• Health Communication
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• v.13 no.2
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• pp.159-166
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• 2018

Background: It is important to investigate patient satisfaction to improve the quality of healthcare. Among the many factors that affect patient satisfaction, perceived health status has been considered as one of the major factors. Therefore, we investigated patient satisfaction through patient experience in outpatient settings according to perceived health status. Methods: This cross-sectional study using questionnaires of patient experience and perceived health status from the Korean National Health and Nutrition Examination Survey 2015 included 4267 people aged over 19 years who met the inclusion criteria. Perceived health status was classified into three: good, fair, and poor. Questions about patient experience consisted of four items: doctor spending enough time with patients, doctor providing easy-to-understand explanation, doctor giving opportunity to ask questions or raise concerns, and doctor involving patient in decisions about care or treatment. Patient experience was classified into two: satisfied and non-satisfied. A multivariate regression model was used to analyze the data. Results: In the good perceived health status group, level of satisfaction was 79.2%, 88.5%, 83.3% and 87.2%, respectively for the four items targeting patient experience. In the poor group, level of satisfaction was 76%, 84.9%, 79.5%, and 83.1%, respectively for the four items. In multivariate logistic regression analyses, the odds ratios of good perceived health status group were 1.775 (1.347-2.338), 1.946 (1.356-2.793), 1.652 (1.218-2.240), and 1.665 (1.193-2.323) compared with the poor group. Conclusion: Perceived health status is associated with patient satisfaction. In particular, the better the perceived health status, the better the patient satisfaction through patient experience.

• Journal of Korean Neurosurgical Society
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• v.65 no.1
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• pp.57-63
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• 2022

Objective : To study the factors relating to operative treatment for spinal metastasis in Thailand during 2005-2014 and to determine the hospital costs, mortality rate, and incidence of perioperative complication. Methods : Inpatient reimbursement data from 2005 to 2014 was reviewed from three national healthcare organizations, including the National Health Security Office, the Social Security Office, and the Comptroller General's Department. The search criteria were secondary malignant neoplasm of bone and bone marrow patients (International Classification of Diseases 10th revision, Thai modification codes [ICD 10-TM], C79.5 and C79.8) who underwent spinal surgical treatment (ICD 9th revision, clinical modification procedure with extension codes [ICD 9-CM], 03.0, 03.4, 03.09, and 81.0) during 2005-2014. Epidemiology, comorbidity, and perioperative complication were analyzed. Results : During the study period, the number of spinal metastasis patients who underwent operative treatment was significantly increased from 0.30 to 0.59 per 100000 (p<0.001). More males (56.14%) underwent surgical treatment for spinal metastasis than females. The most common age group was 45-64 (55.1%). The most common primary tumor sites were the unknown origin, lung, breast, prostate, and hepatocellular/bile duct. Interestingly, the proportion of hepatocellular/bile duct, breast, and lung cancer was significantly increased (p<0.001). The number of patients who had comorbidity or in-hospital complication significantly increased over time (p<0.01); however, the in-hospital mortality rate decreased. Conclusion : During the last decade, operative treatment for spinal metastasis increased in Thailand. The overall in-hospital complication rate increased; however, the in-hospital mortality rate decreased.

• Journal of Korean Physical Therapy Science
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• v.28 no.3
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• pp.11-29
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• 2021

Background: The purpose of this study is to investigate the effects of virtual reality on gait, balance, and upper extremity functions compared to other independent variables or no variables. Additionally, the possibility of virtual reality for stroke patients was discussed. Design: Meta-analysis. Methods: The search for this study was a search term that combined stroke, virtual reality, and training, and the electronic search was conducted through EMBASE, MEDLINE, and Cochrane Library. As a result of the search, 21 studies satisfying the selection criteria of the target study were confirmed as the final analysis target. This study consisted of 21 randomized experimental studies and 21 randomized controlled trials, and the total number of participants was 642. [Experimental group (n=314), control group (n=328); total 642]. As a result of the study, upper extremity function was assessed using a box and block test, a modified Ashworth scale, and a scale including range of motion. The balance was evaluated by the berg balance scale. Gait was a Timed Up and Go test (TUG), stride length, and gait function. Scales including a walking rate scale were evaluated. The effect size for the intervention of the analytical study was meta-analyzed with the RevMan 5.3.3 program of the Cochrane library. Results: The results of the study showed that the function of walking was statistically significant. Balance showed statistically significant results. The upper extremity function showed no statistically significant results. Conclusion: Through this rehabilitation treatment by applying virtual reality environment to the rehabilitation of stroke patients in the future can be proposed as an effective intervention method for the balance and gait function of stroke patients.

