• Title/Summary/Keyword: care sensitivity

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The Usefulness of Whole-blood Interferon-gamma Release Assay for the Diagnosis of Extra-pulmonary Tuberculosis (폐외 결핵에서 전혈 인터페론 감마 측정법의 진단적 유용성)

  • Lee, Hye-Min;Cho, Sung Gun;Kang, Hyung Koo;Park, Sung Woon;Lee, Byung Ook;Lee, Jae Hee;Jeon, Eun Ju;Choi, Jae Chol
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.4
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    • pp.331-337
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    • 2009
  • Background: The whole-blood interferon-gamma release assay (QuantiFERON-TB Gold [QFT-G]: Cellestis, Carnegie, Victoria, Australia) has been studied primarily for the use of diagnosing active pulmonary tuberculosis (TB) or latent TB. In the present study, the usefulness of QFT-G was evaluated for the diagnosis of extra-pulmonary tuberculosis (EP-TB). Methods: From June 2006 to February 2009, we evaluated the usefulness of QFT-G in patients (n=65) suspected with EP-TB, retrospectively. The diagnostic sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the QFT-G assay were analyzed. Results: EP-TB was diagnosed in 33 (51%) participants. The overall sensitivity, specificity, PPV, and NPV of the QFT-G assay for EP-TB were 78%, 79%, 81%, and 77%, respectively. Of the 33 with EP-TB, 14 (42%) were diagnosed with TB pleurisy, 7 (21%) with TB lymphadenitis, 7 (21%) with intestinal TB, and 5 (15%) with EP-TB in other sites. In subgroup analyses according by site of infection, the QFT-G showed 86% sensitivity, 64% specificity, and 78% NPV in TB pleurisy. On the other hand, the sensitivity, specificity, and NPV of the assay were 71%, 83% and 71%, respectively in TB lymphadenitis, and 86%, 100% and 88%, respectively in intestinal TB. Among the patients with suspected alternative site EP-TB, the sensitivity, specificity, and NPV of the assay were 50%, 80% and 67%, respectively. Conclusion: The QFT-G assay showed moderate diagnostic accuracy in EP-TB. However, negative QFT-G assay does not exclude EP-TB because of the low NPV of this assay.

Cost-Effectiveness Analysis of Home Care Service for Cerebrovascular Disease Patients (가정간호서비스의 비용효과분석;뇌혈관질환자를 중심으로)

  • Lim, Ji-Young;Park, Young-Joo
    • Journal of Korean Academy of Nursing Administration
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    • v.8 no.2
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    • pp.323-334
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    • 2002
  • Purpose: This study was designed to analyse economical efficiency of home care service by comparing a cost-effectiveness ratio(CER) between hospitalization and home care service. Method: The analytic framework of this study was constructed in 5 stages; perspective of the analysis, measurement of costs, measurement of effects, analysis of CER, and sensitivity analysis. The SAS program was utilized for the general characteristics of the subjects, descriptive statistics, homogeneous test, normality test and difference test. Result: The results were as follows; 1) CER was 35,248,256 of ADL, 7,996,026 of nursing satisfaction, 6,144,946,000 of QALY of patients in the hospital and 11,168,863 of ADL, 2,322,239 of nursing satisfaction, 3,674,556,000 of QALY of patients in the home care center. ICER was 438,067,932 of ADL, -190,044,176 of nursing satisfaction, 8,615,336,000 of QALY. 2) In the sensitivity analysis of sex, age and discount rate, the CER of patients in the home care center was lower than the CER of patients in the hospital. Conclusion: With these findings, it affirmed that home care service had an economical efficiency compared with hospitalization in cerebrovascular disease patients. Therefore, these results will be used to develop governmental policy or expansion of the home care service.

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Influencing factors on Moral Distress in Long-term Care Hospital and Facility Nurses

  • Kim, Hyun Sook;Yu, Sujeong;Lim, Kyung Choon
    • Journal of the Korea Society of Computer and Information
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    • v.24 no.5
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    • pp.121-130
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    • 2019
  • The purpose of this study was to explore the level of the moral distress for nurses working in long-term care hospitals or nursing homes, and identify factors that influence the moral distress. Data were collected through self-reported questionnaires including the Korean version of Moral Distress Scale-Revised (KMDS-R), Jefferson Empathy Scale for Health professionals (K-JSE-HP), Moral Sensitivity Questionnaire (K-MSQ), and the Hospital Ethical Climate Survey (HECS). A total of 194 nurses from 11 long-term care hospitals or 27 nursing homes completed the structured questionnaires. Data were analyzed using IBM SPSS Statistics version 25. As results, the mean score for moral distress was $73.81{\pm}51.29$ in this study. The moral distress of nurses working at nursing homes was higher than that of nurses working in long-term care hospitals. Among the sub-factors of moral distress, the 'futile care' was the highest score and the 'limit to claim the ethical issue' was the lowest. The main factor affecting moral distress among nurses in this study was the ethical climate of organization. In this paper, we propose that in order to effectively reduce the moral distress of nurses working in a long-term care hospital or a nursing home, it is more impactful to address structural issues related to the caregiver workplace than to adjust individual factors.

