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Current Status and Activation Plan of Hospice Palliative Care in Korea - Based on Hospice Palliative Care Facilities Survey (국내 호스피스.완화의료 현황 및 활성화 방안 - 호스피스.완화의료 기관 조사를 바탕으로)

  • Kyung, Min-Ho;Jang, Yu-Mi;Han, Kyung-Hee;Yun, Young-Ho
    • Journal of Hospice and Palliative Care
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    • v.13 no.3
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    • pp.143-152
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    • 2010
  • Purpose: This study aimed to evaluate the current status of hospice palliative care facilities in Korea. Based on the result, we attempted to suggest activation plans of hospice palliative in Korea. Methods: To conduct a survey, we obtained a list of hospice palliative care facilities from related agencies and academic societies. A survey was conducted from February, 2009 to March, 2009. The survey was consisted of general characteristics of organizations, manpower, facilities & equipments, and so on. In addition, we used data from Statistics Korea to estimate the number of beds required and the bed occupancy rate. Results: Total number of facilities responded to the questionnaire were 53. Forty-two facilities were general hospitals and 6 facilities were clinics among the total 53 facilities, and 18.8% of facilities were located in Seoul, Incheon and Gyeonggido. Overall bed occupancy rate was rather low as 21.9%, and there were 4 provinces where bed occupancy rates were 0%. Deaths in hospice palliative care facilities during 2008 were 6.3% of total deaths from cancers. As for the questions about the financial status of facilities, 86% of facilities were answered financial insufficiency. Also more than half of the facilities gave financial insufficiency as the reason for shortage of human resource supplies and inability to achieve the standard for authorization by the government. Facilities answered in order to activate the hospice palliative care, governmental support is needed, mostly in financial support (71.2%), donation tax deduction (43.1%), and setting up a public utility foundation (23.5%). Conclusion: This study showed low rates of hospice palliative care use and bed occupancy in Korea. Regional variance in bed occupancy rate was significantly high. As a roadblock for these problems, most of the facilities cited financial insufficiency. Therefore, there must be some action plans to boost financial support to activate hospice palliative care in Korea. Finally, efforts to improve these circumstances including lack of understanding about hospice and palliative care, are needed as well.

Changes in Bird Community in Artificial Wetlands of Sihwa Lake, South Korea (시화호 인공습지 조성 후 조류군집의 변화)

  • Hur Wee-Haeng;Lee Woo-Shin;Rhim Shin-Jae
    • Korean Journal of Environment and Ecology
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    • v.19 no.3
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    • pp.279-286
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    • 2005
  • This study was conducted to analyze the changing pattern of the bird community after the construction of artificial wetland at Sihwah lake from may 2000 to January 2002. Total seventy seven bird species were recorded at Sihwa artificial wetland area during the survey. Number of the bird species and individuals were increased in second year than first survey year. Especially shorebirds and raptors were more increased than other groups. Long-term and continuous monitoring of bird community would be needed to clarify the reasons of increasing pattern of bird species and individuals in artificial wetlands of Sihwa lake. Until now, this area has been considered as suitable habitat for dabbling ducks than shore birds and has simple habitat environment consisting of open water surface and reed beds. Therefore, we suggest the follows for creation of diverse habitat types: 1) seasonal water-level manipulation 2) management of diverse aquatic plants and 3) creation of diverse land cover; sandy fields, gravelly fields, grasslands, etc.

The Effect of Perceived Internal Marketing and Customer Orientation on the Organizational Commitment of Nurses in Specialized Hospital (전문병원간호사가 지각한 내부 마케팅과 고객지향성이 조직몰입에 미치는 영향)

  • Lim, Kyoung-Min;Jo, Eun-Joo;Kwon, Jeong-Ok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.3
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    • pp.489-498
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    • 2016
  • This study examined the effects of internal marketing and customer orientation on the organizational commitment of nurses in specialized hospitals. This research was conducted from May 1 to 30, 2015 and involved 149 nurses at 5 specialized hospitals in Busan, The collected data were analyzed by descriptive statistics, t-test, ANOVA, Scheffe's test, Pearson correlation coefficients, stepwise multiple regression by the SPSS WIN 18.0 program. As a result, there were significant differences in the organizational commitment according to age, marital status, education, clinical experience, position, work shift, working unit, number of beds, and experience of participation for employee satisfaction survey. Organizational commitment was positively related to the internal marketing. In addition, there was a positive correlation between the organizational commitment and customer orientation. Meaningful variables that influenced the organizational commitment were internal marketing, working unit, education, and position. The total explanation power was 58.5% and the internal marketing was the most influential factor. In conclusion, to enhance the organizational commitment of nurses working in specialized hospitals, educational opportunities need to be provided to increase the professionalism of nurses, and efforts will be needed to improve the working environment and develop internal marketing strategies, such as regular satisfaction surveys.

