• Title/Summary/Keyword: pattern of care

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Preschooler's Internal Representation Profile Types and Diurnal Cortisol Regulation Pattern at Home (유아 내적 표상 유형과 가정에서의 코티솔 패턴 변화)

  • Min, Hyun Suk;Moon, Young Kyung
    • Korean Journal of Childcare and Education
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    • v.11 no.1
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    • pp.153-171
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    • 2015
  • The purposes of this study were to explore the relations of preschoolers' narrative representation profile types to diurnal cortisol regulation pattern at home. Fourteen story stems from the MacArthur Story Stem Battery (MSSB, Bretherton, et al., 1990) were administered to 40 preschoolers(22 boys, 18 girls, aged 5) recruited from 8 kindergartens in the Seoul and Gyeonggi areas. And also, their saliva cortisol was collected. The children's responses were aggregated into 5 dimensions, based on content themes and performance scores, which included emotions expressed and narrative coherence using the MacArthur Narrative Coding System(Robinson, et al., 2004). Data were analyzed by means of cluster analysis. Five response profiles emerged over the course of this research: Prosocial, Anxiety, Dyregulated aggression, Restricted, and Avoidance profiles. Cortisol at home showed decrease diurnal cortisol regulation patterns, however it showed a difference according to narrative response profiles. Restricted, Prosocial, and Avoidance profiles showed decrease diurnal cortisol regulation patterns. Anxiety profiles showed flat pattern, and Dyregulated aggression profile showed rising diurnal cortisol regulation pattern. These results show the preschoolers' internal representation may affect the diurnal cortisol reaction in daytime.

A Study on the Most Frequent Diseases of Health Insurance Program and the Primary Care Physicians in Korea (의료보험 다빈도 상병과 1차진료 의사에 관한 연구)

  • 김철환;문옥륜
    • Health Policy and Management
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    • v.3 no.1
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    • pp.124-145
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    • 1993
  • General practitioners, internists, pediatricians, and family physicians are classified as so-called primary care physicians in the United States. We carried out this study for the purpose of answering the following question; "Who are the primary care physicians in Korea\ulcorner" We analyzed the 663, 154 claims which were drawn from the health insurance processing file made during the period of one month, April 1992 on the basis of systemic random sampling technique. The 663, 154 cases were matched with the doctor's file registered at the National Federation Medical Insurance by using the indivisual physician code number and analyzed according to the kind of specialty. If we follow the Geyman's definition of primary care physician in the United States, this study shows that they can take care of 43.2% of the total private clinic's claims in Korea. Provided that general practitioners and family physicians are considered the same way as in the United Kingdom, they could with only 8.3% of the total claims in Korea. The most frequent diseases are those which rank first to 46th in the total private clinic's claims. The proportion of the most frequent diseases was highest for pediatricians(90.4%) and followed by internists(81.4%), otolaryngologists(78.7%) and family physicians(76.5%). The proportion of the most frequent diseases in the most common 46 diseases was highest for radiologists(80.4%) and the next was as follows : general practitioners(78.3%), family physicians(67.4%), and internists(67.4%). We classified the most common 20 diseases of each specialty into 17 categories of ICD-9 and compared it with those of general practitioners. The specialists who had managed a similar disease pattern to those of general practitioners were identified as anesthesiologists, family physicians, general surgeons, and internists. Some specialists practicing at private clinics managed the diseases which were not quite appropriate for their specialties. After we evaluated each specialty by the most common diseases, the most frequent diseases, and the most frequent 20 diseases of each specialty in terms of the 17 categories of ICD-9, a tentative assumption is made that the primary physicians in the Republic of Korea are general practitioners, anesthesiologists, family physicians, internists, and general surgeons. This study has concluded that the categories of the primary care physicians are so diverse that their roles and distributions are distorted accordingly. Vigorous health policy efforts in correcting the malcomposition need to be made for the better provision of primary health care in Korea. in Korea.

