• Title/Summary/Keyword: 환자건강문제

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Job Competency in Ultrasonography of Korean Radiological Technologists (한국 방사선사의 초음파진단검사 직무역량에 관한 고찰)

  • Lim, Chang Seon;Kim, Chuk Bok;Namkung, Jang Sun;Jin, Gye Hwan
    • Journal of the Korean Society of Radiology
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    • v.13 no.6
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    • pp.857-864
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    • 2019
  • Many countries, including Canada, operate a sonographer license system separately from a radiological technologist license. However, in Korea, radiological technologists perform ultrasound imaging under the guidance of doctors. Therefore, in order to have the opportunity to provide a systematic education by analyzing the job competency of the radiological technologist's ultrasound imaging, based on the Canadian National Competency Profile (NCP) lists, this study measured the job content validity of the job competences and detailed competencies required for performing ultrasonography in Korea. From the results of comparing and analyzing the importance of the core competencies included in the Korean radiological technologist's job competencies and the degree of job performance, the average overall importance was 4.087, the average of overall performance was 3.640, showing that the importance was higher than the performance and that there was a statistically significant difference. In conclusion, 'A Communication', 'B Professional responsibilities', 'D Operation of equipment' and 'G Workplace health and safety' showed high job content validity. However, it is said that as 'C Patient assessment and care', 'E Critical thinking and problem solving', and 'H Image' showed low job content validity, it is necessary to seek ways to strengthen and complement these competencies.

A BERGPT-chatbot for mitigating negative emotions

  • Song, Yun-Gyeong;Jung, Kyung-Min;Lee, Hyun
    • Journal of the Korea Society of Computer and Information
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    • v.26 no.12
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    • pp.53-59
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    • 2021
  • In this paper, we propose a BERGPT-chatbot, a domestic AI chatbot that can alleviate negative emotions based on text input such as 'Replika'. We made BERGPT-chatbot into a chatbot capable of mitigating negative emotions by pipelined two models, KR-BERT and KoGPT2-chatbot. We applied a creative method of giving emotions to unrefined everyday datasets through KR-BERT, and learning additional datasets through KoGPT2-chatbot. The development background of BERGPT-chatbot is as follows. Currently, the number of people with depression is increasing all over the world. This phenomenon is emerging as a more serious problem due to COVID-19, which causes people to increase long-term indoor living or limit interpersonal relationships. Overseas artificial intelligence chatbots aimed at relieving negative emotions or taking care of mental health care, have increased in use due to the pandemic. In Korea, Psychological diagnosis chatbots similar to those of overseas cases are being operated. However, as the domestic chatbot is a system that outputs a button-based answer rather than a text input-based answer, when compared to overseas chatbots, domestic chatbots remain at a low level of diagnosing human psychology. Therefore, we proposed a chatbot that helps mitigating negative emotions through BERGPT-chatbot. Finally, we compared BERGPT-chatbot and KoGPT2-chatbot through 'Perplexity', an internal evaluation metric for evaluating language models, and showed the superity of BERGPT-chatbot.

The Long-term Follow-up Study of Therapeutic Effects of 8 French Catheter for Spontaneous Pneumothorax (자연 기흉의 치료에서 8 French 도관삽입의 치료 효과에 대한 장기적 관찰)

