• 기본간호학회지
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• 제2권2호
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• pp.115-130
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• 1995

The incidence of oral complications among adult cancer patients undergoing chemotherapy varies from 12 to 80%. Adequate oral hygiene has been shown to be important in prevention of oral complication and an essential role is reserved for the nursing staff. These considerations prompted the decision to survey by means of a questionaire, the nurses who give care to cancer patients. The Questions were included multidisciplinary treatment, inspection skill, nursing intervention, nursing education, problem in mouth care, solution for problem solving. - Results are fellow : 1. A total of 116 of the nurses returned the questionaire 2. According to 88.2% of the respondents, the policy with regard to oral-hygine is determined by the physician and the nurse. 62.1% of nurses do not consult the dentist When oral complication is occured. 3. In only 34.5% of case was a penight used to provide the necessary extra illumination nursing Inspection of oral cavity. 4. Frequency of oral complications observed by the respondents is that they observed complications in < 25% of patients. The nature of the complication varied from ulcer, stomatitis, infection, dry mouth, candidiasis, herpes simplix, bleeding. 5. Percentages of respondents who use the intervention indicated 1) to prevent oral complication : 0.9% normal saline gargling(44%), 0.02% chlorhexidine gargling, oral dressing(38.8%), observation, nutrition, restriction of alcohol and tabaco(23.2%) 2) to deal with the early symptoms 0.9% normal saline gargling (47.4%), cryotherapy(37.9%), 0.02% chlorhexidine gargling(20.7%) 3) to help alleviate severe complications : dental consult, holding the chemotherapy(34.5%), 0.9% normal saline gargling(31.1%), cryotherapy(18.0%) 6. According to 70% of the respondents, insufficient attention is given to oral complication during nursing education classes only 8.6% said that both the theory and the practical aspects had been deal with in sufficient detail during their training. The results of the survey indicate thatoral care in cancer patients undergoing chemothrapy has a number of problem. There are not enough dentist to provide the necessary care for patients undergoing chemotherapy. The expertise of the nurses with respect to the pathogenesis of the complication is limited. In the training of nurses, additional attention to oral examinations and oral hygine is warranted. The care of patients should be the responsibility of a multidisciplinary team approach. The nurse occupies a key position with in this team, which includes the medical oncologist, a dentist.

• Journal of Dental Anesthesia and Pain Medicine
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• 제19권3호
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• pp.167-173
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• 2019

This case report describes a frail, middle-aged woman with multiple comorbidities who was scheduled to undergo extraction of all remaining teeth in anticipation of cardiac quadruple valve intervention. Dental and anesthetic management of the patient are discussed. Medical care of the patient with a high burden of comorbidities requires a multidisciplinary approach even for a routine dental procedure.

• Archives of Plastic Surgery
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• 제34권5호
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• pp.617-621
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• 2007

Purpose: With the necessity of comprehensive care for the breast cancer patients, Breast Care Center of our hospital started to work in March 2004. This study examined the 3-year execution of Breast Care Center. The role of Breast Care Center was evaluated in aspect of clinical activities in quality and quantity. Methods: A retrospective review was carried out from 2001 to 2007 with breast cancer patients. The number and type of breast cancer surgery and breast reconstruction procedure were compared before and after Breast Care Center's foundation. Time required for the diagnosis and treatment was also compared. Regression analysis and T-test were used to identify the statistical significance. Results: The number of breast cancer surgery did not statistically increase compared with progressive increase of breast cancer. QUART(quadrantectomy, axillary dissection, radiotherapy) procedure statistically significantly increased and MRM(Modified Radical Mastectomy) procedure decreased for breast cancer surgery after foundation of Breast Care Center. The number of breast reconstruction procedures statistically significantly increased. The number of immediate TRAM free flap (Transverse Rectus Abdominal muscle free flap) procedures has grown 3.8 times after foundation of Breast Care Center. The time required for diagnosis and treatment was also shortened. Conclusion: After foundation of Breast Care Center, the number of breast reconstruction surgery increased, while the counselling time in breast reconstruction was reduced. Breast Care Center provided a prompt and comprehensive care to the breast cancer patients through the multidisciplinary therapeutic approaches.