• Journal of Oriental Neuropsychiatry
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• v.33 no.4
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• pp.361-376
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• 2022

Objectives: To understand experiences of daily life and Korean medicine treatment process and perspectives of caregivers caring for children with tic disorder. Methods: A semi-structured interview was conducted with caregivers of patients under 13 years who were experiencing Korean medicine treatment for tic disorder. A total of five participants were interviewed. The analysis was performed according to a four-step phenomenological method. Results: The following four components were derived from the experience of caring for children with tic disorder: general perception of tics, negative emotions caused by tics, social deprivation, and living with a child with tics. The following four components were derived from Korean medicine treatment experience for tic disorders: criteria for selecting treatment, awareness of Korean medicine, treatment experience in Korean medicine, and what needs to be improved. Conclusions: According to results of this study, caregivers caring for children with tic disorder experienced negative emotions such as frustration, guilt, and anxiety. They also experienced social deprivation such as stigma and prejudice. Korean medicine treatment can be an effective alternative for improving symptoms of tic disorders. The application of insurance benefits to Korean medicine is needed for patients and caregivers to autonomously choose treatment.

• Nutrition Research and Practice
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• v.16 no.6
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• pp.801-812
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• 2022

BACKGROUND/OBJECTIVES: Diet planning in childcare centers is difficult because of the required knowledge of nutrition and development as well as the high design complexity associated with large numbers of food items. Artificial intelligence (AI) is expected to provide diet-planning solutions via automatic and effective application of professional knowledge, addressing the complexity of optimal diet design. This study presents the results of the evaluation of the utility of AI-generated diets for children and provides related implications. MATERIALS/METHODS: We developed 2 AI solutions for children aged 3-5 yrs using a generative adversarial network (GAN) model and a reinforcement learning (RL) framework. After training these solutions to produce daily diet plans, experts evaluated the human- and AI-generated diets in 2 steps. RESULTS: In the evaluation of adequacy of nutrition, where experts were provided only with nutrient information and no food names, the proportion of strong positive responses to RL-generated diets was higher than that of the human- and GAN-generated diets (P < 0.001). In contrast, in terms of diet composition, the experts' responses to human-designed diets were more positive when experts were provided with food name information (i.e., composition information). CONCLUSIONS: To the best of our knowledge, this is the first study to demonstrate the development and evaluation of AI to support dietary planning for children. This study demonstrates the possibility of developing AI-assisted diet planning methods for children and highlights the importance of composition compliance in diet planning. Further integrative cooperation in the fields of nutrition, engineering, and medicine is needed to improve the suitability of our proposed AI solutions and benefit children's well-being by providing high-quality diet planning in terms of both compositional and nutritional criteria.

• Physical Therapy Korea
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• v.30 no.1
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• pp.15-22
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• 2023

Background: Delivery workers repeatedly get in and out of trucks and walk or run to deliver packages during work. Iliotibial band syndrome (ITBS) is a well-known non-traumatic overuse injury of the lateral side of the knee caused by frequent knee flexion and extension. Hip muscle strength is among the factors that prevent lower extremity injuries. Although many studies have examined the relationship between ITBS and hip muscle strengths, there was no study comparing hip muscle strength and ratio between delivery workers with and without ITBS. Objects: This study aimed to compare hip muscle strength and hip internal/external rotator and adductor/abductor strength ratios between delivery workers with and without ITBS. Methods: Fourteen delivery workers with ITBS matched inclusion criteria in the present study among 20 participants. Because total sample size was required 28 subjects by G*power program (ver. 3.1.9.4; University of Trier), 14 delivery workers without ITBS were recruited. Hip muscle strengths were measured in a side-lying position using a Smart KEMA pulling sensor (KOREATECH Co. Ltd.). An independent t-test was used to compare hip muscle strengths and hip internal/external rotator and hip adductor/abductor strength ratios between delivery workers with and without ITBS. Results: The adductor/abductor strength ratio was significantly greater in delivery workers without ITBS than in those with ITBS (p < 0.05). The strengths of the hip abductor, hip adductor, hip internal rotator, hip external rotator, and the ratio of internal/external rotator strengths were not significantly different between the delivery workers with and without ITBS (p > 0.05). Conclusion: This study's findings showed that delivery workers with ITBS had significantly lesser adductor/abductor strength ratio, while the strengths of the hip abductor and adductor muscles did not differ significantly. These results suggest that adductor/abductor strength ratio should be considered when evaluating and treating ITBS in delivery workers.

• The Journal of Korean Medicine
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• v.43 no.4
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• pp.102-130
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• 2022

Objectives: The persistence and unpredictability of coronavirus disease (COVID-19) and new measures to prevent direct medical intervention (e.g., social distancing and quarantine) have induced various psychological symptoms and disorders that require self-treatment approaches and integrative treatment interventions. To address these issues, the Korean Medicine Mental Health (KMMH) center developed a field manual by reviewing previous literature and preexisting manuals. Methods: The working group of the KMMH center conducted a keyword search in PubMed in June 2021 using "COVID-19" and "SARS-CoV-2". Review articles were examined using the following filters: "review," "systematic review," and "meta-analysis." We conducted a narrative review of the retrieved articles and extracted content relevant to previous manuals. We then created a treatment algorithm and recommendations by referring to the results of the review. Results: During the initial assessment, subjective symptom severity was measured using a numerical rating scale, and patients were classified as low- or moderate-high risk. Moderate-high-risk patients should be classified as having either a psychiatric emergency or significant psychiatric condition. The developed manual presents appropriate psychological support for each group based on the following dominant symptoms: tension, anxiety-dominant, anger-dominant, depression-dominant, and somatization. Conclusions: We identified the characteristics of mental health problems during the COVID-19 pandemic and developed a clinical mental health support manual in the field of Korean medicine. When symptoms meet the diagnostic criteria for a mental disorder, doctors of Korean medicine can treat the patients according to the manual for the corresponding disorder.