  • Shin, Jong-Wook;Lee, Byoung-Hoon;An, Chang-Hyeok;Choi, Jae-Sun;Yoo, Jee-Hoon;Lim, Seong-Yong;Kang, Yoon-Jung;Koh, Hyung-Ki;Kim, Jae-Yeol;Na, Moon-Jun;Park, In-Won;Sobn, Dong-Suep;Choi, Byoung-Whui;Hue, Sung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1094-1104
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    • 1997
  • Background : Spontaneous pneumothoraces(SP) are divided into primary spontaneous pneumothoraces (PSP) which develop in healthy individuals without underlying pulmonary disorders and secondary spontaneous pneumothoraces(SSP) which occur in those who have underlying disorders such as tuberculosis or chronic obstructive lung diseases. Yet there is no established standard therapeutic approach to this disorder, i.e., from the spectrum of noninvasive treatment such as clinical observation with or without oxygen therapy, to aggressively invasive thoracoscopic bullectomy or open thoracotomy. Although chest tube thoracostomy has been most widely used, the patients should overcome pain in the initiation of tube insertion or during indwelling it potential infection and subcutaneous emphysema. Thus smaller-caliber tube has been challenged for the treatment of pneumothorax. Previously, we studied the therapeutic efficacy of 8 French catheter for spontaneous pneumothorax. But there has been few data for effectiveness of small-caliber catheterization in comparison with that of chest tube. In this study, we intended to observe the long-term effectiveness of 8 French catheter for the treatment of spontaneous pneumothoraces in comparison with that of chest tube thoracostomy. Method : From January, 1990 to January, 1996, sixty two patients with spontaneous pneumothoraces treated at Chung-Ang University Hospital were reviewed retrospectively. The patients were sub-divided into a group treated with 8 French catheter(n=23) and the other one with chest tube insertion(n=39). The clinical data were reviewed(age, sex, underlying pulmonary disorders, past history of pneumothorax, size of pneumothorax, follow-up period). And therapeutic effect of two groups was compared by treatment duration(duration of indwelling catheter or tube), treatment-associated complications and recurrence rate. Results : The follow-up period(median) of 8 French catheter group and chest tube group was 28 and 22 months, which had no statistical significance. Ther was no statistically significant difference of clinical characteristics between two groups with SP, PSP, SSP. The indwelling time of 8 French catheter group was $6.2{\pm}3.8$ days, which was significantly shorter than that of chest tube group in SP, $9.1{\pm}7.5$ days(p=0.047). In comparison of treatment-related complication in PSP, 8 French catheter group as 6.25% of complication showed lower tendency than the other group as 23.8% (p=0.041 ; one-tailed, p=0.053; two-tailed). The recurrence rate in each group of SP was 17.4%, 10.3%, which did not show any statistically significant difference. Conclusion : Treatment with 8 French catheter resulted in shorter indwelling time in sponteous pneumothorax, and lower incidence of treatment-related complication in primary spontaneous pneumothorax. And the recurrence rate in each of treatment group showed no statistically significant difference. So, we can recommend the 8 French small-caliber catheter for the initial therapy for spontaneous pneumothorax for the replacement of conventional chest tube thoracostomy. But further prospective study with more subjects of spontaneous pneumothorax will be needed for the evaluation of effectiveness of 8 French cateter.

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A Study of Reliability and Validity on the Korean Version of Social Adaptation Self Rating Scale(SASS) (한국어판 사회적응자기평가척도(SASS)의 신뢰도 및 타당도 연구)

  • Kim, Hyeong-Seob;Kim, Yong-Ku;Yoon, Choong-Han;Jeong, Han-Yong;Cheong, Young-Ki
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.2
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    • pp.212-227
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    • 2000
  • This study was designed to testify the reliability and validation on the Korean version of the Social Adaptation Self-rating Scale(SASS) which was developed from Bose et al. for the evaluation of social motivation and behavior of depressed patients in 1997. Interests for the social world, those of social functioning, of patients were involved in the addition of new measure of disturbance. And those were distinct from abnormalities of thought, mood and symptoms of patients with major depression. As the previous reports there were several evidences that treatments may be less likely to be effective if the system they act on is dysfunctional. Thus, a better social situation favoured better outcome. As a matter of fact, however, those reports were developed in the course of the evaluation of interpersonal therapy(IPT) and cognitive therapy. Accordingly the conversed question -whether pharmacological therapy with antidepressants can impact on social functioning in addition to addressing the core features of illness- has been addressed. To date, anyhow, it is accepted that enhancement of social functioning may be a therapeutic principle in its own right and illness rarely divorced from social context. In terms of those concepts the introduction of an assessment of social functioning into pharmacotherapeutic studies of depression has been welcomed and might be a potent instrument for evaluating the relative pharmacoeconomic benefits of different treatments. Despite of many scales which were applied for the evaluation of symptoms in the patients with depression, however, the scale for the evaluation of social functiong has not been introduced in Korea yet. Thus, this study was designed to introduce the concepts of social functioning in the patients with depression and to testify the reliability and validation on Korean version of SASS. This Korean version of SASS was submitted to a reliability and validation procedure based on the data from healthy general population survey in 291 individuals and 40 patients with major depression. Cronbach a was 0.790 in total subjects group and the correlation of test-retest was statistically significant(y=0.653, p<0.0l). Thus, the Korean version of SASS might be shown to be valid and reliable. The results of multivariate analyses allowed the identification of 3 principle factors(factor 1 = intersts in social activities, factor 2 = active interpersonal relationship, factor 3 = selfesteem) in normal group, however, it could be counted as only one factor in the depression group because nearly total items of SASS were involved in factor 1. In the view of these results, the Korean version of SASS may be useful additional tool for the evaluation of social functioning in depression.

