• Title/Summary/Keyword: Korean medicine education

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Triage Accuracy of Pediatric Patients using the Korean Triage and Acuity Scale in Emergency Departments (한국형응급환자분류도구를 적용한 응급실에서 소아 환자의 중증도 분류 정확성)

  • Moon, Sun-Hee;Shim, Jae Lan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.11
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    • pp.626-634
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    • 2018
  • This retrospective study investigates the accuracy of triage procedures for pediatric patients in emergency departments (EDs) using the Korean Triage and Acuity Scale (KTAS). The study includes 250 randomly selected initial nursing records and clinical outcomes of pediatric patients who visited one regional ED or a local ED from October 2016 to September 2017. The collected data were analyzed by a qualified expert to determine the true triage score. The accuracy of triage was defined as the agreement between the triage score of the emergency nurses (ENs) and the true triage score as determined by the expert. Based on expert comments, the cause of the triage error was analyzed and the KTAS score was compared with the discharge, length of stay (LOS), and medical cost. The results showed that the degree of agreement in the triage score between the experts and the ENs was excellent (weighted kappa=0.77). Among the causes of triage discordance, the most frequent was the incorrect application of vital signs to the KTAS algorithm criteria (n=13). Patients with high severity KTAS levels 1 and 2 were discharged less often (${\chi}=43.25$, p<0.001). There were significant differences in the length of stay (F=12.39, p<0.001) and cost (F=11.78, p<0.001) between KTAS scores when adjusting for age. The results of this study indicate that KTAS is highly accurate in EDs. Hence, the newly developed triage tool is becoming well established in Korea.

Attitudes on Medical Market Opening and Factors for Selecting a Foreign Hospital of Korean University Hospital Outpatients (환자들의 의료시장개방에 대한 인식도와 외국병원 선택요인 - S대학교병원 외래환자들을 대상으로 -)

  • Yoon, Yur-Yong;Yu, Seung-Hum;Kim, You-Young;Oh, Hyohn-Joo
    • Korea Journal of Hospital Management
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    • v.8 no.3
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    • pp.32-48
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    • 2003
  • Korea is to open its medical markets to foreign hospitals starting in the year 2006 regardless of our will(DDA, Doha Development Agenda). To accurately understand the characteristics of Korean medical users, their detailed and various needs, their attitudes toward the opening of Korean medical markets, and factors affecting these users in choosing foreign medical service providers would be first step needs to be taken by the Korean medical facilities that need to survive and develope through the fiercely competitive era coming with the opening of Korean medical markets to foreign medical service providers and would be very important in hospital management. The subjects of this study were 500 patients randomly selected from the outpatients who visited one of university hospitals in Seoul on the 14th-16th days of April 2003, and conducted a self-completion questionnaire. The answers of 463 respondents among the selected patients(93% of a responding rate)were analyzed through the Excel and statistics programs. The attitudes on the opening of the medical markets were shown in agreement 56.5%(247 persons), disagreement 6.9%(30 persons), and no idea 36.6%(160 persons). In consideration of only the answers as agreement and disagreement exclusive of the answer as no idea, 89.2% of the respondents agreed to the opening of the medical markets while 10.8% objected to the opening. The approval rate was higher with the higher education and income levels. Moreover, The approval rate for the opening of the medical markets was relatively high regardless of the satisfaction in the medical service, and the most important reason of the agreement was the guarantee of the patients(national)option. The main reason of the disagreement was high medical fee(50.5%), and the other reasons showing low rates were outflow of the domestic fund to the foreign countries(13.6%), damage of medical influences on the public(11.4%), lack of competition of the domestic medical industry(9.1%)and so on. As for the factors of selecting the foreign hospitals in the opening of the medical markets, the patients considered the authority(competency)of doctors firstly, and the other principal factors were worldwide fame and reliance, specific explanation of doctors, modernized medical instruments, convenient consultation procedure, etc. The patients agreed to the opening of the medical markets at a high rate regardless of the satisfaction in the medical service, and the most principal reason of the agreement was the guarantee of the patients(national)option for the medical care. Connected with the factors to select the hospitals, the approval reasons for the opening of the medical markets were the authority(competency)of the doctors as the first one, and then fame and tradition, reliance, overall diagnosis and modernized medical instruments, doctors specific explanation, and so on. However, these factors are actually associated with the Quality of the medical care, and consequently the approval reasons for the opening of the medical markets are connected with the security of the medical care. Accordingly, the guarantee of the patients(national)option answered as the main reason of the agreement can be also understood as the awareness of the right to have a variety of options for the security of the medical quality.

