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Observational Study on Patient's Satisfactions and Quality of Life (QoL) Among Cancer Patients Receiving Treatment with Palliative Care Intent in a Tertiary Hospital in Malaysia

  • Sharifa Ezat, Wan Puteh;Fuad, Ismail;Hayati, Yaakub;Zafar, Ahmed;Wanda Kiyah, George Albert
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.695-701
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    • 2014
  • The main objective of palliative treatment for cancer patients has been to maintain, if not improve, the quality of life (QoL). There is a lack of local data on satisfaction and QoL among cancer patients receiving palliative treatment in Malaysia. This study covers patients with incurable, progressive cancer disease receiving palliative treatment in a teaching hospital in Kuala Lumpur, comparing the different components of QoL and correlations with patient satisfaction. A cross-sectional survey using Malay validated SF36 QoL and PSQ-18 (Short Form) tools was carried out between July 2012 -January 2013 with 120 cancer patients receiving palliative treatment, recruited into the study after informed consent using convenient sampling. Results showed that highest satisfaction were observed in Communication Aspect ($50.6{\pm}9.07$) and the least in General Satisfaction ($26.4{\pm}5.90$). The Mental Component Summary ($44.9{\pm}6.84$) scored higher when compared with the Physical Component Summary ($42.2{\pm}7.91$). In this study, we found that patient satisfaction was strongly associated with good quality of life among cancer patients from a general satisfaction aspect (r=0.232). A poor significant negative correlation was found in Physical Component (technical quality, r=-0.312). The Mental Component showed there was a poor negative correlation between time spent with doctor (r=-0.192) and accessibility, (r=-0.279). We found that feeling at peace and having a sense of meaning in life were more important to patients than being active or achieving good physical comfort. More studyis needed to investigate patients who score poorly on physical and mental component aspects to understand their needs in order to achieve better cancer care.

Nursing Education between South and North Korea through Verbal Evidence from Defecting North Korean Medical Personnels (탈북 의료인의 증언을 바탕으로 본 북한 간호교육의 제도와 교과과정 조사 연구)

  • 신경림;김일옥
    • Journal of Korean Academy of Nursing
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    • v.31 no.2
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    • pp.169-179
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    • 2001
  • Recently, there has been an increasing interchange between South Korea and North Korea. Accordingly, there has been active research to understand the society and culture of North Korea, it has been attempted to have comparative study about nursing education to increase understanding between South and North Korea. In the current educational system, 12 years of education is required for entering a nursing college or university in South Korea, but there are only 10 years for entering nursing college in North Korea. After finishing undergraduate studies one can enter graduate school for a masters degree and or a doctoral degree, but there is a longitudinal relation to medical education in North Korea. Regarding the number of nursing educational institutions, there are 50 BSN programs & 61 Diploma programs in South Korea and 11 Diploma programs in North Korea. In regards to curriculum, South Korea has diverse subjects for general education for freshmen, then is subjects to basic specialities sophomore year, and speciality subject and clinical practices from junior year corresponding to the student's intentions. North Korea has minor subjects for general education and basic specialities in freshmen, speciality subjects sophomore year, speciality subjects and clinical practice in the junior year that may not correspond with the student's intentions. The most outstanding difference in the curriculum is North Korea has various subjects for oriental medicine with clinical application. North Korea also does not teach computer science and English is at a very low level. In clinical practice, South Korea has various settings for clinical practice including community health institutions under the nursing professor or clinical instructor. However, North Korea has limited settings for clinical practice (general hospitals) under a doctor's instruction. Also both South and North Korea have a similar licensing system. Therefore, there must be many more studies regarding North Korea, especially in nursing and nursing education in order to decrease differences and confusion between the Koreas and to prepare for a future unification.

