• Korean Journal of Hospice Care
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• v.2 no.1
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• pp.58-74
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• 2002

This paper constitutes a descriptive investigation and used a structured questionnaire to investigate nurses' and doctors' recognition of cancer patients. The subjects were extracted from the medical personnel working at the internal medicine, the surgery ward, the obstetrics and gynecology department, the pediatrics department, the cancer ward, and the emergency room of five general hospitals located in Seoul and Gyeonggi Province. The research lasted from August, 2001 to September 2001. Total 137 nurses and 65 doctors were included and made out the questionnaires directly distributed by the investigator. The study tool was also developed by the investigator and consisted of such items as the demographic and social characteristics, the medical personnel's recognition degree of cancer and cancer patients, their recognition of the management of cancer patients, and their participation in a hospice. The results were analyzed using the SPSS Window program in terms of technological statistics, ranks, t-test, and ANOVA. The reliability was represented in Cronbach' α=.75. The nurses' and doctors' recognition degree of cancer and cancer patients had an overall average of 3.86 at the 5 point-scale. The items that received an average of 4.0 or more included 'Medical personnel should explain about the cancer cure plans to the cancer patient and his or her family', 'A patient whose case has been diagnosed as a terminal cancer should be notified of it, 'If I were a cancer patient, I would want to get informed of it,' and 'Cancer shall be conquered whenever it is'. In the meantime, the items that received an average of 3.0 or less was 'My relationship with the cancer patient's family has gotten worse since I announced his or her impending death.' And according to the general characteristics and the difference test, the recognition degree of cancer and cancer patient was high among the subgroups of nurses, females, married persons, who were in their 30s, who had a family member that was a cancer patient, and who received a hospice education. The biggest number of the nurses and doctors saw 'a gradual approach over several days'(68.8%) as a method to tell a cancer patient about his or her cancer diagnosis or impending death. Those who usually tell tragic news were the physician in charge(62.8%), the family members or relatives(32.1%) and the clergymen(3.8%) in the order. The greatest number of them recommended a cancer patient's home as the place where he or she should face death because they thought 'it would stabilize his or her mentality'(91.9%) while a number of them recommended the hospital because they 'should give the psychological satisfaction to the patient'(40%) or 'should try their best until the last moment of the patient's death'(30%). A majority of the medical personnel regarded 'smoking or drinking' and 'diet' as the causes of cancer. The biggest symptom of a cancer patient was 'pain' and the pain management of a cancer patient was mostly impeded by the 'excessive fear of drug addiction, tolerance to drugs and side effects of drugs' by medical personnel, the patient, and his or her family. The most frequently adopted treatment plan of a terminal cancer patient was 'to do whatever the patient or his or her family wants' to resort to a hospice' and 'to continue active treatment efforts' in the order. The biggest reasons why a terminal cancer patient went to see a doctor were 'pain alleviation' 'control of symptoms other than pain(intravenous supply)' and 'incapability of the patient's family' in the order. Terminal cancer patients placed their major concern in 'spiritual(religious) matter' 'emotional matters' their family' 'existence' and 'physical matters' in the order. 113(58.5%) of the whole medical personnel answered they 'would recommend' an alternative treatment to a terminal cancer patient mostly because they assumed it would 'stabilize the patient's mentality.' Meanwhile, 80(41.5%) of them chose 'not to recommend it mostly due to the unverified effects and high cost of it(78.7%). A majority of them, I. e. 190(94.1%) subjects said they 'would recommend' a hospice to a terminal cancer patient mostly because they thought it would help the patient to 'mentally prepare'(66.6%) Only 17.3% of them, however, had received a hospice education, most of which was done through the hospital duty education(41.4%) and volunteer training(34.5%). The follows are results of this study: 1. The nurses and the doctors turned out to be still passive and experience confusion in dealing with a cancer patient despite their great sense of responsibility for him or her. 2.Nurses and Doctors realize the need of a hospice, but an extremely small number of them participate in a hospice education or performance. Thus, a whole recognition of a hospice should be changed, for which purpose a hospice education for nurses and doctors should be provided. 3.Terminal cancer patients preferred their home to a hospital as the place to face their impending death because they felt it would bring 'mental stability.' And most of nurses and doctors think it would be unnecessary for them to be hospitalized just for control of their symptoms. Accordingly a terminal cancer patient can be cared at home, and a home hospice care needs to be activated.

