• Journal of Korean Clinical Nursing Research
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• v.17 no.2
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• pp.228-238
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• 2011

Purpose: The purpose of this study was to investigate parent expectation and satisfaction with respect to pediatric inpatient care and to identify the variables related to parent satisfaction. Methods: The study was conducted in pediatric wards of a tertiary children's hospital in Korea. The participants were 361 parents of children who were inpatients. Data were collected using a structured questionnaire (The Pediatric Family Satisfaction Questionnaire) at the time of discharge. Results: The highest parent expectation domain was medical service. The parents were most satisfied with nursing service and least satisfied with general hospital service and accommodation. The parents expressed lower satisfaction with hospital facilities, equipment, noise, cleanliness, and communication by health care professionals. Parents with younger children reported higher expectation from the complete hospital service and those who had a longer length of stay reported higher expectation from the nursing service. Conclusion: To improve the quality of hospital services, we need to understand parent expectation and improve and provide clear communication. In addition, the general hospital service and accommodation should not be overlooked for improvement.

• Journal of Home Health Care Nursing
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• v.31 no.1
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• pp.77-88
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• 2024

Purpose: This study aimed to develop and assess the impact of an integrated infection control education program on the awareness, attitudes, and performance of infection control among caregivers in long-term care facilities. Methods: Participants were recruited from two long-term care facilities with 25 caregivers in both the experimental group and the control group. This study used non-equivalent control group quasi-experimental pre-post design. The effectiveness of a developed Integrated Infection Control Education Program was evaluated based on infection control awareness, attitudes, and performance. Data were analyzed using SPSS/WIN 28.0 through descriptive statistics, chi-square tests, Fisher's exact tests, and independent t-tests. Results: There was a statistically significant difference in the degree of awareness (t=-5.00, p<.001), attitude (t=-4.91, p<.001), and performance (t=-6.66, p<.001) of infection control between the two groups. Conclusion: Given these results, the integrated infection control education program significantly improved infection control awareness, attitudes, and performance among caregivers in long-term care facilities. This study is noteworthy because it provided comprehensive education on infection control practices to caregivers in environments that are particularly susceptible to infections, especially following COVID-19. This educational program is actively utilized and validated in practice, it would enhance the infection control performance of caregivers, thereby reducing infection rates within facilities, shortening the length of stay for elderly residents in long term care facilities, and contributing to the reduction of healthcare costs.

• Archives of Plastic Surgery
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• v.46 no.2
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• pp.140-146
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• 2019

Background Thoracodorsal vessels (TDVs) and internal mammary vessels (IMVs) have both been widely employed as recipient vessels for use in free muscle-sparing transverse rectus abdominis myocutaneous (MS-TRAM) flaps. However, whether TDVs or IMVs are preferable as recipient vessels for autologous breast reconstruction with a free MS-TRAM flap remains controversial. The purpose of this study was to compare the clinical outcomes when TDVs were used as recipient vessels to those obtained when IMVs were used as recipient vessels for autologous breast reconstruction with a free MS-TRAM flap. Methods A retrospective matched-cohort study was performed. We retrospectively reviewed data collected from patients who underwent a free MS-TRAM flap for autologous breast reconstructions after mastectomy between March 2003 and June 2013. After a one-to-one matching using age, 100 autologous breast reconstructions were selected in this study. Of the 100 breast reconstructions, 50 flaps were anastomosed to TDVs and 50 to IMVs. Patient demographics and clinical outcomes including operation time, length of hospital stay, postoperative complications, and aesthetic score were compared between the two groups. Results No statistically significant differences were found between the two groups in patient demographics and clinical outcomes, including the complication rates and aesthetic scores. There were no major complications such as total or partial flap loss in either group. Conclusions The results of our study demonstrate that both TDVs and IMVs were safe and efficient as recipient vessels in terms of the complication rates and aesthetic outcomes.

• Journal of Korean Critical Care Nursing
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• v.13 no.2
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• pp.12-23
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• 2020

Purpose : This study aimed to evaluate the clinical outcomes of direct interhospital transfers (IHTs) of patients with acute aortic syndrome (AAS) led by advanced practice nurses (APNs). Methods : From September 2014 to June 2017, the study retrospectively investigated 183 patients with AAS who were transferred to a high-volume tertiary hospital. Results : One hundred forty-eight (81%) patients were admitted through direct IHTs, and 35 (19%) patients were admitted through non-direct IHTs. The direct IHT group had a significantly shorter time from symptom onset to hospital arrival than the non-direct IHT group (11.4 vs. 32.1 h, p=.043). There were no significant differences in other clinical outcomes, such as peri-transfer status, mortality, hospital length of stay, and readmission, between the two groups. In the direct IHT group, 55% of transfers were led by APNs. There was no significant difference in outcomes between APN- and physician-led transfers. Conclusions : Implementation of direct IHTs markedly shortened the time from symptom onset to hospital arrival in patients with AAS. Finally, direct IHTs can potentially improve the outcomes of patients with AAS, a condition with time-dependent mortality and morbidity. In addition, APNs can effectively lead the direct IHT of patients with AAS.

