• Journal of Korean Academy of Nursing Administration
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• v.2 no.1
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• pp.141-150
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• 1996

As the medical markets have gradually changed from suppliers' markets to consumers' ones, the demands for consumer-centered strategies of hospital management and marketing, improved medical services, etc., have been increasing. Under such circumstances, this study was aimed at evaluating the marketing policies of our hospitals centering around the internal, cxternal and mutual marketing for consumers, and thereby presenting more influential strategies for hospitals. For this purpose, the employees and patients of a third stage general hospital in Seoul were surveyed by means of a questionnaire. All in all, 285 patients and 284 employees answered the questionnaire. The results of the survey can be summarized as follows : First, patients come to a hospital directly, according to rumors or being introduced by its employee. Second, the important factors determining patients' choice of a hospital are facility, medical staff, traffic and employee. Other factors are patient's age, living area, distance between patient's house and hospital, etc. Third, patients' perception of a hospital affects their choice of the hospital. Fourth, employees and patients perceive differently the marketing strategies of the hospital. Fifth, well-planned marketing strategies may change some sources of inconveniences into those of conveniences. Based on the above findings, effective marketing strategies for gonoral hoopitale can be presented as followes. 1. The poblic relations of hospital should be established first with visiting patients and employees. 2. The marketing strategies should be-based on the factors determing patient's preferences for hospital. 3. The marketing strategies should be flcxiblc enough to complement the weak points of the hospital. 4. The marketing strategies should be directed towards the improved medical services as well as mutual actions between consumers and employccs. 5. The marketing strategies should take into consideration employees perception and thus induce their voluntary participation. All in all, the study may be limited in that its results cannot be easily generalizod due to its small size, patients' variublcs rather than qualitative medical services are primarily reviewed, and that it depended on a straight forward questlonnaire survey.

• Archives of Plastic Surgery
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• v.47 no.2
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• pp.126-134
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• 2020

Background Pectus excavatum is less common in females than in males, and it often aggravates a coexistent breast asymmetry. We conducted a study comparing female patients' versus medical professionals' evaluation of pectus excavatum repair to assess differences in aesthetic outcome ratings. Moreover, we evaluated the influence of surgical correction on patients' self-perception. Methods Of 30 female patients who were initially screened, 18 patients (mean age, 20 years) who underwent bar removal after surgical correction of pectus excavatum deformity participated in the survey (60%). They completed a questionnaire rating their appearance before and after surgery and responded to a psychological questionnaire about the changes that they had experienced. The mean interval between pectus bar removal and evaluation was 28 months. Standardized preoperative and postoperative patient photographs were evaluated using the same questionnaire by a panel of medical professionals and students (n=24) and the results were compared. Results Patients rated their preoperative deformity as more severe than the other evaluators, revealing the significant impact of the deformity on patients' self-perception. Postoperatively, patient and professional evaluations were much better than before and were very similar. The psychological evaluation showed a clear improvement in well-being. The ratings of the medical professionals were not influenced by their degree of medical education. Conclusions Surgical correction of pectus excavatum in female patients positively influences body perception and psychological well-being. It should therefore not be considered as a merely aesthetic correction, but as an important procedure to restore a patient's self-perception.

• Journal of Hospice and Palliative Care
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• v.16 no.3
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• pp.175-182
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• 2013

