Purpose: The aim of this study was to examine effects of patient safety culture and burnout on safety management activities with a focus on clinical experience of nurses in general hospitals. Methods: Self-administered questionnaires were given to nurses in a general hospital in C Province, and 107 questionnaires were used for final analysis. Collected data were analyzed using SPSS/WIN 21.0 Program for t-test, ANOVA, Pearson correlation coefficients, and multiple regression. Results: The highest score as perceived by general hospital nurses for patient safety culture was for 'Immediate superior/Manager' (3.84), for burnout, the highest score was for 'Emotional exhaustion' (4.13), and for safety management activities, the highest score was for 'Prevention of infection' (3.96). Patient safety culture and safety management activities perceived by general hospital nurses showed significant positive correlations (r=.35 p<.001). The correlations between burnout and safety management activities perceived by the nurses showed significant negative correlations (r=-.37, p<.001). Results of hierarchical regression analysis conducted to identify factors that affect safety management activities showed that patient safety culture (${\beta}=.40$ p<.001) was effective for controlling safety management activities. Conclusion: The findings indicate a need to build a patient safety culture that fits the characteristics and situations of various hospitals.
As the importance of strengthening the competency of managers who are in charge of cash collection and disbursement, and preparing for financial statements becomes more visible, this study examined the competency of middle-level managers of accounting department in general hospitals in Korea. Based on the literature, competency was measured by seven components: achievement and action, service, influence, management, cognition, individual effectiveness, and change management. Survey questionnaires included the respondents' perceived importance and performance of each of the seven components of competency. A total of 84 managers from 29 general hospitals responded to the survey between October 2015 and November 2015. Descriptive statistics, mean comparison (t-tests and ANOVAs), and multiple linear regression were conducted. The results of this study are as follows. Overall perceived importance of the competency was 4.16, while the performance was 3.87, and thus, the difference was 0.29. Among the seven components of the competency, cognition and change management had higher scores in terms of difference between the importance and performance. The regression analyses found that female managers had higher perceived importance and performance of competencies in achievement and action, and influence compared to male counterparts. In addition, participants in this study responded that main reasons for the gap between the perceived importance and performance are low compensation, lack of support, lack of knowledge, insufficient technical experience, excessive workload, and regulations. The results of this study can be used when designing capacity building training opportunities for the hospital accounting department. Also, the managers may evaluate themselves and look at the areas where they can narrow the gap between the perceived importance and performance of the competency that is required for today's leading managers.
Background: The multidrug resistance 1 gene (MDR1) C3435T polymorphism has been demonstrated to influence the P-glycoprotein (P-gp) activity level which is related to inflammation and carcinogenesis. This meta-analysis was performed to estimate the association between the MDR1 C3435T polymorphism and the risk of gastric cancer (GC) and peptic ulcer (PU). Materials and Methods: A literature search was conducted with PubMed, Embase and the Cochrane library up to November 2013. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of association. Data were analyzed using Review Manager (Version 5.2), and Stata package (version 12.0) for estimation of publication bias. Results: Six case-control studies were included, of which five were for GC and two for PU. Overall, no evidence was found for any association between the MDR1 C3435T polymorphism and the susceptibility to GC and PU. In the stratified analysis by H. pylori infection status, stage and histology classification of GC, and PU type, there was still no significant association between them. Conclusions: This meta-analysis suggested that the MDR1 C3435T polymorphism is not associated with susceptibility to GC and PU. Large and well-designed studies are warranted to validate our findings.
Purpose: The purpose of this study was to determine the factors related to the social support, family and friend support as well as home care nurse support, in family caregivers of patients with home care service. Method: The participants were 111 family caregivers of patient, who were receiving home care services from home health care centers of 3 different general hospitals located in Seoul. The data was collected, using self-administered questionnaires. Result: The level of family and friend support varied significantly according to patients' mental status, period of home care nursing, frequency of home care service, caregiver's education level, family income, and family functioning level. On the other hand, home care nurse support varied significantly according to patients' mental status, caregiver's age, existence of interchangeable family caregivers, and family functioning level. There was a significantly positive correlation between the social support the family caregivers' perceived and family function while there was a negative correlation between family and friend support and the period of home care service. Conclusion: Thus, the establishment of nursing interventional program, with understanding of their social support, is needed for both patients and their caregivers.
