• The Journal of Korean Physical Therapy
• /
• v.1 no.1
• /
• pp.83-102
• /
• 1989

The purpose of this study is to analyse the factors affecting rehabilitation of physically disabled persons . Data were collected from 118 physically disabled persons who were registered at facilities for disabled persons by an interview surevey Conducted from October 17 to October 26, 1988. The three facilities for the survey were selected by stratified random sampling. The results were as follows : 1. Using factor analysis, 10 variables were-grouped into 4 factors : physical need, need for social problem-solving, need for social interaction and educational need. The proportion of variance explained by these factors was $58.3\%$. 2. Age, religion and job were significantly related to the functional life scale score, but other variables were not. 3. Family APGAR score and severity of disability were significantly rotated to the functional life scale score. 4. From the multiple regression analysis on rehabilitation of the physically disabled person, the following: three variables were statistically significant : age, severity of disability and family functioning. These results suggest that age, severity of disability and family functioning variables are important factors for rehabilitation of physically disabled persons. Since the family functioning variable can be controlled by care, rehabilitation team should monitor the variable closely to improve the efficiency of rehabilitation. Because of their implication for further study, some variables, other than those considered here, are needed for studying rehabilitation of physically disabled persons.

• The Korean Journal of Emergency Medical Services
• /
• v.20 no.3
• /
• pp.7-19
• /
• 2016

Purpose: The purpose of the study was to investigate the correlation between injury and injury severity score (ISS) in geriatric traffic accident patients transported by 119 emergency medical technicians (EMTs). Methods: The subjects were 240 traffic accident patients over 65 years old transported by 119 rescue services emergency departments in Busan from January 1, 2014 to August 31, 2015. Results: ISS increased in motorcycle traffic accidents (p=.026), truck injuries (p=.005), and head and neck injury (p<.001). Vital signs were evaluated by 119 rescue EMT. ISS increased in cases of unresponsive unconsciousness (p<.001), hypotension (p=.001), and bradycardia (p<.001). The need for bleeding control and dressing by the EMTs increased ISS significantly (p=.022). Conclusion: In the initial evaluation of geriatric traffic patients, ISS can increase in motor cycle accidents and truck injuries. Due to high ISS, patients with head and neck injury, chest injury, hypotension, or tachycardia should be transferred to advanced level hospitals.

• Nutrition Research and Practice
• /
• v.10 no.4
• /
• pp.398-403
• /
• 2016

BACKGROUND/OBJECTIVES: Atopic dermatitis (AD), a chronic inflammatory skin disease, is accompanied by disruption of the epidermal lipid barrier, of which ceramide (Cer) is the major component. Recently it was reported that vitamin C is essential for de novo synthesis of Cer in the epidermis and that the level of vitamin C in plasma is decreased in AD. The objective of this study was to determine the associations among clinical severity, vitamin C in either plasma or epidermis, and Cer in the epidermis of patients with AD. SUBJECTS/METHODS: A total of 17 patients (11 male and 6 female) aged 20-42 years were enrolled. The clinical severity of AD was assessed according to the SCORAD (SCORing Atopic Dermatitis) system. Levels of vitamin C were determined in plasma and biopsies of lesional epidermis. Levels of epidermal lipids, including Cer, were determined from tape-stripped lesional epidermis. RESULTS: The clinical severity of patients ranged between 0.1 and 45 (mild to severe AD) based on the SCORAD system. As the SCORAD score increased, the level of vitamin C in the plasma, but not in the epidermis, decreased, and levels of total Cer and Cer2, the major Cer species in the epidermis, also decreased. There was also a positive association between level of vitamin C in the plasma and level of total Cer in the epidermis. However, levels of epidermal total lipids including triglyceride, cholesterol, and free fatty acid (FFA) were not associated with either SCORAD score or level of vitamin C in the plasma of all subjects. CONCLUSIONS: As the clinical severity of AD increased, level of vitamin C in the plasma and level of epidermal Cer decreased, and there was a positive association between these two parameters, implying associations among plasma vitamin C, epidermal Cer, and the clinical severity of AD.