Purpose: Spirituality is an important domain and is related with physical and psychological symptoms in terminal cancer patient. The aim of this study is to examine how patients' spirituality is associated with their physical and psychological symptoms as it has been explored by few studies. Methods: In this cross sectional study, 50 patients in the palliative ward of a tertiary hospital were interviewed. Spiritual well-being, depression, anxiety and pain is measured by Functional Assessment of Chronic-Illness Therapy-Spirituality (FACIT-Sp), hospital anxiety and depression scale (HADS) and the Korean version of the Brief Pain Inventory (BPI-K). The correlations between patients' spiritual well-being and anxiety, depression and pain were analysed. The association between spiritual well-being and age, gender, palliative performance scale (PPS), religion, mean pain intensity, anxiety, depression were assessed by univariate and multivariate regression analyses. Results: Spiritual well-being was negatively correlated with the mean pain intensity (r=-0.283, P<0.05), anxiety (r=-0.613, P<0.05) and depression (r=-0.526, P<0.05). In multivariate regression analysis, spiritual well-being showed negative association with anxiety (OR=-1.03, 95% CI=-1.657~-0.403, P=0.002) and positive association with the existence of religion (OR=9.193, 95% CI=4.158~14.229, P<0.001). Conclusion: In this study, patients' anxiety and existence of religion were significantly associated with spiritual well-being after adjusting age, gender, PPS, mean pain intensity, depression. Prospective studies are warranted.

• Archives of Plastic Surgery
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• v.38 no.4
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• pp.505-507
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• 2011

Purpose: Liposarcoma is the most common soft tissue sarcoma, and usually occurs on the thigh or in the retroperitoneal space, but rarely in the oral region. This report presents a case of liposarcoma of the cheek and includes a review of the literatures. Methods: A 21-year-old woman was admitted with a palpable mass in her cheek of about two years duration, which increased in size gradually initially, but had increased rapidly over the three months. There was no particular pain or tenderness. MRI showed a well-enhanced, well-defined mass, which suspected to be hemangioma. Results: The spherical, well-encapsulated mass was surgically excised. Biopsy results revealed myxoid liposarcoma. FDG PET-CT on the seventh postoperative day, revealed a minimal to mild FDG-uptake soft tissue lesion around the mass defect area without evidence of distant metastasis. The patient is being observed and undergoing radiation therapy. Conclusion: Liposarcoma in the head and neck region is a rare disease, and can be overlooked as a benign tumor without a pathologic diagnosis. Therefore, proper treatment and follow-up are required based on an understanding of this disease.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.2
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• pp.143-147
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• 2017

The use of novel oral anticoagulants (NOACs) has increased in recent times in an effort to overcome the shortcomings of warfarin. They are being used primarily for the prevention of thrombosis caused by atrial fibrillation and offer the advantages of having fewer drug interactions than warfarin, no dietary restrictions, and no requirement for regular blood tests. Although there is reportedly less postoperative bleeding even if the drug is not discontinued during procedures that can cause local bleeding, such as dental procedures, no well-designed clinical studies have assessed postoperative bleeding associated with the use of these drugs. This article reports a case of a 74-year-old male patient who was taking rivaroxaban. The patient underwent a dental implant procedure after discontinuing rivaroxaban for one day and subsequently suffered delayed bleeding on postoperative day 6. Accordingly, this article also reports that the use of NOACs may also lead to delayed bleeding.

• Journal of Chest Surgery
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• v.29 no.6
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• pp.672-674
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• 1996

Chylothorax is a rare, but well-recognized complication of cardiothoracic surgery and operations in the region of the esophageal or aortic diaphragmatic hiatus. Especially, in nutritionally depleted patients requiring esophagectomy for benign or malignant diseases, it is a potentially life-threatening disorder that has profound respiratory, nutritional and immunologic co sequences . We have experienced a case of chylothorax after transhiatal esophagectomy in benign esophageal stricture. The diagnosis of chylothorax was confirmed after feeding through the jejunostomy tube by the change of the character of pleural effusion and high triglyceride level on the 5th postoperative day. On the thirteenth postoperative day, supradiaphragmatic thoracic duct ligation was performed through right thoracotomy. We could remove the chest tube on the 22th postoperative day, and the patient is being followed-up at out patient clinic without complications.