Cultural Knowledge, Empathy and Cultural Sensitivity of University Students Majoring in Health And Welfare (보건의료 및 복지 전공 대학생의 다문화 지식, 공감, 문화적 민감성에 관한 연구)

  • Oh, Won-Oak;Jung, Woo-Sik;Kang, Hyung-Gon;Kim, Eun-Hye;Suk, Min-Hyun
    • Journal of the Korean Society of School Health
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    • v.23 no.2
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    • pp.192-199
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    • 2010
  • Purpose: Multi-cultural families are increasing highly in Korea. Health care professionals and students majoring in health and welfare need to develop their cultural competence for quality of life from multi-cultural families. This study was to be conducted by examining the level of culture knowledge, empathy, and cultural sensitivity of university students majoring in health and welfare. Methods: Convenience sampling method was used and 408 students from 3 universities were evaluated for final analysis. Data collection was conducted through the use of questionnaires. Results: The score of cultural knowledge of students was very low. Empathy and cultural sensitivity showed middle range. There was a significant correlation between cultural knowledge and empathy, empathy and cultural sensitivity. However, there was no significant correlations between cultural knowledge and cultural sensitivity. Conclusion: An understanding of multi-cultural enables health and welfare providers to specialize service in cross- cultural situations of multi-cultural families in Korea. Ways to improve cultural competence for students majoring in health care and welfare is needed.

Effects of clinical practice stress and moral sensitivity on clinical competency in nursing students (간호대학생의 임상실습스트레스와 도덕적 민감성이 임상수행능력에 미치는 영향)

  • Song, Yeoungsuk;Lee, Joon-Young
    • The Journal of Korean Academic Society of Nursing Education
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    • v.26 no.2
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    • pp.157-166
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    • 2020
  • Purpose: This study was conducted to explore how clinical practice stress and moral sensitivity affect the clinical competency of nursing students. Methods: Participants had completed at least a one year (2 semesters) clinical nursing practicum through K University in D Metropolitan City. A total of 188 nursing students were recruited: third grade (n=104) and fourth grade (n=84). The questionnaires were adopted with clinical practice stress, Korean version of moral sensitivity questionnaire (K-MSQ), and the clinical competency. Results: Clinical competency was positively correlated with patient-oriented care (r=.27, p<.001) and the professional responsibility (r=.32, p<.001) of the moral sensitivity (r=.27, p<.001). The attitude of medical personnel experiencing clinical practice stress shows a significant positive relationship with clinical competency (r=.15, p=.038). The attitude of medical personnel (β=.09, p=.194) experiencing clinical practice stress, patient-oriented care (β=.16, p=.041) and professional responsibility (β=.23, p=.003) of the moral sensitivity explained 12% of the variance in clinical competency (F=9.17, p<.001). Therefore, the influential factors on clinical competency were two sub-factors of moral sensitivity. Conclusion: Moral educational programs should be considered to develop a nursing students' clinical competency.

Attitudes, Stigma, and Moral Sensitivity of Nurses toward HIV and AIDS (간호사의 HIV/AIDS에 대한 태도와 낙인 및 도덕적 민감성)

  • Hwang, Kyung-Hye;Cho, Ok-Hee;Yoo, Yang-Sook;Chung, Mi-Young
    • Journal of Home Health Care Nursing
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    • v.24 no.2
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    • pp.142-150
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    • 2017
  • Purpose: The purpose of this study was to examine the relationships of attitudes, stigma, and moral sensitivity of nurses toward HIV/AIDS. Methods: The participants were 530 nurses working in general hospitals in South Korea. A structured questionnaire regarding attitudes, stigma toward HIV/AIDS, and moral sensitivity was used. The data were analyzed using t-tests, ANOVAs, and Pearson correlation coefficients. Results: Nurses' attitudes toward HIV/AIDS differed by job position; nurses' moral sensitivity toward HIV/AIDS differed by age, marital status, education level, clinical practice career, and job position; and nurses' stigma toward HIV/AIDS differed by age, clinical practice career, subjective economic status, HIV/AIDS education experience, and HIV/AIDS patient care experience. Attitudes of nurses toward HIV/AIDS were more negative when stigma toward HIV/AIDS was higher (r=-0.58, p<.001), these attitudes were not correlated with moral sensitivity. Conclusions: The attitudes of nurses toward HIV/AIDS were more negative when stigma toward HIV was higher, and these attitudes were not correlated with moral sensitivity. Therefore, nurses should be provided education that takes their age, marital status, clinical practice career, and experiences in HIV-related education and caregiving into account.

