• Title/Summary/Keyword: Patterns of care study

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Radiotherapy in prostate cancer treatment: results of the patterns of care study in Korea

  • Chang, Ah Ram;Park, Won
    • Radiation Oncology Journal
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    • v.35 no.1
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    • pp.25-31
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    • 2017
  • Purpose: The purpose of this study was to describe treatment patterns of radiotherapy (RT) for prostate cancer in Korea. Materials and Methods: A questionnaire about radiation treatment technique and principles in 2013 was sent to 83 radiation oncologists and data from 57 hospitals were collected analyzed to find patterns of RT for prostate cancer patients in Korea. Results: The number of patients with prostate cancer treated with definitive RT ranged from 1 to 72 per hospital in 2013. RT doses and target volumes increased according to risk groups but the range of radiation doses was wide (60 to 81.4 Gy) and the fraction size was diverse (1.8 to 5 Gy). Intensity-modulated radiation therapy was used for definitive treatment in 93.8% of hospitals. Hormonal therapy was integrated with radiation for intermediate (63.2%) and high risk patients (77.2%). Adjuvant RT after radical prostatectomy was performed in 46 hospitals (80.7%). Indications of adjuvant RT included positive resection margin, seminal vesicle invasion, and capsular invasion. The total dose for adjuvant RT ranged from 50 to 72 Gy in 24-39 fractions. Salvage RT was delivered with findings of consecutive elevations in prostate-specific antigen (PSA), PSA level over 0.2 ng/mL, or clinical recurrence. The total radiation doses ranged from 50 to 80 Gy with a range of 1.8 to 2.5 Gy per fraction for salvage RT. Conclusion: This nationwide patterns of care study suggests that variable radiation techniques and a diverse range of dose fractionation schemes are applied for prostate cancer treatment in Korea. Standard guidelines for RT in prostate cancer need to be developed.

Nurse Managers in a Difficult Situation on Caring Clients: A Critical Discourse Analysis (병동 간호관리자의 문제상황 관리 경험)

  • Cho, Myung Ok
    • Korean Journal of Adult Nursing
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    • v.19 no.5
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    • pp.56-69
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    • 2007
  • Purpose: This study aimed to explore the discourses and the patterns of problem solving behaviors among the nurse managers. The focus of the study was the difficult situations in caring with patients and their families. Methods: Field study was performed at a for-profit hospital from March, 2004 to March, 2007. The participants of the study were 5 head nurses and 2 nurses in charge. The data were collected with iterative interviews and participant-observations. For the analysis of the data, taxonomy and critical discourse analyzing were applied. Results: The nurse mangers who showed wholistic patterns of behavior took the role of a broker among the client system, professional nursing system, medical system, and other allied health system. The nurse managers whose approach was profession-centered took the role of protector of nursing system. The nurse manager who practiced nurse-oriented pattern of behavior tried not to have harm against other members of health system. The experiences of nurse managers were effected from the discourses of patriarchal and market mechanism. Conclusion: The situation that provoke conflict between clients and nurses become more common with the changes to the health care system and to society. Nurse managers take the role of these conflict problems. The successful solving of conflict in a nursing care setting promotes the quality of care and satisfaction of clients. Programs for enhancing nurse's problem solving competency should anchored be in their practices.

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The Sleep/Activity Patterns of Premature Babies in the Neonatal Intensive Care Unit (일 대학병원 신생아집중치료실 입원 미숙아의 수면/활동 양상)

  • Jeon, Hye-Jeong;Jeong, Nam-Yeun;Kim, Tae-Im
    • Child Health Nursing Research
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    • v.13 no.2
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    • pp.147-156
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    • 2007
  • Purpose: The purpose of this study was to investigate the sleep/activity patterns of premature babies. Method: The subjects were 55 premature babies who were hospitalized in the Neonatal Intensive Care Unit (NICU) of one University Hospital in Daejeon from September 1, 2004 to March 31, 2006. The sleep/activity patterns of the premature babies were observed for 24 hours a day for 7 days. The observations were made and recorded by the researcher and 5 trained research assistants using NCASA records developed by Barnard et al. (1979). For statistical analysis, frequency, average, t-test, and Pearson correlation coefficients were used. Results: The infants slept more and had less awake periods during daytime than full-term infants. As the hospital stay of the premature babies increased, the amount of daytime sleep and total daily sleep decreased, and the amount of daytime awake periods increased. Conclusions: The findings suggest that the level of physical and physiological maturity of premature babies is one of the major variables that affect their sleep/activity patterns. Furthermore, the findings of this study will provide information about the sleep/activity patterns of premature babies, and present baseline data to develop the nursing intervention programs which support optimum development for the premature babies.

