• Journal of Preventive Medicine and Public Health
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• 제56권3호
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• pp.221-230
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• 2023

Objectives: The second wave of coronavirus disease 2019 (COVID-19) cases in Indonesia, during which the Delta variant predominated, took place after a vaccination program had been initiated in the country. This study was conducted to assess the impact of COVID-19 vaccination on unfavorable clinical outcomes including hospitalization, severe COVID-19, intensive care unit (ICU) admission, and death using a real-world model. Methods: This single-center retrospective cohort study involved patients with COVID-19 aged ≥18 years who presented to the COVID-19 emergency room at a secondary referral teaching hospital between June 1, 2021 and August 31, 2021. We used a binary logistic regression model to assess the effect of COVID-19 vaccination on unfavorable clinical outcomes, with age, sex, and comorbidities as confounding variables. Results: A total of 716 patients were included, 32.1% of whom were vaccinated. The elderly participants (≥65 years) had the lowest vaccine coverage among age groups. Vaccination had an effectiveness of 50% (95% confidence interval [CI], 25 to 66) for preventing hospitalization, 97% (95% CI, 77 to 99) for preventing severe COVID-19, 95% (95% CI, 56 to 99) for preventing ICU admission, and 90% (95% CI, 22 to 99) for preventing death. Interestingly, patients with type 2 diabetes had a 2-fold to 4-fold elevated risk of unfavorable outcomes. Conclusions: Among adults, COVID-19 vaccination has a moderate preventive impact on hospitalization but a high preventive impact on severe COVID-19, ICU admission, and death. The authors suggest that relevant parties increase COVID-19 vaccination coverage, especially in the elderly population.

• 대한소아치과학회지
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• 제44권4호
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• pp.403-411
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• 2017

본 연구의 목적은 치과적 외상이 있는 소아청소년 입원환자의 치과 협진 의뢰에 대한 본원의 현황을 분석하고 발전 방향을 모색하는 것이다. 이에 2011년 3월부터 2017년 2월까지 6년간 원주세브란스기독병원 의과에 입원한 소아청소년 환자의 치과 협진 의뢰에 대한 후향적 분석을 하였다. 조사 항목으로 협진 의뢰 주소와 치과적 진단명, 협진 의뢰과, 치과적 외상 후 협진 의뢰 시기, 입원 기간과 치과적 외상 후 협진 의뢰 시기의 관계, 외상으로 의과에 입원하는 것과 치과적 외상 발생의 관계, 치과적 외상의 원인과 발생 나이, 치과적 외상에 대한 치료, 치과적 외상 환자의 퇴원 후 치과 외래 재내원 등이 있었다. 협진 의뢰 주소와 치과적 진단명에서 치과적 외상이 차지하는 비율이 가장 높았고, 협진 의뢰과는 외과 계열의 진료과가 가장 높은 비율을 보였다. 입원 기간과 치과적 외상 후 협진 의뢰 시기는 양의 상관 관계를 보였다. 외상을 이유로 의과에 입원하는 것과 치과적 외상 발생은 통계적으로 유의하게 연관이 있었고, 교통 사고로 인해 의과에 입원한 환자의 경우 100% 치과적 외상이 동반되었다. 입원실에서 발생한 치과적 외상 환자의 나이는 유의하게 적었다. 치과적 외상과 입원 중 치료, 치과적 외상과 퇴원 후 치과 외래 재내원은 각각 통계적으로 유의한 연관이 없었다. 교통 사고에 의해 의과에 입원한 소아청소년 환자에 대해서 치과적 외상이 동반될 가능성이 크고, 치과 협진 의뢰 시기가 지연될 수 있다. 어린 소아 환자의 경우 입원실에서 치과적 외상의 발생 가능성이 크다. 또한, 치과적 외상 환자의 입원 중 치료와 퇴원 후 치과 외래 재내원이 잘 이루어지지 않고 있다. 이와 같은 결과들에 대해 협진 의뢰 체계의 개선, 입원 병동 내 전담 인력 배치와 치과 시설 및 장비 구비, 의과 주치의에 대한 교육, 주치의 간의 원활한 의사소통 등이 대안이 될 수 있다. 본 연구는 의과와 치과의 교육 및 연구 자료로 활용되어 치과적 외상이 있는 소아청소년 입원환자의 치과 협진 의뢰에 관한 발전에 기여할 것으로 기대된다.

