• Women's Health Nursing
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• v.6 no.2
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• pp.234-257
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• 2000

At present in the medical care, the study and effort for producing health service to consider efficiency, effectiveness, and quality are urgently called for because of the difficulty in the keen competition according to the inter- nationalization and opening, the operation in the medical institution service testing system, the change in the medical policy of KDRGs, and the lack of the health care cost increasing rate. As an alternative, the case management for the new management system is introduced in the U.S., and the Critical Pathway that is the method designing the contents of activity and its result has been developed and applied in order to anticipate and manage the patient-outcome for the realization of the cost-effective case-management. Thus, this study intended to analyze the effectiveness to obtain by developing the Critical Pathway presented as the method to improve the quality-betterment and cost effectiveness through the continuous and consistent patient management for the hysterectomy patient and applying it to the real practice. As a study method, this author formed a conceptual framework through considering five Critical Pathway used in the current U.S. and three Critical Pathway presented in the literature to develop the Critical Pathway for the hysterectomy patient, and made out the preliminary Critical Pathway through reviewing the old chart. This author made the verified the validity of the expert group about the developed Critical Pathway, and to confirm the possibility of practice application, completed and settled the final Critical Pathway after using the Critical Pathway to the hysterectomy patient from March 1st to 15th, 1997. Finally, to analyze the application-effect of the developed Critical Pathway, this author offered health care service applying the Critical Pathway to the hysterectomy patient from April 15th to August 31th, 1997. The guide for the Critical Pathway was carried out in advance by outpatient setting nurse for outpatient setting visit before the operation, and after hospitalization the primary nurse monitored the execution degree on the every duty. After discharge this author surveyed the complication through phone visiting, and one month after discharge surveyed the patient's reaction about the offered service when outpatient setting visit and analyzed the result. The source for health care cost was obtained by the statistics about the hospital charge which was offered by the General Business Department. The results were as follows. 1. It was decided that the vertical line of the Critical Pathway was made up of eight items such as monitoring/assessment, treatment, line/drains, activity, medication, lab test, diet, patient teaching, and the horizontal line of the Critical Pathway was made up of from hospitalization to discharge. 2. After the analysis of service contents through reviewing the old chart, it was decided that the horizontal line of the preliminary Critical Pathway was made up of from hopitalization to fourth postoperative day, and the vertical line of it was divided into eight items which were the contents to occur with the time frame of the horizontal line. 3. After the verifying the validity of the expert group about the preliminary Critical Pathway, the horizontal line was amended from hopitalization to third postoperative day, and taking their consensus, some contents of the horizontal line was amended and deleted. 4. From March 1st to 15th, 1997, to confirm the clinical suitability, this author offered eight hysterectomy patients the medical service through the Critical Pathway. The result was that three of them could be discharged at the expected discharge day, and the others later than that day. Supplementing the preliminary Critical Pathway through analyzing the cause of that delay- case, this author developed the final Critical Pathway. 5. There were no significant differences between the experimental and the control group in the incidence of complication(P > 0.05). 6. The 92.4% of experimental group was satisfied with the Critical Pathway service. 7. The length of hospital stay of the experimental group offered with the Critical Pathway service was 4.6 days and there was a significant difference that it was 1.3 days shorter than that of the control group(t=-29.514, P=0.000). 8. There wsa a significant difference that the mean medical charge per one patient of the experimental group offered the Critical Pathway service was cheaper \124,150 than that of the control group(t=-9.826, P=0.000). 9. The result that the author assumed and analyzed hospital income with the rate of turning bed was assumed that the increase of hospital income was \63,245,072 for that study, and the income increase was expected with \68,704,864 for a year. The result that this author applied the Critical Pathway to the hysterectomy patient have no differences in the incidence of complication, high satisfaction with that service, and the length of hospital stay decreased in the experimental group, and the mean hospital charge per one patient decreased, but hospital income increased. Suggestions for further study and nursing practice are as follows. 1. The study to apply the Critical Pathway for a year, verify the validity, and measure the effect repeatedly is needed. 2. To apply and manage the Critical Pathway effectively, the study to computerize it is needed. 3. The study to develop hospital-based Critical Pathway about other diseases or procedure, and measure the effect is needed.

