• 한국병원경영학회지
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• 제17권2호
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• pp.52-72
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• 2012

In this study, we examined the effect of customer satisfaction and switching cost on continuous use intention to suggest how organizations can retain their customers when market growth slows down and competition becomes stronger. We carefully developed and modified survey instruments through a pre-test, and subsequently surveyed 432 dental care users in Seoul and Busan areas. As a result of regression analysis, higher procedural learning switching cost, relational switching cost, and customer satisfaction were manifested in the increased continuous use intention. In contrast, higher financial switching cost and customer satisfaction with insufficient effort for information acquisition led to decreased switching intention. In addition, procedural initial switching cost and residents in Seoul led to increased switching intention. Understanding continuous use intention and switching intention is important for healthcare institutions striving to maintain market position. The findings of this study suggest a paradigm shift from conventional transactional marketing to strategic relational marketing to be effective in the healthcare environment today.

• Journal of Trauma and Injury
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• 제32권1호
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• pp.17-25
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• 2019

Purpose: We investigated how prehospital, emergency room (ER), and delta shock indices (SI) correlate with outcomes including mortality in patients with polytrauma. Methods: We retrospectively reviewed the medical records of 1,275 patients who visited the emergency department from January 2015 to April 2018. A total of 628 patients were enrolled in the study. Patients were divided into survivor and non-survivor groups, and logistic regression analysis was used to investigate independent risk factors for death. Pearson coefficient analysis and chi-square test were used to examine the significant relationship between SI and clinical progression markers. Results: Of 628 enrolled patients, 608 survived and 27 died. Multivariate logistic regression analysis reveals "age" (p<0.001; OR, 1.068), "pre-hospital SI >0.9" (p<0.001; OR, 11.629), and "delta SI ${\geq}0.3$" (p<0.001; OR, 12.869) as independent risk factors for mortality. Prehospital and ER SIs showed a significant correlation with hospital and intensive care unit length of stay and transfusion amount. Higher prehospital and ER SIs (>0.9) were associated with poor clinical progression. Conclusions: SI and delta SI are significant predictors of mortality in patients with polytrauma. Moreover, both prehospital and ER SIs can be used as predictive markers of clinical progression in these patients.

• 동서간호학연구지
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• 제15권1호
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• pp.54-62
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• 2009

Purpose: The purpose of this study was to examine the effects of relaxation therapy to reduce anxiety level among spinal anesthesia surgery patients. Methods: The study employed a quasi-experimental pre-and-posttest design with nonequivalent control group. The experimental group was provided with the 15-min muscle relaxation therapy on the day before the surgery and an hour before the spinal anesthesia. Data were collected from 44 patients (22 in experimental and 22 in control group) who were planned to have spinal anesthesia surgery from an orthopedic surgery department at a general hospital in Seoul from January 13 to March 21, 2006. Results: The experimental group reported lower level of state anxiety after the surgery (23.18 vs. 33.64) than did control group but was not statistically significant. There were no significant differences in blood pressure or pulse rate between experimental and control groups after surgery. Conclusions: The further research should be conducted to polish the muscle relaxation therapy for various types of patients and to create more comfortable environment setting for application of the therapy. The muscle relaxation therapy may be a convenient and useful nursing intervention to reduce anxiety among spinal anesthesia surgery patients if more studies prove its effectiveness.

• Child Health Nursing Research
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• 제30권1호
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• pp.17-30
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• 2024

Purpose: This pilot study aimed to assess the feasibility, preliminary efficacy, and effects of a mobile app healthcare coaching program developed based on self-regulation theory among youths with type 1 diabetes. Methods: A mixed-method design was utilized. Participants were randomly assigned into intervention (n=23, 12-week coaching program) or control groups (n=16, usual care). Pre- and post-intervention assessments included self-efficacy, diabetes management behavior, and health outcomes (quality of life, depression, and HbA1c). Quantitative data were analyzed with SPSS/WIN ver. 26.0. The narrative information from the participants in the healthcare coaching program underwent content analyzed. Results: The intervention group had significantly lower depression scores (t=2.57, p=.014) than the control group. No significant differences were observed in self-efficacy, diabetes management behavior, and health outcomes between the two groups. The average frequency of health behavior monitoring per week among the participants was 1.86±1.60. The qualitative findings indicated that participants perceived improved diabetes self-management with the intervention; however, challenges during vacations, dietary control difficulties, and a lack of disease awareness were identified. Conclusion: The healthcare coaching program improved psychological aspects for youth with type 1 diabetes. Further research is needed to develop and implement mobile app interventions aimed at enhancing compliance with diabetes management in pediatric and adolescent populations.

