• Asian Pacific Journal of Cancer Prevention
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• v.16 no.1
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• pp.259-263
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• 2015

Background: In the field of cancer, the ICD-10 coding convention is based on the site of a neoplasm in the body and usually ignores the morphology, thus the same code may be assigned to tumors of different morphologic types in an organ. Nowadays, all general (provincial) and center hospitals in Thailand are equipped with the hospital information system (HIS) database. Objective: This study aimed to find the characteristics and magnitude of agreement represented by the positive predictive value (PPV) of provisional cancer diagnoses in the HIS database in Pattani Hospital in Thailand in comparison with the final cancer diagnosis of the ICD-10 codes generated from a well established cancer registry in Songklanagarind Hospital, the medical school hospital of Prince of Songkla University. Materials and Methods: Data on cancer patients residing in Pattani province who visited Pattani Hospital from January 2007 to May 2011 were obtained from the HIS database. The ICD-10 codes of the HIS computer database of Pattani Hospital were compared against the ICD-10 codes of the same person recorded in the hospital-based cancer registry of Songklanagarind Hospital. The degree of agreement or positive predictive value (PPV) was calculated for each sex and for both sexes combined. Results: A total of 313 cases (15.9%) could be matched in the two databases. Some 222 cases, 109 males and 113 females, fulfilled the criteria of referral from Pattani to Songklanagarind Hospitals. Of 109 male cancer cases, 76 had the same ICD-10 codes in both hospitals, thus, the PPV was 69.7% (95%CI: 60.2-78.2%). Agreement in 76 out of 113 females gave a PPV of 67.3% (95%CI: 57.8-75.8%). The two percentages were found non-significant with Fisher's exact p-value of 0.773. The PPV for combined cases of both sexes was 68.5% (95%CI: 61.9-74.5%). Conclusions: Changes in final diagnosis in the referral system are common, thus the summary statistics of a hospital without full investigation facilities must be used with care, as the statistics are biased towards simple diseases able to be investigated by available facilities. A systematic feedback of patient information from a tertiary to a referring hospital should be considered to increase the accuracy of statistics and to improve the comprehensive care of cancer patients.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.5867-5870
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• 2013

Background: Cervical cancer is the second most common cancer among Malaysian women with an ASR of 17.9 and a mortality rate of 5.6 per 100,000 population in 2008 (GLOBOCAN, 2008). The 5 year prevalence was estimated to be 14.5 per 100,000 population. As the second most common cancer affecting productive females, cervical cancer imposes an impact to the socioeconomic aspect of the country. However, the poor uptake of cervical cancer screening is a major problem in detecting early pre-cancerous lesions and thus, delay in initiating treatment for cervical cancer. Realizing the urgency to increase the uptake of PAP smear, besides enhancing the promotion of PAP smear screening for women above 35 years old, the call-recall system for pap smear screening had been piloted in one of the suburban districts which aimed to improve regular participation of women for cervical and breast cancer screening. This is of public health importance as identifying the best feasible option to increase patient's respond to participate in the screening program effectively in our setting will be helpful in implementing an organized regular population based screening program tailored to our setting. The pilot program of cervical cancer screening in Klang was an opportunity to assess different options in recalling patients for a repeat pap smear to increase their participation and adherence to the program. Methods and Results: This was a population based randomized control trial. Women aged 20-65 years in the population that matched the inclusion and exclusion criteria were re-called for a repeat smear. There are four different intervention groups; letter, registered letters, short messages services (SMS) and phone calls where 250 subjects were recruited into each group. Samples were generated randomly from the same population in Klang into four different groups. The first group received a recall letter for a repeat smear similar to the one that has been given during the first invitation. The intervention groups were either be given a registered letter, an SMS or a phone call to re-call them. The socio-demographic data of the patients who came for uptake were collected for further analysis. All the groups were followed up after 8 weeks to assess their compliance to the recall. Conclusions: The study will provide recommendations about the most effective methods for recall in a population based pap smear screening program on two outcomes: i) patients response; ii) uptake for repeat pap smear.

