• Journal of Korean Academy of Nursing
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• v.17 no.3
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• pp.204-217
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• 1987

It is generally accepted that the delivery of health care is undergoing many changes specially those related to acute, contagious disease care and to the increase of chronic illnesses which can not be cured but are controlable. The health care practitioner can not be soley responsible for the control of their clients' care. Because the clients will play a vital role in controlling their illnesses, long term participation by both the health care provider and the client is necessary. Since most individuals with hypertension do not experience signs or symptoms, the disease is difficult to detect and even when diagnosed, clients do not comply well with their hypertension regimens. The noncompliant client is at increased risk for compliants involving the heart, brain, kidney and other organs. In an effort to explore methods of increasing patient participation in and adherence to treatment programs for hypertension, the researcher used health contracting to promote self care. The research questions are; 1) Will the health contracting increase compliance in health behavior and reduce the blood pressure\ulcorner 2) If clients comply with their regimens will this reduce their blood pressure\ulcorner The research design utilized in this study was a quasi-experimental design. A purposive sample, was abtained from two churches in the 1. area, consisting of 64 clients with hypertension. The data was collected from the middle of January to the 1st of September 1985. Randomization was only of the two church groups into experimental and control groups. Compliance with health behavior related to the hypertensive regimen, blood pressure and body weight were measured, compared and analyzed. In the experimental group measurements were made 6 times; one month before the education program after education program when health contracting was done and 4 more times once a month for 4 months. In the control group measurements were made 3 times; one month before the education program after the education program, and once 4 months later. There was no health contracting. The data were analyzed by t-test, Pearson correlation and ANOVA according to purpose of the study. The result of this study may be summarized as follows: The result related to the hypothesis on the effect of health contracting are as follows: H$_1$; “The hypothesis that the experimental group, with a health contractual agreement will demonstrate increased compliance levels for health behavior than the control group” was supported(t＝-5.29, df＝62, p＝.000). H$_2$; “The hypothesis that the experimental group, with a health contractual agreement, will demonstrate a greater reduction in blood pressure than the control group” was supported (for systolic blood pressure t＝2.72, df＝62, p＝.009, for diastolic blood pressure t＝1.95, df＝62, p＝.050). H$_3$; The hypothesis that the greater the compliance of the client with health behavior the lower the client's blood pressure will be was partially supported (for systolic pressure r＝-.2981, p＝.008, for diastolic pressure r＝-.1720, p＝.087). From the examination of the results of this study it can be concluded that the interaction between the nurse and the client, contracting to define goals and reinforcing compliant behavior, leads to improved compliance with health care behaviors and thus to an increase in the effectiveness of nursing care. Further consideration need to be given to the inclusion of the concept of health contracting in primary nursing and to further research in this area.

• 대한예방의학회:학술대회논문집
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• 1998.10b
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• pp.44-45
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• 1998

• The korean journal of orthodontics
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• v.42 no.4
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• pp.201-206
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• 2012

Objective: To determine the changes in dental anxiety, state anxiety, and trait anxiety levels of patients and their parents after 3 months of active orthodontic treatment. Methods: We evaluated 120 patients and one parent of each patient. State Anxiety (STAI-S), Trait Anxiety (STAI-T), and Corah's Dental Anxiety Scale (DAS) were administered before orthodontic treatment (T1) and after 3 months of treatment (T2). Differences in scores between T1 and T2 were compared using paired-sample t-tests and the relationship between the scores of the DAS and the STAI were analyzed using a bivariate two-tailed Pearson correlation test. Results: Dental anxiety and state anxiety levels decreased among the patients after adjustment to orthodontic treatment (p < 0.001). However, 3 months of treatment was not sufficient to decrease the anxiety levels of parents (p > 0.05). Patient trait anxiety affected patient state anxiety and dental anxiety (p < 0.01). Additionally, a significant correlation was found between patient dental anxiety and parent dental anxiety (p < 0.05). Conclusions: Dental anxiety and state anxiety levels decrease after patients become familiar with their orthodontist and they became accustomed to orthodontic treatment. However, 3 months is not a sufficient length of time to decrease parental anxiety levels.

• Archives of Craniofacial Surgery
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• v.18 no.2
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• pp.128-131
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• 2017

With advances in diagnostic technology, radiologic diagnostic methods have been used more frequently, and physical examination may be neglected. The authors report a case of pediatric medial orbital trapdoor fracture in which the surgery was delayed because computed tomography (CT) findings did not indicate bone displacement, incarceration of rectus muscle, or soft tissue herniation. A healthy 6-year-old boy was admitted to the emergency room for right eyebrow laceration. We could not check eyeball movement or diplopia, because the patient was irritable. Thus, we performed facial CT under sedation, but there was normal CT finding. Seven days later, the patient visited our hospital due to persistent nausea and dizziness. We were able to perform a physical examination this time. Lateral gaze of right eye was limited. CT still did not show any findings suggestive of fracture, but we decided to perform exploratory surgery. We performed exploration, and found no bone displacement, but discovered entrapped soft tissue. We returned the soft tissue to its original position. The patient fully recovered six weeks later. To enable early detection and treatment, thorough physical examination and CT reading are especially needed when the patient shows poor compliance, and frequent follow-up observations are also necessary.

