This is a descriptive study on the perception and attitude toward DNR in adults. Structured questionnaires were used and 210 subjects were studied. In recognition of DNR, DNR was helpful for 'a comfortable dying(64.3%)'. The need for DNR in situation investigated 'For dignified dying (41.3%)' and 'to alleviate patient suffering(23.9%)'. Respondents who do not agree with DNR are shown 'Because legal issues can arise(61.7%)', 'Because human dignity is the life-sustaining priority(16.7%)'. In the attitude toward DNR, the most significant result was 'I want to know if I have an incurable disease (4.21).' There was no difference in attitudes toward DNR among adults. The DNR is not a method of Withdrawing in lifeprolonging treatment, It should be addressed in a comprehensive context in which human beings exercise autonomy over the process of dying and death.
Objectives : The purpose of this study was to identify factors that affect the utilization of Korean medicine (KM) among children with cerebral palsy (CP) and explore a processing model of decision-making by their parents. Methods : We conducted an individual in-depth interview with 21 mothers of children with CP who were recruited during the observational study. A grounded theory of Strauss and Corbin was used for qualitative analysis. Thus, collected data were classified into open coding including 121 concepts, 27 sub-categories and 7 categories. Results : The central phenomenon of the process of using KM for children with CP is 'KM as an optional treatment not essential'. Therefore there are many obstacles to starting KM treatment and it is easily interrupted for various reasons, unlike general rehabilitation treatment. However, if the patient experiences the therapeutic effect, the parents want to continue KM treatment. They try to provide treatment as much as possible if they can afford it. The parents give priority to general rehabilitation treatment and value the information and experience provided by the caregivers in similar situation as well as expert opinions. Conclusions : To expand and generalize KM treatment for children with CP, efforts to change interventional conditions such as treatment effect, treatment cost, treatment compliance, and convenience of treatment based on the understanding of the strategy used by the parents in KM utilization.
With the advent of experience era, the user experience has attracted much attention in all walks of life. And the importance of user experience emphasize began to be emphasized. It analyzed the interfering factors of user experience of smart phone medical APP, and evaluated their relative importance. Then it made suggestions on the priority of medical APP development and provided reference for medical APP design optimization and service quality improvement. First of all, based on the related research about user experience theory, smartphone APP user experience and mobile medical APP, it summarized the user experience elements of smartphone medical APP. Secondly, 200 subjects in the 20-40 age group who chose smartphone download experience and used medical APP were surveyed to rate the effect of 18 factors. The results show that the factors such as product resources, medical advertising recommendations, doctor-patient interaction, emotional pleasure, easy to learn, and other factors have a significant impact on users' good experience when using app.
The effect of improvement by keeping the former as the priority was examined through an evaluation of the role of the blood transfusion management (BTM) division. This division manages the status of blood for transfusion, evaluates the adequacy of blood transfusion (EABT), monitors and responds to the occurrence of transfusion-related side effects, and performs other tasks necessary for BTM. Although the establishment and operation of the BTM division can lead to the efficient evaluation of transfusion adequacy, there are disadvantages in that it takes time for EABT and it is difficult for the staff in charge of the BTM division to evaluate the adequacy of all the blood. In the future, it is essential to introduce a BTM division and committee specific to Korean patients to implement safe and appropriate BTM in medical institutions, and to assist medical institutions in training their personnel.
Objectives: The high readmission rate of patients with chronic obstructive pulmonary disease (COPD) has led to the worldwide establishment of proactive measures for identifying and mitigating readmissions. This study aimed to identify factors associated with readmission, as well as groups particularly vulnerable to readmission that require transitional care services. Methods: To apply transitional care services that are compatible with Korea's circumstances, targeted groups that are particularly vulnerable to readmission should be identified. Therefore, using the National Health Insurance Service's Senior Cohort database, we analyzed data from 4874 patients who were first hospitalized with COPD from 2009 to 2019 to define and analyze readmissions within 30 days after discharge. Logistic regression analysis was performed to determine factors correlated with readmission within 30 days. Results: The likelihood of readmission was associated with older age (for individuals in their 80s vs. those in their 50s: odds ratio [OR], 1.59; 95% confidence interval [CI], 1.19 to 2.12), medical insurance type (for workplace subscribers vs. local subscribers: OR, 0.84; 95% CI, 0.72 to 0.99), type of hospital (those with 300 beds or more vs. fewer beds: OR, 0.77; 95% CI, 0.66 to 0.90), and healthcare organization location (provincial areas vs. the capital area: OR, 1.66; 95% CI, 1.14 to 2.41). Conclusions: Older patients, patients holding a local subscriber insurance qualification, individuals admitted to hospitals with fewer than 300 beds, and those admitted to provincial hospitals are suggested to be higher-priority for transitional care services.