• Journal of muscle and joint health
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• v.19 no.1
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• pp.57-70
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• 2012

Purpose: This study aimed to investigate the level of physical activity and to identify factors related with physical activity for the elderly with Diabetes Mellitus (DM). Methods: The subjects were 154 diabetic outpatient at 3 hospitals located in J city. Data were collected from February 1 to 17 in 2012. Data were analysed using Chi-square test, ANOVA, and logistic regression by SPSS/WIN 18.0. Results: Mean physical activity level per week measured by International Physical Activity Questionnaire (IPAQ) was $2247.01{\pm}2533.73$ MET-minutes (minimally active). There were significant differences in the level of physical activity by age, spouse, education, job, admission, duration of DM, and DM therapy. There were significant differences in subjective health status, objective and subjective obesity, satisfaction with physical body, perception of aging, self-efficacy, perceived benefits, perceived barriers, and social support among the inactive, minimally active, and health enhancing physical activity groups. Factors influencing the level of health enhancing physical activity were spouse (OR=10.192), self-efficacy (OR=5.351), subjective obesity (OR=.114), and perceived barriers (OR=.069). Conclusions: The level of physical activity of elderly patients with DM was minimally inactive. Physical activity program enhancing self-efficacy and decreasing perceived barriers, as well as improving the correct perception of subjective obesity is recommended as a nursing intervention.

• Journal of The Korea Institute of Healthcare Architecture
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• v.18 no.4
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• pp.39-51
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• 2012

Purpose: Hospitals for patients and their guardians can, from the concept of healing, be removed from just gaining profits, but suggest a future-oriented direction for the hospital. Accordingly, there have been studies related to the selection of hospitals, but most were related to preference and satisfaction, and only recently did research from the concept of tradeoffs of factors for selection began to grow rapidly. Methods: From this context, this study evaluates the level of importance for factors of selecting hospitals using the analytical hierarchy process, and identifies the correlation with users, gender, age group, and outpatient features in order to identify the difference of awareness among different groups for selecting hospitals. In the factors for selection 26 factors in six categories were set through studies of preceding research, and after surveying 144 people, the following results were attained. Results: 1) The overall analysis results were found in the order of medical level, medical service, and fame, and low for facilities, which is similar to the cases of preceding studies. 2) For user analysis, it was similar between patients and guardians, but there was a slight difference in awareness among nurses, who are also medical service providers. Nurses showed relatively high level of importance in direct factors such as medical technologies and medical services, while guardians of patients showed higher importance in indirect factors such as facility environments and convenience. 3) Women showed higher assessments of importance levels in environmental factors, while men in physical factors. 4) The older the age group, the lower level importance there was on medical level, while the importance on fame reduced the further the commute to the hospital was.

• Journal of the Korean Dietetic Association
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• v.2 no.2
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• pp.199-215
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• 1996

