• Journal of the Korean Dietetic Association
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• v.22 no.1
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• pp.53-69
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• 2016

The purpose of this study was to analyze the importance-performance of clinical nutrition management in convalescent hospitals. The research was carried out based on questionnaires administered from March to April, 2015 to 73 dietitians at 40 convalescent hospitals in the Gyeongnam area. There was a statistically significant difference between the mean scores for importance (4.01/5.00) and performance (2.95/5.00) of clinical nutrition management. The importance and performance grid analysis showed that participation in a nutritional management committee, administration of patients using a cooperation program among hospital departments, cooperation with a medical team on patient's nutrition status, nutrition initial assessment, nutrition care process for patients showing malnutrition, nutrition care process for tube feeding patients, management of a therapeutic diet, meal management using dietary slip instructions including a therapeutic diet, and explication of a therapeutic diet for patients scored high regarding importance and performance (doing great area). Medical records on patient's nutrition management, and nutrition counseling for requested patient scored low regarding the importance and high regarding performance (overdone area). Participation in medical rounds, personal nutrition education for patients, group nutrition education for patients, nutrition education for medical teams, development of a menu for therapeutic diet and standardized recipes, and provision of information on diet therapy for patients after discharge scored low regarding importance and performance (low priority area). Accreditation of convalescent hospitals and interest of medical professionals in clinical nutrition management were effective variables for the importance-performance gap of clinical nutrition management. In conclusion, the accreditation process and positive awareness of medical professionals with regard to clinical nutrition management had positive effects on reduction of the importance-performance gap in clinical nutrition management at convalescent hospitals. The strength of clinical nutrition management in the accreditation and development of an education program for increasing medical team or administrator interest in clinical nutrition management could lead to improvement of clinical nutrition management for elderly patients in convalescent hospitals.

• Journal of East-West Nursing Research
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• v.19 no.2
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• pp.128-137
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• 2013

Purpose: This study was performed to identify the effects of oriental herbal tea on the brain function elders at the day care center and the nursing home. Methods: This study used a pre-post quasi-experimental design with a non-equivalent control group. Total 38 of elderly population (20 of experimental group and 18 of control group) was recruited. 100 mL of a type of oriental herbal tea developed for purpose of this study was given to each subject 3 times a day for 30 days (from May to Jun 2013). The brain function quotient was used to measure brain function. The data were analyzed by SPSS/WIN 18.0. Results: After drinking the oriental herbal tea, more significant improvement on attention quotient (AQ), anti-stress quotient (ASQ), emotion quotient (EQ) and brain quotient (BQ) were found in the experimental group than control group. Conclusion: This study shows that oriental herbal tea can be a health promotion option in elders. Therefore the tea can be utilized as an effective intervention for the health of elders in health facilities.

• Journal of Neurocritical Care
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• v.11 no.2
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• pp.102-109
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• 2018

Background: A sians were known to have a relatively lower incidence of venous thromboembolism (VTE), and there is insufficient evidence to suggest a specific D-dimer threshold level for screening VTE in patients with acute stroke. Methods: We prospectively enrolled patients with acute ischemic stroke admitted to Jeju National University Hospital. The inclusion criteria were: 1) aged ${\geq}18$ years, 2) admission within seven days of symptom onset, and 3) an initial National Institute of Health Stroke Scale (NIHSS) score >1 for the affected lower limb. Ultrasound scans of the lower limbs and plasma D-dimer assays were performed on days 7-14 and 15-28 after stroke onset. Results: Of 285 patients admitted during the study period, 52 patients met inclusion criteria (mean age 74.5, male 40.4%, median initial NIHSS score 12, and unable to walk unassisted at discharge 76.9%). During 7-14 days, 23 of 52 patients (44.2%) had a D-dimer level above 1.57 mg/L, and 9.6% had a level above 5.50 mg/L. Proximal deep vein thrombosis (DVT) was detected in 3 patients (5.8%, 95% confidence Interval 1.2-16.0%) on ultrasound examination. All DVTs were found in elderly female patients with severe leg weakness. No patient was diagnosed with pulmonary embolism during the study period. Conclusion: The incidence of VTE seems to be very low among Korean patients with acute ischemic stroke. Advanced age, female sex, and severe leg weakness were important risk factors for developing DVT in this study.

