• Korean Journal of Adult Nursing
• /
• v.19 no.1
• /
• pp.35-44
• /
• 2007

Purpose: This study was conducted to examine the knowledge level and assessment experience of nurses in regards to delirium, and to utilize the study results as baseline data for planning delirium education programs for nurses. Methods: Subjects were 465 nurses who were working in a general hospital. A 'delirium related knowledge and assessment experience' questionnaire was used to collect data. Results: Knowledge levels regarding delirium averaged 70 out of 100, and at each domain, they scored 87 for etiology of delirium, 62 for symptoms, and 69 for nursing management. The knowledge level of delirium was significantly different according to educational level (F=3.851, p=.022), past education related to geriatrics(t=2.471, p=.014), and awareness of need for in-service education on geriatric nursing(F=2.663, p=.032). About 85% of nurses had past experience of dealing with delirious patients and only 7.7% of nurses used delirious state assessment tools. Conclusion: According to the above results, it is necessary, not only to provide delirium related educational programs for nurses, but also to emphasize the usefulness of applying the assessment tool.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.9
• /
• pp.3639-3644
• /
• 2015

Oral, cervical and breast cancers, which are either preventable and/or amenable to early detection and treatment, are the leading causes of cancer-related morbidity and mortality in India. In this paper, we describe implementation science research priorities to catalyze the prevention and control of these cancers in India. Research priorities were organized using a framework based on the implementation science literature and the World Health Organization's definition of health systems. They addressed both community-level as well as health systems-level issues. Community-level or "pull" priorities included the need to identify effective strategies to raise public awareness and understanding of cancer prevention, monitor knowledge levels, and address fear and stigma. Health systems-level or "push" and "infrastructure" priorities included dissemination of evidence-based practices, testing of point-of-care technologies for screening and diagnosis, identification of appropriate service delivery and financing models, and assessment of strategies to enhance the health workforce. Given the extent of available evidence, it is critical that cancer prevention and treatment efforts in India are accelerated. Implementation science research can generate critical insights and evidence to inform this acceleration.

• Journal of dental hygiene science
• /
• v.13 no.1
• /
• pp.105-114
• /
• 2013

The purpose of this study was to offer information to medical institution of specializing in orthodontic patients by surveying the influence of orthodontic patients' perception of treatment according to orthodontic treatment upon satisfaction and recommendation with orthodontic treatment, targeting patients with completion of orthodontics who have experience of having received orthodontic treatment. As a result of SAS ver. 9.1 analysis on what was surveyed from February 2010 to August, the following conclusions were obtained. In comparing perception of treatment on orthodontic treatment according to general characteristics, women compared to men were indicated to be higher (p<0.05) in inconvenience recognition (p<0.05) on orthodontic device and in inconvenience during orthodontic treatment (p<0.05). In perception of treatment on orthodontic treatment, the inconvenience of orthodontic device accounted for 79.3%, thereby having been recognized by the majority of subjects. Even the inconvenience during orthodontic treatment was being recognized by 69.8%. The orthodontic treatment expenses appeared enough to be expected by 61.6%. The frequency of visiting hospital during orthodontic treatment was indicated as saying of having been proper by 72.8%. The period of orthodontic treatment was indicated to be proper as well by 61.2%. Even understanding about treatment contents during orthodontic treatment was indicated to be understood by 62.6%. In the results of correlation among subjects' cooperation with dental treatment, satisfaction with treatment service, recommendation of this clinic, and satisfaction with the convenient facilities, the significantly positive correlation was shown (p<0.05) in all among items in each.

• Health Policy and Management
• /
• v.26 no.2
• /
• pp.135-147
• /
• 2016

Background: The voluntary diagnosis-related groups (DRG)-based payment system was introduced in 2002 and the government mandated participation in the DRG for all hospitals from July 2013. The main purpose of this study is to examine the independent effect of mandatory participation in DRG on various outcomes of patients. Methods: This study collected 1,809,948 inpatient DRG data from the Health Insurance Review and Assessment database which contains medical information for all patients for the period 2007 to 2014 and examined patient outcomes such as length of stay (LOS), total medical cost, spillover, and readmission rate according to hospital size. Results: LOS of patients decreased after DRGs (large hospitals: adjusted odds ratio [aOR], 0.87; 95% confidence interval [CI], 0.78-0.97; small hospitals: aOR, 0.91; 95% CI, 0.91-0.92). The total medical cost of patients increased after DRGs (large hospitals: aOR, 1.22; 95% CI, 1.14-1.30; small hospitals: aOR, 1.22; 95% CI, 1.21-1.23). The results reveals that spillover of patients increased after DRGs (large hospitals: aOR, 1.27; 95% CI, 0.70-2.33; small hospitals: aOR, 1.18; 95% CI, 1.16-1.20). Finally, we found that readmission rates of patients decreased significantly after DRGs (large hospitals: aOR, 0.28; 95% CI, 0.26-0.29; small hospitals: aOR, 0.59; 95% CI, 0.56-0.63). Conclusion: The DRG payment system compared to fee-for-service payment in South Korea may be an alternative medical price policy which can reduce the LOS. However, government need to monitor inappropriate changes such as spillover increase. Since this study also is the results based on relatively simple surgery, insurer needs to compare or review bundled payment like new DRG for expansion of various inpatient-related diseases including internal medicine.

