• Title/Summary/Keyword: Medical Care Use

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Adverse Effects of Chloral Hydrate in Neonates: Frequency and Related Factors (신생아에서 Chloral Hydrate의 부작용의 빈도와 관련 인자)

  • Lee, Ju-Young;Youn, Young-Ah;Kim, Soon-Ju;Lee, Hyun-Seung;Kim, So- Young;Sung, In-Kyung;Chun, Chung-Sik
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.130-136
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    • 2011
  • Purpose: Chloral hydrate is a common drug frequently used for procedural sedation. But data on chloral hydrate use in the newborns are limited. This study examined the frequency of adverse effects of chloral hydrate and factors related to the adverse effects. We also examined if there were additional adverse effects when an additional sedative was used. Methods: The medical records of 104 patients admitted to neonatal intensive care unit of Seoul St. Mary's Hospital from March 2010 to February 2011 who used chloral hydrate for procedural sedation were retrospectively reviewed. Results: Adverse effects after administration of chloral hydrate were noted in 41.3% of the 104 patients. The adverse events included oxygen desaturation (18.8%), increase in apneic episodes (17.5%), increase in bradycardia (10%), and feeding intolerance (3.8%). Using oxygen at the time of chloral hydrate administration was independently associated with adverse effects (odds ratio [OR], 10.911: 95% confidence interval [CI], 2.082-57.178) and with the necessity for an additional sedative after administration of chloral hydrate (OR, 4.151: 95% CI, 1.455-11.840). Using one additional sedative agent after chloral hydrate showed no difference in adverse effects except feeding intolerance. Conclusion: Patients dependent on oxygen at the time of chloral hydrate administration may were found to be at higher risk for adverse effect of chloral hydrate and for an additional sedative. When an additional sedative is needed, it could be used with monitoring feeding intolerance after chloral hydrate administration.

Investigation of Espoused Theories in Nursing Practice (간호실무에서 신봉이론(Espoused theories)에 대한 탐색적 연구)

  • Suh, Moon Ja;Kim, Hae Sook;Lee, Eun Hee;Park, Young Sook;Cho, Kyung Sook;Kang, Hyun Sook;Im, Nan Young;Kim, Joo Hyun;Lee, So Woo;Cho, Bok Hee;Lee, Myung Hwa;Chi, Sung Ai;Hah, Yang Sook;Son, Young Hee;Kwon, Sung Bok;Kim, Hee Jin;Choo, Jin A
    • Korean Journal of Adult Nursing
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    • v.13 no.1
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    • pp.53-69
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    • 2001
  • As a nursing practice involves nurses'actions in a specific context of health care, this study has focused on exploring the espoused theories in nursing practice within the action science perspectives. Espoused theories are the belief, principles, and rationale expressed by the practitioner as guiding her/his actions in a situation of practice. The data were analysed qualitatively and 25 elements of espoused theories of nursing action were identified and clustered into 6 categories. The 25 elements of espoused theories are as follows: The clinical nurse worked in wholistic and individual nursing, focussed on the patient's needed, comfort and supportive nursing (5 theories of nursing goal); excellent skills, knowledge based, assessment and data collection, explaining, educating or a scientific basis(6 theories of nursing intervention): advocacy, value oriented, treatment, accountability and commitment(4 theories of nursing ethics); human respect, partnership, trust(3 theories of patient-nurse relationship) : knowledgable, accumulated clinical experiences and personally lived experiences, positive perspectives(4 theories of nurse), role of intervention, rewarding, peer relationship(3 theories of situations). The above mentioned espoused theories are similar to that of nursing textbooks which students learned through basic nursing education and almost the same as the Acts ofa Nurse in Korean. However, we are doubtful whether nurses actually do as they think. Therefore, it is recommended to review the theories-in-use in order to find any discrepancies between the espoused theories and the reality of nursing actions.

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Through analyzing the health insurance data provided by Health Insurance Review & Assessment Service (HIRA) of Korea, understanding the characteristic of patient who were diagnosed somatic dysfunction and analysis of the current local status of the usage of code M99 (건강보험심사평가원 데이터의 분석을 통한 체성기능부전 환자의 특성 및 M99 진단명의 사용현황 분석)