Predictors of Taking Tuberculosis Drugs for Health Care Workers with Latent Tuberculosis Infection (잠복결핵감염 의료기관 종사자의 결핵약 복용 예측요인)

  • Lee, Eun Sun;Min, Hye Sook
    • Journal of muscle and joint health
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    • v.26 no.2
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    • pp.120-130
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    • 2019
  • Purpose: The purpose of this study was to investigate the predictors of tuberculosis (TB) drugs in health care workers diagnosed with latent tuberculosis Infection (LTBI). Methods: This study was a descriptive correlation study. Data were collected by using a self-report questionnaire. The collected data were analyzed by -test, t-test, and logistic regression analysis. Results: There were involved 160 participants, 35 (21.9%) who took the TB drugs, and 125 (73.8%) who did not take the TB drugs. The predictors on taking TB drugs in health care workers with LTBI were subjective norms (OR=3.33, p<.001), perceived sensitivity (OR=2.67, p=.026), perceived barrier (OR=0.14, p=.014), and unmarried (OR=4.69, p=.006) than married, health care worker category 2 group (OR=5.84, p=.015) and 1 group (OR=4.25, p=.022) than 3, 4 group, sleep over 7 hours (OR=4.11, p=.022) than less 7 hours sleep. Conclusion: In order to promote the use of TB drugs in health care workers with LTBI, it is necessary that take intervention strategies to increase the subjective norms and perceived sensitivity and to decrease the perceived barriers.

An Ecological Study on Infant-Mother Attachment in a Nonmaternal Care (타인 양육 영아-어머니 애착에 대한 생태학적 연구)

  • 양연숙
    • Journal of the Korean Home Economics Association
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    • v.40 no.7
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    • pp.1-14
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    • 2002
  • This study investigated infant, mother/famny, and nonmaternal care characteristics contribution to infant- mother attachment through ecological perspective. Participants were forty 12-to 18-month-o1d infants and their mothers. Infants were observed in the Strange Situation to assess the pattern of infant-mother attachment; the Observational Ratings of the Caregiving Environment was used to assess the caregiving environment. Mothers were interviewed with the questionnaires, and observed in the laboratory "living room". There were significant effects of material sensitivity/responsiveness and good quality child care on secure attachment. Infant, mother/family, and nonmaternal care characteristics were mutually related.

A Meta-analysis of the Timed Up and Go test for Predicting Falls (낙상 위험 선별검사 Timed Up and Go test의 예측 타당도 메타분석)

  • Park, Seong-Hi;Lee, On-Seok
    • Quality Improvement in Health Care
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    • v.22 no.2
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    • pp.27-40
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    • 2016
  • Purpose: Globally, falls are a major public health problem. The study aimed to evaluate the predictive validity of the Timed Up and Go test (TUGT) as a screening tool for fall risk. Methods: An electronic search was performed Medline, EMBASE, CINAHL, Cochran Library, KoreaMed and the National Digital Science Library and other databases, using the following keywords: 'fall', 'fall risk assessment', 'fall screening', 'mobility scale', and 'risk assessment tool'. The QUADAS-II was applied to assess the internal validity of the diagnostic studies. Thirteen studies were analyzed using meta-analysis with MetaDisc 1.4. Results: The selected 13 studies reporting predictive validity of TUGT of fall risks were meta-analyzed with a sample size of 1004 with high methodological quality. Overall predictive validity of TGUT was as follows. The pooled sensitivity 0.72 (95% confidence interval [CI]: 0.67-0.77), pooled specificity 0.58 (95% CI: 0.54-0.63) and sROC AUC was 0.75 respectively. Heterogeneity among studies was a moderate level in sensitivity. Conclusion: The TGUT's predictive validity for fall risk is at a moderate level. Although there is a limit to interpret the results for heterogeneity between the literature, TGUT is an appropriate tool to apply to all patients at a potential risk of accidental fall in a hospital or long-term care facility.

Recent Advances in a Microfluidic Paper-based Analytical Devices and its Point of Care Testing Applications (종이기반 미세유체 분석소자를 활용한 현장검사 기술과 그 응용)

  • Yoo, Yong Kyoung;Kim, Cheonjung;Lee, Junwoo;Lee, Jeong Hoon
    • Ceramist
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    • v.21 no.3
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    • pp.293-301
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    • 2018
  • Paper-based analytical devices (${\mu}PAD$) are highly advantageous for portable diagnostic systems owing to their low costs and ease of use. ${\mu}PADs$ are considered as the best candidates for realizing the World Health Organization (WHO) ASSURED criteria: affordable, sensitive, specific, user-friendly, rapid and robust, equipment-free, and deliverable to end users. However, they have several limitations such as low sensitivity and accuracy. This article reports a mini review for a micro-fluidic paper-based analytical devices (${\mu}PAD$), especially for addressing low sensitivity and accuracy issues.