• Title/Summary/Keyword: Healthcare Criteria

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A Case Study of Home Health Care for Postpartum Women and their Newborns (산욕부와 신생아의 가정간호 사례연구)

  • Jun, Eun-Mi
    • 모자간호학회지
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    • v.4 no.1
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    • pp.3-11
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    • 1994
  • Presently there is an increasing demand for home health care services due to changes in the demographic structure as a result of an increasing elderly population, socio-economic improvements, and changes in the family structure, as well as the growing number of people with degenerative diseases. In addition to these reasons, rising medical costs and there a shortage of patient beds space in the hospital, particularly since introduction of national medical insurance. There has been an increasing demand for health care health care services. This study was done to identify the basic data for home health care management. It focused on developing client selection criteria, assessment tools, and recording methods. This was accomplished by the researchers visiting the patients in their homes. The research process included preparation investigation, tool development, training of the project researcher, and visiting the clients in their homes. The research tools are as follows : 1. Record development : a) The selection criteria tool for home health care of postpartum women was a structured tool and consisted of four parts. b) The structured assessment tool consisted of a general items, obstetric history, past medical history, methods of feeding, medications taken before admission, laboratory test results, discharge instructions, discharge medications, family tree, economic status, environmental status, a map, health assessment of postpartum women and their newborns. c) The visit note I consisted of the frequency of visits. Visit note II consisted of the date ; nursing problems ; nursing process including the initial assessment ; nursing goal ; visit plan ; postpartum women and their neonate health status, diagnosis, goal, implementation, evaluation, summary, next plan, for visit revision. d) Problem note consisted of the date, problem numbers, nursing diagnosis, problem appearance date problem resolution date. The research results are as follows : 1. Nursing problems : The nursing problems of the postpartum women and their neonates were evaluated by the number of nursing diagnoses and the change in the pattern of nursing diagnosis related to the number of visits. a) Nursing diagnosis The nursing diagnosis was classified according to physical function, psychosocial function, family system maintained function. b) The changes of nursing diagnosis related to the number of visits. As the type of nursing diagnosis changed related to the number of visits the number of nursing diagnoses decreased. 2. Contents of home health care : The content was categorized according to assessment, direct care, counseling, education, family care, reporting to with the attending doctor. The recommendations based on the research results are as follows : 1. Tool development Replication of this study is needed to test the validity of the assessment tools used. 2. Home visit a) Home health care nurses should be licensed and qualified. A referral form from the attending doctor is needed for legal protection of nurses. b) The first home visit need to be within 24 hours of discharge from the hospital to decrease the anxiety of frightened postpartum women. c) When the changes occur in the newborn's status, home health care nurses should consult a pediatrician. Communication within the home healthcare team is essential and needs to consistent and done smoothly. 3. Home health care A Study is required to develop protocols for education of staff and for operation of all aspects of this program.

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Evaluation of Information Consistency of Clinically Significant Drug Interactions in Tyrosine Kinase Inhibitors (타이로신키나아제 억제제의 임상적으로 유의한 약물상호작용 정보 일관성 분석)

  • An, Seulki;Lee, Ju-Yeun;Ah, Young-Mi
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.1
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    • pp.44-50
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    • 2020
  • Background: Drug-drug interactions (DDIs) in patients using oral anticancer treatment are more common than in those using injectable anticancer agents. In addition, DDIs related to anticancer treatment are known to cause clinically significant outcomes, such as treatment failure and severe toxicity. To prevent these negative outcomes, significant DDIs are monitored and managed using the information provided in drug databases. We aimed to evaluate the consistency of information on clinically significant DDIs for tyrosine kinase inhibitors (TKIs) between representative drug databases. Methods: We selected clinically significant DDIs involving medications that are co-prescribed with TKIs and met the following criteria: the severity level of DDIs was equal or greater than "D" in Lexicomp® or "major" in Micromedex®. We then analyzed the consistency of the severity classification and evidence level between the drug databases. Spearman's correlation coefficient was used to identify the relationship between DDI information in the drug databases. Results: In total, 627 DDI pairs were identified as clinically significant; information on these was provided by Lexicomp® and Micromedex® for 571 and 438 pairs, respectively, and both drug databases provided information on 382 DDI pairs. There was no correlation between the severity and evidence level of DDIs provided in the two databases; Spearman's correlation coefficient for Lexicomp® and Micromedex® was -0.009 (p=0.861) and -0.064 (p=0.209), respectively. Conclusion: To judge the significance of DDIs, healthcare providers should consider that the information on DDIs may be different between drug information databases; hence, clinical factors must be considered concurrently.