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Analysis of Frequent Disease and Medical Expenses Structure of Patients Admitted in a Vaterans Hospital (일개 보훈병원 입원환자의 상병 및 진료비 구조분석)

  • Kim, Kyoung-Hwan;Lee, Sok-Goo;Kim, Jeong-Yeon
    • Journal of agricultural medicine and community health
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    • v.30 no.1
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    • pp.1-14
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    • 2005
  • Objectives: This study attempts to analyze the length of hospital stay and expenses of frequent disease admitted in a Vaterans Hospital. Methods: Data was collected from January 1, 2001 to December 31, 2003 from the Claim records of 9,640 patients in a Vaterans Hospital. Results: The results were as follows: 1. In age & sex distribution, there was male 70.9%, female 29.1%, and 35.8% of them is 70 age group. Frequency by insurance program was Health insurance 78.1%, Medical aid 14.2%, no insurance 4.1%, others 3.6%. Distribution of each department was internal medicine 28.3%, orthopedic surgery 21.3%, surgery 16.6%, neurosurgey 7.1%, pediatrics 5.9%. Also, in the veterans group, male to female patient ratio was 99.3% male to 0.7% female, them over 70 years old was 51.6%, and them which live in daejeon was 43.5%. 2. In frequency of disease, there was gastroenteritis 4.8%, pneumonia 3.8%, cartaract 3.7%, cerebral infarct 3.2%, hyperplasia of prostate 3.0%. In frequency of korean standard classification of diseases, there was injury and poisoning and certain other consequences of external causes 17.1%, diseases of digestive system 16.1%, diseases of musculoskeletal system and connective tissue 13.9%, diseases of respiratory system 9.4%, diseases of genitourinary system 8.6%. Also, in veterans group, frequency of them was diseases of musculoskeletal system and connective tissue 19.4%, diseases of digestive system 16.8%, injury and poisoning and certain other consequences of external causes 15.7%, diseases of genitourinary system 9.7%, diseases of circuatory system 8.2%. 3. Average length of hospital stay was 29.0 days for total patients, 51.8 days for the veterans group, 15.7 days for the non-veterans one. Average total expenses was 3,669,579 won, the veterans group 7,263,877 won, the non-veterans one 1,560,333 won. The ratio of insurer to insuree was 55.2 : 44.8, the ratio of amount paid by patient in the veterans group 61.7%, in the non-veterans one 33.0%. 4. In items of medical expenses, fee for hospital accommodation was 34.7%, fee for medication 13.2%(injection 7.8%, drug 5.4%), fee for service 48.6%(physical therapy 26.3%, operation 9.7%, laboratory examination 5.2%, radiological examination 3.1%, etc), others 3.4%. In them for the veterans group, fee for physical therapy was 35.3%, fee for hospital accommodation 35.2%, fee for injection 6.2%, fee for operation 5.9%, for the non-veterans one, fee for hospital accommodation 35.7%, fee for operation 16.4%, fee for injection 11.4%, fee for laboratory examination 8.3%. 5. In the comparison of the frequency by Korean standard classification of diseases and distance between the hospital and home, the region under 21.5Km was more frequent in symptoms, signs an abnormal clinical and laboratory findings 56.0%, injury and poisoning and certain other consequences of external causes 55.6%, diseases of the eye and adnexa 52.9%, the one over 21.5Km was more frequent in neoplasms 57.4%, diseases of musculoskeletal system and connective tissue 55.9%, diseases of genitourinary system 53.5%.

