• Title/Summary/Keyword: service methods

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The Current Status of Utilization of Palliative Care Units in Korea: 6 Month Results of 2009 Korean Terminal Cancer Patient Information System (말기암환자 정보시스템을 이용한 우리나라 암환자 완화의료기관의 이용현황)

  • Shin, Dong-Wook;Choi, Jin-Young;Nam, Byung-Ho;Seo, Won-Seok;Kim, Hyo-Young;Hwang, Eun-Joo;Kang, Jina;Kim, So-Hee;Kim, Yang-Hyuck;Park, Eun-Cheol
    • Journal of Hospice and Palliative Care
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    • v.13 no.3
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    • pp.181-189
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    • 2010
  • Purpose: Recently, health policy making is increasingly based on evidence. Therefore, Korean Terminal Cancer Patient Information System (KTCPIS) was developed to meet such need. We aimed to report its developmental process and statistics from 6 months data. Methods: Items for KTCPIS were developed through the consultation with practitioners. E-Velos web-based clinical trial management system was used as a technical platform. Data were collected for patients who were registered to 34 inpatient palliative care services, designated by Ministry of Health, Welfare, and Family Affairs, from $1^{st}$ of January to $30^{th}$ of June in 2009. Descriptive statistics were used for the analysis. Results: From the nationally representative set of 2,940 patients, we obtained the following results. Mean age was $64.8{\pm}12.9$ years, and 56.6% were male. Lung cancer (18.0%) was most common diagnosis. Only 50.3% of patients received the confirmation of terminal diagnosis by two or more physicians, and 69.7% had an insight of terminal diagnosis at the time of admission. About half of patients were admitted to the units on their own without any formal referral. Average and worst pain scores were significantly reduced after 1 week when compared to those at the time of admission. 73.4% faced death in the units, and home-discharge comprised only 13.3%. Mean length of stay per admission was $20.2{\pm}21.2$ days, with median value of 13. Conclusion: Nationally representative data on the characteristics of patients and their caregiver, and current practice of service delivery in palliative care units were obtained through the operation of KTCPIS.

Needs and Satisfaction of Cancer Patients on the Medical Services in Jeju Special Self-Governing Province (제주지역 암환자의 의료서비스 요구도 및 만족도 분석)

  • Kim, Woo-Jeong;Kim, Min-Young;Chang, Weon-Young;Choi, Jae-Hyuck
    • Journal of Hospice and Palliative Care
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    • v.13 no.3
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    • pp.153-160
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    • 2010
  • Purpose: The purpose of the present study was to investigate needs and satisfaction on the medical services of cancer patients in Jeju Special Self-Governing Province. Methods: Total 174 cancer patients, who visited at the clinic of Jeju National University Hospital, submitted informed consent and participated in this study from July 13 to July 30, 2009. Self questionnaire was used and data were analyzed with Kolmogorov-Smirnov test, Mann-Whitney U test, ANOVA, and Kruskal-Wallis test. Results: Participants expressed the needs of most economical support (3.38 out of 4), followed by counseling of treatment plan (3.22), information of disease (3.07), and disease management except cancer (2.97). Participants were satisfied most with religious counseling (3.41), followed by nursing service support (3.39), employment counseling (3.26), and counseling for family or interpersonal relationships (3.26). The satisfaction of economical support was the lowest (1.98). Satisfaction of men was higher than women, and needs in patients who were living with children was the highest. Patients who were living alone or with children showed the lowest satisfaction about the medical services. There were no significant differences in the general characteristics, however, participants who were older than 60 years of age or had higher income showed lower needs and higher satisfaction. There were no significant differences in the medical characteristics, however, thyroid cancer patients and patients who were treated with radiation therapy or transarterial embolization showed low satisfaction. Conclusion: Cancer patients seemed to need more economical support, information of treatment or disease, and symptom management. Furthermore, there were various needs about the services, depending on family formation or economical support of patients. Therefore, it is certain that patients who were suffering from other cancers, except the 5 major cancers, needed more services. In conclusion, continuous and systemic policy to consider patient's characteristics and needs are needed in community as well as health care system.

