• Title/Summary/Keyword: Medical Support

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Current status of nutritional support for hospitalized children: a nationwide hospital-based survey in South Korea

  • Kim, Seung;Lee, Eun Hye;Yang, Hye Ran
    • Nutrition Research and Practice
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    • v.12 no.3
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    • pp.215-221
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    • 2018
  • BACKGROUND/OBJECTIVES: The prevalence of malnutrition among hospitalized children ranges between 12% and 24%. Although the consequences of hospital malnutrition are enormous, it is often unrecognized and untreated. The aim of this study was to identify the current status of in-hospital nutrition support for children in South Korea by carrying out a nationwide hospital-based survey. SUBJECTS/METHODS: Out of 345 general and tertiary hospitals in South Korea, a total of 53 institutes with pediatric gastroenterologists and more than 10 pediatric inpatients were selected. A questionnaire was developed by the nutrition committee of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition. The questionnaires were sent to pediatric gastroenterologists in each hospital. Survey was performed by e-mails. RESULTS: Forty hospitals (75.5%) responded to the survey; 23 of them were tertiary hospitals, and 17 of them were general hospitals. Only 21 hospitals (52.5%) had all the required nutritional support personnel (including pediatrician, nutritionist, pharmacist, and nurse) assigned to pediatric patients. Routine nutritional screening was performed in 22 (55.0%) hospitals on admission, which was lower than that in adult patients (65.8%). Nutritional screening tools varied among hospitals; 33 of 40 (82.5%) hospitals used their own screening tools. The most frequently used nutritional assessment parameters were weight, height, hemoglobin, and serum albumin levels. In our nationwide hospital-based survey, the most frequently reported main barriers of nutritional support in hospitals were lack of manpower and excessive workload, followed by insufficient knowledge and experience. CONCLUSIONS: Although this nationwide hospital-based survey targeted general and tertiary hospitals with pediatric gastroenterologists, manpower and medical resources for nutritional support were still insufficient for hospitalized children, and nutritional screening was not routinely performed in many hospitals. More attention to hospital malnutrition and additional national policies for nutritional support in hospitals are required to ensure appropriate nutritional management of hospitalized pediatric patients.

Effects of the College Financial Support Program on Development of the Department (전문대학 재정지원사업이 학과발전에 미치는 영향연구)

  • Yoou, Soon Kyu;Choi, Hea Kyung;Uhm, Tai Hwan
    • The Korean Journal of Emergency Medical Services
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    • v.7 no.1
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    • pp.213-234
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    • 2003
  • The purposes of this study which was done by questionnaire survey and case study of First Aid Certification Program in Seoul Health College were to analyze results and effects of the college financial support program from Ministry of Education & Human Resources Development. The significant 164 data were collected from 300 professors in 8 colleges having the Department of Emergency Care from Oct. 1, 2002 to Dec. 31, 2002 and analyzed using SPSS in terms of t-test, ANOVA, Pearson's correlation coefficient and so on. The conclusions and suggestions from this study were summarized as follows; (1) Degree of acknowledgement about aims, contents, results of the college financial support program was above the middle(participants 4.21, non-participants 3.63) and higher relation than the others in case of participants(r:0.32 p<0.001), planning team(r:0.22 p<0.05). (2) Degree of acknowledgement about improvement of curriculum & educational facilities through the program was above the middle and higher relation than the others in case of participants. (3) Degree of acknowledgement about positive influence on acquirement rate of certification(licence) & job through the program was above the middle and performance & adaptation at work place was higher relation than the others in case of participants. (4) Degree of acknowledgement about positive influence on improvement of learning of student's major through the program was above the middle and higher relation than the others in case of participants. (5) The respondents thought that the program had a negative influence on professor's educational activities & research such as study 40.4%, lecture 23.1%, student guidance 12.5%. (6) When the program was administered by planning team, there were difficulties such as execution of budget 42.1%, cooperation with companies 17.1%, cooperation among program teams 11.8%, when it was administered by non-planning team there were difficulties such as execution of budget 45.5%, cooperation among departments 22.7%, cooperation with companies 13.6%. (7) Because it was too short to execute the budget, the ministry have to select proposed programs before the next school year. (8) This program should be changed temporary, insufficient support into consecutive, sufficient support for more characterization & specialization of the college which has a long-term developmental plan & vision.