• Progress in Medical Physics
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• v.24 no.3
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• pp.135-139
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• 2013

We evaluated the effect of two kinds of breathing biofeedback technique such as audio-instruction and audio-visual biofeedback on breathing reproducibility and the CTV coverage during repeated treatment regimes in respiration-gated radiotherapy. In this study, the breathing data of nineteen lung cancer patients acquired from Medical College of Virginia (MCV) during five weeks were used. The dose evaluation algorithm was programmed in MATLAB. In the result, the CTV coverage was decreased as 30.0% due to the breathing irreproducibility for free-breathing. For audio-visual biofeedback, the CTV coverage was improved as 20.0% because patients can learn how control their breathing stably. And the audio-instruction was effective to preserve the breathing reproducibility.

• The Journal of the Korea Contents Association
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• v.16 no.1
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• pp.585-594
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• 2016

This study is aimed at researching and analyzing the students' recognition and practice of the patents medical information, who are majoring in medical records and will be working as medical records technician, letting them recognize the importance of information, and at offering basic data required for development of medical records curriculum and for establishment of medical records protection policy. This study was conducted from 18th May through 6th June 2015, targeting 340 students enrolled four universities, by t-test, variance analysis, Pearson correlation analysis and multiple regression analysis. As a result of this study, the point of protection recognition and practice recognition is 3.55 and 3.49, respectively, out of 5. With regard to recognition of medical information protection, there was a significant difference in grade, satisfaction for major, experience of medical information protection education and recognition of law, while for recognition of practice, in grade, satisfaction for major, educational experience and damage of medical information exposure. Recognition of protection and recognition of practice had a significant static correlation, and recognition of information exposure, recognition of social issue and recognition of legal system had significant positive effect on recognition of practice. In order to raise the recognition of protection and recognition of practice, based on this study, it is considered necessary for the universities to educate the damage of medical information exposure and importance of medical records management, and to raise the students' recognition.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.10
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• pp.299-307
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• 2020

Purpose: The purpose of this study was to investigate the financial hardships affecting the quality of life of cancer survivors. Method: Data were collected from five convalescent hospitals using self-administered questionnaires, and 422 questionnaires were used for the final analysis. We used a 5-step hierarchical multiple-regression analysis by entering each sociodemographic variable, medical variable, and three types of financial hardship (a material situation, the psychological response, and coping behavior coming from cancer treatment cost) into each step. Results: The results of statistical analysis indicate that the most influential factor in the quality of life was the financial difficulty, which was the frustration that they could not work as usual or support their family financially. In addition, the performance of physical activity, accompanying diseases, women patients, psychological burden on cancer treatment cost, the satisfaction of communication with medical staff for medical expenses, and the feeling unsuccessful financial coping strategy were predictors for the quality of life of cancer survivors. Conclusion: This study provides a blueprint for the development of intervention programs in practice to improve the quality of life of cancer patients, clinical intervention plans, and health policies.

• Journal of Korean Academy of Nursing
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• v.29 no.6
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• pp.1365-1378
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• 1999

This study is a methodological research study to develop an instrument to measure in patients with cancer and to test the validity and reliability of the instrument. The research procedure was as follows : 1) The first step was to develop conceptual framework based on a comprehensive review of the literature and in-depth interviews with patients with cancer. This conceptual framework was organized in to three dimensions (the intrapersonal dimension, the significant-other and context related dimension, the transcendental dimension). Initially 59 items were adopted. 2) These items were analyzed through the index of content validity(CVI) and 53 items were selected which met more than 80% on the CVI. 3) The pretest was carried out with 87 patients with cancer. After the pretest results were analyzed by item analysis, 44 items were selected. A second test of content validity was conducted and 6 items were eliminated considering the 80% CVI. 4) To test for reliability and validity, data collection was done during the period from January 25, 1999, to February 26, 1999. The subjects for the test were 160 patients with cancer and 185 healthy persons. analysis, item analysis and multitrait-multimethod method to analyze validity. The findings are as follows : 1) The Cronbach's alpha coefficient for internal consistency was .92 for the total 38 items and .79, .82, .85, for the three dimensions in that order. 2) The item analysis was based on the corrected item to total correlation coefficient( .30 or more) and information about the alpha estimate if this item was dropped from the scale. 3) As a result of the initial factor analysis using principal component analysis and varimax rotation, one item was deleted because of factor complexity (indiscriminate factor loadings). In the secondary factor analysis, 7 factors with eigenvalue of more than 1.0 were extracted and these factors explained 56 percents of the total variance. The seven factors were labeled as 'family relationship', 'emotional condition', 'physical discomfort', 'meaning and goal of life', 'contextual stimuli', 'change of body image', 'guilt feelings'. 4) The convergence effect between this instrument and the life satisfaction scale was identified and there was significant positive correlation(r= .52, p= .00). The discriminant validity between this instrument and the depression scale(CES-D) was tested and there was significant negative correlation(r= -.50, p= .00). The instrument for accessing the suffering of patients with cancer developed in this study was identified as a tool with a high degree of reliability and validity. In this sense, this tool can be effectively utilized for assessment in caring for patients with cancer.