Care Needs of Hospice Patients in Comparison with Those from the Family Caregivers' Perspective: Q methodology (호스피스 환자의 돌봄 요구와 가족이 인지하는 환자의 돌봄 요구 비교: Q 방법론)

  • Yong, Jin-Sun;Hong, Hyun-Ja
    • Journal of Hospice and Palliative Care
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    • v.7 no.2
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    • pp.153-168
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    • 2004
  • Purpose: The purpose of tile study was to identify types of care needs of hospice patients and those from the family caregivers' perspective and to compare these two groups in reporting patients' care needs through Q-methodology. Methods: Twenty three Q-statements concerning care needs were selected through in-depth interviews of hospice patients. Data were collected from 20 hospice patients as well as 20 family caregivers respectively by sorting 23 Q-statements into 9 points standard. Data analysis was performed by using PC QUANL program. Results: Principal component analysis identified four types of care needs of the hospice patients. Overall, the accuracy of family caregiver reports was 48% in all types of care needs. Type 1 was named 'physical care needs type' for those whose greatest need was physical care to be free of pain and comfortable. The accuracy in Type 1 was 62.5%. Type 2 was named 'emotional care needs type' for those who would like to share love and intimacy with their family members. The accuracy in Type 2 was 20%. Type 3 was named 'spiritual care needs type' for those who would like to receive forgiveness from their God and prayers and visitation of clergy. The accuracy in Type 3 was 60%. Type 4 was named 'social care needs type' for those who would like to complete their ongoing work and to give service to others. The accuracy in Type 4 was 50%. Conclusion: There was a great difference between hospice patients and the family caregivers in reporting patients' care needs. Thus, hospice nurses need to educate family caregivers to more accurately assess patients' care needs.

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A study for the factors on choosing hospitals and patients satisfaction between Geriatric Hospitals and General Hospitals (노인병원과 종합병원의 선택요인 및 환자만족도 분석)

  • Yoon, Seo-Jung;Yu, Seung-Hum;Kim, Young-Hoon;Lee, Ji-Jeon
    • Korea Journal of Hospital Management
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    • v.9 no.2
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    • pp.46-75
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    • 2004
  • This research anticipated on acknowledging the inpatients factors in choosing which hospital for the geriatric hospital and general hospital they would prefer to go to the analization of different factors in patients satisfaction, and the relation between satisfactory standards and the patients intentions on recommendation or re-visiting the hospital. The statistical data was based upon the 359 question and answer papers that were done by inpatients that were hospitalized in two geriatric hospitals and two general hospitals, and the methods used for analyzing were frequency, t-test, factor analysis, and hierarchical multiple regression. The results are as follows. 1. The factors on choosing hospitals between geriatric hospital and general hospitals were different. The priority for the geriatrics was kindness, and then considerate nursing, and the reliance of treatment. The patients of general hospitals looked first for reliance of treatment, reputation and history of the hospital, and the kindness of the staff. The kindness of the staff, good nursing, and easy procedures were the primary factors of choosing geriatric hospital. 2. The four primary factors in choosing which hospital patients would go to were the predominance of the facilities, kindness and convenience, the reliance and proximity of medical treatment, and recommendation. The patients in the geriatric hospital first looked for kindness and convenience, second the reliance and proximity of medical treatment, third predominance of facilities, and last recommendation. The general hospitals main priority was the reliance and proximity of medical care, second predominance of facilities, kindness and hospitality, and last recommendation. 3. The satisfaction rate was higher in the geriatric hospital compared to general hospitals, but the satisfactory of factors were very similar. Patients in the geriatric hospital were pleased with the hospital staffs kindness, quick nursing and the improvement of inconvenient matters, and clear diagnosis of the doctors. The general hospital patients were satisfied with the hospital staffs clear explanation and accurate diagnosis 4. The analysis in the satisfactory factors turned out to be the environment of the hospital, kindness of the staff, and convenience. Both the patients of the geriatric hospital and general hospitals were very pleased with the kindness of the hospital staff. Ranking second and third was convenience and service for the geriatric hospital, and environment of the hospital and convenience for the general hospital. 5. According to a rank of multiple recurrent analysis of the patients satisfaction and the intention of re-visiting in addition to intention of solicitation, in the case of a geriatric hospital, when the intention of re-visiting is the dependent variable, the first stage shows that the less insurance the patient has, the higher was the intention of re-visiting. In the second stage, the more satisfied the patient is of the staffs kindness, the higher was the intention of re-visiting. Further more, when the intention of solicitation is the dependent variable, the first stage shows that not all the independent variables were significant, but the second stage shows that the more satisfied the patient is of the staffs kindness and the hospital along with the medical treatment expenses, the higher was the intention of solicitation. 6. In the first stage of a rank of multiple recurrent analysis of the satisfaction of the general hospital and the intention of re-visiting, not all the variables were significant, but in the second stage, all the satisfaction by factors were significant. Moreover, when the intention of solicitation was the dependent variable, the first stage shows not all the variables were significant, but in the second stage, all the satisfaction by factors were significant. That is to say, in the case of a general hospital, the satisfaction of the hospital and the medical treatment expenses were high, and the more satisfied the patient is of the hospitals environment and the staffs kindness, the intention of re-visiting and the intention of solicitation was higher.

