• Quality Improvement in Health Care
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• v.4 no.1
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• pp.64-80
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• 1997

Background : An important issue in health care today is in trying to center service around the hospitalized patient. There is a "Kindness Movement" developing now, where in the focus of Health Care is being changed from simply treating the basic physical needs of the patient with sophisticated technology, to keeping emotional well being healthy with more humane and attentive treatment. In our attempt to reach the goal of a completely satisfied patient, we undertook a study of the common complaints of patients, and the subsequent nature of the interventions. Method : The study was carried out in two stages, first the patients made known their complaints by filling out questionnaires, then we collected data on the attempts to alleviate the complaints. The questionnaire provided 19 different complaints, which were then analysed for such variables as content, source of complaint, persons treating the complaint, and length of time and method used to solve the complaint. Results : 1. The Chief complaints made by patients(99.1%) were of physical discomfort, such as pain, nausea, vomiting, indigestion, diarrhea and constipation. 2. The complaints were voiced primarily by either of the patient's family, or by the patients themselves(78.4). 3. The complaints were intervened by nurses alone(53.5%), physicians alone(25.5%), or by nurses and physicians together(19.25%). 4, The method by which the complaints were resolved included the utilization of prescriptions(55.7%), further explanation and education(25. 5%) and notification after treatment(13.2%). 5. Most complaints were voiced during the dayshift(42.6%, 7:00-15:00), followed by the evening shift(36.0% 15:00~22:00), and then the nightshift(21.3 %, 22:00-07:00). 6. The time required for successful resolution of the patient's problems varied from 10~88.9min, according to the nature of the complaint. Conclusion : Hopefully by knowing beforehand the nature of both complaint and intervention, we can anticipate problems and shorten reaction time, in order to provide for a more satisfied patient.

• The Journal of Korean Society for School & Community Health Education
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• v.14 no.3
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• pp.89-99
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• 2013

Objectives: This study was designed to examine the effects of oral health behaviors and use of dental clinics on periodontal diseases in women, the purpose of this study is to provide basic information to develop program for dental health promotion in young women. Methods: We conducted a survey targeting 486 women that agreed with the survey and were going to dental clinic from October 1, 2013 to October 18, 2013. We surveyed them by self-administered questionnaire and analyzed it by SPSS Win 19.0 program. Results: 1. For differences in periodontitis according to general characteristics, if th age is high, ratio of periodontitis is high. Married woman is higher than single one in ratio of periodontitis. Also the more number of birth, the higher ratio of periodontitis is.(p<.05) 2. For differences of periodontitis by dental care behavior, ratio of periodontitis of non-smokers is significantly low. For one that brush one's teeth broadside, the ratio of periodontitis is high.(p<.05) 3. For differences of periodontitis by use of dental clinic service, ratio of periodontitis of one that have more times visit to a dental clinic, more annual average cost for dental care, and regular dental check-ups is relatively low.(p<.05). 4. For determinant factors influencing on periodontitis, ratio of periodontitis of one that is old, have more stress, have a low level of education, and have preventive dental care is high. Ratio of periodontitis of one that have less toothbrushing and brush one's teeth after having lunch or a snack and before sleeping is significantly low. Conclusions: From this study, dental health behavior as the factor influencing on periodontitis of young women is statistically meaningful. Because this dental health behavior has a lot of potential to be improved by government and local community efforts such as education and social support, we think that systematic and various educational program development is needed to strengthen self dental care ability effectively with policy support.

