• Journal of dental hygiene science
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• v.8 no.4
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• pp.215-224
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• 2008

In order to meet the medical demand according to the changing medical environment and to provide patients with quality dental treatment and improve treating environment by establishing reasonable management plan, with 149 patients for whom continuous dental health program has been applied, the degree of satisfaction with the dental treatment, and the influence factors on the satisfaction were investigated. Using the SPSS Ver. 13.0, mean value analysis were performed on the satisfactions with dental care service and the quality of dental care service according to general characteristics, and regression analysis were performed on the influence of general characteristics and the degree of satisfaction with dental care service on the satisfaction of dental treatment. The result of the multiple regression analysis revealed the human (staff), environment, and the procedure of treatment as the influence factors of the satisfaction with dental treatment. Systematic management and training should be implemented to improve the quality of dental care service and enhance the satisfaction.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.9 no.2
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• pp.300-310
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• 2002

Purpose: This study describes the perception of comfort by hospital nurses. Q-methodological was used. Method: The participants completed a 37-item a sort made up of statements which could be ranked in terms of their relevance to the subjective meaning of comfort Result: Three interpretable types of comfort were identified. They are as follows : Type I, emotional and spiritual well-being style: The nurses perceived that patients feel comfortable when they feel emotional support from others and spiritual easiness. The nurses felt that the patients put worth in hope for a healthy life. free from pain and fear of death. Type II, acceptive medical environment style: The nurses perceived that patients have a secure and satisfied attitude towards prompt responses, exact information and skilled Intervention techniques. They also perceived that patients feel safe and secure when they feel free of pain and medical staff are kind. Type III, physical well-being style; The nurses perceived that patients feel safe and comfortable when they feel free of pain and have a good sleep and are able to maintain a comfortable position. They perceived that patients put a high value on meeting the basic needs of safety, such pain, sleep and positioning. Conclusion: The result of this study can be used as a basis to develop nursing measures for promoting comfort. Further studies are recommended on factors which influence nurses' perception of comfort and strategies to promote comfort according to the style of the patients.

• Safety and Health at Work
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• v.12 no.3
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• pp.304-310
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• 2021

Background: Healthcare settings have been recognized among the most hazardous places to work. Based on the five categories of occupational hazards that were identified by the ILO and WHO, this study aimed to analyze policy framework relevant to occupational health protection of health workers (HWs) in public health service in China, then discussed how to share the experience of the National Health Service (NHS) England for improvement. Methods: Based on policy learning theories, policy analysis and qualitative interview were used in this study. Results: In the Chinese public health service, at least five laws related to the regulation of occupational health protection for HWs; however, enforcement of relevant laws was separated and multi-centered; the national monitoring system, which targeted to occupational hazards and health outcome for HWs in China, had yet to be developed; the top three priorities were workplace violence, bloodborne pathogens, and musculoskeletal disorders; national strategies included Security Hospital, and Healthy China 2030. In NHS England, three laws were fundamental; several monitoring systems had been set up, including NHS Staff Survey, Commissioning for Quality and Innovation incentive scheme; mental health, musculoskeletal problem, and nutrition disorder and overweight were raised great concern; Health and Safety, and NHS Healthy Workforce Program were critical nationwide strategies. Conclusion: There were several similarities as well as differences between the Chinese public health system and NHS England, which laid foundation of learning by China. Recommendations of improving occupational health policies in China were provided, based on the lessons learned from the NHS England.

