• Title/Summary/Keyword: Patient's data

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Quality Improvement in Patient Care Services : Obstacles and Approaches (진료의 질관리에 대한 시론 -장애와 접근-)

  • 한달선
    • Health Policy and Management
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    • v.2 no.2
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    • pp.112-130
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    • 1992
  • Patient care services are provided to individual patients in response to their health needs produced by illnesses or injuries. The services are often addressed to very serious conditions, and also they constitute the most expensive component of health care services. Therefore, the importance of quality is emphasized, but there are many indications that patient care quality is far from a satisfactory state in most of the countries. Based upon this observation, it is attempted to examine obstacles and approaches to quality improvement in patient care services. In doing so, following Taguchi's(1986) definition of product quality, quality of patient care services is conceived of as better when the less is the sociental loss attributalbe to variability of intended function and harmful side effects they emhibit after being delivered. Some distinguishing features of medical care sector pose difficulties in implementing effective quality improvement programs in patient care services. Nevertheless, newly proposed method of quality management, based on industrial quality management approach, seems to have a great deal of potential to effectively cope with such difficulties. This method, unlike the traditional approach to quality assurance, focuses on total organisational processes, not individuals, as the obproach to quality assurance, focuses on total organizational processes, not individuals, as the objects of quality improvement; variation, not comparison with standards, in quality measurement; and continuous improvement, not removing only bad quality care, as an ideal. Prerequisite to a successful use of any quality mangement method is motivating providers to improve quality. Conceivable approaches for such motivation are self-regulation, external controls and promotion of competition. Since these approaches are not mutually exclusive, they may be employed in an appropriate combination. In Korea, medical care providers are now functioning under the circumstances where they have little reason for making efforts to improve quality of their services. Once these circumstantial conditions are changed to exert pressures on providers to improve quality, the use of adequate quality management method becomes an issue. In this connection, much attention shoould be directed to the newly proposed method described above. In all these efforts for improving quality of patient care services, health insurance would be able to play a pivotal role. Poviders of medical care, buth indiciduals and organizations, are usually very responsive to the measures that affect their financing, and thus health insurance can be a strong instrument for motivationg providers to improve quality. Also, the insurance continuously acquires data on patient care, which could be processed to produce information required to effective quality control.

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A development of the automated system for adjusting the 6 D.O.F circular fixator

  • Jung, Sang-Gil;Park, Bum-Seok;Sim, Hyung-Joon;Jang, Jae-Ho;Han, Chang-Soo;Han, Jung-Soo
    • 제어로봇시스템학회:학술대회논문집
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    • 2004.08a
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    • pp.1642-1647
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    • 2004
  • In this article, we present the development of the automated system for adjusting the 6 D.O.F circular fixator. The system includes scheduling software to adjust the Hexapod Circular Fixator (HCF) and an automated strut system with the ability of the multiple synchronized motion. HCF was designed to control a 6 degree-of-freedom Ilizarove fixator and it's mechanism is known as the Stewart Platform. HCF scheduler evaluates each value of altered length of the HCF struts to correct the complex skeletal deformity by using the X-ray data of the patient. The data of HCF scheduler feed into the automated strut system which be able to provide the scheduled adjustment and the automated strut is synchronized by input data.

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A Study on Experience of Health Behaviors of the Menopausal Women (폐경기 여성의 건강행위 경험 연구)

  • Park, Sun Young
    • Korean Journal of Adult Nursing
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    • v.19 no.3
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    • pp.483-494
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    • 2007
  • Purpose: The objective of the study is to describe the experience of health care activities of the menopausal women through phenomenological methodology. Methods: Seven menopausal women participated in the study. Open in-depth interviews were used to collect data, and data were analyzed by the phenomenological methods suggested by Colaizzi. Results: The data were separated into 4 categories of uncomfortable life due to physical and emotional change, building consistency in daily life through regulating a routine rhythm, recovering normality, recovering stability, and 8 clusters of themes; securing regularity in daily life, securing availability in daily life, regulating through elimination and diminishment, regulating through supplementation, being patient and control self, expressing self, review the context and exchanging views, expending a world through one's faith. Conclusion: Participants accepted menopause not as a disease but as a natural course of life and realized that menopausal health problems could be naturally settled in general health care activities in daily life.

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Nurses' Experiences of Do-Not-Resuscitate (DNR) by the Narrative Inquiry (내러티브 탐구를 통한 심폐소생술금지 (DNR) 환자 간호경험)

  • Woo, Mi Kyung;Kim, Miyoung
    • Korean Journal of Adult Nursing
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    • v.25 no.3
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    • pp.322-331
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    • 2013
  • Purpose: This study was conducted to understand the meaning of the DNR experiences of nurses. Methods: The data were collected through in-depth interviews, observation, and field records with five nurses from November 2009 to February 2011. The data were analyzed using narrative inquiry methodology. Results: Three fundamental themes were derived from data analysis as following: 'faithfulness to care for comfort,' 'helping for peaceful farewells between the patient and the family,' 'reflecting one's lives with a collision of feeling toward the death.' Conclusion: The results indicate that nurses take a role of an advocate in caring for DNR patients and being concerned about their families' conflict and anguish. In addition, this study indicates the importance of education on living will, advanced directives and preparation for the death tailored to the public including healthcare professionals.