• 한국병원경영학회지
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• 제6권1호
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• pp.41-61
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• 2001

The purpose of this study was to assess pregnant women's knowledge of, attitude to, and satisfaction with prenatal ultrasound and to determine the factors that influence their perception. A self-administered questionnaire survey was completed by two hundred eighty five pregnant women who visited the obstetric departments of three hospitals located in Seoul from October 17, 2000 to October 28, 2000. The major results are as follows. 1. Overall, the respondents did not fully understand the purpose of prenatal ultrasound. 92.2% of respondents stated that the main purpose of prenatal ultrasound was to check the fetus' age, growth and development but only 44.5% of respondents were aware of the fact that chromosomal abnormalities cannot be diagnosed only by prenatal ultrasound. The majority of respondents were aware of the diagnostic limitations of ultrasound. 2. While the majority of respondents were aware of the importance of pre-examination information, only 31.8% of respondents received such information from their health care providers. 3. Regarding the examination quality, 80.3% of respondents were satisfied with the competency of the examination. But more than 50% of respondents stated the cost and waiting time were not acceptable. 4. The knowledge of, attitude to, and satisfaction with prenatal ultrasound showed statistically significant differences according to the characteristics of each hospital. 5. From multiple regression analysis, the major components for knowledge of prenatal ultrasound were characteristics of hospitals, religion, income and gestational age. The major components for attitude toward prenatal ultrasound were characteristics of hospitals, religion and gestational age. The major components for satisfaction with prenatal ultrasound were characteristics of hospitals, income and drinking during the pregnancy. In conclusion, the respondents' perception of prenatal ultrasound is considerably low. More effective educational material or programs with prenatal ultrasound information should be provided to pregnant women prior to prenatal ultrasound examination. New strategies such as process reengineering are recommendable to increase the satisfaction with prenatal ultrasound.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권4호
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• pp.271-280
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• 2017

Background: The number of patients with Alzheimer's disease is growing worldwide, and the proportion of patients requiring dental treatment under general anesthesia increases with increasing severity of the disease. However, outpatient anesthesia management for these patients involves great risks, as most patients with Alzheimer's disease are old and may show reduced cardiopulmonary functions and have cognitive disorders. Methods: This study retrospectively investigated 43 patients with Alzheimer's disease who received outpatient anesthesia for dental treatment between 2012-2017. Pre-anesthesia patient evaluation, dental treatment details, anesthetics dose, blood pressure, duration and procedure of anesthesia, and post-recovery management were analyzed and compared between patients who underwent general anesthesia or intravenous sedation. Results: Mean age of patients was about 70 years; mean duration of Alzheimer's disease since diagnosis was 6.3 years. Severity was assessed using the global deterioration scale; 62.8% of patients were in level ${\geq}6$. Mean duration of anesthesia was 178 minutes for general anesthesia and 85 minutes for intravenous sedation. Mean recovery time was 65 minutes. Eleven patients underwent intravenous sedation using propofol, and 22/32 cases involved total intravenous anesthesia using propofol and remifentanil. Anesthesia was maintained with desflurane for other patients. While maintaining anesthesia, inotropic and atropine were used for eight and four patients, respectively. No patient developed postoperative delirium. All patients were discharged without complications. Conclusion: With appropriate anesthetic management, outpatient anesthesia was successfully performed without complications for dental treatment for patients with severe Alzheimer's disease.

• The Korean Journal of Pain
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• 제34권3호
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• pp.304-314
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• 2021

Background: The study investigated virtual reality (VR) immersion in alleviating procedure-related pain in patients with chronic pain undergoing fluoroscopy-guided minimally-invasive intervention in a prone position at an outpatient clinic. Methods: In this prospective randomized controlled study, 38 patients undergoing lumbar sympathetic ganglion block were randomized into either the VR or the control group. In the VR group, procedure-related pain was controlled via infiltration of local anesthetics while watching a 30-minute VR hypnotic program. In the control group, the skin infiltration alone was used, with the VR device switched off. The primary endpoint was an 11-point score on the numerical rating scale, indicating procedure-related pain. Patients' satisfaction with pain control, anxiety levels, the need for additional local anesthetics during the procedure, hemodynamic stability, and any adverse events were assessed. Results: Procedure-related pain was significantly lower in the VR group (3.7 ± 1.4) than in the control group (5.5 ± 1.7; P = 0.002). Post-procedural anxiety was lower in the VR group than in the control group (P = 0.025), with a significant reduction from pre-procedural anxiety (P < 0.001). Although patients' satisfaction did not differ significantly (P = 0.158) between the groups, a higher number of patients required additional local anesthetics in the control group (n = 13) than in the VR group (n = 4; P = 0.001). No severe adverse events occurred in either group during the study. Conclusions: VR immersion can be safely used as a novel adjunct to reduce procedural pain and anxiety during fluoroscopic pain intervention.

