• Korean Journal of Clinical Pharmacy
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• v.21 no.1
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• pp.14-21
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• 2011

Drug Utilization Review (DUR) is known to play an important role to improve appropriateness of drug prescriptions. This retrospective, observational study was conducted to compare prescription patterns after installation of Computerized DUR Program (Drug Information Framework-$Korea^{TM}$) (Jan-Mar 2008; After) to before DUR program (Jan-Mar 2007: Before). 8 physicians affiliated in the S University Hospital were enrolled in the study and their 3 months' prescription data were analysed for drug prescription trends and DUR conflict events per 7 DUR screening modules (drugdrug interaction, therapeutic duplication, allergy, dosing, disease contra-indication, geriatric contra-indication, pediatric contra-indication). Average rate of DUR modules usage in 2008 (After) were 0.72. Average number of prescription drug per patient were reduced from 5.6 (Before) to 3.8 (After), and DUR program seemed to effect positively on physician's prescription related decision process. Overall DUR conflict events occurred by 8 physicians for 3 months were 17,923 Before and 20,057 After DUR program, and DUR conflict events per prescription were 2.8 Before and 2.9 After, respectively. Therapeutic duplication (37%), geriatric contra-indication (34%) and dosing (18%) were high ranked DUR conflicts. As the study was not sufficient to show a consistent trend to reduce DUR conflicts After, another study to confirm it's effectiveness would be recommended. This study would be of help to develop awareness of DUR program to healthcare providers.

• Women's Health Nursing
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• v.26 no.1
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• pp.49-60
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• 2020

Purpose: Infertile women experience various physical, psychological, and relational problems that affect their infertility-related quality of life (QoL). This study investigated infertile women's infertility-related QoL with the goal of identifying how it is influenced by fatigue, depression, and marital intimacy. Methods: A sample of 140 infertile women was surveyed in a cross-sectional study. Data were collected from February to April 2018 using self-report structured questionnaires at three infertility clinics located in Jeonju, Korea. Data were analyzed using the independent t-test, analysis of variance, Pearson correlation coefficients, and stepwise multiple regression analysis in SPSS for Windows version 25.0. The subjects agreed to complete a face-to-face interview, including administration of the Fatigue Severity Scale, Depression Anxiety Stress Scale-21, Marital Intimacy Scale, and the Fertility Quality of Life tool. Results: The mean age of the participants was 35.6±4.3 years. Infertility-related QoL was negatively correlated with fatigue (r=-.42, p<.001) and depression (r=-.56, p<.001), and positively correlated with marital intimacy (r=.30, p<.001). Multiple regression analysis showed that depression (β=-0.44, p<.001), fatigue (β=-0.27, p<.001), and husband's attitude (β=-0.19, p=.007) had significant effects on the QoL of infertile women, accounting for 40.5% of the variance in infertility-related QoL. Conclusion: The study provides insights into how infertile women's infertility-related QoL was influenced by depression, fatigue, and their husbands' attitudes regarding infertility treatment. To improve infertile women's infertility-related QoL, healthcare providers should consider developing strategies to decrease depression and fatigue in infertile women and to address their husbands' attitudes.

• Women's Health Nursing
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• v.26 no.1
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• pp.28-36
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• 2020

Purpose: This study investigated lifestyle, depression, marital intimacy, and quality of life (QoL) in breast cancer survivors, with the goal of identifying the impacts of these factors on QoL. Methods: A sample of 146 breast cancer survivors was surveyed in this cross-sectional study. Data were collected from March 20 to May 30, 2019, using self-report structured questionnaires at a hospital located in Jeonju, Korea. Data were analyzed using the independent t-test, analysis of variance, Pearson correlation coefficients, and hierarchical regression analysis. Participants agreed to complete a face-to-face interview, including administration of the Health Promoting Lifestyle Profile II, Depression Anxiety Stress Scale 21-Depression Scale, Marital Intimacy Scale, and Functional Assessment Cancer Therapy-Breast Cancer tool. Results: QoL was positively correlated with lifestyle (r=.49, p<.001) and marital intimacy (r=.45, p<.001) and negatively correlated with depression (r=-.72, p<.001). Hierarchical multiple regression analysis showed that depression (β=-0.63, p<.001), marital intimacy (β=0.19, p=.001), and lifestyle (β=0.13, p=.031) had significant effects on the QoL of breast cancer survivors, accounting for 63.3% of variance in related QoL. Conclusion: This study provides insights into how breast cancer survivors' QoL was influenced by depression, marital intimacy, and lifestyle. To improve the QoL of breast cancer survivors, healthcare providers should consider developing strategies to decrease depression, to increase marital intimacy, and to improve lifestyle.