Priority Areas for National Health Care Quality Evaluation in Korea (의료의 질 평가 우선순위 설정)

  • Shin, Suk-Youn;Park, Choon-Seon;Kim, Sun-Min;Kim, Nam-Soon;Lee, Sang-Il
    • Health Policy and Management
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    • v.19 no.3
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    • pp.1-26
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    • 2009
  • Objectives : To identify target areas and set priorities among those areas identified for national quality evaluation. Methods : Target areas were identified from: i) analysis of the national health insurance claims data, mortality and prevalence data ii) various group surveys, including representatives from 22 medical specialty associations, 19 physician associations, QI staffs in hospital, civil organizations, and commissioners of Health Insurance Review and Assessment Service(HIRA) ⅲ) literature reviews and RAM(RAND/UCLA appropriateness method). The priority areas for national quality evaluation represented the full spectrum of health care and the entire life span. The criteria for selecting the priority areas were impact, improvability, and measurability. The priority areas were divided into three categories : short-term, mid-term, long-term. Results: Based on the group surveys and the data analysis, 46 candidates were selected as quality evaluation priority areas. 13 areas were selected as having a short-term priority areas: tuberculosis, community acquired pneumonia, stroke, ischaemic heart disease, diabetes, hypertension, chronic lower respiratory disease(asthma, chronic obstructive pulmonary disease), intensive care unit, emergency room, nosocomial infection, use of antibiotics, multiple medication and renal failure. This results suggested that we need to enlarge the target priority areas to the chronic diseases in short-term. Conclusions: The priority areas identified from the study will assist healthcare quality associated institutions as well as HIRA in selecting quality evaluation areas. It is required to develope and implement strategies for improving the quality of care within the next 5 years.

Association between Dietary Habits and Self-rated Health According to Sasang Constitution (사상체질에 따른 식습관과 주관적 건강상태와의 연관성)

  • Jeong, Kyoungsik;Kim, Hoseok;Lee, Siwoo;Baek, Younghwa
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.34 no.1
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    • pp.53-59
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    • 2020
  • Dietary habits are known to be closely related not only to chronic diseases such as cardiovascular disease and diabetes, but also to self-rated health (SRH). Consequently, there is a highly important lifestyle component in maintaining a healthy life. The aim of the present study was to determine the correlation between diverse dietary habits based on the Sasang constitutions (SC) and SRH. The data were collected from 2,984 participants who met the constitution pharmacology criteria and whose SC were clinically confirmed by SC professionals. Dietary habits were observed by assessing the regularity of diet, meal volume, and meal speed; single-answer questions were used for SRH. Fisher's exact/chi-square test and logistic regression were used to analyze the correlation between dietary habits depending on constitutional type and SRH. In association with constitutional SRH, the Taeum type is related to the amount of meal, the Soeum and Soyang types are related to the regularity of meal and meal volume. In the Taeum type, there was a significantly higher risk of lower SRH when meal volumes were irregular less than previous amounts. Irregular diet, as well as increased or decreased meal volume, negatively correlated with SRH in the Soeum type; in the Soyang type, irregular diet and decreased or irregular meal volume negatively affected SRH. This showed the presence of the different effects of dietary habits on health depending on constitution and also confirmed the association of the regularity of diet and meal volume based on constitution and the frequency of bad dietary habits with SRH. We suggest that personalized healthcare with adequate dietary improvement considering constitution is needed for health management or improvement.