In Korea, the majority of hospital dietitians expend most of their time performing food management related activities, and only a few carry out nutrition care activities in full-time. This study was designed to measure productivity of the clinical nutrition team and assess the role of clinical dietitians in the only 2200-bed teaching hospital in Korea. Six full-time clinical dietitians collected time data for four weeks according to the nutrition care activities outlined. Three clinical dietitians assigned to 7 units recorded how often physicians implemented their recommendations for two months. Two kinds of survey questionaire were developed and sent to the patients and the health care team. The followings are a summary of the results. 1. The clinical nutrition team of 6 full-time dietitians expended 75% of their time performing patient care activities, 20% in non-patient care activities and 5% in delay and transit. 2. Each clinical dietitian assigned to the units carried out 56 patient care activities on daily basis. 3. The average time required for the clinical nutrition services was 60.2 minutes for outpatient counseling, 89 minutes for inpatient counseling, 72.5 minutes for nutrition management, 95 minutes for malnutrition consult and 121 minutes for dysphagia diet management. 4. Physicians' implementation of clinical dietitians' recommendations was 98.5%. 5. Most physicians and nurses viewed the clinical dietitians on the units assertive, contributing to the quality improvement of medical services, and helpful to the patients as well as the health care team. 6. Most patients viewed the clinical dietitians on the units considerate, attentive and helpful. Based on these results, it is suggested that (1) daily meal round and nutrition care monitoring are effective tools for nutrition intervention in the hospital setting. (2) unit assignment of clinical dietitians enhances the patients' satisfaction in the nutrition services provided as well as the perceptions of health care team on clinical dietitian's expertise.

• Journal of Digital Convergence
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• v.10 no.10
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• pp.405-413
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• 2012

This study of male workers of small manufacturing companies with 50 or less determine the level of job stress and Investigated the relevance of these demographic characteristics, health behaviors, and job-related characteristics. The study subjects were 856 male workers, health checkups and screening agencies are engaged in small manufacturing companies with 50 or less people. Data collection period from April 1, 2010 until June 30, during the self - administered questionnaire through a survey was done. The Study results, several demographic characteristics, health-related behavioral characteristics and job-related characteristics of the variables and job stress is surveyed, there was a significant association. Drinking status, occupation, hours of sleep, leisure activities, whether working position, duration, number of hours per week, for inpatient and outpatient experience, whether in the workplace satisfaction, especially those affecting the job stress factors, such as has been pointed out, Therefore, in order to reduce job stress, health-related behaviors and the work environment, and efforts to improve the content of the job.

• Korean Journal of Digital Imaging in Medicine
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• v.13 no.3
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• pp.127-132
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• 2011

This is to improve the complicate process of the existing CD copy flow in Department of Radiology. It is also to improve the medical service of the hospital to secure private information of patients. Survey: The patients who ask for CD copies in the Department of Radiology of this hospital(for 6 months in 2010). Time: Comparing the total amount of time of the previous and the modified CD copy flow. Using the SPSS 12.0 program for testing significance of independent two-samples t-test. Private information: Introducing the identification-system based on the medical law to supplement the security of personal information of patients. There was manifold complaints due to receipt and issuing the prescription in Admission and Discharging office and outpatient department. The time has been approximately 50% reduced from 70 mistunes to 32 mistunes due to simplifying the routes. The security of the personal information has been supplemented by let patients submit documentary evidence based on the medical law. The service in the hospital has been improved as a result of simplifying the whole process of the routes and receipt process. Therefore, the each stage of waiting time has been decreased. In addition, the personal information of the patients has been more secured.

• The Journal of Korean Obstetrics and Gynecology
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• v.31 no.3
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• pp.79-96
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• 2018

Objectives: The objective of this study was to survey the performance of postpartum care and compare the western medicine and Korean medicine according to women's postpartum disease. The purpose of this study was to provide basic data for the prevention and management of postpartum disease. Methods: The subjects were 228 women who experienced postpartum disease. This research was conducted in G city, at outpatient department of western medicine hospital and Korean medicine hospital. The degree of performance of postpartum care was measured on a 4-point scale divided by each area, and was compared in three groups. Results: Postpartum care includes traditional postpartum care and postpartum care in hospitals. The degree of performance of postpartum care means that the higher the score, the better. The traditional postpartum care performance score was 2.35 and the postpartum care performance score at the hospital was 1.63. The results of this study showed that the performance of traditional postpartum care was higher than that of postpartum care administered in hospitals. The perception of traditional postpartum care methods was 'An indispensable postpartum care method for health' (75.9%). The most effective method of postpartum care was 'consolidate in harmony traditional postpartum care and guidance of the medical team' (88.2%). Conclusions: The improvement and satisfaction degree of postpartum care were higher in Korean medicine than in western treatments. Therefore, the most efficient method of postpartum care must be integrated in harmony with the direction of the medical staff and traditional methods of postpartum care.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup1
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• pp.51-54
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• 2001