• The Korean Journal of Blood Transfusion
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• v.29 no.3
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• pp.253-261
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• 2018

Background: A massive blood transfusion (MT) requires significant efforts by the Blood Bank. This study examined blood product use in MT and emergency O Rh Positive red cells (O RBCs) available directly for emergency patients from the Trauma Center in Ajou University Hospital. Methods: MT was defined as a transfusion of 10 or more RBCs within 24 hours. The extracted data for the total RBCs, fresh frozen plasma (FFP), platelets (PLTs, single donor platelets (SDP) and random platelet concentrates (PC)) issued from Blood Bank between March 2016 and November 2017 from Hospital Information System were reviewed. SDP was considered equivalent to 6 units of PC. Results: A total of 345 MTs, and 6233/53268 (11.7%) RBCs, 4717/19376 (24.3%) FFP, and 4473/94166 (4.8%) PLTs were used in MT (P<0.001). For the RBC products in MT and non-MT transfusions, 28.0% and 34.1% were group A; 27.1% and 26.0% were group B; 37.3% and 29.7% were group O, and 7.5% and 10.2% were group AB (P<0.001). The ratios of RBC:FFP:PLT use were 1:0.76:0.72 in MT and 1:0.31:1.91 in non-MT (P<0.001). A total of 461 O RBCs were used in 36.2% (125/345) of MT cases and the number of O RBCs transfused per patient ranged from 1 to 18. Conclusion: RBCs with the O blood group are most used for MT. Ongoing education of clinicians to minimize the overuse of emergency O RBCs in MT is required. A procedure to have thawed plasma readily available in MT appears to be of importance because FFP was used frequently in MT.

• Journal of Korean Academy of Nursing Administration
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• v.5 no.2
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• pp.297-316
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• 1999

The purpose of this study is searching for hemodialysis nursing bahaviors by hemodialysis room nurses and analyzing them. Then, it estimates hemodialysis nursing costs and obtains basic data for development of proper nursing costs. First, it searched for hemodialysis nursing behaviors at a tertiary hospital hemodialysis room in Seoul and classified them. After the content validity was verified by 6 experts, Tool of hemodialysis nursing behaviors was developed. patients who recived hemodialysis were classified by dialysis patient classification tool. The searcher observed hemodialysis nursing behaviors applied to classified patients per 5 minutes. Then hemodialysis nursing hours spent to classified patients were calculated respectively. The direct expenditures and indirect expenditures were estimated. Ultimately, hemodialysis nursing costs were estimated. The results of the study were as follows ; 1. hemodialysis nursing behaviors were grouped by the same knowledge and skills. then, the content validity of them was verified by evaluation tool of nursing intervention classification by expert groups. They consisted of 9 hemodialysis activity domains and 71 hemodialysis nursing behaviors. The predialysis activity domain included 15 nursing behaviors, the activity domain of start-dialysis included 12 nursing behaviors, the activity domain of during- dialysis included 9 nursing behaviors, the activity domain of finish-dialysis included 5 nursing behaviors, the activity domain of after-dialysis included 5 nursing behaviors, the nursing documentation & undertaking and transfering included 5 nursing behaviors, the supply, drug, equipment & environment management activity domain included 7 nursing behaviors, the patient emotional support & education activity domain included 4 nursing behaviors, the emergency activity domain included 9 nursing behaviors. 2. The acute hemodialysis nursing hours were 106.42 minutes per a dialysis and the chroni hemodialysis nursing hours were 72.23 minutes per a dialysis. 3. The direct expenditure was 11.971 won per hour and indirect expenditure was 288won. 4. Finally, the cost of acute hemodialysis was 21,745 won and that of chronic hemodialysis was 14,759 won. By search of hemodialysis nursing behaviors, they will be used as hemodialysis nursing care standard and will be tended toward high qualitative care. Estimation of hemodialysis nursing costs will be used as fundamental data for development of proper nursing costs.

• Journal of Hospice and Palliative Care
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• v.18 no.1
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• pp.16-24
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• 2015

Purpose: This study was conducted to describe and compare how emergency room (ER) nurses and coroners perceive good death and their attitudes toward death. Methods: A survey was performed with 51 ER nurses in P city and 44 coroners nationwide. Data were collected from October 1, 2010 through February 28, 2011. Data were analyzed with descriptive statistics, t-test, ANCOVA, Scheffe's test using the IBM SPSS statistics 21.0 program. Results: For the perception of good death and attitudes toward death, coroners scored higher ($3.01{\pm}0.43$ and $2.87{\pm}0.35$, respectively) than ER nurses group ($2.95{\pm}0.40$ and $2.61{\pm}0.33$, respectively), but the differences were not significant. The results of perception of good death and attitudes toward death were not statistically significant between ER nurses and coroners. Conclusion: The study showed no difference between ER nurses' perception of good death and attitudes toward death and those held by coroners. The findings of the study show that it is necessary to offer steady education on death to nurses and coroners to help them build a proper understanding of good death and grow positive attitudes toward death.