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Study of The Area of Nursing Need by the Family Developmental Stage (가족발달단계에 따른 간호요구영역에 관한 연구)

  • 최부옥
    • Journal of Korean Academy of Nursing
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    • v.7 no.2
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    • pp.43-59
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    • 1977
  • The Community Health Service considers the family as a service unit and places the emphasis of its service on the health problems and the nursing needs of the family rather than the individual. From the conceptual point of view that tile community health service is both health maintenance and health promotion of the family, the community health nurse should have a knowledge of the growth and development of the family and be responsible for the comprehensive support of normal family development. The community health nurse often is in a position to make a real contribution to normal family development. In order to investigate the relationship between the areas of nursing need and family development, the following objectives were established 1. To discover the general characteristics of the study population by the stage of family development. 2. To discover specific nursing needs in relation to the family developmental stage, and to determine the intensity of the nursing needs and the ability of the family to cope with these needs. 3. To discover overall family health nursing problems in relation to the family developmental stage and determine the intensity of the nursing need and the problem solving ability of family. Definitions : The family developmental stages as classified by Dually were used stage 1. Married couples(without children) stage 2. Childbearing Families (oldest child birth to 30 months of age) stage 3. Families with preschool children (oldest child 2½-to 6 years) stage 4. Families with schoolchildren (oldest child 6 to 13 years). stage 5. Families with teenagers (oldest child 13 to 20 years) stage 6. Families as launching centers (first child gone to last child′s leaving home). stage 7. Middle- aged parents (empty nest to retirement) stage 8. Aging family member (retirement to death of both spouses) The areas of nursing need were defined as those used in the study, "A Comprehensive Study about Health and Nursing Need and a Social Diagram of the Community", by tile Nursing research Institute and Center for population. and Family Planning, July 1974. The study population defiled and selected were 260 nuclear families ill two myron of Kang Hwa Island. Percent, mean value and F- test were utilized in tile statistical analysis of the study result. Findings : 1. General characteristics of the study population by tile family developmental stage ; 1)The study population was distributed by the family developmental stage as follows : stage 1 : 3 families stage 2 : 13 families stage 3 : 24 families stage 4 : 41 families stage 5 : 50 families stage 6 : 106 families stage 7 : 13 families stage 8 : 10 families 2) Most families had 4 or 5 members except for those in stage, 1, 7, and 8. 3) The parents′ present age was older in the higher developmental stage and their age at marriage was also younger in the higher developmental stages. 4) The educational level of parents was primarily less than elementary school irrespective of the developmental stage. 5) More than half of parents′ occupations were listed as laborers irrespective of the developmental stage, 6) More than half of the parents were atheists irrespective of the developmental stage. 