• Asian Pacific Journal of Cancer Prevention
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• 제17권9호
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• pp.4275-4279
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• 2016

Background: Cancer is a major health problem due to the aging population with increasing deaths. Family functioning is affected by cancer diagnosis and treatment. The aim of this study was to comparative analysis of the perception of family functioning by heads of families with and without cancer members during illness, focusing on changes or probable changes. Materials and Methods: This comparative study was conducted on two groups (families with a member of the cancer and controls without a family member with cancer). The families were of patients referred to the clinics and hospitals of Imam Khomeini, Taleghani and Omid of Urmia city, the number of samples being 148 for cases and 176for the control group. To collect the data, valid and reliable family functioning (FAD) was applied, a 60-item questionnaire with seven dimensions, with heads of families. To analyze the data SPSS- 23 Software was used for descriptive and analytical statistics. Significance level was defined p <0.05. Results: Among the seven items : problem solving, communication, roles, emotional response, emotional involvement, behavior control and overall functioning, only differences for average scores of problem-solving were statistically significant. Discussion: Contrary to common perception of severe damage for family functioning in families with cancer members, results of this study indicate that functioning in terms of family caregivers is more or less similar to that of the families with other diseases. Only in problem-solving item do these families experience more difficulty. Conclusion: According to the research findings, in nursing from families with cancer patient, it is recommended to focus more on the problem-solving item of the families.

• 핵의학기술
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• 제21권2호
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• pp.49-54
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• 2017

Purpose The high-dose administration of I-131 has been standing for the basic therapy method of thyroid cancer. In korea, it is not necessary for patients to be hospitalized if the administration dose are under 1.2 GBq. However, if the dose are over 1.2 GBq, the patients should be stay in special ward with radiation shield. In such cases, the radioactivity level upon release should be under a dose of $70{\mu}Sv/hr$ at a distance of approx. 1m. This regulation bring the patients to stay for about 2 to 3 days in ward before the release. Materials and Methods Using the inpatients' release data of severance hospital, an inpatient-days were retrospectively calculated and compared with practical data and estimate the inpatient-days with the conditions of korea ($70{\mu}Sv/hr$), Japan ($30{\mu}Sv/hr$), germany ($3.5{\mu}Sv/hr$ at a distance of approx. 2 m), and other european countries. Results When a effective half-life of 15.4 was used, the expected inpatient-days were calculated as 2.15 days in the condition of Japanese regulation and 1.37 days in the condition of korean regulation. The practical inpatient-days of patients in Severance hospital were 1.32 days. Conclusion As ICRP 94 has been mentioned that the release of patients administrated with I-131 for the therapy should be carefully considered because each patients has different thyroid uptake rate and their conditions with family members after the release from the ward. Nonetheless, efforts to bring more aquate data which is for getting closer to the practical data should be continuously studied.

• Perspectives in Nursing Science
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• 제6권1호
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• pp.77-83
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• 2009

The number of nurses per bed at acute-stage hospitals is quite low in Korea compared with other OECD countries. In order to prevent the degradation of the quality of inpatient nursing services due to insufficient nurse staffs, the national health insurance introduced the differentiated nursing care fee system. This did not work as a motive for inducing the employment of nursing staff due to insufficient cost compensation. Because of insufficient nursing staff, family members have to stay with the patient or patients have to hire a personal care attendant. This increases the burden and cost to families. For the activation of hospitals without guardians, there should be policies for raising additional nursing staff such as standardizing jobs among nursing staff, particularly between nurses and nursing assistants, setting adequate standards of staffing in nursing according to medical service, substantiating the cost of nursing under the differentiated nursing care fee system, improving the medical fee system of hospitals without guardians including health insurance payment, supplying nursing staff stably through improving their working conditions such as providing child rearing services and salary increase, clarifying the qualification of personal care attendants working at acute.stage hospitals, developing indexes for assessing the quality of nursing care services, and monitoring for the management of uniform quality.

• 한국의료질향상학회지
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• 제27권1호
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• pp.26-42
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• 2021

Purpose: This study aimed to explore frontline nurses' experience of patient-centered care and understand the factors affecting its implementation in hospitals. Methods: Four focus group interviews were conducted with 30 nurses in two university hospitals. The following theoretical framework of patient-centered care was used: 1) Respect for patients' values, preferences, and expressed needs, 2) Care coordination and integration, 3) Information, communication, and education, 4) Physical comfort, 5) Emotional support and alleviation of fear and anxiety, 6) Involvement of family and friends, 7) Care transition and continuity, and 8) System issues. We performed a directed content analysis. Results: The most frequent patient-centered nursing practices of the hospital nurses were "promoting physical comfort" in inpatient settings and "providing information and communicating" in outpatient settings. The factors influencing patient-centered nursing included the health professionals' mindfulness, work overload and staff shortage, and unreasonable social demands and regulations. Conclusion: A more comprehensive patient-centered nursing practice should be implemented by improving "care transition and continuity," "family/caregiver involvement," and "system building." Health professionals' mindfulness is significant, and organizational supports addressing work overload and staff shortage are needed alongside change in social awareness.

