• 보건행정학회지
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• 제25권1호
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• pp.31-39
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• 2015

Background: The purpose of this study is comparison of the results between regression and multi-level analysis to find out factors influencing outcome indicators (in-hospital death, length of stay, and medical charges) of stroke patients. Methods: By using patient sample data of Health Insurance Review & Assessment Service, patients admitted with stroke were selected as survey target and 15,864 patients and 762 hospitals were surveyed. Results: For the results of existing regression analysis and multi-level analysis, models were assessed through model suitability index value and as a result, the value of results of multi-level analysis decreased compared to the results of regression, showing it is a better model. Conclusion: Factors influencing in-hospital death of stroke patients were analyzed and as a result, intra-class correlation (ICC) was 13.6%. In factors influencing length of stay, ICC was 11.4%, and medical charges, ICC was 17.7%. It was found that factors influencing the outcome indicators of stroke patients may vary in every hospital. This study could carry out more accurate analysis than existing research findings through analysis of reflecting structure at patient level and hospital level factors and analysis on random effect.

• 대한골관절종양학회지
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• 제5권1호
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• pp.63-69
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• 1999

Recently we experienced four cases of soft tissue Ewing sarcoma, developed in the calf muscles in two cases, and one case each in the foot and suprascapular region. We also found that the clinical course in all cases was rather rapid, because of local recurrence and metastatic lesions developing within a few months, followed by the patients' death in about 2 years after the primary tumor was excised. These cases were improperly treated initially as some kind of benign soft tissue tumor. The delay led to missed early accurate diagnosis and was thought to be one of the main causes for the rapid local recurrence and metastasis after tumor excision. The pulmonary metastasis was the most common cause of death.

• Korean Circulation Journal
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• 제52권6호
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• pp.429-440
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• 2022

Background and Objectives: Endovascular therapy (EVT) first strategy has been widely adopted for the treatment of chronic limb threatening ischemia (CLTI) patients in real-world practice. This study aimed to investigate long-term outcomes of CLTI patients who underwent EVT and identify prognostic factors. Methods: From the retrospective cohorts of a Korean multicenter endovascular therapy registry, 1,036 patients with CLTI (792 men, 68.8 ± 9.5 years) were included. The primary endpoint was amputation-free survival (AFS) defined as the absence of major amputation or death. Secondary endpoints were major adverse limb events (MALE; a composite of major amputation, minor amputation, and reintervention). Results: Five-year AFS and freedom from MALE were 69.8% and 61%, respectively. After multivariate analysis, age (hazard ratio [HR], 1.476; p<0.001), end-stage renal disease (ESRD; HR, 2.340; p<0.001), Rutherford category (RC) 6 (HR, 1.456; p=0.036), and suboptimal EVT (HR, 1.798; p=0.005) were identified as predictors of major amputation or death, whereas smoking (HR, 0.594; p=0.007) was protective. Low body mass index (HR, 1.505; p=0.046), ESRD (HR, 1.648; p=0.001), femoropopliteal lesion (HR, 1.877; p=0.004), RC-6 (HR, 1.471; p=0.008), and suboptimal EVT (HR, 1.847; p=0.001) were predictors of MALE. The highest hazard rates were observed during the first 6 months for both major amputation or death and MALE. After that, the hazard rate decreased and rose again after 3-4 years. Conclusions: In CLTI patients, long-term outcomes of EVT were acceptable. ESRD, RC-6, and suboptimal EVT were common predictors for poor clinical outcomes.

• Tuberculosis and Respiratory Diseases
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• 제83권4호
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• pp.324-325
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• 2020

• 종양간호연구
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• 제9권2호
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• pp.95-103
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• 2009

Purpose: The purpose of this study was to examine nursing students' attitude toward death and perception on hospice care. Methods: The survey was performed with 277 nursing students in three universities in Daegu and Busan. The data was collected by questionnaires and were analyzed using descriptive statistics. Results: Regarding the attitude on death, 93.9% of the subjects had ever thought about death. They worried about separation and sadness with family (39.7%). About half (48.7%) of the subjects considered death as a final process of the life. With regard to the perception of hospice, 93% of the subjects heard about hospice through books or nursing courses (83.8%). The best hospice management institution was considered the one run by religious groups or non-profit organizations with government support (33.9%). Ideal model of hospice setting in Korea was hospital or institution specialized with hospice care (47.7%). The barriers the subjects thought to effective hospice care in Korea was the lack of the public consensus on the need for hospice program (37.9%). The average perceptions about the purpose of hospice care was 4.38, whereas, the average of the need of hospice care was 4.06. Conclusion: The findings of the study provides the basis for expanding nursing practice and education related to hospice care.

• 한국간호교육학회지
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• 제26권1호
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• pp.56-66
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• 2020

Purpose: The purpose of this study was to explore nursing students' experiences with patient deaths during clinical practice. Methods: The participants were ten nursing students who had experienced patient deaths during clinical nursing practice at a university hospital in Korea. Individual in-depth interviews were conducted, and the data were analyzed using the content analysis method suggested by Graneheim and Lundman (2004). Results: The participants' experience was structured into six categories: experiencing various emotions in facing patient deaths, viewing oneself as a nursing student at the scene of a patient's death, thinking about death again, finding a pathway of understanding and support for patient death experiences, impressions and regret felt while actually observing terminal care, and picturing oneself as a future nurse dealing with a patient's death. Conclusion: Based on this study, stress management and self-reflection programs are suggested for nursing students who have experienced patient deaths. Practical nursing education for patient death and end of life care is also needed.