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Evaluation of clinical status of removable partial dentures (가철성 국소의치의 임상적 상태에 대한 평가)

  • Yang, Dong-Seok;Cho, Uk;Jeong, Chang-Mo;Jeon, Young-Chan;Yun, Mi-Jung
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.3
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    • pp.320-327
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    • 2009
  • Statement of Problem: Although many efforts have been continually made to estimate long term prognosis of removable partial dentures, the complication of removable partial dentures was still found because of inaccurate fabrication procedure and improper maintenance care. Purpose: The purpose of this study was to evaluate the clinical status of removable partial dentures. Material and methods: A total of 112 individuals with 153 removable partial dentures (35 - 87 years, 64 women and 48 men) were examined by intra-oral examination, diagnostic cast and radiographic examination. Results and conclusion: The results of this study were as follows: 1. Length of service of removable partial dentures was $5.3{\pm}4.3$ years (mean), 4.0 years (median). 2. A total of 45 removable partial dentures were considered failures. The loss of 18 abutments of 369 was founded. 3. Type of arch, Kennedy classification and type of opposite dentition were found to have no influence on longevity and success rate of removable partial dentures (P > .05). 4. Most common major connector was the palatal plate in maxilla and the number of lingual bar and linguoplate designed in mandible were similar. 5. The circumferential type retainer was the most commonly used retainer. 6. Sixty-three percent of the class I and II removable partial dentures incorporated indirect retention into the design. 7. Approximately 81% of the removable partial dentures had at least one defect. Excessive wear of posterior teeth (27.9%), lack of integrity (23.2%), lack of stability (22.6%) were frequent defects of removable partial dentures.

Effect of working time on the film thickness of dental resin cements (레진 시멘트의 혼합 후 시간에 따른 피막도의 변화)

  • Yi, Yu-Seung;Kim, Sung-Hun;Lee, Jai-Bong;Han, Jung-Suk;Yeo, In-Sung;Ha, Seung-Ryong;Kim, Hee-Kyung
    • The Journal of Korean Academy of Prosthodontics
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    • v.53 no.4
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    • pp.325-329
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    • 2015
  • Purpose: The aim of this study was to compare the film thicknesses of several resin cements as a function of time after mixing and to examine the effect of working time on the film thicknesses. Materials and methods: The film thickness (${\mu}m$) of 4 resin cements (n=10), 1 composite resin (Panavia F 2.0), 3 self-adhesive resin (Clearfil SA luting, Zirconite, RelyX U200) cements was measured at 20-second intervals after mixing of the cements up to 200 seconds under a load of 50 N. Linear regression was fitted to verify the effect of working time on the film thickness of each cement. Data were compared to the working time recommended by manufacturers using Wilcoxon test ($\alpha$=.05). Results: All of the materials showed a positive linear correlation between the film thickness and working time. There was no statistically significant difference between the working time based on our results and the values recommended by the manufacturers even though there was a discrepancy between those two values. Conclusion: The film thickness of resin cements could increase with the increase of working time. Working time to meet the ISO standard of $50-{\mu}m$ maximum film thickness could be different from the manufacturer's recommended value.

