• Maxillofacial Plastic and Reconstructive Surgery
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• v.42
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• pp.15.1-15.8
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• 2020

Background: Reconstructing maxillofacial defects is quite challenging for most surgeons due to the region's complex anatomy and cosmetic and functional effects on patients. The use of pre-made alloplastic implants and autogenous grafts is often associated with resorption, infection, and displacement. Recent technological advances have led to the use of custom computer-designed patient-specific implants (PSIs) in reconstructive surgery. This study describes our experience with PSI, details the complications we faced, how to overcome them, and finally, evaluates patient satisfaction. Case presentation: Six patients underwent reconstruction of various maxillofacial defects arising due to different etiologies using PSI. A combined total of 10 implants was used. PEEK was used to fabricate 8, while titanium was used to fabricate 2. No complications were seen in any patient both immediately post-op and in subsequent follow-ups. All patients reported a high level of satisfaction with the final result both functionally and cosmetically. Conclusion: The use of computer-designed PSI enables a more accurate reconstruction of maxillofacial defects, eliminating the usual complications seen in preformed implants and resulting in higher patient satisfaction. Its main drawback is its high cost.

• Journal of Korean Clinical Health Science
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• v.5 no.4
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• pp.1009-1014
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• 2017

Purpose. This study compared the awareness of the evidence-based practice(EBP) in 100 physical and occupational therapists. Methods. A questionnaire on awareness was conducted to examine the attitude toward EBP, the educational experience of EBP, and the performance ability of EBP. A questionnaire consisted of items on the general characteristics, the attitude toward EBP, the educational experience of EBP, and the performance ability of EBP of the subjects. Data analysis was made by IBM SPSS Statistics Ver. 20. The EBP awareness was examined by the independent t-test. Results. For the attitude toward EBP, there was a statistically significant difference in the item of 'Therapists should judge whether they apply study results to individual patient. For the educational experience of EBP, there was no statistically significant difference in all items. For the performance ability of EBP, there was a statistically significant difference in the item about the ability to understand patient's desire for treatment and treatment preference and the item about the ability to determine appropriate treatment process in cooperation with patients. Conclusions. Both two groups showed very low results in the attitude toward EBP, the educational experience of EBP, and the performance ability of EBP. Therefore, it is necessary to enhance EBP education in undergraduate programs and the clinical field.

• Health Policy and Management
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• v.23 no.3
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• pp.289-300
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• 2013

Background: Patients' trust in their physicians or hospitals is important to guarantee the effectiveness of care and to encourage revisits. This study aimed to identify the relationship between the experience of requesting verification of healthcare benefit coverage via the Health Insurance Review Agency (HIRA) and patients' trust in their physicians or hospitals. Methods: For this population-based study, 800 adult respondents aged 20 to 65 years were recruited using random sampling and telephone surveys. Respondents were divided into two groups: 1) 400 people had experience in requesting the HIRA verification service for the purpose of confirmation of whether the costs they paid were appropriate among metropolitan habitants, and 2) 400 people comprised members of the public who had no experience requesting the verification service. Results: Experience with requesting verification services was likely to lower the patients' trust in medical institutions, but not in their physicians (p<0.05). In addition, patients who were satisfied with their physicians and hospitals were more likely to trust the physicians and hospitals than dissatisfied patients. Conclusion: Patients' trust might be an important factor influencing hospital success. Patients' trust in medical suppliers, such as physicians and hospitals, encourages a positive relationship between medical suppliers and patients. Therefore, medical suppliers must provide appropriate care to patients to improve patients' trust in them.