• Journal of Digital Convergence
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• v.10 no.5
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• pp.301-305
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• 2012

This study was performed to examine the relationship between fatigue and fatigue-regulation behavior in Hemodialysis(HD) patients. Methods: The subjects for this study were 107 patients on HD who were registered in a hospital in Seoul. The data were collected from August 2 to August 14, 2010. The collected data were analyzed by the SPSS WIN 12.0 program. Results: The mean score of fatigue was 77.1 which means their experience of high level fatigue. Frequency of the fatigue-regulation behavior and the mean of efficiency of the fatigue-regulation behavior was 8.8 and 22.8. Positive correlation was found between fatigue and fatigue-regulation behavior (r=.45, p=.000). Conclusion: It is considered that the study emphasizes for the healthcare providers to recognize fatigue as the important nursing issue for HD patients. And it is necessary to develop an evidence-based nursing intervention program for regulating fatigue in HD patients.

• Journal of Digital Convergence
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• v.10 no.9
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• pp.429-434
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• 2012

This study was performed to examine the relationship between dependence of elderly peritoneal dialysis patients and burden on family caregivers. The subjects for this study were 50 elderly patients on Continuous ambulatory peritoneal dialysis(CAPD) who were registered in a hospital in Seoul and 50 their family caregivers. The data were collected from April 4 to August 15, 2011. The collected data were analyzed by the SPSS WIN 12.0 program. The mean score of dependence was 139.6 which means their experience of high level dependence. The mean score of burden was 84.2 which means their family caregivers experience of high level burden. Positive correlation was found between dependence of elderly peritoneal dialysis patients and burden on their family caregivers (r=.61, p=.000). It is considered that the study emphasizes for the healthcare providers to recognize dependence as the important nursing issue for elderly CAPD patients. And it is necessary to develop an nursing intervention for decreasing dependence of elderly CAPD patients and burden on their family caregivers.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.351-360
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• 2012

Background: Identification of reliable predictors of leisure time physical activity (LTPA) will enable healthcare providers to intervene and change the patterns of LTPA in the population to improve community health. Objectives: The objectives of this study were to determine prevalence and pattern of LTPA among adult Saudis aged 18-65 years, and to define the socio-demographic determinants that correlate with LTPA in Al-Hassa, Saudi Arabia. Subjects and Methods: A cross-sectional study of 2176 adult Saudis attending urban and rural primary health care centers were selected using a multistage proportionate sampling method. Participants were personally interviewed to gather information regarding socio-demographics, physical activity pattern using the Global Physical Activity Questionnaire (GPAQ). Physical activity (PA) in each domain was expressed in metabolic equivalents (METs). Results: The median total METs minutes/week for LTPA for both genders was 256, higher for men (636 METs minutes/week) compared to women (249METs minutes/week). Overall, only 19.8% of the total PA was derived from LTPA. Of the sampled population 50.0% reported doing no leisure activity. Using the cut off of 600 METs-minutes/day or 150 minutes of moderate intensity over 5 or more days/week, only 21.0% of the included sample were considered as being sufficiently active and 10.4% were in the high active category with beneficial health effects. Multivariate regression analysis showed that male, younger age (<35 years), absence of chronic disease conditions and moderate level of total PA were significant predictors for being active in the LTPA domain. Conclusion: The prevalence and intensity of LTPA among the included sample demonstrated low levels. Nearly 80% of the included sample population did not achieve the recommended LTPA level with beneficial health effects. Female gender, urban residence and associated chronic diseases correlated with a low LTPA.

• 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.