• 동서간호학연구지
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• 제19권2호
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• pp.88-95
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• 2013

Purpose: The purpose of this study was to examine nursing students' attitude toward death and perception on hospice care. Methods: The survey was performed on 103 nursing students in one university in Goseong-gun, Gangwon-do. The data were collected by questionnaires and analyzed using descriptive statistics. Results: Regarding the attitude toward death, 90.3% of the students had thought about death. They worried about sense of loss and sadness due to parting with family (31.1%). About half (51.5%) of the students considered death as a final process of the life. With regard to the perception of hospice, 92.2% of the students heard about hospice through books or nursing classes (65.0%). Public institutions running by government was considered to the students as the best hospice management institution (44.7%). The students thought a ideal model of hospice setting in Korea was hospital or institution specialized with hospice care (51.5%). They considered the barriers to effective hospice care in Korea was the lack of the public consensus on the need for hospice program (35.9%). The average perceptions about the purpose of hospice care was 4.33 whereas the average of the need of hospice care was 3.85. Conclusion: The findings of the study provide the basis for expanding nursing practice and education related to hospice care.

• 가정∙방문간호학회지
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• 제28권3호
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• pp.307-316
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• 2021

Purpose: This study aimed to examine the influence of family support and death preparation on the quality of life in home care hospice patients. Methods: The study recruited 117 patients in home care hospice in four general tertiary hospitals and three general hospitals in three cities. Data were collected using self-reported questionnaires from September 1, 2019 to March 31, 2020 and analyzed using the statistical package IBM SPSS software version 22.0. Results: The quality of life according to the participants' general characteristics of the subjects shows a statistically significant difference between patients who live with supporters and those who do not(Z=2.96, p=.003). A statistically significant correlation was found between predictors such as family support, death preparation, and quality of life. Family support and death preparation affect the quality of life in home care hospice patients and these variables could explain 33.7% of it. Conclusion: To improve the quality of life in home care hospice patients, we should develop an intervention to enhance family support and death preparation.

• 한국산학기술학회논문지
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• 제17권6호
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• pp.510-520
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• 2016

본 연구는 노인요양병원 간호사의 죽음 인식, 영적 안녕, 임종간호 스트레스의 정도를 파악하고 그 관련요인을 분석하여 임종간호 스트레스를 감소시키기 위한 중재 개발의 기초자료로 제공하기 위한 목적으로 시도 되었다. 연구 대상은 노인요양병원 6곳에 근무하는 간호사 181명이었고, 자료 수집은 2015년 7월 16일부터 2015년 8월 1일 까지 구조화된 자기기입식 설문지로 하였다. 연구결과 노인요양병원 간호사의 죽음 인식은 평균 4.30점, 영적 안녕은 평균 3.40점, 임종간호 스트레스는 평균 3.84점이었고, 일반적인 특성에 따른 임종간호 스트레스는 종교, 총 임상경력에서 유의한 차이를 보였다. 임종간호 스트레스의 평균 점수를 기준으로 차이를 분석한 결과 영적 안녕은 임종간호 스트레스에 유의한 영향을 주는 것으로 나타났으며(p=.047), 영적 안녕이 평균 평점 1단위 증가할 때마다 임종간호 스트레스가 '상'그룹에 속할 확률이 Odds비 1.702로 나타났다. 노인요양병원의 임종간호 스트레스를 감소시키기 위한 교육프로그램과 간호중재 개발이 요구되며, 임종간호 스트레스 감소를 통해 임종간호의 질을 높이기 위한 노력을 기울여야 할 것이다.

• 한국콘텐츠학회논문지
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• 제21권4호
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• pp.487-497
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• 2021

본 연구의 목적은 2008년부터 2017년까지의 결핵환자의 결핵 종류, 환자 특성, 입원 및 질병관련 특성, 의료기관 특성에 따른 재원기간과 사망에 영향을 미치는 요인을 파악하고자 한다. 질병관리청에서 제공하는 퇴원손상심층조사자료를 활용하였고, 제6차 한국표준질병사인분류(KCD)의 퇴원시 진단 코드가 결핵(A15, A16, A17, A18, A19, U88.0, U88.1, U84.30, U84.31)인 환자를 추출하여 총 10,634건을 최종 분석에 사용하였다. 수집된 자료는 통계 프로그램 STATA 13.0 프로그램을 이용하여 빈도분석, 교차분석(chi-square test), Fisher's exact test와 로지스틱 회귀분석을 실시하였다. 연구결과로 재원기간에 영향을 미치는 요인으로 폐결핵을 기준으로 폐외결핵, 복합결핵, 내성결핵일 때, 남자보다는 여자일 때, 연령이 높을수록, CCI(Charlson Comorbidity Index) 점수가 높을수록, 병원소재지 서울을 기준으로 광역시일 때 14일 이상 재원환자가 많았지만 외래경유, 병상규모가 작을수록 14일 이상 재원환자가 적었다. 그리고 사망에 영향을 미치는 요인은 폐결핵을 기준으로 폐외결핵, 내성결핵 일 때, 남자보다는 여자일 때, 연령이 높을수록, CCI 점수가 높을수록, 병원소재지가 서울을 기준으로 광역시, 도지역일 때 사망이 높았으나 거주지가 특별시일때 보다는 농촌, 외래경유 입원인 경우 사망이 낮았다. 결론으로 기존의 결핵관리가 조기발견에 따른 신속한 진단과 치료의 환자 관리였다면 앞으로는 장기재원과 치료결과 사망률이 높은 고위험군을 파악하고 이를 지원하는 제도를 위한 연구들이 추가적으로 진행되어야 할 것이다.