• The Journal of Korean Physical Therapy
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• v.30 no.6
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• pp.234-238
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• 2018

Purpose: Aim of this study was to investigate whether there are ipsilateral motor deficits for visuospatial accuracy and fine movements by making a comparison between stroke patients and healthy subjects. We examined whether ipsilateral motor deficits are influenced by the level of functional movements and muscle strength of the upper and lower extremities of the affected side. Methods: Thirty post-stroke subjects and 20 normal aged matched subjects were recruited. Outcome measures for less-affected side were the tracking task and nine-hole pegboard test. Fugl-Meyer test and motricity index were applied for the measurement of functional movements and muscle strength of affected side. Results: Tracking task and nine-hole pegboard test was significantly different between control and experimental group. In terms of accuracy index according to tracking, the experimental group showed a lower accuracy index in the MCP joint than the control group. However, there were no significant difference relation between the level of motor function of the affected side and the motor deficit level of ipsilateral side. Conclusion: Ipsilateral motor deficits may have significant clinical implications. It needs to be noted that although many patients, families, and medical staff are focused only on motor deficits of the affected side, motor deficits of the sound side can cause difficulties in daily living movements requiring delicate movements. In addition, there was no significant correlation between the level of motor function of the affected side and motor deficits of the sound side.

• Journal of Information Technology Applications and Management
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• v.28 no.3
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• pp.49-58
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• 2021

Due to the increasing interest in wellness aroused by the aging population and the pursuing feature of active old age, Korean elderly set importance on long life with their healthy condition. Following the change in the paradigm of the medical delivery system from hospital-oriented, treatment-oriented to personal-centered and self-care, Service design application of Smart Healthcare for the elderly became valuable. Smart Healthcare is a healthcare service provided through the fusion of ICT technologies including mobile/wearable devices, IoT, big data, and information technology, and it is utilized to prevent diseases managing abundant health information and living habits. As a methodology for delivering such Smart Healthcare to the elderly, Service design can be adopted. Therefore, this study would like to present the perquisites of Smart Healthcare design for the elderly through analyzing the results from in-depth interview methods between the elderly and medical staff. As a result of this study, guidelines for Service design application of health vulnerability management for the elderly utilizing smart phones were presented. Therefore, this study presented four prerequisites composed of 'high level of supplementation and ethical decision making', 'improvement of inequality in accessibility and experience', 'resolving problems in policy implementation' and 'user-friendliness' for the Smart Healthcare service design for the elderly. Overall, Service design is expected to play an innovative role in improving the quality of life for the elderly through the process of collecting and delivering information on Smart Healthcare centered on the experience of the elderly.

• Journal of Hospice and Palliative Care
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• v.19 no.1
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• pp.26-33
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• 2016

Purpose: This study was conducted to identify clinical characteristics of oncologic patients at a point when they signed their do-not-resuscitate (DNR) orders. Methods: From January through December 2014, we retrospectively analyzed the records of 197 patients who passed away after agreeing to a DNR order in the hemato-oncology department of a tertiary hospital. Results: Of all, 121 patients (61.4%) were male and 76 (38.6%) were female, and their average age was 58.7 years. Ninety-four patients (47.7%) had gastrointestinal cancer. The ECOG performance status at admission was grade 3 in 76 patients (36.5%) and grade 4 in 11 (5.6%). The patients' mean hospital stay was 20 days. The mean duration from the admission to DNR decision was 13 days, and the mean duration from DNR decision to death was seven days. Conclusion: Study results indicate that a decision on signing or refusing a DNR order was made by medical staff mostly based on the opinions of patients' guardians rather than the patients themselves. This suggests that patients' own wishes are not well respected. Thus, it is urgent to establish institutional devices to enhance cancer patients' autonomy regarding DNR and to define an adequate timing for withdrawal of treatments.

• Korea Journal of Hospital Management
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• v.7 no.2
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• pp.99-123
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• 2002

