• Journal of Chest Surgery
• /
• v.55 no.2
• /
• pp.118-125
• /
• 2022

Background: A time course analysis was undertaken to evaluate how perioperative process-of-care and outcome measures evolved after implementation of an enhanced recovery after thoracic surgery (ERATS) program. Methods: Outcome and process-of-care measures were compared between patients undergoing major elective thoracic surgery during a 9-month pre-ERATS implementation period to those at 1-3, 4-6, and 7-9 months post-ERATS implementation. Outcome measures included length of stay, the 30-day readmission rate, 30-day emergency department visits, and minor and major adverse events. Process measures included first time to activity, out-of-bed, ambulation, fluid diet, diet as tolerated, as well as removal of the first and last chest tube, epidural, patient-controlled analgesia, and Foley and intravenous catheters. Results: In total, 704 patients (352 pre-ERATS, 352 post-ERATS) were included. Mobilization-related process measures, including time to first activity (16.5 vs. 6.8 hours, p<0.001), out-of-bed (17.6 vs. 8.9 hours, p<0.001), and ambulation (32.4 vs. 25.4 hours, p=0.04) saw statistically significant improvements by 1-3 months post-ERATS implementation compared to pre-ERATS. Time to Foley removal improved by 4-6 months post-ERATS (19.5 vs. 18.2 hours, p=0.003). Outcome measures, including the 30-day readmission rate and emergency department visits, steadily decreased post-ERATS. By 7-9 months post-ERATS, both minor (18.2% vs. 7.9%, p=0.009) and major (13.6% vs. 4.4%, p=0.007) adverse events demonstrated statistically significant improvements. Length of stay trended towards improvement from 6.2 days pre-ERATS to 4.8 days by 7-9 months post-ERATS (p=0.06). Conclusion: The adoption of ERATS led to improvements in multiple process-of-care measures, which may collectively and gradually achieve optimization of clinical outcomes.

• The Korean Nurse
• /
• v.36 no.1
• /
• pp.59-76
• /
• 1997

The purposes of this study were to identify the contents and satisfaction level of the patients received home care service, and to compare the differences of the contents by the characteristics of the patients. Seventy eight patients received home care service from 1st Jan. to 30th Sept., 1996 were data-collected to analyze the contents and outcomes of home care service. Sixty-nine patients currently receiving home care service were participated to evaluate the satisfaction level of home care service. The data were analyzed using mean, standard deviation, $x^2$ test, and ANOVA by SPSS $PC^+$ program. The findings of this study were as follow : 1. The contents & outcomes of home care service 1) The mean age of the subjects was 64.4 years: 58% of them were female. Those who living in Seoul were 83% and the rest of the subjects was living in Kyung-Gi. 2) The subjects who had one diagnosis were 41%. Over 60% of them had the disease of neurologic & sensory system. 3) The mean number of visit was 6. Only one visit was 22%. The mean time of care was 79 minutes. Duration of visit from 31 minutes to 60 minutes were 47 %. The subjects who terminated the visit because of death were 67.3%. 62% of the persons who referred them to the home care service were nurses. 4) The pain after the service was more relieved than before. The amounts of intake, the degree of bed sore, edema & fracture after the service were more improved than before. Health status after the service was improved in general. 5) There were significant differences between initial and last conscious level in tracheostomy care & oxygen inhalation care. There was significant difference between initial and last degree of activity in blood sugar check. 6) There were significant differences on the number of visit in assessment of the status, evaluation & observation, vital sign check, skin care, injection, medication, bed sore care, colostomy care, relaxation therapy for pain relief, patient education, family care, exercise therapy, position change, supply of disinfected equipments and infection control. There were significant differences on visiting time in nasogastric tube care, drainage tube care and oxygen inhalation care. 2. The satisfaction level of home care service 1) 50% were male. Over 60 years of the subjects was 61 %. Those who living in Seoul were 82%. 2) The subjects who had one or two diagnosis were 32% respectively. 55% of the persons who referred them to the home care service were nurses. 3) Total level of satisfaction of home care service was very high. 4) The older the age, the higher the satisfaction level. The larger the number of visit, the higher the satisfaction level. 5) The subjects who were in cloudy state were higher level of satisfaction than in alert or coma state. The subjects whose activity were normal or who needed assistance were higher level of satisfaction than bedridden or immobilized subjects. These findings suggested that the patients had substantial need for posthospital care. They tended to be elderly and to have experienced the wide range of health problems associated with aging, chronicity, including limitations in activities, and other serious health problems. So, the nationwide home care systems beyond the limit of demonstration program by local association and the development of the effective financial system of home based health care are necessary for the clients who are in need of home care.

