• Journal of Hospice and Palliative Care
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• v.22 no.2
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• pp.67-76
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• 2019

For hospice palliative care that provides comprehensive and general care, it is necessary to use assessment tools to objectively list issues and detail care plans. The initial assessment is a process of establishing an overall direction of care by identifying the patient's symptoms, social and spiritual issues and palliative care needs on the admission day or within one day of admission. This process is also used to identify the patients' and families' awareness of the illness, prognosis, treatment options and if the Physician Orders for Life-Sustaining Treatment (POLST) has been drafted. Consisting of 13 simple questions regarding the physical, mental, social, and spiritual domains, the Needs at the End-of-Life Screening Tool (NEST) is recommended as an initial assessment tool. Using specific assessment tools, a care plan is established for the issues identified in the initial assessment within three days of admission. A multidisciplinary assessment tool can be helpful in the physical domain. The psychosocial domain evaluates psychological distress, anxiety and depression. The social domain examines an ability to make decisions, understanding of the socioeconomic circumstance, family relationship, and death preparedness. A spiritual evaluation is also important, for which the Functional Assessment of Chronic Illness Therapy-Spiritual WellBeing Scale (FACIT-Sp) or the Spiritual Health Inventory (SHI) can be used. The use of an assessment tool could not only contribute to pain mitigation a better quality of life for patients, but also provide systematic training for a multidisciplinary team; And the process itself could be a stepping stone for the better care provision.

• Journal of the Korean Society of Environmental Restoration Technology
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• v.26 no.2
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• pp.1-11
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• 2023

By delivering effective, in-situ conservation of biodiversity, OECMs can contribute to sustaining existing biodiversity values and improving biodiversity conservation outcomes. In this study, for the reporting of OECMs required by Kunming-Montreal Global Biodiversity Framework, the site-level assessment of the Korea National Arboretum and Buffer Zones were conducted using the assessment tool of IUCN. The site-level assessment was carried out in three steps(step 1: screening, step 2 : consent for full assessment, step 3 : the full assessment). It was found that the criteria were satisfied except for the consent for full assessment, sustainability of governance and management arrangements, and the equity of governance and management. Although the governing authority, rights-holders or any other stakeholders could be identified, the step of acknowledging and agreeing to the full OECM assessment was not possible because the governance was not established. As a result of the assessment of equitable governance and management in the aspect of recognition, procedure, and distribution based on criterion(the equity of governance and management), it is judged that more specific measures are needed in the aspect of recognition. And in the aspect of procedure, there is no legal basis for participation in governance and collection of opinions, so it is judged that there is a limit to listening and reflecting the opinions of stakeholders. In the aspect of distribution, it is necessary to further confirm whether it provides direct benefits to rights-holders such as landowners in the region. And it is necessary to prepare specific criteria to assess the important biodiversity values. Therefore, in order to promote OECM reporting in the future, it is necessary to conduct detailed research on various types of governance establishment and operation plans that can establish the basis for recognizing and agreeing to OECM assessment, specific criteria and reasonable measures to judge equity, and important biodiversity value.

• Journal of Environmental Impact Assessment
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• v.16 no.6
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• pp.511-524
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• 2007

Korea has 30 years of experiences in environmental impact assessment (EIA). Although EIA includes sanitation-public health factor, considering health impacts, among 74 unit projects of 17 sections, health impacts haven't been properly considered or have been ignored in many cases. The increasing awareness on the importance of health impacts has triggered this study to seek an optimal introduction scheme of health impact assessment (HIA). The processes of EIA already include screening, scoping, analysis, impact assessment, consultation, document review, decision making and monitoring, in which they would be the essential parts of HIA. In this context, integrating HIA into the existing EIA process could be the most effective way to use the benefits in both legal and procedural processes existed and to avoid the confusion and overlapping since the close relationships between environment and health impacts might be. Furthermore, it is desirable that the existing sanitation-public health factor should be substituted by and extended to environment-health factor with sufficient determinants to properly consider health impacts. When considering the first step of HIA, the prospective and qualitative approach is suitable more than the retrospective and quantitative one due to the lack of database accumulated. Similarly, an approach based on epidemiology and toxicology could analyze the limited evidences and impacts related to human disease, whereas one based on socio-science and psychology could provide the effective means available for predicting how the people and community will act by the change of surroundings. Checklist approach with various and comprehensive health determinants focused on prospective and qualitative methods will be very useful for more convenient and progressive dissemination of HIA. Various checklist approaches of toolkits could be found from HIA documents elsewhere, for example Westminster Toolkit, and they would be helpful to figure out how to develop common procedures and health determinants for checklist, in which the unique characteristics on korean cultural and political context compared to abroad should be carefully considered since checklist would be the most basic and essential part of HIA. After the establishment of checklist and procedural processes, the pilot projects should be conducted. Main purpose of pilot projects is to apparently prove the effectiveness and profitability of HIA. Pilot projects should be implemented to decide the effectiveness and suitability of HIA for future projects, programs and policies, and should be provided as the positive cases that can be achieved through the proper implementation and progress.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.30 no.2
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• pp.205-212
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• 2020

