• Title/Summary/Keyword: treatment satisfaction

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Use of Complementary and Alternative Medicine among Cancer Patients in Korea (우리나라 소화기암 환자들의 대체의료이용에 관한 연구)

  • Jung, Eun-Young;Han, Dong-Woon;Choi, Byung-Hee;Kim, You-Kyum;Park, Yeon-Hee
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.6
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    • pp.1590-1596
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    • 2007
  • Complementary and alternative medicine (CAM) has gained in popularity among cancer patients in recent years. The use of CAM in cancer patients is common with about one third of patients using some form of CAM in Western countries. The purpose of this study was to analyze the use of CAM and determine what factors affect to use CAM among cancer patients to provide CAM therapy information and assist therapy selection among various CAM therapies to cancer patients. The design of the study was descriptive cross-sectional, and data were collected using a 16-item questionnaire. This study was conducted in subjects with confirmed diagnosis of stomach, colon, liver, or pancreas cancer, in both out-patients clinics and inpatients setting in a tertiary hospital in Seoul Korea. As a result, among the participants, past or current CAM use was reported by 75%, which shows a statistically significant difference in income groups(P<0.05), but no difference in age and religion groups. The most common therapies use by cancer patients included traditional Korean medicine (32.1%), folk remedies (26.6%), exercise (14%), dietary supplements (11.6%), physical therapy (9.9%), diet therapy (5%), and meditation (4%). 77.8% of patients show satisfaction and 64.4% shows perceived effectiveness of CAM. Male patients with higher income, and previous treatment were more likely to use CAM. The main benefits from CAM reported by cancer patients were psychological improvement and symptom improvement. Of the cancer patients used CAM, 30.9% were dissatisfied, 25.8% did not have benefits from the use, and 7.6% experience side effects. Cancer patients who prefer CAM (more than 3 kinds) used it to cure cancer, on the contrary, the one who do not prefer CAM used to improve symptoms and psychological stability. The main sources of information about CAM were family and friends(54.4%), and media(24.5%), doctor and nurse(18.3%), and religion group(2.6%). Findings suggest that due to the relatively high use of CAM among cancer patients in Korea, this topic should be taken into account in the development of a holistic approach to cancer patients and efficient cancer patients management system and proactive and consistent management of CAM is necessary in the health care system in Korea.

Comparison of Efficacy of Propofol When Used with or without Remifentanil during Conscious Sedation with a Target-Controlled Infuser for Impacted Teeth Extraction

  • Sung, Juhan;Kim, Hyun-Jeong;Choi, Yoon Ji;Lee, Soo Eon;Seo, Kwang-Suk
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.14 no.4
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    • pp.213-219
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    • 2014
  • Background: Clinical use of propofol along with remifentanil for intravenous sedation is increasing in these days, but there are not enough researches to evaluate proper target concentration when these drugs are infused by using target controlled infusion (TCI) pump in dental treatment cases. In this study, we compared efficacy of TCI conscious sedation and target concentration of propofol when it used with or without remifentanil during conscious sedation with the help of a TCI for the surgical extraction of impacted teeth. Methods: After IRB approval, all the charts of patients who had undergone surgical extraction of impacted teeth under propofol TCI sedation for 6 months were selected and reviewed for this study. After reviewal of charts, we could divide patients in two groups. In one group (group 1), only propofol was selected for sedation and initial effect site concentration of propofol was $1{\mu}g/ml$ (n = 33), and in another group (group 2), both propofol and remifentanil was infused and initial effect site concentration of each drug was $0.6{\mu}g/ml$ and 1 ng/ml respectively (n = 25). For each group, average propofol target concentration was measured. In addition, we compared heart rate, respiratory rate, and systolic and diastolic blood pressure as well as oxygen saturation. Besides, BIS, sedation scores (OAAS/S), and subjective satisfaction scores were compared. Results: Between group 1 and 2, there were no significant differences in demographics (age, weight and height), and total sedation time. However, total infused dose and the effect site target concentration of propofol was $163.8{\pm}74.5mg$ and $1.13{\pm}0.21{\mu}g/ml$ in group 1, and $104.3{\pm}46.5mg$ and $0.72{\pm}0.26{\mu}g/ml$ in the group 2 with $1.02{\pm}0.21ng/l$ of the effect site target concentration of remifentanil, respectively. During sedation, there were no differences between overall vital sign, BIS and OAAS/S in 2 groups (P > 0.05). However, we figured out patients in group 2 had decreased pain sensation during sedation. Conclusions: Co-administration of propofol along with remifentanil via a TCI for the surgical extraction of impacted teeth may be safe and effective compared to propofol only administration.