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A VALIDITY STUDY OF PARENT BEHAVIORAL RATING SCALES AS DIAGNOSTIC TOOLS OF ATTENTION DEFICIT/HYPERACTIVITY DISORDER (주의력결핍/과잉운동장애(ADHD) 아동의 진단도구로서 부모용 행동 평가지의 타당도 연구 - 한국아동인성검사와 아동 ${\cdot}$ 청소년 행동평가척도를 중심으로 -)

  • Kim, Ji-Hae;So, Yoo-Kyung;Jung, Yoo-Sook;Lee, Im-Soon;Hong, Sung-Do
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.2
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    • pp.282-289
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    • 2000
  • This study was designed to examine the validity of HPR subscale in Korean Personality Inventory for Children(KPI-C) and Attention Problems subscale in Korean Child Behavior Checklist(K-CBCL) as diagnostic tool for Attention-Deficit/Hyperactivity Disorder(ADHD). Nineteen ADHD-1 type, twenty-three ADHD-H type, sixteen Neurosis, and fifteen normal children with the age from 6 to12 were selected based on DSM-IV, and their responses of the KPI-C and CBCL were analyzed. Omnibus F-test results showed that there were significant differences in the F scores of HPR and Attention Problems T scores(p<.05). But in Posthoc analysis, the HPR and AP scores in three clinical groups were significantly higher than in normal group, but there was no group difference among three clinical groups(p<.05). These results shows that HPR subscale and Attention Problems subscale may be useful tools for screening clinical groups(vs normal group) but there was a limit to the clinical validity of two subscales as diagnostic tools for the subtypes of ADHD.

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The Smoking Habits among the OPD Patients and The Success Rates of the Physician's Cessation Order (내과 외래환자에 있어서 흡연 양상과 의사의 금연권고의 성공률)

  • Park, Ki-Chan;Kim, Young-Hoo;Bae, Seong;Lee, Sang-Hun;Chun, Myung-Ho;Lee, Sang-Ki;Jun, Kwang-Su;Lee, Chan-Se
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.3
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    • pp.292-300
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    • 1993
  • Background: To evaluate the effect of doctor's cessation order Methods: From January 1989 to December 1990, Total 1981 patients (male 922, female 1059), who visited OPD of Daedong hospital were selected to investigate the cigarette smoking habits and the success rates of the physician's cessation orders. Results: 1) Among male patients, 64.43% and 27.00% revealed as smoke and non-smoker, respectively and and 8.57% as ex-smoker. In the 20 years old or less age group smoker were 36.11%. 2) Among female patients, the rates of smoker were only 2.83%, ex-smoker were 0.38%. No female patient smoked under 20 years old. 3) As compared with the number of daily smoked cigarettes among the male patients, patient who smoked less than 10 cigarettes were in 2.69%, 11-20 cigarettes in 39.23%, 21-40 cigarettes in 46.30%, more than 40 cigarettes in 11.78%, under 20 years old age gorup the number of smoked cigarettes were 11.54%, 61.54%, 23.08%, 3.84% respectively. Among female patients, smoker were only 37 patients and the number of daily used cigarette were 2.7%, 67.57%, 24.32%, 5.41% respectively. 4) As compared with systemic disease and the smoking habits, female excluded from statistics because of too small number of smoker. Among male patients ex-smoker associated with respiratory disease were 15.21% which was much higher than other disease group (4.35%-8.11%), and among cardiovascular diseae patients, smoker were 81.08% & among cardiovascular disease patients, smoker were 81.08% & among gastrointestinal disease patient 68.93% and among respiratory disease patient 60.84%. In respiratory disease patients group 16.25% smoked more than 40 cigarettes dialy and 13.01% in gastrointestinal disease patients group. 5) Among patients who treated more than 3 months via OPD the success rates of the physcian's cessation order were 62.03% of male patients (we excluded female patients) and there is no gross difference in each age group, but it was highest as 75% in 41-60 years old age group. As compared with difference of systeic disease, the success rate were highest in respiratory disease patients as 78.13% and lowest in gastrointestinal disease patients as 49.94% Conclusion: The smoking rates among the out patients including male and female of internal medical department of General Hospital were same as the general population. Although the sample size was small, on account of the success rates of physician's cessation orders were more than half, we think the cessation recommendation by physician's order is very effective. And we think the cessation recommendation are more effective. And we think the cessation recommendation are more effective than the ex-smoking education in the excluded patients due to fail to follow up more than 3 months.