• Journal of agricultural medicine and community health
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• v.44 no.4
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• pp.195-208
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• 2019

Objectives: The purpose of this study was to analyze whether there are differences in medical expenses according to medical security type in the use of medical services with high disease burden such as coronary intervention. Methods: Chi-square test and covariance analysis(ANCOVA) were conducted to identify the differences in the characteristics and costs according to medical security type of 1,904 patients who underwent coronary intervention in a university hospital from 2011 to 2012. Hierarchical regression analysis was conducted to determine whether the cost affects medical expenses. Results: In the medical aid group, the proportion of women, those without a job, those without a spouse, and those who received hemodialysis was high, length of stay was high, patients using the emergency room and those who died was high. The medical aid patients were significantly higher in the non-benefit medical expenses, optional medical expenses, physician and admission, meals, medications and injections. National health insurance patients were significantly higher in procedure. The medical security type was found to be significant as a variable affecting the medical expenses. Conclusions: Provision of medical expenses should be managed in advance by providing prevention and education services for the vulnerable, and care services in the region should be provided to suppress the occurrence of medical expenses due to the increase in the number of days spent. In addition, it is necessary to support medical expenses to prevent unsatisfactory medical services from occurring for non-benefit and optional care.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.2
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• pp.788-794
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• 2011

The purpose of this study was to investigate the correlation between regular mealtime, oral health knowledge and oral health to prevent dental impairment of college students. This research design is correlation study. Data of 903 were collected from June 1 to June 30, 2010. Data were analyzed using the SPSS PASW Statistics 18.0 Program. More than 50% of respondents were the irregular mealtime. Higher percentage of correct answer in the oral health knowledge showed periodontal disease prevention(82.6%). There were a statistical significant in grade, major, smoking, drinking, and wishing for dental care between general characteristics and regular mealtime respectively(p<.05). Between general characteristics and oral health knowledge were a statistical significant in gender, age, grade, smoking, and dental checkup respectively(p<.05). On the other hand, there was a statistical significant wishing for dental care between general characteristics and oral health(p<.001). Regular mealtime was negatively associated with oral health(p<.01). Education for oral health should include regular mealtime, prohibit of smoking and alcohol, right toothbrushing and so on.

• Journal of dental hygiene science
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• v.12 no.4
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• pp.404-412
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• 2012

The main object of this study is to render a better dental education to mental disabilities, teachers, and their parents. By providing a better dental education to them, mental disabilities would understand the importance of their oral hygiene. The study was held in Seoul at two different locations, named H and E mental welfare facilities. Ninety Three mental disabilities were studied by observing their oral behavior, simple oral hygiene index and plaque index prior and post to dental education. At the end of education, following result were gathered from two mental facilities. First, the level of oral behavior in Class 1,2, and 3 mental disabilities were observed prior and post to the dental education. Overall, there was no significant difference among Class 1 mental disabilities with the dental education. Second, in simple oral hygiene index, the severity of mental illness has affected on their oral behavior (F=6.322, p<.001). Third, in simple oral hygiene index, the frequency of dental education, regardless of severity of mental illness has affected on their oral hygiene (F=5.961, p<.01). Fourth, the plaque index also illustrated that the frequency of dental education, regardless of severity of dental illness has affected on their oral hygiene (F=5.126, p<.05). Finally, the general characteristics of mental disabilities according to changes in oral health awareness to gender, age, disability type, educational level do not statistically significant in all variables. Their simple oral hygiene index and plaque index advanced, although after a while they started to lose focus, which brought back their old habits. Nevertheless, in conclusion I believe that helping mental disabilities more frequently to constant reminder, will not only keep them entertained, but help them realize how important oral hygiene practice is, hopefully increasing and benefiting those with mental disabilities for future reference.