The Clinical Significance of Serum CD23 and CD25 in Chronic Cough Patients (만성 기침환자에서 혈청 CD23와 CD25 측정의 임상적 의의)

  • Choi, Jae-Chol;Park, Young-Bum;Jee, Hyun-Suk;Kim, Jae-Yeol;Park, In-Won;Choi, Byoung-Whui;Hue, Sung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.4
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    • pp.471-477
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    • 2000
  • Background : Coughing is the most common complaint for which patients seek medical service. When caughing continues over 3 weeks in non-smokers who do not take cough-provoking drugs, they are classified as patients with chronic cough. Three well known main causes of chronic caugh are postnasal drip syndrome, bronchial asthma and gastroesophaseal reflux disease. Among them, postnasal drip syndrome is reported to be the most common cause of all in chronic cough diseases, and allergic inflammation plays an important role in the pathogenesis of postnasal drip syndrome. CD23 and CD25 which are low affinity receptor for IgE and IL-2 receptor alpha, respectively, are closely related to allergic inflammation and their roles were evaluated in chronic cough patients. Methods : We evaluated 105 patients with chronic cough and selected 56 patients for measurement of serum CD23 & CD25 levels. We selected 10 normal, medical students for comparison of serum CD23 & CD25 levels. Result : The postnasal drip syndrome was found to be the most common cause of chronic cough. Serum CD23 and CD25 did not increase in chronic cough patient compared to normal controls. However in bronchial asthma patient, serum CD23 level was increased relative to normal control (p<0.05). Conclusion : In bronchial asthma presented as chronic cough, lymphocyte mediated allergic inflammation may related with the pathogenesis of the disease.

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A Research on Effect of Corporate's Competitive Advantage to the R&D Investment in Small and Medium Enterprise (중소기업 유형별 연구개발투자의 영향요인에 관한 실증연구)

  • Choi, Su-Heyong;Choi, Chul-An
    • Management & Information Systems Review
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    • v.33 no.1
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    • pp.191-217
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    • 2014
  • The Purpose of this study is to find the effect factors of R&D investment in SMEs which plays an important role in the national economy, and the differences of the effect factors by the type of SMEs. The subject of this study is about 3,400 SMEs mentioned in "The survey of technical statistics on SMEs in 2007" by Korea Federation of Small and Medium Business. The effect factors are related with the size of business, the infrastructure of R&D and the activities of R&D which have been studied by many researchers. The methods of analysis are regression analysis, moderating effect analysis and the software package used is SPSS 12.0. The results of the study are as fallow. First, it was found that unlike in previous studies which show the effect of the elements of business's size, research infrastructure, research activities on R&D investment, one element alone can't be considered for meaningful result but the various elements have effect on R&D investment at the same time. In other words, the number of employees and the sales as the elements of business's size, the ratio of researchers, the technical ability, the ratio of equipment possession and the intellectual properties as the elements of R&D infrastructure, the activity of ideas and joint research as the elements of R&D activities have positive(+) effect, whereas the participation of CEO in the activity of R&D as the elements of R&D activities activity has negative(-) one. The number of employees, the ratio of researchers, and the sales had relatively high influence whereas equipment possession, technical ability, intellectual properties, the participation of CEO in the research, the activity of idea, joint research had relatively low influence. Next, it was also found that there are differences of the effect factors over the types of SMEs. SMEs were classified into 19 types by eight criteria such as start-ups and existing business by business age; small business and medium business by size; manufacturing business and service business by product type;independent business and subcontractor business by dealing type; businesses in the entering, growing, maturing and restructuring stage by growth stage; businesses with low, medium and high technology by technological level; pioneering business and non-pioneering business by industrial type; and businesses with state-of-the-art technology and non-advanced business by the level of business activities. The meaning of this study lies in the fact that it found the various effect factors should be considered at the same time when conducting study on SMEs' R&D investment, and the differences by the type should be acknowledged. This study surpassed the limitations of the previous studies which focused on a couple of factors and types. This study result can also be considered for other studies on achievement, organization, marketing and others. Moreover, it shows that a differential policy by business type is needed when formulating SME policy.