A Study on Market Segmentation of American Family Restaurants Based on Relational Benefits (관계혜택에 따른 미국 패밀리 레스토랑의 시장세분화에 관한 연구)

  • Kim, Hyun-Jung
    • Culinary science and hospitality research
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    • v.20 no.4
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    • pp.266-279
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    • 2014
  • The purposes of the study are to segment the American family restaurant market based on relational benefits and to compare each group's demographics, dining characteristics, relationship quality(consumer identification, switching costs, satisfaction, commitment), and relational outcomes(positive word-of-mouth intentions and share of purchases). 510 responses were collected from American family restaurant customers and analyzed using frequency analysis, EFA, reliability test, cluster analysis, MANOVA, discriminant analysis, chi-square test, and ANOVA. The results of the study found three different types of relational benefits: confidence, special treatment, and social benefits. The results of cluster analysis identified three market segments, namely, high relational benefits consumers, medium relational benefits consumers, and low relational benefits consumers. The three groups were different in terms of age(p<0.05) and level of education(p<0.05). In addition, high relational benefits consumers showed a higher level of relationship frequency(p<0.001), relationship quality(p<0.001), and relational outcomes(p<0.001), followed by medium and low relational benefits consumers. Overall, the results indicated that family restaurants need to deliver excellent relational benefits to customers in order to achieve desired relationship quality and relational outcomes. Managerial implications were provided.

The Effect of Clinical Training Program for Nursing Faculty (간호학교수 임상연수프로그램 효과 분석)

  • Suh, Moon-Ja;Do, Bok-Neum;Park, Chun-Ja;Kim, Seung-Sil;Chun, Si-Ja;Lee, Sun-Ok;Im, Nan-Young;Park, Young-Im;Jung, Eun-Soon;Kim, Soon-Lae;Choi, S-Mi;Cho, Nam-Ok
    • The Journal of Korean Academic Society of Nursing Education
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    • v.6 no.2
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    • pp.247-261
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    • 2000
  • It is important for nursing faculties to try to improve their professional knowledge and skill in nursing education. Thus it is essential for them to participate in clinical training program. The purpose of this study was to identify the effect and satisfaction of faculty clinical training programs which were managed by Korean Academic Society of Nursing Education and 4 Hospitals(Samsung Medical Center, Seoul National University Hospital, Seoul, Asan Medical Center, Yeonsei Sebrance Medical Center) in Seoul. The data collection was done from July, 1999 to December, 1999 and the 125 subjects were used for the analysis. The purpose of participation of professor to clinical training course was found that to observe of up-to-date treatment method($3.57{\pm}.60$) and to connect between knowledge and practice ($3.63{\pm}.50$). The professors were highly satisfied with 'can see the high-tech institution and facilities($3.45{\pm}.62$)' and 'can confirm in advanced nursing field and practice ($3.38{\pm}.58$)' in clinical training program. And it was found that nursing professors applied the experience of participation in clinical training program to lecture and clinial practice for students. But they were dissatisfied with 'they had no or not enough time to practice'. In conclusion, the clinical training program was useful for nursing professor to educate and instruct the students. It is suggested that the more advanced course and practical program have to be developed for nursing faculties.

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Development of Physician Coaching Model for Improvement of Patient-Doctor Communication (환자-의사 커뮤니케이션 개선을 위한 의사코칭 모델 개발)

  • Na, Hyun Sook;Kwon, Young Dae;Noh, Jin-Won
    • The Journal of the Korea Contents Association
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    • v.13 no.2
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    • pp.331-340
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    • 2013
  • Recently there is a heated debate going on regarding the patient-doctor communication in the medical schools and medical service sector. Patient-doctor communication is an interactive communication made during the consultation session which is known to bring positive effect to both the patient and the doctor. Through this research, a doctor coaching model was developed by combining a method that would help the patient and doctor communicate better by increasing the doctor's communication skill and a coaching mechanism. Through the research, the doctor coaching model consists of 5 levels. First is the 'relationship creation' which would cause the doctor's interest and expectations toward coaching mechanism. Second is 'recognition of change' and this would cause to understand the problem and pros of the doctor's communication with the patient and set a direction regarding the coaching. Third is 'understanding the perspective' and this would lead the doctor to think from the patient's perspective. Fourth is 'increasing problem solving and communication skills' and this would set specific terms as to how the doctor can improve his communication skills. Fifth is 'goal setting and support' where goal regarding the improvements can be set and agreement regarding the ways to maintain and strengthen the advantage can be made. The developed doctor coaching model is most meaningful in a way that it has first adapted a coaching mechanism to improve patient-doctor communication. Also in cases where such will be utilized in the future medical service sector, it is expected to affect greatly the doctor's communication skill and patient sympathizing skills. Hereby it will contribute in increasing the patient's treatment satisfaction.

