• 대한간호학회지
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• 제38권1호
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• pp.29-38
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• 2008

Purpose: This study investigated various factors relatied to wandering behavior of Korean elders with dementia (KED). Methods: A sample of 160 ambulatory residents with dementia from 14 long term care facilities was used to examine demographic, individual, cognitive, physical health, and environmental characteristics by comparing wanderers (N=108) to nonwanders (N=52). Subjects were evaluated by Korean versions of the Mini-mental State Exam (K-MMSE), the Physical and Instrumental Activities of Daily Living (K-PIADL), and the Revised Algase Wandering Scale Nursing Home version (KRAWS-NH) along its six dimensions. Demographic and environmental data were also obtained. Independent sample t-tests, Chi-square test, Fisher's Exact tests, and ANCOVAs were used to examine differences between wanderers and nonwanders. Results: Wanderers were significantly (p<.05) older and had more limitations in K-PADL and K-IADL. The degree of overall wandering and certain features of wandering were significantly different (p<.05) by total number of residents in the facility, type of bedroom (i.e., "Ondol"), and color of bedroom and living-room walls (i.e., sky blue). Conclusions: Findings of this study may be useful in understanding wandering behavior of KEDs and thus developing more culturally specific management strategies.

• 한국간호교육학회지
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• 제13권1호
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• pp.74-81
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• 2007

Purpose: This study was to investigate the factors affecting health-related quality of life in Benign Prostatic Hypertrophy(BPH) Patients. Method: Data was collected on 259 outpatients who were receiving ambulatory treatment after having been diagnosed with BPH. The measurement tool for the quality of life was developed by Epstein and Deverka(1992) and adapted by Kim Yeong-hye(1997). Data was analyzed with the number, percentage, and the mean and multiple regression, by using the SPSS 12.0 program. Result: The mean quality of life in the sexual-life domain respectively. Factors affecting the quality of life in BPH patients were the symptom of BPH(51.4%), the perceived health state(3.6%), and self-efficacy (1.6%). These three factors described 56.6% of quality of life. Conclusion: It's necessary to have an intervention plan that can enhance the most influential disease-symptom management in a patient, and self-efficacy when planning a nursing education program aiming to promote quality of life in BPH patients.

• Archives of Plastic Surgery
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• 제46권3호
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• pp.189-197
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• 2019

There has been an exponential increase in plastic surgery cases over the last 20 years, surging from 2.8 million to 17.5 million cases per year. Seventy-two percent of these cases are being performed in the office-based or ambulatory setting. There are certain advantages to performing aesthetic procedures in the office, but several widely publicized fatalities and malpractice claims has put the spotlight on patient safety and the lack of uniform regulation of office-based practices. While 33 states currently have legislation for office-based surgery and anesthesia, 17 states have no mandate to report patient deaths or adverse outcomes. The literature on office-base surgery and anesthesia has demonstrated significant improvements in patient safety over the last 20 years. In the following review of the proceedings from the PRS Korea 2018 meeting, we discuss several key concepts regarding safe anesthesia for office-based cosmetic surgery. These include the safe delivery of oxygen, appropriate local anesthetic usage and the avoidance of local anesthetic toxicity, the implementation of Enhanced Recovery after Surgery protocols, multimodal analgesic techniques with less reliance on narcotic pain medications, the use of surgical safety checklists, and incorporating "the patient" into the surgical decision-making process through decision aids.

• 한국의료질향상학회지
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• 제9권2호
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• pp.210-228
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• 2002

Background: The purpose of this research was to examine the fall incidence rate and its related factors of fall in inpatients. Methods: The data were collected from the 138 fall incident reports in one tertiary hospital in Seoul from April 1st 1999 to September 30th 2001. The Fall Incident Report Form was originally developed based on that of Massachusetts General Hospital revised in 1995. And this was modified for this survey by the collaborating work of QI team including researcher and department of nursing service of this particular hospital. The contents of Fall Incident Form were general characteristics of patient. factors related to fall. types and places of fall. circumstances, nursing interventions. and outcome. Results: 1) The incidence rate of fall was 0.08% of total discharged patients and 0.081 per 1000 patient-day. This incidence rate is much lower than that of several hospitals in USA. This finding might result from the different incidence report system of each hospital. 2) The characteristics of fall-prone patient were found as follows. They were mostly over 60 years old, in alert mental status, ambulatory with some assistance, and dependent on ambulatory device. The types of diseases related high incidence rate were cerebrovascular disease(3.2), hypertension(1.6), cardiovascular disease(1.4), diabetes(1.3) and liver disease(0.6). 3) The majority of fall events usually occurred m bed. bedside(walking or standing) and bathroom in patient room. Usually they were up on their own when they fell. And there were more falls of elderly occurred during night time than day or evening. 4) 63.8% of fall events resulted in physical injuries such as fracture and usually the patients had diagnostic procedures and some treatment(ex. suture) which caused additional cost to the patients and their families. 5) The found risk factors of fall were drugs(antihypertensive drug, diuretics) and environmental factors like too high bed height, long distance of bedside table and lamp switch, and slippery tile of bathroom floor. Conclusion: Considering these results, every medical and nursing staff should be aware of the risk factors of patients in hospital, and should intervene more actively the preventive managements, specially for the elderly patients during night. Therefore, it is recommended that the development of Fall Prevention Programs based on these results.

