• Title/Summary/Keyword: 분만경험

Search Result 89, Processing Time 0.027 seconds

A Study on Patients' Satisfaction and Service Utilization in the DRG Based Payment System - Patients who Experienced Cesarean Section Before and After the Demonstration Program - (DRG 지불제도에서 환자의 의료서비스 만족도와 제공량에 관한 연구 - 시범사업 전.후 제왕절개 분만 경험 산모를 대상으로 -)

  • Kim, Ji Sook;Park, Hayoung
    • Quality Improvement in Health Care
    • /
    • v.7 no.2
    • /
    • pp.190-202
    • /
    • 2000
  • Background : The objectives of this study were to examine patients' satisfaction with the DRG based payment method and its association with their awareness of the method, to examine patient reported changes in doctors' caring attitude, level of their out-of-pocket payments, providers' acceptance of patients' request for additional services after the program, and to examine changes in service utilization recorded in medical records. Method : One hundred-four patients who had cesarean sections before and after the demonstration program at two hospitals located in Seoul participated in the study. Patients were surveyed before discharges when their charges were finalized. Their medical records were reviewed as well to collect data for service utilization during hospital stays. The association between patients' satisfaction with the payment method and their awareness of the method was analyzed by ${\chi}^2$-test, and the significance of changes in providers' acceptance of patients' request for additional services and service utilization after the program were examined by ${\chi}^2$-test and t-test, respectively. Results : A large proportion of patients did not know of the DRG based payment method at the time of survey and a significantly larger proportion of patients who came to the hospitals with the knowledge satisfied with the method. About the same proportion of patients reported improvement and deterioration in doctors' caring attitude compare to the previous hospitalizations and a similar result was found concerning out-of-pocket payments. Providers' acceptance of patients' request for medication, PCA and painless delivery decreased significantly after the program whereas the acceptance for additional hospital days and laboratory and radiology tests did not. Length of stay, the numbers of days on antibiotics and antianemic medication, and the number of blood tests decreased significantly after the program, however, decreases in the rate of antianemic medication and the number of urine analyses were not statistically significant. Re-operation, in-hospital death, and complications were not observed before and after the program. Conclusion : The study findings indicated a need for better patient education and publicity about the newly introduced payment method to improve their satisfaction with the system. Other study findings concerning service utilization and quality of care indicators were consistent with the government funded evaluation studies.

  • PDF

A Clinical Study of 20 Uterine Sarcomas (자궁육종 20례에 대한 임상적 고찰)

  • Lee, Young-Gi;Park, Yoon-Ki;Lee, Doo-Jin
    • Journal of Yeungnam Medical Science
    • /
    • v.15 no.2
    • /
    • pp.275-285
    • /
    • 1998
  • Sarcoma of the uterus is very rare malignant tumor originating from uterine muscle or connective tissue. We have experienced 20 cases of uterine sarcoma from January 1991 to June 1998. The results were as follows: 1. The pathologic types were 13 cases(65.0%) of leiomyosarcoma, 5 cases(25.0%) of malignant mixed Mullerian tumor, 1 case of rhabdomyosarcoma, and 1 case of angiosarcoma. 2. The average age and parity was 50.2 and 3.7. The chief complaints were irregular vaginal bleeding(35.0%), lower abdominal pain(25.0%), and abdominal mass(25.0%). 3. Nine cases(45.0%) were FIGO stage I, 1 case(5.0%) was stage II, 6 cases(30.0%) were stage III, and 4 cases(20.0%) were stage IV. 4. The survival was from 1.5 months to over 130 months(median 16.5 months), and there was no correlation between survival and FIGO stage or pathologic type. The correlation between survival and number of mitotic figure was incalcurable. 5. CA 125 levels were serially measured as a tumor marker in monitoring patients and the positive rate was 40%. Further study was needed to make a conclusion for usefulness of CA 125 as a tumor marker.

  • PDF

Two Cases of Bilateral Diffuse Cystic Lesion (양측성 미만성 소낭포성 병변 2예)