• Journal of The Korean Society of Clinical Toxicology
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• v.15 no.1
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• pp.31-39
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• 2017

Purpose: Despite the clinical and socio-economic impact of acute poisoned patients, many of the treatments are not standardized in Korea. Moreover, no formal training that is specifically focused on clinical toxicology exists. Rather, training and education are conducted case by case in various institutions. This study was conducted to develop a standardized simulation-based clinical toxicology training curriculum for healthcare providers. This program will focus on specific assessment and treatment of critical toxicology patients, specifically those who have been poisoned with organophosphate. Methods: The study was performed using a pre- and post-design to determine the effects of implementation of this program. The study was conducted at eight different urban teaching hospitals in a simulated room in the clinical area. The study was targeted to 19 groups composed of emergency residents and nurses. Simulation-based learning was conducted for each group. Results: All 19 groups achieved the minimum passing score of 75%. Implementation of the program led to improved performance rates for overall management and cooperative moods competency (p<0.01). Inter-rater agreement between the two evaluators was excellent. In general, the participants thought the program was realistic and were able to recognize and improve the competencies needed to care for organophosphate poisoned patients. Conclusion: Simulation-based learning is an effective educational strategy that can be applied to improving and understanding proper care for rare but critical patients. This program was effective at improving team performance and cooperative moods when managing an organophosphate poisoned patient in the Emergency Department.

• Journal of Preventive Medicine and Public Health
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• v.49 no.4
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• pp.183-196
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• 2016

Objectives: There is no systematic review on economic evaluations of telemedicine in Japan, despite over 1000 trials implemented. Our systematic review aims to examine whether Japan's telemedicine is cost-saving or cost-effective, examine the methodological rigorousness of the economic evaluations, and discuss future studies needed to improve telemedicine's financial sustainability. Methods: We searched five databases, including two Japanese databases, to find peer-reviewed articles published between January 1, 2000 and December 31, 2014 in English and Japanese that performed economic evaluations of Japan's telemedicine programs. The methodological rigorousness of the economic analyses was assessed with a well-established checklist. We calculated the benefit-to-cost ratio (BCR) when a reviewed study reported related data but did not report the BCR. All cost values were adjusted to 2014 US dollars. Results: Among the 17 articles identified, six studies reported on settings connecting physicians for specialist consultations, and eleven studies on settings connecting healthcare providers and patients at home. There are three cost-benefit analyses and three cost-minimization analyses. The remaining studies measured the benefit of telemedicine only, using medical expenditure saved or users' willingness-to-pay. There was substantial diversity in the methodological rigorousness. Studies on teledermatology and teleradiology indicated a favorable level of economic efficiency. Studies on telehomecare gave mixed results. One cost-benefit analysis on telehomecare indicated a low economic efficiency, partly due to public subsidy rules, e.g., a too short budget period. Conclusions: Overall, telemedicine programs in Japan were indicated to have a favorable level of economic efficiency. However, the scarcity of the economic literature indicates the need for further rigorous economic evaluation studies.

• Korea Journal of Hospital Management
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• v.13 no.1
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• pp.65-83
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• 2008

Although a variety of customer relationship management (CRM) activities have been provided by many hospitals in Korea, there lacks empirical evidence on the effect of CRM. The present study was conducted to examine the effect of CRM in terms of the customer response to CRM in a woman's hospital setting. A total of 380 patients receiving inpatient or outpatient care from woman's hospital between October 25 and November 4, 2005 were surveyed for the degree of their experience of and preference for CRM activities of the hospital by 5-point Likert-type scale. Patients were also asked about the level of customer loyalty to the hospital. Eighteen CRM activities offered by the hospital was classified into 4 types of CRM strategies according to Berry and Parasuranman: price, social, structural, and relationship recovery strategy. There's a significant positive correlation between the degree of experience of CRM and preference for CRM(r=0.49, p<0.001). Regression analysis results showed the significant positive relationship between the degree of experience of CRM and customer loyalty(${\beta}$=0.448, p<0.05). Among the 4 CRM strategies, only social(${\beta}$=0.127, p<0.05) and structural strategy(${\beta}$=0.266, p<0.05) showed signifiant positive relationship with customer loyalty. Overall, the favorable customer response to CRM in terms of preference for CRM and customer loyalty indicates that there's a positive effect of CRM on the continuity of the relationship between patients and health care providers.