A portable multichannel FES system for control of paralyzed extremities (마비된 말단근육의 제어를 위한 휴대용 다중 채널의 기능적 전기자극(FES) 장치)

  • 류영재;박봉기;김영민;임영철;김하경
    • 제어로봇시스템학회:학술대회논문집
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    • 1992.10a
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    • pp.90-94
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    • 1992
  • A portable multichannel functional electrical stimulation(FES) system for the fine control of the paralyzed extremities in spinal cord injury patients is described. This system is composed of a stimulation data creating system, a serial communication device, a 16-bit microprocessor, D/A converter of 32 channels and a display device. Stimulation patterns are created from analytical results of integrated EMGs during motion in normal subjects and are stored in the stimulation data creating system as data files. And then the stimulation patterns are sent to the memory in the portable multichannel FES system through serial communication interfacing device. Sophisticated fine control of paralyzed extrimities was realized by transmitting multichannel stimulation patterns to percutaneous intramuscular electrodes, which stimulate the motor function of paralyzed muscle simultaneously. Advantages of this system are as follws: 1) It is possible to modify stimulation patterns in accordance with the patient's situation. 2) This system is small and light.

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Analysis of Multivariate System Using Mahalanobis Taguchi System (Mahalanobis Taguchi System을 이용한 다변량 시스템의 해석에 관한 연구)

  • Hong, Jung-Eui;Kwon, Hong-Kyu
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.32 no.1
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    • pp.20-25
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    • 2009
  • Mahalanobis Taguchi System (MTS) is a pattern information technology, which has been used in different diagnostic applications to make quantitative decisions by constructing a multivariate measurement scale using data analytic methods without any assumption regarding statistical distribution. The MTS performs Taguchi's fractional factorial design based on the Mahahlanobis Distance (MS) as a performance metric. In this work, MTS is used for analyzing Wisconsin Breast Cancer data which has ten attributes. Ten different tests are conducted for the data to determine if the patient has cancer or not. Also, MTS is used for reducing the number of test to define the relationship between each attribute and diagnosis result. The accuracy of diagnosis is compare with two different previous research.

Diagnosis of Spondylopathy Using Mahalanobis Taguchi System (Mahalanobis Taguchi System을 이용한 척추질환 환자의 진단에 관한 연구)

  • Hong, Jung Eui
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.35 no.4
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    • pp.10-15
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    • 2012
  • The Mahalanobis-Taguchi System is a diagnosis and predictive method for analyzing patterns in multivariate cases. The goal of this study is diagnosis of the spondylolisthesis from biomedical data that is derived from the shape and orientation of the pelvis and lumbar spine. The data set has six attributes including pelvic incidence, pelvic tilt, lumbar lordosis angle, sacral slope, pelvic radius and grade of spondylolisthesis and two class including normal and abnormal. From University of California at Irvine machine learning repository, 100 normal and 150 spondylolisthesis patient's data were used for this study. Mahalanobis Taguchi System (MTS) application process and the diagnosis results were described in this paper.

A Method to Compute Bending Angle for Robotic Shaping of Orthodontic Archwire (로봇을 이용한 치과 보철용 아치와이어 제작을 위한 굽힘각 계산 방법)

  • Chung, Seong Youb;Song, Il Jae;Hwang, Myun Joong
    • Journal of Institute of Convergence Technology
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    • v.7 no.2
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    • pp.17-20
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    • 2017
  • Orthodontic treatment is accomplished by attaching an archwire to a bracket on tooth. The shape of the archwire is usually planned from 3-D scanned data of patient's teeth. It is manufactured by bending a metal wire and there have been some researches in progress to automate it. In this paper, we propose a method to obtain the bending angle at the bending point from the shape data of the archwire and verify it by simulation using actual archwire data.

