• Tuberculosis and Respiratory Diseases
• /
• v.80 no.4
• /
• pp.377-384
• /
• 2017

Background: Proper education regarding inhaler usage and optimal management of chronic obstructive pulmonary disease (COPD) is essential for effectively treating patients with COPD. This study was conducted to evaluate the effects of a comprehensive education program including inhaler training and COPD management. Methods: We enlisted 127 patients with COPD on an outpatient basis at 43 private clinics in Korea. The patients were educated on inhaler usage and disease management for three visits across 2 weeks. Physicians and patients were administered a COPD assessment test (CAT) and questionnaires about the correct usage of inhalers and management of COPD before commencement of this program and after their third visit. Results: The outcomes of 127 COPD patients were analyzed. CAT scores ($19.6{\pm}12.5$ vs. $15.1{\pm}12.3$) improved significantly after this program (p<0.05). Patients with improved CAT scores of 4 points or more had a better understanding of COPD management and the correct technique for using inhalers than those who did not have improved CAT scores (p<0.05). Conclusion: A comprehensive education program including inhaler training and COPD management at a primary care setting improved CAT scores and led to patients' better understanding of COPD management.

• Journal of Society of Preventive Korean Medicine
• /
• v.16 no.3
• /
• pp.37-51
• /
• 2012

Objectives : The objective of this study is to determine the present state of patients with breast cancer use of Korean medicine(KM) and predictive factors for the use. Through this, the present study is intended to present reasonable treatment approaches for patients with breast cancer as well as communicating correct information on KM to healthcare providers and presenting objective alternatives for patients with breast cancer management based on the subjects' experience in health benefits obtained from their use of KM. Methods : To collect data for the present study, questionnaire surveys were conducted on outpatients who visited four hospitals located in Seoul, Korea during around three weeks from May 31, 2012. Although the total number of the questionnaire sheet distributed in the form of directly asking questionnaire questions was 300, 12 incomplete questionnaire sheets were excluded. Therefore, the number of questionnaire sheets actually used in analyses was 288 and thus the collect rate was 96%. Results : Major results of this study are as follows. First, the number of subjects who responded to the questionnaire was 288 in total. Forty-six percent of the patients reported KM usage and the most commonly used ginseng and qigong/exercise. KM use was found to be associated with age, experiencing side effects of cancer treamnent. Factors that affect the use of KM were analyzed by Linear Logistic Regression and the results showed that age, experiencing side effects of cancer treatment, effectiveness of cancer treatment, and satisfaction of the treatment were factors that were related with relatively more frequent use of KM. Conclusions : Comparing the previous studies, it could be seen that patients with breast cancer were highly interested in and used KM in which conventional medicine and KM are used simultaneously. Knowledge on the integrative use of KM and conventional therapies is necessary for cancer physicians and traditional Korean medical doctors to help patients make informed choices. KM use may play a role in the positive benefits associated with process of breast center treatment. Healthcare providers should communicate correct information on the KM use that has been scientifically verified and talk with each other openly. The fact that the significant correlation between predictive factors for the use of KM was identified trough the present study is quite meaningful.

• The Korean Society of Law and Medicine
• /
• v.21 no.2
• /
• pp.3-33
• /
• 2020

Until recently the German and the South Korean medical associations reacted cautiously to the introduction of telemedicine between doctor and patient which is exclusively on the platform conducted. But the General Assembly of German Physicians voted to lift the ban on remote treatment with the amendment to Section 7 (4) MBO-Ä(Medical Association's Professional Code of Conduct) in 2018 and the situation has been fundamentally changed in Germany. From then until now 16 of 17 rural medical associations have changed their professional code to allow telemedicine. In addition the legislature started to prepare the basis for the introduction of the electronic health card (eGK) and the telematics infrastructure. So far, various laws such as Medicinal Products Act, Drug Advertisement Act and Social Code have been changed to support legalization of telemedicine and digitalization of health care. Unlike in Germany, the social circumstances such as excessive centralization of the big hospitals in Seoul and the resulting concern of small medical practices for profitability are the main obstacles to the introduction of telemedicine. However the German approach how to legalise the telemedicine and to prepare for legal and technical infrastructure is also interesting in South Korea. The discussions for and against the changes in the law and the telematics infrastructure attempted by the German government for several years indicate that not only lifting the ban on remote treatment, but also harmonization of all the related legal system could guarantee successful implementation of telemedicine.