• 간호행정학회지
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• 제5권2호
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• pp.197-207
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• 1999

The purpose of this research was fourfold: (a) to identify the use rate of the indirect care interventions performed by nurses, (b) to estimate the time to perform each intervention, (c) to identify the indirect care interventions to be delegated to others, and (d) to determine the level of provider preparation needed to delegate indirect care interventions. The sample consisted of 199 nurses working in three hospitals. The Indirect Care Survey developed by the Iowa Intervention Project team was used for data collection. The instrument was translated to Korean and validated by nurse experts. Each of the 26 indirect care interventions were used several times a day. Four interventions (i.e.. Documentation, Shift Report, Specimen Management, and Transport) were performed several times a day by 50% or more of the nurses. The most frequently used intervention was Documentation, followed by the interventions Shift report. Environmental Management, Transport, and Examination Assistance. The least used intervention was Quality Monitoring, followed by the interventions Order Transcription, Referral, Health Care Information Exchange, Multidisciplinary Care Conference, and Product Evaluation. The intervention taking the most time to per-form was Technology Management (155.3 minutes), followed by the interventions Documentation, (122.2 minutes), Delegation (84.4 minutes), Supply management (83.4 minutes), and Preceptor: Student (79.9 minutes), Overall, the nurses reported that they would not delegate to others the majority of the interventions. More than 50% of the nurses would not delegate 21 interventions. Shift Report would not be delegated by 95% of the nurses and Documentation would not be delegated by 92% of the nurses. Caregiver Support would be delegated by 68% of the nurses to family. Three interventions (i.e.. Environmental Management, Examination Assistance, and Transport) would be delegated by more than 50% of the nurses to Nursing Assistant. This study will contributes to determining costs of nursing services and enhancing quality of nursing care. Replication study will be needed with large sample.

• 대한간호학회지
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• 제49권2호
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• pp.191-202
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• 2019

Purpose: Patient-centered care is a widely utilized concept in nursing and health care. However, the key components of patient-centered nursing have not yet been reported. Moreover, previous studies on patient-centered care have mostly focused on components of nursing rather than organizational factors. Therefore, a comprehensive understanding of influential factors of patient-centered care is required. Methods: The purpose of this study was to develop a theoretical model based on person-centered care theory, and the relevant literature and to test the developed model with covariance structure analysis in order to determine the causal paths among the variables. Results: The model fit indices for the hypothetical model were suitable for the recommended level (goodness of fit index=.87, standardized root mean residual=.01, root mean square error of approximation=.06, Tucker-Lewis index=.90, comparative fit index=.92, parsimonious normed fit index=.75). In this study, five of the six paths established in the initial hypothetical model were supported. The variables of teamwork, self-leadership, and empathy accounted for 56.4% of hospital nurses' patient-centered care. Among these, empathy was the strongest predictor of patient-centered care. Conclusion: These results suggest that it is necessary to use strategies to improve self-leadership and empathy. In addition to enhancing the personal factors of nurses, nursing organizations should strive for effective multidisciplinary cooperation with active support for patient-centered care and openness to change.

• 한국보건간호학회지
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• 제12권1호
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• pp.90-102
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• 1998

The primary health care(PHC) movement officially began in 1977 when the 30th World Health Oranization(WHO) Assembly adopted a resolution accepting the goal of attaining a level of health that permitted all citizens of the world to live socially and economically productive lives. As a WHO member nation, Korea has endorsed primary health care as a strategy for achieving the goal of Health For All by the Year 2000. However, PHC, with its empasis on broad strategies, community participation, self reliance, and a multidisciplinary health care delivary team, is not the primary strategy for improving the of Korean. The Neuman's systems model has been described as a grand nursing theory. A grand nursing theory consists of a comprehensive conceptual framework that defines broad perspectives for practice. This model is an example of a conceptual framework that provides structure for development and analysis of an individual or group of patients in the community or in an oranization. One of the model's strength is that it can be useed ina variey of setting. So The Neuman's model is used a nursing process format for community health nursing. The Neuman's model is fully congruent with concept and philosophy of today's PHC.

• Journal of Preventive Medicine and Public Health
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• 제40권6호
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• pp.447-453
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• 2007

Although the New National Health Promotion Plan 2010 target to reduce health inequalities, whether the program will be effective for reducing the health inequalities in Korea remains quite unclear. More and more developed countries have been started to concentrate on comprehensive policies for reducing health inequalities. The health policies of the UK, Netherlands, and Sweden are the most wellknown. I propose that a comprehensive blueprint for tackling health inequalities in Korea should be made and that it must contain five domains: a target, structure and process, life-course approach, area-based approach, and reorganization of health care resources. The target should be based on determinants of health and more attention should be paid to socioeconmic factors. The structure and process require changes from the national health care policy based on medical services to the national health policy that involves the establishment of a Social Deputy?Prime Minister and the strengthening multidisciplinary action. A life-course approach especially focused on the early childhood years. Area-based approach such as the establishment of healthy communities, healthy schools, or healthy work-places which are focused on deprived areas or places is also required. Finally, health care resources should be a greater investment on public resources and strengthening primary care to reduce health inequalities. The policy or intervention studies for tackling health inequalities should be implemented much more in Korea. In addition, it is essential to have political will to encoruage policy action.