  • Lim, Dong-Jun;Lee, So-Young;Hong, Chang-Kyun;Song, So-Hyang;Kim, Chi-Hong;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
    • /
    • v.49 no.2
    • /
    • pp.246-252
    • /
    • 2000
  • Lymphangioleiomyomatosis(LAM) is a rare disease of unknown etiology that occurs mainly in woman in her reproductive age. We recently experienced two cases of bilateral diffuse cystic lesion of the lung on chest X-ray and HRCT. The first case, a 26-year-old female, who had been diagnosed with tuberous sclerosis by the presence of clinical manifestation such as mental retardation, bilateral renal angiomyolipoma, adenoma sebaceum and generalized seizure, was admitted due to a recently developed hemoptysis. Chest PA showed diffuse ground-glass opacity with radiolucent cystic lesions of various sizes on both lung fields. HRCT showed innumerable small cystic lesions with suspicious diffuse ground-glass opacity on both lung fields The second case, a 30-year-old fema1e was admitted due to dyspnea and spewing of blood-tinged sputum for 2 weeks, shortly after delivery. Chest PA showed diffuse reticular and ground-glass opacities on both lung field. HRCT showed multiple well-defined and relatively uniform size air cysts with a uniform wall thickness on entire both lung fields, with small amount of right pleural effusion. By thoracoscopic lung biopsy she was diagnosed with pulmonary lymphangioleiomyomatosis. We report these cases with a brief review of the literatures.

  • PDF

Analysis of Bone Mineral Density Status in Korean Mother : In the Center of One Obstetric Hospital (국내 산모의 골밀도 현황 분석 : 일개 산부인과 전문병원중심으로)

  • Kim, Young-Ran;Kim, Hye-Jin;Choi, So-Young
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.20 no.4
    • /
    • pp.320-328
    • /
    • 2019
  • This study was conducted to provide basic data for prevention of osteoporosis by examining the factors affecting bone mineral density in pregnant mothers. This investigation was a descriptive research study that analyzed a total of 137 medical records. Differences in T-score between general and obstetric characteristics were assessed by independent t-tests and one way ANOVA followed by Scheffe's post-hoc test. The mean age of the subjects was 32.4 years and the mean T-score was 0.34. The BMI measured at 4 weeks after delivery was significantly higher in the underweight group than in the normal group and the overweight group (F=11.935, p<.001). The BMD was significantly higher in subjects with sufficient vitamin D than in subjects with insufficient vitamin D, in subjects with insufficient vitamin D than in subjects with deficiency vitamin D (F=4.906, P=0.009). BMD was significantly higher in cases without experience of abortion than those with more than one experience of abortion (t=4.264, p<.001), and the normal delivery was significantly higher than that of cesarean section (t= 2.019, p=.046). Based on the results of this study, it is necessary to actively prevent the factors affecting BMD during pregnancy and delivery. The findings presented herein can be used as basic data for the management of osteoporosis.

A report on operating a nationwide human milk bank in Korea (전국규모 모유은행 운영보고)

  • Song, Kang-Hoon;Lee, Yoo-Min;Chang, Ji-Young;Park, Eun-Young;Park, Sung-Ae;Cho, Nam-Kyu;Bae, Chong-Woo
    • Clinical and Experimental Pediatrics
    • /
    • v.53 no.4
    • /
    • pp.488-494
    • /
    • 2010
  • Purpose : A human milk bank collects, processes, eliminates, and stores breast milk from donors and provides breast milk to those in need. The authors hereby present the experiences and the objective lessons obtained through operating a nationwide human milk bank over a period of 2 years. Methods : The characteristics of the donors and the recipients and the amounts of breast milk donated, processed, and received at the East-West Neo Medical Center Human Milk Bank were investigated from August 2007 to August 2009. Results : The donor pool consisted of 131 first-time donors and 39 repeat donors who made 341 and 127 donations, respectively. Seventy-nine percent of the donors resided in the Seoul-Kyunggi area, and 60% of the donors were in their 30s. Most information and motivation came from the Internet (66%) or television (14%). A total of 2,736 L of breast milk was collected, and 1,979 L were processed. The cumulative number of recipients was 160 preterm or full-term infants and 21 adults, each group receiving the breast milk 337 and 41 times, respectively. In total, infants received 1,663 L and adults received 179 L. Conclusion : Through the present study, the role and importance of a human milk bank in collecting, pasteurizing, and storing surplus breast milk in through sanitary, medically proven methods and providing this breast milk to recipients could be appreciated and reevaluated. The authors believe that a national support system is necessary to expand this practice to a nationwide scale.