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A Multicenter Study to Identify the Respiratory Pathogens Associated with Exacerbation of Chronic Obstructive Pulmonary Disease in Korea

  • Lee, Hyun Woo;Sim, Yun Su;Jung, Ji Ye;Seo, Hyewon;Park, Jeong-Woong;Min, Kyung Hoon;Lee, Jae Ha;Kim, Byung-Keun;Lee, Myung Goo;Oh, Yeon-Mok;Ra, Seung Won;Kim, Tae-Hyung;Hwang, Yong Il;Rhee, Chin Kook;Joo, Hyonsoo;Lee, Eung Gu;Lee, Jin Hwa;Park, Hye Yun;Kim, Woo Jin;Um, Soo-Jung;Choi, Joon Young;Lee, Chang-Hoon;An, Tai Joon;Park, Yeonhee;Yoon, Young-Soon;Park, Joo Hun;Yoo, Kwang Ha;Kim, Deog Kyeom
    • Tuberculosis and Respiratory Diseases
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    • v.85 no.1
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    • pp.37-46
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    • 2022
  • Background: Although respiratory tract infection is one of the most important factors triggering acute exacerbation of chronic obstructive pulmonary disease (AE-COPD), limited data are available to suggest an epidemiologic pattern of microbiology in South Korea. Methods: A multicenter observational study was conducted between January 2015 and December 2018 across 28 hospitals in South Korea. Adult patients with moderate-to-severe acute exacerbations of COPD were eligible to participate in the present study. The participants underwent all conventional tests to identify etiology of microbial pathogenesis. The primary outcome was the percentage of different microbiological pathogens causing AE-COPD. A comparative microbiological analysis of the patients with overlapping asthma-COPD (ACO) and pure COPD was performed. Results: We included 1,186 patients with AE-COPD. Patients with pure COPD constituted 87.9% and those with ACO accounted for 12.1%. Nearly half of the patients used an inhaled corticosteroid-containing regimen and one-fifth used systemic corticosteroids. Respiratory pathogens were found in 55.3% of all such patients. Bacteria and viruses were detected in 33% and 33.2%, respectively. Bacterial and viral coinfections were found in 10.9%. The most frequently detected bacteria were Pseudomonas aeruginosa (9.8%), and the most frequently detected virus was influenza A (10.4%). Multiple bacterial infections were more likely to appear in ACO than in pure COPD (8.3% vs. 3.6%, p=0.016). Conclusion: Distinct microbiological patterns were identified in patients with moderate-to-severe AE-COPD in South Korea. These findings may improve evidence-based management of patients with AE-COPD and represent the basis for further studies investigating infectious pathogens in patients with COPD.

Development of a Family Pattern Appraisal to Guide a Rogerian Nursing Practice (Rogers 이론에 근거한 가족양상 사정지침개발)