Convergence Effect of Virtual Reality Program on Activities of Daily Living Ability in Stroke Patients : Meta-Analysis (가상현실 프로그램이 뇌졸중 환자의 일상생활활동 능력에 미치는 융합적 효과 : 메타분석)

  • Choi, Ki-Bok;Cho, Sung-Hyoun
    • Journal of the Korea Convergence Society
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    • v.11 no.8
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    • pp.63-70
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    • 2020
  • This study was designed to test the convergence effectiveness of virtual reality programs for patients with stroke by using meta-analysis. Based on the PICOS criteria, we searched domestic literature and selected the final 9 studies in relation to 'stroke' and 'virtual reality programs'. Evaluation of the risk of bias in individual studies was conducted using evaluation tools according to the design of each study. The effect size of the meta-analysis was calculated using CMA program. The mediating effect analysis was conducted by sub-group analysis and meta-regression analysis. The overall effect size of the virtual reality program on the activities of daily living ability was Hedges's g=0.302(95% CI: 0.064~0.540), Therefore, virtual reality programs can increase the activities of daily living in stroke patients and have a positive impact on the medical industry that the convergence of virtual reality industry and healthcare industry.

Older Adults' Perception of Chronic Illness Management in South Korea

  • Kang, Minah;Kim, Jaiyong;Bae, Sang-Soo;Choi, Yong-Jun;Shin, Dong-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.47 no.4
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    • pp.236-243
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    • 2014
  • Objectives: Despite the recent emphasis on a patient-centered chronic care model, few studies have investigated its use in older adults in South Korea. We explored how older Korean adults perceive and cope with their chronic illness. Methods: We conducted focus group interviews in Seoul, Korea in January 2010. Focus groups were formed by disease type (hypertension and type 2 diabetes) and gender using purposive sampling. Inclusion criteria were patients aged 60 and over who had been diagnosed with diabetes or hypertension and received care at a community health center for at least six months prior to participation. Interview data were analyzed through descriptive content analysis. Results: Among personal factors, most participants felt overwhelmed when they received their diagnosis. However, with time and control of their acute symptoms using medication, their worry diminished and participants tended to denying being identified as a patient or sick person. Among socio-familial factors, participants reported experiencing stigma with their chronic illness and feeling it was a symbol of weakness. Instead of modifying their lifestyles, which might interfere with their social relationships, they resorted to only following their medicine regime prescribed by their doctor. Participants also reported feeling that their doctor only prescribed medications and acted in an authoritative and threatening manner to induce and reinforce participants' compliance with treatment. Conclusions: For successful patient-centered management of chronic illnesses, supportive environments that include family, friends, and healthcare providers should be established.

Therapeutic alternatives in painful diabetic neuropathy: a meta-analysis of randomized controlled trials

  • Vilar, Samuel;Castillo, Jose Manuel;Martinez, Pedro V. Munuera;Reina, Maria;Pabon, Manuel
    • The Korean Journal of Pain
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    • v.31 no.4
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    • pp.253-260
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    • 2018
  • Background: One of the most frequent problems caused by diabetes is the so called painful diabetic neuropathy. This condition can be treated through numerous types of therapy. The purpose of this study was to analyze, as a meta-analysis, different treatments used to alleviate painful diabetic neuropathy, with the aim of generating results that help making decisions when applying such treatments to tackle this pathology. Methods: A search was conducted in the main databases for Health Sciences, such as PUBMED, Web of Science (WOS), and IME biomedicina (Spanish Medical Reports in Biomedicine), to gather randomized controlled trials about treatments used for painful diabetic neuropathy. The analyzed studies were required to meet the inclusion criteria selected, especially those results related to pain intensity. Results: Nine randomized controlled trials were chosen. The meta-analysis shows significant positive effects for those treatments based on tapentadol [g: -1.333, 95% CI (-1.594; -1.072), P < 0.05], duloxetine [g: -1.622, 95 % CI (-1.650; -1.594), P < 0.05], pregabalin [g: -0.607, 95% CI (-0.980; -0.325), P < 0.05], and clonidine [g: -0.242, 95 % CI (-0.543; -0.058), P < 0.05]. Conclusions: This meta-analysis indicates the effectiveness of the treatments based on duloxetine, gabapentin and pregabalin, as well as other drugs, such as tapentadol and topic clonidine, whose use is better prescribed in more specific situations. The results provided can help increase the knowledge about the treatment of painful diabetic neuropathy and also in the making of clinical practice guidelines for healthcare professionals.

