• Clinical and Experimental Reproductive Medicine
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• 제40권3호
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• pp.122-125
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• 2013

Objective: The majority of embryo transfers (ETs) to date have been performed on day 3 to reduce the potential risk of developmental arrest of in vitro cultured embryos before ET. Development of sequential media has significantly improved culture conditions and allowed blastocyst transfer on day 5. While day 5 ET provides higher clinical pregnancy outcomes with reduced risks of multiple pregnancies, it still has potential risks of developmental arrest of IVF embryos. The aim of this study was to evaluate the clinical outcomes of day 4 ETs and compare the efficacy of day 4 ET with day 5 ET. Methods: From 2006 to 2009, a total of 747 fresh IVF-ET cycles were retrospectively analyzed (day 4, n=440 or and day 5, n=307). The cycles with any genetic factors were excluded. The rates of matured oocytes, fertilization, good embryos, and clinical pregnancy of the two groups were compared. The chi-square test and t-test were used for statistical analysis. Results: There were no significant differences between the two groups with respect to the mean age of the females and rates of matured oocytes. The pregnancy outcomes of day 4 ET (40.7%) were similar to those of day 5 ET (44.6%). The implantation rate of day 5 ET (24.2%) was significantly higher than that of day 4 ET (18.4%) (p=0.003). Conclusion: Day 4 ET can be chosen to avoid ET cancellation in day 5 ET resulting from suboptimal circumstances in the IVF laboratory, but the decremented quality of embryos for transfer and the decreased pregnancy rate must be taken into consideration.

• Child Health Nursing Research
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• 제30권1호
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• pp.17-30
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• 2024

Purpose: This pilot study aimed to assess the feasibility, preliminary efficacy, and effects of a mobile app healthcare coaching program developed based on self-regulation theory among youths with type 1 diabetes. Methods: A mixed-method design was utilized. Participants were randomly assigned into intervention (n=23, 12-week coaching program) or control groups (n=16, usual care). Pre- and post-intervention assessments included self-efficacy, diabetes management behavior, and health outcomes (quality of life, depression, and HbA1c). Quantitative data were analyzed with SPSS/WIN ver. 26.0. The narrative information from the participants in the healthcare coaching program underwent content analyzed. Results: The intervention group had significantly lower depression scores (t=2.57, p=.014) than the control group. No significant differences were observed in self-efficacy, diabetes management behavior, and health outcomes between the two groups. The average frequency of health behavior monitoring per week among the participants was 1.86±1.60. The qualitative findings indicated that participants perceived improved diabetes self-management with the intervention; however, challenges during vacations, dietary control difficulties, and a lack of disease awareness were identified. Conclusion: The healthcare coaching program improved psychological aspects for youth with type 1 diabetes. Further research is needed to develop and implement mobile app interventions aimed at enhancing compliance with diabetes management in pediatric and adolescent populations.

• 보건교육건강증진학회지
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• 제35권5호
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• pp.69-78
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• 2018

Objectives: This study is aimed to analyze service user's benefit and perceived-outcomes of visiting healthcare. Methods: Using a questionnaire survey we analyzed the subjective service quality and satisfaction of survey respondents. The sampling was designed with socioeconomic characteristics(age, sex, user group et al.), and each respondent (N=1,000) was presented with double-bounded dichotomous choice questions. To measure the value of visiting healthcare, we employed a contingent valuation method. Results: The respondents were satisfied with service and quality on visiting healthcare. And the acceptance-to-pay of respondent's benefit was 50,458 won for each visit and in totality, service user's benefit was 185.9 billion won. Conclusions: It is necessary to invest in visiting healthcare in public health centers.

• Clinical and Experimental Reproductive Medicine
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• 제32권3호
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• pp.261-268
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• 2005