Objective: This study aimed to report the therapeutic effect of acupuncture on chemotherapy-induced peripheral neuropathy (CIPN). Methods: The articles were sourced from databases including PubMed, EMBASE, Cochrane Library, CNKI, CiNii, WHO ICTRP, JSOM, KMBASE, KISS, NDSL, and OASIS as of July 2019. The main search keywords were peripheral neuropathy and acupuncture, and only randomized controlled trials using acupuncture for therapeutic purposes were included. Cochrane's risk of bias was used to assess the risk of bias, and the Review Manager 5.3 program was used for meta-analysis. Results: Six studies with a total 394 participants were included. When combined treatment of acupuncture and usual care was compared with usual care alone, quality of life improved more significantly in the combination treatment group (SMD=-2.71, 95% CI: -5.01 to -0.41, P=0.02, I2=97%). The CIPN pain score was lower among the combination treatment group, but not to a significant degree (SMD=-2.55, 95% CI: -5.14 to 0.04, P<0.05, I2=98%). There were no severe side effects in any studies. Conclusion: Acupuncture combined with usual care may be considered to safely relieve CIPN pain and improve quality of life for cancer patients. However, as there are few randomized controlled trials studying the effect of acupuncture on CIPN, further well-designed research is needed.
Objective: This study was aimed to report the therapeutic effects of herbal medicine on chemotherapy-induced peripheral neuropathy (CIPN). Methods: The prior studies were searched from the databases included PubMed, Cochrane Library, EMBASE, CNKi, CiNii, KISS, NDSL, KMBASE, and OASIS until September 2020. The main search keywords were chemotherapy, peripheral neuropathy, and herbal medicine, and only randomized controlled trials that analyzed the therapeutic efficacy of herbal medicine were included. The Cochrane's Risk of Bias was used for assessment of the risk of bias and the Review Manager 5.3 program was used for meta-analysis. Meta-analyses were grouped by the administration routes of herbal medicines (oral administration or topical use). Results: Nine studies with a total of 563 participants were included. Compared with usual care, the effective rate was higher in oral administrated herbal medicine (RR 1.67, 95% CI 1.25 to 2.23; p<0.001, I2=31%). In addition, topical herbal medicine showed an significantly higher effective rate than placebo (RR 2.20, 95% CI 1.52 to 3.18; p<0.001, I2=0%) and usual care (RR 2.24, 95% CI 1.74 to 2.89; p<0.001, I2=66%). There was no severe adverse effect in all participants. Conclusions: Herbal medicine appears to improve neuropathy caused by chemotherapy in cancer patients more than conventional therapy of CIPN. However, as there is heterogeneity between the included studies and a lack of blinding, further well-designed researches are more needed.
Objectives: This study assessed the effectiveness of Hwanggigyejiomul-tang for postoperative breast cancer-related lymphedema (BCRL) by a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: A search was conducted using keywords such as "breast cancer", "lymphedema", "edema", "Huangqi Guizhi Wuwu decoction", "Huangqi Guizhi Wuwu tang", and "Hwanggigyejiomul tang" in 10 databases (PubMed, Cochrane, ScienceDirect, CNKI, CiNii, RISS, KISS, ScienceON, OASIS, DBpia) on February 11, 2024. There were no limits on the publication period and language, and the quality of the studies was evaluated using Cochrane's risk of bias tool. A meta-analysis was performed based on the outcome measurements, such as total effective rate (TER), increase in shoulder joint mobility (flexion, extension, abduction, adduction), Fugl-Meyer assessment (FMA), and visual analog scale (VAS) using Review Manager Web. Results: Eleven RCTs were selected. The treatment group (Hwanggigyejiomul-tang-gagambang or hapbang with control group intervention) showed a more statistically significant effect compared with the control group (physical therapy or western medicine) in TER (upper limb circumference change), TER (upper limb edema grade change), increase in flexion angle, increase in extension angle, increase in adduction angle, FMA, and VAS. Conclusions: Hwanggigyejiomul-tang is effective in treating postoperative BCRL. However, because of the low quality of the included studies, more clinical studies are required to increase the possibility of clinical use.
