveals that education level, religion, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. 8. When herbal clinics of public health centers and general herbal medicine institutions are compared, a survey on additional treatments that herbal clinics need the most reveals that education level, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of subjects who want various forms of herbal medicines reveals that occupation and insurance type (p<0.05) of subjects show a statistically significant difference. Conclusion : In order to improve efficiency of treatments and enhance patient's satisfaction level, this study suggests measures such as providing a differentiated acupuncture treatments as a whole, streamlining an reception procedure, adopting more elaborated computer system for a patient to get proper medical attention, standardizing a treatment duration in order for a maximum result, keeping regular office hours, and optimizing a consultation time for a patient.

• Journal of Hospice and Palliative Care
• /
• v.13 no.4
• /
• pp.216-224
• /
• 2010

Purpose: The purpose of this study was to evaluate a community-based cancer patient management program (CBPCMP) which was collaborated between a hospice center and public health centers. Methods: The CBPCMP proceeded on four steps; 1) Signing agreements with three public health centers, 2) Enrolling the domiciliary terminal cancer patients, 3) Providing home hospice service, and 4) Inquiring patient's level of satisfaction. From February 1 to December 31 in 2009, 43 terminal cancer patients were referred and provided with home hospice service. The hospice team made a total of 605 visits. Medical records for each visit and data from satisfaction surveys were analyzed. Results: 76.7% of patients were older than 60 years, and 90.7% of the patients were alert. The level of functional status for 76.7% of patients rated as lower than ECOG grade 1. 62.8% of the patients or their caregivers signed hospice service agreements. On the initial evaluation, the most frequent reasons for referral were general weakness (86.0%), followed by anorexia (72.1%). Nurses visited the patients' most frequently (371 visits), followed by volunteers (216 visits). Nurses provided emotional support and health promotion counseling on 95.1% and 22.9% of visits, respectively. The mean satisfaction score rated by patients and their family was 4.45 out of 5. Conclusion: This study tested CBPCMP in collaboration with hospice centers and public health centers. CBPCMP showed a possibility to improve the quality of end of life care. To insure the quality care, however, the guidelines for home hospice service should be developed.

• Journal of dental hygiene science
• /
• v.9 no.3
• /
• pp.345-351
• /
• 2009

The aim of this study is understanding the relationship between degree of knowledge and actual condition on oral health care to raise people's attention on oral health care and to develop a oral health care program and respondents are 121 diabetes patients. The conclusion of this study is as follows; 1. In terms of degree of Knowledge, women have better knowledge on dental healthcare than men. People aged between 20 and 50 have relatively good knowledge and the longer patients fight against diabetes the more they know about oral healthcare. 2. In actual oral healthcare condition, only 21.5% of patients use rolling method. Patients who have good knowledge have relatively high frequency of dental treatment. Most patients see dentists for their oral healthcare consultation. 3. All the respondent group hesitate to have dental treatment because of expensive cost. Surprisingly. most patients with good knowledge answers that diabetes has nothing to do with dental disease. 4. In terms of degree of knowledge and having oral healthcare program, diabetes patients who are having programs has better knowledge. 5. Respondent group which has middle level of knowledge in oral healthcare give high marks on oral healthcare but does not show statistical significance.