• Korean Journal of Adult Nursing
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• v.20 no.2
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• pp.353-363
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• 2008

Purpose: This study was conducted to develop a timeout protocol as the process of patients verification in the operating room, and to evaluate its effects. Methods: The timeout protocol was developed based on the experience of practices and the universal protocol of JCAHO 2004. The subjects of this study were 192 surgical members working in the operating room at an university hospital in Daegu, Korea. Results: The timeout protocol was developed in six steps; participants verification, encouragement of compliance, verification of right 3 PSP, agreement of surgical team members, verification of the parties to a patient, patient agreement. The data which have been resulted from the experimental group show significantly higher than those of control group as follows; cognition(t = -6.580, p = .000), contents of performance; progress of anesthesiologist as leader(${\chi}^2$ = 29.029, p = .000), verification of right patient, right site and right procedure(${\chi}^2$ = 40.663, p = .000), participation of surgical team(${\chi}^2$ = 68.412, p = .000), and the number of cases of performance(${\chi}^2$ = 242.900, p = .000). Conclusion: It suggests that medical accidents caused by failures in a preoperative verification process can be prevented if a timeout is conducted active involvement and effective communication among surgical team members for a final verification of the correct patient, procedure, and site.

• Journal of Korean Academy of Nursing Administration
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• v.13 no.3
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• pp.321-334
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• 2007

Purpose: The objectives of this study were to understand and compare perception and experience between clinical staffs(nurses and pharmacists) and Quality Improvement managers. Method: A qualitative study was conducted with 14 clinical staffs and QI managers who are working at tertiary hospitals in Korea. Interviews were recorded and transcribed for systematic analyses of qualitative data. Results: Most critically, while QI managers acknowledged that establishment of the patient safety culture and reduction of medical errors are urgent tasks for QI effort, clinical staffs don't seem to share such perceptions. All participants agree that staff shortage and no compliance to safety procedures were major reasons for medical error occurrences. Many suggested that an organizational culture where errors were perceived as a systematic problems rather than individual failures or carelessness should be formed to promote voluntary reporting of medical errors. Conclusion: A more systematic effort and attention at the hospital leadership and public policy level should be promoted to constitute societal consensus on the urgence of promoting patient safety culture and more specific approaches to tackle the patient safety problems.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.132-135
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• 1999

Although the vast majority (about 70%) of patients with cancer will have pain directly related to neoplastic invasion into pain-sensitive bone and soft tissue structures,as many as 20% of the adults will have pain caused directly by cancer therapy. Treatment related pain problems are important for several reasons; their appearance may be confused with more omnious pain syndromes associated with tumor recurrence or progression that may be directly lead to death of the patient; when severe, compliance with recommandations for further therapy may be adversely affected. Now, we report a case of postsurgical pain syndrome after radical neck dissection in a patient with tonsilar cancer. The pain after radical neck dissection result from injury to the cervical plexus,cranial nerve,and cervical sympathetics. In our case, we ruled out soft tissue infection and tumor recurrence,and successfully treated with gasserian ganglion block with pure alcohol in the patient having neuropathic pain in the mandible and preauricular region after radical neck dissection.

• Journal of Oral Medicine and Pain
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• v.40 no.1
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• pp.3-9
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• 2015

The etiopathogenesis of burning mouth syndrome (BMS) seems to be complex and many patients probably involves interactions among local, systemic, and/or psychological factors in the pathophysiologic mechanism. Although there are controversies over whether the psychological factor is a cause or a result of BMS, several studies have supported strong relationships between psychological factors and chronic pain. It has been suggested that somatic complaints from unfavorable life experiences may influence both individual personality and mood changes; however, initiation of BMS symptoms is not necessarily correlated with stressful life events despite their elevated psychological stress. If the psychological distress is not a causal factor of BMS, it seems that BMS patients may be particularly vulnerable to psychological problems, primarily depression, anxiety, and hostility due to the characteristic entities of BMS such as chronic persistent pain itself. It seems likely that both physiological and psychological factors play a role in causing, perpetuating and/or exacerbating BMS; therefore, both two components of the patient's symptoms must be addressed. The acceptance of psychological factors by the patient is often an important element of BMS, management. The evaluation of psychological and emotional status of BMS patient enables clinicians to recognize prolonged negative and subclinical factors which can complicate the management of pain or indirectly perpetuate other physical factors. This evaluation improves the doctor-patient relationships, motivation, and compliance through a correct understanding of the clinical problem. Appropriate emotional and psychological evaluation may be required prior to developing a treatment plan in order to gain the successful treatment outcome.

• 대한상한금궤의학회지
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• v.13 no.1
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• pp.145-153
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• 2021

Objective : This study aimed to report the improvement of a patient with anorexia by treatment with Jinmu-tang (Hyunmu-tang) based on the disease pattern identification diagnostic system (DPIDS) of the Shanghanlun provisions. Methods : We evaluated the progress of symptoms, patient compliance, and presence of side effects after the patient was administered Jinmu-tang. The clinical response was estimated according to the number of meals a day, the size of meals, the number of complaints of abdominal pain in a week, and a Likert scale. Results : According to the DPIDS, the patient was diagnosed according to provision 316 with soyinbing. After administration of Jinmu-tang for 45 days, the number of meals a day and the size of meals increased, the number of complaints of abdominal pain in a week decreased, and the Likert scale score decreased from 3 to 0. Conclusions : This case report suggests that the word "腹痛" (abdominal pain) in the 316th Shanghanlun provision indicates anxiety about abdominal pain, which affected anorexia in this case.

• Restorative Dentistry and Endodontics
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• v.37 no.3
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• pp.180-184
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• 2012

Traumatic injuries of the face often involve root fractures especially in anterior teeth. The prognosis and the treatment of the root fracture depend on the extent of the fracture line, general health and patient compliance. This case report outlines a new conservative trial treatment modality to stabilize the maxillary central incisors with horizontal root fracture on the cervical to middle third by fabricating canine guidance to remove loading on the traumatized maxillary central incisors during eccentric movements and thus inducing spontaneous healing of the fractured line between the fragments. Radiographs after thirty months showed adequate healing with no signs of pathological changes including root resorption, ankylosis or displacement. Long term follow-up revealed that vitality, stability and aesthetics were maintained and the patient was satisfied with the outcome.