• Tuberculosis and Respiratory Diseases
• /
• v.79 no.3
• /
• pp.111-120
• /
• 2016

Asthma is a prevalent and serious health problem in Korea. Recently, the Korean Asthma Guideline has been updated by The Korean Academy of Tuberculosis and Respiratory Diseases (KATRD) in an effort to improve the clinical management of asthma. This guideline focuses on adult patients with asthma and aims to deliver up to date scientific evidence and recommendations to general physicians for the management of asthma. For this purpose, this guideline was updated following systematic review and meta-analysis of recent studies and adapting some points of international guidelines (Global Initiative for Asthma [GINA] report 2014, National Asthma Education and Prevention Program [NAEPP] 2007, British Thoracic Society [BTS/SIGN] asthma guideline 2012, and Canadian asthma guideline 2012). Updated issues include recommendations derived using the population, intervention, comparison, and outcomes (PICO) model, which produced 20 clinical questions on the management of asthma. It also covers a new definition of asthma, the importance of confirming various airflow limitations with spirometry, the epidemiology and the diagnostic flow of asthma in Korea, the importance and evidence for inhaled corticosteroids (ICS) and ICS/formoterol as a single maintenance and acute therapy in the stepwise management of asthma, assessment of severity of asthma and management of exacerbation, and an action plan to cope with exacerbation. This guideline includes clinical assessments, and treatment of asthma-chronic obstructive pulmonary disease overlap syndrome, management of asthma in specific conditions including severe asthma, elderly asthma, cough variant asthma, exercise-induced bronchial contraction, etc. The revised Korean Asthma Guideline is expected to be a useful resource in the management of asthma.

• Therapeutic Science for Rehabilitation
• /
• v.10 no.1
• /
• pp.77-93
• /
• 2021

Objective : The purpose of this study was to investigate the lifestyle changes in patients with COVID-19 and their effects on health and the quality of life. Methods : A mixed study method was used for 15 confirmed cases admitted to residential treatment centers in September 2020. The YLP was used to evaluate the lifestyle patterns, and the Korean version of WHOQOL-BREF, MSBS-8, ISI-K, and PHQ-9 were used to analyze health and quality of life before and after COVID-19. The results obtained through in-depth interviews were analyzed using Colaizzi's thematic analysis. Results : YLP (p<.01), WHOQOL-BREF (p<.01), MSBS-8 (p<.01), and ISI-K (p=.05) showed statistically significant differences between the assessment outcomes before and after COVID-19. In addition, 179 meaningful statements, 14 sub-themes, 11 themes, and 3 categories were elicited. The final 3 categories are the emotions of the confirmed cases, the experiences in residential treatment centers and the needs from the perspective of the confirmed cases. Conclusion : There are negative effects on lifestyle, health, and quality of life on confirmed cases. In response, the confirmed cases requested several activities and counseling. Therefore, it is necessary to develop a program to improve the lifestyle, quality of life, and health of asymptomatic cases and cases with mild symptoms.