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The Analysis of Need with Homebound Disabled Persons in a Country Area (일부 농촌지역 재가 장애인의 요구도 분석)

  • Jung, Byeong-Ok;Lee, Cu-Rie;Kim, Keun-Jo;Park, Heung-Ki;Kim, Bonn-Won
    • Journal of Korean Physical Therapy Science
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    • v.13 no.4
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    • pp.43-62
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    • 2006
  • The survey was conducted with participation of the 289 handicapped persons residing at the rural area OOeup-gun in Kyungbook for the period of March 2 - May 31, 2006, to study the nature in general of the handicapped and the boundaries of their need. For the nature in general of the handicapped, the study was done by gender iscrimination, age, marital status, religion, educational level, occupation, monthly income, disability cause, disabled duration, disability type, disability level. For the boundaries of their need, the study was done by demand of financial support, educational demand, demand of voluntary workers, need of rehabilitation and medical treatment, job training, improvement of living conditions, or so. Using the Win.SPSS program, we made a frequency analysis and conclusions on the nature in general of the handicapped and the boundaries of their need on a 2-test. Conclusions are : 1. Nature in general of the handicapped The existence of the handicapped shows high at the age over 51 (71.6%), male-handicapped (65.1%), primary school graduates (62.9%), farming engaging (65.2%), monthly income less than one million Won (80.5%), cause by disease (53.8%), duration more than 10 years (61.6%), disability at level 3 (39.8%), extremity disability (66.4%). 2. Correlation of nature in general with demand of the handicapped a. In demanding the financial support, support for helper’s compensation shows high (p<0.05). In demanding the necessity of voluntary workers, the male-handicapped appears high during the absence of family assistance and the female-handicapped appears differently per week and also appears high during the absence of family assistance (p<0.05). b. In educational demand of the handicapped by their age, the age below 30 demands technical-job training and the age over 31 demands medical education for health care (p<0.01). c. In demanding the financial support by educational level, support for living cost shows high (p<0.05). d. In demanding improvement of living conditions by postnatal cause of disability, improvement of house structure shows high (p<0.05). e. In demanding assistance of voluntary workers by disabled duration, "No Need" shows high in the disabled duration more than 4 years (p<0.05). f. In demanding rehabilitation and medical treatment by disability type, home-visiting treatment, oriental medical treatment and physical therapy show high (p<0.001). g. In educational demand by disability level, medical education for health care shows high (p<0.01).

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A Comparison of Clinical Efficacy of Weaning Method Between the Mode of Intermittent Mandatory Ventilation and Intermittent Mandatory Ventilation Plus Pressure Support (기계적 호흡 치료로부터의 이탈방법으로서 Intermittent Mandatory Ventilation 단독 사용과 Pressure Support를 병용한 Intermittent Mandatory Ventilation의 비교)

