Objectives: This study investigated factors associated with the retention of people living with human immunodeficiency virus (HIV) on antiretroviral therapy (ART) during the first 3 years of treatment. Methods: A retrospective study using electronic health records was conducted at a tertiary hospital in Jakarta, Indonesia. Adult HIV-positive patients who started ART from 2010 until 2020 were included. A binary logistic regression model was used to identify factors associated with ART retention in the first 3 years. Results: In total, 535 respondents were included in the analysis. The ART retention rates for the first, second, and third years were 83.7%, 79.1%, and 77.2%, respectively. The multivariate analysis revealed a negative association between CD4 count when starting ART and retention. Patients with CD4 counts >200 cells/mL were 0.65 times less likely to have good retention than those with CD4 counts ≤200 cells/mL. The year of starting ART was also significantly associated with retention. Patients who started ART in 2010-2013 or 2014-2016 were less likely to have good retention than those who started ART in 2017-2020, with adjusted odds ratios of 0.52 and 0.40, respectively. Patients who received efavirenz-based therapy were 1.69 times more likely to have good retention than those who received nevirapine (95% confidence interval, 1.05 to 2.72). Conclusions: Our study revealed a decline in ART retention in the third year. The CD4 count, year of enrollment, and an efavirenz-based regimen were significantly associated with retention. Patient engagement has long been a priority in HIV programs, with interventions being implemented to address this issue.
Kang, Bum Seung;Yang, Hey Jung;Hong, Min Ha;Kim, Hyun Soo;Song, Hoo Rim;Kim, Young Jong;Kim, Woo Jung
Korean Journal of Psychosomatic Medicine
/
v.25
no.1
/
pp.12-18
/
2017
Objectives : Psychiatric staffs may experience excessive work stress, burnout, and reduced job satisfaction in clinical settings. This can increase chances of diminishing their overall working efficiency or having difficulty managing their own mental health. The purpose of this study was to investigate the effect of group mindfulness-based cognitive therapy(MBCT) on job stress, burnout, self-efficacy, resilience, and job satisfaction. Methods : Twenty eight psychiatric staffs who agreed to participate in the study were included. Self-report questionnaires were used to measure job stress, burnout, resilience, self-efficacy, and job satisfaction. To examine the effects of group MBCT, the scores were compared before and after MBCT. Results : Work stress and burnout scale scores were significantly decreased after group MBCT. Resilience, job satisfaction, and self-efficacy scale scores were significantly increased after group MBCT. Conclusions : In the current study, group MBCT for psychiatric staffs helped to reduce their work stress and burnout, and, as well, helped to improve resilience, self-efficacy, and job satisfaction. This suggests that, in mental health treatment settings, psychiatric staffs can improve their mental health through group MBCT. Improving mental health of psychiatric staff may also have a positive impact on their patients.
Myung Hwan Yoo;Kyoung Sim Kim;Yong Wook Kim;Eun Young Kim;Young Kim;Hae In Jang;Hyoung Min Cho
Pediatric Infection and Vaccine
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v.29
no.3
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pp.141-146
/
2022
Purpose: Congenital tuberculosis (TB) is difficult to diagnose owing to its non-specific symptoms. Delayed diagnosis increases the risk of nosocomial infections. We examined the TB status of infants and healthcare workers who were in proximity to preterm twins diagnosed with congenital TB 63 days after birth and 48 days after admission to the neonatal intensive care unit (NICU). Methods: Contact investigations were conducted on 24 staff members and 35 infants who had contact with the twins with congenital TB. Results: Two of the exposed infants, both of whom had received the Bacille Calmette-Guérin vaccine, had positive tuberculin skin test results. Four of the 24 exposed staff members had positive interferon-gamma release assay (IGRA) test results before exposure and were not re-tested after exposure; the remaining 20 had negative IGRA test results. All exposed staff members and infants had normal chest radiographic findings. Conclusions: Although transmission of TB in the NICU is unusual, it can occur. These results support the need for a systematic investigation of the TB status of exposed infants, their family members, and healthcare workers.