Effect of the Nutrition Education for Infant Feeding on Mother's Knowledge, Attitude, Practice of Weaning (영유아 섭식에 관한 영양교육이 어머니의 영양지식.태도 및 실천에 미치는 효과)

  • Kim, Mi-Yang;Ahn, Hong-Seok
    • Journal of the Korean Society of Food Culture
    • /
    • v.18 no.4
    • /
    • pp.320-332
    • /
    • 2003
  • This study evaluated the effect of the nutrition education about infant feeding on the change of mother's knowledge, attitude and practice of weaning. The subjects consisted of treatment group (n=54) and control group (n=34). The treatment group participated in 6 times nutrition education and 5 times surveys. Nutrition education for weaning of the treatment group improved nutrition knowledge, attitude and practice in infant feeding. Before education, mean scores of control group and treatment group were 7.3 and 7.5 respectively but there was no significant difference. Both group got low score in a statement about weaning period, but they got good score in a statement about weaning method. After education, treatment group got better score(9.1) than control group(8.3) significantly (p<0.05). Treatment group was more desirable than control group specially in a use of Sun-sik, sugar, salt and weaning food mixed with formula after education (p<0.05). Practice of spoon feeding was more frequent in treatment group after education, however, control group used sugar and commercial weaning food more frequently than treatment group(p<0.05). Intake frequency of cow's milk and cookies of infants at age 9-12 month in control group was higher than treatment groups(p<0.01). Thus the nutrition education to mother seems to be effective in achieving desirable dietary behavior of infants.

Predominant T Helper 1 Immune Response in Women with Reproductive Failures (반복 유산 및 착상실패를 보이는 환자에서 Th1 면역반응에 대한 연구)

  • Han, Ae-Ra;Yang, Kwang-Moon;KwakKim, Joanne
    • Clinical and Experimental Reproductive Medicine
    • /
    • v.37 no.3
    • /
    • pp.231-237
    • /
    • 2010
  • Objective: To evaluate whether T helper 1 (Th1) immune response is predominant in women with reproductive failures (recurrent spontaneous abortion and recurrent implantation failure) and the activation of T cell is related to Th1 propensity. Methods: Women with a history of recurrent implantation failure or recurrent spontaneous abortion comprise the study group (n=37). Controls are normal fertile women without a history of infertility or pregnancy losses (n=11). Th1/Th2 ratios of interferon (INF)-$\gamma$/interleukin (IL)-10 and tumor necrosis factor (TNF)-$\alpha$/IL-10 expression on $CD3^+/4^+$ cells, CD154, and CD69 expression on T cells are measured by flow cytometric analysis. Results: The ratios of TNF-$\alpha$ to IL-10 expressing on $CD3^+/4^+$ cells (Th1/Th2 cell ratios) are significantly higher in study group ($42.1{\pm}2.3$) as compared with that of controls ($28.7{\pm}2.7$) (p=0.002). The overall trend of CD154 and CD69 expression on T cells are elevated in study group than those of controls. The proportion (%) of $CD3^+/4^+/154^+$ cells ($1.7{\pm}0.5$ vs. $0.3{\pm}0.2$, p=0.038) and the % of $CD3^+/8^+/154^+$ cells ($0.6{\pm}0.2$ vs. $0.1{\pm}0.0$, p=0.024) are significantly higher in study group. The % of $CD3^+/69^+$ cells ($5.6{\pm}1.9$ vs. $1.3{\pm}5.4$, p=0.046) and % of $CD3^+/8^+/69^+$ cells ($4.8{\pm}1.3$ vs. $1.8{\pm}0.2$, p=0.035) among $CD3^+/8^+$ cells are significantly increased in study group. Conclusion: Women with reproductive failures have Th1 propensity with increased T cell activation. These finding means that activated T cell has a harmful effect on early pregnancy and implantation by induction of Th1 immunity.

A Comparison of Body Shape Changes Between Deep Tissue Massage and Illite-Combined Deep Tissue Massage - Focusing on women in their 30s - (딥티슈마사지와 일라이트병행 딥티슈마사지의 체형변화 비교 -30대 여성을 대상으로-)

  • Jeong, In-Sun;Park, Jeong-Yeon
    • Journal of Korea Entertainment Industry Association
    • /
    • v.14 no.6
    • /
    • pp.279-287
    • /
    • 2020
  • This study aims to put forth an efficient way of improving body shapes by examining the effects of deep tissue massage and illite-combined deep tissue massage on body shape changes, and identifying body shape changes when applying each method. This study targeted twenty women in their thirties, and ten separate subjects were placed in different groups. Then deep tissue massage and illite-combined deep tissue massage were performed once a week, for a total of eight weeks. Moire Topography was applied before the experiments, four weeks later and eight weeks later to compare changes in spinous process inclination, shoulders and hips. The data collected were analyzed using SPSS v. 21.0, and the study results are as follows. In relation to general characteristics of the subjects, professionals occupied the highest proportion of them, and 90% of them were married. Here, 77.8% of them had experience in giving birth, and 78.6% of them chose natural birth. In addition, 57.1% of the subjects holding a majority had two children. When measuring spinous process inclination, shoulders and hips in the illite-combined deep tissue massage group and in the deep tissue massage group before the experiments, the illite-combined deep tissue massage group showed somewhat higher values in every area than the deep tissue massage group, but no statistically significant differences were not found, which means the homogeneity existed between them. When comparing body shape changes between the two massage methods, there were significant differences(p<.05, p<.01), because the illite-combined deep tissue massage group showed a much higher decline in spinous process inclination, shoulders and hips than the deep tissue massage group. This implies illite-combined deep tissue massage was more effective in improving body shapes than deep tissue massage. Therefore, illite-combined deep tissue massage is considered to be helpful in improving body shapes, and it is anticipated that this massage method can be used in relevant fields, including the skin care industry.