7) The higher the developmental stage(from stage 2 to stage 6 ), the wider the distribution of children′s ages. 8) More than half of the families were of middle or lower socio-economic level. 2. Problems in specific areas of nursing need by family developmental stage, the intensity of nursing need and the problem solving ability of the family : 1) As a whole, many problems, irrespective of the developmental stage, occurred in tile areas of Housing and Sanitation, Eating Patterns, Housekeeping, Preventive Measures and Dental care. Problems occurring ill particular stages included the following ; stage 1 : Prevention of Accident stage 2 : Preventive Vaccination, Family Planning. stage 3 : Preventive Vaccination, Maternal Health, Family Planning, Health of Infant and Preschooler. stage 4, 5 : Preventive Vaccination, Family Planning, Health of School Children. stage 6 : Preventive Vaccination, Health of School Children. 2) The intensity of the nursing need in the area of Acute and Chronic Diseases was generally of moderate degree or above irrespective of the developmental stages except for stage 1. Other areas of need listed as moderate or above were found in the following stages: stage 1 : Maternal Health stage 3 . Horsing and Sanitation, Prevention of Accident. stage 4 . Housing and Sanitation. stage 5 : Housing and Sanitation, Diagnostic and Medical Care. stage 6 : Diagnostic and Medical care stage 7 : Diagnostic and Medical Care, Housekeeping. stage 8 : Housing and Sanitation, Prevention of Accident, Diagnostic and Medical Care, Dental Care, Eating Patterns, Housekeeping. 3) Areas of need with moderate problem solving ability or less were as follows : stage 1 : Diagnostic and Medical Care, Maternal Health. stage 2 : Prevention of Accident, Acute and Chronic Disease, Dental Care. stage 3 : Housing and Sanitation, Acute and Chronic Disease, Diagnostic and Medical Care, Preventive Measure, Dental Care, Maternal Health, Health of Infant and preschooler, Eating Patterns. stage 4 : Housing and Sanitation, Prevention of Accident, Diagnostic and Medical Care, Preventive Measure, Dental Care, Maternal Health, Health of New Born, Health of Infant and Preschooler, Health of school Children, Eating Patterns, Housekeeping. stage 5 . Housing and Sanitation, Prevention of Accident, Acute and Chronic Disease, Diagnostic and Medical Care, Preventive Measure, Dental Care, Preventive Vaccination, Maternal Health, Eating Patterns. stage 7, 8 : Housing and Sanitation, Prevention of Accident, Acute and Chronic Disease, Diagnostic and Medical Care, Preventive Measures, Dental Care, Preventive Vaccination, Eating Patterns , Housekeeping. Problem occurrence, the degree of nursing need and the degree of problem solving ability 1 nursing need areas for the family as a whole were as follows : 1) The higher the stages(except stage 1 ), the lower the rate of problem occurrence. 2) The higher the stage becomes, the lower the intensity of the nursing need becomes. 3) The higher the stages (except stages 7 and 8), the higher. the problem solving ability. Conclusions ; 1) When the nursing care plan for the family is drawn up, depending upon the stage of family development, higher priority should be give to nursing need areas ① at which problems were shown to occur ② where the nursing need is shown to be above moderate degree and ③ where the problem solving ability was shown to be of moderate degree. 2) The priority of the nursing service should be Placed ① not on those families in the high developmental stage but on those families in the low developmental stage ② and on those areas of need shown in stages 7 and 8 where the degree nursing need was high and the ability to cope low.

