Kim, Kyeong-Won;Lee, Kyeong-Soo;Kang, Pock-Soo;Kim, Woo-Shik;Lee, Hee-Kyeong
The Journal of Korean Academy of Prosthodontics
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v.47
no.2
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pp.215-221
/
2009
Statement of problem: Recently the populations of patients receiving implant surgery are greatly increase for maintaining oral health. Purpose: This study was conducted for implanted patients to assess the chewing ability patient satisfaction level and changes in quality of life before and after the implant surgery. Material and methods: The current study subjected 109 adult patients, older than 20 years of age, who received implant surgery from December, 2006 to October, 2007 at the 6 dental clinics located at Daegu and Ulsan metropolitan cities. Twice of surveys were conducted for the patients before and after receiving the dental implant surgery. Results: As the motivation of receiving implant surgery, 45.9% of the patients selected the surgery for the chance o "f chewing function recovery", and " failure of treatment and complications" was found to be the most worrisome at the time of surgery by recording 38.5%.The satisfaction level before the implant surgery scored 30.37, while the score was increased to 45.01 after the surgery by showing a significant difference before and after receiving the surgery(P<.001). Regard on the surgery, 91.8% of the patients responded as "Satisfy", and 89% of the study subjects responded that they have willingness to recommend the surgery to their families and friends. The chewing ability score measured by using the surveys on edible foods, the score before the surgery was 15.24, while the score was increased to 19.11 after the surgery by showing a significant difference before and after receiving the surgery(P<.001). The quality of life score was also found to be increased to 11.17 after the surgery from 9.99 before the surgery by showing a significant difference(P<.001). Conclusion: In a future, the studies on the numbers of implanted loss teeth and the location of tooth loss are necessary, more long-term follow study are needed, and it is thought to be necessary to enlarge the sample size of subjects in conducting the studies.
Purpose: Critical pathways (CP), also known as clinical pathways, are management plans that display goals for patients and have led to improved outcomes for many disease entities. This study was aimed at developing a critical pathway for the surgical treatment of gastric cancer patients and evaluating its usefulness. Materials and Methods: A CP was developed and implemented by a team of surgeons, nurses, nutritionists, and administrative officials. Among the 117 patients who received curative gastrectomies for gastric cancer at Kangnam St. Mary's Hospital, The Catholic University of Korea, between October 2003 and August 2004, 26 patients were treated according to the CP. We evaluated its usefulness by comparing the clinical characterisctics, postoperative progress, hospital stays, and costs between the CP and the non-CP groups. Patient satisfaction was also surveyed with questionnaires. Results: Of the initial 26 patients in the CP group, two were excluded from the final evaluation; one patient had a duodenal stump leakage, and the other had a gastric stasis postoperatively. In 8 patients, protocol violation occurred; six patients refused to be discharged on the $7^{th}$ postoperative day, one patient who had an gastric staisis postoperatively stayed for 2 additional days, and one patient who needed ICU care stayed for 4 additional days. The drop-out rate was $7.7\%$ (2/26), and the variance rate was $30.8\%$ (8/26). The mean hospital stay was 11.3 days ($10\~15$ days) for the CP group compared with 17.5 days ($9\∼68$ days) for the non-CP group, resulting in a difference of about 6 days (P<0.05). The mean hospital stays after surgery were 10.3 days ($7\∼68$ days) and 8.3 days ($7\∼12$ days) for the non-CP and the CP groups, respectively, but the difference was statistically not significant (P>0.05). The mean charge during the hospital stay was higher in the non-CP group ( $\\$ 6,292,200) than in the CP group ( $\\$ 4,863,685). The charge per hospital day was higher in the CP group ( $\\$ 430,414) than in the non-CP group ( $\\$ 359,554). Patient satisfaction was higher in the CP group than in the non-CP group. Conclusion: By developing and applying a critical pathway in the surgical treatment of stomach cancer patients, we could reduce the length of hospital stay as well as the cost. A multi-centered prospective study to establish a standard treatment pathway and to demonstrate its effectiveness is needed in the future.