• Korea Journal of Hospital Management
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• v.17 no.2
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• pp.21-33
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• 2012

Purpose : This study aims to suggest application of patients DB to hospital marketing by performing market segmentation and selecting target market. Consequently help to establish suited strategy of marketing. Method : 14,072 patients hospitalized in a University Medical Center were recruited into this study. In order to classify the customer groups, cluster analysis was used with RFM(Recency, Frequency, Monetary) model, and 1-way ANOVA verified the differences among groups. And then, sociodemographical status, healthcare utilization and diagnosis(ICD-10) of each group were compared to draw a marketing strategy. Results : Four groups were classified through clustering analysis, and'high use and high profit' and'low use and high profit' groups were selected as a target market. The features of target market were as follows, the female proportion was high; used a private room; hospitalized through the emergency room; had operation; length of stay was long; had many comorbidity and cooperative treatment. There was difference in each feature of target market: as for the'high use and high profit' group, many patients were diagnosed with 'certain infectious and parasitic diseases'; and as for the'low use and high profit'group, the proportion of patients who purchased'industrial accident compensation insurance'and'auto insurance'was relatively high; many patients were diagnosed with'Injury, poisoning and certain other consequences of external causes'. Conclusion : It is needed to establish'positioning' strategy by monitoring and communicating with'high use and high profit' group. And for the case of'low use and high profit' group, it is necessary to make a follow-up management and lead them to have a medical check-up.

• Proceeding of Spring/Autumn Annual Conference of KHA
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• 2005.11a
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• pp.351-354
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• 2005

In 2004. as a part of special housing policy for low income household, Korean government initiated 'Multiple-dwelling Purchase and Public Rental Program'(MDPPRP) to help people whose needs for appropriate housing cannot be met in private housing market. The main goal of this program was to provide the base for self support of tenants by purchasing 'Multiple-housing' in bundle and transferring them into rental housing with low price to the low income tenants. Unlike other public rental housing programs, this model program limited the length of stay in the rental housing by six years to lead tenant's self support. The purpose of this study was to evaluate the effectiveness of this model program for further expanding enforcement. For this, two groups of residents of 'multiple-dwelling purchase and public rental program' and permanent rental housing were compared and analyzed. Thirty two tenants of MDPPRP were interviewed for the study. As research methods, document review, onsite tenant interviews using questionnaire were used. As a whole, most of the tenants were satisfied with their 'multiple-dwelling' environment in physical and socio-psychological aspects.

• Journal of Korean Neurosurgical Society
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• v.56 no.6
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• pp.469-474
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• 2014

Objective : The use of direct lumbar interbody fusion (DLIF) has gradually increased; however, no studies have directly compared DLIF and transforaminal lumbar interbody fusion (TLIF). We compared DLIF and TLIF on the basis of clinical and radiological outcomes. Methods : A retrospective review was performed on the medical records and radiographs of 98 and 81 patients who underwent TLIF and DLIF between January 2011 and December 2012. Clinical outcomes were compared with a visual analog scale (VAS) and the Oswestry disability index (ODI). The preoperative and postoperative disc heights, segmental sagittal/coronal angles, and lumbar lordosis were measured on radiographs. Fusion rates, operative time, estimated blood loss (EBL), length of hospital stay, and complications were assessed. Results : DLIF was superior to TLIF regarding its ability to restore disc height, foraminal height, and coronal balance (p<0.001). As the extent of surgical level increased, DLIF displayed significant advantages over TLIF considering the operative time and EBL. However, fusion rates at 12 months post-operation were lower for DLIF (87.8%) than for TLIF (98.1%) (p=0.007). The changes of VAS and ODI between the TLIF and DLIF were not significantly different (p>0.05). Conclusion : Both DLIF and TLIF are less invasive and thus good surgical options for treating degenerative lumber diseases. DLIF has higher potential in increasing neural foramina and correcting coronal balance, and involves a shorter operative time and reduced EBL, in comparison with TLIF. However, DLIF displayed a lower fusion rate than TLIF, and caused complications related to the transpsoas approach.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.22
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• pp.9985-9996
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• 2014

