• 한국노년학
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• v.31 no.4
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• pp.1155-1167
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• 2011

The purpose of this study was to investigate the frequency of falls, fear of falling, perceived health status, and number of disease according to cognitive function in community-dwelling the elderly women. This study utilized a descriptive survey design. Data were collected for six months with 311 elderly women who visited in public health center at S city. After obtaining Institutional Review Board(IRB) approval, a face-to-face, and private interview was conducted with each participant who was eligible and agreed to participate in this study by trained graduate-level nursing students. The questionnaires consisted of MoCA-K, K-MMSE, Fall Efficacy Scale, PHS scale. The collected data were analyzed with SPSS/WIN 17.0 program, which was used descriptive statistics, Chi-Square test and t-test, Correlation. The major findings of this study were as follows; 1) The average age of the subjects was 71.68±5.13 and cognitive function score was 22.14±4.32. approximately 35% of participants had fallen within one year. 2) there were significant differences in perceived health status according to cognitive function. 3) fear of fall and cognitive function, perceived health status and cognitive function were significant correlation. In conclusion, this study will contribute to establish strategies for preventing fall. Interventions for fall prevention and fear of fall enhancement should be developed with the consideration of the level of cognitive function in the elderly. Reducing the fear of falling through the comprehensive nursing intervention will ultimately improve the quality of life in the elderly.

• Journal of Yeungnam Medical Science
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• v.8 no.1
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• pp.107-126
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• 1991

The purpose of the study was to assess the morbidity pattern and the medical care utilization behavior of the urban residents in the poor area. The study population included 2,591 family members of 677 households in the poor area of Daemyong 8 Dong, Nam-Gu, Taegu and 2,686 family members of 688 households, near the poor area in the same Dong, were interviewed as a control group. On this study the household interview method was applied. Well-trained interviewers visited every household in the designated area and individually interviewed heads of households or housewives for general information, morbidity condition, and medical care utilization with a structured questionnaire. Individuals were interviewed from 1 to 30 December 1988. The major results were summarized as follows : The proportion of the people below 5 years of age was 4.2% of the total study population and 5.5% were above 65 years of age in the poor area. This was slightly higher than in the control area. The average monthly income of a household in the poor area was 403,000 won versus 529,000 won in the control area. Fifty-eight percent of the residents in the poor area and sixty-one percent in the control area were medical security beneficiaries, but the proportion of medical aid beneficiaries was 7.8% in the poor area and 4.6% in the control area. The 15-day period morbidity rate of acute illnesses was 57.1 per 1,000 in the poor area and 24.2 per 1,000 in the control area. Respiratory disease is the most common acute illness in both areas. The most frequently utilized medical facility was the pharmacy among the patients with acute illnesses in the poor area. Among them 58.1% visited pharmacy initially while 38.4% of the patients in the control area visited a clinic. Among persons with illnesses during the 15 days 8.8% in the poor area and 4.6% in the control area did not seek any medical facility. Mean duration of utilization of medical facilities was 3.5 days in the poor area and 3.3 days in the control area. Initially of the medical facilities in Daemyong 8 Dong, The pharmacy in the poor area and the clinic in the control area were most commonly utilized. The most common reason for visiting the hospital was 'regular customers' in the poor area and 'geographical accessibility' in the control area. The one year period morbidity rate of chronic illness in the poor area was 83.0 per 1,000 population and 28.0 per 1,000 in the control area. Disease of nervous system was the most common chronic illness in the poor area while cardiovascular disease in male and gastrointestinal disease in female were most prevalent in the control area. The most frequently utilized medical facility was the pharmacy among the patients with chronic illnesses in the poor area. Among them 24.2% visited the pharmacy initially while 34.7% of the patients in the control area visited the out-patient department of the hospital within a 15-day period. Among the patients with chronic illnesses 34.9% in the poor area and 16.0% in the control area did not seek any medical facility. Mean duration of utilization of medical facilities was 9.2 days in the poor area and 9.9 days in the control area within a 15-day period. Initially of the medical facilities in Daemyong 8 Dong, the pharmacy in the poor area and the hospital in the control area were most commonly utilized. The most common reason for visiting the hospital, clinic, health center or pharmacy in the poor area was 'geographical accessibility' while the reason for visiting herb clinic was 'good result' and 'reputation' in both areas.