• Korean Journal of Occupational Health Nursing
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• v.10 no.2
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• pp.174-182
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• 2001

This study was performed to find out the differences between noise levels of hospital wards and the nurses efforts for noise management in some general hospitals. The hospital wards selected were the intensive care unit(ICU), the emergency room(ER), the nursery room(NR), the internal medicine(IM), the general surgery(GS) among the 5 general hospitals located in Seoul. The data were collected from August 3 to September 13, 1999 through questionnaire survey and noise measurement in each nursing station of hospital wards. Data analysis was done by SPSS 8.0 package among the 305 questionnaires and 24 hours monitored noise levels. Frequency, Chi-square and ANOVA test were used. The study results were as belows: 1. The noise level measured by 24 hours monitoring survey were exceeded on the standard limit in all the hospital wards. Data also showed that noise levels were significantly different in each ward among the three shifts working duties. 2. The subjects were all female nurses. They were mostly working in the ICU ward(28.9%). They were 26~30 years old (43.9%), junior college graduates(57.0%), working for 1~5 years(55.1%) as staff-nurse(85.6%). There were no significant differences between hospital wards and general characteristics of nurses. 3. The noise levels perceived by nurses were regarded as 'Highly noisy'(56.4%), especially during the 11:30 and 15:30 (30.2%) o'clock. Data also showed that noise education was not ever given to nurses(89.9%). Nurses also responded that they hardly put an effort to reduce noise level(54.8%). However, there were significant differences between wards and noisy working time, experience of noise education and level of effort for noise reduction. 4. Nurses also perceived the ventilator alarm and EKG-alarm as the most disturbing sounds in the ICU, human voice and telephone ringing in the ER, human voice and EKG-alarming in the NR, human voices and telephone ringing in IM and GS both wards respectively in order. There were significant differences between hospital wards and noise making factors. 5. Nurses were shown that they regarded highly 'Sound reduction of the human voice', 'Careful handling on medical instruments', and 'Immediate appliances on alarming materials' as the practical method for noise management. There were significant differences between hospital wards and behavioral practical efforts for noise management. According to that results, the statistical differences were shown in the 24 hour monitored noise levels in each ward. Also, nurses perceived the noise severity differently and they approached variously on the practical efforts for noise reduction in each ward. Thus, author thinks that concrete and systematic endeavor will be necessary for noise reduction and management in hospitals for better working and healing environment for both of patients and staffs.

• Journal of Korean Society of Rural Planning
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• v.25 no.1
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• pp.113-125
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• 2019

The purpose of this study is to provide the demand information about services (S/W) and infrastructure (H/W) for rural welfare and culture. The survey was conducted on the overall satisfaction level, the condition change, the importance-satisfaction level of each field and the top priority items for administrative agencies and rural residents. In the overall satisfaction level, administrative agencies responded more than 'normal' to all fields, but the overall satisfaction level was lower than 'normal' in the fields excluding the healthcare field in the case of rural residents. In terms of condition changes compared to the past five years, both administrative institutions and local residents evaluated the improvement. IPA analysis was conducted to identify the priority ranking of each field and it was found that emergency medical facilities in the healthcare field, infant day care facilities in the social welfare field, movie theaters in the culture field, lifelong education institutions and academy facilities in the education field and private sports facilities in the leisure and sports field were most needed, respectively. The results of this study are expected to be helpful in increasing the efficiency and presenting the improvement direction about the development policy of the rural culture and welfare.

• The Journal of Korean Society for School & Community Health Education
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• v.20 no.2
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• pp.69-80
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• 2019

Objectives: In this study, we tried to analyze the factors affecting Length Of Stay for serious patients in Republic of Korea. Methods: The study included 139,172 serious patients in the 2012-2016 discharge details. Using the SPSS 23.0 program, we conducted a rank regression analysis with social and social demographic characteristics as control variables, medical institution characteristics and medical use characteristics as independent variables, and Average Length Of Stay as a dependent variable. Results: Average Length Of Stay for participants was found to be 9.92days. And the location and bed size of medical institutions were not statistically significant, the hospitalization path was more urgent(B=0.43) than the outpatient (p<0.001), and there was no secondary diagnosis(B=0.35). However, Average Length Of Stay was higher (p<0.001) than there was no main surgery(B=0.80). After discharge, Average Length Of Stay for funding(B=0.43) and death(B=0.72) was long (p<0.001). Average Length Of Stay for participants was found to be 9.92days. And the location and the bed size of the medical institution were not statistically significant, and the hospitalization pass had longer Length Of Stay for emergency patients(B=0.43) than for outpatients(p<0.001). There was a longer Length Of Stay(B=0.35) than none was diagnosed. There were longer Length Of Stay(p<0.001) than there was no major surgery(B=0.80). After discharge, the outpatients had longer Average Length Of Stay(B=0.43) and deaths(B=0.72) than those who returned home(p<0.001). Conclusion: As a result of analyzing the factors affecting Average Length Of Stay of the participants, it was confirmed that regardless of the location and bed size of medical institutions, hospitalization route, department diagnosis, main surgery, and whereabouts after discharge. Therefore, appropriate interventions and necessary support must be provided so that efficient Length Of Stay can be managed according to the medical use characteristics of serious patient.