Park, Jang-Soon;Yu, Seung-Hum;Sohn, Tae-Yong;Park, Eun-Cheol
Korea Journal of Hospital Management
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v.8
no.1
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pp.112-134
/
2003
The purpose of this study is to analyze the consumer's expectation before the health care service and the consumer's satisfaction after it. The participants of the study are inpatients in a general hospital located in Seoul. The resources were collected from the self-administration questionnaire survey run parallel with face to face interview. In order to measure the degree of the consumer's expectation, 349 samples were collected from the first questionnaire survey on the date of admission to the hospital. The second questionnaire survey was carried out on the date of discharge to the hospital with the participants responding to the first questionnaire survey. There are 154 samples collected from this survey. The results from the analysis of these resources are as follow. First, the survey shows that one of the highest consumers' expectations was about the generosity, kindliness and sincerity from the staff at the hospital, specially from doctors. Second, according to the analysis of the factors affecting the expectations of the consumers, with regard to path of admission to a hospital relating to patient's features, outpatient who gets into a hospital expected good medical care much more than the other patients. In regard of doctor's features, patients usually and highly expect good medical care from doctors who have good carrier and much experience. Third, according to the second questionnaire survey, what patients are satisfied most with is about the generosity and sincerity from staff at a hospital, especially from doctors and their gem attitudes. The results from survey show that the differences among the degree of consumers' satisfaction are very variable, depending on surrounding environments and facilities. The only fact that expectation didn't meet with satisfaction appeared to the case about technology and skill of medical care and the case about updated medical skills and equipments. Fourth, comparing the degree of expectation with the degree of satisfaction of consumers, correlative analysis was concerned significantly and specifically about the part of overall cleanliness relating to facilities and surrounding environments, the items about medical examination and test plan procedure relating to skill of medical care, professional specialties and convenience for procedure, and the items about satisfying explanations and concern about patients from doctors relating to staff's generosity and sincerity. Fifth, the analysis of the factors affecting the degree of how much patients are satisfied with shows that relating to sociodemographical features, patients are not satisfied with the case when the time and process of medical treatment are getting longer. It is surveyed that consumer were satisfied with the motivation to visit a hospital and the insurance type in patient's feature and so were the medical department and the factor of the degree of the expectation in disease's feature. Sixth, according to analysis based on the survey, patients would join again a hospital when they get satisfaction from the medical care and also they want to come again regarding to doctor's capability. For example, when doctors are old, have a good carrier and much experience, patients would come again. As seen from the above, consumers are usually satisfied with the medical treatment more than that they expected before. They would intend to use again when they get satisfaction from the medical care provided at a hospital. Patients and consumers highly expect good attitude as well as capacity from medical doctors and they are also generally satisfied with those things. Therefore, in order to increase the degree of consumer's satisfaction and their intention to come again, the hospital staff would have to commit themselves to achieve high quality service continuously and would have to make an effort to offer the finest quality service.
Since the start of the Korean Society of Quality Assurance in Health Care in 1994, QA has improved, but it is time to develop our own policies that are more appropriate for Korean hospitals. American Quality Assurance policies are difficult to apply to the Korean medical community due to the differences in health insurance policies, and hospital structure between the two countries. Methods : I would like to propose more efficient organization and management of Quality Assurance according to the specific structures of hospitals in Korea. All of the hospital departments and committees should report to the Quality Assurance office, which in turn should report to the director. I would like to suggest that the current insurance review staff be used for the Quality Assurance office. A nurse should be in charge of the Quality Assurance department. The Quality Assurance department should have three sections: Medical Inssurance Review, QA records for the different Medical Departments, and QA records for the Ancillary Departments. A staff physician should be the chairman of the hospital QA committee, which should serve as the advising body to the QA Department. The QA Committee should be organized into eight subcommittees so that all departments thought the hospital are represented. The current Medical Insurance Review offices in Korea have similar responsibilities to the QA Department: therefore I would like to recommend that the Medical Insurance Review office be changed the the QA office. If there are presently two separate Medical Insurance and QA offices, these should be combined into one office. Conclusion : These changes would surely benefit hospitals and strengthen the efficiency of both Insurance Review and Quality Assurance.
This study aims to explain the process of providing important medical images for the diagnosis of pneumonia caused by coronavirus disease 2019 (COVID-19) through the only mobile hospital computed tomography (CT) in Korea. Since January 28, 2020, medical imaging examinations have been provided to confirmed and suspected COVID-19 patients, and the quality of images was evaluated based on the objective and subjective indicators. In order to prevent the transmission in the hospital that may occur due to exposure to medical staff and general patients, personal protective equipment was worn and the separate route was used blocking human infection factors. For 11 weeks, a total of 185 tests were performed for 98 confirmed patients and 72 suspected patients. The average time to complete the test was 33 minutes. In the course of the test, no cross-infection cases were examined. During the outbreak of the COVID-19, the only mobile hospital CT room of Korea provided medical imaging examinations without infection among medical staff and patients and also provided adequate medical images without significant difference (p >0.05) in determining the degree of pneumonia progression compared to a stationary in-hospital CT.