Determinants of Length of Stay in Geriatric Hospitals - Focused on Alzheimer Dementia's Inpatients (요양병원 입원 알츠하이머 치매노인의 재원일수 결정요인 분석)

  • Bang, Hyo-Jung;Lee, Kwang-Soo
    • The Journal of the Korea Contents Association
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    • v.13 no.12
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    • pp.900-909
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    • 2013
  • This study purposed to analyze the determinants of length of stay for patients having alzheimer dementia in geriatric hospitals. Sample data was collected from the National Patient Sample (NPS) produced by the Health Insurance Review & Assessment Service (HIRA) in 2009. Total 538 alzheimer inpatients over 65 years were used in the analysis. Patients were classified into 5 risk groups to represent the case-mix differences of patients. Organizational characteristics of geriatric hospitals such as number of beds, doctors, and nurses were included in the analysis model. In multivariate regression analysis, hospital variables were not statistically significant in explaining the length of stay. Two risk group were statistically significant in analysis, However, their signs of relationship with the dependent variable were opposite to the expectations. These results suggest that the characteristics of patients and hospitals did not have impacts on the length of stay. There will be needs to test the effects of other factor such as social needs which represents the socio-economic status of the family for the patients.

Doctor's and Nurses' Perception and Experiences of DNR (DNR(Do-Not-Resuscitate)에 대한 의사와 간호사의 경험 및 인지도)

  • Han, Sung-Suk
    • Journal of Korean Academy of Nursing Administration
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    • v.11 no.3
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    • pp.255-264
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    • 2005
  • This study is a descriptive research in investigating the perception of doctors and nurses with regard to DNR, and data were collected through survey questionnaires. The period of collecting data was between July 15 and October 30, 2004, distributing 128 questionnaires to 128 participants, and a total of 110 questionnaires from 55 doctors and 55 nurses were collected (86%)among 70 different hospitals. The collected data were analyzed using SAS program to get real number and percentage, and were also analyzed with $X^2$-test. The Study Results are as follows: 1. Respondents who agreed with the necessity of DNR was 97.27%, the reasons of DNR necessity were 59.20% of 'impossibility of recovery in spite of lots of efforts,' and 35.20% of 'for the purpose of choosing a comfortable and dignified death,' and 97.2% of respondents answered that it was necessary to give explanation of DNR to serious case patients, terminal patients and their family. 2. Problems derived from DNR decisions were 44.44% of 'lack of treatment and nursing,' 21.11% of 'guilty conscience about failing to do best efforts,' and 71.57% of CPR implementation right after DNR decision. 3. Reasons of implementing CRP for patients with DNR decision were 50.94% of 'for the presence of family and relatives at the point of patient's death,' 20.76% of 'guardian's change of DNR decision,' and 16.98% of 'no communication for the consent after DNR decision.' 4. With regard to who was to make DNR decision? there was a difference in the opinion between doctors' and nurses' group while the group of doctors chose 'by the consent of the family and the doctor in charge,' and the group of nurses chose 'patient's intension,' and with regard to Have you received DNR related education? and Will people who want DNR increase if there is explanation given? there was a difference between the two groups. 5. In the catholic institutions, respondents of 71.7% said that it was necessary to take DNR depending upon the situation, and 73% said that they had performed DNR before. 6. In the institutions with over 500 beds, 91.92% of respondents said that there should be an establishment of guideline book as a written format to implement DNR. From the results of this study, it was found that DNR was implemented and executed broadly in clinical fields in the absence of necessary instructions and/or guideline, and that DNR order was placed to the group of doctors who got less opportunity for proper education than did that of nurses.