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A Survey on Physical Complaints Related with Farmers' Syndrome of Vinylhouse and Non-vinylhouse Farmers (비닐하우스 재배농민과 일반농민의 농부증 관련 신체증상 호소율 조사)

  • Lee, Ju-Young;Park, Jung-Han;Kim, Doo-Hie
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.2 s.46
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    • pp.258-273
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    • 1994
  • To compare the physical complaints of vinylhouse farmers with those of non-vinylhouse farmers, a personal interviews on 250 vinylhouse and 142 non-vinylhouse farmers were conducted in Sungjoo county in Kyungpook province selected by a random sampling from July 5 to July 10, 1993. Blood pressure of the subjects was also measured. Vinylhouse farmers had a higher average age, larger family size, shorter experience of farming, more working hours per day and working days per year and higher annual income than the non-vinylhouse farmers. The frequency of pesticide spray of the vinylhouse farmers was 3.4 times on the average in June 1993 as compared with 2.0 times of non-vinylhouse farmers, and 16.7 times for the vinylhouse farmers during the last one year while it was 8.3 times for the non-vinylhouse farmers in the same period. While 39.6% of vinylhouse farmers experienced pesticide intoxication symptoms such as headache, nausea, vomiting, dizziness, itching, and skin irritation, etc. during the month of June, 25.4% of non-vinylhouse farmers experienced such symptoms. The most frequent symptoms among eight symptoms that constitute the farmers' syndrome were lumbago, numbness of hand or foot, shoulder pain and dizziness regardless of sex and type of farming. Prevalence of the farmers' syndrome in male and female among vinylhouse farmers were 22.1%, 43.4%, respectively, and the prevalence in non-vinylhouse farmers was 23.2% for male and 50.7% for female. There was no statistically significant difference in the prevalence of farmers' syndrome between vinylhouse and non-vinylhouse farmers. However, the prevalence in female was about 2 times higher than that of male. When the effects of other factors were adjusted by multiple logistic regression for farmers' syndrome, the prevalence in female was 3.0 times higher than that of male. The prevalence of farmers' syndrome was increased as the age of farmers increased in both vinylhouse and non-vinylhouse farmers, and adjusted odds ratio of farmers' syndrome increased by 3% as the age increased by 1 year. Adjusted odds ratio for Farmers' syndrome in farmers who experienced pesticide intoxication during the month of June was 3.1 times higher than that of farmers who did not have such experience. While the prevalence of hypertension in male and female non-vinylhouse farmers were 22.4%, 13.7%, respectively, the prevalence in vinylhouse farmers were 13.5% for male and 12.0% for female. However, there was no association between farmers' syndrome and hypertension. It was found in this study that the vinylhouse farmers are at a high risk of pesticide intoxication, which is associated with tile common physical complaints. To reduce such risk it is necessary to develop farming methods which do not require the pesticide or may use less pesticide, a safer method of pesticide spraying, and the protective equipments which can be worn at a high temperature and have a better protective effect. Also education of farmers for the correct methods of ventilation after pesticide spraying in the vinylhouse and wearing the protective equipments may be considered as a supportive method. Since inappropriate posture at work and intensive labor may cause farmers' syndrome, it is recommended to develop farming tools which reduce physical burden and take a rest and exercise periodically during work. It is necessary to strengthen the hypertension management program of the Kyungpook province, because the prevalence of hypertension was as high as about 15%.

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Hypertension Management Status in Rural Hypertensives (농촌지역(農村地域) 고혈압환자(高血壓患者)의 고혈압(高血壓) 관리행태(管理行態))