  • 이광옥;한영란;김희정
    • Journal of Korean Academy of Nursing
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    • v.25 no.4
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    • pp.751-773
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    • 1995
  • We, clinical nurse specialists practising and guiding student practice in a Community health nursing clinic, wanted to develop a family pattern appraisal consistent with Rogers' conceptual system, the nursing model guiding our practice. We use Rogers' model because it is harmonious with the traditional Korean view of the one human, natural and cosmic world. The purpose of our research was to contribute to science - based nursing practice, not only, one helpful model, but also a model of how to use, in guiding practice, a conceptual system which reflects nurse practitioners' philosophy of nursing, is intellectually satisfying, and enriches meaning in daily nursing life. The research objectives were to review the literature on Rogers' model and analyse it according to Kim's five - level analytical framework, to explore Rogers' definition of family, to review appraisals based on Rogers' model, and to develop a family appraisal which is culturally appropriate for use in our community. This work including the use of the appraisal and its refinement with families in our practice which was done during 1994 and 1995, in Seoul, in the Capital of the Republic of Korea. At the highest level of analysis, Rogers conceptual system emphasizes acausality and multidimentional meaning ; the world view is characterized by process, movement and wholeness. The epistemology Is one of holism and the knowledge base includes all forms of experience, from sensory to mystical, objective, and subjective. At the metaparadigm level, nursing focuses on the unitary human being and the environment. At the level of nursing philosophy, the model identifies human being, nursing, nurse, and illness and health. At the paradigm level the model assumes the irriducibility of the human to parts, noncausality and continual change. Rogers' practice methodology consists of pattern manifestation appraisal and deliberative mutual patterning. Under-standing patterns and patterning of people is the key to helping them achieve their potential. At the theory level, the basic assumptions, key concepts, and homeodynamic principles were identified. Rogers states the family energy field is an undividable, four-dimensional negentropic energy field which is in a larger envircinmental field show-ing such characteristics as cannot be predicted by knowledge of individual family members. Based on the word of Rogers scholars, we chose Rogers' correlates of patterning to understand the family unit as a whole-frequency, rhythms, motion, time perception, sleeping-waking beyond waking, pragmatic -imaginative-visionary to develop the appraisal. We, also used some of Barrel's (1988) criteria including interpersonal network and professional health care access and use, and Cordon's (1982) criteria including self perception - self concept modified to fit the family. Our family Pattern appraisal included 1. Influencirg data, 2. Professional health care access and use, 3. Family self perception-self concept, 4. Family interpersonal network, 5. Sleep-wake-be-yond waking, 6. Pragmatic-imaginary-visionary, 7. Family frequency and rhythm, 8. Family motion, 9. Family time perception. The appraisal was used with four families and modified to eliminate overlap and to make it possible for the family member to express themselves more easily. We plan to gain more experience with the appraisal toward further development of the tool.

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Study on the Evolution pattern of Tea Industry Service Mode: Focusing on the Needs of Each Generation in GuangXi, China (차 산업 서비스 모델의 변천 패턴에 대한 연구 - 중국 광시 지역 세대별 니즈를 중심으로)

  • Ping, Li;Jang, Wansok;Pan, Yonghwan
    • Journal of the Korea Convergence Society
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    • v.12 no.6
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    • pp.65-74
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    • 2021
  • Since 2020, the GuangXi government of China has focused on the deep integration of tea industry with leisure and cultural tourism, popular science education, health care and elderly care industries. Among the output value targets of the tertiary industry, the GuangXi government plans to achieve 25 billion yuan, and the tea industry is developing rapidly. Through questionnaire survey, field research and interview, this paper studies the differences of demand behavior and selection attributes of tea products among consumers in different years, and finally studies the evolution pattern of service mode of tea industry in GuangXi. The results show that there are obvious differences in life and work style, shopping habits, service design, user experience, social needs and personality needs of each generation consumers in different years. Based on the analysis of demand and behavior habits of tea products, the evolution pattern of service mode of tea industry in GuangXi is studied. Based on the above results, according to the differences of consumers' choice of tea products in different years, the service mode of tea industry in GuangXi is improved The development of tea industry in service design, user experience level is worthy of in-depth attention.

Trends in the Consumption of Opioid Analgesics in a Tertiary Care Hospital from 2000 to 2012 (단일 상급종합병원에서 마약성 진통제의 최근 13년간 사용 경향 조사)

  • Cho, Yoon Sook;Lee, Ju-Yeun;Kim, Hyang Sook;Kwon, Kyenghee
    • YAKHAK HOEJI
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    • v.58 no.4
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    • pp.268-276
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    • 2014
  • Background: World Health Organization considers opioid analgesic use as an important measure in the treatment of pain relief. However, there are limited data about the pattern of opioid analgesic use in tertiary care hospitals in Korea. The aim of this study was to describe the trends in the prescribed amount of the opioid for 13 years from 2000 to 2012 in a single tertiary care hospital. Methods: The data from the prescribed amount of opioid use in patients aged over 18 years were retrieved from medical charts and longitudinal pharmacy records of Seoul National University Hospital. Yearly prescribed amount of opioids were calculated using defined daily dose adjusted by hospital stay (DDD/1000${\bullet}$HS). Results: Over the 13 years of the study period, overall use of opioid has increased by 64.1%. Although, the opioid use by hospitalized patients comprised 98%~99% of total amount of opioid use, the proportions of opioid use by outpatient and by cancer patient increased from 1.1% to 2.2% and from 60.5% to 69.3%, respectively. The use of non-injectable opioids has increased by 47% and that of injectables has increased by 70%. While the amount of codeine and morphine use has decreased, the use of both transdermal and injection formulation of fentanyl has increased dramatically. Also, the use of oxycodone has increased, especially in outpatient setting. Conclusion: This longitudinal study showed that opioid analgesic use in tertiary hospital, especially in outpatient is continuously increasing. Improvement in pain management in tertiary care hospital can be cautiously inferred based on this results.