• Asian Pacific Journal of Cancer Prevention
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• 제17권11호
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• pp.4999-5003
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• 2016

The testicular cancer (TCa) incidence is increasing in many countries, with age-standardized incidence rates up to 7.8/100,000 men in the Western world, although reductions in mortality and increasingly high cure rates are being witnessed at the same time. In Africa, where rates are lower, presentation is often late and morbidity and mortality high. Given this scenario, awareness of testicular cancer and practice of testicular self-examination among future first response doctors is very important. This study was conducted to determine knowledge and attitude to testicular cancer, and practice of testicular self-examination (TSE) among final (6th) year medical students. In addition, the effect of an intervention in the form of a single PowerPoint(R) lecture, lasting 40 minutes with image content on testicular cancer and testicular self examination was assessed. Pre and post intervention administration of a self-administered structured pre tested questionnaire was performed on 151 medical students, 101 of whom returned answers (response rate of 66.8%). In the TC domain, there was a high level of awareness of testicular cancer, but poor knowledge of the age group most affected, with significant improvement post intervention (p<0.001). Notable also was the poor awareness of the potential curability of TC, this also being improved following the intervention (p<0.001). A poor level of awareness and practice of testicular self-examination pre-intervention was found considering the nature of the study group..Respondents had surprisingly weak/poor responses to the question "How important to men's health is regular testicular self-examination?" Answers to the questions "Do you think it is worthwhile to examine your testis regularly?" and "Would you be interested in more information on testicular cancer and testicular self-examination?" were also suboptimal, but improved post intervention p<0.001, p<0.001 and p=0.037. Age, gender and marital status were without specific influence. In conclusion, this study showed poor levels of knowledge regarding epidemiology of TCa and its potential curability when detected early. There was also a poor awareness of, practice of, and poor attitudes to TSE. The significant improvement in these parameters post intervention indicates value in educational intervention. We recommend inclusion of TCa coverage and TSE teaching in the secondary school curriculum (targeting adolescents). Greater emphasis should also be given to testicular cancer in the curricula of medical schools and other training institutions for health care personnel.

• 한국응급구조학회지
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• 제11권3호
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• pp.93-109
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• 2007

The pre-hospital care in site transportation care and site care will be divided, it will follow in site or evacuation it will enforce it will can evacuate in condition of the emergency patient of like this at the initial stage and emergency care from inside fire fighting helicopter back transfer means and the manpower security of the specialty emergency necessary personnel(nursing and 1st EMT's) as the medical treatment agency and modernization of first aid equipment necessity inside American securing and fire fighting helicopter and specialty first aid packet won about lower the emergency care which is appropriate cannot become accomplished are the actual condition in total lack of emergency care equipment. Consequently craving augmentation, in order to be adapted with the handling kind transfer whose specialty and is appropriate and present time of rapid increase and the citizen of emergency demand by fire fighting helicopter simplicity transfer compared to it is a condition where the countermeasure preparation is earnest. Must expand emergency care equipment first even in fire fighting helicopter and 1st EMT's which it follows in him become arrangement and quickly the execution and specialty temporary disposal(ALS) must be enforced a temporary disposal and must buy the life which is. Also it gets by experience a helicopter induction outline, a radio communication method and the patient helicopter on-board hour attention point back various attention fact back with the body and when where it stands but accurately there must be it will be able to induce the helicopter. Also every manuals anger it does a helicopter transfer method and the emergency care method back and that all processes must do fixed form anger, it becomes feed. Also it related with a helicopter transfer even from the relationship agency many research to lead, difference of the advanced foreign nation and the maximum it is the actual condition where the medical emergency system construction which it reduces is earnestly demanded. Also with emergency structure(crane) it confronts to an aviation transfer even from the establishment college and education it leads intensively and 1st EMT's of the good quality which relates with an aviation structure expects is cultivate at all.

• 대한방사선기술학회지:방사선기술과학
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• 제30권1호
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• pp.39-46
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• 2007

CT 조영제의 부작용을 예방하여 환자만족도와 방사선사 및 간호사의 업무만족도를 향상을 위해 표준진료지침서를 개발하고 적용하였다. 표준진료지침서 개발은 팀으로 구성하여 단계적으로 실시하였다. 대상은 환자 및 방사선사와 간호사를 대상으로 만족도를 평가하였다. 표준진료지침서를 적용하는 군이 만족도가 높게 조사되었고, 방사선사와 간호사는 표준진료지침서를 적용하는 경우 환자의 조영제 부작용 정보를 사전에 파악하는 효과와 조영제 부작용을 예방 효과가 있어 만족도가 증가하였다. 조영제 부작용은 표준진료지침서를 적용하기 전 90명에서 적용 후 66명으로 감소하는 효과가 있었다. 표준진료지침서를 적용하여 환자 정보제공(24%), 조영제 예방효과(19%), 조영제 부작용의 사전 인지효과(39%), 지식정도(19%)로 업무 만족도 향상 효과가 있었다. 혈관외유출은 표준진료지침서 적용전은 13건이었고, 적용 후는 6건으로 감소하였다. 혈관외유출 위치와 조영제 용량을 종합의료정보시스템(HMIS)에 입력하여 혈관외유출 예방과 검사 만족도를 높이는 효과가 있다. 환자 정보를 파악하여 조영제 부작용 예방효과와 처치로 의료 질 향상 및 만족도 증가하였다. 표준진료지침서를 지속적으로 적용하여 환자, 검사자의 만족도 및 의료질을 증진하도록 한다.