• Journal of Korean Neurosurgical Society
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• v.56 no.1
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• pp.21-27
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• 2014

Objective : Infectious spinal disease is regarded as an infection by a specific organism that affects the vertebral body, intervertebral disc and adjacent perivertebral soft tissue. Its incidence seems to be increasing as a result of larger proportion of the older patients with chronic debilitating disease, the rise of intravenous drug abuser, and the increase in spinal procedure and surgery. In Korea, studies assessing infectious spinal disease are rare and have not been addressed in recent times. The objectives of this study are to describe the epidemiology of all kind of spinal infectious disease and their clinical and microbiological characteristics as well as to assess the diagnostic methodology and the parameters related to the outcomes. Methods : A retrospective study was performed in all infectious spinal disease cases presenting from January 2005 to April 2010 to three tertiary teaching hospitals within a city of 1.5 million in Korea. Patient demographics, risk factors, clinical features, and outcomes were assessed. Risk factors entailed the presence of diabetes, chronic renal failure, liver cirrhosis, immunosuppressants, remote infection, underlying malignancy and previous spinal surgery or procedure. We comparatively analyzed the results between the groups of pyogenic and tuberculous spinal infection. SPSS version 14 statistical software was used to perform the analyses of the data. The threshold for statistical significance was established at p<0.05. Results : Ninety-two cases fulfilled the inclusion criteria and were reviewed. Overall, patients of tuberculous spinal infection (TSI) and pyogenic spinal infection (PSI) entailed 20 (21.7%) and 72 (78.3%) cases, respectively. A previous spinal surgery or procedure was the most commonly noted risk factor (39.1%), followed by diabetes (15.2%). The occurrence of both pyogenic and tuberculous spondylitis was predominant in the lumbar spine. Discs are more easily invaded in PSI. At initial presentation, white cell blood count and C-reactive protein levels were higher in PSI compared to TSI (p<0.05). Etiological agents were identified in 53.3%, and the most effective method for identification of etiological agents was tissue culture (50.0%). Staphyococcus aureus was the most commonly isolated infective agent associated with pyogenic spondylitis, followed by E. coli. Surgical treatment was performed in 31.5% of pyogenic spondylitis and in 35.0% of tuberculous spondylitis cases. Conclusion : Many previous studies in Korea usually reported that tuberculous spondylitis is the predominant infection. However, in our study, the number of pyogenic infection was 3 times greater than that of tuberculous spinal disease. Etiological agents were identified in a half of all infectious spinal disease. For better outcomes, we should try to identify the causative microorganism before antibiotic therapy and make every effort to improve the result of culture and biopsy.

• Journal of Korean society of Dental Hygiene
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• v.17 no.3
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• pp.449-463
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• 2017