• Journal of Korean Academy of Nursing Administration
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• v.7 no.1
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• pp.53-64
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• 2001

The study was done to evaluate patient satisfaction with nursing care. The study subjects were patients admitted in a general hospital in Gangwon province. The instrument used in the study was developed by Lamonica. The reliability alpha of this tool 0.8596. The survey method was applied to collect data period of data collection was total 21days from September 4rd to September 24th in 2000. The data was analysed by statistical method of %, mean, ANOVA, Pearson's Correlation Coefficients though SPSS program. The follows are the summaries of results of the study. 1. The highest scores of satisfaction was shown in the area of technical professional nursing and the lowest scores was shown in area of nursing education. 2. The crossed analysis of patient general characteristics and satisfaction of nursing care showed a significance by marriaged status(p<0.05) but no significance by factors of sex, ages, education, religency. 3. Job satisfaction of nurses showed 2.79 in average on the basic of 5 marks. 4. The significant Correlation were found between job satisfaction degree and bed rotation rates , number of patients by one nurse, experience of nurse(p<0.05). 5. The significant Correlation were found between nursing satisfaction degree and ages, job satisfaction, bed rotation rates, number of patients by one nurse(p<0.05), experience of nurse(p<0.01). On basis of the above findings the following recommendations are made : to suggest to improve environment of nursing unit. And to suggest to improve job satisfaction for improvement of nursing satisfaction in practice.

• Journal of Chest Surgery
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• v.24 no.2
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• pp.190-196
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• 1991

Clinical experience of 48 acute pericarditis with effusion was reviewed and presented. There were 28 male and 20 female patients ranging from 3 years to 77 years old. Malignant effusion; Twenty patients had underlying malignancy. These etiologies were lung ca[8 patients, 40%], breast ca[7 patients 35%], lymphoma[2 patients, 10%], esophageal ca[1 patients, 5%], stomach ca[1 patient, 5%], ovarian ca[1 patient, 5%]. Uremic effusion; 15 patients with renal failure required surgical intervention. Traumatic effusion; 7 patients had traumatic pericarditis. These etiologies were stab wound [5 patients, 71.4%] and aspiration[2 patients, 28.6%]. Pyogenic effusion: 6 patients had pyogenic pericarditis. These etiologies were empyema thoracis[3 patients, 50%], liver abscess[2 patients, 33.3%], pneumonia[1 patient, 16.7%]. The patients were treated by pericardiocentesis, subxiphoid tube drainage, pericardiectomy: 4 of them underwent pericardiocentesis; 37, subxiphoid tube drainage; 5, pericardiectomy. We conclude that subxiphoid tube pericardial drainage was effective for treatment of pericardial effusion.

• Proceedings of the KAIS Fall Conference
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• 2009.12a
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• pp.934-936
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• 2009

This study was to identify the correlation between the degree of burden, stress and social support of family caregivers in ICU patient. The subjects were 146 family care givers observed at a general hospital at D city. The level of stress that family caregivers experience the average points of 2.18, which is considered less than average. The level of burden that average point of 2.51. Points for level of subjective feeling ranged from 1.74 to 3.90. The average point of 3.03 is higher than that for objectively recognized feeling. The points for social support that average point of 3.03 for social support proves that families feel positive about the social support they are receiving. The level of stress which shows that the lower the income, the higher the stress. The effect on stress shows significance in subjective feelings of burden, social support, and employment, indicating that they have correlations with stress. Both the feeling of burden and social support have an impact upon the stress that patient families experience.

• Journal of Chest Surgery
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• v.20 no.2
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• pp.404-410
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• 1987

An 18-day-old male neonate with hypoplastic left heart syndrome underwent surgical intervention by modification of the Norwood procedure on September 23, 1986. Hypoplastic left heart syndrome is a serious congenital cardiac anomaly that has a fatal outlook if left untreated. Included in this anomaly are [1] aortic valve atresia, and hypoplasia of the ascending aorta and aortic arch, [1] mitral valve atresia or hypoplasia, and [3] diminutive or absent left ventricle. Patent ductus arteriosus is essential for any survival, and there is usually a patent foramen ovale. Coarctation of the aorta is frequently associated with the lesion.z With a limited period of cardiopulmonary bypass, deep hypothermia, and circulatory arrest, the ductus arteriosus was excised. The main pulmonary artery was divided immediately below its branches, and the distal stump of the divided pulmonary artery was closed with a pericardial patch. The aortic arch was incised, and a 1 5mm tubular Dacron prosthesis was inserted between the main pulmonary artery and the aortic arch. A 4mm shunt of polytetrafluoroethylene graft was established between the new ascending aorta and the right pulmonary artery to provide controlled pulmonary blood flow. Following rewarming, the heart started to beat regularly, but the patient could not be weaned from cardiopulmonary bypass. At autopsy, the patient was found to have hypoplasia of the aortic tract complex with mitral atresia and aortic atresia. A secundum atrial septal defect was noted. Right atrial and ventricular hypertrophy was present, and the left ventricle was entirely absent. Although unsuccessful in this case report, continuing experience with hypoplastic left heart syndrome will lead to an improvement in result.