Purpose: This study was aimed to investigate educational need of nursing managerial competency in the hospitals. Method: The data were collected from 296 nurses(nurse manager and nurse) who had worked in 9 hospitals using the structured questionnaires. Data was analysed by the SPSS for Windows 12.0 program. Results: Educational needs of the nurse managerial competency development were very high. Most of items in the areas of 'human resource management', 'leadership', 'ethic/ law responsibility' and 'quality improvement' were needed for nurse managerial competency development. Current level of the nurse managerial competency level in practice was lower than education need. However nurses had moderate level ability in the areas of 'ethic/ law responsibility', 'human resource management' and 'nursing information management'. There were significant differences in current level and need of the nurse managerial competency(p=.000). Education needs of the nurse managerial competency were influenced by age, clinical career, position, education level, experience of nurse manager education(p<.05). 5) Education program operations were preferred to 'the theme course', 'lecture', 'external education institution'. Conclusion: Education program of the nursing managerial competency development is urgently needed for nurses who have worked in a hospital.
Purpose: The purpose of this study was to develop 360 feedback for nursing unit manager based on the current personnel evaluation system and to evaluate the new tool according to evaluation subjects. Total of 277 subjects of nurse unit managers and staff nurses were participated in this study. Method: The study was conducted in three phases each for development, application, and analysis of 360 feedback. SAS program was utilized for data analysis with descriptive statistics, t-test, and analysis of variance. Result: The evaluation criteria of the developed 360 feedback tool consisted of 13 subscales such as professional knowledge, apprehension & judgement, job performance, applicability, creativity, leadership, responsibility, promptness & accuracy, administrative ability & sense of mission, activeness, cooperation, communicability, and general attitude. The internal consistency of the tool was Cronbach's alpha .939. The evaluation score by! peers(M=4.30) was the highest one, followed by self-evaluation(M=4.23), evaluation by supervisor(M=4.17), and evaluation by subordinate(M=4.10). The differences in the total evaluation scores among the subjects supervisor, self, peer, and subordinate were not statistically significant, but significant differences were found in some subscales scores. Conclusion: Further research is required to test the reliability and validity of the $360^{\circ}$ feedback tool, and to test the outcome and the process of $360^{\circ}$ feedback system.
Introduction: Preplacement health examination (PHE) is performed when a worker starts a certain work task which is designated as having occupational risks by the Ministry of Employment and Labor (MOEL). All data related to health examination except PHE are reported to the MOEL by the law. This study has been performed to understand the status of PHE at certain workplaces. Methods: PHE data gathered in a university hospital were analyzed and they were followed with results of the special health examination (SHE) in 2019 and 2020. Those who were evaluated as unfit to work as it was, were interviewed directly or indirectly through an occupational health manager to follow up the management status of their recognized health problems. Results: The unfit to work (unFTW) rate of PHE was 2.8%, and was not different according to the size of workplace or having occupational health service. The major cause of unfit to work was the uncontrolled life-style diseases such as hypertension and diabetes. The rate of SHE followed by PHE was 31.1%. It was not different by the unFTW rates, however, they were different according to having a full time in-house occupational health manager. Thirty-one among 71 examinees who were evaluated as unFTW underwent SHE after controlling their health condition and were finally evaluated as fit to work. Nineteen among 31 started to take medicine and eight have been placed in the work without designated risks. Conclusion: PHE can be used for new workers, who may have unknown or uncontrolled life-style diseases, to be asked to manage life-style diseases as well as work-related risks such as shift work. In order to have a better tracking system for work-related risks, the information of PHE should be analyzed together with other data from health examination.
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