• Korean Journal of Clinical Pharmacy
• /
• v.30 no.1
• /
• pp.19-30
• /
• 2020

Objective: To describe patterns of spontaneous reporting on adverse events following immunization (AEFIs) using the human papilloma virus (HPV) vaccine according to the Brighton Collaboration (BC) criteria. Methods: We used the Korea Adverse Event Reporting System (KAERS) database including vaccinations between 2008 and 2017. To apply BC criteria, we classified 58 BC AEFIs into World Health Organization Adverse Reaction Terminology (WHO-ART) codes. We applied MedDRA standard medical queries that were pre-defined as five BC AEFIs. Terminology mapping between MedDRA and WHO-ART terms was performed by three researchers. Descriptive statistics of individual case safety reports were analyzed according to BC applicability. Disproportionality analyses were performed on each BC AEFI and each preferred AEFI term according to the case-noncase approach; reporting odds ratio (ROR) and 95% confidence intervals (CI) were calculated. Results: Among the 30,266 reports of vaccinations between 2008 and 2017, 2,845 reports included the HPV vaccine. Of these reports, 1,511 (53.1%) included at least one BC AEFI. Reports from physicians or manufacturers included more BC AEFIs than from other reporters. Injection site reactions and fever were frequently reported in BC AEFIs; spontaneous abortion and ectopic pregnancy (ROR, 14.29 [95% CI, 4.30-47.49]) and vasculitic peripheral neuropathy (ROR, 8.57 [95% CI, 2.61-28.10]) showed the highest ROR. Among non-BC AEFIs, dizziness or myalgia were frequently reported; exposure during pregnancy (ROR, 23.95 [95% CI, 16.27-35.25]) and inappropriate schedule of administration (ROR, 22.89 [95% CI, 16.74-31.31]) showed the highest ROR. Conclusion: BC criteria would be applicable for labeled AEFIs, whereas analyzing non-BC AEFIs would be useful for detecting unlabeled AEFIs.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.19 no.9
• /
• pp.374-383
• /
• 2018

This study was conducted to compare the unmet needs and quality of life of permanent and temporary ostomates. The research subjects were 128 ostomates with colorectal cancer or other advanced cancers. Data were collected by self-reported completion of the Comprehensive Needs Assessment Tool in Cancer (CNAT) and the City of Hope Quality of Life (COH-QOL) Ostomy Questionnaire from February 1 to April 5, 2018. Collected data were analyzed by chi-squared and independent t-tests using IBM SPSS 21.0. The results showed that the unmet need for temporary ostomates was significantly higher than that of permanent ostomates (t=-2.284, P=0.024). Moreover, temporary ostomates showed a higher unmet need for information and education (t=-2.747, p=0.007), psychological problems (t=-2.578, p=0.011), and physicians (t=-2.599, p=0.010). Although quality of life of temporary ostomates seems lower than that of permanent ostomates, there was no significant difference between groups (t=-1.364, P=0.0175). Therefore, it is necessary to develop a self-management program to provide appropriate information and psychological support for temporary ostomates.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.20 no.10
• /
• pp.351-357
• /
• 2019

