• Korean Journal of Adult Nursing
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• v.24 no.3
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• pp.317-326
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• 2012

Purpose: The purpose of this study was to identify the effects of an exercise program on muscle strength, Activities of Daily Living (ADL), health perception, and depression among post-stroke elders. Methods: Nonequivalent control group design with pretest and posttest was used. A total of 23 post-stroke elders who met inclusion criteria were recruited. Muscle strength in upper and lower extremities, ADL, health perception, and self-rated symptoms of depression were measured. The exercise program consisted of deep breathing, range of motion, and muscle strengthening exercises using Thera-band, 30~40 min/day, three days a week, for 12 weeks. Results: Muscle strength of right shoulder (U=11.50, p=.001), right leg (U=13.50, p=.002), and health perception (U=24.00, p=.010) in the experimental group was significantly higher compared to the control group at 12 weeks of post-intervention. Depression scores were significantly lower in the experimental group compared to the control group at 6 weeks (U=28.00, p=.021), at 12 weeks (U=22.00, p=.006) of an exercise program. Conclusion: By applying this program, post-stroke elders showed increases in muscle strength and a decrease in depression as well as improvement of health perception. Further study is needed to verify the effects of the exercise program on cardiovascular physiologic variables through long-term follow-up.

• Journal of Science and Technology Studies
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• v.13 no.1
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• pp.77-109
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• 2013

The global diffusion of Evidence-Based Medicine (EBM) is changing the landscape of medicine and the healthcare system. STS scholars have shown how EBM works when put into practice. In continuing to add to the literature of previous scholars, this paper traces the historical process and debate over Prostate-Specific Antigen (PSA) testing as an early screening test for prostate cancer in the U.S. This study will reveal that both pros and cons of the testing using EBM as a crucial resources of the debate, and in the process both 'flexibly' interpret and mobilize the hierarchy of scientific evidence for EBM despite the fact the hierarchy is imagined to being scientific criteria that is rigid. Furthermore, this paper will argue that this phenomenon, for which EBM currently seems to support the cons side of PSA screening, was constructed in the context of appraisal of the value 'quality of life' in the EBM system. This case study proposes that those who study the debate of medical technology in the EBM era should contextualize and analyze EBM as part of this debate rather than simply taking EBM for granted.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.21 no.4
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• pp.423-432
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• 2014

Purpose: This study was done to evaluate effectiveness of deep breathing exercise as a postoperative intervention to prevent pulmonary complications. Methods: A search of databases from 1990 to 2012 was done including MEDLINE, EMBASE, CINAHL, Cochrane Library and eight Korean databases. Ten studies met eligibility criteria. Researchers trained in systematic review, independently assessed the methodological quality of selected studies using the Cochrane's risk of bias tool. Data were analyzed using RevMan 5.2 program. Results: Among ten RCTs in four studies, deep breathing exercise was compared with an instrument using interventions such as incentive spirometry, in the other four studies deep breathing exercise was compared with non-intervention, and in last two studies bundles of interventions including coughing and early ambulation were assessed. A significant difference was found between deep breathing exercise group and non-intervention group. The odds ratio (OR) of occurrence of pulmonary complications for deep breathing exercise versus non-intervention was 0.30. However, there was no significant difference between deep breathing exercise group and incentive spirometry group (OR=1.22). Conclusion: Deep breathing exercise is vital to improving cost-effectiveness and efficiency of patient care in preventing postoperative pulmonary complications. For evidence-based nursing, standardized guidelines for deep breathing in postoperative care should be further studied.

• The Korean Journal of Health Service Management
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• v.7 no.4
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• pp.289-303
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• 2013

This study looks at priorities in managing public hospitals by figuring out categories needed to examine the quality of each hospital. In order to analyze priorities and relative importance of valuation indicator in Seoul municipal hospitals, surveys were sent via e-mail to medical professionals who have participated in evaluation of municipal hospitals. The analytic hierarchy process (AHP) was conducted using the Expert Choice 11.5 program. The results show that 'providing public service' is considered to be the most important category for all kinds of public hospitals, followed by 'improving the quality of medical care', 'hospital management and governance', and 'efficient hospital management'. The importance of 'hospital management and governance' and 'efficient hospital management' is different depending on the types of hospitals, but the importance of 'providing public service' and 'improving the quality of care' remains the same regardless of the types of hospitals. Based on these results, the study comes to a conclusion that public hospitals should place high value on certain categories and their management purposes should differ depending on their specific fields and characteristics. This study will help furthering discussions on the identity and roles of public hospitals.

