• Korean Journal of Adult Nursing
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• v.26 no.6
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• pp.653-667
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• 2014

Purpose: This study was aimed to develop frequently-used clinical scenarios and scoring rubrics to assess core basic nursing skills in adult health nursing clinical practice for clinical evaluation based on program learning outcomes (PO). Methods: This study was a methodological research combining focus group interviews and questionnaires to select and construct scenarios. Data were collected from clinical practitioners, adult health nursing professors, and new nurses from November, 2013 to April, 2014. The developed scenarios and rubrics were applied to nursing students by way of showing an example. Results: The 12 frequently-used clinical scenarios were developed. The proportion of the evaluation rubrics were 30% for clinical instructors where as 70% for college instructors. In order for students to achieve the important learning outcomes from the courses for clinical practice, four program outcomes (POs) were selected as well as a rubric for each POs was developed. Students who had situation-based clinical practices showed higher levels of satisfaction on mastery of core basic nursing skills and communication skills. Conclusion: This findings of the study suggested the strategies for complementing pitfalls in clinical setting and achieving PO during students' clinical practicum.

• The Korean Journal of Emergency Medical Services
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• v.27 no.1
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• pp.127-137
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• 2023

Purpose: This study aimed to analyze the treatment outcomes according to the socioeconomic factor of patients who visited the emergency room. Methods: This study conducted frequency analysis, percentage analysis, and Fisher's exact test analysis method, using the R 4.1.2 program based on the 2019 data from the Korea Health Panel. Results: Among the treatment results of 1,648 patients, 392 patients were hospitalized or transferred to other hospitals, 845 were discharged after treatment, 224 were discharged, and 7 died. The Fisher's exact test of treatment outcomes and socioeconomic factors was not statistically significant for status of the worker and employment relationship, but was significant for the housing, household, economic activity, and insurance types, and marital status and education. Conclusion: The results of this study indicate that it is necessary to conduct follow up studies on socioeconomic factors to provide basic data that can contribute to fairness and equity in the health care field.

• Journal of Korean Academy of Nursing
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• v.48 no.5
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• pp.506-520
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• 2018

Purpose: To compare the effects of the Interaction Model of Client Health Behavior (IMCHB)-based oral health program (OHP) and walking exercise program (WEP) on oral health behaviors, periodontal disease, physical activity, and psychological indicators (depression, stress, and quality of life) in pregnant women. Methods: A nonequivalent control group pretest-posttest design was adopted to compare the effects of a 12-week OHP and WEP on pregnant women (n=65). Pregnant women were randomly assigned to the oral health group (OHG; n=23), walking exercise group (WEG; n=21), or control group (CG; n=21). Data were analyzed by the ${\chi}^2-test$, Fisher's exact test, Scheffe test, and repeated measures ANOVA, using the Statistical Package for the Social Sciences for Windows (version 21.0). Results: The OHG and WEG showed significant improvements in oral health behaviors, periodontal disease, and psychological indicators as compared to the CG. The WEG showed significant improvement in physical activity as compared to the OHG and CG. Conclusion: These findings indicate that the IMCHB-based OHP and WEP were effective in improving periodontal disease, physical activity, and psychological indicators. However, further studies are needed to identify the positive effects of the OHP and WEP on birth outcomes.

• Journal of Yeungnam Medical Science
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• v.35 no.2
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• pp.156-164
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• 2018

Environmental contaminants are one of the important causal factors for development of various human diseases. In particular, the perinatal period is highly vulnerable to environmental toxicants and resultant dysregulation of fetal development can cause detrimental health outcomes potentially affecting life-long health. Perfluoroalkyl compounds (PFCs), emerging environmental pollutants, are man-made organic molecules, which are widely used in diverse industries and consumer products. PFCs are non-degradable and bioaccumulate in the environment. Importantly, PFCs can be found in cord blood and breast milk as well as in the general population. Due to their physicochemical properties and potential toxicity, many studies have evaluated the health effects of PFCs. This review summarizes the epidemiological and experimental studies addressing the association of PFCs with neurotoxicity and immunotoxicity. While the relationships between PFC levels and changes in neural and immune health are not yet conclusive, accumulative studies provide evidence for positive associations between PFC levels and the incidence of attention deficit hyperactivity disorder and reduced immune response to vaccination both in children and adults. In conclusion, PFCs have the potential to affect human health linked with neurological disorders and immunosuppressive responses. However, our understanding of the molecular mechanism of the effects of PFCs on human health is still in its infancy. Therefore, along with efforts to develop methods to reduce exposure to PFCs, studies on the mode of action of these chemicals are required in the near future.