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Development of a Standard Tool for Pattern Identification of Gastroesophageal Reflux Disease (GERD) (위식도역류질환 변증도구 개발 연구)

  • Han, Ga-jin;Leem, Jung-tae;Lee, Na-la;Kim, Jin-sung;Park, Jae-woo;Lee, Jun-hee
    • The Journal of Internal Korean Medicine
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    • v.36 no.2
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    • pp.122-152
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    • 2015
  • Objectives: This study was designed to develop a standard tool for pattern identification of gastroesophageal reflux disease (GERD) patients. Methods: Korean and Chinese literature was selected that mentioned pattern identification of GERD. We gathered the pattern identification and their symptoms and a Chinese medical doctor proficient in Korean translated the Chinese characters into Korean. A Korean linguist then confirmed the translation results to develop a draft of the standard tool for pattern identification of gastroesophageal reflux disease (PIGERD). The final PIGERD was developed after assessment by an expert committee composed of professors from the Korean Medicine University, using the following items: inclusion of the pattern identification and its symptoms, importance of items, and validity of translation. Results: Six pattern identifications and 94 symptoms were selected from 45 references and translated into Korean. Four pattern identifications [pattern/syndrome of liver qi invading the stomach (肝胃不和), spleen-stomach weakness (脾胃虛弱), spleen-stomach dampness-heat (脾胃濕熱), and stomach yin deficiency (胃陰不足)] and 49 symptoms were then selected through the Delphi method by the expert committee. The final standard PIGERD tool was completed after the assessment of translation validity and reflection of individual opinions by the expert committee. This tool consists of 40 items including tongue and pulse diagnosis. The weighted value was also computed from assessment of the importance of items. Conclusions: We developed a standard tool for pattern identification of gastroesophageal reflux disease (PIGERD) to clarify the pattern identification of patients with gastroesophageal reflux disease for standardized diagnosis.

Prevalence and Risk Factors of Myofascial Pain Syndrome on School Boys (청소년들에서 근막동통증후군의 유병률과 위험요인)

  • Lim, Hyun-Sul;Lee, Jong-Min;Kim, Duck-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.2
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    • pp.184-192
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    • 2000
  • Objectives : To inquire the prevalence and the risk factors for myofascial pain syndrome (MPS) on young boys in order to use these results as the fundamental data for the prevention of their MPS. Methods : For 7 days in May 1999, this research was taken on 489 male students ranging from 6th to 12th grade. We randomly selected a class for every group and from these classes we operated physical examinations, self-reported questionnaires and from a rehabilitation doctor, MPS test was taken. Thoracic kyphosis and lumbar lordosis were also taken by using the inclinometer. We defined MPS as a regional pain complaint, palpable taut band that is painful on compression. Results : The shoulder MPS prevalence of the subjects were 29.7 persons/100 persons. The statistics revealed that as grades went up, the percentage significantly increased in the MPS prevalence. As of case-control study, 145 students who were tested postive in all aspects were placed as cases, and 176 students who were perfectly normal as controls on risk factors. As a result of comparing the student groups who were stisfied with their chairs to the student groups were not satisfied, the taller showed a significantly higher odds ratio (p<0.01). By the multiple logistic regression test, we concluded that the MPS disease was prevailed far more in the students in the higher grades (Odds ratio: 1.16, 95% C.I.: 1.03-1.31), and also those who were dissatisfied with their chairs than in the ones who were satisfied (Odds ratio: 1.92, 95% C.I.: 1.17-3.17). Conclusions : Significant correlations showed between the MPS diagnosed group and the students who are dissatisfied with their chairs. As a result, more research and observation has to be made concerning this disease, and the desks and chairs should be adjusted to suit the student's physical standards.

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Effects of continuous involved weight bearing training on symmetrical weight supporting rate improvement and gait characteristics of patients with Hemiplegia (전자체중계를 이용한 환측 체중부하훈련이 편마비 환자의 제중지지율과 보행에 미치는 효과)