Objectives: The purpose of this study was to identify the needs and improvement measures of the risk assessment system through a survey of asbestos abatement companies. Methods: This study prepared a questionnaire that includes improvement measures for the risk assessment system(six questions) and the necessity of a risk assessment system for asbestos abatement(one question). The questionnaire was sent to 2,170 asbestos abatement companies and returned by 83 companies(return rate = 3.8%). We conducted frequency analysis, ANOVA, and Chi-squared testing at the 5% significance level. Results: This study analyzed the survey results and identified six main opinions on the risk assessment system and improvement measures. First, giving an advantage to companies with a high grade(S and A grades) in public bidding and/or qualification screening showed a similar preference(agree: 50.6%, disagree: 49.4%). Second, 57.6% of the respondents wanted to allow air showers along with water showers for low risk asbestos work. However, 23.2% of the respondents asserted that only a water shower should be allowed since there is no scientific evidence supporting the removal of asbestos by air shower. Third, in order to prevent missing the enrollment of workers, simply submitting a change report should be allowed when any worker is changed (40.0%). Fourth, 43% of the respondents answered that they did not know how to calculate the proper number of negative pressure units. The reasons given were a lack of guidelines or standards(38.9%), inconvenience (36.1%), and absence of education(25%). Fifth, the respondents who were favorable toward the necessity of a risk assessment system gave higher scores compared to unfavorable respondents on the necessity of the management of workers' work history(favorable respondent = 3.96 out of 5, unfavorable respondent = 2.68) and the necessity of professional training for workers(favorable respondent = 3.71, unfavorable respondent = 2.56). Finally, the respondents favorable toward a risk assessment system showed higher scores on the awareness of calculating the proper number of negative pressure units(4.79) compared to unfavorable respondents(3.3). Conclusions: The opinions of asbestos abatement companies identified through the survey in this study can be usefully utilized as fundamental information to improve the risk assessment system.

• Fire Science and Engineering
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• v.15 no.4
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• pp.24-33
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• 2001

This article proposes a strategy for producing accident scenarios in quantitative risk, which is peformed in process design or operation steps. Present worldwide chemical processes need off-site risk assessment as well as on-site one. Most governments in the world require industrial companies to submit the proper emergency plans through off-site risk assessment. Korea is also preparing for executing Integrated Risk Management System along with PSM and SMS. However.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.25 no.3
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• pp.142-155
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• 2014

Objectives : The aim of this study was to develop an assessment tool for measurement of children's functioning in the mental health service. We conducted a preliminary study to develop a sensitive and inclusive scale focused on the functional changes of children rather than just focusing on their symptoms or screening. Methods : The Child and Adolescent Functional Assessment Scale and the Korean-Child Behavior Checklist (K-CBCL) were both administered to 134 parents of children with emotional or behavioral problems who participated in the Aizone program and also to 186 parents of elementary school children in the Seoul metropolitan area as a control group. SPSS version 12.0 was used for statistical analysis. Results : Most of the reliability coefficients were over 0.70 except those of the conduct behavior items, which showed relatively high internal consistency. The corrected item-total correlations ranged from .411 to 758, except those of conduct behavior items and special measure items. In a concurrent validity test with K-CBCL, the total behavior problem score of K-CBCL was highly correlated with the total score of the Child and Adolescent Functional Assesment Scale (r=.610). For the construct validity, confirmatory factor analysis was performed for each of four areas, including behavior (at home/school), achievement, peer relationship, and emotion. Conclusion : The results showed that the scale was statistically reliable and valid, except for conduct behavior items. This study was conducted only for parents with elementary children. An adolescents group should be included in future studies.

• Journal of the Ergonomics Society of Korea
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• v.34 no.4
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• pp.335-351
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• 2015

Objective: The aim of this study was to perform a usability test for CPAD (Cognitive Perceptual Assessment for Driving) and improve it based on the test results. Background: The cognitive perceptual assessment for driving is a computer-based assessment tool to assess the driving capacity of people with brain-damages. It may be a good tool for evaluating the brain-damaged drivers' safe driving capabilities and screening cognitive and perceptual deficits related to driving. We performed a usability test to improve the CPAD based on the result. Method: Both the software consisting of 8 sub-tests (depth perception, sustained attention, divided attention, stroop test, field dependency, digit span, trail making A, trail making B) and the hardware including the input and output devices ( joystick, mouse, keyboard, touch screen) were evaluated through user interviews. Also we identified the problems and issues in using them by observing the participants performing the CPAD tasks. Results: Based on the results, the task instructions were visually and auditorily improved and more practice examples were added to help the users understand the instructions better and increase the input accuracy, a response time window was added and the joystick and touch screen were simplified, which made it easier for the user to perform the CAPD tasks. Conclusion: User discomforts were minimized by improving the task environment, unless it had affected the evaluation criteria. Application: We plan to distribute the improved version of the CPAD to the regional rehabilitation hospitals, and the driving support centers for people with disabilities throughout the country, so it could be used as an evaluation tool for disabled drivers' cognitive and perceptual functions.