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The Ratio of Medical Aid over Health Insurance of Age Adjusted Mortality Rate of Tuberculosis and Related Factors (의료보장유형에 따른 연령표준화 결핵 사망률비와 관련 요인)

  • Na, Baeg-Ju;Kang, Moon-Young;Hong, Jee-Young;Kim, Eun-Young;Kim, Keon-Yeop;Lee, Moo-Sik;Yang, Sang Kyu
    • Journal of agricultural medicine and community health
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    • v.31 no.1
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    • pp.9-20
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    • 2006
  • Objectives: This study was aimed at investigating the ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis and related factors. And we want to compare the ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis and related factors among the provinces. Methods: In order to compare, the data was referred to National health insurance center for affirming the insurance type of the dead. And age adjusted mortality rate of tuberculosis of each insurance type was analyzed by whole country and the provinces. Related factors of the provinces were gathered from public statistic books. We analysed correlation study between the ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis and related factors among the provinces. Results: Major findings were as follows 1. The ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis was 5.6. And the ratio was relatively high at 40-60 ages. 2. The ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis by the province was varying. And the factors that were financial independence, crowdedness, percent of people on medical aid, population size served by each public health center, number of hospital by a million peoples have correlated with increment of the ratio. Conclusions: As a consequence of tuberculosis control, the ratio was high. Thus this finding suggests that medical utilization and preventive behavior, environment of tuberculosis patient are under handicapped condition. Especially large cities like metropolitan area who have high financial independence, high population density, high percentage of medical aid peoples have high ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis. There is need for additional and systematic research on the attitude or tendency toward medical services(inc1uding preventive services) utilization of medical aid tuberculosis patients.

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Report on the improvement of the in vitro and specimen reception environment system (핵의학과 검체 접수 환경시스템의 개선사례 보고)

  • Kim, Jung In;Kang, Mi Ji;Kim, Na Kyung;Park, Ji Sol;Kwon, Won Hyun;Lee, Kyung Jae
    • The Korean Journal of Nuclear Medicine Technology
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    • v.25 no.2
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    • pp.29-34
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    • 2021
  • Purpose Sample reception environment system in nuclear medicine has not changed much compared to 20 years ago. When preparing sample for in vitro test, there was no significant change because the test was carried out by generating an own specimen from the parent specimen. In this study, We would like to introduce a method that automatically removes the sample cap using the automated decapper equipment and enables automatic reception at the same time. In addition, including a provisional reception system. Materials and Methods In 2019, it was intended to get a device that automatically removes the cap of a patient's blood sample. This equipment is the same as the equipment used in the Department of Laboratory Medicine (Vacuette Ⓡ Unicap Belt Decapper, Greiner bio-one, Austria). However, the purchase was delayed due to differences in tube size, budget, and space. In January 2020, we borrowed domestic automatic decapper equipment and modified it to suit our laboratory environment. After 9 months, we were able to introduce a system that automatically removes the lid of a patient's blood sample and at the same time automatically accepts the test. And, through the provisional reception system, it was possible to know the arrival of the specimen in a short time. Results With the use of an automatic decapper device, the sample cap was automatically removed, and the reception proceeded at the same time. So, it was very efficient at work because it shortened the sample preparation time by about 20 minutes. In addition, it was possible to prevent the examiner's musculoskeletal disorders caused by repeated wrist use. After using the provisional reception system, patients were able to be discharged quickly, and the number of phone calls to confirm the arrival of samples was reduced. Conclusion Most hospitals have about four employees in the nuclear medicine in vitro laboratory. It is effective to use automatic decapper equipment and a provisional reception system for organizations that perform work with the minimum number of personnel.

The Effect of the Dental Patients' Perception about Dental Hygienist on the Social Demand of Dental Hygienist (치과 내원환자들의 치과위생사에 대한 인식도가 치과위생사의 사회적 요구도에 미치는 영향)

  • Choi, Jung-Mi;Lee, Eun-Ju
    • Journal of dental hygiene science
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    • v.12 no.4
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    • pp.392-403
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    • 2012
  • This study aims at providing the basic data to help establish the right identity of dental hygienist and develop the work of dental hygienists, and thereby investigating the effect of patients' perception of dental hygienist on their social demand of dental hygienist, by conducting a survey of 300 patients visiting dentists around Busan-Gyeongnam region from April 7, 2012 to April 25, 2012. The collected data is statistically analyzed by SPSS (Statistical Packages for Social Science 14.0. SPSS Inc., Chicago, IL, USA). First, I analyzed the frequency by suggesting the demographic and descriptive characteristics of data, and conducted t-test and One-Way ANOVA at 5% of significance level to figure out the degree of perception and social demand of dental hygienists depending on customers' reason for visiting dentists, and also conducted regression analysis to find the effect of the perception of dental hygienist on patient's social demand of dental hygienist. The result suggests that as the perception of the dental hygienists' role, the social demand for dental hygienists' image increases, but as perception of dental hygienists' image increases, the social demand of dental hygienists' image decreases. Therefore, it suggests that as the knowledge about dental hygienists increases, patients demand their service more, while the perception of their image lowers the social demand for their image. It turns out that as the knowledge of dental hygienists increase, the social demand for the knowledge also increases.