• Journal of Hospice and Palliative Care
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• 제7권1호
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• pp.49-63
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• 2004

배경: 호스피스 암 환자에게 적합한 경과기록지의 부재 또한 적절한 암성 통증 관리의 장애요인으로서 기존의 "문제 지향식 의무기록"의 경과기록지 형식에서 벗어나 호스피스 암 환자를 위한 의무기록지(HOMR)를 개발하게 되었다. 방법 및 결과: 2004년 3월부터 5월 사이 고대 구로병원 호스피스 팀은 20여 차례의 모임을 갖고 호스피스 환자의 초기 평가 이후 경과기록에 사용할 수 있는 의무기록지를 개발하였다. 구성항목의 결정은 pilot study를 통해 수정과정을 거쳤다. HOMR은 A4용지 크기로 작성자를 위한 지침서 1장과 2장의 경과기록지로 구성되었다. 앞면에는 환자의 인적 사항, 현재 문제목록 및 활동 수행 능력 상태, 검사 결과, 1주일 간의 활력 징후 및 I/O, 배변 횟수가, 뒷면에는 통증 부위, 통증의 성격 및 강도, 약물 및 비약물 요법, 진정 정도, 동반 증상, 약물 부작용 등을 한꺼번에 기록할 수 있도록 구성되어 있다. 결론: 호스피스 암 환자를 위한 의무기록지는 짧은 여명과 다양한 신체 증상을 갖고 있으며 증상의 변화가 빠르지만 만성적인 경과를 보이는 호스피스 환자에게 적합하며 그 자체만으로도 교육자료로서의 가치가 높고 환자를 돌보는 데 있어 진료의 질을 평가하거나 심사할 수 있으므로 진료의 질을 높이는 역할도 기대된다.

• Journal of Hospice and Palliative Care
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• 제21권3호
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• pp.75-83
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• 2018

목적: 호스피스 완화의료에서 환자의 기대 여명 예측뿐 아니라 퇴원형태를 예측하여 적절한 치료를 제공할 필요가 있다. 이번 연구에서는 입원 초기 환자의 퇴원 형태 예측에 유의한 요소들을 알아보고 효율적인 완화의료의 방향에 대해 제시하고자 한다. 방법: 2016년 4월 1일부터 2017년 12월 31일까지 P병원 호스피스 병동에 입원한 말기암환자 568명 중 377명을 대상으로 하였으며 입원 시 사정한 환자의 수행 지수, 증상 및 징후, 사회 경제적 상태와 혈액검사 자료를 바탕으로 연구를 진행하였다. 결과: 입원 당시 높은 수행지수, 양호한 증상 및 징후, 정상에 가까운 혈액검사 수치를 보일 때 생존 퇴원할 가능성이 높았다. 결론: 환자의 퇴원형태 예측에 ECOG, KPS, Global health, Mental status와 같은 수행지수, dyspnea, anorexia, dysphagia, fatigue와 같은 증상 및 징후, CBC, LFT, BUN, CRP 혈액검사 수치가 유의한 지표임을 확인하였다.

• Journal of Preventive Medicine and Public Health
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• 제26권4호
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• pp.650-660
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• 1993

This study aims to describe the causes of medically unnecessary hospital stay at a teaching tertiary hospital, using modified version of Delay Tool in which the causes of delay are divided into slx major categories : delay related to test scheduling, test results, surgery, medical staff, patient/family, and administration. For the analysis of hospital stay, 6,479 inpatient-days were reviewed in two medical and four surgical departments for one month. Initially inappropriate hospital stays were identified using Appropriateness Evaluation Protocol (AEP), and causes of delay listed in Delay Tool were assigned to each of them. In both medical and surgical services, the most important cause of delay was related to medical staffs, ranging from 3.6% to 51.6% of total inpatient days. Next important category was delay related to test scheduling in medical services ($4.7{\sim}9.2%$), and delay related to surgery in surgical services ($7.3{\sim}15.0%$). Among subcategories of delay related to medical staffs, delay due to conservative care was the most important cause of inappropriate hospital stay ($2.9{\sim}6.4%$). Each clinical departments had different distribution among delay categories, which could not be fully justified by their clinical charateristics. The Delay Tool would be helpful in exploring factors related to the inefficient use of hospital beds. As a measurement tool of inappropriate hospital stay, however, the Delay Tool should be refined in the definitions of categories and its contents.