• Child Health Nursing Research
• /
• v.20 no.2
• /
• pp.123-131
• /
• 2014

Purpose: This study was conducted to examine the effects of simulation education integrated with problem based learning (SIM-PBL) on clinical competency and self-efficacy in post operation nursing care for children. Methods: This study was a quasi-experimental design. Thirty six students in the third year of a 4-year baccalaureate nursing program were recruited conveniently and assigned to the control or intervention groups using time difference. Students were all in a pediatric nursing clinical practicum. The control group received the regular clinical practicum in a hospital setting. For the intervention group, a SIM-PBL education replaced 150 minutes of their clinical practicum. Results: The intervention group showed greater improvement in two areas of clinical competency compared with the control group; physical assessment (t= 3.019, p=.005) and post operation advice (t=2.428, p=.021). However, no statistically significant differences in improvement in any areas of self-efficacy were found between two groups. Conclusion: The results indicate that the SIM-PBL education is effective in improving some areas of clinical competence, but not self-efficacy in post operation nursing care for children. Further study is needed to develop SIM-PBL programs for various clinical topics and evaluate the effectiveness on the learning outcomes.

• The Journal of the Korea Contents Association
• /
• v.10 no.4
• /
• pp.216-224
• /
• 2010

The main purpose of this prospective longitudinal study was to evaluate, according to a standard clinical classification and assessment method, the effect of a standardized manual stretching and therapeutic massage program on patients with clearly defined congenital muscular torticollis. A total of 52 cases of congenital muscular torticollis who were first seen when they were less than one year old and were treated with conservative physical therapy. Before treatment, the patients were divided into one of three clinical groups: (1) sternomastoid tumor group, (2) muscular torticollis group, and (3) postural torticollis group. Of the 52 patients, 32 (61.5%) made up the sternomastoid tumor group; 15 (28.9%) the muscular torticollis group; and 5 (9.6%) the postural torticollis group. Multivariate analysis of the outcomes showed that the duration of treatment was significantly differentiated according to the clinical group (p<0.01), age at presentation (p<0.01), and a passive rotation deficit of the neck (p<0.01). The current study showed that well controlled conservative physical therapy is safe and effective in the treatment of congenital torticollis in about 84.6% of patients who are first seen before the age of one year.

• The Journal of the Korea Contents Association
• /
• v.15 no.4
• /
• pp.330-341
• /
• 2015

The purpose of this study was to examine the effect of the film 'The Island' on 2nd year nursing students' nursing informatics (NI) competency. The participants were sixty-eight students in a baccalaureate nursing program of a private university, taking the course, 'Nursing & Informatics' in the 2012 fall semester. Over the 15 weeks, the film was used for five weeks as introduction to NI, peer-to-group discussions, and self-reflection on lessons learned regarding NI. A qualitative content analysis was used to explore the students' experiences and perceptions on their NI competency. As a result, students signified the NI concept as the assessment of biometrics data, promotion of optimal health with the support of various technologies, and integration of patient-centered care into routine practice. They also highlighted the importance of security and safety measures as well as high quality health technology including the ubiquitous health monitoring system. Overall, the lesson outcomes of the course were met. As a supportive, instructional strategy, the use of the movie, 'The Island', was effective for nursing students in achieving NI competencies. Further study is warranted to determine if movies can be used as a means of continuing education to improve informatics competences in healthcare professionals.

• Journal of the Korean Society for Library and Information Science
• /
• v.56 no.1
• /
• pp.201-220
• /
• 2022

This study suggests a theoretical model of information literacy instructions in the context of the Extended Essay included in IB(International Baccalaureate) Diploma Program Core. The study particularly analyzed I-LEARN model as a model to teach and learn with information for inquiry-based learning since the model was developed for the purpose of learning with information. Some school districts in Korea adapted IB programs to address the need for better education. Findings indicate the followings. First, students can achieve deep understanding by applying a model of information literacy instructions that provides scaffolding. Second, the expected roles of school librarians in information literacy instructions for Extended Essay are process specialists, teachers, and instructional partners. Third, I-LEARN model is appropriate as a framework to teach information literacy skills for inquiry needed for Extended Essay. Fourth, I-LEARN assessment rubric is useful in assessing the process and outcomes of students' information seeking and use. Implications include that school librarians should develop themselves as experts in information literacy instructions for inquiry-based learning such as Extended Essay, and that Korean schools recognize the crucial role of school librarians in teaching information literacy skills for inquiry-based learinng.