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Working Patterns and Job Satisfaction in Primary Health Practitioners (보건진료전담공무원의 업무분석과 직무만족도)

  • Kim, Jin Hak;Song, Min Sun
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.24 no.1
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    • pp.69-78
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    • 2017
  • Purpose: The purpose of this study was to identify the frequency and duration of primary health practitioners' work, and their job satisfaction, and to confirm differences in work and job satisfaction by type of primary health care post. Methods: Work frequency, duration of work, and job satisfaction were estimated by 371 primary health practitioners. Chi-square test and t-test were used to identify the differences in working patterns and job satisfaction by type of primary health care post. Results: Primary health practitioners were found to spend more time working with the elderly population than with students, pregnant women, children, people with disabilities, and multicultural families. Those in costal areas were more concerned with students than those working inland. In the latter group of practitioners, more time was spent working with patients with chronic diseases, pregnant women, women, children, multicultural families, and mental health clients. Also, the job satisfaction of inland primary health practitioners was significantly higher than that of costal practitioners. Conclusion: It is necessary to identify the characteristics of primary health practitioners' work, focusing on changes in the medical service environment. Furthermore, it is necessary to provide job training according to type of primary health care post, as practitioners' approaches should differ between posts.

Factors Affecting Sleeping Patterns among Hospitalized Elderly (일 중소병원 입원노인환자의 수면양상에 영향을 미치는 요인)

  • Shim, Hye-Jung;Kim, Jin-Sun;Kim, Kye-Ha
    • Korean Journal of Adult Nursing
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    • v.20 no.4
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    • pp.573-587
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    • 2008
  • Purpose: The purpose of this study was to identify the factors affecting sleeping patterns among hospitalized elderly. Methods: A descriptive correlational study was conducted. Participants were 121 hospitalized elderly in a hospital located in a county. A structured questionnaire was used for data collection. Collected data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation, and stepwise multiple regression. Results: Almost a half of hospitalized elderly in this study suffer from sleep disturbances. As results of univariate analyses, physical symptoms, anxiety, depression, and environmental factors disturbed sleep among hospitalized elderly. However, the result of stepwise multiple regression analysis identified that anxiety and environmental factors were significant predictors of sleeping patterns for hospitalized elderly and these two factors accounted 32.5% of variance of sleeping patterns among hospitalized elderly. Conclusion: Sleep assessment should be conducted on admission to identify sleep difficulties and thereby to improve quality of nursing care. Nurses and other health care personnels should make efforts to decrease anxiety and to eliminate environmental barriers of sleep among hospitalized elderly. Educational programs for nursing staff that offer information about sleep and sleep promoting interventions for the elderly patients are critical. Moreover, sleep promotion intervention program should be developed, applied and evaluated.

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Developing standardized Clinical Dietetic Staffing Indices in Hospital Foodservice (업무분석을 통한 임상 영양사 적정인원 산출 사례연구(II))

  • 양일선
    • Journal of Nutrition and Health
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    • v.28 no.7
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    • pp.675-687
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    • 1995
  • The purpose of this study were to analyze work patterns of clinical dietitians by time study, to investigate labor time used in each clinical dietetic activity, and to develop standardized indices of clinical dietetic staffing needs. Two general hospitals(A & B) in Seoul were selected for study. The results of this study can be summarized as follows. 1) For the A hospital, the percentage of clinical dietetic activities such as attending meeting, professional research, foodservicemanagement, clerical activity for the foodservice, administrative activity and delay were 17.5%, 1.3%, 14.5%, 23.4%, 21.3%, 4.6%, and 17.3% respectively, while 22.4% 3.5%, 23.7%, 10.9%, 15.8%, 4.2%, and 19.5% respectively for the B hospital. 2) For the A hospital, the percentage of direct patient care like outpatient nutrition education, group nutrition education, and patient meal planning were 69.5%, 10.5%, 7.6%, and 12.4% respectively while 78.9%, 7.3%, 8.9%, and 5.1% respectively for the B hospital. 3) Time spent for performing direct patient care such as basic care, intermediate care, and indepth care per patient were 28.0min, 73.1min, and 53.0 min respectively for the A hospital, while 45.3 min, 76.2 min, and 52.6 min respectively for the B hospital. 4) Full time clinical dietitian staffing needs were calculated for the three parts ; basic care, intermediate care, and in-depth care. For A hspital, the appropriate numbers of full time clinical dietitian were 3.5 persons in basic care, 3.6 persons in intermediate care, and 1.3 persons in in-depth care, while 6.1 persons, 6.3 persons, 3.2 persons respectively for B hospital.

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A Survey on Health Promoting Lifestyle Patterns and Self-Care Activities of Patients with Rheumatic Disease (류마티스 환자의 건강증진 생활양식과 자기간호행위)

  • Sohng Kyeong Yae;Moon Jung Soon;Park Ho Ran;Lee So Young
    • Journal of Korean Public Health Nursing
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    • v.16 no.2
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    • pp.337-345
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    • 2002
  • This study was designed to explore health promoting lifestyle patterns (HPLP) and self-care activities and identify related variables of patients with rheumatic disease. One hundred fifty rheumatic patients were recruited from two university based rheumatic centers according to selection criteria. Collected data were analyzed using SAS program through which with a structured questionnaire. T-test. ANOVA, and Pearson correlation coefficients were tested. The results were as follows: 1. The mean HPLP score of the subjects was 2.71, showed significant differences with economic condition and educational level. The better economic condition and more educated, showed the higher HPLP score. 2. They showed the highest practices in nutrition(mean score=3.11), and the lowest practices in exercise(mean score = 1.99). 3. The mean self-care activity score of the subjects was 3.36, showed significant differences with economic condition and educational level. The better economic condition and more educated, showed the higher self-care activity score. 4. The HPLP score of the subjects showed positive correlations with self-care activity score(r= .66). Developing health promotion programs focused on exercise and stress management is recommended not only for better health practices of patients with rheumatic disease but also for enhancing their level of well-being and life satisfaction.

