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The Relationship between the Stress and Climacteric symptoms of Middle-Aged Women (중년여성의 스트레스와 갱년기 증상과의 관계)

  • Park, Bok-Hee;Lee, Young-Sook
    • Women's Health Nursing
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    • v.6 no.3
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    • pp.383-397
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    • 2000
  • This study of purpose was to define the relationship between the stress and climacteric symptoms of middle-aged women in order to provide basic data for the development of women's health care program as nursing intervention. The research tools used were a Soon-Young Park's stress questionnaire (4 points scale) and a self diagnostic MENSI scale (3 points scale) developed by a research team of Ill-Yang Pharmacy Co. This research was conducted in Korea in Muan-Gun. Chonnam province, from 22th November to 20th December 1999. The research used a survey design. Seven hundred eleven healthy middle-aged women, aged 40 to 64, and were a convenience sample by stratified ratio using the matching fixed residential and aging blocks. The data were analyzed by GLM. Pearson correlation coefficient and Scheffe test using SAS/ PC+. The results were summarized as follows : 1. The percentage of psychological stress with the following items was: fatigue and enervation, 70.0%; nervous, 61.8%; weakness, 58.5%; The percentage of physical stress with the following items were ; fatigue of eye. 82.3%; backache, 78.0%; headache, 73.8%. 2. The level of psychological stress was 40% of below average level (0-5 points), 31.7 of average level (6-12points), 20.8% of precaution level (13-19 points), and 7.5% of warning level (over 20points). The level of physical stress were 20.1% of below average level (0-5 points), 34.8 of average level (6-12 points), 29.4 of precaution level (13-19 points), and 15.7% of warning level (over 20 points). There were higher physical stress level than psychological stress level of the subjects. 3. The percentage of climacteric symptoms with the following items were : numbness, 75.3%; forgetfulness, 71.0%; pain of joints, 71.0%. The level of climacteric symptoms were 61.8% of mild level 1(10-15 points), 33.0% of moderate level (16-30 points), 5.2% of severe level (over 31 points). 4. There were high positive correlations significantly between the climacteric symptoms and the psychological stress (r=.564. P<0.000), and between the climacteric symptoms and the physical stress of the subjects(r=.678, P<0.000). 5. There were significant differences in the climacteric symptoms of the subjects among below average level, average level, precaution level, and warning level of the psychological stress (F=74.108. P<0.000. Scheffe test). 6. There were significant differences in the climacteric symptoms of the subjects among below average level, average level and precaution level, and warning level of the physical stress ((F=128.181, P<0.000, Scheffe test). In summary, climacteric symptoms complained by middle-aged women are high positive correlated to the level of the stress. Also climacteric symptoms were affected by stress.

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An Analysis of the Financial Performance of Korean Medicine Hospitals in Korea: Focusing on Financial Ratios and Investment Efficiency (재무분석을 통한 한방병원의 경영성과 분석 - 재무비율 및 투자효율을 중심으로)

  • Choi, WonYoung;Lim, Byungmook
    • The Journal of Korean Medicine
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    • v.41 no.1
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    • pp.1-10
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    • 2020
  • Objectives: This study investigated the financial performance of Korean Medicine hospitals in Korea in order to understand the current status of hospital management and improve its efficiency. Methods: Financial statements of 24 medical corporations, 19 juridical foundations and 18 school hospitals from 2016 to 2018 were obtained from the secondary data published by the Health Insurance Review and Assessment Service, the National Tax Service and the Korea Advancing Schools Foundation. Financial performance was measured on 6 dimensions: liquidity, profitability, activity, growth, cost and productivity (investment efficiency) by analyzing 8 financial indicators: Liability to Total Assets, Net Profit to Patient Service Revenues, Total Assets Turnover, Growth Rate of Patient Service Revenues, Operating Expenses to Patient Service Revenues, Value Added to Patient Service Revenues, Value Added to Total Assets, and Value Added to Personnel Expenses. Results: Korean Medicine hospitals showed lower Liability to Total Assets, Liquidity and Value Added to Total Assets than Western Medicine hospitals did. They also showed higher Value Added to Patient Service Revenues and Value Added to Personnel Expenses than Western Medicine hospitals did. They also showed higher Value Added to Patient Service Revenues and Value Added to Personnel Expenses than those of Western Medicine hospitals do. The net profit decreased significantly (-50.8%) in 2018 whereas Patient Service Revenues increased (6.9%) for the same period due to Operating Expenses increase and Non-Operating loss. Conclusions: These findings suggest that the Korean Medicine hospital sector in Korea needs to improve liquidity and financial structure and to enhance profitability by reducing Personnel Expenses and generating Non-operating revenues in order to improve its investment efficiency and competitiveness.