• Journal of Oral Medicine and Pain
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• v.31 no.4
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• pp.283-296
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• 2006

Along with the development of scientific technologies, health care has been growing remarkably, and as the social life quality improves with increasing interest in health, the demand for medical service is rapidly increasing. However, medical accident and medical dispute also are rapidly increasing due to various factors such as, increasing sense of people's right, lack of understanding in the nature of medical practice, over expectation on medical technique, commercialize medical supply system, moral degeneracy and unawareness of medical jurisprudence by doctors, widespread trend of mutual distrust, and lack of systematized device for solution of medical dispute. This study analysed 30 cases of civil suit in the year between 1994 to 2004, which were selected among the medical dispute cases in dental field with the judgement collected from organizations related to dentistry and department of oral medicine, Yonsei university dental hospital. The following results were drawn from the analyses: 1. The distribution of year showed rapid increase of medical dispute after the year 2000. 2. In the types of medical dispute, suit associated with tooth extraction took 36.7% of all. 3. As for the cause of medical dispute, uncomfortable feeling and dissatisfaction with the treatment showed 36.7%, death and permanent damage showed 16.7% each. 4. Winning the suit, compulsory mediation and recommendation for settlement took 60.0% of judgement result for the plaintiff. 5. For the type of medical organization in relation to medical dispute, 60.0% was found to be the private dental clinics, and 30.0% was university dental hospitals. 6. For the level of trial, dispute that progressed above 2 or 3 trials was of 30.0%. 7. For the amount of claim for damage, the claim amounting between 50 million to 100 million won was of 36.7%, and that of more than 100 million won was 13.3%, and in case of the judgement amount, the amount ranging from 10 million to 30 million won was of 40.0%, and that of more than 100 million won was of 6.7%. 8. For the number of dentist involved in the suit, 26.7% was of 2 or more dentists. 9. For the amount of time spent until the judgement, 46.7% took 11 to 20 months, and 36.7% took 21 to 30 months. 10. For medical malpractice, 46.7% was judged to be guilty, and 70% of the cases had undergone medical judgement or verification of the case by specialists during the process of the suit. 11. In the lost cases of doctors(18 cases), 72.2% was due to violence of carefulness in practice and 16.7% was due to missing of explanation to patient. Medical disputes occurring in the field of dentistry are usually of relatively less risky cases. Hence, the importance of explanation to patient is emphasized, and since the levels of patient satisfaction are subjective, improvement of the relationship between the patient and the dentist and recovery of autonomy within the group dentist are essential in addition to the reduction of technical malpractice. Moreover, management measure against the medical dispute should be set up through complement of the current doctors and hospitals medical malpractice insurance which is being conducted irrationally, and establishment of system in which education as well as consultation for medical disputes lead by the group of dental clinicians and academic scholars are accessible.

• Journal of agricultural medicine and community health
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• v.24 no.2
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• pp.269-289
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• 1999

This study was conducted to examine the relationship among health concern, health practice and ADL of elderly staying at home in a rural community and their affecting factors. Data were collected through direct interviews made with 480 old people aged more than sixty-five from November 15, 1998 to December 20, 1998. Out of 189 male and 291 female, the high-level group that showed high health concern accounted for 44.4%, the medium-level group for 13.1%, and the low-level group for 42.5%, in the health practice, the high-level group accounted for 3.8%, the medium-level group for 18.8%, and the low-level group for 77.5%. In the self-rated health status, the high-level group accounted for 29.0%, the medium-level group for 31.0%, and the low-level group for 40.0%, and in the ADL, the high ADL group accounted for 91.5%, and the low-level ADL group for 8.5%. The result of the chi-square test showed that for male, there was a significant relation between the health concern and the health practice index score. In the relation between the health practice index score and the self-rated health status, there was significant positive relationship between health practice index and self-rated health status, and in the relation between the health practice Index score and the ADL, old people with higher health practices showed good ADL(but not significant). Old people with good ADL also showed good self-rated health status. In the multiple regression analysis where the health practice was used as a dependent variable, the health concern was added to the sociodemographic variables as an independent variables, a formula was formed for male old people only and ones with high concern in health showed good health practice. In the multiple logistic regression analysis where the sociodemographic variables to which the health practices was added were used as an independent variable and the ADL as a dependent variable, the ADL appeared to be not good if for male old people the living costs were born by their sons and daughters and as for female old people their ages increased, but it was good if old people had sources of health information such as hospitals or health centers. The self-rated health status was worse, for male old people, if they had short living costs or diseases and for female old people, if they had spouses, living costs born by their sons and daughters or diseases, but it was better, for male old people, if they had periodical gatherings or carried out health practices a lot, and for female old people, if they had sources of health information such as hospitals or health centers or carried out health practices a lot. In view of the results stated above, the higher the old people had health concern, the more they carried out health practices, and the more they carried out health practices, the better they had ADL and self-rated health status that served as the level of health. Further, the better ADL, the better self-rated health status.