Precedent based design foundations for parametric design: The case of navigation and wayfinding

  • Kondyli, Vasiliki;Bhatt, Mehul;Hartmann, Timo
    • Advances in Computational Design
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    • v.3 no.4
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    • pp.339-366
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    • 2018
  • Parametric design systems serve as powerful assistive tools in the design process by providing a flexible approach for the generation of a vast number of design alternatives. However, contemporary parametric design systems focus primarily on low-level engineering and structural forms, without an explicit means to also take into account high-level, cognitively motivated people-centred design goals. We present a precedent-based parametric design method that integrates people-centred design "precedents" rooted in empirical evidence directly within state of the art parametric design systems. As a use-case, we illustrate the general method in the context of an empirical study focusing on the multi-modal analysis of wayfinding behaviour in two large-scale healthcare environments. With this use-case, we demonstrate the manner in which: (1). a range of empirically established design precedents -e.g., pertaining to visibility and navigation- may be articulated as design constraints to be embedded directly within state of the art parametric design tools (e.g., Grasshopper); and (2). embedded design precedents lead to the (parametric) generation of a number of morphologies that satisfy people-centred design criteria (in this case, pertaining to wayfinding). Our research presents an exemplar for the integration of cognitively motivated design goals with parametric design-space exploration methods. We posit that this opens-up a range of technological challenges for the engineering and development of next-generation computer aided architecture design systems.

The Future Requirements and Supply of Opticians in Korea (우리나라 안경사 인력의 수급전망과 정책방향)

  • Oh, Youngho
    • Journal of Korean Ophthalmic Optics Society
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    • v.15 no.4
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    • pp.398-404
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    • 2010
  • Purpose: Concerns had been voiced about an oversupply of optometrists in Korea. So, this study aimed to forecast the supply and demand for opticians for policy implications. Methods: Baseline Projection model combined with demographic method was adopted as the supply forecasting method and so was a ratio method using the number of physician and population using weight of healthcare utilization. Results: Under the 'physician to optician ratio', there would be a surplus of 83~700 opticians in 2010 and an undersupply of 15 to surplus of 6,118 opticians in 2025. Under the 'population to optician ratio', there would be a surplus of 1,055 opticians in 2010 and surplus of 9,376 opticians in 2025. Conclusions: We concluded that there would be oversupply for opticians until 2025, although the shortage and surplus of opticians might depend on the ratio's criteria. Hence, policies would need to be developed that could solve the imbalance in requirements and supply for opticians.

Action Research in Hospital Settings: A Literature Review of International Nursing Journals (국외 간호학술지에서의 의료기관 내 실행연구 동향분석)

  • Moon, Jeong Eun;Song, Mi-Ok;Kim, Hee Young;Park, Hyun Young;Kim, Eun A;Kim, Yun Min;Jang, Keum Seong
    • Journal of Korean Academy of Nursing Administration
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    • v.22 no.1
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    • pp.46-56
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    • 2016
  • Purpose: Purpose of this study was to identify major trends of action research from 2006 to 2013 and suggest directions for activating and advancing domestic action research in nursing. Methods: A review was made of 118 action research studies in hospital settings reported in international journals. Search from PubMed, Ovid, and CINHAL was done using analysis criteria developed by the researchers. General and methodological characteristics and focus on changing outcomes of action research were analyzed. Results: The major group of researchers belonged to colleges/universities (40.7%). Methods included use of qualitative methods (61.0%), research questions (24.6%), and use of theoretical models (35.6%). Prevalent data collection methods were interviews (20.2%), and 48.3% showed more than a 1-cycle process including spiral circulation structure. Focus of changing outcomes of the 56 papers including more than 1-cycle were practice (66.1%), environment (8.9%), client-nurse (7.1%). Conclusion: Trends in action research in nursing were identified providing necessary reasons to increase action research in nursing as follows: needs of various researchers including stakeholders as well as healthcare providers, various research designs including unconstrained reflection and writing, specific presentation of adapted theoretical models and action strategies, and quality assurance for validity and reliability of research processes and outcomes.