This study was conducted to determine whether follow-up management is carried out continuously following CQI activity and to analyze the factors behind the success and failure of follow-up management. Past presentations from 1994-1999 of CQI coordinators and lecturers from various institutions who presented at The Korean Society of Quality Assurance in Health Care(KoSQA) on the conditions of follow-up management in each institution were analyzed. The results of this study were as follows; Since the number of subjects on CQI increased each year at symposiums, this has expanded to all medical institutions. Although medical institutions usually conduct 11-20 subjects on CQI per year, there were many such occasions where more than 31 subjects were conducted. Moreover, institutions with less than 800 beds have come up with more projects than those with more than 800 beds, thus 23.3% of these institutions had at least 1 person involved in 4 projects. This had created an overload of responsibilities for specific persons' involvement, prompting them to incline toward formalities in their work rather than substantial activities. Among the projects presented at the symposiums, 51.7% demonstrated that follow-up management could be carried out. In particular, 55.3% of the projects from provincial regions could carry out follow-up management compared to 48.8% in Seoul. Moreover, it was demonstrated that 80% of the projects from institutions with 600-799 beds carried out follow-up management most effectively. With regards to previous presentations, the older they were, it was found that follow-up management could not be effectively carried out. Some institutions that responded that follow-up management was carried out effectively in their institutions were found to have conducted follow-up management without any inspection strategies or the appropriate tools. CQI activities were executed and terminated with no consistency and team members had no real concern for it. The most important factors that contribute to an effective follow-up management are the need for concern and interest from the directors of the hospitals, from the relevant departments and team members in addition to the role of the supervising department, follow-up management through management of target goals, consistency in tasks along with communication between all team members. The biggest problems were perceived to be overload of work due to accumulation of proposed projects in addition to lack of awareness pertaining to follow-up management. CQI is beneficial for all staff for the improvement of the mind and business administration and thus it is believed to be desirable. To carry out follow-up management effectively, leadership, analysis and application of information, follow-up management and planning, as well as quality management are perceived to be essential, on the other hand, the results showed a significant difference. To prevent CQI activities from becoming just an activity, the basic system should be reconstructed and augmented based on the problems derived from the results of this study. Moreover, we hope this study will be used as reference material that would encourage the administration of follow-up management after CQI activities in most hospitals. Furthermore, various studies on follow-up management should be conducted for CQI activities in the future.

• Journal of the Korean Dietetic Association
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• v.19 no.1
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• pp.69-81
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• 2013

The purpose of this study was to evaluate the difference in perception of clinical nutrition service (CNS) between doctors and dietitians working in hospitals in Busan and the Gyeongnam area. Research was performed through questionnaires (from November to December 2011) at over 100 beds. 73.3% of dietitians were aware of the Nutrition Support Team (NST), while only 15.6% of doctors were aware of it. Due to heavy work and lack of medical staff, doctors didn't participate in NST, although most of them recognized the necessity of NST. 61.7% of dietitians screened and managed malnourished patients, whereas only 29.8% of doctors did. The main reason dietitians didn't treat malnourished patients was the absence of a treatment system in the hospital. Less than 50% of dietitians participated in the doctor's round to malnourished patients. As for why dietitians didn't participate in doctor's rounds, 71% of doctors chose understaffed dietitians and 38.1% of dietitians chose the doctors' unawareness of the importance of the dietitian in doctor's rounds. For the lower rate of nutrition counseling in provincial regions, compared to the capital region, 46.8% of doctors cited a lack of connection between doctors and clinical dietitians, while 43.3% of dietitians cited the lack of doctors' awareness on the importance of nutrition counseling. Although 87.3% of the doctors and 91.6% of the dietitians answered that CNS is important for treatment, the perception of onsite performance status on CNS was found to be low in both groups. 48.9% of doctors and 50.0% of dietitians regarded dietitians in the hospital as personnel in charge of food services, rather a member of the medical team. To improve the awareness of the importance of the CNS, and the image of clinical dietitians, 31.2% of doctors answered "to introduce a professional dietitian license for each disease" and 26.7% of dietitians answered "to change the system in the hospital". Most subjects found that a separation of clinical nutrition services from the food service part is needed. These results suggest that it is important to narrow the difference in perceptions of clinical nutrition services between doctors and dietitians for an organized clinical nutrition management of patients in hospitals in Busan and the Gyeongnam area.