• Korean Journal of Clinical Pharmacy
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• v.23 no.1
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• pp.42-48
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• 2013

Background: Patients diagnosed with cancer tend to have multiple risk factors for drug related problems such as old age, comorbid conditions, self-medication, additional medications for supportive therapy, and the cancer treatment itself. Objective: The aim of this study was to investigate notable polypharmacy and related problems in oncology patients during hospitalization or following clinic visit. Method: The electronic medical records of patients who were discharged from oncology division at Seoul National University Hospital (SNUH) from June $1^{st}$ to June $30^{th}$, 2011 were retrospectively reviewed. Results: A total of 334 discharged patients were included in this study. Among them, 221 patients had pre-admission medications. Forty percent of the patients, including 60.3% of elderly patients (over 65 years of age) were prescribed more than 5 kinds of medications. Twenty percent of the patients were prescribed to take medications more than 7 times a day. Medication duplications were observed in 2.4% of patients. In 10.5% of the reviewed patients, 47 cases of potential drug-drug interaction including 3 cases of contraindication and 17 cases of major clinical implication according to Micromedex were detected. Medication changes were made in 88% of patients during hospitalization and in 94.7% of patients at their first visit after discharge. Antidiarrheal agent (loperamide) was prescribed along with laxatives in 18.5% of the prescriptions and inadequate instructions on how to take it were observed in 63% of the prescriptions. Conclusion: This study identified the prevalence of polypharmacy and related problems in cancer patients, which presents the need for an active role of pharmacists in pharmaceutical care in oncology wards.

• Health Policy and Management
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• v.34 no.2
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• pp.196-210
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• 2024

Background: In January 2018, revised elderly fixed outpatient copayment for the elderly were implemented. When people ages 65 years and older receive outpatient treatment at clinic-level medical institutions (clinic, dental clinic, Korean medicine clinic), with medical expenses exceeding 15,000 won but not exceeding 25,000 won, their copayment rates have decreased differentially from 30%. This study aimed to examine the changes of health utilization of elderly after revised elderly fixed outpatient copayment. Methods: We used Korea health panel data from 2016 to 2018. The time period is divided into before and after the revised elderly fixed outpatient copayment. We conducted Poisson segmented regression to estimate the changes in outpatient utilization and inpatient utilization and conducted segmented regression to estimate the changes in medical expenses. Results: Immediately after the revised policy, the number of clinic and Korean medicine outpatient visits of medical expenses under 15,000 won decreased. But the number of clinic outpatient visits in the range of 15,000 to 20,000 won and Korean medicine clinic in the range of 20,000 to 25,000 won increased. Copayment in outpatient temporarily decreased. The inpatient admission rates and total medical expenses temporarily decreased but increased again. Conclusion: We confirmed the temporary increase in outpatient utilization in the medical expense segment with reduced copayment rates. And a temporary decrease in medical expenses followed by an increase again. To reduce the burden of medical expense among elderly in the long run, efforts to establish chronic disease management policies aimed at preventing disease occurrence and deterioration in advance need to continue.

• 한국노년학
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• v.37 no.1
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• pp.103-123
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• 2017

The purpose of this study is to explore the phenomenon in-depth with its context that what are changes of life in the older patients with social admission by applying the phenomenological research method, and to understand the essential meanings and structure of change experiences of life in elderly patients with social admission. The participants were 15 patients with chronic disease over 65 ages who were selected by convenience sampling. Data were collected through individual in-depth interviews from April to July 2016, and were analyzed using Colaizzi (1978)'s phenomenological analysis method. The essential meanings and structure of change experiences of life in the older patients with social admission were derived into six clusters of themes as follows: 'A lot of concerns are solved', 'New relationship', 'Life as a ordinary person that it looks nothing like a patient', 'The body and mind are comfortable', 'Fear of discharge','Social isolation'. The results of this study contributed to promoting a deeper understanding of change of life in older patients with social admission, and provided for the basic data of strategic approach in solving the social admission problem in long-term hospital.