• The Journal of Korean Obstetrics and Gynecology
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• v.35 no.2
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• pp.54-69
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• 2022

Objectives: The purpose of this study is to reflect the patient's perspective in the process of developing Korean medicine clinical practice guideline (CPG) of puerperal wind disorder by survey. Methods: Five hundred fifty patients were surveyed from November 3rd, 2021 to November 8th, 2021 by internet. This study is an exploratory cross-sectional survey study, and descriptive statistics and frequency analysis were conducted on respondents' general characteristics, postpartum symptoms, the history of using treatment institution for puerperal wind disorder, satisfaction of medical institutions and perception of postpartum care. Results: Survey results showed that 92.0% of respondents experienced symptoms after childbirth, and 56.2% of the symptoms were arthralgia, followed by obesity with 41.8%. Among puerperal wind disorder patients, 34.2% had treatment history, and 54.3% received Korean medical treatment. Treatment satisfaction was confirmed to be higher in Korean medical treatment. The necessity of postpartum care was recognized at 95.7% of respondents, and the performance rate of traditional Korean postpartum care was also high. Conclusions: Based on a realistic patient-centered basis, it is a study that can lay the foundation for standardizing Korean medicine treatment and strengthening coverage in the future.

• Journal of Preventive Medicine and Public Health
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• v.56 no.6
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• pp.563-572
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• 2023

Objectives: The high readmission rate of patients with chronic obstructive pulmonary disease (COPD) has led to the worldwide establishment of proactive measures for identifying and mitigating readmissions. This study aimed to identify factors associated with readmission, as well as groups particularly vulnerable to readmission that require transitional care services. Methods: To apply transitional care services that are compatible with Korea's circumstances, targeted groups that are particularly vulnerable to readmission should be identified. Therefore, using the National Health Insurance Service's Senior Cohort database, we analyzed data from 4874 patients who were first hospitalized with COPD from 2009 to 2019 to define and analyze readmissions within 30 days after discharge. Logistic regression analysis was performed to determine factors correlated with readmission within 30 days. Results: The likelihood of readmission was associated with older age (for individuals in their 80s vs. those in their 50s: odds ratio [OR], 1.59; 95% confidence interval [CI], 1.19 to 2.12), medical insurance type (for workplace subscribers vs. local subscribers: OR, 0.84; 95% CI, 0.72 to 0.99), type of hospital (those with 300 beds or more vs. fewer beds: OR, 0.77; 95% CI, 0.66 to 0.90), and healthcare organization location (provincial areas vs. the capital area: OR, 1.66; 95% CI, 1.14 to 2.41). Conclusions: Older patients, patients holding a local subscriber insurance qualification, individuals admitted to hospitals with fewer than 300 beds, and those admitted to provincial hospitals are suggested to be higher-priority for transitional care services.

• Tuberculosis and Respiratory Diseases
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• v.87 no.3
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• pp.329-337
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• 2024

Background: Fractional exhaled nitric oxide (FeNO) is known to useful biomarker for detecting eosinophilic airway inflammation. However, there is a lack of evidence regarding the role of FeNO in chronic obstructive pulmonary disease (COPD). We aimed to assess whether elevated FeNO and its impact on treatment change into an inhaled corticosteroid (ICS)-containing regimen and association with acute exacerbation (AE) in patients with COPD. Methods: We retrospectively analyzed 107 COPD patients without a history of asthma from March 2016 to December 2019. The patients whose FeNO value was more than 50 parts per billion (ppb) were defined into the high FeNO group. Multivariable analysis with logistic regression was used to identify factors associated with AE in COPD. Results: The median FeNO value was 32 ppb (interquartile range, 19 to 45) and 34 (20.0%) patients were classified as high FeNO group (median 74 ppb). In the high FeNO group, changes in inhaler treatment into an ICS-containing regimen occurred in 23 of 34 patients after the measurement of FeNO. In multivariate analysis, high FeNO was not a contributing factor for AE, but only the high blood eosinophil count (≥300 cells/µL) was associated with AE (adjusted odds ratio, 2.63; 95% confidence interval, 1.01 to 6.91; p=0.049). Conclusion: High FeNO value had a significant impact on the prescription of ICSs in COPD patients, but it did not show a significant association with AE either on its own or with changes in treatment.