This study was conducted to evaluate outpatient experiences of a general hospital and help identify the medical service status experienced by the patients in the overall process of outpatient care, and analyze the major factors influencing patient experience and perception. A total of 100 patients having more than 2 outpatient clinic visits at a university hospital from May 14, 2018 to May 28, 2018, were selected to participate in the survey, comprising 60.0% females and 40.0% males. Considering age, majority belonged to the >60 years old age group (53.0%) as compared to <59 years (47.0%). "Hospital is close by" was the highest motivation to visit the hospital (42.0%), followed by "Medical staff is skilled" (36.0%), "Recommended by another hospital" (7.0%), and "Recommended by people" being the lowest (1.0%). Taken together, the results of this study can be used as basic data to identify the issues for providing better patient-centric medical services, and to formulate plans for creating medical services that meet the patient needs and differentiated medical services.

• Health Policy and Management
• /
• v.16 no.1
• /
• pp.1-16
• /
• 2006

Recently, there has been prevailing of the combined utilization (CU) with herbs and prescribed drugs in medical therapies in the world. But the information about frequency, efficacy and safety of this CU has not well known in Korea, yet. This study aimed to identify the status of CU by Koreans, and to inquire which side effects of CU represent to those people. A self-completed questionnaire survey was performed through each health examination center in twenty general hospitals and one oriental hospital. Of the initial 2,100 health examinees, 1,851 were participated in this survey, resulting in a response rate of 88.1%. The proportion of CD was 26.3%. The most commonly mentioned reason of CD was 'to promote general health and well-being' (17l persons, 35.5%). The main route of taking CD was self-purchase at drugstore or at herbs market, followed by the prescription of (oriental)physicians. 33.0% (151 persons) of those who took the CD rated it as effective. 93 respondents (19.8%) were experienced several adverse effects including nausea, fatigue, and dizziness. The growing simultaneous use of herbal products and pharmaceutical drugs by Korean consumers may be continuously increased the risk of herb-drug interactions. The medical professionals should be provided with comprehensive and up-to-date information about potential benefits and risks of herbs and prescribed drugs. In the future studies it may be recommended to deal common cold, health promotion, indigestion, headache, and hypertension for the effect and safety of the CD by well-organized prospective study design.

• Journal of Hospice and Palliative Care
• /
• v.18 no.3
• /
• pp.208-218
• /
• 2015

Purpose: Although a Do-Not-Resuscitate (DNR) order is widely in use, it is one of the challenging issues in end-of-life care. This study was conducted to investigate attitudes toward DNR according to education and clinical experience. Methods: Data were collected using a structured questionnaire comprising 30 items in a tertiary hospital in Seoul, Korea. Results: Participants were 238 nurses and 72 physicians. Most participants (99%) agreed to the necessity of DNR for reasons such as dignified death (52%), irreversible medical condition (23%) and patients' autonomy in decision making (19%). Among all, 33% participants had received education about DNR and 87% had DNR experience. According to participants' clinical DNR experience, their attitudes toward DNR significantly differed in terms of the necessity of DNR, timing of the DNR consent and post-DNR treatments including antibiotics. However, when participants were grouped by the level of DNR education, no significant difference was observed except in the timing of the DNR consent. Conclusion: This study suggests that the attitudes toward DNR were more affected by clinical experience of DNR rather than education. Therefore, DNR education programs should involve clinical settings.