• The Journal of the Korea institute of electronic communication sciences
• /
• v.11 no.7
• /
• pp.707-716
• /
• 2016

The current research focused on the needs for discharge education and the educational performance of nurses perceived by mothers of premature infants. The subjects for the current research were 54 mothers of premature infants hospitalized in the neonatal intensive care unit at K general hospital in G metropolitan city. The data was collected between June 9, 2014 and September 30, 2014 through self-recording surveys. The needs for discharge education were $4.21{\pm}0.60$ and the perceived educational performance of nurses was $3.95{\pm}0.73$. There was a significant difference between the needs for discharge education and the perceived educational performance in abnormal symptom monitoring and management ($0.55{\pm}0.97$, p=0.001), excrement management ($0.45{\pm}1.11$, p=0.004) and growth development ($0.41{\pm}1.08$, p=0.007). The needs for discharge education was significantly different according to delivery type (vaginal delivery: $4.41{\pm}0.47$, caesarean section: $4.03{\pm}0.47$, p=0.040) and birth order (first: $4.37{\pm}0.53$, second: $4.25{\pm}0.51$, over third: $3.75{\pm}0.72$, p=0.031). Perceived educational performance of nurses was significantly different according to baby sitter (yes: $4.15{\pm}0.66$, no: $3.48{\pm}0.67$, p=0.002). ]

• Journal of Gastric Cancer
• /
• v.2 no.4
• /
• pp.205-212
• /
• 2002

Purpose: Malnutrition is a common postoperative complication that occurs after gastric resection. Several causes for malnutrition have been proposed, which include malabsorption and poor oral calorie intake. We performed this study to evaluate whether nutritional counseling would increase oral calorie intake and improve nutritional status in patients who had undergone gastrectomy. Materials and Methods: Twenty-two patients were randomly selected as the study group from among patients who had undergone gastrectomy for early gastric cancer and gastric polyp between October 1999 and December 2000. Body weight, hemoglobin, serum albumin, and serum transferrin were checked before and after the gastrectomy. Oral calorie intake was evaluated by using a 3-day oral-intake diary, and one nutritionist performed outpatient-based nutritional counseling. Eighteen patients who had undergone gastrectomy for the same disease during the same period were selected as the control group. Results: During an average interval of 14.8 months, the study patients received nutritional counseling an average of 3.4 times at an average interval of 4.4 months. The study group took a mean of $2055.6\pm418.1$ Cal per day and the control group $1792.1\pm421.9$ Cal (P=0.05). Sixty-eight percent (15 patients) of the study group patients reached the daily-required calorie intake. Postoperative bodyweights were $64.0\pm9.9$ kg for the study group and $64.3\pm10.8$ kg for the control group (P>0.05). No statistically significant differences were observed among the other. Sixty-five percent of the patients (26 patients) had a weight loss of less than $10\%$ of the preoperative body weight, and $35\%$ had more than a $10\%$ weight loss, but there was no statistical difference between the calorie intakes of these patients. Conclusions: Nutritional counselling increased the oral calorie intake, but nutritional status was not improved. These results suggest that nutritional derangement after gastrectomy cannot be corrected by adequate oral intake itself.

• Korean Journal of Community Nutrition
• /
• v.7 no.6
• /
• pp.852-862
• /
• 2002

The purposes of this study were 1) to review the Medical Nutrition Therapy (MNT) Act of the United States, 2) to introduce the efforts of the American Dietetic Association (ADA) to expand the Medicare coverage for MNT and 3) to provide information about the reimbursement under Medicare Part B for the cost of MNT. The MNT Act defined MNT services as “the nutritional diagnostic, therapeutic, and counseling services provided by a Registered Dietitian or nutritional professional for the purpose of managing diabetes or renal diseases”. Also, the MNT Act defined “conditions for coverage of MNT”, “limitations on coverage of MNT”, and “qualifications of MNT service provider”. To expand the coverage of Medicare to include MNT, the ADA realized the need for development of a protocol for MNT, as well as studies to evaluate the effectiveness and cost-effectiveness of the MNT protocol developed. Therefore, the ADA supported the studies to develop a strong database of scientific investigations of nutritional services. Furthermore, the ADA needed credible data that could be used by Policy makers, so the ADA contracted with the Lewin Group to if out the study to gather the additional data needed to strengthen the ADA's position. In the report of the Lewin Group, which was entitled, “The Cost of Covering Medical Nutrition Therapy under Medicare : 1998 through 2004”, it was concluded, that if coverage for MNT in the Part B portion of Medicare had begun in 1998, by 2004, approximately $ 2.3 billion would have been saved through reduced hospital spending under Part A of Medicare ($ 1.2 billion) and reduced physician visits under Part B ($ 1.1 billion) Effective January 1 2002, the US Congress extended Medicare coverage to include MNT to beneficiaries with diabetes or renal diseases. The Centers for Medicare and Medicaid Services (CMS) established the duration and frequency for the MNT based on published reports or generally accepted protocols (for example, protocols suggested by the ADA). The number of hours covered by Medicare is 3 hours for the initial MNT and 2 hours for a follow-up MM. In 2002, a Medicare coverage policy was made to define the Physician's Current Procedural Terminology (CPT) codes 97802, 97803, and 97804 for MNT.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.5
• /
• pp.3131-3137
• /
• 2013