  • Kim, Hyun-Sook;Kam, Sin;Kim, Jong-Yeon;Park, Ki-Soo;Lee, Kyeong-Soo
    • Journal of agricultural medicine and community health
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    • v.28 no.1
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    • pp.93-106
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    • 2003
  • Objectives: This study was conducted to investigate the treatment status and its related factors of the rural hypertensives. Methods: A questionnaire survey was performed to 618 rural hypertensives during September, 2002. Results: The proportion of those who were compliant to the antihypertensive medication was 68.9%. The compliance rate to the antihypertensive medication was significantly related with sex and economic status(p<0.05). That is, if they were female, higher economic level, the regular antihypertensive medication rate was higher. The regular antihypertensive medication rate was higher when they had higher knowledge for hypertension, higher severity for hypertension of him or her(p<0.01). And the compliance rate to the antihypertensive medication was significantly related with hypertensives' own explanatory model for hypertension(p<0.01). The rate of drug use except antihypertensives was 12.5%. The rate of drug use except antihypertensives was higher when they experienced side effects of antihypertensive drug and when they had irregular medication for antihypertensive drug(p<0.01). The rate of medical equipment use was 18.9%. The utilization rate of medical equipment such as jade mat, germanium material was significantly related with age, experience of side effects of antihypertensive drug, medication status for antihypertensive drug(p<0.05). The rate of folk therapy use was 16.2%. The rate of folk therapy use was higher when they had no family, when they had knowledge about hypertension on the average, when they had hypertension over 10 years(p<0.05), and when they experienced side effects of antihypertensive drug and when they had irregular medication for antihypertensive drug(p<0.01). The rates of drug use except antihypertensives, medical equipment use, and folk therapy were significantly related with hypertensives' own explanatory model for hypertension(p<0.05). Conclusions: On consideration of above findings, it would be essential to provide knowledge about hypertension and its treatment, and severity of hypertension complications through health education.

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Development and Validation of the Self-Care for Aspiration Pneumonia Prevention Scale in the Community Dwelling Elderly with Risk of Dysphasia (삼킴장애 위험 지역사회 재가노인들의 흡인성 폐렴 예방을 위한 자가간호 측정도구 개발)

  • Yang, Eun Young;Lee, Shin-Young
    • Journal of Korean Academy of Nursing
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    • v.50 no.3
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    • pp.474-486
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    • 2020
  • Purpose: The purpose of this study was to develop and validate a Korean version of the Self-Care for Aspiration Pneumonia Prevention (SCAPP-K) scale in older adults at risk of dysphasia. Methods: The Hertz and Baas model of scale development and validation was used. In the development stage, items were generated via literature review and interviews with medical experts, older adults, and caregivers. Ten experts assessed the items for content validity. Subsequently, 12 older adults participated in a pilot test to determine the comprehensibility and appropriateness of the SCAPP-K scale. The validation stage involved a cross-sectional survey with 203 older adults for exploratory factor analysis (EFA) and 200 older adults for confirmatory factor analysis (CFA) and to determine convergent and discriminant validity. To test the validity and reliability of the scale, EFA using principal component analysis with varimax rotation and CFA were conducted, and convergent and discriminant validity as well as internal consistency reliability were determined. Results: As a result of EFA, three self-care factors (knowledge, resources, behaviors) with 21 items were validated. The CFA and convergent and discriminant validity indicated the applicability of the three-factor self-care scale. The reliability of the SCAPP-K scale was acceptable, with Cronbach's α=.87~.91. Conclusion: The SCAPP-K scale has acceptable validity and reliability and can contribute to clinical practice, research, and education to improve self-care for the prevention of aspiration pneumonia in older adults at risk of dysphasia.

A Comparative Study on Self-care Practices between the Natural Menopause Group and the Artificial Menopause Group (자연폐경 부인과 인위적폐경 부인간의 자기건강관리에 관한 비교연구)

  • Jung Moon-Hee
    • Journal of Korean Public Health Nursing
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    • v.4 no.2
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    • pp.15-23
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    • 1990
  • This study was carried out to explore the illness-related activities of the menopaused women. To achieve such a purpose, sixty-six cases of the middle aged women were sampled the naturally and the artificially menopaused group respectively from 1st, Aug. to 31th, Aug. in 1988. For the collection of data, 1, 140 women aged between 45-54 were selected through stratified sampling techniques in urban and rural area. Among them the final subjects for analysis were restricted to only those who had experienced menopause naturally or artificially. And then, after control for age and education analysis was performed. The data was analysed by use of frequency, percentage, $X^2-test,$ t-test, Pearson correlation coefficiency and stop-wise multiple regression. The obtained results were as follows. I. As for the se1f-perception on menopausal symptoms, it was revealed than Korean women, neithe in naturally and artificially, accepted the change of menstruation itself as serious. This shows us that middle-aged women had positively receptive attitudes that the change of menstruation is follwed by amenorrhea. 2. The artificially menopaused group scored more than the naturally one: (I) on the self-control activities such as self-assessment, lay-consultation, fever check, pulse check and observation of vagina discharge, (2) on the self-decision activities such as hospital and pharmacy utilization, (3) on the self maintenance activities such as walking, aerobic, weight check, skin care, skin protect, calori control diet control, milk intake, vegetable intake, cold water drinking before meal, parasol use and BP check The above results lead us that the self care practices of the menopaused women revealed' coping wit I menopausal symptoms at the first level in community and must be developed by the adequate nursin intervention.

