Journal of Korean Academy of Fundamentals of Nursing
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v.17
no.4
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pp.575-587
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2010
Purpose: The purpose of this study was to analyze the research on adherence for secondary prevention in patients with coronary artery disease (CAD) in Korea, and to identify the strategies for improvement that should be included in future studies. Methods: Electric literature searches were conducted for Pubmed, CINAHL, RISS4U, KISTI, DBpia, KoreaMed, National Assembly Library, and National Library of Korea. A total of forty two articles published between 1986 and 2009 were selected based on established inclusion criteria. Results: Forty research papers were related to nursing, and there was only one research paper focused 011 elderly people with CAD. There were no papers using concept analysis, qualitative study. or randomized controlled clinical trial. Almost all definitions of adherence were adopted from outdated compliance definitions with the attribute of 'paternalistic obligation', Measurement tools were not based on theoretical framework of adherence but borrowed from tools for measuring self-care, health behavior, or self-efficacy. Overall patient's adherence was analyzed in most studies, except for a few studies which focused on diet and exercise only. Educational strategy was the main strategy used in intervention studies. Conclusions: The concept of adherence and measurement tools need to be clarified, along with development of the specific adherence interventions according to the type of adherence in patients with CAD.
Journal of The Korea Institute of Healthcare Architecture
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v.24
no.3
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pp.49-57
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2018
Purpose: The increase in patients requiring hemodialysis has resulted in an increase dialysis-associated infections risk. but there are no Renal Dialysis unit design standard meet specified safety and quality standards. Therefore, appropriate Establish standards and legal regulation is important for the provision of initial certification and maintenance of facility, equipment, and human resource quality. Methods: Literature survey on the design guideline and standards of Renal Dialysis unit design in Korea, U.S, Germany, Singapore, Hongkong, Dubai. Results: There are no established standards for facilities in dialysis units in Korea. To prevent infections in dialysis patients, necessary establish standards. Considering the domestic and overseas Health-care facilities standards, the major factors to be considered in the medical environment for Renal Dialysis Unit are as follows. First, planning to separate Clean areas(treatment area) from contaminated areas(medical waste storage area). Second, ensure sufficient space and minimum separation distance. Although there may be differences depending on the circumstances of individual institutions, renal dialysis unit consider the space to prevent droplet transmission. Third, secure infrastructure of infection prevention such as sufficient amount of hand hygiene sinks. Hand washing facilities for staff within the Unit should be readily available. Hand hygiene sinks should be located to prevent water from splashing into the treatment area. Fourth, Heating, ventilation and air conditioning (HVAC) system for Renal Dialysis Unit is all about providing a safer environment for patients and staff. Implications: The results of this paper can be the basic data for the design of the Renal Dialysis Units and relevant regulations.
Kim, Myoung-Soo;Kim, Jung-Soon;Jung, In-Sook;Kim, Young-Hae;Kim, Ho-Jung
Journal of Korean Academy of Nursing
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v.37
no.2
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pp.185-191
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2007
Purpose. The purpose of this study was to develop and evaluate an error reporting promoting program(ERPP) to systematically reduce the incidence rate of nursing errors in operating room. Methods. A non-equivalent control group non-synchronized design was used. Twenty-six operating room nurses who were in one university hospital in Busan participated in this study. They were stratified into four groups according to their operating room experience and were allocated to the experimental and control groups using a matching method. Mann-Whitney U Test was used to analyze the differences pre and post incidence rates of nursing errors between the two groups. Results. The incidence rate of nursing errors decreased significantly in the experimental group compared to the pre-test score from 28.4% to 15.7%. The incidence rate by domains, it decreased significantly in the 3 domains-"compliance of aseptic technique", "management of document", "environmental management" in the experimental group while it decreased in the control group which was applied ordinary error-reporting method. Conclusion. Error-reporting system can make possible to hold the errors in common and to learn from them. ERPP was effective to reduce the errors of recognition-related nursing activities. For the wake of more effective error-prevention, we will be better to apply effort of risk management along the whole health care system with this program.
This research investigated the retired elderly who had moved to rural areas. The propose of the study was to examine the point at which there must be a difference in the patterns of a return to farming and determine the actual condition of their preparations for migration. This study had surveyed 408 seniors who wereare over 50 years old and had moved to rural areas after their retirement and analyzed the data by the SPSS PC 11.0 program. The results were as follows. First, the relevancy of U-turn, J-turn, and I-turn types that were affected by social demography was found to be dependent on their education levels and family patterns. Second, the actual conditions of the process of preparation by the types of a return to the farming were different according to the motivation and preparation fund. Nevertheless, the most important factor was the influence of their spouses. Third, the actual conditions of the process of adaptation by the patterns of a return to the farming showed no difference between the degree of efforts of the social supportand elevation of the friendship among the neighbors. The recognition of rural life problems were more acquainted towards the area of farming life. Among the 6 problem areas, leisure, health care, and economic problems were highly considered.
Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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2010.05a
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pp.852-855
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2010
Based on the rapid development of the computer network technology, the ubiquitous sensor network (USN) was developed to enable us to have access to the communication environment anywhere and anytime without the need for recognizing computers or networks. Moreover, with the increasingly high interest on individual health, the USN technology is being applied to diverse sectors for healthcare and disease prevention. In this paper, a system was designed and implemented using the USN-based RF communication for doctors and nurses who care patients in the hospital to easily measure and control the physiological data on blood pressure and blood sugar. In addition, a database was designed using MS SQL database to store and manage the blood pressure and blood sugar data, which were passively or actively measured from patients. Using the results of this study, the physiological data of patients can be managed in real time and emergency situation can be instantly addressed. It is expected that the healthcare service can be improved and the paradigm of healthcare service environment can be changed.
Le, Minh Tam;Nguyen, Vu Quoc Huy;Truong, Quang Vinh;Le, Dinh Duong;Le, Viet Nguyen Sa;Cao, Ngoc Thanh
Endocrinology and Metabolism
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v.33
no.4
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pp.447-458
/
2018
Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrinopathies among reproductive-age women. Its metabolic features often overlap with those associated with metabolic syndrome (MS) and insulin resistance syndrome (IRS). The objective of this study was to determine the prevalence and predictors of MS and IRS in infertile Vietnamese women with PCOS. Methods: A cross-sectional study was conducted at a tertiary fertility centre at Hue University Hospital from June 2016 to November 2017. A total of 441 infertile women diagnosed with PCOS based on the revised 2003 Rotterdam consensus criteria were enrolled. MS and IRS were defined based on the National Heart, Lung, and Blood Institute/American Heart Association Adult Treatment Panel III 2005 and American College of Endocrinology IRS 2003 criteria, respectively. Complete clinical and biochemical measurements of 318 women were available for analysis. Independent predictors of MS and IRS were identified using multivariate logistic regression. Results: The overall prevalence of MS and IRS in women with PCOS was 10.4% and 27.0%, respectively. We identified older age (>30 years) and obesity as independent predictors of MS and IRS. Elevated anti-$M{\ddot{u}}llerian$ hormone levels increased the risk of IRS, but not that of MS. Conclusion: MS and IRS are prevalent disorders among infertile Vietnamese women with PCOS. PCOS is not solely a reproductive problem. Screening and early intervention for MS and/or IRS based on anthropometric, metabolic, and reproductive hormone risk factors should be an integral part of fertility care.
Purpose: The aim of this study was to investigate the risk factors for brain reperfusion injury in ischemic stroke patients and to analyze the clinical outcomes. Methods: A retrospective study was conducted in 168 patients who underwent mechanical thrombectomy. The data were analyzed using descriptive statistics, t-test, Mann-Whitney U test, Chi-Square test, Fisher's exact test, and logistic regression with IBM SPSS/WIN 24.0. Results: Brain reperfusion injury occurred in 67 patients (39.9%) with a low favored outcome (𝛘2=6.01, p=.014). On multivariable analysis, blood urea nitrogen (Odds ratio [OR]=1.14, 95% Confidence interval [CI]=1.06-1.23), aphasia (OR=6.16, CI=1.62-23.40), anosognosia (OR=4.84, CI=1.13-20.79), presence of both aphasia and anosognosia (OR=7.33, CI=1.20-44.60), and time required to achieve targeted blood pressure (OR=1.00, CI=1.00-1.00) were identified as risk factors for brain reperfusion injury. A statistically significant difference was detected in clinical outcomes, including hemorrhagic transformation (𝛘2=6.32, p=.012), intensive care unit length of stay (Z=-2.08, p=.038), National Institute of Health Stroke scale score at discharge (Z=-3.14, p=.002), and modified Rankin Scale score at discharge (Z=-2.93, p=.003). Conclusion: This study identified the risk factors and presented the clinical outcomes of brain reperfusion injury. It is necessary to consider these risk factors for evaluating the patients and to establish nursing interventions and strategies.