Nursing outcomes of inpatient on level of nursing staffing in long term care hospitals (요양병원 간호인력 확보수준에 따른 입원환자의 간호결과)

  • Kim, Eun Hee;Lee, Eunjoo
    • Journal of the Korean Data and Information Science Society
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    • v.26 no.3
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    • pp.715-727
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    • 2015
  • This study was conducted to explore the impact of nursing staffing on inpatient nursing outcomes in long term care hospitals. A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals. Patients per RN was a significant indicator of foley catheter ratio in high risk group and low risk group. Patients per RN&NA was a significant indicator of decline in ADL for patients with dementia, non dementia, urinary incontinence and new pressure ulcer development in the high risk group. The average nursing outcome of inpatient in high grade was higher than that low grade in long care hospital. This higher level of nursing staffing and the higher the grade shown a positive effect on the nursing outcomes of the inpatient. We therefore recommend modifying the above nurse staffing policy so as to make it more effective in improving nursing outcomes.

Predicting the number of disease occurrence using recurrent neural network (순환신경망을 이용한 질병발생건수 예측)

  • Lee, Seunghyeon;Yeo, In-Kwon
    • The Korean Journal of Applied Statistics
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    • v.33 no.5
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    • pp.627-637
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    • 2020
  • In this paper, the 1.24 million elderly patient medical data (HIRA-APS-2014-0053) provided by the Health Insurance Review and Assessment Service and weather data are analyzed with generalized estimating equation (GEE) model and long short term memory (LSTM) based recurrent neural network (RNN) model to predict the number of disease occurrence. To this end, we estimate the patient's residence as the area of the served medical institution, and the local weather data and medical data were merged. The status of disease occurrence is divided into three categories(occurrence of disease of interest, occurrence of other disease, no occurrence) during a week. The probabilities of categories are estimated by the GEE model and the RNN model. The number of cases of categories are predicted by adding the probabilities of categories. The comparison result shows that predictions of RNN model are more accurate than that of GEE model.

Development and Evaluation of an Evidence-based Nursing Protocol for Postoperative Nausea and Vomiting (근거기반의 수술 후 오심·구토 관리 프로토콜의 개발 및 임상적 평가)

  • Oh, In Ohg;Yoo, Jae Yong;Oh, Eui Geum
    • Journal of Korean Biological Nursing Science
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    • v.19 no.2
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    • pp.86-97
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    • 2017
  • Purpose: Postoperative nausea and vomiting (PONV) is very common among postoperative orthopedic surgical patients with patient-controlled analgesia (PCA), especially for narcotics. Therefore, the purpose of this study was to investigate the effects of an evidence-based PONV management protocol on nursing and patient outcomes. Methods: A methodological study was conducted to develop PONV protocol and a quasi-experimental study to evaluate the effectiveness of protocol. The preliminary PONV protocol was drawn by conducting a systematic review and by reviewing clinical guidelines and best practice recommendations. Validation of the content was done by expert clinicians, and the clinical applicability was evaluated by staff nurses and patients. The effect was evaluated in clinical outcomes associated with PONV and nursing outcomes. Results: In the experimental group, the occurrence of vomiting (z= 2.147) was significantly decreased, the maintenance PCA (${\chi}^2=4.212$) and the satisfaction of patients (z= 5.007) were significantly higher. In the outcomes of nurses, the PONV knowledge of nursing care (z = 3.791), awareness (z = 2.982) and self-efficacy (z= 2.745) were higher in the experimental group. The attitude towards evidence-based nursing practice (z= 2.446) was significantly positive. Conclusion: The results show that an evidence-based approach to the implementation of PONV care is effective in improving patient clinical outcomes and quality of care.