• Journal of Hospice and Palliative Care
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• 제14권2호
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• pp.101-109
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• 2011

목적: ACOVE project에서는 말기 치료의 질 평가를 위한 임상질지표를 개발하였다. 그러나 말기 치료에 대하여 의료전문가들의 의견을 반영하여 만든 임상질지표와 보호자들의 의견은 실제로 다를 수 있다. 따라서 호스피스 치료 질에 대한 보호자들의 인식 정도를 파악하기 위해 본 연구를 시행하였다. 방법: 2009년 7월부터 10월까지 총 4개월간 경북대학교 병원과 대구 보훈병원의 호스피스 병동에 입원해 있는 환자의 보호자를 대상으로 익명의 횡단면 질문지 조사(cross-sectional anonymous questionnaire)를 시행하였다. 총 120명을 선정하고 이 중 모든 질문에 성실히 답한 69명을 최종대상자로 하였다. 통계분석은 SPSS WIN ver. 14.0을 이용하여 independent t-test와 Pearson's chi-square test를 시행하였다. 결과: 좋은 임상질지표 중 가장 동의율이 높은 항목은 '완화의학 팀이나 완화의학 전문가에 의한 의학적 진찰'과 '가족들이 지켜보는 앞에서의 임종' 이었으며 이 항목들은 88.4%의 보호자가 동의하였다. 반면에 낮은 동의율을 보인 항목은 '환자와 심폐소생술에 대해 논하는 것' 으로 15.9%가 동의하였다. 나쁜 임상질지표 중 동의율이 높은 항목은 '낙상이나 욕창이 발생하는 것은 바람직하지 않다' 라는 항목이었으며 94.2%의 보호자가 동의하였고 가장 낮은 동의율을 보인 것으로는 '병원에서 임종하시는 것은 바람직하지 않다'라는 항목으로 11.6%가 동의하였다. 그리고 동의를 많이 한 그룹일수록 여자의 비율, 환자가 자신의 예후를 인지한 비율, 경제 수준이 높은 사람의 비율이 높았다. 결론: 본 연구에서는 이전 여러 연구에서 임상질지표로 권유되어진 항목들에 대한 보호자들의 동의율이 낮은 항목들이 있었으며 일부 항목들의 동의율과 보호자들의 특성이 관련이 있었다.

• 보건교육건강증진학회지
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• 제27권4호
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• pp.83-90
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• 2010

objectives: This study was conducted to estimate medical expenditure attributable to overweight and obesity in adults with ischemic heart disease and stroke using Korea National Health and Nutrition Examination survey data and Korea National Health Corporation data. methods : The medical expenditure of ischemic heart disease and stroke related to overweight and obesity were composed of inpatient care costs, outpatient care costs and medication costs. The population attributable risk (PAR) of overweight and obesity was calculated from national representative data of Korea such as the National Health Insurance Corporation cohort data and 2005 Korea National Health and Nutrition Examination survey data. results: The medical expenditure attributable to overweight and obesity of ischemic heart disease were 97.4 billion won(74.1-122 billion won). and stroke were 64.6 billion won(33.1-98.1 billion won). Consequently, these costs corresponded to 11.4% of total medical expenditure due to ischemic heart disease and stroke. conclusion: We conclude that overweight and obesity have increased medical expenditure from ischemic heart disease and stroke in Korea. These findings provide important support for implementing overweight and obesity management strategies in Korea.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제2권1호
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• pp.116-124
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• 1991

1985년 9월 30일부터 1990년 12월 31일 사이에 서울대병원 소아정신과에 입원하여 행동장애로 진단받은 어린이 및 청소년 총 48명을 대상으로 병록고찰을 통해 간호문제를 분석해보았다. 그 결과 미성숙한 자아발달, 낮은 자아정체감, 역기능적 부모-자녀관계, 가족내 상황적 위기, 정신지체, 간질 등 원인적 요인에 따르는 개인의 비효율적 대처기전, 사회적 상호작용장애, 자기개념장애, 폭행잠재성, 부모역할장애, 성장 ${\cdot}$ 발달장애 같은 문제가 입원초기부터 중기이후까지 지속되었고 자기간호결핍, 수면장애, 영양장애, 불안, 고체온증 등 입원중기 이후에는 해결된 일시적 문제들을 보였다. 따라서 행동장애 입원환아들을 위한 간호접근은 보다 근본적이고 지속적인 문제에 따른 장기적 계획을 통해 환아들의 자아기능 증진, 자아정체감 확립, 대인관계개선을 도와야 하고 환아 뿐 아니라 가족을 위한 지지적, 교육적 접근에 중점을 두어야 함을 보았다.