Objective: To compare the clinical results and pregnancy outcomes of in vitro fertilization (IVF) between GnRH antagonist cycles and GnRH agonist (GnRH-a) cycles including flare-up and long protocol in women with advanced age. Materials and Methods: Retrospective clinical study. From January 2001 to September 2003, IVF cycles of female patient 37 years over were included in this study. GnRH-a long protocol (62 cycles, 61 patients) and GnRH antagonist multi-dose flexible protocol (66 cycles, 51 patients) were compared with the control group of GnRH-a flare-up protocol (151 cycles, 138 patients). IVF cycles for non-obstructive azoospermia (NOA), endometriosis III, IV and polycystic ovarian syndrome (PCOS) were excluded in this study. Clinical results such as total gonadotropin dose, serum E2 on hCG administration, the number of retrieved oocytes and the pregnancy outcomes - clinical pregnancy rate (CPR), implantation rate (IR) and live birth rate (LBR) per embryo transfer - were compared. Results: There were significant differences in the total dose of gonadotropin (GnRH-a flare-up vs. GnRH-a long vs. GnRH-antagonist; 41.8 vs. 54.7 vs. 24.8), serum E2 on hCG administration (1787.2 vs. 1881.6 vs. 788.0), the numbers of retrieved oocytes (8.1 vs. 11.1 vs. 4.5) and endometrial thickness (9.1 vs. 10.4 vs. 8.0) which were significantly lower in GnRH-antagonist cycles. But pregnancy outcomes shows no significant differenced in CPR (25.0% vs. 35.8% vs. 24.5%), IR (11.7% vs. 12.3% vs. 10.1%) and LBR (15.8% vs. 28.3% vs. 15.1%) Conclusion: In women with advanced age, GnRH-antagonist cycles can result in comparable pregnancy outcomes to GnRH-a cycles including flare-up and long protocol. GnRH-a long protocol show higher CPR, IR and LBR than GnRH antagonist multi-dose flexible protocol and flare-up protocol without significant differences.

• 한국보건간호학회지
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• 제32권1호
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• pp.5-18
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• 2018

Purpose: We present improvements to the Korean home visiting healthcare service based on analysis of Korean home visiting healthcare services considering recent sociodemographic changes and demands for healthcare services. Methods: This is a review study in which the results are derived through a literature review and data analysis. We collected data through a search of electronic databases, Google Scholar, and governmental websites. Results: Changes in Korean home visiting healthcare services are classified into four stages: 'introduction (1990-2000)', 'pilot project (2003-2006)', 'nationwide expansion (2007-2012)', 'various types (2013-2018)'. Korean home visiting healthcare service based on public health centers has achieved outcomes such as improved health behavior and health management, increased health management ability, and establishment of comprehensive healthcare infrastructure. Conclusion: In the future, the demand for home visiting healthcare service will increase steadily because of deepening social polarization, rapid aging of the population, and increases in chronic diseases. To improve health management and health equity, we suggest that Korean home visiting healthcare service will expand to all the people as a core public health service. It is necessary to establish a management team for various types of home visiting healthcare service in the public health center.

• Clinical and Experimental Reproductive Medicine
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• 제43권2호
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• pp.133-138
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• 2016

Objective: To determine the incidence of embryo retention (ER) in the transfer catheter following embryo transfer (ET) in blastocyst transfer and investigate whether retransferring retained embryos has an impact on reproductive outcomes in patients undergoing in vitro fertilization-ET. Methods: We retrospectively analyzed the records of 1,131 blastocyst transfers, which comprised 223 single blastocyst transfer (SBT) and 908 double blastocyst transfer (DBT) cycles. Each SBT and DBT group was classified depending on whether ET was performed without retained embryos in the catheter during the first attempt (without-ER group) or whether any retained embryos were found following ET (ER group) for the purpose of comparing reproductive outcomes in a homogenous population. Results: The overall incidence of finding retained embryos was 2.8% (32/1,131). There were no retained embryos in SBT cycles. In DBT cycles, implantation rates (30.0% vs. 26.6%), positive ${\beta}-hCG$ rates (57.2% vs. 56.2%), clinical pregnancy rates (45.3% vs. 46.9%), and live birth rates (38.9% vs. 43.8%) were not significantly different between the without-ER and ER groups. There were no significant differences in the mean birth weight (g) $2,928.4{\pm}631.8$ vs. $2,948.7{\pm}497.8$ and the mean gestational age at birth ($269.3{\pm}17.2days$ vs. $264.2{\pm}25.7days$). A total of nine cases of congenital birth defects were found in this study population. Eight were observed in the without-ER group and one in the ER group. Conclusion: Our results suggest that retransfer of retained embryos does not have any adverse impact on reproductive outcomes in blastocyst transfer cycles. Furthermore, our results support finding that SBT might be advantageous for decreasing the incidence of retained embryos in catheters.

• 임상간호연구
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• 제21권1호
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• pp.116-126
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• 2015

Purpose: The purpose of this study was to examine the relationship between social support (family, healthcare provider, friends/peer), treatment belief, hope, and health status in patients on hemodialysis, and to identify direct and indirect effects of the variables on patients' health status. Methods: The self-regulation model was used to establish a path model. Data were collected from 240 patients. Multidimensional Scale of Perceived Social Support, Revised Illness Perception Questionnaire, Herth Hope Index, and Medical Outcomes Study Short Form-12 were used. Data were analyzed using the SPSS and AMOS programs. Results: The model was supported by fit statistics ($x^2=3.33$, p=.343, GFI .995, RMSEA .021, AGFI .968, NFI .986, CFI .999, TLI .993). Family and friends/peer support showed a significant direct influence on hope, while healthcare provider support directly influenced treatment belief. Social support, treatment belief, and hope directly and indirectly influenced health status, explaining 28.7% of the variance. Conclusion: These results show mechanisms underlying connections between social support and health status by demonstrating impact of social support and showing treatment belief and hope as mediators between social context and outcomes. To promote health of patients on hemodialysis, it is necessary for patient, family, healthcare professional, and friends to collaborate.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제17권2호
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• pp.35-44
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• 2011