Journal of the Korea Academia-Industrial cooperation Society
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v.19
no.8
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pp.276-282
/
2018
This study was conducted to improve the quality of home-based cancer management programs through a survey of satisfaction and needs of the program provided by a regional cancer center. From March 2015 to October 2015, we conducted face to face surveys of patients and caregivers enrolled in home-based cancer management. A total of 101 patients, 59 patients and 41 caregivers, were enrolled. Breast cancer was the main cancer and 51 (86%) patients and 36 (85%) caregivers were satisfied with the number of visits for home-based cancer management. For the service application route, 22 patients (37.29%) obtained information through the cancer center publicity paper and 11 caregivers (26.19%) received recommendations from acquaintances. Except for treatment provided directly to the patients, psychological counseling was the most preferred, and satisfaction regarding picnic and cancer education were also high. Satisfaction with the program provided by regional cancer center was relatively high ($4.14{\pm}1.21$ on a 5-point scale). Additionally, satisfaction of the patients was higher than that of the caregivers, but this difference was not significant ($4.29{\pm}1.11$, $3.93{\pm}1.31$, p = 0.141). Self-esteem was higher among caregivers than patients, but this difference was not significant. To improve the quality of life of cancer patients and caregivers, it is necessary to develop customized programs considering patients' economic situations and need for psychological counseling.
Journal of the Korea Academia-Industrial cooperation Society
/
v.13
no.1
/
pp.117-124
/
2012
This study is aimed to investigate the relationship among safety accident and perception of patient safety culture, to provide the basic data for building the patient safety culture of hospital nurses. The self-administered questionnaires were given to 129 nurses employed in hospital during the period from November 10th to 15th, 2011. The safety accident occurrence of patient was statistically significant difference according to safety education of nurse and job satisfaction of nurses. As a results, nurses' perception to the patient safety culture of hospital shows on the average score($3.46{\pm}0.3$). Among three categories, patient safety culture in a ward, and patient safety culture within hospital and safety awareness in a ward show respectively on the average score $3.59{\pm}0.3$, $3.41{\pm}0.5$, $3.41{\pm}0.4$. The score of level of patient safety culture of hospital nurses was statistically significant difference according to marital status, safety education, occupational satisfaction and health status. In correlation among safety accident occurrence of patient and safety education of nurse, patient safety culture in a ward, patient safety culture within hospital and safety awareness in a ward showed positive relationship. The results of this study indicate that education program are needed to prevent safety accident occurrence of patient, and to build the patient safety culture of hospital nurses, and to increase the safety education and occupational satisfaction, and to improve the nurses' health status.
Kim, Woo-Jeong;Kim, Min-Young;Chang, Weon-Young;Choi, Jae-Hyuck
Journal of Hospice and Palliative Care
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v.13
no.3
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pp.153-160
/
2010
Purpose: The purpose of the present study was to investigate needs and satisfaction on the medical services of cancer patients in Jeju Special Self-Governing Province. Methods: Total 174 cancer patients, who visited at the clinic of Jeju National University Hospital, submitted informed consent and participated in this study from July 13 to July 30, 2009. Self questionnaire was used and data were analyzed with Kolmogorov-Smirnov test, Mann-Whitney U test, ANOVA, and Kruskal-Wallis test. Results: Participants expressed the needs of most economical support (3.38 out of 4), followed by counseling of treatment plan (3.22), information of disease (3.07), and disease management except cancer (2.97). Participants were satisfied most with religious counseling (3.41), followed by nursing service support (3.39), employment counseling (3.26), and counseling for family or interpersonal relationships (3.26). The satisfaction of economical support was the lowest (1.98). Satisfaction of men was higher than women, and needs in patients who were living with children was the highest. Patients who were living alone or with children showed the lowest satisfaction about the medical services. There were no significant differences in the general characteristics, however, participants who were older than 60 years of age or had higher income showed lower needs and higher satisfaction. There were no significant differences in the medical characteristics, however, thyroid cancer patients and patients who were treated with radiation therapy or transarterial embolization showed low satisfaction. Conclusion: Cancer patients seemed to need more economical support, information of treatment or disease, and symptom management. Furthermore, there were various needs about the services, depending on family formation or economical support of patients. Therefore, it is certain that patients who were suffering from other cancers, except the 5 major cancers, needed more services. In conclusion, continuous and systemic policy to consider patient's characteristics and needs are needed in community as well as health care system.