Journal of the Korean BIBLIA Society for library and Information Science
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v.30
no.3
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pp.291-314
/
2019
In this study, to improve the satisfaction of library users in the hospital and to examine how to activate the library in the future, the satisfaction of library, facilities and environment, staff, service, We conducted a demand survey and searched for the operation plan of the library that satisfied the user. As a result, in order to revitalize the library in the hospital, first, in the case of the collection, it is necessary to expand the number of collections of various topics with the latest contents. Second, it is urgent to expand the number of library staff in the hospital. In addition, it is necessary to improve communication expertise based on medical expertise and ability to respond quickly to user requests. Third, it is necessary to expand the size of library and convenience facilities in the hospital by facilities and environment. Fourth, in case of service, it is necessary to improve service quality and provide various services. Experts should provide subject search service, medical information source service, general health information service (patient and carer) according to the user. Finally, in the case of programs, it is necessary to expand the infrastructure for program operation, to diversify the targets, and to extend the program continuity.
The aim of this study is to suggest theoretical foundations on which hospital employees could estimate medical care services not in the position of providers but consumers. For this purpose this study compares satisfaction of providers but consumers. For this purpose this study compares satisfaction of patients with medical care service with that of hospital employees. 287 patients and 261 employees in three university hospitals in Daegu were selected as samples of investigation and asked questions. Statistical analysis was taken using SAS package. The result of this study are as follows. 1) Among the five fields of medical services patients and hospital employees have different views in doctor hospital staff(except doctor) treatment system availability service but parking service 2) Hospital employees overestimate the level of medical care services compared with patients 3) Demographical variables make a difference in medical satisfaction 4) In satisfaction-evaluation after r ceiving treatment medical system service is influential variables in both patients and hospital employees. And in patient group doctor service is following variables while availability and parking service is influential variables in employees.
In this study, satisfaction with salary of the clerical saff in health care organization was analyzed with a view to provide data contributive to efficient wage management for the clerical staff of hospitals. For the analysis, it was investigated if there is any difference in satisfaction with wage depending on the individual and environmental characters as well as comparative factors perceived by self or by others in-and outside the working place. The findings of the analysis may be summed up as follows: First, in support of the hypothesis that the satisfaction with wage of the clerical staff in hospitals will individual factors, statistically significant difference were found in the satisfaction with wage depending on age and career, but there was little significant difference depending on gender and education. Thus, the hypothesis I in this study can be partly adopted. Second, with regard to the hypothesis that the satisfaction with wage of the clerical staff in hospitals will vary with environmental variables, significant differences were found in terms of comparative factors perceived by self or by others inside the working place and those perceived by others outside the working place, and significant difference was also shown in the comparative factors perceived by others outside the working place. Whereas, however, there was no significant difference in the satisfaction with wage depending on the position, which led to the partial adoption of the hypothesis II. This study has following limits in search of difference in satisfaction with wage of clerical staff in hospital depending on individual and environmental variables: the sample is too small to represent the general wage level satisfaction of the whole health care organizations, since the survey hasn't covered the wage level and management of the employees in all hospitals; the professional attitude and rate of fluctuation that are closely connected with the wage level are not considered.
Purpose : This study aims to investigate the status of delirium intervention in adult intensive care unit (ICU) patients and the perception of this delirium by medical staff. Methods : This retrospective study involves 185 patients, whereas, a descriptive survey is conducted with 197 medical staff members. Results : The delirium group includes 100 patients (54.1%). The incidence of delirium is 64.9% in the medical ICU, 65.9% in the surgical ICU, 42.4% in the neuro ICU, and 46.5% in the cardiac ICU. The percentages of delirium prevention intervention differs between the two groups: 65.0% in the delirium group and 95.3% in the non-delirium group. The medical staff recognize that delirium is a common problem in the ICU (100.0%) and requires active medical intervention (98.5%). Conclusion : The length of stay at the ICU is longer in the delirium group than in the non-delirium group. It is necessary to standardize delirium prevention and treatment protocols to be equally applicable to all ICU patients.
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