• Korean Medical Education Review
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• v.26 no.2
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• pp.93-107
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• 2024

Interprofessional education (IPE) is relatively new in medical schools in South Korea. Since the introduction of IPE in 2022, its effective and sustainable implementation has been of great interest in medical schools. This study analyzed literature on the development of IPE in the United States, Canada, the United Kingdom, Australia, and Japan to explore strategies for successful IPE in Korean medical schools. A systematic literature search focused on institutionalizing IPE yielded 30 papers for review. The findings included the following crucial elements for effective IPE: (1) government or institutional-led support; (2) establishment of networks and partnerships; (3) development of standardized core competency frameworks for IPE; and (4) inclusion of IPE in accreditation standards. These aspects underscore the importance of IPE as an essential component of health professional education that should be effectively and sustainably implemented in academic settings. The study concludes that the successful integration and sustainable development of IPE in Korean health education will necessitate expanded and proactive governmental support. Moreover, promoting collaborations among universities, hospitals, and local healthcare institutions will be vital for creating synergies in implementing IPE programs. Establishing networks to develop and execute joint IPE initiatives and securing initial support for conceptualizing and developing competency frameworks will be critical. Additionally, forming consortia of healthcare accreditation bodies to collaboratively develop and incorporate IPE standards into evaluation criteria will be essential. Efforts to surmount these challenges will contribute to building a structural and institutional support system for the successful introduction and sustainability of IPE in Korea.

• The Journal of Korean Obstetrics and Gynecology
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• v.24 no.4
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• pp.105-113
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• 2011

Objectives: To examine the current status of clinical research in oriental medicine, and to assess 'risk of bias'(ROB) of randomized clinical trials(RCTs) in oriental medicine in Korea. Methods: Special committee for EBM, KOMS(Korean Oriental Medicine Society) reviewed 17 journals related to oriental medicine in Korea (from the first issue to May 2010), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 2, 2010), and PubMed (1966 to May 2010). Then we selected eligible RCTs in terms of oriental medicine, and assessed 'risk of bias'. Results: We reviewed 12,653 articles from the 17 journals, and 41 articles from CENTRAL and PubMed. After non-clinical articles were excluded, 1,004 articles were left. Among them, the number of eligible studies in terms of oriental medicine was 306. In these eligible studies, 130 were RCTs. Of RCTs, 69 were on acupuncture, 25 on herbal medicine. The proportion of 'unclear' is high in the criteria of 'Allocation concealment', 'Blinding of participants and personnel', 'Blinding of outcome assessment' and 'Other bias'. On the other hand, 'low' has high in the criteria of 'Incomplete outcome data' and 'Selective reporting'. Conclusions: Risk of bias on oriental medicine is unclear in terms of 'allocation concealment' and 'blinding'. For high-quality research in oriental medicine, further research should be needed on randomization and blinding in the RCTs.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.27 no.4
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• pp.206-214
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• 2024

Purpose: Few studies have reported the prevalence of inflammatory bowel disease unclassified (IBDU) among Korean pediatric IBD (PIBD) population. To address this gap, we used two tertiary centers and nationwide population-based healthcare administrative data to estimate the prevalence of Korean pediatric IBDU at the time of diagnosis. Methods: We identified 136 patients aged 2-17 years with newly diagnosed IBD (94 Crohn's disease [CD] and 42 ulcerative colitis [UC]) from two tertiary centers in Korea between 2005 and 2017. We reclassified these 136 patients using the revised Porto criteria. To estimate the population-based prevalence, we analyzed Korean administrative healthcare data between 2005 and 2016, which revealed 3,650 IBD patients, including 2,538 CD and 1,112 UC. By extrapolating the reclassified results to a population-based dataset, we estimated the prevalence of PIBD subtypes. Results: Among the 94 CD, the original diagnosis remained unchanged in 93 (98.9%), while the diagnosis of one (1.1%) patient was changed to IBDU. Among the 42 UC, the original diagnosis remained unchanged in 13 (31.0%), while the diagnoses in 11 (26.2%), 17 (40.5%), and one (2.4%) patient changed to atypical UC, IBDU, and CD, respectively. The estimated prevalences of CD, UC, atypical UC, and IBDU in the Korean population were 69.5%, 9.4%, 8.0%, and 13.1%, respectively. Conclusion: This study is the first in Korea to estimate the prevalence of pediatric IBDU. This prevalence (13.1%) aligns with findings from Western studies. Large-scale prospective multicenter studies on PIBDU are required to examine the clinical features and outcomes of this condition.