• Tuberculosis and Respiratory Diseases
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• v.66 no.3
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• pp.192-197
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• 2009

Background: Despite the benefits of home oxygen therapy in patients suffering chronic respiratory failure, previous reports in Korea revealed lower compliance to oxygen therapy and a shorter time for oxygen use than expected. However, these papers were published before oxygen therapy was covered by the national insurance system. Therefore, this study examined whether there were some changes in compliance, using time and other clinical features of home oxygen therapy after insurance coverage. Methods: This study reviewed the medical records of patients prescribed home oxygen therapy in our hospital from November 1, 2006 to September 31, 2008. The patients were interviewed either in person or by telephone to obtain information related to oxygen therapy. Results: During study period, a total 105 patients started home oxygen therapy. The mean age was 69 and 60 (57%) were male. The mean oxygen partial pressure in the arterial blood was 54.5 mmHg and oxygen saturation was 86.3%. Primary diseases that caused hypoxemia were COPD (n=64), lung cancer (n=14), Tb destroyed lung (n=12) and others. After oxygen therapy, more than 50% of patients experienced relief of their subjective dyspnea. The mean daily use of oxygen was 9.8${\pm}$7.3 hours and oxygen was not used during activity outside of their home (mean time, 5.4${\pm}$3.7 hours). Twenty four patients (36%) stopped using oxygen voluntarily 7${\pm}$4.7 months after being prescribed oxygen and showed a less severe pulmonary and right heart function. The causes of stopping were subjective symptom relief (n=11), inconvenience (n=6) and others (7). Conclusion: The prescription of home oxygen has increased since national insurance started to cover home oxygen therapy. However, the mean time for using oxygen is still shorter than expected. During activity of outside their home, patients could not use oxygen due to the absence of portable oxygen. Overall, continuous education to change the misunderstandings about oxygen therapy, more economic support from national insurance and coverage for portable oxygen are needed to extend the oxygen use time and maintain oxygen usage.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.110-122
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• 2009

Purpose: Nowadays, A medical institution assesment could get more interest about a quality of medical services from many hospitals that developed the active activities for improving medical services. Also, there is an other additional issue which is the patients risk management. Uijeongbu ST. Mary's hospital Nuclear Medicine department has been changed many work process after PET-CT introduction and renovation of its place since 2008. Therefore, modified structure and the way of existing work process have contained risk factors. The purpose of this study would be the appropriate risk management process while imaging examination process, the removal risk factors and improved activities through the analysis risk factors. Materials and Methods: Nuclear Medicine department new process should analysis through many-sided, Firstly, make and trained risk management manual after then apply an actual work. Result analysis showed the number of risk accident occurrence that comparing the last year and after the improved activities. Secondly, producing risk management public relations film has been showed an applicable patient after then the customer service measurement checked for a hundred patient by questionnaire. Lastly, Risk factors were eliminated through the facilities participation improving activities which could change for the better risk factors. Results: The number of safety accident occurrence(medication error, fall and collision) were checked as zero after the improving activities both PET-CT and gamma camera examination. The results of questionnaire showed as follows; 74% marked as understanding of the test process and 81% checked "satisfaction" after the public relations film showing. The question "Did you consider about the risk factors?", both PET-CT and gamma camera checked as 94% and 89% respectively. Customer risk management could be accomplished effectively through the improving activities at the nuclear medicine department. Conclusions: The study would be an opportunity that spread risk factors were systematically showed and analyzied. Also, It showed the possibility of the minimized safety accident and its feedback, if application of the response manuel that could be a standard of radiology technician's work method to react safety accident. It was the more effective that visual material could be easy to approach as a methodology of risk factors. As far as I have concerned that It could help the safety and convenience through continuous and detailed activities that offer to patients.

• Journal of Hospice and Palliative Care
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• v.8 no.1
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• pp.37-44
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• 2005

Purpose: To provide the basic data in developing the nursing intervention for patients who have symptoms of insomnia after undergoing hemopoietic stem cell transplantation (HSCT). This was achieved through investigating sleep quality and sleep patterns according to admission time, and discharge time. Methods: Data was put together by studying 52 HSCT patients who have been admitted to the department of HSCT from August 2002 to August 2003, in a university hospital. Research instruments used were, PSQI for sleep quality and a specified questionnaire for sleep patterns. Results: The PSQI regarding the past mono which was measured at the last day of hospitalization, was 11.8. This was significantly higher than 5.3, which was a measurement for the past month before the hospitalization (t=11.41, P=0.000). Looking at it with 7 categories-quality of sleep, consistency of sleep, sleep period, effectiveness of sleep, sleeping disorder, usage of sleeping pills, impediment of daily life- the PSQI for a month after admission increased significantly compared to the rate measured for a month before admission. Comparing the subjects sleep pattern before and after admission, it showed a significant difference regarding time attending sleep, time it takes to sleep, wake-up time, total time of sleep, day time sleep, number of times waking up during sleep, number of usage of sleeping pills, actions that are taken during sleep disorder, reasons for insomnia. Conclusion: The PSQI score of patients who undergo hemopoietic stem cell transplantation have increased significantly after hospitalization. Compared to the change of sleep patterns when hospitalized, significant changes were observed. Therefore nursing interventions addressing sleep are needed.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.8 no.1
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• pp.34-42
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• 1997