Objectives: The objective of this study was to identify the relationship between emotional labor and occupational stress of the dental hygienists, and the effects of emotional labor on their occupational stress and health problems including depression, anxiety and sleep. Methods: The survey was conducted using the questionnaires about dental hygienists' working in medical institutions in Busan, Gyeongsangnam-do from August 19th and October 7th, 2016. Total of 225 participants were selected for data analyses. Frequency analysis, t-test, ANOVA, Pearson's correlation coefficient analysis, and regression analysis were conducted using SPSS Windows ver. 21.0 program(SPSS Inc., Chicago, IL. USA). Results: The analysis of the factors affecting emotional labor, occupational stress, anxiety, and sleep by participants' characteristics showed that those with higher education level, work position and annual salary had higher emotional labor. In addition, participants who worked 5 days every other week and were responsible for patient consultation had higher emotional labor. The analysis of correlations among emotional labor occupational stress, anxiety, and sleep showed positive correlations between emotional experience and emotional expression, occupational stress and emotional expression, and anxiety and emotional expression. On the other hand, negative correlation was found between anxiety and emotional experience. Regression analysis was conducted to examine the effect of emotional labor on job stress. Emotional labor was a factor affecting job stress and anxiety. Conclusions: In order to improve emotional control and vulnerability to stress among dental hygienists, intra-organizational training opportunities and mental health care strategies are needed. Additional broad-based studies are required to identify the factors affecting the occupational stress and emotional labor and to develop relevant intervention measures.

• Clinical and Experimental Pediatrics
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• v.58 no.11
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• pp.421-426
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• 2015

Purpose: The vancomycin dosage regimen is regularly modified according to the patient's glomerular filtration rate (GFR). In the present study, we aimed to assess the usefulness of serum cystatin C (Cys-C) concentration, compared with serum creatinine (SCr) concentration, for predicting vancomycin clearance (CLvcm) in neonates. Methods: We retrospectively analyzed the laboratory data of 50 term neonates who were admitted to the neonatal intensive care unit and received intravenous vancomycin, and assessed the pharmacokinetic profiles. Creatinine clearance (CLcr) and GFR based on Cys-C (GFRcys-c) were estimated using the Schwartz and Larsson formulas, respectively. Results: The mean CLvcm (${\pm}$standard deviation) was $74.52{\pm}31.17L/hr$, the volume of distribution of vancomycin was $0.67{\pm}0.14L$, and vancomycin half-life was $9.16{\pm}17.42hours$. The SCr was $0.46{\pm}0.25mg/dL$ and serum Cys-C was $1.43{\pm}0.34mg/L$. The peak and trough concentrations of vancomycin were $24.65{\pm}14.84$ and $8.10{\pm}5.35mcg/mL$, respectively. The calculated GFR based on serum creatinine concentration (GFR-Cr) and GFRcys-c were $70.2{\pm}9.45$ and $63.6{\pm}30.18mL/min$, respectively. The correlation constant for CLvcm and the reciprocal of Cys-C (0.479, P=0.001) was significantly higher than that for CLvcm and the reciprocal of SCr (0.286, P=0.044). GFRcys-c was strongly correlated with CLvcm (P=0.001), and the correlation constant was significantly higher than that for CLvcm and CLcr (0.496, P=0.001). Linear regression analysis showed that only GFRcys-c was independently and positively correlated with CLvcm (F=41.9, P<0.001). Conclusion: The use of serum Cys-C as a marker of CLvcm could be beneficial for more reliable predictions of serum vancomycin concentrations, particularly in neonates.

• The Journal of Internal Korean Medicine
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• v.27 no.2
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• pp.500-509
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• 2006

Objectives: We performed this study to check the effect of Cold-Heat attribute analyzed quantitatively by questionnaire on halitosis patient. Methods: We made a questionnaire composed of 15 items(6 categories) about the contents of Cold-Heat and asked 105 subjects to answer in the form Likert-like seven-points score. And then, we extracted Cold-Heat attribute from 15 items, 6 categories, 6 weighted categories, heat score and cold score. On the other hand we measured the halimeter measurements. VAS, winkle tongue coating index. Afterward, the data were analyzed by statistical methods. Results:1) In the 15 items, question number 6, 7, 8 is negative correlated with halimeter measurements. Question number10 is positive correlated with halimeter measurements. And question number 11, 12, 14 is positive correlated with VAS. 2) In the 6 categories, constipation is negative correlated with halimeter measurements. Chill is positive correlated with VAS. And Cold-limbs is positive correlated with halimeter measurements. 3) In the 6 weighted score categories, constipation is negative correlated with halimeter measurements. Chill is positive correlated with VAS. And Cold-limbs is positive correlated with halimeter measurements. Conclusions: Further clinical research is necessary in the development of the questionnaire's items. And to get the better of this study, we should research more analytic method made casual relationship clear between Cold-Heat attributes and the index of halitosis.