A Study on the Duration and Character of Lochia in Women Hospitalized at Korean Medical Postpartum Care Center (한방병원 부속 산후조리원을 이용한 산모의 산후 오로 기간과 특징에 관한 고찰)

  • Cho, Seung-Hee;Kim, Song-Baek
    • The Journal of Korean Obstetrics and Gynecology
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    • v.26 no.3
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    • pp.59-72
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    • 2013
  • Objectives: The aim of this study was to assess the duration of lochia in women hospitalized at Korean medical postpartum care center and to identify factors that influence duration of lochia. Methods: On the obstetric variables of 315 cases, the duration of lochia was analyzed. In the postpartum care center, the obstetric variables were asked of 315 cases of women, and who examined a body composition. After discharge, women were surveyed for the duration of lochia by telephone. Results: The median duration of lochia was 30 days and the range was 18~53 days. Maternal age, parity and mode of delivery were associated with its duration. So, its duration was longer on women over the age of 35, multipara and women had a Cesarean section. Its duration was correlated with gestational age and BMI before pregnancy, but not neonatal gender, birth weight, maternal BMI change during pregnancy, maternal body weight gain, BMI before delivery. Conclusions: It was 30 days that the median duration of lochia of women who had been got Korean medical postpartum care management, and which was slightly different from previous studies. And it was influenced by maternal age, parity, mood of delivery, gestational age and BMI before pregnancy. In future more studies or surveys for the duration of lochia of women with no treatment, lochial pattern and so on should be done.

The study for recent changes of disease-mix in health insurance data (의료보험 통계자료를 이용한 최근 우리나라 질병구조 변화관찰 - 의료보험관리공단 자료를 중심으로 -)

  • Yu, Seung-Hum;Jung, Sang-Hyuk
    • Journal of Preventive Medicine and Public Health
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    • v.23 no.3 s.31
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    • pp.345-357
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    • 1990
  • Accumulated data on medical care utilization among the insured in Korea Medical Insurance Corporation can explain the health status of the population. The purpose of this study was to analyze a change of the disease-mix and utilization pattern by controlling the size of the population enrollment. Major findings of the study are as follows : 1. The changes of inpatient disease-mix a. Utilization rate was 139.2% in 1988 against 1980. b. Disease groups higher than the average utilization rate included neoplasms, endocrine, nutritional and metabolic diseases and immunity disorders, mental disorders etc. Meanwhile, disease groups seen less often were infections and parasistic diseases, diseases of blood and bloodforming, diseases of the digestive system etc. c. Utilization rate was up 106.3% in 1988 compared to 1985, and diseases above that average level were ill-defined intestinal infections, chronic liver disease and cirrhosis, diabetes mellitus, essential hypertension, etc. d. The disease-mix by institution in 1988 compared to 1985 shows that chronic disorders rank high in general hospitals whereas opthalmologic, obstetric, and orthopedic diseases rank high in private clinics. 2. The changes of outpatient disease-mix a. Utilization rate was up 175.2% in 1988 compared to 1980. b. Disease groups higher than the average utilization rate included neoplasms, endocrine, nutritional and metabolic diseases and immunity disorders, mental disorders etc. And disease groups seen less often were infections and parasistic diseases, diseases of the respiratory system, diseases of the genitourinary system. etc. c. Utilization rate was up 104.0% in 1988 compared to 1985, and diseases above that average level were gastric ulcer, diseases of hard tissues of teeth, etc. And diseases seen below that average level were acute nasopharyngitis(common cold). acute upper respiratory infections of multiple or unspecified sites, etc. It was concluded that medical care utilization level was increased, and that, from 1980 to 1988, disease-mix shifted to the chronic disorders. Chronic disorders accounted for more medical care utilization in general hospitals.