A Theory Construction on the Care Experience for Spouses of Patients with Chronic Illness (만성질환자 배우자의 돌봄 경험에 대한 이론 구축)

  • Choi, Kyung-Sook;Eun, Young
    • Journal of Korean Academy of Nursing
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    • v.30 no.1
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    • pp.122-136
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    • 2000
  • Chronic illness requiring attention and management during a long period of time puts great burden onto patients, their family and society. For patients with chronic illnesses, providing social support is the most important, and the fundamental support comes from their spouses. Amount and quality of support from spouses seems to differentiated according to the sex of patients. Female patients tend to believe that their spouses are not very supportive. Therefore, the researchers assessed the burden of husbands of female arthritis patients to discover the factors that result in greater burden. Also, they developed a theoretical model of husbands′ care for their wives through a qualitative research into husbands′ experience. Method 1: The study material was 650 female arthritis patients registered in an arthritis clinic. The questionnaire about the disease experience of female arthritis patients and the burden of husbands were sent. Returned questionnaires numbered 210(32.3%) and 27 were excluded because of inadequate answers. The remaining 183 questionnaires were analyzed. The mean age of the patients was 51 years and the mean age of spouses was 55 years. The mean marital period was 28 years. The average duration since diagnosis was 9.1 years. Education level was varied from primary school to graduate school, and average income/month was 1,517,300 won. Method 2: Initial questionnaire studies on the burden of husbands were performed. Among 183 responding husbands, 23 consented to participate for a qualitative research. Data was obtained by direct and telephone interviews. The mean age of participants was 58 years, and the educational level and socioeconomic status also varied. Result: 1. Husbands′ burden: The average burden was 57.68 with a range of 6-96. 2. Burden and general characteristics: The husband′s burden correlated with the age of the patients, numbers in the family, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and the husband′s understanding of the level of severity. 3. Linear correlation analysis on burden: The husbands′ burden is explained in 22.5% by husband′s recognition of level of severity and husbands′ age. 4. There were four patterns of the burden on husbands: both objectve burden and subjective burden were high(pattern I), both of objectve burden and subjective burden were low(pattern II), objective burden was high but subjective burden was low(pattern III), objective burden was low but subjective burden was high(pattern IV). The pattern was correlated with the family income, educational level of the patients and their husbands, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and husband′s understanding of level of severity. 5. The core category of the caring experience of the husbands with arthritis patients was "companionship". The causal factor was the patients′ experience due to symptoms : physical disfigurement, pain, immobility, limitation of house chores, and limitation of social activities. Contextural factors are husbands′ identification of housework and husbands′ concern about the disease. The mediating factors are economic problems, fear of aging, feeling of limitation and family support. The strategy for interaction is mind control and how to solve emotional stress. The "companionship" resulted from caring activities, participation of household activities, helping patients′ to coping with emotional experience. 6. Companionship is established through the process of entering intervention, and caring state of mind. Entering intervention is the phase of participation of therapy and involvement of houseworks. The caring phase consists of decision on therapy, providing therapy, providing direct care, and taking over the household role of wife. Through caring phase, the changing phase set a stage in which husbands consolidate the relationship with their wives, and are reminded of the meaning of marriage. As a result, in changing phase, husbands′ companionship is enhanced. In conclusion, nursing care of chronic illnesses should include a family member especially the spouse. All information on disease shoud be provided to patients and whole family member. Strong support should also be provided to overcome difficulties in taking over role of other sex. Then the quality of life of patients and families will be much improved.

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Clinical Considerations of the Surgical Treatments of the Pressure Sore (욕창의 수술적 치료에 대한 임상적 고찰)

  • Lee, Keun Cheol;Moon, Joo Bong;Kwon, Yong Seok;Cha, Byung Hoon;Kim, Seok Kwun
    • Archives of Plastic Surgery
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    • v.34 no.5
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    • pp.574-579
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    • 2007
  • Purpose: The number of sore patients are increasing steadily, especially in old ages, chronic disease and paralytic patients. Most of patients need to surgical treatment. The aim of this paper is to assess clinical analysis of surgical treatment and to consider operative methods, complications, and recurrences.Methods: We reviewed the data from 82 consecutive patients with 101 pressure sores from March 2003 to May 2006 to discuss the occurrence rate and recurrence rate according to the site on the basis of the presence or absence of paraplegic and its etiology-the patients were categorized into three diagnostic groups: traumatic paraplegics(TP), nontraumatic paraplegics (NTP), and nontraumatic nonparaplegics(NTNP). We examined the sites and sizes of each lesions, patient's state, primary causes of pressure sore, operative methods as each sites and groups, occurrence of complications and recurrences on each groups. Results: In 82 patients, 52 patients were male, 30 patients were female. The male to female ratio was 1.7 :1. Mean age was 55.8 years. 27 patients were in TP group, 35 in NTP group, and 20 in NTNP group, respectively. The common site of sore were sacral area (50.5%), greater trochanteric area(15.8%) and ischial area(13.9%). In each group, incidence rate of recurrence and complication were 11.1%, 40.7% in TP, 5.7%, 5.7% in NTP and 15%, 45% in NTNP. Conclusion: Surgeons must consider the general condition of the patient and possibility of recurrence and returning of daily life. We propose that cutaneous flap, fasciocutaneous flap or skin graft as well as musculocutaneous flap be useful to repair of sore site as each patient's state.