• Quality Improvement in Health Care
• /
• v.7 no.2
• /
• pp.218-228
• /
• 2000

Background : Among 'structure', 'process' and 'outcome' approaches, outcome evaluation is considered as the most direct and best approach to assess the quality of health care providers. Risk-adjustment is an essential method to compare outcome across providers. This study has aims to judge performance of hospitals by severity adjusted mortality rates of coronary artery bypass graft (CABG) surgery. Methods : Medical records of 584 patients who got the CABG surgery in 6 general hospitals during 1996 and 1997 were reviewed by trained nurses. The MedisGroups was used to quantify severity of patients. The predictive probability of death was calculated for each patient in the sample from a multivariate logistic regression model including the severity score, age and sex. For evaluation of hospital performance, we calculated ratio of observed number to expected number of deaths and z score [(observed number of deaths - expected number of deaths)/square root of the variance in the number of deaths], and compared observed mortality rate with confidence interval of adjusted mortality rate for each hospital. Results : The overall in-hospital mortality was 7.0%, ranged from 2.7% to 15.7% by hospital. After severity adjustment the mortality by hospital was from 2.7% to 10.7%. One hospital with poor performance was distinctly divided from others with good performance. Conclusion : In conclusion, severity-adjusted mortality rate of CABG surgery might be applied as an indicator for hospital performance evaluation in Korea. But more pilot studies and improvement of methodologies has to be done to use it as quality indicator.

• Journal of Korean Clinical Nursing Research
• /
• v.14 no.1
• /
• pp.161-172
• /
• 2008

Purpose: This study was to classify patient severity score for hemodialysis patients. Method: The subject of this study was 1,575 patients. To study the severity of the patients, we used t-test and ANOVA. The congruity was measured by Kappa coefficient and the severity in each medical facility was analyzed by ANOVA. Result: The results showed that there was a significant difference according to the levels of medical center (F=171.187, p<.0001). Categorizing the severity of the patients in each medical facility, group II and III of the secondary medical institution had higher ratio than the primary medical institution. There was not a single patient coming under group IV in both of the primary or secondary medical institutions. However, the tertiary medical institutions had more subjects in group II and III than the primary and secondary medical institutions. The group IV with the highest severity had 11 patients(1.5%), demonstrating that the tertiary medical institution had higher severity patients than the primary or secondary medical institutions. Conclusion: The results of this study appropriately reflects the repayment system of medical expenses by the government. Also, it provides the fundamental information to develop nursing fee system taken into account of the systemic differences among the primary, secondary and tertiary medical institutions.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.33 no.4
• /
• pp.91-98
• /
• 2022

Objectives: Comprehensive behavioral intervention for tics (CBIT) is effective in children with chronic tic disorders. This study aimed to assess the effect of group-based CBIT (group-CBIT) on tic severity and comorbid symptoms. We compared the efficacy of group CBIT with that of a control. Methods: Thirty children with chronic tic disorder or Tourette's disorder were enrolled in this study. Eighteen were assigned to the group-CBIT for eight sessions, and 12 were assigned to the control group. Tics and comorbid symptoms were assessed pre- and post-intervention using the Yale Global Tic Severity Scale (YGTSS), Premonitory Urge for Tics Scale, attention-deficit hyperactivity disorder Rating Scale-IV, Children's Yale-Brown Obsessive-Compulsive Scale, and the Korean-Children Behavioral Checklist. We compared the pre- and post-intervention results of each group and determined the difference in the pre- and post-intervention results between intervention and the control group. Results: The YGTSS motor and vocal tic interference, global impairment, and global severity scores decreased in the intervention group only. Group CBIT was superior in reducing the motor tic interference, impairment score, and global severity score to the control group. Conclusion: The group-CBIT showed an improvement in tic symptoms, especially in reducing the level of interference and impairment of tics.

• Journal of Chest Surgery
• /
• v.52 no.6
• /
• pp.400-408
• /
• 2019

Background: For decades, trauma has been recognized globally as a major cause of death. Reducing the mortality of patients with trauma is an extremely pressing issue, particularly for those with severe trauma. An early and accurate assessment of the risk of mortality among patients with severe trauma is important for improving patient outcomes. Methods: We performed a retrospective medical record review of 582 patients with severe trauma admitted to the emergency department between July 2011 and June 2016. We analyzed the associations of in-hospital mortality with the baseline characteristics and initial biochemical markers of patients with severe trauma on admission. Results: The overall in-hospital mortality rate was 14.9%. Multivariate logistic regression analysis showed that the patient's Rapid Emergency Medicine Score (REMS; odds ratio [OR], 1.186; 95% confidence interval [CI], 1.018-1.383; p=0.029), Emergency Trauma Score (EMTRAS; OR, 2.168; 95% CI, 1.570-2.994; p<0.001), serum lactate levels (SLL; OR, 1.298; 95% CI, 1.118-1.507; p<0.001), and Injury Severity Score (ISS; OR, 1.038; 95% CI, 1.010-1.130; p=0.021) were significantly associated with in-hospital mortality. Conclusion: The REMS, EMTRAS, and SLL can easily and rapidly be used as alternatives to the injury severity score to predict in-hospital mortality for patients who present to the emergency department with severe trauma.