• Journal of Chest Surgery
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• v.55 no.5
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• pp.378-387
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• 2022

Background: Atrial fibrillation (Afib) is a marker of increased cardiovascular morbidity and mortality. Owing to the increased prevalence of Afib in patients undergoing cardiac surgery, assessing the effect of Afib on postsurgical outcomes is important. We aimed to analyze the effect of preoperative Afib on clinical outcomes in patients undergoing cardiac surgery using a large surgical database. Methods: This retrospective cohort study was based on the national health claims database established by the National Health Insurance Service of the Republic of Korea from 2009 to 2015. Diagnosis and procedure codes were used to identify diseases according to the International Statistical Classification of Diseases, 10th revision. Results: We included 1,037 patients (0.1%) who had undergone cardiac surgery from a randomized 1,000,000-patient cohort, and 15 patients (1.5%) treated with isolated surgical Afib ablation were excluded. Of these 1,022 patients, 412 (39.7%), 303 (29.2%), and 92 (9.0%) underwent coronary artery bypass, heart valve surgery, and Cox-maze surgery, respectively. Preoperative Afib was associated with higher patient mortality (p=0.028), regardless of the surgical procedure. Patients with preoperative Afib (n=190, 18.6%) experienced a higher cumulative risk of overall mortality (hazard ratio [HR], 1.435; 95% confidence interval [CI], 1.263-2.107; p=0.034). Subgroup analysis revealed a reduced risk of overall mortality with Cox-maze surgery in Afib patients (HR, 0.500; 95% CI, 0.266-0.938; p=0.031). Postoperative cerebral ischemia or hemorrhage events were not related to Afib. Conclusion: Preoperative Afib was independently associated with worse long-term postoperative outcomes after cardiac surgery. Concomitant Cox-maze surgery may improve the survival rate.

• Journal of Gastric Cancer
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• v.15 no.3
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• pp.159-166
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• 2015

Purpose: Laparoscopic total gastrectomy (LTG) is more complicated than laparoscopic distal gastrectomy, especially during a surgeon's initial experience with the technique. In this study, we evaluated the short-term outcomes of and learning curve for LTG during the initial cases of a single surgeon compared with those of open total gastrectomy (OTG). Materials and Methods: Between 2009 and 2013, 134 OTG and 74 LTG procedures were performed by a single surgeon who was experienced with OTG but new to performing LTG. Clinical characteristics, operative parameters, and short-term postoperative outcomes were compared between groups. Results: Advanced gastric cancer and D2 lymph node dissection were more common in the OTG than LTG group. Although the operation time was significantly longer for LTG than for OTG ($175.7{\pm}43.1$ minutes vs. $217.5{\pm}63.4$ minutes), LTG seems to be slightly superior or similar to OTG in terms of postoperative recovery measures. The operation time moving average of 15 cases in the LTG group decreased gradually, and the curve flattened at 54 cases. The postoperative complication rate was similar for the two groups (11.9% vs. 13.5%). No anastomotic or stump leaks occurred. Conclusions: Although LTG is technically difficult and operation time is longer for surgeons experienced in open surgery, it can be performed safely, even during a surgeon's early experience with the technique. Considering the benefits of minimally invasive surgery, LTG is recommended for early gastric cancer.

• Radiation Oncology Journal
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• v.31 no.1
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• pp.25-33
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• 2013

Purpose: We reviewed the treatment outcomes and prognostic factors for patients with anal canal carcinoma who were treated with curative intent chemoradiotherapy (CRT) at Severance Hospital from 2005 to 2011. Materials and Methods: Data for 38 eligible patients treated during this period were reviewed. All patients were treated with curative intent using radiotherapy (RT) with (n = 35) or without concomitant chemotherapy (n = 3). Among 35 patients who received CRT, most of the chemotherapeutic regimens were either 5-fluorouracil (5-FU) plus mitomycin C (23 patients) or 5-FU plus cisplatin (10 patients). Recurrence-free survival (RFS), colostomy-free survival (CFS), overall survival (OS), and locoregional control (LRC) rates were calculated using the Kaplan-Meier method and survival between subgroups were compared using the log-rank test. Cox's proportional hazard model was used for multivariate analysis. Results: Over a median follow-up period of 44 months (range, 11 to 96 months), 3-year RFS, CFS, OS, and LRC were 80%, 79%, 85%, and 92%, respectively. In multivariate analysis, tumor size >4 cm was an independent predicting factor for poorer RFS (hazard ratio [HR], 6.35; 95% confidence interval [CI], 1.42 to 28.5; p = 0.006) and CFS (HR, 6.25; 95% CI, 1.39-28.0; p = 0.017), while the presence of external iliac lymph node metastasis was an independent prognosticator for poorer OS (HR, 9.32; 95% CI, 1.24 to 70.3; p = 0.030). No treatment-related colostomies or deaths occurred during or after treatment. Conclusion: Curative intent CRT resulted in excellent outcomes that were comparable to outcomes in previous randomized trials. No severe treatment-related toxicities were observed.