Aortic aneurysm has poor prognosis and high mortality, but the incidence of aortic aneurysm is in increasing state. From July, 1986 to July, 1996, we operated on 25 patients with aortic aneurysm and analysed the clinical results and relations between the duration from symptoms onset to operation(Sx-Op), the duration from admission to operation(Adm-Op), preoperative blood pressure, preoperative heart rate and postoperative mortality, retrospectively. The patients were classified as dissecting aneurysm(10 cases), abdominal aortic aneurysm(9 cases), Marfan's syndrome(3 cases), descending thoracic aortic aneurysm(3 cases). The operative technique were graft interposition in 17 cases, Bentall's operation in 4 cases, aneurysm bypass in 2 cases, and wrapping of aorta in 2 cases. Seven patients died of several causes, bleeding in 5 cases, acute renal failure in 1 case and respiratory failure in another one case. Before 1992, the early stage of operation, 6 mortality among 14 operated patients occurred, and after then 1 mortality among 11 operated patients occurred. Eighteen survivors were followed up from 1 to 118 months(mean 50.6 months), and total follow up was 911 patient-months. During the follow up period one patient died of melena 30 months after operation. The other patients did not complain chest pain or dyspnea. The surgical mortality was improved in the late period, and the major cause of death was intraoperative or postoperative bleeding. The Sx-Op duration, the Adm-Op duration, preoperative blood pressure and preoperative heart rate were proven to have no statistical relations with postoperative mortality.
Park, Keon-Uk;Won, Kyoung-Sook;Koh, Young-Min;Baik, Jae-Jung;Chung, Yeon-Tae
Tuberculosis and Respiratory Diseases
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v.42
no.3
/
pp.361-369
/
1995
Background: A number of different weaning techniques can be employed such as spontaneous breathing trial, Intermittent mandatory ventilation(IMV) or Pressure support ventilation(PSV). However, the conclusive data indicating the superiority of one technique over another have not been published. Usually, a conventional spontaneous breathing trial is undertaken by supplying humidified $O_2$ through T-shaped adaptor connected to endotracheal tube or tracheostomy tube. In Korea, T-tube trial is not popular because the high-flow oxygen system is not always available. Also, the timing of extubation is not conclusive and depends on clinical experiences. It is known that to withdraw the endotracheal tube after weaning is far better than to go through any period. The tube produces varying degrees of resistance depending on its internal diameter and the flow rates encountered. The purpose of present study is to evaluate the effectiveness of weaning and extubation following a 60 minutes spontaneous breathing trial with simple oxygen supply through the endotracheal tube. Methods: We analyzed the result of weaning and extubation following a 60 minutes spontaneous breathing trial with simple oxygen supply through the endotracheal tube in 18 subjects from June, 1993 to June, 1994. They consisted of 9 males and 9 females. The duration of mechanical ventilation was from 38 hours to 341 hours(mean: $105.9{\pm}83.4$ hours). In all cases, the cause of ventilator dependency should be identified and precipitating factors should be corrected. The weaning trial was done when the patient became alert and arterial $O_2$ tension was adequate($PaO_2$ > 55mmHg) with an inspired oxygen fraction of 40%. We conducted a careful physical examination when the patient was breathing spontaneously through the endotracheal tube. Failure of weaning trial was signaled by cyanosis, sweating, paradoxical respiration, intercostal recession. Weaning failure was defined as the need for mechanical ventilation within 48 hours. Results: In 19 weaning trials of 18 patients, successful weaning and extubation was possible in 16/19(84.2 %). During the trial of spontaneous breathing for 60 minutes through the endotracheal tube, the patients who could wean developed slight increase in respiratory rates but significant changes of arterial blood gas values were not noted. But, the patients who failed weaning trial showed the marked increase in respiratory rates without significant changes of arterial blood gas values. Conclusion: The result of present study indicates that weaning from mechanical ventilation following a 60 minutes spontaneous breathing with $O_2$ supply through the endotracheal tube is a simple and effective method. Extubation can be done at the same time of successful weaning except for endobronchial toilet or airway protection.