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.
Kim, Jong-Yeol;Kwon, O-Sang;Lee, Yu-Jung;Kim, Jae-Hyo;Kim, Eung-Sun;Kim, Yu-Lee;Shon, In-Chul
Korean Journal of Acupuncture
/
v.24
no.4
/
pp.47-54
/
2007
Objection : A medicine which is patient-initiative and preventive is required in Korea, which is going to an aging society. On this, we started this study to make a new rule to diagnose and treat more definitely by linking traditional Oriental medicine to Sasang Constitional medicine, which thought to be suitable because of Sasang Constitional medicine has been valued on staying, diet and human's nature which means preventive medical propensity. Methods : On this study, we discriminated Sasang Constition of 161 students, who is in college of oriental medicine, Wonkwang university, by using QSCCII program; and in those students, we checked 30 volunteers's five vicera's Back-su point on riging and depression, tenderness reaction, and color reaction after cupping treatment. Results : As a result of study of riging and depression of five vicera's Back-su point, we could confirm that defecient organ's Back-su point were more depressed than excess organ in Seum-in, Taeeum-in, Soyang-in. As a result of study of tenderness reaction of five vicera's Back-su point, we could confirm that excess organ's Back-su point showed stronger tenderness reaction than defecient organ in Seum-in, Taeeum-in; and excess organ's Back-su point showed weaker tenderness reaction than defecient organ in Soyang-in. As a result of study of color reaction after cupping treatment of five vicera's Back-su point, we could confirm that excess organ's Back-su point showed stronger color reaction than defecient organ in Seum-in, Taeeum-in; and excess organ's Back-su point showed weaker color reaction than defecient organ in Soyang-in. Those data suggest that there are close correlation between Sasang Constition and on riging and depression, tenderness reaction, and color reaction after cupping treatment of five vicera's Back-su point in treditional Oriental medicine. Conclusions : From this study, we can make a new rule to differentiate Sasang Constition by clearfy a relation between Sasang Constition and five vicera's Back-su point; and with this rule, we could contribute to popularization and objectification of Sasang Constition medicine and further more, Oriental medicine by making a Sasang Constition diagnosis instrument. With this, a trait of Sasang Constition medicine that is preventive and valued on character of individuals will contribute to building a patient-initiative and preventive medical system and will expend the domain of Oriental medicine.
Kim, Soo-Kyoung;Ahn, Seung-Tae;Choi, Sung-Chul;Kim, Kwang-Chul;Park, Jae-Hong
Journal of the korean academy of Pediatric Dentistry
/
v.37
no.3
/
pp.381-386
/
2010
As the vertical fracture occurs at the various locations following the long axis of a root, treatment method of crown-root fractured anterior teeth is decided according to the depth. If the fracture line is close to the crown, gingivectomy, orthodontic - forced eruption or surgical extrusion of apical fragment could be done. If the line is over 1/3 length of the root, the prognosis is poor and extraction is usually undertaken. However, extraction of maxillary incisor at growing children causes many complications such as esthetic, phonetic problem and alveolar bone resorption. Therefore, preservation of tooth is the highest priority. Recently, intentional replantation with composite resin could be considered as alternative treatment of crown-root fractured anterior tooth. This report presents a patient in mixed dentition with deep vertical crown-root fracture of the maxillary permanent central incisors by trauma. Intentional replantation of the fractured teeth was performed using composite resin. After 2 years, specific clinical symptom has not been found and the patient was satisfied of esthetic result. This method suggests the new technique to preserve a tooth as an alternative to extraction, although it is technically sensitive and the reports of long-term prognosis is insufficient.