• Tuberculosis and Respiratory Diseases
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• v.48 no.4
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• pp.428-437
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• 2000

Background : Five year survival rate of postoperative stage I non-small cell lung cancer(NSCLC) reaches to 66%. In the remaining one third of patients, however, cancer recurs and the overall survival of NSCLC remains dismal. To evaluate clinical and pathologic characteristics of recurred NSCLC, the patterns and factors for postoperative recurrence in patients with staged I and II NSCLC were studied. Method : A retrospective analysis was performed in 234 patients who underwent radical resection for pathologic stage I and II NSCLC. All patients who were followed up for at least one year were included in this study. Results : 1) There were 177 men and 57 women The median age was 63. The median duration of the follow up period was 732 days (range 365~1,695 days). The overall recurrence rate was 26.5%, and the recurrence occurred $358.8{\pm}239.8$ days after operation. 2) The ages of recurred NSCLC patients were higher ($63.2{\pm}8.8$ years) than those of non-recurred patients ($60.3{\pm}9.8$ years)(p=0.043). The recurrence rate was higher in stage II (46.9%) than in stage I (18.8%) NSCLC p<0.001. The size of primary lung mass was larger in recurred ($5.45{\pm}3.22\;cm$) than that of non-recurred NSCLC ($3.74{\pm}1.75\;cm$, p<0.001). Interestingly, there were no recurrent cases when the resected primary tumor was less than 2cm. 3) Distant recurrence was more frequent than locoregional recurrence (66.1% vs. 33.9%). Distant recurrence rate was higher in females and in cases of adenocarcinoma. Brain metastasis was more frequent in patients with adenocarcinoma than in those with squamous cell carcinoma (p=0.024). Conclusion: The tumor size and stage were two important factors for determining the possibility of a recurrence. Because distant brain metastasis was more frequent in patients with adenocarinoma, a prospective study should be conducted to evaluate the effectiveness of preoperative brain imaging.

• Tuberculosis and Respiratory Diseases
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• v.48 no.2
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• pp.223-235
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• 2000

Background: Liquid ventilation is associated with decreased inflammatory response in an injured lung. This study was performed to investigate if whether perfluorocarbon(PFC) can decrease chemokine expression in airway epithelial cells. Methods: A549 cells were used for airway epithelial cells and perfluorodecalin for PFC. To expose cells to PFC, lower chamber of Transwell$^{(R)}$plate was used. This study was performed in two parts. In the first part, we examined whether PFC could decrease chemokine expression in airway epithelial cells through inhibition of other inflammatory cells. Peripheral blood mononuclear cells(PBMC's) were isolated and stimulated with lipopolysaccharide(LPS, 10 ${\mu}g/mL$) for 24 hours with or without exposure to PFC. Then A549 cells were stimulated with conditioned media(CM) containing the culture supernatants of PBMC. After 24 hours, the expressions of interleukin-8(IL-8) and RANTES were measured. In the second part of the study, we studied whether PFC could directly suppress chemokine expression in airway epithelial cells. A549 cells were stimulated for 24 hours with interleukin-l$\beta$ and/or tumor necrosis factor-$\alpha$ with or without exposure to PFC, and then the chemokine expression was measured. Northern analysis was used to measure the mRNA expression, and ELISA was used for immunoreactive protein measurements in culture supernatant. Results: 1. IL-8 and RANTES mRNA expression and immunoreactive protein production were increased significantly by CM from LPS-stimulated PBMC in A459 cells compared to with CM from unstimulated PBCM (p<0.05), but exposure of PFC had no significant effect on either mRNA expression or immunoreactive protein expression. 2. IL-8 and RANTES mRNA expression and immunoreactive protein production were increased significantly by IL-1$\beta$ and TNF-$\alpha$ in A549 cells(p<0.05), but exposure of PFC had no significant effect on neither either mRNA expression nor immunoreactive protein production. Conclusion : Decreased chemokine expression of airway epithelial cells may not be involved in decreased inflammatory response observed in liquid ventilation. Further studies on possible mechanisms of decreased inflammatory response are warranted.