• 모자간호학회지
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• v.4 no.1
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• pp.3-11
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• 1994

Presently there is an increasing demand for home health care services due to changes in the demographic structure as a result of an increasing elderly population, socio-economic improvements, and changes in the family structure, as well as the growing number of people with degenerative diseases. In addition to these reasons, rising medical costs and there a shortage of patient beds space in the hospital, particularly since introduction of national medical insurance. There has been an increasing demand for health care health care services. This study was done to identify the basic data for home health care management. It focused on developing client selection criteria, assessment tools, and recording methods. This was accomplished by the researchers visiting the patients in their homes. The research process included preparation investigation, tool development, training of the project researcher, and visiting the clients in their homes. The research tools are as follows : 1. Record development : a) The selection criteria tool for home health care of postpartum women was a structured tool and consisted of four parts. b) The structured assessment tool consisted of a general items, obstetric history, past medical history, methods of feeding, medications taken before admission, laboratory test results, discharge instructions, discharge medications, family tree, economic status, environmental status, a map, health assessment of postpartum women and their newborns. c) The visit note I consisted of the frequency of visits. Visit note II consisted of the date ; nursing problems ; nursing process including the initial assessment ; nursing goal ; visit plan ; postpartum women and their neonate health status, diagnosis, goal, implementation, evaluation, summary, next plan, for visit revision. d) Problem note consisted of the date, problem numbers, nursing diagnosis, problem appearance date problem resolution date. The research results are as follows : 1. Nursing problems : The nursing problems of the postpartum women and their neonates were evaluated by the number of nursing diagnoses and the change in the pattern of nursing diagnosis related to the number of visits. a) Nursing diagnosis The nursing diagnosis was classified according to physical function, psychosocial function, family system maintained function. b) The changes of nursing diagnosis related to the number of visits. As the type of nursing diagnosis changed related to the number of visits the number of nursing diagnoses decreased. 2. Contents of home health care : The content was categorized according to assessment, direct care, counseling, education, family care, reporting to with the attending doctor. The recommendations based on the research results are as follows : 1. Tool development Replication of this study is needed to test the validity of the assessment tools used. 2. Home visit a) Home health care nurses should be licensed and qualified. A referral form from the attending doctor is needed for legal protection of nurses. b) The first home visit need to be within 24 hours of discharge from the hospital to decrease the anxiety of frightened postpartum women. c) When the changes occur in the newborn's status, home health care nurses should consult a pediatrician. Communication within the home healthcare team is essential and needs to consistent and done smoothly. 3. Home health care A Study is required to develop protocols for education of staff and for operation of all aspects of this program.

• Perspectives in Nursing Science
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• v.10 no.2
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• pp.87-96
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• 2013

Purpose: The purpose of this study was to investigate the relationships of activity status, anxiety, depression, social support, symptom experience, and functional status in patients with lung cancer based on the theory of unpleasant symptoms. Methods: The participants for this study were 101 lung cancer patients who visited the out-patient department for treatment or follow-up at one hospital in Seoul. Data were collected from January 1 to February 8, 2013 using self-reported questionnaires and clinical records. To measure variables, the functional scale and symptom scale of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30, EORTC QLQ-Lung Cancer 13, Eastern Cooperative Oncology Group Performance Status, Hospital Anxiety and Depression Scale, and Multidimensional Scale of Perceived Social Support were used in this study. The data were analyzed using SPSS 19.0 software for Windows. Results: The symptom experience showed more severity in patients with lower activity status, higher anxiety and depression. With lower activity status and social support, functional status was lower. When anxiety, depression, and symptom experience were higher, functional status was also lower. The significant factors predicting symptom experience were depression, anxiety, activity status, and social support, which explained 57.8% of the variance. Conclusion: These results suggest that psychological factors such as anxiety and depression had a negative influence on the symptom experience of lung cancer patients. Therefore, providing emotional support based on the patients' needs prior to providing symptom management could be a useful strategy for improving symptom experience and functional status.