• Journal of Korean Critical Care Nursing
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• v.13 no.3
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• pp.51-61
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• 2020

Purpose : This study aimed to explore and describe good nursing experiences of patients with cancer. Methods : Data were collected using individual in-depth interviews with 15 males and 8 females who were hospitalized in a Korean cancer hospital. The transcribed script was analyzed using Colaizzi's phenomenological method. Results : As a result, three theme clusters and nine themes were identified. The three theme clusters were as follows: "being kind and expert in every step along the cancer care trajectory," "taking an omnipotent mediator role supporting patients' well-being," and "providing professional care touching patients' mind and body." Three themes were assigned to each cluster to illustrate the given phenomena. Conclusion : Cancer patients wanted considerate understanding and sincere care from nurses while they experienced physical and emotional suffering owing to the cancer, treatment trajectory, and hospital system. To improve the quality of nursing care for cancer patients, patient-centered care combined with nurses' expertise in oncology care must be provided based on the insights from our study's findings.

• Journal of Home Health Care Nursing
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• v.3
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• pp.86-97
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• 1996

The traditonal inpatient acute hospital setting is organized primarily for the intensive management of disease, but not well-suited for continuity of care for the chronically ill patients after being discharged from hospital. For the planning of the continuity of care, firstly, it is necessary to assess the home care needs of the discharged pateints in the context of the nursing diagnosis. Therefore, this study is designed to identify the home nursing care need trajectory of the patients with chronic illness after discharged from one of the the General Hospitals in Seoul, Korea. The subjects are the patients with chronic illness such as stroke, musculoskeletal disease, hypertension, cancer etc., in average age of 52. 2 years old. The findings of this study are as follows : 1) The limitaion of ADL has been constantly facing to the subjects and has not been changed 4 weeks after being discharged. And the sense of with-drawal was getting worse at 4th weeks than the 1st week after being discharged. 2) The lists of the patient's problems are the impairment of mobility, elimination pattern, inactivity, impairment of skin integrity, ineffective airway clearance, and potential anxiety, self concept deficit, ineffective family coing, etc. Those problems were diminished in quantity at the first week after discharged, but at the 4th week, those problems were getting worse. 3) The need of specialized nursing care such as tube feeding, ostomy care, $O_2$ inhalation, IV therapy, teaching and exercise are considered as the most consisting problems facing to the subjects. 4) In general, the chronically ill patients and their caregivers have not been adapted well even at the 4th weeks after being discharged. 5) Considering those findings, the basic care for patients should be given and the trainging for process of the adaptation after discharged should be encouraged prior being discharged from hostital. For this suggestion, the systematic discharge planning should be carried and the hospital based home nursing model should be implemented at the general hospital for the chronically ill patients.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.6
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• pp.313-322
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• 2019

Early childhood caries is a global healthcare concern in developing and industrialized countries. If left untreated, it leads to immediate and long-term complications that affect the well-being and quality of life of concerned families. Therefore, many preventive and treatment approaches are available to the healthcare provider to curb this virulent form of caries. After behavioral interventions, general anesthesia is used in specific settings when a young patient presents with extensive teeth damage and exhibits a lack of cooperation that is incompatible with conventional dental office care. However, without proper follow-up, any positive results might be lost over time.

• Clinical and Experimental Pediatrics
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• v.61 no.1
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• pp.1-5
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• 2018

We often overlook the importance of several safety issues such as identification of patients, timeout procedure, hand hygiene, handoff communication, and many others. This ignorance, along with many other issues, leads to medical error being ranked as a third leading cause of death in the U.S. Consequently, quality improvement (QI) has become one of the major subjects in healthcare despite a relatively short history. Improving quality is about making healthcare safe, effective, patient-centered, timely, efficient, and equitable. Understanding the need and methodology of QI as well as participation is now essential for physicians. Although basic QI methodology has not changed, one of the most fascinating changes in recent QI is conducting large-scale QI projects through multicenter networks. Prospective multicenter QI projects utilizing the Korean Neonatal Network are a substantial initiation of pediatric QI in Korea. The Korean Pediatric Society should set ambitious goals for QI activities for every primary care pediatrician and pediatric subspecialist.