• Journal of Acupuncture Research
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• v.35 no.2
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• pp.95-100
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• 2018

Background: The aim of this study is to assess the feasibility of acupuncture treatment for the management of subacute and chronic post-thoracotomy pain in patients with traumatic multiple rib fractures. Methods: A total of 30 participants who have undergone thoracotomy after traumatic multiple rib fractures will be recruited. Participants will be invited and equally randomised into acupuncture plus usual care and usual care alone groups. A computer-generated random number sequence will be used and concealed using opaque, sealed, sequentially numbered envelopes. Twelve sessions of manual and electrical acupuncture performed by Korean medicine doctors will be provided over a span of 3 months to participants allocated to the acupuncture group. Participants in the usual care group will continue pain medication, exercise and physical therapy as required. Study feasibility will be measured based on the proportion of patients who complete the measurement of pain at 12 or 24 weeks after baseline. The clinical outcomes will include; the average pain intensity over the recent week at rest, movement and cough, quality of life, patient's global assessment of recovery, respiratory function measured by the pulmonary function test and use of pain medication at 4, 8, 12 and 24 weeks after enrolment. Adverse events will be recorded for all participants. Written informed consent will be obtained from all participants. The local ethics committee has approved the study. This pilot trial will inform further studies investigating the potential role of acupuncture for subacute and chronic post-thoracotomy pain in patients with traumatic multiple rib fractures.

• Journal of Korean Clinical Nursing Research
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• v.17 no.2
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• pp.176-191
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• 2011

Purpose: This methodological study translated, adapted, and validated the evidence based guideline of RNAO (Registered Nurses Association of Ontario) in Canada, for acute stroke care to domestic circumstances. Methods: Quality of the RNAO guideline was evaluated using AGREE tool. Then the guideline was translated into Korean and a preliminary guideline was established After checking content validation by an expert group, the Korean version of the guideline was applied to clinical settings to see its applicability. Results: The RNAO guideline in Korea was deemed appropriate. The Korean version of the guideline was drawn up with 56 items in 3 areas in stroke system related nursing, nursing of acute stroke inpatients, and stroke nursing assessment. A questionnaire survey was performed on appropriateness, enforceability, and applicability of those recommendations. A total of 54 recommendations were finalized after deleting 2 items below CVI 0.7 and correcting 3 items by taking professional advices. After trial application of the guideline to 40 stroke patients hospitalized at a ward of a hospital in Seoul, its performance was improved but was not statistically significant. Conclusion: This guideline is expected to contribute to improving nursing quality by offering it as a guide to evidence based practices for acute stroke care in Korea.

• Journal of Chest Surgery
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• v.54 no.1
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• pp.25-30
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• 2021

Background: Life-long anticoagulant therapy is mandatory for patients who undergo heart valve replacement with implantation of a mechanical prosthesis. The aim of this study was to investigate the effects of a nurse-led patient educational program concerning oral anticoagulant therapy intake after heart valve replacement surgery on patients' knowledge of important parameters of anticoagulant administration. Methods: In this single-center study, 200 patients who underwent surgical implantation of a mechanical prosthesis were divided into 2 groups. The control group received the basic education concerning oral anticoagulants, while the intervention group received a personalized educational program. Results: Personalized education was correlated with a better regulation of therapeutic international normalized ratio (INR) levels and adequate knowledge among patients. Therapeutic levels of INR were achieved in 45% of the patients during the first month, 71% in the third month, and 89% in the sixth month after discharge in the intervention group, compared to 25%, 47%, and 76% in the control group, respectively. Patients' satisfaction with the information was higher in the intervention group than in the control group. The percentage of satisfaction reached 80% for the intervention group versus 37% for the patients of the control group. Conclusion: The implementation of the nurse-led educational programs was associated with improved clinical results and increased adherence to oral anticoagulant treatment.