The loss of posterior support may cause attrition of anterior teeth, and loss of occlusal vertical dimension (OVD). The collapse of the posterior support will eventually cause the pathologic change of the TMJ and masticatory muscles, unesthetic facial appearance and decreased masticatory function. Patients with destroyed dentition need extensive prosthetic treatments. Proper diagnosis and treatment planning are necessary for the stability of the neuromuscular system and the TMJ, and esthetic and functional definitive restorations. In this case, 63 year-old male presented with decreased masticatory force and esthetic problems due to pathologic destruction of teeth structure on entire dentition. Based on assessment of OVD including intraoral findings, radiographic examination and diagnostic cast, full-mouth rehabilitation with increase of OVD was planned using fixed partial denture and removable partial denture. Diagnostic wax-up was done after 4 mm increase of OVD determined by assessment of OVD. The OVD was maintained with the overlay type removable interim prostheses for 12 weeks to ascertain his comfort and adaptation to the new OVD. After the adaptation period, second interim prostheses with tooth preparation maintaining the established OVD was delivered. After 4 weeks, final prostheses were fabricated and delivered. After 7 month follow-up period, occlusal stability is maintained. Through this procedure, satisfactory outcomes were achieved both in functional and esthetic aspects.
Purpose : To analyze the result of arthroscopic synovectomy of the shoulder for rheumatoid arthritis. Material and Method : Sixteen patients were treated from May, 1998 to December, 2002 who undergone arthroscopic synocvectomy of the shoulder for rheumatoid arthritis. The study group constisted 2 men and 14 women. the age at surgery ranged from 32 to 66 years, with average of 50 years. The result were analyzed using the clinical assessment of shoulder surgery classification system issued by the Japanese Orthopaedic Association and subjective satisfactation of the patients cartegorized excellent, good, poor. Results : The mean score of ROM was increased from 13.9 preoperative to 23.8 postoperative and the mean score of pain was inclosed from 22.0 preoperative to 26.5 postoperative. The result of subjective satisfaction were 7 excellent, 7 good,2 unsatisfied, so forteen cases $(88\%)$ above the good. Conclusions : The shorter morbidity date, and the letter damage of articular cartillage, the better results of the arthroscopic synocvectomy of the shoulder for rheumatoid arthritis.
The Journal of Korean society of community based occupational therapy
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v.3
no.1
/
pp.21-31
/
2013
Objective : This study was aimed to survey the present situation and satisfaction in assistive technology of the physically disabled person. Method : 110 patients, being diagnosed with spinal cord injury and stroke, were chosen and structured interview was carried out using by a questionnaire. Result : The followings are the results of this study. First, spinal cord injury(76.2%) and stroke(72.5%) patients used the most wheelchair and mobility devices in assistive technology device. Second, they were satisfied in effectiveness of assistive technology device. Third, spinal cord injury(39.4%) patients used the most repair service in assistive technology service. Fourth, stroke(28.2%) patients used the most application and training service. Fifth, they were satisfied in professionality while were dissatisfied in service delivery program. Conclusion : The results of this study would contribute to better assistive technology for the physically disabled person.
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