Enuresis is repeated involuntary or intentional voiding of urine into bed or clothes over age 5. Though it would be a self-remitting disorder, it could be serious problem in emotional and socio-adaptational aspects. The author reviewed the enuretic patients of Child & Adolescence psychiatric section in Chungnam National University Hospital during past 3 years. 46(4.9%) of 936 patients were diagnosed as enuresis in DSM-Ⅳ. The author evaluated their comorbidity by the data of diagnostic review made in two psychiatrists, and emotional aspects(self-concept, anxiety, depression) through the self-rating scales (Piers-Harris children’ self concept scales, RCMAS, state-trait anxiety inventory for children, child’s depresson inventory). Thirty(65.2%) of the 46 enuretic patients had additional diagnoses such as attention deficit hyperactive disorder, mental retardation, encopresis, oppositional defiant disorder, depression, anxiety disorder, autism, somatoform disorder, tic disorder, obsessive-compulsive disorder, sleep disorder, etc. Sixteen enuretic patients had at least one comorbid disorder. Eleven patients had two, and three patients had more than three. Fourteen of 46 enuretic patients were evaluated through self-rating scales of self-concept, anxiety and depression. But we couldn’t obtain meaningful results. Maybe it was due to the small sample size(N＝14) and the influence of the comorbid disorders. Finally, it was an impressive evidence that there exist many comorbid disorders in enuresis(esp. attention deifict/hyperactive disorder). In emotional aspects, the author thought that further evaluation should be needed for more meaningful results.

• Journal of dental hygiene science
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• v.8 no.1
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• pp.7-12
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• 2008

The purpose of this study is to improve the oral health after understanding the usage status of oral health items and to conduct active guidance for prohibition of smoking. The survey of 326 visitors for continuous oral health management in the dentist from April 2nd 2007 to May $20^{th}$ is accomplished. The data is handled from the SPSS 12.0 statistics program and we can get the results like below. 1. The number of people answering the usage of the smooth toothbrush is 64.5% which is higher in smoking peoples than in non-smoking ones (p < 0.001). Non-smoking people 61.4% answering '3 minutes more' per brushing their teeth is higher than smoking respondents. 2. The more used device is the interdental brush by non-smoking people 36.7% than smoking ones and the answer. 3. The percentage answering 'recommendation in the dentist' in the question about the motive using the oral health devices are nearly same in 69.6 % and 67.5% by non-smoking and smoking persons. The most reason not using these devices is 'don't know how to use this' and the number of smoking guys is 38.7% which is higher than that of non-smoking ones(p < 0.05). 4. The percentage of answering 'regular visiting the dentist', the method for oral health management is 28.3% in smoking parts and 35.3% in non-smoking ones which is slightly higher. From this study, the usage and the recognition of oral hygiene devices of the patient with smoking is a little bit lower than those of non-smoking patients and small difference is shown. So public relations of the effects and the necessity of the oral hygiene devices to all people have to be performed and the education and the activity prohibiting smoking are expanded by the dental hygienist based on the understanding of oral health when the patients are smoking or not.

• Journal of dental hygiene science
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• v.13 no.1
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• pp.97-104
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• 2013

This study investigated the safety management behavior of dental professionals to minimize exposure to harmful elements of amalgam and resin. As for the use of amalgam and resin, 85.8% of them used amalgam. 100% of used composite resin 100%. 97.8% used acryl resin, and 95.7% used tray resin. 95.2% and 36.5% of them were aware of the harm of amalgam and resin respectively. When using resin, their safety management behavior score was 1.99 on average, and the lowest score was 2.50 on average for 'ventilate the indoor air when handling resin'. Their average score of the safety management behavior was 1.83 when using amalgam. The lowest score was 2.89 on average for 'use the rubber dam for patients when handling amalgam'. As a result of the safety management behavior based on general characteristics, all characteristics were significant with regard to amalgam, and my position at work and work experience were significant with regard to resin (p<0.05). The correlation between the safety management behavior and general characteristics was analyzed when dental amalgam and resin are used. Amalgam was statistically correlated with academic background (p<0.05) and position at work (p<0.05), whereas resin was statistically significantly correlated with age (p<0.05) and position at work (p<0.05). Accordingly, education about the harm of dental materials must be continuously provided for dental professionals when they handle dental materials so that safety management behavior will be conducted correctly, and active efforts to protect the health of dental professionals from harmful chemicals must be made.