• Health Policy and Management
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• v.16 no.4
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• pp.68-85
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• 2006

With the competitive environment accelerating in healthcare industry, the hospital network system is considered as one of the strategies for clinical and managerial efficiency. This study was intended to offer a theoretical view on the hospital network system and to analyze the current network status of hospitals in Korea. Specifically, network types were classified based on the criteria modified from previous studies, and were used to describe and compare the scope and intensity of associated activities. The questionnaire survey was conducted with 237 hospitals during the period of December 27 2005 to January 25 2006. Above 90% of tertiary and secondary care hospitals were under the network system, while only 20% of primary care clinics were affiliated. In general, the scope and intensity of network activities was limited. Vertical and/or clinical integration was more common than horizontal and/or managerial integration. Three most frequent types of hospital network systems were clinical-vertical integration (Type A), clinical/managerial-vertical integration(Type B), and clinical/managerial-horizontal /vertical integration (Type C). Such network types differentiated significantly different features of affiliated hospitals and network systems. The affiliation duration to the network system was the only significant factor influencing on the network type. The strategic approach to the network system was emphasized for hospitals to increase the potential advantage of hospital network systems.

• Journal of Ginseng Research
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• v.38 no.4
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• pp.239-243
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• 2014

Background: To investigate the antidiabetic effects of hydrolyzed ginseng extract (HGE) for Korean participants in an 8-wk, randomized, double-blinded, placebo-controlled clinical trial. Methods: Impaired fasting glucose participants [fasting plasma glucose (FPG) ${\geq}5.6mM$ or < 6.9mM who had not been diagnosed with any disease and met the inclusion criteria were recruited for this study. The 23 participants were randomly divided into either the HGE (n = 12, 960 mg/d) or placebo (n = 11) group. Outcomes included measurements of efficacy (FPG, postprandial glucose, fasting plasma insulin, postprandial insulin, homeostatic model assessment-insulin resistance, and homeostatic model assessment-${\beta}$) and safety (adverse events, laboratory tests, electrocardiogram, and vital signs). Results: After 8 wk of HGE supplementation, FPG and postprandial glucose were significantly decreased in the HGE group compared to the placebo group. No clinically significant changes in any safety parameter were observed. Our study revealed that HGE is a potent antidiabetic agent that does not produce noticeable adverse effects. Conclusion: HGE supplementation may be effective for treating impaired fasting glucose individuals.

• Korean Journal of Clinical Pharmacy
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• v.10 no.1
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• pp.30-37
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• 2000

Adverse drug reactions (ADR) may result in increased hospital admissions, morbidity and mortality, adding extra cost to healthcare expenditures. Thus, it is critical to activate ADR monitoring and reporting program in tertiary hospitals in developing countries such as Korea. This study was performed to identify the types of ADR being reported in a tertiary hospital, Samsung Medical Center, and to find out the ways to improve current ADR monitoring system. Of 464 ADR reports submitted to the pharmacy department during the 6-month survey period, $97.8\%$ of the reports were from out patient and $48.5\%$ were from patients aged between 50 and 60. The medical department with the highest frequency in ADR reporting was Internal Medicines $(35.6\%)$. The most common ADR manifestations were gastrointestinal complaints $(43.4\%)\;and\;75\%$ of the reported cases were mild in their severity. The most common drugs suspected of causing ADR were CNS drugs which accounted for $32.8\%$. In terms of causality assessment, $85.1\%$ of the reports were probable cases by WHO causality assessment criteria. In regards to sources of report, $75.6\%$ of ADR were reported by physicians and $24.4\%$ by nurses. There were no ADR reported by pharmacists. In conclusion, there is an urgent need to improve ADR monitoring system for inpatient and to motivate pharmacist involvement in ADR monitoring and reporting in Korea.