• 대한간호학회지
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• 제6권2호
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• pp.18-24
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• 1976

This study to find out the causes and degree of anxiety experienced by hospitalized patients, with the objective of instituting improvement of Nursing care program based on the needs of patients. The present study was carry out from July 1 , 1975 to October 10, 1975 with 168 patients random sampling from those admitted of Kyung Hee Medical Center. The Questionnaire form included 47 questions which are considered to be anxiety events for admitted patients and was divided into four areas namely, such events related to 1) hospital environment, 2) Psychology and emotion, 3) Nursing care and treatment, and 4 )Education. The results of the study were as follows : 1) Most of the respondents (70.09%) felt uneasy about their disease affected by the behaviors of medical personnel. 2) Regarding the correlation between anxiety felt by patients and their educational level. Only 9 sub- items of 47 items showed significant difference. 3) There was revealed no particular significance in the correlation between anxiety felt by patients and period of hospitalization. 4) Only 5 sub- items out of 47 items showed significant difference ill the correlation between anxiety felt by patients and previous experience of operation. 5) Only 3 sub-items out of 47 items showed signigicant difference in the correlation between anxiety felt day patients and previous experience of hospitalization. 6) Regarding the extent of anxiety felt by patients, "insufficient explanation about meals" showed the highest score followed. "The visit of physicians and Nurses to the patient is too frequent " showed the lowest score and "Nurses change too frequently the physical posture of patients" followed.

• 대한두경부종양학회지
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• 제11권2호
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• pp.167-172
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• 1995

Pharyngocutaneous fistula(PCF) is one of the complications following total laryngectomy in laryngeal and hypopharyngeal cancer. Fistula lead to delayed wound healing, more serious complications such as carotid blow-out, prolonged hospitalization, significant patient morbidity and occasional mortality. Identification of patients at high risk for fistula formation, appropriate preventive measures, and appropriate management are the head and neck surgeon's responsibility. So we analyzed the clinical data of pharyngocutaneous fistula which was developed after total laryngectomy. Following results were obtained: 1) Occurrence of PCF increases with salvage surgery compared to curative surgery. 2) Early detection and effective management of PCF are the key factors to decreasing the hospitalization period. 3) Constructing a pharyngostoma seems to be an ideal method of preventing dangerous complications and ultimately closing the fistula. 4) Simultaneous reconstruction is necessary in the high risk group.

• 지역사회간호학회지
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• 제19권4호
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• pp.673-683
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• 2008

Purpose: This study was aimed to evaluate the performance of a community-based home care services model. Method: The subjects were 138 patients who have been enrolled during a 6 month's period, nursing records and nursing service bills. The data was collected by self report and chart review. The mean cost per visit was compared with those of hospitalization & clinic visit in the data from National Health Insurance Corporation. Result: A significant number of patients were bed ridden(63.8%) and unconscious (27.5%), and most of the patients had complex chronic diseases. Except nursing assessment, bed sore care was the most frequent nursing treatment(25.1%) in home care services. The mean cost per visit of home care services was 34,665 won, which was lower than those of hospitalization & clinic visit for medical aid. The patients were highly satisfied with the services by visiting nurse specialists. Conclusion: Community-based home care services provided cost-effective and satisfied services. Community-based home care services needs systematic supports to expand it's domain for promoting community health.

• 대한간호학회지
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• 제43권2호
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• pp.287-295
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• 2013

Purpose: The purpose of this study was to identify vancomycin-resistant enterococcus (VRE) colonization rate in patients admitted to the intensive care unit (ICU), associated risk factors and clinical outcomes for VRE colonization. Methods: Of the 7,703 patients admitted to the ICUs between January, 2008 and December, 2010, medical records of 554 VRE colonized and 503 uncolonized patients were reviewed retrospectively. To analyzed the impact of colonization on patients' clinical outcomes, 199 VRE colonized patients were matched with 199 uncolonized patients using a propensity score matching method. Results: During the study period, 567 (7.2%) of the 7,703 patients were colonized with VRE. Multivariate analysis identified the following independent risk factors for VRE colonization: use of antibiotics (odds ratio [OR]=3.33), having bedsores (OR=2.92), having invasive devices (OR=2.29), methicillin-resistant Staphylococcus aureus co-colonization (OR=1.84), and previous hospitalization (OR=1.74). VRE colonized patients were more likely to have infectious diseases than uncolonized patients. VRE colonization was associated with prolonged hospitalization and higher mortality. Conclusion: Strict infection control program including preemptive isolation for high-risk group may be helpful. Further research needs to be done to investigate the effects of active surveillance program on the incidence of colonization or infection with VRE in the ICU.