• Journal of Trauma and Injury
• /
• v.21 no.2
• /
• pp.78-84
• /
• 2008

Purpose: Recently, the incidence of blast injury has been on the increase worldwide. The purpose of this study was to evaluate and analyze blast injuries in South Korea. Methods: This was a retrospective multi-center study of blast injuries in three tertiary military centers. The medical records of patients with blast injuries from January 2003 to December 2007 were reviewed. The injury severity was evaluated according to the Injury Severity Score (ISS), the Revised Trauma Score (RTS), and the Trauma Score and the Injury Severity Score (TRISS). Results: This study revealed epidemiological data of blast injury in the three tertiary military hospital. A total of 94 cases of blast injury had occurred. Various body regions were involved. The most frequently injured site was the upper extremity (52.1%). The mechanisms for the blast injuries were primary (41.5%), secondary (74.5%), tertiary (7.4%), and quaternary (29.8%). The mean injury-to-hospital arrival time was $3.2{\pm}1.7hour$. The rate of admission was 88.3%, and the rate of ICU admission was 32.5%. Thirty-six (36) cases required an emergency operation. Most were performed by an Orthopedist (55.6%), an Ophthalmologist (19.4%), or a general surgeon (13.9%). The mortality rate from blast injury was 4.3%. Conclusion: This was the first paper to present data on the type of injury, the site of injury, the cause of death, and the mortality from blast injury in South Korea. Chest injury, brain injury, tertiary injury mechanisms, $ISS{\geq_-}16$, and a Maximal Abbreviated Injury Scale Score $(ABI){\geq_-}4$ were significantly associated with death.

• Health Policy and Management
• /
• v.32 no.4
• /
• pp.356-367
• /
• 2022

Background: The emergence of new infectious diseases threatens public health, increasing socioeconomic damage, and national risks. This study aimed to develop an evidence-based risk assessment tool to quickly respond to new infectious diseases. Methods: The risk elements were extracted by reviewing the risk assessment methods of the World Health Organization, United States, Europe, United Kingdom, and Germany, and the validity and priority of elements were determined through expert meetings and Delphi surveys. Then, the scale and level for each risk element were defined and a final score calculation method according to the risk evaluation result was derived. The developed risk assessment tool was verified using data at the time of domestic transmission of an emerging infectious disease. Results: In case of spread of actual infectious diseases, priority is determined based on the criticality of the elements in each area of transmissibility and severity, from which the weighted score of the risk assessment is derived. Then, the risk score for each element was calculated by multiplying the average value of the risk evaluation by its weight and the evaluation risk assessment score for the two areas was calculated. At last, the final score is plotted in a matrix where the x-axis indicates the transmissibility and the y-axis the severity and plotted on the coordinate plane for time series use. Conclusion: With respect to transmissibility and severity, this risk assessment method to respond to new and re-emerging infectious diseases enables rapid and evidence-based evaluation by quantitatively and qualitatively assessing various risk elements.

• Journal of Korean Academy of Nursing Administration
• /
• v.8 no.1
• /
• pp.5-15
• /
• 2002

This study was attempted to help in explore new direction about classification of the severity of the pediatric patients admitted at NICU. Data were collected from 230 patients who admitted at Neonatal Intensive Care Unit of 3 University hospitals and 1 General hospital during 7 months period from september 1, 2000 to April 30, 2001. The results were as follows: 1. The degree of severity of the pediatric patients admitted at NICU shown ranged 1-102 and averaged 17.7. 2. With the respect to the severity of the pediatric patients admitted at NICU, there were statistically significant relation in passing day(s) to admission(r=-.153, p=.020), hospital day(s)(r-.501, p=.000), gestational age(r=-.354, p=.000), birth weight(r=-.280, p=.000), Apgar score at 1 min and at 5 min(4=-.340, p=.000; r=-.322, p=.000), present body weight(r=-.151, p=.023). 3. The severity of the pediatric patients according to general characteristics, there were significant difference in admitting day of the patients(t=2.339, p=.020), Apgar score at 1min and 5min(F=7.893, p=.000; t=3.568, p=.001).