• The Journal of the Korea Contents Association
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• v.9 no.5
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• pp.174-181
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• 2009

Recently hospitals are implementing a One Stop Service as part of patient-care service. With the One Stop Service, medical treatment including consultation, inspection, and results are changing to be made available in one visit. Therefore most examinations are reserved for the same day; however, there are cases in which additional visits are necessary because of certain properties related to exams. This study compares and analyzes the number of reinspections before and after reforms. By designating the order of priority for BMD examinations and implementing education from information obtained in the OCS E-manual update, the number of reinspections for wards was reduced from 58 to 21, Outpatient departments were reduced from 51 to 12, and errors in reservations made by employees in the department of radiology were reduced from 98 to 11. Reinspections can be reduced with full understanding the factors related to reinspection and a background check prior to inspection in order to determine the order of priority for inspections. This will also reduce workers' stress and increase their efficiency and at the same time decease patient dissatisfaction and improve hospital reliability.

• Korean Journal of Adult Nursing
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• v.24 no.4
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• pp.348-357
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• 2012

Purpose: This retrospective chart review study was carried out in order to examine the frequency of delirium, and to identify the risk factors associated with the development of delirium in elderly patients with arthroplasty. Methods: Data were collected from medical records of patients who received arthroplasty during one and half year in a hospital. Three hundred sixty five patients were selected for the study. The onset of delirium was reviewed based on the result of psychological doctor's consultation or nurse's assessment with Confusion Assessment Method and delirium onset risk factors were examined. Data were analyzed with descriptive statistics, t-test, $x_2$-test, Fisher's exact test and logistic regression analysis. Results: Delirium occurred with 31 patients (8.5%) out of 365 patients who underwent arthroplasty. There were statistically significant differences between incidence of delirium and gender ($x_2$=6.11, p=.025), age ($x_2$=32.81, p<.001), hearing difficulty ($x_2$=8.08, p=.012), albumin level of preoperational day (t=-3.43, p<.001), albumin (t=-2.20, p=.028) and hemoglobin level (t=-2.83, p=.005) of operational day. Age and gender were the most significant predictive factors with regard to the incidence of delirium. Conclusion: Through understanding of these results, nurses will be able to identify those patients who may be at risk for developing delirium in early stages.

• Korea Journal of Hospital Management
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• v.7 no.2
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• pp.37-51
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• 2002

It has been 2 years since the implementation of the separation of prescription and drug dispensing policy. This study analyzes the effects of the policy on the job contents and personnel structure of hospital pharmacy. The main purposes of the analysis are to determine if the policy has causes the increase of professional activities of pharmacists in hospital and to investigate whether the hospital pharmacy is equipped with enough manpower to provide high quality pharmaceutical service as intended by the policy. The level of professionality of pharmacists' activities is measured by the number of activities of direct involvement in inpatient care such as participation in patient rounding, medication consultation, the number of hospital committee the pharmacists involved and the number of continuous education pharmacists took. The adequacy of personnel structure to provide high quality pharmaceutical care is measured by the level of compliance to the governmental standard of hospital pharmacy personnel. In order to collect the data, surveys were performed for two periods: year 1999 (before the implementation of the policy) and year 2001 (after the implementation of the policy). The results show that the pharmacists' participation in inpatient rounding decreased and that the inpatient medication history management activities, operation of ward pharmacy, participation in hospital committee increased. In personnel structure, the average number of pharmacist per hospital decreased and the number of prescription processing per pharmacist increased. Based on the results this study concludes that the professional activities of hospital pharmacists has increased a little and there were structural changes in hospital pharmacy service activities to increase the professionalism in providing care. However, the pharmacy departments were understaffed hampering the strive to increase the provision of professional pharmaceutical service in hospitals.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.3
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• pp.208-213
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• 2013

The spectrum of physically challenged patients who visit to a dental clinic for treatments are diverse: from ones of mild disabilities, who lead their lives in a similar way of ordinary people, to others who suffer from diseases that are difficult to be diagnosed, and need medical expertise due to systemic care or special techniques and instruments because of behavior management and difficulty of treatments. The patient in this case was 25-year-old autistic male patient who visited the clinic on account of overall treatment for multiple carious lesions. He could perform normal daily life to some degree under the care of a guardian. This case report describes predicaments of making a treatment plan resulted from lack of information about disabled patients, and difficulties of proceeding treatment procedures under general anesthesia. It is considered that sufficient consultation and history taking are needed before treatment for disabled patients.