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Comparison of the lipids levels, C-reactive protein and adiponectin in adolescent male by fat intake (청년기 남성의 지방 섭취 수준에 따른 혈중지질 함량, C-반응성 단백질 및 아디포넥틴 비교)

  • Lee, Sung-Hye;Park, Mi-Young;Kim, Soon-Kyung;Min, Young-Ki
    • Journal of Nutrition and Health
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    • v.45 no.4
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    • pp.303-314
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    • 2012
  • The purpose of this study was to investigate the relationship between dietary fat intake, anthropometric data, blood lipids, C-reactive protein, and adiponectin in Korean male college students. Forty-eight subjects were divided into 2 groups based on dietary fat intake: UERF (under 30% of energy ratio for fat source), AERF (above 30% of energy ratio for fat souce). We collected dietary intake data using 24-hour dietary recall for 3 days. Anthropometric and biochemical parameters were measured by using standard methods. Segmental body composition analysis was carried out using an 8-electrode multifrequency bioelectrical impedance method of body fat estimation. There was no significant difference in anthropometric data and serum lipid profile between UERF and AERF group. Serum C-reactive protein level was significantly higher in the AERF group compared to the UERF group. Although there was no significant difference in serum adiponectin level between UERF and AERF groups, subjects had lower adiponectin levels. Correlation data show that serum adiponectin level was positively correlated with vegetable intake (p < 0.05). In addition, dietary fat intake had a positive correlation with meat (p < 0.01), whereas a negative correlation with grain (p < 0.01), vegetables (p < 0.05), and fish (p < 0.05). These results suggest that the increased fat intake of non-obese Korean male college students is associated with their increased serum C-reactive protein concentration. Therefore, proper guidelines on fat intake and nutrition education are necessary for the prevention and management of metabolic syndromes.

Gender specific effect of major dietary patterns on the metabolic syndrome risk in Korean pre-pubertal children

  • Park, Soo Jin;Lee, Seung Min;Kim, Seon Mee;Lee, Myoungsook
    • Nutrition Research and Practice
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    • v.7 no.2
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    • pp.139-145
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    • 2013
  • There is a lack of data on metabolic risk factors during pre-puberty, which is important for identifying the subgroups of youth, at whom early interventions should be targeted. In this study, we evaluated the prevalence of metabolic risk factors and its subsequent relations with dietary patterns in Korean pre-pubertal children through a cross-sectional sample (n = 1,008; boys = 513) of pre-pubertal children (aged 8-9 years) from a sub-study of the Korea Metabolic Syndrome Research Initiatives (KMSRI) in Seoul, Korea. Measures of anthropometry and blood pressure as well as fasting blood samples were used in the analysis. A three-day food records were collected. The metabolic syndrome was defined according to the age-adjusted National Cholesterol Education Program Adult Treatment Panel III guidelines. An added metabolic risk score was calculated for each subject by summing the quintile values of the five individual risk factors. Among the 5 risk components of metabolic syndrome, high waist circumference (WC) was the major factor (P < 0.001). A significant increasing trend of the added metabolic syndrome risk score was observed with the increase of WC (P (trend) < 0.001) among both genders. The cutoff point for high WC for pre-pubertal children was 61.3 cm for boys and 59.9 cm for girls. The prevalence of high triglyceride (TG) values was significantly higher in girls than it was in boys (P < 0.01). Girls in the highest quintile of balanced dietary pattern scores had lower TG values (P (trend) = 0.032) than did those in the lowest quintile. Moreover, girls in the highest quintile of western dietary pattern scores showed increasing trend for the added metabolic risk score (P (trend) = 0.026) compared with those in the lowest quintile. Adverse associations exist between western dietary patterns and the accumulation of metabolic risks among girls, not in boys, even during pre-puberty.