Parenteral Nutrition in Hospitalized Adult Patients in South Korea (성인 입원환자의 정맥영양요법 사용 현황)

  • Ock, Miyoung;Lee, Sera;Kim, Hyunah
    • Journal of Clinical Nutrition
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    • v.10 no.2
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    • pp.38-44
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    • 2018
  • Purpose: Parenteral nutrition (PN) is known to provide therapeutic beneficial improvements in malnourished patients for whom enteral nutrition is not feasible. The objective of this study was to investigate the current clinical characteristics and utilization of PN in Korea. Methods: We analyzed the Health Insurance Review Agency National Inpatients Sample database from 2014 to 2016, which included 13% of all hospitalized patients in Korea. Adult patients aged 20 years or older and receiving premixed multi-chamber bag containing PN were included for this study. Patient characteristics, admission type, primary diagnosis, and hospital demographics were evaluated. SAS version 9.4 was used for data analysis. Results: From 2014 to 2016, 149,504 patients received premixed PN, with 226,281 PN prescriptions being written. The mean patient age was 65.0 years, and 81,876 patients (54.8%) were male. Premixed 3-chamber bag and 2-chamber bag PN solutions were utilized in 131,808 (88.2%) and 32,033 (21.4%) patients, respectively. The number of patients hospitalized through the emergency department were 70,693 (47.3%), whereas 43,125 patients (28.8%) were administered PN in intensive care units. In the adult PN patients, the highest primary diagnosis was malignant neoplasm of the stomach (8,911, 6.0%), followed by organism unspecified pneumonia (7,008, 4.7%), and gastroenteritis and colitis of unspecified origin (6,381, 4.3%). Overall, 34% of adult PN patients were diagnosed with malignancies, the most common being neoplasm of the stomach (17.7%), neoplasm of bronchus/lung (11.2%), neoplasm of colon (11.1%), and neoplasm of liver/intrahepatic bile ducts (10.0%). PN solutions were most frequently administered in the metropolitan area (55.0%) and in hospitals with more than 1,000 beds (23.6%). Conclusion: PN was commonly administered in older patients, with primary diagnosis of malignancy in a significant number of cases. This study is the first large-scale description of PN-prescribing patterns in real-world clinical practice in South Korea.

Potentially Unnecessary Gastrointestinal Drug Use in Patients with Acute Cystitis (외래 급성 방광염 환자에서 잠재적으로 불필요한 위장약 사용)

  • Taeyeon Kim;Song Hyeon Jeon;Nam Kyung Je
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.1
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    • pp.8-21
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    • 2023
  • Background: Gastrointestinal (GI) drugs are often co-prescribed with other medications to prevent GI complications. This study aimed to evaluate the prescribing pattern of potentially unnecessary GI drugs in patients with acute cystitis who were prescribed oral antibiotics and investigate the influencing factors affecting this. Methods: We identified female patients ≥20 years with acute cystitis who visited the outpatient clinic and were prescribed oral antibiotics between July and December by analyzing Health Insurance Review and Assessment Service (HIRA)-National Patients Sample (NPS)-2019 data. Patients with no prior history of GI disorders within 180 days prior to acute cystitis, excluding or including the date of diagnosis of acute cystitis, were selected (Group A and B). Multiple logistic regression analysis was performed to estimate the factors affecting the prescription of potentially unnecessary GI drugs. Results: A total of 1,544 in Group A and 552 patients in Group B were included for the final analysis. Potentially unnecessary GI drugs were prescribed in 1,176 patients in Group A (76.2%) and 231 patients in Group B (41.8%). Third generation cephalosporines and sulfonamides showed the lower odds ratio for prescribing GI drugs than penicillins. Prescribers from Urology clinics showed more than twice odds ratio for the prescription of GI drugs compared to prescribers from internal medicine clinics. Conclusion: The results of this study showed that potentially unnecessary GI drug prescriptions for patients with acute cystitis were high in South Korea. The positive risk factors affecting the prescription of unnecessary GIs were not patient-related factor but healthcare facility and prescriber-related factors.

Ten Year Trend of Cancer Incidence in Seoul, Korea: 1993-2002 (서울시 암 발생률의 10년간 추이: 1993-2002)