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Clinical Nutrition Service in Korean Tertiary Hospitals and General Hospitals: Result of Nationwide Cross-Sectional Survey (국내 상급종합병원과 전국 분포 종합병원의 임상영양서비스 실태 조사 연구: 전국 규모 설문조사를 통하여)

  • Um, Mi Hyang;Park, Yoo Kyung;Lee, Song Mi;Lee, Seung Min;Lee, Eun;Cha, Jin A;Park, Mi Sun;Lee, Ho Sun;Rha, Mi Yong;Lyu, Eun Soon
    • Journal of the Korean Dietetic Association
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    • v.20 no.3
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    • pp.183-198
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    • 2014
  • The purpose of this study was to investigate the status of clinical nutrition services provided at tertiary hospitals and general hospitals in Korea. In total, 157 questionnaires were distributed to the departments of nutrition at hospitals on September 2013. The results of this study are as follows. The median number of beds was 607 and average length of stay was 8 days. 63.1% of dietitians had over 5 years of career experience. Nutritional screening rate was 97% in tertiary hospitals but only 67.2% in general hospitals (P<0.001). The rate of equipment with computerized nutritional screening system was 100% in tertiary hospitals but 71.9% in general hospitals (P<0.001). Hospitals with the best regarding nutritional care were hospitals accredited by JCI (Joint Commission International). On the other hand, hospitals not accredited by the JCI but KOIHA (Korea Institute for Healthcare Accreditation) showed the lowest performance rate of nutritional care. Nutrition support teams (NSTs) were established in all tertiary hospitals but in only 73% of general hospitals (P<0.001). The rate of actively operating NSTs was 89% in tertiary hospitals but only 62% in general hospitals (P<0.001). There is a need to provide proper standardized clinical nutrition services as a primary treatment and we observed large variations in the quality of nutritional service between hospitals. Therefore, local solutions are needed to implement nutritional programs and policies for improved service and care.

Application Testing and Comparative Effectiveness of Green-tide Mitigation Technique in the Lower Part (Chusori) of the So-ok Stream (Daecheong Reservoir), Korea (소옥천 하류(추소리)에서 녹조현상 경감기술의 현장 시험 적용 및 효과 비교)

  • Shin, Jae-Ki;Kim, Youngsung;Noh, Joonwoo;Kim, Jong-Myung;Hwang, Soon-Jin
    • Korean Journal of Ecology and Environment
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    • v.49 no.4
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    • pp.258-270
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    • 2016
  • This study was conducted to test the green-tide mitigation technique in the lower part of the Sook Stream (Chusori) of Daecheong Reservoir from June 27 to August 24, 2014. And the effects were compared with weekly monitoring result of the watching station of the algae alert system (AAS) as well as test beds reach. The green-tide in a test bed was begun from the upstream, and it was gradually transferred and spread toward the downstream by the hydrological factors. The total amount of algae removed by algae removal device during the test period was 33,920 kg, and solids dewatered by natural gravity was 8,480 kg. Also chlorophyll-a content was 2.83 kg, the number of blue-green algae cells was equivalent to $78.6{\times}10^{14}$ cells. Compared with the results of the watching station of AAS, the pre-concentrate removal work in the outbreak waters was able to suggest the possibility of green-tide mitigation. In addition, an effective management of the green-tide was required spatial and temporal occurrence information and practical device technology. Particularly, the optimal timing of algae removal in the river-reservoir hybrid system was recommended at times before the monsoon rainy season and reached the lowest water level.

Traumatic Brain Injury in Children under Age 24 Months : Analysis of Demographic Data, Risk Factors, and Outcomes of Post-traumatic Seizure

  • Yoon, Sang-Youl;Choi, Yeon-Ju;Park, Seong-Hyun;Hwang, Jeong-Hyun;Hwang, Sung Kyoo
    • Journal of Korean Neurosurgical Society
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    • v.60 no.5
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    • pp.584-590
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    • 2017
  • Objective : Traumatic brain injury (TBI) in children under age 24 months has characteristic features because the brain at this age is rapidly growing and sutures are opened. Moreover, children this age are completely dependent on their parents. We analyzed the demographic data and risk factors for outcomes in TBI patients in this age group to elucidate their clinical characteristics. Methods : We retrospectively reviewed the medical records and radiological films of children under 24 months who were admitted to Kyungpook National University Hospital from January 2004 to December 2013 for TBI. Specifically, we analyzed age, cause of injury, initial Glasgow coma scale (GCS) score, radiological diagnosis, seizure, hydrocephalus, subdural hygroma, and Glasgow outcome scale (GOS) score, and we divided outcomes into good (GOS 4-5) or poor (GOS 1-3). We identified the risk factors for post-traumatic seizure (PTS) and outcomes using univariate and multivariate analyses. Results : The total number of patients was 60, 39 males and 21 females. Most common age group was between 0 to 5 months, and the median age was 6 months. Falls were the most common cause of injury (n=29, 48.3%); among them, 15 were falls from household furniture such as beds and chairs. Ten patients (16.7%) developed PTS, nine in one week; thirty-seven patients (61.7%) had skull fractures. Forty-eight patients had initial GCS scores of 13-15, 8 had scores of 12-8, and 4 had scored 3-7. The diagnoses were as follows : 26 acute subdural hematomas, 8 acute epidural hematomas, 7 focal contusional hemorrhages, 13 subdural hygromas, and 4 traumatic intracerebral hematomas larger than 2 cm in diameter. Among them, two patients underwent craniotomy for hematoma removal. Four patients were victims of child abuse, and all of them had PTS. Fifty-five patients improved to good-to-moderate disability. Child abuse, acute subdural hematoma, and subdural hygroma were risk factors for PTS in univariate analyses. Multivariate analysis found that the salient risk factor for a poor outcome was initial GCS on admission. Conclusion : The most common cause of traumatic head injury in individuals aged less than 24 months was falls, especially from household furniture. Child abuse, moderate to severe TBI, acute subdural hematoma, and subdural hygroma were risk factors for PTS. Most of the patients recovered with good outcomes, and the risk factor for a poor outcome was initial mental status.