Clinical investigation of lipoid pneumonia in adults (성인에서 발생한 지방성 폐렴의 임상적 고찰)

  • Hyun, Jae Geun;Rhee, Chong H.
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.965-975
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    • 1996
  • Background : Exogenous lipoid pneumonia is caused by inhalation or aspiration of animal, vegetable or mineral oil. Most cases are ascribed to aspiration of oil in laxatives or nose drops Petroleum, another pure hydrocarbon used as a base in various medications, is occasionally involved. Especially animal oil produces severe tissue inflammatory reaction, but most patients present with only abnormal chest X-ray and no specific clinical symptoms or signs. Method: Seven patients, 3 males and 4 females, with exogenous lipoid pneumonia, who was hospitalized or referred to pulmonary division at Samsung Medical Center from December 1994 10 July 1996, were included. They hadn a history of laking shark liver oil(so-called "squalene") for varying period of time. We reviewed clinical, radioloic and pathologic findings. Result: Patients look 7 to 30 capsules of "squalene" a day for at least one month to 5 years. Six cases had chronic disease such as diabetes, hypertension, or cerebrovascular accident. Respiratory symptoms of mild fever, cough and sputum were present in 3 cases and in 3 cases there was no clinical symptoms and signs but abnormal findings by chest X - ray. The major radiologic findings by simple chest X - ray and computed tomography consisted of consolidation, infiltration involving mainly right middle and both lower lobes, and ground-glass opacity. Five of six bronchoscopic examinations demonstrated both lipid droplets floating on the surface of bronchoalveolar lavage fluid and Lipid-laden macrophages in bronchoalveolar lavage fluid or lung tissue. Follow-up chest X -ray showed improvement in 4 cases but no marked interval change in 3 cases after removal of exposure to "squalene". Conclusion: Shark liver oil can induce lipoid pneumonia in adults. In case of high clinical suspicion, confirmation of "squalene" use by careful history taking is required and bronchoscopy is helpful in diagnosis.

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Effects of Usual Source of Care by Patients with Diabetes on Use of Medical Service and Medical Expenses (당뇨병 환자의 상용치료원 보유가 의료이용 및 의료비에 미치는 영향)

  • Lee, So Dam;Shin, Euichul;Lim, Jae-Young;Lee, Sang Gyu;Kim, Ji Man
    • Korea Journal of Hospital Management
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    • v.22 no.3
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    • pp.1-17
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    • 2017
  • Purposes: Diabetes is a metabolic disorder that requires continuous care in order to prevent complications, as it can impose a critical burden on families and society due to various complications, including terminal renal failure, non-traumatic lower extremity amputation, and adult blindness. The usual sources of care are "specified private clinics, public health centers, or other facilities to visit when ill or when health-related advice is needed". These usual sources of care offer preventative services, have a high overall satisfaction rate in terms of public health care, and decrease the inpatient rates and medical costs of medical aid recipients. This study analyzed the current status of diabetic patients over 20 years of age based on their possession of a usual source of care, and the effects of this possession on the frequency of their medical service usage and its costs. Methodology: Based on data from the 7th Korea Health Panel, a Tobit analysis was used to analyze the different factors that can affect the frequency of medical service usage and its costs for diabetic patients with and without a usual source of care. Findings: The medical costs of diabetic patients with a usual source of care decreased in terms of inpatient, and the outpatient visits and inpatient costs of the group with a usual source of care in the form of a mainly-visiting doctor decreased more than those of the group with a mainly-visiting medical institution only. Practical Implications: Having a usual source of care can increase the treatment continuity, leading to reduced inpatient, and having a mainly-visiting doctor as the usual source of care further increases the treatment continuity. Based on these results, a new policy is needed to increase and strengthen diabetic patients? possession of a usual source of care.