  • Shin, Myung-Hee;Oh, Hyun-Kyung;Ahn, Yoon-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.2
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    • pp.92-99
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    • 2008
  • Objectives : Effective cancer prevention and control measures can only be done when dependable data on the cancer incidence is available. The Seoul Cancer Registry (SCR) was founded to provide valid, comparable and representative cancer incidence data for Koreans. We aimed to compare the cancer incidence in the first (1993-1997) and second term (1998-2002) of the SCR, and we analyzed the annual incidence trend during that 10 years. Methods : The SCR detects potential cancer cases through the Korean Central Cancer Registry (KCCR) data, the health insurance claims, the individual hospital's discharge records and the death certificates. About 87% of the SCR data is registered through the KCCR. The rest of the data is registered by SCR registrars who visit about $70{\sim}80$ mid-sized hospitals in Seoul to review and abstract the medical records of the potential cancer patients. Results: The total number of new cancer cases was higher in $1998{\sim}2002$ than in $1993{\sim}1997$ by 20.6% for men and 18.4% for women, respectively. The age-standardized rate (ASR) of total cancer per 100,000 increased 1% (from 295.4 to 298.3) for men and 5.1% (from 181.5 to 190.7) for women, between the two periods. The commonest cancer sites during 1998-2002 for men were stomach, liver, bronchus/lung, colorectum, bladder and prostate, and the commonest cancer sites for women were breast, stomach, colorectum, cervix uteri, thyroid and bronchus/lung. Compared with the ASRs in 1993, the ASRs in 2002 increased for colorectum (58.4% for men, 27.1% for women), prostate (81.5%), breast (58.3% for women), thyroid (141% for women), and bronchus/lung (15.4% for women). The ASRs for stomach (-18.7% for men, -20.7% for women) and uterine cervix cancer (-39.7%) had decreased. Conclusions : The cancer incidence is increasing in Seoul, Korea, especially for the colorectum and prostate for men, and for the breast, colorectum, bronchus/lung and thyroid for women.

A Study on the Current State of Pediatric Dentists and the Adequacy of Supply and Demand Based on Covered Services (소아치과 전문의 인력 현황 및 공급 적정성에 관한 연구 - 급여 진료 항목을 기준으로)

  • Yeo Won Lim;Yong Kwon Chae;Ko Eun Lee;Ok Hyung Nam;Hyoseol Lee;Sung Chul Choi;Mi Sun Kim
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.3
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    • pp.360-372
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    • 2023
  • The aim of this study was to identify the current state of pediatric dentists, evaluate the adequacy of pediatric dentist supply and demand, and find out the perception of all pediatric dentists on the current state of pediatric dentists and policy establishment. An Online survey was conducted among pediatric dentists. The questionnaire was subdivided into 'general characteristics', 'number of dental treatments and working days per year', 'proportion of covered services', 'perceptions of supply and demand of pediatric dentists'. Through the Korean Academy of Pediatric Dentistry, the Health Insurance Review and Assessment Services, the National Health Insurance Service (NHIS), and the Korean Statistical Information Service, the current state of pediatric dentists, the number of claims for covered services, and the decrease in births per year were investigated. Dental clinics claiming to be pediatric dentistry reached half of all medical institutions, but only 3.78% of pediatric dentists actually worked. 61.36% of all pediatric dentists were concentrated in the metropolitan area, showing a national imbalance. Although the population of children and adolescents have continuously decreased over the past 20 years, the number of NHIS-covered services has shown a continuous increase. Over the past 10 years, the optimal supply of pediatric dentists has been maintained at around 4,000. According to the analysis, 92.15% of pediatric dentists thought that it was necessary to prepare policies and support measures at the government level. This study is expected to be used as basic data for establishing a demand estimation method for pediatric dentistry specialists in the future.

National Data Analysis of General Radiography Projection Method in Medical Imaging (영상의학검사 일반촬영 분야의 촬영기법에 대한 분석)

  • Kim, Jung-Su;Kim, Jung-Min;Lee, Young-Han;Seo, Deok-Nam;Choi, In-Seok;Nam, So-Ra;Yoon, Yong-Su;Kim, Hyun-Ji;Min, Hye-Lim;Her, Jea;Han, Seong-Gyu
    • Journal of radiological science and technology
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    • v.37 no.3
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    • pp.169-175
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    • 2014
  • According to database of medical institutions of health insurance review & assessment service in 2013, 1118 hospitals and clinics have department of radiology in Korea. And there are CT, fluoroscopic and general radiographic equipment in those hospitals. Above all, general radiographic equipment is the most commonly used in the radiology department. And most of the general radiographic equipment are changing the digital radiography system from the film-screen types of the radiography system nowadays. However, most of the digital radiography department are used the film-screen types of the radiography system. Therefore, in this study, we confirmed present conditions of technical items for general radiography used in hospital and research on general radiographic techniques in domestic medical institutions. We analyzed 26 radiography projection method including chest, skull, spine and pelvis which are generally used in the radiography department.