Survey of the Knowledge of Korean Radiology Residents on Medical Artificial Intelligence (의료 인공지능에 대한 대한민국 영상의학과 전공의의 인식 조사 연구)

  • Hyeonbin Lee;Seong Ho Park;Cherry Kim;Seungkwan Kim;Jaehyung Cha
    • Journal of the Korean Society of Radiology
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    • v.81 no.6
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    • pp.1397-1411
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    • 2020
  • Purpose To survey the perception, knowledge, wishes, and expectations of Korean radiology residents regarding artificial intelligence (AI) in radiology. Materials and Methods From June 4th to 7th, 2019, questionnaires comprising 19 questions related to AI were distributed to 113 radiology residents. Results were analyzed based on factors such as the year of residency and location and number of beds of the hospital. Results A total of 101 (89.4%) residents filled out the questionnaire. Fifty (49.5%) respondents had studied AI harder than the average while 68 (67.3%) had a similar or higher understanding of AI than the average. In addition, the self-evaluation and knowledge level of AI were significantly higher for radiology residents at hospitals located in Seoul and Gyeonggi-do compared to radiology residents at hospitals located in other regions. Furthermore, the self-evaluation and knowledge level of AI were significantly lower in junior residents than in residents in the 4th year of training. Of the 101 respondents, only 16 (15.8%) had experiences in AI-related study while 91 (90%) were willing to participate in AI-related study in the future. Conclusion Organizational efforts through a radiology society would be needed to meet the need of radiology trainees for AI education and to promote the role of radiologists more adequately in the era of medical AI.

The Trend of Inpatients in California State Hospitals and Its Implications for Mental Health Policies in Korea (캘리포니아주 주립병원 입원환자들의 변화 추세 및 한국 정신보건제도의 발전을 위한 정책적 함의)

  • Hwang, Sung-Dong
    • Korean Journal of Social Welfare
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    • v.39
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    • pp.350-373
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    • 1999
  • The patient population of U. S. state mental hospitals has changed drastically since the 1960s, when the deintstitutionalization movement began. This paper is designed to look at what happened to the number of inpatients of state hospitals in California during the last 150 years and, from this, to explore implications for the future of the mental health system in Korea, especially for the viability of mental hospitals. The data had been collected by field research(visits to state hospitals and State Department of Mental Health, and interviews with mental health administrators) and accessing statistical publications and various reports. Since the first state hospital opened in 1851 the statewide inpatient population of individuals who were mentally disabled has grown and peaked at 37,489 in 1959. The number of patients in state hospitals, however, began declining in the early 1960s and was reduced to 10,874 by 1971, and to 4,973 by 1986. As of 1997, there were only 4, 263 inpatients remaining in the state hospital system. This dramatic decrease slowed down somewhat in 1980s and 1990s, but this trend seems irreversible except for the inpatients referred by the court. Now the beds in state hospitals are filled with more and more forensic patients, which constitutes nearly 70% of the total inpatient population. Based on these findings, it is well expected that the number of inpatients of mental hospitals in Korea will also be reduced in a significant way as the community-based mental health care system is gradually replacing the traditional one. Mental hospitals need to introduce more diversified programs for the care of the mentally ill, and concurrently more vigorous aftercare programs are required in the community.

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