Journal of Korea Society of Industrial Information Systems
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v.14
no.2
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pp.32-50
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2009
Since 1990 when order communication system(OCS) was first introduced, the use of information technology in medical service has been widely accepted in order to enhance quality and customer relationship as well as to increase managerial efficiency. Medical information system is rapidly increasing and is trying to make ubiquitous healthcare environment through telemedicine system. Especially, medical profession and government have taken interest in electronic medical record (EMR) system which can digitalize and manage all medical records in hospitals. By recording patient's medical information in real time, EMR system can improve service efficiency and customer service quality including short waiting time, various utilization of clinic information, and reduced cost.
Psychiatrists who treat violent or potentially violent patients may be sue for failure to control aggressive outpatients and for the discharge of violent inpatients. Psychiatrists may be sued for failing to protect society from the violent acts of their patients if it was reasonable for the psychiatrists to have known or should have known about the patient's violent tendencies and if the psychiatrists could have done something that could have safeguarded in public. The courts of a number of jurisdictions have imposed a duty to protect the potential victims of a third party on persons or institutions with a special relationship to that party. In the landmark case of Tarasoff v Regents of University of California, the California Supreme Court held that the special relationship between a psychotherapist and a patient imposes on the therapist a duty to act reasonably to protect the foreseeable victims of the patient. Under Tarasoff, when a therapist has determined, or under applicable professional standards should determine, that a patient poses a serious threat of violence to another, he incurs an obligation to use reasonable care to protect the intended victim against such danger. In addition to a Tarasoff type of action based on a duty to warn or protect foreseeable victims of psychiatric outpatients, courts have also imposed liability on mental health care providers based on their custody of patients known to have violent propensities. The legal duty in such a case has been stated to be that where the course of treatment of a mental patient involves an exercise of "control" over him by a physician who knows or should know that the patient is likely to cause bodily harm to others, an independent duty arises from that relationship and falls on the physician to exercise that control with such reasonable care as to prevent harm to others at the hands of the patient. After going through a period of transition, from McIntosh, Thompson and Brady case, finally, the narrow rule of requiring a specific or foreseeable threat of violence against a specific or identifiable victim is the standard threshold or trigger element in the majority of states. Judgements on these kinds of cases are not enough yet in Korea, so that it may be too early to try find principles in these cases, however it is hardly wrong to read the same reasons of Tarasoff in the judgements of Korea district courts. To specific, whether a psychiatric institute was liable for violent behavior toward others depends upon the patients conditions, circumstances and the extent of the danger the patients poses to others; in short, the foreseeability of a specific or identifiable victim. In this context if a patient exhibit strong violent behavior toward others, constant observation should be required. Negligence has been found not exist, however, when a patient abruptly and unexpectedly attack others or unidentifiable victim. And the standard of conduct that is required to meet the obligation of "due care" is based on what the "reasonable practitioner" would do in like circumstances. The standard is not one of excellence or superior practice; it only requires that the physician exercise that degree of skill and care that would be expected of the average qualified practitioner practicing under like circumstances. All these principles have been established in cases of the U.S.A and Japan. In this article you can find the reasons which you can use for psychotherapist's liability for failure to protect third person in Korea as practitioner.
Purpose: This study was undertaken to provide the framework for development of a genetic counseling training program, and an accreditation and certification process suitable for non-M.D. genetic counselors in Korea. Materials and Methods: Global standards of genetic counseling curriculums, training program accreditation (TPA), and the certification process for genetic counselors (CPGC) in the U.S.A and Japan were reviewed, and a questionnaire survey was performed to elicit opinions among health-care providers including physicians, nurses, technicians, researchers, and educators. In addition, input from professional communities, including the Korean Society of Medical Genetics (KSMG) and Institute for Genetic Testing Evaluation, was sought in formulating the framework of this study. Results: Comparison of U.S.A. and Japan educational systems showed similarities in curriculum, accreditation, and certification programs. Analysis of 117 respondents opinions showed a high level of agreement in the area of global standards; 88% indicated that KSMG should be in charge of TPA and CPGC, while 77% favored a certification exam composed of both written exam and interview components. Conclusion: Based upon this study we propose that the KSMG should be in charge of providing the TPA and CPGC for non-MD genetic counselors. Requirements for the entrance to a Master's degree genetic counseling program should be open to successful four year undergraduate students in all areas, provided the candidates demonstrate the abilities to master the graduate level of study in human genetics, clinical genetics, statistics, psychology, and other required subjects. Eligibility for certification should include qualified candidates of genetic counseling with no formally approved education, but a sufficient amount of clinical experience, in addition to accredited program graduates. Certification examinations should be carried out every two years and the certification should be good for five years, as is the case in Japan.
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