• Tuberculosis and Respiratory Diseases
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• v.82 no.2
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• pp.118-125
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• 2019

Background: Lung cancer is a leading cause of morbidity and mortality worldwide, and the incidence continues to rise. Although many prognostic factors have been identified, the clinical characteristics and outcomes in Korean lung cancer patients are not well defined. Methods: Of the 23,254 new lung cancer cases registered at the Korea Central Cancer Registry in 2013, total 489 patients from 19 hospitals were abstracted by the Korean Central Cancer Registry. The clinical data retrospectively analyzed, patients were followed up until December 2015. Results: The median age was 69 years (interquartile range, 60-74 years); 65.4% were male and 62.1% were ever-smokers. Cough was the most common initial symptom (33.5%); 13.1% of patients were asymptomatic. While squamous cell carcinoma was the most common subtype in male patients (37.2%), adenocarcinoma was the most frequent histological type in all patients (48.7%) and females (76.3%). The majority of patients received treatment (76.5%), which included surgery, radiation therapy, and chemotherapy. Older age (hazard ratio [HR], 1.037), lower body mass index (HR, 0.904), ever-smoker (HR, 2.003), small cell lung cancer (HR, 1.627), and distant metastasis (HR, 3.990) were independent predictors of mortality. Patients without symptoms (HR, 0.387) and without treatment (HR, 0.364) were associated with a favorable outcome in multivariate Cox analysis. Conclusion: Lung cancer in Korea occurs predominantly in elderly patients, with adenocarcinoma being the most frequent subtype. The prognosis was poorer in ever-smokers and older, malnourished, and untreated patients with advanced lung cancer.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.10
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• pp.243-249
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• 2019

This study examined the patient's advantage and respect self-decision to protect human dignity and values, who are on the pathway of the hospice palliative care and death process. The study subjects were the elderly who had signed the advance medical directives at C Christian religious facilities in S region. The survey period was started on July 1st, 2019 and lasted for ten days. The study resulted in four topics and eight sub-topics on the motivation for preparing advanced medical directives. The four topics were 'for children', 'fear of pain', 'want to clear my life', 'felt the necessity', and the sub-topics were 'don't want to make a burden to children', 'don't want to make a worry of medical expenses', 'fear of pain', 'have experience of taking caring of painful death process', 'relaxed mind', 'importance of self-decision', 'have known it before but now decided', and 'it is the new information and decided'. This research is meaningful in that it can form the basis for improving well-dying education programs for the good death of the elderly and supplementing effective systems for preparing advance medical directives.

• Information Systems Review
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• v.20 no.2
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• pp.111-137
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• 2018

Considering the increase in health insurance benefits and the elderly population of the baby boomer generation, the amount consumed by health care in 2020 is expected to account for 20% of US GDP. As the healthcare industry develops, competition among the medical services of hospitals intensifies, and the need of hospitals to manage the quality of medical services increases. In addition, interest in online reviews of hospitals has increased as online reviews have become a tool to predict hospital quality. Consumers tend to refer to online reviews even when choosing healthcare service providers and after evaluating service quality online. This study aims to analyze the effect of sentiment score of healthcare service quality on hospital rating with Yelp hospital reviews. This study classifies large amount of text data collected online primarily into five service quality measurement indexes of SERVQUAL theory. The sentiment scores of reviews are then derived by SERVQUAL dimensions, and an econometric analysis is conducted to determine the sentiment score effects of the five service quality dimensions on hospital reviews. Results shed light on the means of managing online hospital reputation to benefit managers in the healthcare and medical industry.

• Journal of International Academy of Physical Therapy Research
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• v.5 no.2
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• pp.752-756
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• 2014

This study investigated the effects of changes to the pulsation factor of pulsed direct currents on wound healing. Patients with a pressure ulcer at a care hospital for the elderly were randomly divided into three groups: Group 1 involved the application of $100{\mu}s$ in pulse duration, 10 ms in pulse period, 100 pps in a pulsation factor, 15 mA in pulse amplitude, and polarity red+ by using pulsed direct currents; Group 2 involved a change of pulse period to 8 ms; and Group 3 received general wound management. Although there were no statistically significant differences in the changing stages of pressure ulcers among the groups, all the groups dropped in numerical stages. In the two groups to which pulsed direct currents were applied, there was a statistically significant reduction in the stages of pressure ulcers from the initial assessment to the 12-week assessment (p<.05). Even though there were no statistically significant differences in changes to the area of pressure ulcers among the groups, a statistically significant decrease was found in pulsed direct current group 2 whose pulse period was shortened (p<.05). There was no difference in the healing rate of pressure ulcers among the groups, but it made a numerical increase in pulsed direct current group 1 and group 2 and a numerical decrease in group 3. There were no significant differences in the characteristics of those who had a full recovery among the groups. Those findings indicate that pulsed direct currents have positive effects on the wound healing of patients with a pressure ulcer and that a treatment with pulsed direct currents whose pulsation factor is raised by reducing the pulse duration is especially effective.