  • Shin, Jae-Kwon;Joo, Han-Soo;Lee, Seong-Yup;Shin, Ye-Sle;Ko, Won-Il;Park, Ki-Byung;Kim, Min-Kyu;Ha, In-Hyuk
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.11 no.1
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    • pp.53-64
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    • 2016
  • Objectives : The aim of this study is to assess the usage of diagnosis codes for somatic dysfunctions and the general characteristics of patients diagnosed with the code, by analyzing health insurance data provided by the Health Insurance Review & Assessment Service(HIRA) of Korea. This investigation is intended to outline future and willing to contribute to further use of diagnosis code and the approach of Oriental Medicine to somatic dysfunction. Materials and Methods : By analyzing HIRA data, those diagnosed with M99 codes, a code attributed to somatic dysfunction, were selected for analysis. Patients included were assessed for the relevant general characteristics, and the specific diagnostic criteria. The current usage rates and noteworthy characteristics of diagnostic codes of somatic dysfunctions were assessed. A comparative analysis between clinical departments and subcategories, and a comparative analysis to data of 2014 was conducted. Results : Patients given M99 codes constituted a small minority of all patients diagnosed in 2011 as shown by HIRA data. The codes were more frequently to older patients, females, outpatients, and those who filed for Health Insurance compensation. Medical institutions participating in the diagnosis were mostly primary care facilities, usually specializing in orthopedic(Western medicine sector) and internal medicine (Oriental Medicine sector). The most registered code in 2011 and 2014 was M995. The same trend can be observed in Oriental/Western medicine institutions and Public health center, on the other hand, between them, have some different patterns both 2nd and 3rd. Conclusions : This investigation is that of current usage of diagnostic codes of somatic dysfunction. HIRA insurance claim data was analyzed. Based on the current results, more precise diagnostic standards of somatic dysfunction are warranted. This study will provide a foundation for future Oriental Medicine approach to somatic dysfunctions.

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A Case Study on the Occupational Therapy Evaluation and Intervention Plan of a Community Asperger Syndrome Child Receiving Coping Model (지역사회 아스퍼거 장애 아동을 대상으로 대처모델(coping model)을 적용한 작업치료 평가 및 중재계획수립: 사례연구)

  • Lee, Mi Ji
    • Therapeutic Science for Rehabilitation
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    • v.2 no.1
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    • pp.87-91
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    • 2013
  • Objective : This case study examined the evaluation of occupational therapy and plan to intervention of community asperger syndrome child receiving coping model. Methods : We selected child which 7-year-old boy. Evaluation periods were 2weeks which consisted of external factors and internal factors. External factors were made up interaction of subject, environments and participation of school and community. Internal factors were made up observation and structured evaluation about development state and medical conditions. Also it included observation of appropriate mood and emotions. Results : After evaluation receiving coping model, we planed to intervention. First, subject able to use his time effectively. Second, we'll have intervention program about delayed fine motor areas. Third, we'll educate self-control skills and coping skills of subject's action which not controlled himself. Fourth, we'll find the personal and physical sources to care subject. Conclusion : Our research has planed occupational therapy intervention receiving coping model of asperger syndrome subject. Future research need to practical applications.

Interferon-${\gamma}$ Release Assay among Tuberculin Skin Test Positive Students in Korean High Schools

  • Park, Young-Kil;Lee, Seung-Heon;Kim, Su-Young;Ryoo, Sung-Weon;Kim, Chang-Ki;Kim, Hee-Jin;Cho, Eun-Hee;Yoo, Byung-Hee;Lee, Jong-Koo;Ko, Won-Jung
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.6
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    • pp.328-333
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    • 2010
  • Background: There are several active tuberculosis (TB) cases in Korean high schools each school year. The risk of transmission in schools is extremely high due to the considerable time spent in closed classrooms. We evaluated the control of latent tuberculosis infection in Korean high schools. Methods: When a student was identified with active TB, tuberculin skin testing was performed on their classmates and on students in their same school grade. When a student had a positive tuberculin skin tests (TST), they underwent follow-up testing with QuantiFERON-TB Gold In-Tube (QFT). The manufacturer recommended a cut-off of 0.35 IU/mL to determine QFT positivity was applied. Results: A total of 131 pulmonary tuberculosis (TB) patients were included based on the criteria for screening TB contacts in the National Tuberculosis Control Program. Seventy-five (57.2%) students tested smear positive. TST were performed on 7,109 students who were classmates of, or in the same grade as, a TB patient. Of the contacts, 1,231 students (17.3%) were TST positive and they were screened with QFT. Six hundred-sixty-six (55.0%) of the tested students returned a positive QFT result and the rate of positivity was significantly associated with the increasing size of TST indurations (p<0.0001). Conclusion: The use of QFT resulted in approximately 45% of TST positive students not being given chemoprophylaxis.