  • Choi, Jeong-Eun;Koh, Youn-Suck;Cho, Won-Kyoung;Lim, Chae-Man;Kim, Woo-Sung;Park, Pyung-Hwan;Choi, Jong-Moo;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.4
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    • pp.372-378
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    • 1994
  • Background: Pressure support ventilation(PSV) is a new form of mechanical ventilatory support that assists spontaneous inspiraory effort of an intubated patient with a clinician-selected amount of positive airway pressure. Low level pressure support during inspiration can overcome the resistive component of inspiratory work imposed by an endotracheal tube. However the clinical efficacy of PSV as a weaning method has not been established yet. Object: The aim of study was to evaluate the efficacy of PSV when it is added to intermittent mandatory ventilation(IMV) in facilitating weaning precess compaired to IMV mode alone. Method: When the subject patients became clinically stable with their arterial blood gas analysis in acceptable range, they underwent weaning process either by IMV alone or by IMV plus PSV. The level of pressure support was held constant throught the weaning period. For the patients who required mechanical ventilation for less than 72 hr, 2h weaning trial was performed with IMV rate starting from 6/min. For the patients who required mechanical ventilation more than 72 hr, 7 hr weaning trial was performed with IMV rate starting from 8/min. For the patients who failed three consecutive trials of weaning, retrial of weaning was attempted over 3 days with IMV rate starting from 8/min. Clinical characteristics, APACHE II score and nutritional status were compared. For all patients, heart rate, mean blood pressure and respiratory rate were mornitored for 48 hrs after weaning trial started. Results: The total number of weaning trial was 37 in 23 patients(18 by IMV, 19 by IMV+PSV). Total ventilation time, APACHE II score and nutritional status were not statistically different between the two groups. The weaning success rate were not statistically different(38.3% by IMV, 42.1% by IMV+PSV) and the changes of mean blood pressure, heart rate, respiratory rate during first 48 hours were not different between the two groups. Conclusion: Low level PSV when added to IMV for weaning trial does not seem to improve the success rate of weaning from mechanical ventilation. PSV at 10cm $H_2O$ did not induce significant physiologic changes during weaning process.

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Factors Influencing Married Immigrant Women's Perceived Health Status: The National Survey of Multicultural Families 2012 (여성결혼이민자의 주관적 건강상태에 영향을 미치는 요인: '2012년 전국다문화가족실태조사'를 중심으로)

  • Yun, Ji Won;Kang, Hee Sun
    • Women's Health Nursing
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    • v.21 no.1
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    • pp.32-42
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    • 2015
  • Purpose: The purpose of this study was to investigate factors that influence married female immigrants' perceived health status. Methods: This study was a retrospective review of dataset from the 2012 National Multicultural Family Survey in Korea. Data were analyzed using descriptive statistics, t-tests, an analysis of variance (ANOVA), Pearson correlation analysis, and multiple regression with the data of 3,014 married female immigrants. Results: Multiple regression analysis showed that demographic factors (age, education level, nationality, period of residency in Korea, and residential area), socio-economical factors (monthly family income, employment, support from the government for basic living, and Medicaid), social support factors (marital conflict, satisfaction with family relationships, some one to talk about self or family matters, meeting with homeland friend, and participation in community meeting), and immigration factors (life satisfaction, experience of social discrimination, and difficulties with living and using medical care) were associated with perceived health status. Conclusion: It is important to pay closer attention to immigrant women who have low economic status, less social support, experience difficulties with living in Korea and using medical care. An effective support system for this population should be developed in order to help them successfully transition.

Influence of Family and Medical Staff Support and Hope on Organ Transplant Recipients' Psychosocial Adjustment (장기이식 수혜자의 가족 및 의료인 지지와 희망이 사회 심리적 적응에 미치는 영향)

  • Kim, Ok Soo;Choi, Kyung Sook
    • Journal of Korean Clinical Nursing Research
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    • v.22 no.1
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    • pp.78-87
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    • 2016
  • Purpose: This study was conducted to investigate the factors that influence the psychosocial adjustment of organ transplant recipients. Methods: Participants were 132 organ transplant recipients who received follow-up more than 3 months after the organ transplantation at one general hospital in Seoul. A questionnaire survey was done from November 3 to December 3, 2015. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, and hierarchical multiple regression. Results: Family support, medical staff support and hope were significantly correlated with psychosocial adjustment. In the hierarchical multiple regression analysis, hope appeared to be the most important factor influencing psychosocial adjustment (${\beta}=.39$, p<.001). Conclusion: The findings show that hope had an influence on the psychosocial adjustment of organ transplant recipients. Thus, to improve psychosocial adjustment it is important for nurses to develop interventions to increase hope in organ transplant recipients.