• Journal of Engineering Education Research
• /
• v.14 no.1
• /
• pp.20-31
• /
• 2011

This study was conducted to get the significant implications for the accreditation of engineering education in Korea from the case of Japan. We researched the terminology of 'accreditation', the outline, the current progress, and argument over the accreditation of engineering education in Japan. We suggested the seven implications for ABEEK. First, ABEEK has to use the engineering societies more in assessing the programs. Second, ABEEK should be flexible to meet the original goals. Third, ABEEK can use the observer system to train the examiners. Fourth, ABEEK needs to provide the real benefits to the students and accredited programs to encourage them to finish the accredited course. Fifth, the programs need to organize the committes in the direction that every faculty member can share the assessment results and execute the real course improvement. Sixth, ABEEK should permit the programs to use the curricular courses to check the achievement of program outcomes. And seventh, ABEEK needs to have meta-evaluation to exercise the reasonable authority.

• Journal of Intelligence and Information Systems
• /
• v.27 no.1
• /
• pp.65-82
• /
• 2021

Stock market investors are generally split into foreign investors, institutional investors, and individual investors. Compared to individual investor groups, professional investor groups such as foreign investors have an advantage in information and financial power and, as a result, foreign investors are known to show good investment performance among market participants. The purpose of this study is to propose an investment strategy that combines investor-specific transaction information and machine learning, and to analyze the portfolio investment performance of the proposed model using actual stock price and investor-specific transaction data. The Korea Exchange offers daily information on the volume of purchase and sale of each investor to securities firms. We developed a data collection program in C# programming language using an API provided by Daishin Securities Cybosplus, and collected 151 out of 200 KOSPI stocks with daily opening price, closing price and investor-specific net purchase data from January 2, 2007 to July 31, 2017. The self-organizing map model is an artificial neural network that performs clustering by unsupervised learning and has been introduced by Teuvo Kohonen since 1984. We implement competition among intra-surface artificial neurons, and all connections are non-recursive artificial neural networks that go from bottom to top. It can also be expanded to multiple layers, although many fault layers are commonly used. Linear functions are used by active functions of artificial nerve cells, and learning rules use Instar rules as well as general competitive learning. The core of the backpropagation model is the model that performs classification by supervised learning as an artificial neural network. We grouped and transformed investor-specific transaction volume data to learn backpropagation models through the self-organizing map model of artificial neural networks. As a result of the estimation of verification data through training, the portfolios were rebalanced monthly. For performance analysis, a passive portfolio was designated and the KOSPI 200 and KOSPI index returns for proxies on market returns were also obtained. Performance analysis was conducted using the equally-weighted portfolio return, compound interest rate, annual return, Maximum Draw Down, standard deviation, and Sharpe Ratio. Buy and hold returns of the top 10 market capitalization stocks are designated as a benchmark. Buy and hold strategy is the best strategy under the efficient market hypothesis. The prediction rate of learning data using backpropagation model was significantly high at 96.61%, while the prediction rate of verification data was also relatively high in the results of the 57.1% verification data. The performance evaluation of self-organizing map grouping can be determined as a result of a backpropagation model. This is because if the grouping results of the self-organizing map model had been poor, the learning results of the backpropagation model would have been poor. In this way, the performance assessment of machine learning is judged to be better learned than previous studies. Our portfolio doubled the return on the benchmark and performed better than the market returns on the KOSPI and KOSPI 200 indexes. In contrast to the benchmark, the MDD and standard deviation for portfolio risk indicators also showed better results. The Sharpe Ratio performed higher than benchmarks and stock market indexes. Through this, we presented the direction of portfolio composition program using machine learning and investor-specific transaction information and showed that it can be used to develop programs for real stock investment. The return is the result of monthly portfolio composition and asset rebalancing to the same proportion. Better outcomes are predicted when forming a monthly portfolio if the system is enforced by rebalancing the suggested stocks continuously without selling and re-buying it. Therefore, real transactions appear to be relevant.