  • Lee, Suk-Min;Shim, Tae-Ho
    • Journal of Korean Physical Therapy Science
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    • v.10 no.1
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    • pp.7-17
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    • 2003
  • The purpose of this study was to investigate the effect of the involved lower limb weight bearing training on symmetrical weight supporting rate improvement and gait characteristics of patients with hemiplegia including their gait velocity, cadence, stride length, step length of the non affected side, step length of the affected side, foot angle of the non affected side, foot angle of the affected side, base of support, and so on. The subject of the study was 28 men and women patients with hemiplegia from 22 to 77 age, among patients who doctor diagnosed as hemiplegia due to stroke or traumatic brain injury, were possible to do independent gait more than 45m without others assistance, the flexion contracture of hip pint was less than $15^{\circ}$, did not have contracture for knee pint and one more than $5^{\circ}$ for ankle joint, did not have contraindication for exercise or gait did not show visual defect due to brain injury. The patients, the subject of the study, were classified into 14 patients of treatment. group applying continuous involved weight bearing with general therapeutic exercise and 14 patients of control group applying general therapeutic exercise, and then analyzed their gait before and after exercise. Temporal distance gait analysis(Boening, 1977) was used to analyze their gait, and ink foot-print was applied as one of measurement methods. However, it was statistically signifiant in the change rate(%) of gait characteristics, and treatment group's patients with hemiplegia had been highly changed in gait characteristics in comparison with control group. From the above-mentioned results, could find that continuous involved weight bearing training for patients with hemiplegia was effective to improve their gait ability and it could increase the ability in comparison with general exercise.

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Literature Review with Collaboration Between doctors and nurses (간호사와 의사 간의 협력에 관한 이론적 고찰)

  • Woo, Seon-Hye
    • Journal of Home Health Care Nursing
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    • v.7 no.1
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    • pp.73-82
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    • 2000
  • Twenty-first century coming of health care in our country is in a situation of much conflict because the relationship between nurses and doctors is seen in terms of a traditional and vertical structure. Accordingly. it is very difficult to find collaboration amongst individuals of these two professions. Now nursing is trying to find independence and autonomy by carrying out independent professional skills. This study on collaboration and the obstacles hindering its pursuit. The strategies of collaboration to give better health care quality are as follows; First, a program for professionals should be developed to enhance professional knowledge and technology and train nursing professionals so that nursing can be acknowledged as a profession with a power to carry out on independent job. Second, collaboration reduces expenses and results in satisfactory performances of duty, high productivity, low incidence of medical accident, and higher satisfaction of the patient. Therefore the leader in the higher position should take positive stance for collaboration and help create a cooperative situation through the development of practical orders for collaboration. opening cooperative wards, and meeting for collaboration. Third, a collaboration model should be introduced into the courses of the nursing and medical school curriculum, which would influence job atmosphere after graduation. Fourth, nurses should have pride in their jobs as professionals and have confidence in their professional skill, knowledge and ability. Nurses should make an effort to share responsibility and have independence and autonomy. Fifth, common people as well as doctors know little about professional practice and the role of nurses, so a publicity campaign is also required.

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Design and Implementation of Multiple Control Server for Telemedicine Service (원격진료 서비스를 위한 다중접속 제어서버 설계 및 구현)

  • Kim, Do-Yoon;Yoo, Sun-Kook;Kim, Nam-Hyun
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.49 no.1
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    • pp.39-46
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    • 2012
  • We can adapt telemedicine systems in advancement of information technology capabilities and increase of network bandwidth. The telemedicine service can be applied to a public health center, a school, a prison and islands in lacks of medical equipments and medical staffs. The telemedicine services which can be provided high quality medical services. We designed the multiple control server system consisting 3 sub-function, patients and doctors name list, network types, connection states and computer equipments. The telemedicine link configuration was decided as 'Flowing', or 'By-passing' in accordance the network type and bandwidth of patient systems or doctor systems. The multiple control server system was performed the best communication configuration over heterogeneous networks. This system was achieved high quality telemedicine services through dynamic wired and wireless networks at any time. This study represented a hybrid multimedia telemedicine system over heterogeneous networks. We expected that the designed system could provide not only the high quality services, tele-diagnosis and tele-consultation, but also the effective emergency telemedicine services to multi-patients in the heterogeneous network environments.