The aim of this study is to review the literature addressed the methodology to measure and evaluate the health outcomes as evidences for health benefits through the study on the healing environment, garden, therapeutic garden and viewing landscape and so forth. The research methods and measures used to assess health effects in the reviewed studies have applied in a different way ranged from quantitative methods (physical measures or quantitative observations) to qualitative methods (qualitative observations and surveys). In a literature review of research articles on the health outcomes have been found various research methods and measures used to assess health effects. This study will be concentrated mainly on methodological considerations in order to find the significant evidences related to evidence-based design (EBD). Future research should build the body of methodological knowledge to find more empirical evidences as sound scientific data and to improve the effectiveness of design interventions.

• Clinical and Experimental Reproductive Medicine
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• 제35권1호
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• pp.69-76
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• 2008

목 적: 본 연구에서는 한국 불임 여성의 난포자극호르몬 수용체 유전자형의 분포 빈도를 파악하고, 체외수정 시술에서 난포자극호르몬 수용체 유전자형에 따른 과배란 유도 과정에서의 난소 반응과 각종 임상 결과와의 관련성을 알아보고자 하였다. 연구방법: 연구대상은 제일병원에 내원한 여성 불임 환자 1, 020명을 대상으로 난포자극호르몬 수용체의 유전자형, 즉 Thr307Ala (T/A)과 Asn680Ser (N/S)을 조사하였으며, 이들 중에서 과배란 유도와 체외수정 및 배아이식술을 시행한 302주기에서의 임상 결과를 이들의 유전자형에 따라 비교하였다. 결 과: 대상 환자에서 난포자극호르몬 수용체의 Thr307Ala와 Asn680Ser의 유전자형 빈도는 TT/NN 군이 44.80% (n=457), TA/NS 군이 41.96% (n=428) 그리고 AA/SS군이 10.49% (n=107)의 분포로 조사되었다. 과배란 유도에서의 각 유전자형에 따른 대상 환자의 나이, 난소 반응에 관련된 사용한 난포자극호르몬의 용량과 이에 따른 혈중 에스트라디올의 농도와 채취된 난자의 수 등에서 통계적으로 유의한 차이가 나타나지 않았다. 그러나 배아이식 후 AA/SS 유전자형 환자에서의 착상률이 TT/NN에 비해 통계적으로 유의하게 높게 나타났다 (24.5% vs 15.7%, p<0.05) 결 론: 대표적인 세 가지 TT/NN, TA/NS 그리고 AA/SS 유전자형에 따른 과배란 유도에서의 난소 반응은 통계적으로 의미있는 차이를 나타내지 않았다. 그러나 각각의 유전자형에 따라 난소 반응과 임상 결과가 다소 차이가 나타남을 확인할 수 있었으며, 이에 대한 추가적인 연구가 필요할 것으로 생각된다.

• 한국의료질향상학회지
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• 제23권1호
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• pp.69-90
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• 2017

Purpose: The purpose of this study was to analyze the impact of healthcare accreditation and to provide empirical evidence to validate positive effectiveness. Methods:Six electronic databases (KERIS, KoreaMed, NDSL, Ovid-medline, Embase, Cochrane library) were accessed in May 2016. Keywords used were 'accreditation' and 'Joint Commission on Accreditation of Healthcare Organization (JCAHO)'. Of the initially identified 3,008 articles, 60 studies on healthcare accreditation were selected based on inclusion criteria that are hospital accreditation, accreditation by disease and clinical center accreditation. These were retrieved and analyzed. Result: The 60 study results were on the impact of healthcare accreditation. Results were classified into four perspectives of Balanced Score Card (Financial, Customer, Internal Process, Learning & Growth). In internal process perspective, results revealed that healthcare accreditation has made a positive impact on "care process and procedure". In learning & growth perspective, healthcare accreditation has made a positive influence on "leadership", "organizational cultures" and "change mechanisms". However, it revealed that healthcare accreditation does not directly affect financial performance. It is also difficult to reach a definitive conclusion that healthcare accreditation programs affect patient satisfaction of customer and clinical outcome of the internal process. Conclusion: Healthcare accreditation programs provide positive impact on change of care process and building communication-oriented hospital culture. However, more rigorous and diverse research is needed on financial effects and clinical outcomes of healthcare accreditation.