• Perspectives in Nursing Science
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• 제10권1호
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• pp.32-40
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• 2013

Purpose: The purpose of this study was to examine the health care status and healthy life practices among hypertensive patients in our South Korea in a bid to provide some information on the efficient management of hypertension. Methods: The data of the fifth Korea National Health and Nutrition Examination Survey of 2011 (KNHANES V-2) was utilized to analyze the state of hypertension management of 1,932 adults who were at the Western age of 19 and up and suffered from hypertension in order to identify what factors were related to their health care status and healthy life practices. IBM SPSS/WIN Statistics 20 software was employed, and frequency analysis and a ${\chi}^2$-test were carried out. Results: According to the results of the analysis, subjective health status, depression, and suicidal thoughts were significantly related to variable income, while health status and healthy life practices were not significant in town. Furthermore Depression, alcohol dependency, and walking were significant in hypertension patients who had experienced hypertension education programs. Conclusion: This study will provide database on hypertension management. Furthermore, multidisciplinary approaches should be taken for efficient and effective care for hypertension patients.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제17권1호
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• pp.15-22
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• 2011

Nowadays, a proportion of healthcare service for the elderly has been improved due to the factors, such as a prolonged life expectancy, a growth of aging population and a change of member of family. For these factors, it is necessary for the elderly to receive treatment for multidisciplinary diseases, associated with psychological care of sociological concept. It is quite difficult in an acute-care hospital to accommodate the elderly patient because of the fact that an acute-care hospital is required to maintain a high level of medical care and technical standard. That is why specialized medical service is needed for the elderly. In the case of Germany, they are at the stage of the change from large scale facilities to specialized facilities applying the integrated concept. This paper addresses the medical environmental factor and distinction of medical facilities for the elderly through survey and analysis relating to all change in Germany. Therefore, it aims to suggest a fundamental resource for architectural planning and network of medical facilities for the elderly.

• Journal of Trauma and Injury
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• 제23권2호
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• pp.113-118
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• 2010

Purpose: Prolonged stay in the emergency department (ED), which is closely related with the time interval from the ED visit to a decision to admit, might be associated with poor outcomes for trauma patients and with overcrowding of the ED. Therefore, we examined the factors affecting the delay in the decision to admit severe trauma patients. Also, a multidisciplinary department system was preliminarily evaluated to see if it could reduce the time from triage to the admission decision. Methods: A retrospective observational study was conducted at a tertiary care university hospital without a specialized trauma team or specialized trauma surgeons from January 2009 to March 2010. Severe trauma patients with an International Classification of Disease Based Injury Severity Score (ICISS) below 0.9 were included. A multivariable logistic regression analysis was used to find independent variables associated with a delay in the decision for admission which was defined as the time interval between ED arrival and admission decision exceeded 4 hours. We also simulated the time from triage to the decision for admission by a multidisciplinary department system. Results: A total of 89 patients were enrolled. The average time from triage to the admission decision was $5.2{\pm}7.1$ hours and the average length of the ED stay was $9.0{\pm}11.5$ hours. The rate of decision delay for admission was 31.5%. A multivariable regression analysis revealed that multiple trauma (odds ratio [OR]: 30.6, 95%; confidence interval [CI]: 3.18-294.71), emergency operation (OR: 0.55, 95%; CI: 0.01-0.96), and treatment in the Department of Neurosurgery (OR: 0.07, 95%; CI: 0.01-0.78) were significantly associated with the decision delay. In a simulation based on a multidisciplinary department system, the virtual time from triage to admission decision was $2.1{\pm}1.5$ hours. Conclusion: In the ED, patients with severe trauma, multiple trauma was a significant factor causing a delay in the admission decision. On the other hand, emergency operation and treatment in Department of Neurosurgery were negatively associated with the delay. The simulated time from triage to the decision for admission by a multidisciplinary department system was 3 hours shorter than the real one.