Background: Visual inspection of cervix with acetic acid (VIA) is offered at 252 centers in 64 districts of Bangladesh. VIA+ve women are managed at colposcopy clinics of Bangabandhu Sheikh Mujib Medical University (BSMMU) and 14 Medical College Hospitals (MCHs). This research work has been supported by 'UICC Cancer Prevention Campaign' programme. Objectives: This study explored the role of print materials and electronic media to improve cervical cancer screening in the present socio-cultural context of Bangladesh. Methods: This study was performed from January to August 2011 at two upazilas of Bangladesh (Singair with screening facility and Sonargaon without screening facility). Data were collected by focus group discussion (FGD) with women, husbands and community people before and after intervention. Information on cervical cancer screening and VIA camps was disseminated using advertisement through local cable line of the television, microphone announcement, service providers and leaflet throughout the week prior to a VIA camp. Three-day VIA camps were organized at the upazila health complex (UHC) of both upazilas. Quantitative data was gathered from women at the camps on source of information on VIA and the best method of awareness creation. Results: The population was aware of "cancer" and a notable number knew about cervical cancer. Baseline awareness on prevention and VIA was low and it was negligible where screening services were unavailable. Awareness was increased fourfold in both upazilas after interventions and half of the women and the majority of the community people became aware of screening and available facilities. Cable line advertisement (25.5%), microphone announcement (21.4%), and discussion sessions (20.4%) were effective for awareness creation on VIA. Television was mentioned as the best method (37.4%) of awareness creation. Conclusion: Television should be used for nation-wide awareness creation. For local awareness creation, cable line advertisement, microphone announcements and health education at Uthan Baithaks/ EPI sessions can easily be adopted by the government.

• The Journal of the Korea Contents Association
• /
• v.12 no.1
• /
• pp.416-429
• /
• 2012

This study was to assess the effects of a recovery oriented integrated rehabilitation program on cognitive social function, rehabilitation motivation, and mental health recovery. This program is involved motivation enhancement program with 4 subprograms composed of cognitive rehabilitation, emotion management, vocational rehabilitation, family education program. The subjects were 34 patirents with schizophrenia who had been hospitalized at National Mental Hospital on local area. The study was a non-equivalent control group non-synchronized design with two groups, an experimental group(18 patients) and a control group(16 patients). The collected data were analyzed using SPSS 12. 0. The results of the data show that there was not a significant increase in the symptom, cognitive and social function. But there was a significant increase in readiness of rehabilitation(maintenance, p=.027) and mental health recovery (p=.039). Short term recovery oriented integrated rehabilitation programs in inpatient settings are more available for motivation of rehabilitation and mental health recovery than symptom reduction or functional improvement. Therefore there should be more efforts to create more recovery oriented service provision in clinical settings.

• The Journal of the Korea Contents Association
• /
• v.12 no.1
• /
• pp.346-352
• /
• 2012

This study compared and analyzed fetus, newborn infant, and delivery methode of 141 women who received medical service from the first examination to the delivery in an obstetrics and gynecology specialized hospital located in Gwangmyeong, Gyeonggi-do from Jan. 2010 to Dec. 2010 and had a regular delivery after 37 weeks of pregnancy (73 non-employed and 68 employed women), depending on employment state of the subjects. The following are the results derived from the study. 1. The weight of the mothers after 37 weeks of pregnancy and the average gestational age was no statistical difference depending on the employment state. 2. In 37 weeks, the average fetal weight in the non-employed group was $2.90{\pm}0.27kg$ and the rate of small for gestational age infants was 2.75%. Meanwhile, the average fetal weight in the employed group was $2.76{\pm}0.28kg$ and the rate of small for gestational age infants was shown to be 10.3%. It is known that the fetal weight of the non-employed group was significantly higher for 37 weeks of pregnancy (p<0.05). 3. The newborn infant weight of the non-employed group was $3.42{\pm}0.43kg$ in average while that of the employed group was $3.18{\pm}0.35kg$. It is known that the newborn infant weight of the non-employed group was significantly higher (p<0.05). 4. In terms of delivery method, cesarean constituted 32.9% in the non-employed group while constituting 16.2% for the employed group. It is known that cesarean was shown to be significantly higher among the non-employed group (p<0.05).