• Journal of Computing Science and Engineering
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• v.6 no.1
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• pp.51-59
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• 2012

We describe the framework of a data-fuelled, interdisciplinary team-led learning system. The idea is to build models using patients from one's own institution whose features are similar to an index patient as regards an outcome of interest, in order to predict the utility of diagnostic tests and interventions, as well as inform prognosis. The Laboratory of Computational Physiology at the Massachusetts Institute of Technology developed and maintains MIMIC-II, a public deidentified high- resolution database of patients admitted to Beth Israel Deaconess Medical Center. It hosts teams of clinicians (nurses, doctors, pharmacists) and scientists (database engineers, modelers, epidemiologists) who translate the day-to-day questions during rounds that have no clear answers in the current medical literature into study designs, perform the modeling and the analysis and publish their findings. The studies fall into the following broad categories: identification and interrogation of practice variation, predictive modeling of clinical outcomes within patient subsets and comparative effectiveness research on diagnostic tests and therapeutic interventions. Clinical databases such as MIMIC-II, where recorded health care transactions - clinical decisions linked with patient outcomes - are constantly uploaded, become the centerpiece of a learning system.

• The Journal of Korean Academic Society of Nursing Education
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• v.26 no.3
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• pp.269-280
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• 2020

Purpose: Clinical nurses are the ideal health care providers to advocate for vulnerable and underserved populations such as people with disability. This study aimed to understand factors influencing nursing advocacy for people with disability among clinical nurses. Methods: The subjects of this study were 186 clinical nurses who were working in three hospitals in B and D cities. Self-report questionnaires were used to collect the data. Data were analyzed using IBM SPSS Statistics 25 with descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficients, and multiple regression analysis. Results: Clinical experience and esthetical nursing competency have positive correlations with nursing advocacy, and optimism-human rights has a negative correlation with nursing advocacy. Factors influencing nursing advocacy for people with disability were identified as patient directivity (β=0.36, p=.001), optimism-human rights (β=-0.18, p=.008) and clinical experience (≥10) (β=0.14, p=.036). The final model consisting of these factors explained 19% of the variance of nursing advocacy (F=14.99, p=.001). Conclusion: The findings of this study indicate the importance of developing and implementing nursing interventions that can improve patient directivity and optimism-human rights toward people with disability among clinical nurses. These nursing advocacy interventions can be provided as part of continuing education as well as the nursing curriculum.

• Korean Journal of Adult Nursing
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• v.22 no.6
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• pp.570-581
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• 2010

Purpose: This study was conducted to develop a Cancer Patient Guide with patients involvement using evidenced based practice research. The purpose of this patient guide was to help patients undergoing chemotherapy to manage their nausea and vomiting based on evidence. Methods: The design of the research was a methodological study. The participants consisted of seven cancer patients who were asked about their ' need for nausea and vomiting management, and secondly, 16 expert & 15 cancer patients to evaluate the Cancer Patient Guide using the DESCERN tool. Results: 1) Sixty-four relevant research evidences based articles were reviewed. 2) Patients were interviewed as to their needs in controlling nausea and vomiting. 3) The preliminary Cancer Patient Guide utilizing the research evidenced and the cancer patients interviews was then evaluated and revised by the experts and cancer patients. Lastly, the Cancer Patient which included an overview of chemotherapy, pathophysiology of nausea & vomiting, pharmacological and non-pharmacological interventions was finalized with each intervention supported by research evidence and patients' narratives of their experience. Conclusion: The Cancer Patient Guide was developed using evidenced based research and cancer patients in-put and be used to improve patients' self-management skill of nausea and vomiting in chemotherapy. The guide t also provides evidence based patient friendly information and contributes as a baseline data for developing and evaluating evidence-based guide for patients.