The Treatment of Adult Respiratory Distress Syndrome (ARDS) Using Extracorporeal Membrane Oxygenation (ECMO) (성인 호흡곤란 증후군에 있어 체외막 산소화 장치를 이용한 치료)

  • Kim, Go-Woon;Choi, Eun-Young;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.1
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    • pp.1-7
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    • 2012
  • Extracorporeal Membrane Oxygenation (ECMO) support to tissue oxygenation has been shown to improve survival in patients with life threatening respiratory distress syndrome or cardiac failure. Extracorporeal life support such as ECMO, including extracorporeal $CO_2$ removal ($ECCO_2R$), is used as temporary support until successful recovery of organs. A recently published multicentre randomized controlled trial, known as the CESAR (conventional ventilation or extracorporeal membrane oxygenation for severe adult respiratory failure) trial, was the first trial to demonstrate the utility of ECMO in acute respiratory distress syndrome (ARDS). During the 2009 influenza A (H1N1) pandemic, there were many reports of patients with severe ARDS related to H1N1 infection treated with ECMO. These reports revealed a high survival rate and effectiveness of ECMO. In this review, we explain the indication of ECMO clinical application, the practical types of ECMO, and complications associated with ECMO. In addition, we explain recent new ECMO technology and management of patients during ECMO support.

The Association Between Social Support and Impaired Fasting Glucose and Type 2 Diabetes

  • Kang, Yun-Jung;Park, Sang-Nam
    • Biomedical Science Letters
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    • v.22 no.4
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    • pp.189-198
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    • 2016
  • The purpose of this study was to examine the effect of social support on type 2 diabetes by classifying it into diabetes and impaired fasting blood sugar, a pre-diabetic state. Subjects of this study were 22,846 adults aged 30 years or above who agreed and registered to participate in the "Korean Health Examine Cohort (KOEX)" study that simultaneously collects questionnaires and biological samples at 8 university hospitals around the nation. Normal fasting blood sugar was defined as below 100 mg/dL, and impaired fasting blood sugar was defined as 100~125 mg/dL. Diagnosis of diabetes was defined as fasting blood sugar of 126 mg/dL or above, diagnosis by a doctor, or medication of insulin or oral hypoglycemic agent. Social support groups were divided into 4 groups, and Group 1 (G1) had high positive support and low negative support. This is the reference group with the highest social support. During multivariate analysis, female group (G3) that had high positive support and high negative support showed prevalence of impaired fasting blood sugar 1.19 times higher (95% CI = 1.02~1.41) than G1. As this study confirmed that social support increases fasting blood sugar of women after correction for socioeconomic status, health behavior, and biological and medical variables, it implies the importance of social relations such as social support in addition to management of personal risk factors for prevention of type 2 diabetes.

Home Care Support and Support Requirements According to Health Condition in the Poor Elderly People Living Alone (일 지역 취약가구 독거노인의 건강상태에 따른 가정지원과 도움요구)

  • Park, Ji-Won;Kim, Yong-Soon;Kim, Ki-Sook
    • Journal of Home Health Care Nursing
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    • v.16 no.2
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    • pp.89-97
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    • 2009
  • Purpose: To identify the health condition, home care support, support requirement of poor and elderly people living alone. Method: Data was collected through self-administered questionnaires and analyzed by descriptive statistics, t-test, ANOVA and correlation. Survey involved 269 conveniently selected who have a social support in H city. Result: Perceived health condition of subjects was bad to moderate (mean score: 2.22). There were significant home care support differences according to gender, religion, education level and dwelling pattern. Support requirement was influences only by the dwelling pattern. Perceived health condition showed a positive correlation with home care support of friends and neighbors, and a negative correlation with support requirement (medical, material, economic emotional support). Conclusion: These findings are expected to make a positive contribution to create an ideal intervention for public visiting nurses and social workers to improve the quality of life in poor and elderly people who live alone.

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