Background and Aim: Laparoscopic and open rectum surgery for rectal cancer remains controversial. This systematic review compared the short-term and long-term efficiency and complications associated with laparoscopic and open resection for rectal cancer. Materials and Methods: We searched PubMed, Embase, Cochrane Library, ISI Web of Knowledge and the China Biology Medicine Database to identify potential randomized controlled trials from their inception to March 31, 2014 without language restriction. Additional articles were identified from searching bibliographies of retrieved articles. Two reviewers independently assessed the full-text articles according to the pre-specified inclusion and exclusion criteria as well as the methodological quality of included trials. The meta-analysis was performed using RevMan 5.2. Results: A total of 16 randomized controlled trials involving 3,045 participants (laparoscopic group, 1,804 cases; open group, 1,241 cases) were reviewed. Laparoscopic surgery was associated with significantly lower intraoperative blood loss, earlier return of bowel movement and reduced length of hospital stay as compared to open surgery, although with increased operative time. It also showed an obvious advantage for minimizing late complications of adhesion-related bowel obstruction. Importantly, there were no significant differences in other postoperative complications, oncological clearance, 3-year and 5-year or 10 year recurrence and survival rates between two procedures. Conclusions: On the basis of this meta-analysis we conclude that laparoscopic surgery has advantages of earlier postoperative recovery, less blood loss and lower rates of adhesion-related bowel obstruction. In addition, oncological outcome is comparable after laparoscopic and open resection for rectal cancer.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.3
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• pp.259-265
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• 2020

Purpose: Perforation of choledochal cyst (CC) is a relatively rare clinical presentation in pediatric populations and difficult to predict preoperatively. We assess the clinical implications by comparing clinical parameters based on a single-center experience between perforated and nonperforated CC to facilitate the appropriate management for future interventions. Methods: A total of 92 cases of CC in pediatric patients (aged <18 years) who received surgical management between January 2003 and December 2018 at a Pusan National University Children's Hospital were reviewed. After screening the clinical features of perforated cases, we compared the demographic findings, clinical characteristics, and some laboratory results between the perforated and nonperforated groups. Results: Perforated CC was identified in 8 patients (8.7%), and nonperforated CC in 84 patients (91.3%). Perforation can be classified into three categories: free perforation of cyst (3 cases), pinpoint perforation of cyst (2 cases), and necrotic change of cyst (3 cases). CC perforation occurred significantly more commonly in patients aged <24 months. Clinically, the perforated group showed significantly higher frequency of fever and higher C-reactive protein (CRP) level during the initial visit. Conclusion: Perforation is more likely to be suspected in patients aged <24 months presenting together with fever and high CRP level in the initial visit. It is also necessary to keep in mind that it indicates not only a possibility of complicated disease status regardless of its association with stones but also a difficulty of applying a minimal invasive procedure and relatively increased length of hospital stay.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.47-51
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• 2013

Background: Postoperative complications after esophagectomy can lead to considerable patient discomfort and prolonged length of hospital stay. Lack of physical activity can be one of the independent risk factors for postoperative complications because physical activity is closely related to physical function. The objective of this study was to determine whether physical activity among esophageal cancer patients decreases their risk of postoperative complications after esophagectomy. Materials and Methods: We investigated 51 consecutive patients with newly diagnosed resectable esophageal cancer who were scheduled to receive esophagectomy between January 2009 and November 2011. Demographic, clinicopathologic, and treatment information were recorded and physical function was measured. The last 7-days short version of the International Physical Activity Questionnaire was used to assess physical activity before the operation. Stepwise multiple logistic regression analysis was used to determine whether preoperative physical activity is related to the risk of postoperative complications. Results: Male gender [OR 18.6, (95%CIs: 1.2-284.4); P=0.035], 3-field lymph node dissection (OR 9.6, [95%CIs: 1.4-66.6]; P=0.022), low-level physical activity (OR 28.3, [95%CIs: 3.5-227.7]; P=0.002), and preoperative comorbidities [OR 5.9, (95%CIs: 1.1-31.5); P=0.037] were found to be independently associated with postoperative complications. Conclusions: The present study shows that low-level physical activity, preoperative comorbidities, and 3-field lymph node dissection are independent and significant risk factors for postoperative complications after esophagectomy. Although further study is required, maintaining high-level physical activity preoperatively may decrease the risk of postoperative complications.