• Journal of Oriental Neuropsychiatry
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• v.21 no.2
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• pp.1-15
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• 2010

Objectives : This study was performed to develop a standard instrument of Pattern Identification for jing ji and zheng chong. Methods : The advisor committee on this study was organized by 15 neuropsychiatry professors of oriental medical colleges. The items and structure of the instrument were based on review of published literature. We took consultation 2 times from the advisor committee and we also took additional advices by e-mail. Results : 1. We divided the symptoms and signs of jing ji and zheng chong into 9 pattern identification. - heart deficiency with timidity(心膽虛怯), heart qi deficiency(心氣虛), heart blood deficiency(心血虛), heart yang inactivity(心陽不振), heart blood stasis(心血瘀阻), phlegm turbidity obstructing(痰濁阻滯), yin deficiency with effulgent fire(陰虛火旺), water qi intimidating the heart(水氣凌心), dual deficiency of the heart and spleen(心脾兩虛). 2. We got the mean weights that reflect standard deviation to each symptom of 9 pattern identification which had been scored on a 100-point scale. 3. We made out the Korean instrument of the pattern identification for jing ji and zheng chong. It was composed of 17 questions in question-and-answer form. Conclusions : Instrument of Pattern Identification for jing ji and zheng chong was developed through experts' disscussion. If the validity and reliability of this instrument is confirmed through additional clinical trial, the instrument of pattern identification for jing ji and zheng chong is expected to be applied to the subsequent research.

• Journal of The Korean Society of Clinical Toxicology
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• v.4 no.1
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• pp.17-24
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• 2006

Objectives: To analyze the general characteristics and clinical differences of poisoning in children and adolescents and to take precautions of occasions. Methods: We retrospectively evaluated poisoning children and adolescents (less than 19 years) visiting to the emergency medical center of tertiary hospital in urban area. We collected demographic data, substance exposure data (materials, causes of poisoning and amount), and clinical outcome of poisoning for the past 2 years and 9 months. Results: 189 cases were reported of concerning poisoning in children and adolescents. The age groups were divided into four categories. (1) Infants group:<2 year, (2) Preschool age group: $2{\sim}5year$, (3) Children group: $6{\sim}12year$ and (4) Adolescents group: $13{\sim}18year$. The most vulnerable age group was the infants group. There were two-peaks of age distribution in poisoned patients on the whole. Various types of materials belonged to classes of druqs (56.6%). household products (34.4%) and industrial solvents (9.0%). On adolescents group, the frequency of drug poisoning was significantly high, in comparison with infants, preschool age, and children group (p=0.001). Most of the patient groups had been poisoned accidentally(73.5%), while most cases of adolescents poisoning had been intentional. 63% of the adolescents group had a suicidal purpose. Conclusion: The incidence of poisoning was most highly due to drugs. The cause of poisoning is most commonly accidental. while in adolescent group, intentional poisoning is mostly common. Special cares, like keeping children away from drugs, will be needed to prevent children poisoning, and psychiatric consultation and supportive cares can reduce the adolescents poisoning cases.

• Korean Journal of Clinical Pharmacy
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• v.26 no.2
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• pp.128-136
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• 2016

Objective: This study was to explore the association between having a usual source of care and adherence to medicines in patient with chronic diseases. Methods: The 2012 Korea Health Panel was used as a data source. We analyzed 4,418 respondents that were diagnosed with chronic diseases and utilized health care services. Non-adherence to medication, a dependent variable, was defined as "not taking the medicines that were prescribed for treating chronic disease" or "not following the direction for medication". Whether having a usual source of care or not was used as a key independent variable, which was defined as having a regular site or a regular doctor for medical test, treatment, and consultation. Sex, age, education level, marital status, income, the type of health insurance, the number of chronic disease and CCI (Charlson Comorbidity Index) were included as covariates in the analysis. We conducted a multivariate logistic regression. Results: Totally, 30 percent of respondents reported to experience non-adherence to medication. Having a usual source of care was significantly associated with lower non-adherence to medication regardless its type, which is a regular doctor (OR=0.61, 95% CI=0.53-0.70) or a regular site (OR=0.67, 95% CI=0.58-0.78). Furthermore, having a usual source of care was associated with both of medication persistence (OR=0.66, 95% CI=0.54-0.81) and compliance (OR=0.65, 95% CI=0.56-0.76). Conclusion: Our results showed the possibility that usual source of care is able to conduct a positive role in improving adherence to medication with better management of chronic disease.