• Korean Journal of Clinical Pharmacy
• /
• v.9 no.1
• /
• pp.27-34
• /
• 1999

The goal of oral anticoagulation therapy with warfarin is to maintain INR values within the therapeutic range in order to prevent complications such as bleeding and thrombosis. The purposes of this study were to investigate the current level of anticoagulation control using INR values, to investigate the incidences of thromboembolism and bleeding complications, and to compare the effect of low intensity INR regimen with therapeutic range recommended by ACCP (American College of Chest Physician). Two hundred three patients with mechanical heart valve replacement done at Yonsei University Cardiovascular Center between January 1994 and December 1996 were selected and reviewed retrospectively. The target INR ranges of $2.5\sim3.5$ (ACCP standard) and low intensity INR of $2.0\sim3.5$ were used for evaluation. According to ACCP standard, $51.2\%$ of patients and $31.1\%$ of INR values were within the therapeutic range when average INR and cumulative INR were used, respectively. Applying low intensity INR values of $2.0\sim3.5$, the therapeutic control was achieved in $57.4\%\;and\;90.1\%$, using average INR and total INR, respectively. The incidences of major and minor bleedings were $0.5\%\;and\;26.6\%$, respectively. The incidence of thromboembolism was $0.5\%$. There was no significant difference in terms of complication incidences between INR $2.0\sim2.5\;and\;INR\;2.5\sim3.5$ groups. However, INR values at the time of bleeding were generally high. In conclusion, the evaluation of patients with mechanical heart valve replacement showed low level of therapeutic control with warfarin therapy. This is partially explained by the fact that the physicians at Yonsei University Cardiovascular Center were using lower intensity INR values as a goal than recommended INR. Also, in the near future, systematic anticoagulation service should be implemented at various hospitals in Korea so that patients on anticoagulant therapy can be more closely monitored to be within the recommended INR by ACCP.

• Journal of Korean Academy of Nursing
• /
• v.30 no.1
• /
• pp.84-97
• /
• 2000

The Necessity and Purpose of the Study Recently the number of patients with chronic diseases and the aged patients is increasing steadily. Furthermore, due to the expansion of health insurance system, the number of patients hospitalized in the general hospital is increasing at a surprising speed. However, hospitals urge the early discharge of the patients for the efficiencies of hospital administration, and therefore, the number of patients who must be taken care of in their home is also increasing. Homecare nursing is one of the health care service for the patients at home who require continual attention and care, and now increasing attentions are given to it as one of the professional nursing fields. However, it was almost impossible to find a study on the actual experiences of the homecare nurses written by their own language in Korea, that it also posed a great difficulty in understanding their diverse experience. Considering these situation, this study will help understanding of them, and provide the fundamental data on their experiences for making policies to develop homecare nursing. Methods of Research Phenomenological research method was employed to analyze the lived experiences of homecare nurses fundamentally. Data collection Data were collected from August 1998 to December 1998 from ten homecare nurses who worked for patients under the homecare nursing setting as model cases designated by Seoul Nurses Association and who agreed to the purpose of this study after listening to and understanding the explanation completely. The in-depth interview was carried at the time which was convenient both for the researcher and participants for one or two hours, and recovered with the approval participants. The first interview covered diverse and broad areas like the situation of homecare nursing, and their feelings and thoughts over it, and in the second and third interviews, more specific questions are asked. Data Analysis For the phenomenological analysis, contents analysis was employed. The data collected from the participants were analyzed into the following procedures according to Van Manen 's phenomenological analysis. 1) Reserve the preconception of the researcher by restricting it inside parenthesis. 2) Make a thorough observation of the lived experiences by insight process. 3) Analyze the contents (Find out the repetitive factors) 4) Interpret the essence found. 5) State the meaning of the interpretation. Results and discussion 1. Fear and expectation for the first visit. (unfamiliarity, awkwardness, anxiety, shivering) 2. Mingle with the family (feeling friendly with the family, becoming like a family member) 3. Being proud of her own know-how (learning the know-how, organizing alternatives, building up confidence) 4. Pity for the poor. (criticizing the current government, feeling ashamed, feeling anger) 5. Difficulty of constructing cooperative system with physicians (strenuousness, frustration) 6. Helplessness due to the lack of support system (difficulty to get supplies, annoyance, embarrassment by institutional restraints) 7. Anxiousness for heavy traffic and parking (annoyance, hastiness) 8. Ethical conflicts (pity for the patients and family, skepticism about lengthening life maintenance) 9. Burden for the possible accident (pressure, anxiety, conflict, physical exhaustion) 10. Establishment of identity as a professional (fulfillment, worth, joy) 11. Being distressed at other's ignorance