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Health Care Utilization and Its Determinants of Public Officials with Detected Diseases through Periodic Health Examination Program In Health Insurance (일개 시지역 공무원 건강진단 유소견자의 의료이용양상과 결정요인)

  • Moon, Sang-Youn;Park, Jae-Yong;Kam, Sin;Han, Chang-Hyun
    • Health Policy and Management
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    • v.10 no.3
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    • pp.1-18
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    • 2000
  • This study was conducted to find medical care utilization pattern and to examine the affecting factors on medical facilities utilization using Andersen's medical care service behavioral model. Three hundreds and five public officials with detected disease through the health examination in 1998 were surveyed using self-administered questionnaire. And 230 data were available and analyzed. The results of this study were summarized as follows: Among variables of predisposing factors, knowledge for disease, confidence about periodic health examination program in health insurance, and the attitude toward medical utilization in the usual showed significant relations with the medical utilization. Other variables were not related with the medical utilization. Variables of enabling factors did not show significant relations with the medical utilization. Recognition of family members for detected disease had significant relations with the medical utilization. Among variables of need factors, absence caused by detected disease was significantly related with the medical utilization. The number of non-occupational diseases detected, but untreated people were 75(32.6%) of total subjects, mainly because detected diseases seemed insignificant to them. With multiple logistic regression analysis, the significant variables having an effect on the medical facilities utilization were 'knowledge for disease', 'attitude toward medical utilization in the usual', 'recognition of family members for detected disease' and 'experience of absence caused by detected disease'. On considerations of above findings, counselling for detected disease and its treatment, health education for individuals and program for family support promotion are needed for health management of public officials with diseases detected in health examination.

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A Study on Nursing Diagnoses and Nursing Intervention Classification -focused on Home Health Care Clients- (간호진단과 중재분류에 관한 조사연구 -가정 간호 대상자를 중심으로-)

  • 김조자;최애규;김기란;송희영
    • Journal of Korean Academy of Nursing
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    • v.29 no.1
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    • pp.72-83
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    • 1999
  • The purpose of this study was to classify, from collected home health care records data, nursing diagnoses according to the NANDA system and nursing interventions according to the NIC system, and to link nursing interventions to nursing diagnoses. For this study, 101 home health care records of clients seen between September, 1994 and November, 1996 at Yonsei Medical Center, Seoul, were analyzed. The results of this study are summarized as follows : 1. The most frequent nursing diagnoses were ‘Risk for infection’ and ‘Altered nutrition : Less than body requirements’, then ‘Impaired skin intergrity’ and ‘Ineffective airway clearance’ in the Exchange pattern of NANDA nine human response patterns. 2. The most frequent nursing interventions were the interventions in the Physiological : Complex domain, there were 690(50.7%) interventions among a total 1347 interventions. This results corresponds to Yom, Young Hee(1995)’s research, both Korean and U.S. nurses used the interventions in the Physiological : Complex do main most often on a daily basis. And respiratory nursing interventions were most frequent because 32.7% of the subjects were respiratory patients. 3. The next step was to link the nursing interventions to nursing diagnoses. The most frequent nursing diagnosis was ‘Risk for infection’ and 19 interventions for ‘Risk for infection’ were used 267 times. Then 14 interventions for ‘Impaired skin integrity’ were used 258 times, 12 interventions for ‘Ineffrective airway clearance’ were used 193 times, 12 interventions for ‘Altered nutrition : Less than body requirements’ were used 122 times, 10 interventions for ‘Activity intolerance’ were used 75 times, and 11 interventions for ‘Knowledge deficit’ were used 52 times. 4. The use of standardized classification in the areas of nursing diagnoses and nursing interventions facilitates clinical decision making and prompt nursing activity, and so enhances the effectiveness of nursing care.

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