• Korean Journal of Health Education and Promotion
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• v.27 no.4
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• pp.105-112
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• 2010

Objectives: The purpose of this study was to know different effect with uncontrolled hypertension patients after providing health promotion program which consisted with medicine, exercise, nutrition. Methods: The subjects of this study was comprised by uncontrolled hypertension patients in spite of medication and didn't care the pressure by medication. The health promotion program was progressed by group exercise three times a week, nutrition education once a week and medical consultation once a month for 12 weeks. Subjects were measured for body composition(weight, fat mass, % body fat and body mass index), hemo-dynamics(systolic blood pressure(SBP), diastolic blood pressure(DBP), and resting heart rate), and physical fitness (cardiopulmonary endurance, muscular strength, muscular endurance, balance, and flexibility). Results: Groups showed significant improvement in every measure except resting heart rate. SBP is decreased both taking drug group about 18.4mmHg and without taking drug group about 19.4mmHg.(p<0.001) DBP is decreased both taking drug group about 8.7mmHg and without taking drug group about 9.0 mmHg.(p<0.001) Conclusion: There are no statistical significant differences of SBP and DBP decreasing effects by medication, Since effects of decreasing pressure are not different by medication, I think the health promotion program is effective to uncontrolled hypertension patients to decrease pressure.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.4
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• pp.1435-1442
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• 2015

Purpose: To study the patient load, treatment pattern, survival outcome and its predictors in patients with brain metastases treated by radiotherapy. Materials and Methods: Data for patients with brain metastases treated by radiotherapy between 2003 and 2007 were collected from medical records, the hospital information system database, and a population-based tumor registry database until death or at least 5 years after treatment and retrospectively reviewed. Results: The number of treatments for brain metastases gradually increased from 48 in 2003 to 107 in 2007, with more than 70% from lung and breast cancers. The majority were treated with whole brain radiation of 30 Gy (3 Gy X 10 fractions) by cobalt-60 machine, using radiation alone. The overall median survival of the 418 patients was 3.9 months. Cohort analysis of relative survival after radiotherapy was as follows: 52% at 3 months, 18% at 1 year and 3% at 5 years in males; and 66% at 3 months, 26% at 1 year and 7% at 5 years in females. Multivariate analysis demonstrated that the patients treated with combined modalities had a better prognosis. Poor prognostic factors included primary cancer from the lung or gastrointestinal tract, emergency or urgent consultation, poor performance status (ECOG 3-4), and a hemoglobin level before treatment of less than 10 g/dl. Conclusions: This study identified an increasing trend of patient load with brain metastases. Possible over-treatment and under-treatment were demonstrated with a wide range of survival results. Practical prognostic scoring systems to assist in decision-making for optimal treatment of different patient groups is absolutely necessary; it is a key strategy for balancing good quality of care and patient load.

• Journal of Physiology & Pathology in Korean Medicine
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• v.24 no.4
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• pp.543-552
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• 2010

The objectives of this study are to examine the current status and problems of herb-drug interaction (HDI) information and information database in Korea and suggest the better way to establish useful HDI database. We collected HDI studies that published in Korea and analyzed according to objective, methods, selection criteria of herbs, number of study, correlation between study subject and frequently used herbal medicine (HM). Then we selected representative HM database on the internet made by Korea Food and Drug Administration (KFDA) among the several databases and analyzed its contents related to HDI. Several HDI studies were carried out from laboratory based research to clinical trials and HM databases have been developed for providing information about different aspects of traditional Korean medicine. But the information of HDI and information database are still far from practical applications because there are no coherence to select study subjects and methods among researchers. So, it is necessary to build up HDI database led by the government for providing systematic HDI information. HDI information database is expected to be able to provide useful evidence for health professionals in prescription and consultation to reduce the chance of adverse effects and improve the quality of medical care.