Age Differences in Signs and Symptoms of Patients with Temporomandibular Disorders

  • Jo, Jung Hwan;Park, Ji Woon;Kim, Ji Rak;Seo, Hyong Duk;Jang, Ji Hee;Chung, Jin Woo
    • Journal of Oral Medicine and Pain
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    • v.40 no.2
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    • pp.55-62
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    • 2015
  • Purpose: The aims of this study were to evaluate the differences in subjective symptoms, clinical characteristics, distribution according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) subgroup, psychological profile of TMD patients, and to identify the prevalence and trend according to age. Methods: A total of 1,052 patients (261 men and 791 women; mean age, $34.40{\pm}15.73$ years) who visited the Orofacial Pain Clinic of the Department of Oral Medicine, Seoul National University Dental Hospital complaining of TMD symptoms of were evaluated. All patients were questioned for medical history, clinical symptoms and contributing factors. Clinical examination and patient grouping based on RDC/TMD was conducted. Radiographies were taken. The Korean version of RDC/TMD axis II and Symptom Checklist-90-Revision (SCL-90-R) were administered to evaluate pain-related disability level and psychological status of the patients. Results: Prevalence peaked in the 20-year-old age group. There were more women than men in all groups. The highest T-score among SCL-90-R dimensions was somatization in each group, except for teenagers who showed the highest T-score in interpersonal sensitivity. The 30-year-old age group showed the highest distribution of high disability based on the graded chronic pain scale. Age was positively associated with pain intensity (r=0.100), number of positive muscles on palpation (r=0.137) and negatively associated with maximum mouth opening (r=-0.168). Conclusions: Subjective symptoms and clinical characteristics of TMD patients show distinct tendencies according to different age groups. Treatment should be customized and personalized according to age for efficient symptom resolution and patient satisfaction.

Convalescent Hospital Doctors and Nursing Staff Awareness of the Differential Rating : Focused on Doctors, Nursing Staff (요양병원 의사 및 간호인력 차등등급에 따른 인지도 - 의사, 간호인력 중심으로)

  • Kim, Byung-Ho;Park, Young-Seok
    • The Journal of the Korea Contents Association
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    • v.15 no.12
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    • pp.285-293
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    • 2015
  • This study was performed in order to provide better quality health care services and satisfaction, the basis for the differential rating system to be operational by identifying how to recognize and respect in hospital operating efficiently and according to the rating differential with convalescent hospital doctors and nursing staff target was. The results of this study are as follows. Rating and doctors as a result of the independent sample t-test to analyze the differences of the nursing grade, second grade doctors were able to see that higher efficiency and improve the patient's rights organization in nursing improving patient safety in two grades, improve care and patient rights this product was confirmed to be enhanced higher. Doctor and as a result of the ANOVA analysis to analyze the differences in accordance with the nursing staff level, improve patient safety, hospital finances, the hospital doctor in the first grade, Nursing grade 2, the right to improve patient education and self-development, and two doctors, nursing grade 1 in was found that high. Overall, doctors, nursing staff of higher grade, first grade and second grade is the difference between me and a different result each category future convalescent hospital doctors and nursing staff of the differential rating system 1, it is necessary to consider restructuring among a calculation based on 2 ratings there will be.

A Study for Deducing the Problems and Improvements of Health Safety and Welfare Policy for Korean Firefighters by Delphi (델파이 기법을 통한 소방공무원 보건안전정책의 문제점 및 개선방안 도출)

  • Park, Chanseok
    • Journal of the Society of Disaster Information
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    • v.16 no.1
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    • pp.34-43
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    • 2020
  • Purpose: In this study, we will try to find out problems and improvements of the policies in order to verify whether the plans contribute to the health and welfare of the firefighters properly. Method: By the Delphi analysis by experts. Result: There are problems such as absence of Firefighters' hospital, insufficient mental health education program in fire department, lack of on-site risk assessment system, problem on ineffectiveness of mental and physical health care business, lack of substantiality on mental and physical stability program, absence of mental health education, ensuring the confidentiality for users of mental health programs, lack of support for parent firefighters, lack of firefighters' retirement design and insufficient treatment for female firefighters. Conclusion: There are Improvements such as establishing Firefighters' hospital, improving mental health education and training CISD leaders in the fire department, preparing disaster risk assessment system, effectiveness measurement for visiting psychological counseling projects, improving the program through customer satisfaction surveys, establishment of mental health education system, ensuring confidentiality by improving personnel systems, encourage childcare leave and introduce childcare facilities at fire stations, revitalizing retirement Firefighters and policy development for female firefighters.