• Journal of Acupuncture Research
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• 제37권1호
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• pp.59-63
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• 2020

The effects of complex Korean medicine treatment including acupotomy, on irritable bowel syndrome (IBS) are reported in this case study. A 54-year-old woman with diarrheal symptoms that alternatively improved and worsened for many years and worsening abdominal pain visited the emergency room and was diagnosed with IBS; she was admitted for approximately 2 weeks at the Acupuncture and Moxibustion Department of National Medical Center (NMC). Numerical rating scale (NRS), irritable bowel syndrome-quality of life (IBS-QOL), and gastrointestinal symptom rating scale (GSRS) scores were evaluated on the day of hospitalization, midway through the hospitalization period, and on the day of discharge. Abdominal pain was measured daily using NRS, and the score decreased from 8 at admission to 0 at discharge. The IBS-QOL percentile score improved from 42 points to 100 points. The total GSRS score also improved, from 30 points to 2 points. These results suggest that complex Korean medicine treatment with acupotomy, is useful for treating internal diseases, such as IBS, as well as musculoskeletal disorders.

• Child Health Nursing Research
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• 제21권4호
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• pp.302-310
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• 2015

Purpose: The purpose of this study was to compare the rate of breastfeeding and factors which affect late preterm infants' (LPIs) breastfeeding according to gestational age. Methods: Participants were LPIs of 34 weeks (n=70), 35 weeks (n=75), and 36 weeks (n=88). Data were collected from July to December, 2011 from four university hospitals in D city. Descriptive statistics and odds ratio were used to compare three groups. Results: The rate of breastfeeding at 1 week after LPIs' discharge was 32.9%, 37.3%, 23.9% at 34, 35 and 36 weeks, respectively. The tendency to breastfeed in LPIs of 34 weeks was lower for LPIs born by Cesarean-section, while it was higher for LPIs with a longer period of breastfeeding during hospitalization and higher body weight at the first day of feeding. The prevalence of breastfeeding in LPIs of 35 weeks and 36 weeks was higher for infants with a history of more frequent breastfeeding during hospitalization. Conclusion: The rate of breastfeeding in LPIs of 36 weeks was the lowest. This study suggests that nurses should give more customized education to mothers with LPIs of 36 weeks during their stay in hospitals.

• 한방안이비인후피부과학회지
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• 제35권4호
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• pp.163-171
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• 2022

Objectives : The aim of this study was to report that effect of Korean medicine treatment for patient with peripheral facial nerve palsy accompanied by hemifacial spasm through hospitalization. Methods : We treated a patient with facial nerve palsy by acupuncture, electroacupuncture, herbal medicine, pharmacopuncture and cupping. The effect of treatment was evaluated using the House-Brackmann scale, the Yanagihara grading system, and the visual analogue scale(VAS). Results : During the 18 days hospitalization period, the symptoms of hemifacial spasm disappeared and the facial palsy improved. The House-Brackmann scale changed from 4 grade to 2 grade, the Yanagihara grading system changed from 19 to 47, and the VAS changed from 3 to 0. Conclusions : This case report suggests that Korean medicine could be effective for facial palsy accompanied by hemifacial spasms.

• 동의신경정신과학회지
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• 제33권3호
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• pp.339-349
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• 2022

Objectives: The purpose of this study was to report the effectiveness of the combination of Giungoroen-therapy, as well as other Korean medicine therapy on postoperative delirium. Methods: The patient was diagnosed with postoperative delirium, that occurred after arthroscopic debridement two months before hospitalization. The patient received Giungoroen-therapy in addition to conventional Korean Medicine treatment, including acupuncture, herbal medicine, and moxibustion. The evaluation variables to check the effectiveness of the interventions, were the Korean Nursing Delirium Screening Scale (Korean Nu-DESC) and the Korean Version of the Delirium Rating Scale-Revised-98 (K-DRS-R-98). Results: During the hospitalization period, the Korean Nu-DESC score decreased from 5 to 1, and the K-DRS-R-98 score decreased from 36 to 23. The subjective expression of anxiety had been reduced. Conclusions: The combination of Giungoroen-therapy, as well as other Korean medicine therapy including acupuncture, moxibustion, and herbal medicine may be useful in alleviating postoperative delirium.