• 보건행정학회지
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• 제21권4호
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• pp.585-598
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• 2011

This study was conducted to examine the trend of national health insurance service use with relation to pregnancy, childbirth, and the puerperium among pregnant and postpartum women older than 35 over the last decade. A descriptive analysis was conducted, using the data which were drawn from the "nationwide claim database of Korean National Health Insurance Corporation(NHIC)". Data were composed of the total cases related to pregnancy, childbirth, and the puerperium (International Classification of Disease, $10^{th}$revision [ICD-10] codes O00-O99) from 2001 to 2008. During 2001-2008, the number of pregnant and postpartum women older than 35 had continuously increased and the percentage of them also had increased in both hospital and ambulatory care. There are similar trends in their total use of national health insurance service and total expenditure. According to demographic characteristics, there was the biggest increase of the percentage in residents in large cities, self-employed workers, ones in the highest income level. According to ICD-10 codes, there was the biggest increase of the percentage in O10-O16 (oedema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium). According to the major prevalent disease, there was the biggest increase of the percentage in O60 (preterm labor and delivery). Throughout the past decade, the necessity has been emphasized of supporting pregnant and postpartum women older than 35. But in maternal and child health care, they are in an early stage of development. The findings of this study would be helpful in developing the support programs for the aged pregnant and postpartum women.

• Journal of Preventive Medicine and Public Health
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• 제26권4호
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• pp.614-627
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• 1993

It is well known that a physician's personal characteristic affects his practice pattern. Furthermore, a physician's specialty has powerful influences on his practice pattern. However, despite the fact that specialization has received the most attention for its influence on physician's service behavior, few studies have been conducted on the variations of contents and volume of physician's services. This study has intended to identify factors influencing the practice variations according to various physician characteristics. There are some other evidences that medical care providers are different in using of health services and resources in Korea. Four physician characteristics were selected for the analysis, two demographical factors, age and sex, and two practice factors, place of practice and medical specialty. Also, three indicators of service amount (total amount of insurance claim bill, number of visits per case, number of prescriptions per case) were selected. From the pool of insurance claims for ambulatory care received by the Korean National Federation of Medical Insurance(NFMI), 84,898 cases were randomly sampled. In the meantime using physician database of NFMI, 613 general practitioners (GP), 107 regular family physicians (FP), 483 'grandfather' family physicians(GFP), and 1,157 specialist practitioners(SP) were randomly sampled. Their different practice contents were compared concerning the specialty, age groups, sex, and practice sites (urban-rural) Specialist physicians tend to provide more costly care than do generalists. General practitioners and family physicians usually make fewer following visits and prescriptions. Age is also the important factor in determining the amount of services, which is highest at the physician's age group of 40's. Female doctors and urban practitioners use much more resources than their counterparts respectively. Research findings suggest that physician's characteristics particularly the specialty can affect practice patterns and resource utilizations. Other characteristics such as age and sex are not controllable but physician's specialty is relatively easily controllable during the entire phases of policy implementation. This is all the more true in the individual's initial decision of his specialty. Specialization therefore should receive policymaker's attention for its potential influence on medical care utilization and health care expenditure.

• 한국전문물리치료학회지
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• 제12권1호
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• pp.54-62
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• 2005

The purpose of this study was to find the effects of using aid in enhancing walking ability inpatients with spinal cord injury who have received rehabilitative care. The study population consisted of 24 spinal cord injury patients referred to the Department of Rehabilitation Medicine in the National Rehabilitation Center (NRC). All subjects were ambulatory with or without an assistive devices. All of the participants were assessed on SCIM II, WISCI II, FIM, MBI, gait speed (m/s), and walking endurance (120 min/m). The data were analyzed using a paired t-test, a one-way ANOVA, and a Duncan test. The results revealed that TSCIM II and all of the items of SCIM II of the cervical ASIA D group patients were higher than those of the Thoracic ASIA A and C group patients (p<.05). The FIM, MBI, and WISCI II of the cervical ASIA D group patients were higher than those of the Thoracic ASIA C group patients (p>.05). The walking velocities of the lumbar ASIA C group patients were higher than those of Thoracic ASIA A group patients (p<.05). The walking endurance of the lumbar ASIA C group patients was higher than that of the thoracic ASIA C group patients (p<.05). The ASIA D group patients used bilateral standard canes or crutches, but none used AFO. The ASIA A and C group patients used bilateral standard walkers with KAFO for standing and walking. The findings suggest that injury level as well as the functionality of walking aids should be considered when formulating a rehabilitative plan for patients with spinal cord injury.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제23권3호
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• pp.71-80
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• 2017