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Comparison of Three- and Four-dimensional Robotic Radiotherapy Treatment Plans for Lung Cancers (폐암환자의 종양추적 정위방사선치료를 위한 삼차원 및 사차원 방사선치료계획의 비교)

  • Chai, Gyu-Young;Lim, Young-Kyung;Kang, Ki-Mun;Jeong, Bae-Gwon;Ha, In-Bong;Park, Kyung-Bum;Jung, Jin-Myung;Kim, Dong-Wook
    • Radiation Oncology Journal
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    • v.28 no.4
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    • pp.238-248
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    • 2010
  • Purpose: To compare the dose distributions between three-dimensional (3D) and four-dimensional (4D) radiation treatment plans calculated by Ray-tracing or the Monte Carlo algorithm, and to highlight the difference of dose calculation between two algorithms for lung heterogeneity correction in lung cancers. Materials and Methods: Prospectively gated 4D CTs in seven patients were obtained with a Brilliance CT64-Channel scanner along with a respiratory bellows gating device. After 4D treatment planning with the Ray Tracing algorithm in Multiplan 3.5.1, a CyberKnife stereotactic radiotherapy planning system, 3D Ray Tracing, 3D and 4D Monte Carlo dose calculations were performed under the same beam conditions (same number, directions, monitor units of beams). The 3D plan was performed in a primary CT image setting corresponding to middle phase expiration (50%). Relative dose coverage, D95 of gross tumor volume and planning target volume, maximum doses of tumor, and the spinal cord were compared for each plan, taking into consideration the tumor location. Results: According to the Monte Carlo calculations, mean tumor volume coverage of the 4D plans was 4.4% higher than the 3D plans when tumors were located in the lower lobes of the lung, but were 4.6% lower when tumors were located in the upper lobes of the lung. Similarly, the D95 of 4D plans was 4.8% higher than 3D plans when tumors were located in the lower lobes of lung, but was 1.7% lower when tumors were located in the upper lobes of lung. This tendency was also observed at the maximum dose of the spinal cord. Lastly, a 30% reduction in the PTV volume coverage was observed for the Monte Carlo calculation compared with the Ray-tracing calculation. Conclusion: 3D and 4D robotic radiotherapy treatment plans for lung cancers were compared according to a dosimetric viewpoint for a tumor and the spinal cord. The difference of tumor dose distributions between 3D and 4D treatment plans was only significant when large tumor movement and deformation was suspected. Therefore, 4D treatment planning is only necessary for large tumor motion and deformation. However, a Monte Carlo calculation is always necessary, independent of tumor motion in the lung.

Prevalence and Infection Status of Salmonella in 25 Conventional Swine Farms in Korea (국내 25개 양돈장의 살모넬라 유병율 및 감염유형)

  • Park, Choi-Kyu;Kim, Hee-Jung;Kim, Jin-Hyun;Cho, Jae-Keun;Kim, Young-Hwa;Jung, Yoon-Soo;Bae, Chae-Wun;Park, Jun-Cheol;Kim, In-Cheul;Kim, Ki-Seuk
    • Journal of Life Science
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    • v.23 no.10
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    • pp.1267-1272
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    • 2013
  • The aim of this study was to determine the prevalence and infection status of Salmonella species (spp.) in 25 conventional pig farms by traditional fecal culture and serological methods to develop a Salmonella control program for Korean pig farms. The individual seroprevalence of Salmonella spp. in pigs reared in the 25 pig farms was 83.1% in sows and 6.4-32% in different aged pig groups, with the total seroprevalence 28.4% (141/848). The seroprevalence of the tested pigs increased in accordance with the decrease in maternal antibody and the rearing period on these farms. Of note, all the 25 pig farms contained at least two or more anti-Salmonella antibody-positive sows. In the fecal cultures Salmonella spp. were isolated only in three (12.0%, 3/25) of 16 serologically Salmonella-suspected farms (64.0%, 16/25), showing the limitation of the fecal culture method and the need for serum assays to understand the exact status of Salmonella infection in swine herds, which likely contain subclinically infected pigs or carriers. The results highlight the need to establish a supply system of Salmonella-free gilts for the promotion of a national Salmonella control program on swine farms in Korea. Further studies will be needed to develop an effective monitoring system for the implementation of a national Salmonella control program.