• Research in Community and Public Health Nursing
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• v.15 no.4
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• pp.539-550
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• 2004

Purpose: The purpose of this study was to evaluate the achievements of the project, and also to find out its strengths and weaknesses. Method: This evaluative study employed system theory and analytic techniques by using criteria which were relevance, appropriateness, adequacy, progress, effectiveness and satisfaction for input, process, output, and outcome of program. Study subjects were participants in the home health care program implemented in G public health center in Inchon metropolitan city in 2003. Results: Input factors including recruitment personnel, and support organization development were not adequately met for the program. However. the goal and objectives of the project were really appropriate for the community needs as well as government's policy. For the Process evaluation, home health care record form and computer data base had not progressed as scheduled, but overall program activities were finished on time. However, cooperation between organizations in the health center during service activity were not supportive. Managerial ability of program charged personnel about coordination and integration of team members was not affirmative. Output and outcome evaluation showed that people improved self care ability were 221 (17.5%). and 71 (5.62%) of subjects were moved into category of possible self-care. Client's satisfaction for this project showed a high degree. Conclusions: Based on the above results support organization and staff personnel for this program should be developed. Also, a community network of resources should be established and case management services should be focused continuously in community based home health care.

• Journal of Korean Clinical Nursing Research
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• v.19 no.2
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• pp.245-254
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• 2013

Purpose: This study was done to examine predictive validity of Critical Care Non-verbal Pain Scale (CNPS) and develop criteria for pain assessment using CNPS with critically ill patients who have communication problems. Methods: Data were collected from intensive care units at three major general hospitals in Seoul and Kyunggi province. During each observation, a nurse assessed pain severity using CNPS ratings (range 0-9) at four treatment stages: at rest, during central catheter dressing change (nonpainful procedure), position change and suctioning (routine painful procedures). Patients also assessed their pain using a self-report 4-point VRS-4. Results: There were significant differences between the four treatment stages except between "at rest" and "nonpainful procedure". Strong correlations were found between CNPS and VRS-4 for "at rest" (r=.552, p<.001), central catheter dressing change (r=.505, p<.001), position change (r=.709, p<.001), and suctioning (r=.662, p<.001). ROC curve analysis of CNPS based on 3 point on VRS-4 showed the cutoff point was 3 for CNPS, the starting point for pain management with 73% sensitivity, 92.2% specificity, 73% positive predictive value, and 92.8% negative predictive value. Conclusion: Results indicate that CNPS is a valid tool for measuring pain in critically ill patients with communication problems and 3 point should be the standardized pain treatment point.

• Korean Journal of Clinical Pharmacy
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• v.24 no.4
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• pp.255-264
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• 2014

Objective: The aims of this study are to investigate the total volume of prescribed medicines against Alzheimer's disease (AD) and the trends of usage by analyzing the claims-data from the Korea National Health Insurance Service. Method: The demographic and claims-data were included the major AD treating medicines such as donepezil, galantamine, rivastigmine and memantine, and analyzed during the period of 2010~2012. The assessing criteria were gender, age, habitation, types of medical institution, code of ingredients, outcomes of treatment, volume and amount of claims, and the numbers of patients with dementias. After trimming the data, it were analyzed by the market size, demographic traits, characteristics of medical service, characteristics of each anti-AD medicine, etc. Results: Among the chosen 4 medicines, donepezil had the top prescription volumes. Most prevalent prescribing preparations of donepezil were conventional types. However, among the non-conventional types, oro-dispersible formulation is the fast increasing one in both volume and growth rate. This specialized preparations to improve both toleration and adherence, tend to being prescribed generally at the tertiary medical institutions. While the younger patients with mild-to-moderate AD mostly treated by expensive medicines in resident at the tertiary hospitals, the rest older patients with severe AD have been treated non-expensive one at long-term care facilities. Conclusion: AD is a chronic illness therefore, long-term use of therapeutic medications are highly important. If an anti-AD treatment was applied steadily in the earlier stages, it would be achieved not only improving the quality of life of patient but also reducing the expenses in the medical and nursing cares. As the socioeconomical impacts of AD is expanding, healthcare professionals need to aware the importance of pharmacotherapy and to improve sociopolitical fundamentals.