A Study on Object Recognition for Safe Operation of Hospital Logistics Robot Based on IoT (IoT 기반의 병원용 물류 로봇의 안전한 운행을 위한 장애물 인식에 관한 연구)

  • Kang, Min-soo;Ihm, Chunhwa;Lee, Jaeyeon;Choi, Eun-Hye;Lee, Sang Kwang
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.17 no.2
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    • pp.141-146
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    • 2017
  • New infectious diseases such as MERS have been in need of many measures such as initial discovery, isolation, and crisis response. In addition, the culture of hospitals is changing, such as the general public 's visiting and Nursing Care Integration Services. However, as the qualifications and regulations of medical personnel in hospitals become rigid, overseas such as linens, wastes movements are replacing possible works with robots. we have developed a hospital logistics robot that can carry out various goods delivery within a hospital, and can move various kinds of objects safely to a desired location. In this thesis, we have studied a hospital logistics robot that can carry out various kinds of goods delivery within the hospital, and can move various kinds of objects such as waste, and linen safely to a desired location. The movement of a robot in a hospital may cause a collision between a person and an object, so that the collision must be prevented. In order to prevent collision, it is necessary to recognize whether or not an object exists in the movement path of the robot. And if there is an object, it should recognize whether it moves or not. In order to recognize human beings and objects, we recognize the person with face/body recognition technology and generate the context awareness of the object using 3D Vision image segmentation technology. We use the generated information to create a map that considers objects and person in the robot moving range. Thus, the robot can be operated safely and efficiently.

Validation Study of Clinical Utility and Usability on Korean Version of the Life-Space Assessment to Assess Community Mobility (지역사회 이동성을 측정하는 한국어판 생활공간 평가(Korean Version of the Life-Space Assessment; K-LSA)의 임상적 유용성 및 사용성 검증 연구)

  • Kim, Jeong-Hui;Chang, Moon-Young
    • The Journal of Korean society of community based occupational therapy
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    • v.8 no.1
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    • pp.1-10
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    • 2018
  • Objective : The purpose of study is to validate the clinical utility and usability of the Korean version of the Life Space Assessment(K-LSA) which is an assessment tool of community mobility of older adults. Methods : Surveys on the clinical utility and usability of the K-LSA are carried out with a total of aoaa60 occupational and physical therapists. The surveys included the multiple choice questions on the clinical utility and open questions on the usability. Responses to multiple questions are post processed by frequency analysis and technical statistics, and responses to the open questions are categorized by common factors in each questions. Results : Average value of clinical utility ranges from 3.6 to 4.0 with positive responses of 'fair (3 point)', 'agree (4 point)' and 'strongly agree (5 point)' being 95~100%. Average value for clinical usability ranges from 3.6 to 4 with positive answers of 'fair (3 point)', 'easy (4 point)' and 'very easy (5 point)' being 88.3~100%. Additionally out of open-type questions of clinical usability, it was pointed out that the concept of 'neighborhood' for the life space level 3 and 4 is unclear. Conclusion : The current study and research outcomes showed that the K-LSA is a validated tool in Korean health care system for the clinical utility and usability in measuring community mobility, and that it is straightforward in practical use. It will help clinicians and therapists promote the social participation of older adults, and set an intervention goal for enhancing community mobility. It will further help clinicians and researchers in education and research for medical intervention and goal-setting.

Chest-wall Surface Dose During Post-mastectomy Radiation Therapy, with and without Nonmagnetic Bolus: A Phantom Study

  • Choi, Cheon Woong;Hong, Joo Wan;Park, Cheol Soo;Ahn, Jae Ouk
    • Journal of Magnetics
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    • v.21 no.2
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    • pp.293-297
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    • 2016
  • For mastectomy patients, sufficient doses of radiation should be delivered to the surface of the chest wall to prevent recurrence. A bolus is used to increase the surface dose on the chest wall, whereby the surface dose is confirmed with the use of a virtual bolus during the computerized treatment-planning process. The purpose of this study is an examination of the difference between the dose of the computerized treatment plan and the dose that is measured on the bolus. Part of the left breast of an Anderson Rando phantom was removed, followed by the attainment of computed tomography (CT) images that were used as the basis for computerized treatment plans that were established with no bolus, a 3 mm-thick bolus, a 5 mm-thick bolus, and a 10 mm-thick bolus. For the computerized treatment plan, a prescribed dose regimen was dispensed daily and planning target volume (PTV) coverage was applied according to the RTOG 1304 guidelines. Using each of the established computerized treatment plans, chest-wall doses of 5 points were measured; this chest-wall dose was used as the standard for the analysis of this study, while the level of significance was set at P < 0.05. The measurement of the chest-wall dose with no bolus is 1.6 % to 10.3 % higher, and the differences of the minimum average and the maximum average of the five measurement points are -13.8 and -1.9, respectively (P < 0.05); however, when the bolus was used, the dosage was measured as 3.7 % to 9.2 % lower, and the differences of the minimum average and the maximum average are 7.4 and 9.0, -1.2 and 17.4, and 8.1 and 19.8 for 3 mm, 5 mm, and 10 mm, respectively (P < 0.05). As the thickness of the bolus is increased, the differences of the average surface dose are further increased. There are a variety of factors that affect the surface dose on the chest wall during post-mastectomy radiation therapy, for which verification is required; in particular, a consideration of the appropriate thickness and the number of uses when a bolus is used, and which has the greatest effect on the surface dose on the chest wall, is considered necessary.