• Journal of Korean Public Health Nursing
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• v.22 no.1
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• pp.62-73
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• 2008

Purpose: To examine the outcomes of a smoking cessation clinic at a public health center, in Hwasung city in 2006 and to examine the perceptions of the users regarding the clinic services. Method: 620 smokers who visited the smoking cessation clinic from January, 2006 to November, 2006 were enrolled. An instrument developed by the researcher was used to collect their perceptions. The instrument comprised 24 questions, on a 5-point Likert scale investigating the clinic services in terms of counseling time, environment, readiness of the counselors, counseling information, campaign method, medication use, and follow-up services. The general characteristics of the participants were collected from the database developed by the Ministry of Health & Welfare. The data were analyzed with frequencies, percentage, mean and standard deviation methods. Results: The outcomes of the smoking cessation clinic in Hwasung city in 2006 showed some limitations in terms of low-income group, female smokers, and young adult smokers. Conclusion: Strategies for solving these limitations were necessary to increase the effectiveness of the smoking cessation clinic. Clinic services focused on cognitive-behavioral therapy needed to be developed in accordance with chemotherapy. More effective publicizing campaigns of the clinic services also needed to be developed for more people to know about the clinic. Strategies to increase the accessibility for the people living far from the clinic were also necessary. Assessment of the smokers who did not visit clinic was also recommended in order to determine their intentions, or barriers to visit the clinic.

• Physical Therapy Rehabilitation Science
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• v.6 no.1
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• pp.26-32
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• 2017

Objective: The purpose of this study was to evaluate the relationship between quality of life (QoL) of the caregiver and disease severity with motor function in children with cerebral palsy (CP). Design: Cross-sectional study. Methods: Research data were collected in the Rehabilitation Clinic of Daegu University. The Gross Motor Function Measure (GMFM-88) and the functional independence measure (FIM) were used for assessment by three occupational therapists, and the 36-item short form health survey (SF-36) were applied to the caregivers. One hundred six caregivers of under 18 years who were diagnosed with CP completed a survey and interview. The caregivers' QoL was evaluated using Medical Outcomes Study SF-36. The children's motor function was scored using GMFM-88 in five dimensions: lying and rolling; sitting; crawling and kneeling; standing and walking, running and jumping and CP's FIM scores. Results: Out of the 8 domains of the Medical Outcomes Study SF-36, the "physical functioning", "physical role functioning", "mental health", and "bodily pain" domains were significantly correlated to "total" percentage scores of the GMFM-88 (p<0.05). In addition, the "mental health" domain was correlated to each subdomain of the GMFM-88, which includes, "lying and rolling", and "crawling and kneeling". Similarly, of Medical Outcomes Study SF-36, "physical functioning", "bodily pain", and "mental health" domains were significantly correlated with "transfer" and "locomotion" of FIM scores (p<0.05). Conclusions: This study showed that the QoL of the caregivers were well correlated with the motor function of children with CP. It is also important to support not only physical health but also psychological health of caregivers of children with CP, especially those with severe motor function.

• Proceedings of The Korean Society of Health Promotion Conference
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• 2005.09a
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• pp.153-195
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• 2005

There has been 10 years since The Health Promotion Act was legislated. The government began to establish a health promotion fund on the basis of Health Promotion Act in 1995, and to manage and operate the fund from 1998. It is evaluated that health promotion program have had various outcomes in many aspects. First, there has been growing awareness of the impotance of health promotion through the establishment of Health Plan 2010 and the effort to actualize the Plan. Second, the importance of securing health equity and identifying health determinants have been recognized during the planning process of Health Plan 2010. Third, the health promotion program have mainly focused on improving healthy life style of the population. As a result, desirable health behavior change of the population could be expected from the result of 2005 National Health and Nutrition Survey. Fourth, public health centers began to play a crucial role in implementing health promotion programs, and began to build infrastructure for health promotion programs. Fifth, the outcomes of health promotion programs by public health centers and private health organizations have been increasing. Finally, training for health promotion personnel and their participation in the program could be the foundation for the higher level of outcome achievement from the health promotion programs. Important challenges for future health promotion would be identification of the determinants and risk factors of health in Korea, establishment of local health promotion plan, building infrastructure for health promotion, creation of specific action model by public health center, development of diverse health promotion programs and health promotion program for the elderly, conducting research for evidence concerning major factors reducing the need for health care through prevention disease activities, and establishment of evaluation and feed back system for health promotion programs.