A Comparison of Hospice Care Research Topics between Korea and Other Countries Using Text Network Analysis (텍스트네트워크분석을 활용한 국내·외 호스피스 간호 연구 주제의 비교 분석)

  • Park, Eun-Jun;Kim, Youngji;Park, Chan Sook
    • Journal of Korean Academy of Nursing
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    • v.47 no.5
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    • pp.600-612
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    • 2017
  • Purpose: This study aimed to identify and compare hospice care research topics between Korean and international nursing studies using text network analysis. Methods: The study was conducted in four steps: 1) collecting abstracts of relevant journal articles, 2) extracting and cleaning keywords (semantic morphemes) from the abstracts, 3) developing co-occurrence matrices and text-networks of keywords, and 4) analyzing network-related measures including degree centrality, closeness centrality, betweenness centrality, and clustering using the NetMiner program. Abstracts from 347 Korean and 1,926 international studies for the period of 1998-2016 were analyzed. Results: Between Korean and international studies, six of the most important core keywords-"hospice," "patient," "death," "RNs," "care," and "family"-were common, whereas "cancer" from Korean studies and "palliative care" from international studies ranked more highly. Keywords such as "attitude," "spirituality," "life," "effect," and "meaning" for Korean studies and "communication," "treatment," "USA," and "doctor" for international studies uniquely emerged as core keywords in recent studies (2011~2016). Five subtopic groups each were identified from Korean and international studies. Two common subtopics were "hospice palliative care and volunteers" and "cancer patients." Conclusion: For a better quality of hospice care in Korea, it is recommended that nursing researchers focus on study topics of patients with non-cancer disease, children and family, communication, and pain and symptom management.

Factors influencing the composite quality score from the quality assessment program for long-term care hospitals (요양병원의 입원급여 적정성 평가 결과에 미치는 영향 요인 분석)

  • Lee, Sang-Kab;Seol, Jin-Ju;Lee, Kwang-Soo
    • Korea Journal of Hospital Management
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    • v.25 no.3
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    • pp.78-86
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    • 2020
  • Purposes: This study purposed to identify factors influencing the composite quality score from the quality assessment program for long-term care hospitals Methodology: The study variables was obtained from HIRA(Health Insurance Review and Assessment Service): the composite quality scores and hospital variables such as number of doctors, nurses, beds, medical technicians, medical equipments, administrative region, ownerships from 3rd (2010) to 7th (2018) quality assessment program. National Statistical Portal(www.kosis.go.kr) provided the number of senior citizens aged over 65 in city·county·district area. SAS 9.4 was used for the data processing and used to analyze the data. Findings: The results showed that composite quality score increased past 9 years. Hospital variables such as number of doctor, nurse, medical technicians, bed and public hospitals had significant positive relationship with the composite quality score. Administrative region(district) showed higher scores compare to that of city. Compare to the score of quality assessment year(2010), as the assessment year move to 2012, 2013, 2015, 2018, results showed higher significant positive coefficients. Practical Implication: Continuously improve the performance of long-term care hospitals, current quality assessment program are needed to update their system such as adopting indicators measuring the service process, or compensating the cost for quality assessment program. It will enable to provide more reasonable and accurate performance assessment scores.

Effects of Robot-Mediated Gait Training Combined with Virtual Reality System on Muscle Activity: A Case Series Research

  • Heo, Seoyoon;Kim, Mooki;Choi, Wansuk
    • Journal of International Academy of Physical Therapy Research
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    • v.11 no.2
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    • pp.2021-2027
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    • 2020
  • Background: Previous robot-mediated gait training has been proven several limitations such as pointless repeated motion training, decreased presence, etc. In this research, adult stroke patients were participated in robot-mediated gait training accompanied with or without virtual reality program. Objectives: Exploring whether the results indicated virtual reality system has contribution to muscle strength and balance ability. Design: A case series research, cross-over trial. Methods: Eleven participants (male 4, female 7) with adults diagnosed as stroke from medical doctor ware engaged. The participants received 2 treatment sessions of identical duration, robot-assisted gait training with virtual reality and robot-assisted gait training with screen-off randomly crossed over include 1-day for each person of wash-out period. The parameter was muscle activity, the researchers assessed sEMG (surface electromyography). Results: The result showed less muscle activities during training in robot-assisted gait training with virtual reality circumstances, and these indicated muscles were gluteus medius muscle, vastus medialis muscle, vastus intermedius and vastus lateralis muscle, semimembranosus muscle, gastrocnemius-lateral head, and soleus muscle (P<.05). Conclusion: In this study, we analyzed the outcome of muscle activity for clinical inference of robot-assisted gait training with virtual reality (VR). Less muscle activity was measured in the treatment accompanied by VR, therefore, a more systematic, in-depth and well-founded level of follow-up research is needed.