Results of Syndesmotic Screw Fixation versus Posterior Malleolus Fixation in Syndesmotic Injury at Pronation External Rotation Stage IV Ankle Fracture with Posterior Malleolus Fracture: Postoperative One Year Follow-up (후과 골절을 동반한 Lauge-Hansen 회내-외회전형 4단계 족관절 골절에서 원위 경비인대 결합 손상에 대한 원위 경비 나사 고정술과 후과 고정술의 결과 비교: 수술 1년째 추시 결과)

  • Park, Se-Jin;Jeong, Hwa-Jae;Shin, Hun-Kyu;Seo, Dong-Seok;Choi, Young-Min;Kim, Eugene
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.1
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    • pp.29-35
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    • 2014
  • Purpose: The purpose of this study is to compare the radiologic and clinical results of syndesmotic screw fixation and posterior malleolar fixation for syndesmotic injury in Lauge-Hansen classification pronation-external rotation (PER) stage IV ankle fractures with posterior malleolus fracture. Materials and Methods: We designed a retrospective study that included patients with Lauge-Hansen classification PER stage IV ankle fracture with posterior malleolus fracture. Of 723 patients who underwent ankle fracture surgery from March 2005 to November 2012, 29 were included in this study. In this study, syndesmotic injury was treated with syndesmotic screw fixation or posterior malleolus fixation. There were 15 cases of syndesmotic screw fixation and 14 cases of posterior malleolar fixation. We compared the radiologic and clinical results at one year postoperatively. Posterior malleolus fragment size on a pre-operative computed tomographic image, and tibiofibular overlap, medial clear space, articular step-off, Kellgren-Lawrence grade, and Takakura classification on a postoperative one year followup radiograph were used for comparison of the radiologic results. The clinical results were assessed using the American Orthopaedic Foot and Ankle Society score, visual analogue scale score, and patient subjective satisfaction score. Results: Posterior malleolar fragment size was $12.62%{\pm}3.01%$ of the joint space in the syndesmotic screw fixation group and $27.04%{\pm}4.34%$ in the posterior malleolar fixation group. A statistical difference was observed between the two groups. However, other results, including tibiofibular overlap, medial clear space, articular step-off, Kellgren-Lawrence grade, Takakura classification, and clinical scores showed no statistical difference. Conclusion: In the Lauge-Hansen classification PER stage IV ankle fracture with posterior malleolus fracture, if the posterior malleolus fracture can be reduced anatomically and fixated rigidly, syndesmotic screw fixation, which can cause several complications, is usually not required for achievement of a satisfactory syndesmotic stability; this would be a recommendable option for treatment of syndesmotic injury.

Diagnosis and Treatment of Chronic Medial Ankle Instability (만성 내측 족관절 불안정성에 대한 진단 및 치료)

  • Kim, Jin-Su;Young, Ki-Won;Lee, Han-Sang
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.12 no.1
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    • pp.37-41
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    • 2013
  • Purpose: We investigated the short term results of medial deltoid ligament repair after diagnosis of chronic medial ankle instability. Materials and Methods: 262 military patients with ankle instability symptom were evaluated between May 2007 and December 2009. We diagnosed 29 chronic medial ankle instability cases with medial drive through sign under arthroscopy, radiologic findings and physical exam, treated with deltoid talo-navicular band repair using anchor suture. We used the American orthopedic foot and ankle society ankle-hindfoot score (AOFAS), visual analog scale (VAS) and ankle functional satisfactory scores were carried out. Results: 29 patients (11.1%) has chronic medial ankle instability, mean AFOAS score, VAS was improved from 65.4(range; 43-83), 6.0(range; 4-10) to 82.0(range; 60-100), 3.2(range; 1-7). Patients satisfaction were excellent 13(44.8%), good 11(37.9%) and poor 5(17.2%). Two cases was recurred and revised with allo-tendinous reconstruction. Conclusion: We underwent surgery to repair the talo-navicular ligament for chronic medial ankle instability, and about 83% of satisfactory results were obtained.

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