• Korea Journal of Hospital Management
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• v.28 no.3
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• pp.58-67
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• 2023

Purpose: The purpose of this study was to analyze the factors associated with long-term hospitalized patients in long-term care hospitals using the quality assessment data for long-term care hospitals by the Health Insurance Review. Methods: Among 1,376 long-term care hospitals, frequency analysis and descriptive statistics were used to analyze the characteristics of these hospitals. Multiple linear regression was conducted to examine the associations between infrastructure characteristics, medical personnel characteristics, health outcomes and the proportion of long-term hospitalized patients. Results: The research findings indicate that the number of patients per doctor, the number of patients per nurse, and the number of patients per nursing staff were positively associated with the proportion of long-term hospitalized patients. Among health outcomes, a higher proportion of patients with more than a 5% weight loss compared to the previous month and the proportion of patients showing improvement in ADL, were more likely to have a lower proportion of long-term hospitalized patients. However the proportion of diabetic patients with HbA1c test results within the appropriate range was positively associated with the proportion of long-term hospitalized patients. Conclusion: The present study results provide fundamental data for the establishment of policies for long-term care hospitals. Based on this study, it is important to suggest screening methods for unnecessary long-term hospitalizations, such as sufficient medical personnel to improve the quality of care in long-term care hospitals. It is also necessary to clearly separate the roles of medical institutions and long-term care facilities and implement policies to support patients' social reintegration.

• Pediatric Infection and Vaccine
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• v.24 no.3
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• pp.134-140
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• 2017

Purpose: Severe combined immunodeficiency (SCID) is the most serious form of primary immunodeficiency. Infants with SCID are susceptible to life-threatening infections. To establish newborn screening for SCID in Korea, we performed a screening test for T-cell receptor excision circle (TREC) and ${\kappa}$-deleting recombination excision circle (KREC) in neonates and investigated the awareness of SCID among their parents. Methods: Collections of dried blood spots from neonates and parent surveys were performed at the Samsung Medical Center and Cheil General Hospital & Women's Healthcare Center in Korea. The amplification crossing point (Cp) value <37.0 was defined as TREC/KRECpositive based on cutoff values from measuring multiplex real-time polymerase chain reaction. A Cp value >39.0 was defined as negative. Results: For TREC/KREC screening, 141 neonates were enrolled; 63 (44.7%) were male. One hundred forty neonates (99.3%) had positive TREC/KREC results at the time of the initial test; 82.3% and 75.9% were positive and 17.0% and 23.4% were weakly positive for TREC and KREC, respectively. In one neonate (0.7%), the initial TREC/KREC test result was negative. However, repeated tests obtained and confirmed a positive result. For an awareness survey, 168 parents were engaged. Only 2% of parents (3/168) knew that the newborn screening test for SCID had been introduced and performed in other countries. Eighty-four percent of parents (141/168) replied that nationwide newborn SCID screening should be performed in Korean newborns. Conclusions: In this study, newborn SCID screening was performed along with assessment of public awareness of the SCID test in Korea. The study results showed that newborn SCID screening can be readily applied for clinical use at a relatively low cost in Korea.

• Journal of Nutrition and Health
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• v.52 no.4
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• pp.332-341
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• 2019

Purpose: Poor nutrition in hospitalized patients is closely linked to an increased risk of infection, which can result in complications affecting mortality, as well as increased length of hospital stay and hospital costs. Therefore, adequate nutritional support is essential to manage the nutritional risk status of patients. Nutritional support needs to be preceded by nutrition screening, in which accuracy is crucial, particularly for the initial screening. To perform initial nutrition screening of hospitalized patients, we used the Catholic Kwandong University (CKU) Nutritional Risk Screening (CKUNRS) tool, originally developed at CKU Hospital. To validate CKUNRS against the Patient-Generated Subjective Global Assessment (PG-SGA) tool, which is considered the gold standard for nutritional risk screening, results from both tools were compared. Methods: Nutritional status was evaluated in 686 adult patients admitted to CKU Hospital from May 1 to July 31, 2018 using both CKUNRS and PG-SGA. Collected data were analyzed, and the results compared, to validate CKUNRS as a nutrition screening tool. Results: The comparison of CKUNRS and PG-SGA revealed that the prevalence of nutritional risk on admission was 15.6% (n = 107) with CKUNRS and 44.6% (n = 306) with PG-SGA. The sensitivity and specificity of CKUNRS to evaluate nutritional risk status were 98.7% (96.8 ~ 99.5) and 33.3% (28.1 ~ 39.0), respectively. Thus, the sensitivity was higher, but the specificity lower compared with PG-SGA. Cohen's kappa coefficient was 0.34, indicating valid agreement between the two tools. Conclusion: This study found concordance between CKUNRS and PG-SGA. However, the prevalence of nutritional risk in hospitalized patients was higher when determined by CKUNRS, compared with that by PG-SGA. Accordingly, CKUNRS needs further modification and improvement in terms of screening criteria to promote more effective nutritional support for patients who have been admitted for inpatient care.