Choi, Seo Young;Bae, Ji Min;Choi, Ji Won;Yang, Gi Young;Lee, Byung Ryul;Kim, Kun Hyung
Korean Journal of Acupuncture
/
v.35
no.3
/
pp.130-138
/
2018
Objectives : The purpose of this study is to explore patients' perceptions that deserve attention when designing core questions for a clinical practice guideline of Korean medicine(KM) for degenerative lumbar spinal stenosis (LSS). Methods : Patients who had been admitted to Pusan National Korean Medicine Hospital from November 1, 2015 to October 31, 2016 were invited to the survey. Patients were eligible if they were both clinically and radiologically confirmed as degenerative LSS. The structured questionnaire was distributed by mail and outpatient visits. Questions included types of experienced Korean/Western medical interventions for LSS, their perceived effectiveness on symptoms, the necessity for studies of KM for degenerative LSS, the types of KM interventions to be investigated and the types of outcome measures after treatments. Data were descriptively analysed. Results : Twenty of thirty-one invited participants responded to the questionnaire. Acupuncture and herbal medicine were the most frequently used KM interventions. Eighteen respondents reported that KM treatments were helpful for their improvement. Sixteen patients who mentioned that research on KM is needed chose acupuncture as the top priority(88%) among KM interventions. The most important outcomes in the view of nineteen respondents included functional recovery (68%) and pain relief (53%). Thirteen respondents (65%) replied that both short-term and long-term outcome were important for them. Conclusions : Our findings may have limited validity due to the small number of respondents and the potential selection and information bias. Further qualitative studies and large-scale surveys to comprehensively identify patients' views are warranted.
The urgent needs to establish hospice care systems in Korea arise from the following reasons: 0) a drastic increase in chronically ill patients with the increase of aged population: (2) rapid changes in living environment from the traditional habitation (e. g., Many Koreans living in apartment complexes, which is the most popular form of modern residence in recent years, prefer to die in the hospital.): the overall increase in patients with advanced cancer: (4) recent trends in early discharge of terminally ill patients from the limited hospital facilities to accomodate other medical insurance beneficiaries; (5) easy acceptance of euthanasia owing to the recent social atmosphere that belittles the dignity of human life; (6) medical and nursing care of AIDS patient in terminal stage; (7) and the problem associated with inhumane medical care system, overtreatment, and groundless fears against narcotics. Terminally ill patients were used to be treated in the hospital in the past. In these days, however, they are forced to have home cares with little assistance from the qualified medical personnel because of insufficient hospital facilities, which are even short for the need of emergency patients and provide priority cares to medical insurance beneficiaries with other acute problems. And yet, neither are there any administrative organizations nor systematic medical studies that deal with the level of terminally ill patient's need, their family's problems and resources of hospice care systems in Korea. Thus, most patients are not able to get appropriate medical care at the terminal stage of their lives. The objective of this study is to make comprehensive database for various hospice care organization currently in operation, link them through medical information system, and develop an easily accessible hospice care model that meets the need of most Korean people. Our survey results may be summarized as follows: Nationally there are 40 organizations that provide partial or full hospice care. However, these organizations are not linked to any formal medical service network. Furthermore, the objective of hospice care, care principles, personnel with appropriate training, educational programs, standard for care, costs, consulting service to patients' family members, the extent of medical care from professional staff members, status of hospice facility, and management of those institutions are neither clearly defined nor organized compared to the international hospice care standards. The surveys on patients of terminal stage. grouped in hospice and non-hospice care patients. reveal what they want visiting nursing care to help their pain control. psychological. social and spiritual demands. While the more than 90% of hospice care patients want to reduce their pains. the non-hospice care patients. in addition to their desire for pain control. demanded more psychological. social and spiritual helps as well. The results of this research could be utilized to 0) define the standard of hospice care. (2) provide the guidance for hospice medical care costs. (3) establish the database of hospice care systems. (4) develop softwares. (5) build communication network through Medinet. and (6) provide an organized visiting home nursing care system. These information should be a valuable resource to many medical staffs who are involved in cancer therapy. nursing care. and social welfare programs.
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