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A Patterns of Care Study of the Various Radiation Therapies for Prostate Cancer among Korean Radiation Oncologists in 2006 (Patterns of Care Study를 위한 2006년 한국 방사선종양학과 전문의들의 전립선암 방사선치료원칙 조사연구)

  • Kim, Jin-Hee;Kim, Jae-Sung;Ha, Sung-Whan;Shin, Seong-Soo;Park, Won;Cho, Jae-Ho;Suh, Chang-Ok;Oh, Young-Taek;Shin, Sei-Won;Kim, Jae-Chul;Jang, Ji-Young;Nam, Taek-Keun;Choi, Young-Min;Kim, Il-Han
    • Radiation Oncology Journal
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    • v.26 no.2
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    • pp.96-103
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    • 2008
  • Purpose: To conduct a nationwide academic hospital patterns of the practice status and principles of radiotherapy for prostate cancer. The survey will help develop the framework of a database of Korean in Patterns of Case Study. Materials and Methods: A questionnaire about radiation treatment status and principles was sent to radiation oncologists in charge of prostate cancer treatment at thirteen academic hospitals in Korea. The data was analyzed to find treatment principles among the radiation oncologists when treating prostate cancer. Results: The number of patients with prostate cancer and treated with radiation ranged from 60 to 150 per academic hospital in Seoul City and 10 to 15 outside of Seoul City in 2006. The primary diagnostic methods of prostate cancer included the ultrasound guided biopsy on 6 to 12 prostate sites(mean=9), followed by magnetic resonance imaging and a whole body bone scan. Internal and external immobilizations were used in 61.5% and 76.9%, respectively, with diverse radiation targets. Whole pelvis radiation therapy(dose ranging from 45.0 to 50.4 Gy) was performed in 76.9%, followed by the irradiation of seminal vesicles($54.0{\sim}73.8$ Gy) in 92.3%. The definitive radiotherapy doses were increased as a function of risk group, but the range of radiation doses was wide(60.0 to 78.5 Gy). Intensity modulated radiation therapy using doses greater than 70 Gy, were performed in 53.8% of academic hospitals. In addition, the simultaneous intra-factional boost(SIB) technique was used in three hospitals; however, the target volume and radiation dose were diverse. Radiation therapy to biochemical recurrence after a radical prostatectomy was performed in 84.6%; however, the radiation dose was variable and the radiation field ranged from whole pelvis to prostate bed. Conclusion: The results of this study suggest that a nationwide Korean Patterns of Care Study is necessary for the recommendation of radiation therapy guidelines of prostate cancer.

A Study on the Patterns of Medical Utilization among Inhabitants in Ulnung Island (울릉도 주민들의 의료이용 형태)

  • Lim, Hyun-Sul;Kim, Doo-Hie
    • Journal of agricultural medicine and community health
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    • v.21 no.2
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    • pp.243-251
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    • 1996
  • Authors surveyed the inhabitants in Ulnung Island to assess the patterns of medical utilization. One hundred eighty six population(65 male and 121 female) were surveyed with formed questionnaire from Aug. 16 to Aug. 19 in 1994. Results are as follows. 1. The prevalence rate of acute diseases was 19.3%. 2. The prevalence rate of chronic diseases was 35.0%. In classification of chronic disease, the disease of musculoscletal system was the highest(33.9%) and that of digestive system in next order. 3. The first-visit medical facility when disease developed was community health center mainly. The admission care was taken in 37.6%. The 80.0% among location of medical facility for admission care was out of island. The surgical operative care were taken in 19.9%. The 86.5% among location of medical facility for surgical operative care was out of island. 4. Among the contents of dissatisfaction for medical service within island, 'Insufficient equipment' was the highest(35.8%), and 'Insufficient traffic networks' in next order. The results of this study suggest that public health facilities and medical personnel be strengthened and emergency transfer system be secured in Ulnung Island.

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