Studies on Dairy Farming Status, Reproductive Efficiencies and Disorders in New Zealand (I) A Survey on Dairy Farming Status and Milk Yield in Palmerston North Area (뉴질랜드 (Palmerston North) 의 낙농 현황과 번식 및 번식장해에 관한 연구(I) Palmerston North 지역의 낙농 현황과 우유 생산량에 관한 조사 연구)

  • 김중계;맥도날드
    • Korean Journal of Animal Reproduction
    • /
    • v.24 no.1
    • /
    • pp.1-18
    • /
    • 2000
  • Eighty dairy farms in Palmers ton North area in New Zealand were surveyed on 1) general characteristics (10 Questions), 2) milk yield and feed supplementary (7 questions), 3) reproductive efficiencies (12 questions) and 4) reproductive disorders (12 questions) by mail questions from February to July, 1998. Among those 4 items from 38 dairy farms (47.5%), especially in items 1) and 2), overall dairy farming situation, supplementary feeding and milk yields were surveyed and analyzed for Korean dairy farmers (especially in Cheju island) to have better understanding or higher economical gains. The results were as follows. 1. In dairy experience, 21 (45%) among 38 dairy farms surveyed were answered that farming less than 15 years, 15~19 year, 20~25 years and over 26 years experience were 3 (7.9%), 7 (18.4%), 6 (15.8%) and 5 (13.2%) which generally showed longer experience compare to Korean dairy farming situation. In survey of labour input and business goal of dairy farming, self-managing farms, sharemilkers, unpaid family manpowering farms, manager running farms, farms with hired worker, farms with part time helper and other type was 21 (55.3%), 10 (26.3%), 2 (3.5%), 3 (5.3%), 18 (31.6%), 2 (3.5%), and 1 (1.8%), respectively. 2. Analyzing pasture and tillable land, pasture according to feeding scale (200, 300 and 400 heads) were 56, 90 and 165.3 ha, and tillable lands were 51, 78 and 165 ha which showed some differences among feeding scale. In recording methods in 38 farms replied, 36 (95%) dairy handbook and 23 (70%) dual methods taking farms were higher than that of 10 (26.3%) computer and 15(39.5%) well-recorder methods. 3. Dairy waste processing facilities in environmental field were almost perfect except of metropolitan area, and so no problem was developed in its control so far. Hence, 26 farm (68.4%) of pond system was higher rather than those in 8 (21.2%) of using as organic manure after storing feces of dairy cattle, 1(2.6%) bunker system and 3 (7.9%) other type farms. 4. In milking facilities, 33 farms (86.9%) of Harringbone types were higher than those in 3 (7.9%) of Walkthrough types, 1 (2.6%) of Rotary system and other types. Although the construction facilities was not enough, this system show the world-leveled dairy country to attempted to elevate economic gains using the advantage of climatic condition. 5. In milking day and yearly yield per head, average 275 milking days and 87 drying days were longer than that of 228 average milking days in New Zealand. Annual total milk yield per head and milk solid (ms) was 3,990 kg and approximately 319 kg. Dairy milk solid (ms) per head, milk yield, fat percentage was 1.2 kg, 15.5 kg and average 4.83% which was much higher than in other country, and milk protein was average 3.75%. 6. In coclusion, Palmerstone North has been a center of dairy farming in New Zealand for the last 21 years. Their dairy farming history is 6~9 year longer than ours and the average number of milking cows per farm is 355, which is much greater than that (35) of Korea. They do not have dairy barn, but only milking parlors. Cows are taken care of by family 0.5 persons), are on a planned calving schedule in spring (93%) and milked for 240~280 days a year, avoiding winter. Cows are dried according to milk yield and body condition score. This management system is quite different from that of Korean dairy farms. Cows are not fed concentrates, relying entirely on pasture forages and the average milk yield per cow is 3,500 kg, which is about 1/2 milk yield of Korean dairy farms. They were bred to produce high fat milk with an average of 4.5%. Their milk production cost is the lowest in the world and the country's economy relies heavily on milk production. We Korean farmers may try to increase farming size, decreasing labor and management costs.

  • PDF