Purpose: At the moment prevention and treatment of animal related diseases is becoming a social concern as the demand for animal increases. Furthermore, The design of the veterinary medical teaching hospital are even more complex because they have to accommodate medical program for animal and education and research program for students. However, there are a few experience and useful guidelines for the planning of the veterinary medical teaching hospital. So it is not easy for the regional hub universities to work out the proper plan for the construction of the veterinary medical teaching hospital for their own. This study has been started in order to provide basic informations for the planning of Korean veterinary medical teaching hospital. Methods: Interview to veterinarian, intern and employee of the veterinary medical teaching hospital and Field surveys to veterinary medical teaching hospital in Korea have been conducted for the data collection. The drawings of three universities of veterinary medical teaching hospital have been analysed and diagramed. Results: The result of this study can be summarized into three points. The first one is that the veterinary medical teaching hospital spaces are divided into five areas (ambulatory care, central medical care, hospitalization, education and research, operations and support) and each area is divided independently and connected properly. The second one is that the veterinary medical teaching hospital differs from hospital in the detailed space plan in the sense that the animal is a patient. The third one is that each hospital has different operating practices and programs according to local conditions Implications: It is meaningful as a basic source of veterinary medical teaching hospital design in the future.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제21권1호
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• pp.17-26
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• 2015

Purpose : This study examined the social and environmental change in the outpatient department of psychiatry, were analyzed disease characteristics and using characteristics of the mental illness. Thus, this aims to provide a material that can be used for efficient spatial composition of psychiatry. Methods : This study was conducted through a literature review, observation surveys, interviews. Results : Psychiatry is aware of the need to respond to the current needs of ambulatory space, there are concerns that the spatial configuration for your needs. In accordance with the results of studies conducted are as follows: 1) Specialty care programs and space needs based on segmentation and specialization of the disease 2) Considered in conjunction with the layout of essential space and other departments 3) Spatial composition and furnishings for characteristic of psychiatry 4) Spatial configuration taking into account the patient's characteristic. Implications : This study looked at the change of social change and the environment related to psychiatry. Grasp the present state of spatial composition in psychiatry. And the use characteristics of patients and guardians were investigated. Meanwhile, studies of psychiatric outpatient department is still lacking. As a result, its significance is to analyze the spatial composition requirements.

• 농촌의학ㆍ지역보건
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• 제28권1호
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• pp.67-77
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• 2003

통합보건지소의 운영실태를 조사하고 이를 평가함으로써 지역주민에게 더욱 효율적이고 지역주민의 요구에 부합하는 서비스를 제공하는데 필요한 사업방향을 제시하는 것이 연구의 목적이다. 경상북도의 통합보건지소 3개소와 경상남도의 통합보건지소 2개소, 총 5개소의 통합보건지소를 2000년 12월 부터 2001년 1월까지 방문하여 보건지소 통합 전후의 인력, 시설, 장비, 진료 및 보건사업의 내용과 통합운영의 문제점 및 개선방안에 대한 면담을 실시하였다. 조사 대상 통합보건지소의 통합 전후 인력변화는 전체 인력은 6.8명에서 9.6명으로 2.8명 증가하였으며, 근무자 수는 통합보건지소는 6-14명으로 변이가 컸다. 통합 전후의 인력은 의사와 치과의사, 간호인력은 비슷하였고, 임상병리사와 방사선사는 한 명도 근무하지 않다가 3개 통합보건지소에 배치되었다. 보건지소 통합 후 일반진료와 치과진료는 약간 증가하였고, 방사선검사와 물리치료, 임상병리검사는 크게 증가하였다. 보건사업의 변화는 방문보건사업 건수와 이동진료 건수, 보건교육 연인원은 통합 전에 비하여 통합 후에 크게 증가하였으며, 예방접종과 자궁경부암 검진은 비슷하였다. 고혈압과 당뇨병 등록 환자수는 약간 증가하였다. 보건지소 통합 이후에 검사건수가 증가하였으나 서비스의 질은 높아졌다고 보기 어려우나, 방문보건, 이동진료, 보건교육사업은 크게 증가하여 긍정적인 현상으로 보인다. 보건지소 통합의 문제점은 인력간 업무의 내용의 불명확성, 과다하게 넓은 건물의 관리의 어려움, 보강되지 않은 장비, 운영비의 미책정, 보건교육을 위한 전문교육의 부족 등이었다. 향후 통합보건지소 기능 활성화를 위하여 의사, 간호인력 및 행정직을 배치하기 위한 최소배치 기준을 보건지소의 기준과는 별도로 설정하여야 할 것이며, 진료 및 방문서비스의 질을 향상시킬 수 있는 기본장비를 확충하는 것이 필요하다. 또한 인력간 업무의 분장을 명확히 하고, 업무관련 가이드라인을 개발하여 제공함으로써 업무의 효율성을 증대시켜야 한다.