A Study on the Knowledge and Attitude about Emplyee's Health Management in the Provinces (경기지역 일 산업장 근로자의 건강관리에 대한 지식 및 실태에 관한 연구)

  • Kim, Eun-Hee
    • Research in Community and Public Health Nursing
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    • v.6 no.2
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    • pp.299-318
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    • 1995
  • This study was conducted in order to grasp the condition of the Worker's knowledge and attitude about health management. And to offer the basic materials for the health promotion in industrial field. The objects were comprised 336 of volunteered who work in E.shoemaking factory. The material of this study was the questionair (chronbach a=.8871) suited to the purposed of this research which has been made through studying references. All the guestionaire were collected inmediately without explanation. The data collected from 18th September to 1st Octover. Analysis of the data was done utilizing SAS program for percentage, mean, ANDVA. The result are as follows: 1. General features of the objects of study. Male was highest (58.6%), mean age was 30.07 years, graduated high school was highest(59.2%), producer in present place of employment was highest (76.2%), mean career was 7.45 years. 2. The conditions of attitude about health man agement. Correct answer of health examination was 77.8%. Having experience of health examination was 69.5%, among them have regularity was 70.9%. Think it too much trouble to do not health examination was 69.7%. Have got to do health examination was 95.6%. The reason of set up health clinic was emergency care 58.9%, health education 22.1%. Using health clinic was 70.4%, by monthly was 53.0%. The reason of think it too much trouble to use not health clinic was 65.2% The need of health clinic was 96.4% 3. The conditions of knowledge about health management. When 5 points was given to 'very affirming' and 1 point was given to 'very deny', the total average was 3.67, the range was 2.96-4.54. Exactly, company must given to employee put in operative health examination was highest, worked 34 hours per week on harmful worked place was lowest. And knowing about kind of harmful work was 2.86, dangerous work was 2.90. 4. Correlation between the general features and attitude variables. Female group may have more knowledge on reason of health examination. Over 50 years aged group, middle school graduated group, white colored group, less then 1 year career group may have more knowledge on health examination. White colored group may have more attitude on health examination$(\chi^2=5.210,\;P<.07)$. High careered group may have more using on health clinic $(\chi^2=12.08,\;P<.007)$. 5. Difference between the general features and knowledge of health management. High educated group were highest score in knowledge (F=5.214, P<.002). White colored group were highest score in knowledge (F=23.019, P<.000). 6. Difference between the attitude and knowledge of health management. Needing of health examination group were highest score in knowledge. (t=2.54, P<.011). Using of health clinic group were highest score in knowledge(t=190, P<.048). Needing of health clinic group were highest score in knowledge(t=5.13, P<.000).

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Analysis on the Relationship between the Number of Clinics and the Use of Preventable Hospital Service: focusing on asthma patients (지역 내 의원 수와 예방 가능한 병원 서비스 이용 간의 관계분석: 천식 환자를 중심으로)

  • Lee, Hyun-Ji;Park, You-Hyun;Cho, Hyung-Kyung;Seol, Jin-Ju;Kwak, Jin-Mi;So, Ye-Kyeong;Park, Su-Jin;Lee, Kwang-Soo
    • Korea Journal of Hospital Management
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    • v.25 no.4
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    • pp.94-102
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    • 2020
  • Purposes: The purpose of this study was to analyze the trends of hospitalization and emergency room visits of asthma patients over the three years in 25 districts of Seoul. And analyzed the relationship between preventable hospital service uses and number of clinics for asthma patients. Methods: Data was collected from a customized database of the NHI(National Health Insurance) for 2016 to 2018. The number of clinics means Internal Medicine, Pediatrics, Ear-Nose-Throat, and Family Medicine clinics. The hospital service means the number of adults admission for asthma and the number of total asthma emergency visits. This study used kappa analysis to assess the agreements of indicators between years, and structural equation modeling analysis was applied to analyze the relationship. Findings: The kappa value of the number of adults admission for asthma was compared between 2016 and 2017(kappa score=0.68), and was lowered when compared between 2016 and 2018(kappa score=0.26). And the value of kappa in the number of total asthma emergency visits due to asthma between 2016 and 2017(kappa score=0.51) was lower than that of between 2016 and 2018(kappa score=0.60). And the results showed that the number of clinics significantly negatively related to the uses of hospital services in asthmatic patients(β=-0.5, p=0.005). Practical Implication: This research could provide policy implications for strengthening primary care services that can contribute to the reduction of preventable hospital services.