Objective : Authors analyzed clinical outcomes of cranioplasty according to the materials used for covering defects of the skulls. Methods : From January 1997 to February 2000, there were forty one patients undergone cranioplasty at our institution. We used refrigerated autogenous bone flaps in 19 cases(group A) and methyl methacrylate(MMA) in 22 cases(group B). The medical records and plain skull radiographs of the patient were reviewed. Results : There were thirty men and eleven women. Mean follow up period was 12 months(From operation to last Outpatient department follow up). The mean operative time of the group A($136.8{\pm}3$ minutes) was shorter than the group B($172.7{\pm}2$ minutes, Mann-Whitney test, p=0.001). In group A, the degree of satisfaction was good in 8 cases, fair in 10, and poor in 1. In the group B, there were fair in 13 and poor in 9. So the cosmetic result was superior in the group A(Chi-square test, p=0.00). The complications were occured in one case of flap infection in the group A and 6 in the group B(one stitch abscess, 4 infected flaps, one subgaleal hematoma). Conclusion : Cranioplasty using refrigerated autogenous bone flap showed shorter operative time, better cosmetic results, and less complication rate than those using MMA.

• Korean journal of dermatology
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• v.56 no.9
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• pp.539-542
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• 2018

Background: Patients with acne are at risk of using various over-the-counter drugs (OTCs). In addition, several OTCs are introduced in pharmacies in Korea. However, only few drugs are supported by well-established data. Among the treatments, acne patches are easy to purchase and use. Thus, they are widely used by patients. Objective: This study aimed to investigate the patient's perception and usage of acne patches. Methods: A questionnaire survey was conducted on 80 patients with acne who visited the outpatient department of the National Medical Center for 2 months. Results: A total of 42 (52.5%) patients answered that they had used acne patches, and 38 (47.5%) patients stated that they had never used patches. Moreover, 27 (64.29%) patients responded that they used the patches on inflammatory lesions. Moreover, several patients were using acne patches after pricking themselves. There was only one response to confirm the ingredient when purchasing acne patch. Moreover, 14 (33.33%) participants responded that they noted side effects after using acne patches. Overall, the satisfaction score for the use of acne patches was 5.05. Conclusion: Patients often use acne patches because they can be easily purchased and used. However, they do not know how to properly choose and use the product that fits their skin. Therefore, doctors must educate patients on how to properly select and use the products.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.8 no.1
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• pp.1-5
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• 2015

Purpose: The purpose of this study was to analyze the effectiveness of local steroid injection for infraspinatus under ultrasonographic guidance in patients with posterior shoulder pain during horizontal adduction test. Materials and Methods: Twenty one cases of patients, from May 2013 to May 2014, showed positive horizontal adduction test were retrospectively analyzed. We performed ultrasonography-guided infraspinatus injection using steroid to these patients in the outpatient clinics. We evalulated results for visual analogue score (VAS) for pain, UCLA score for these patients before injection, following 3 months and 6 months after injection. Results: After ultrasonography-guided infraspinatus injection using steroid, there were clinically significant improvements in VAS and UCLA score at 3 month's follow-up period (p<0.05). But there were no significant differences in VAS and UCLA score between 3 months and 6 months (p>0.05). Fourteen of 21 (67%) cases showed much improved and improved satisfaction. Respectively, seven of 21 (33%) cases showed not improved and aggravation satisfaction. Conclusion: Ultrasonography-guided infraspinatus injection using steroid is an effective treatment method for the patients with exacerbated posterior shoulder pain during horizontal adduction test.