• Korean Journal of Clinical Pharmacy
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• v.34 no.1
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• pp.62-70
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• 2024

Background: Drug-related problems have the potential to threaten patient health, and pharmacists are in a position to prevent such problems through prescription reviews and patient counseling, actively engaging in pharmaceutical care activities. This study aims to categorize and analyze the intervention activities of pharmacists in community pharmacies concerning drug-related problems, following international criteria. Methods: Over a six-month period, prescription interventions completed in a community pharmacy in Seoul were selected as the research subjects. The causes of interventions were classified according to the Pharmaceutical Care Network Europe (PCNE) drug-related problems (DRPs) classification system and the types and frequencies of DRPs were identified. Results: Among a total of 49,334 prescriptions, 527 interventions were completed, constituting approximately 1.07% of the daily average filled prescriptions. Individuals over 60 years of age represented more than 50%. The primary cause of DRPs was prescribing and drug selection issues, comprising 256 cases (48.58%), with specific subcategories including 109 cases of drug selection, 79 cases of treatment duration errors, 47 cases of dose selection, and 21 cases of inappropriate dosage form selection. Patient-related issues accounted for 204 cases (38.71%). Conclusion: The study demonstrated that the pharmacists' intervention in community pharmacies contributes to the safe use of medication by patients.

• Journal of Genetic Medicine
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• v.7 no.2
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• pp.125-132
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• 2010

Purpose: Preimplantation genetic diagnosis (PGD), also known as embryo screening, is a pre-pregnancy technique used to identify genetic defects in embryos created through in vitro fertilization. PGD is considered a means of prenatal diagnosis of genetic abnormalities. PGD is used when one or both genetic parents has a known genetic abnormality; testing is performed on an embryo to determine if it also carries the genetic abnormality. The main advantage of PGD is the avoidance of selective pregnancy termination as it imparts a high likelihood that the baby will be free of the disease under consideration. The application of PGD to genetic practices, reproductive medicine, and genetic counseling is becoming the key component of fertility practice because of the need to develop a custom PGD design for each couple. Materials and Methods: In this study, a survey on the contents of genetic counseling in PGD was carried out via direct contact or e-mail with the patients and specialists who had experienced PGD during the three months from February to April 2010. Results: A total of 91 persons including 60 patients, 49 of whom had a chromosomal disorder and 11 of whom had a single gene disorder, and 31 PGD specialists responded to the survey. Analysis of the survey results revealed that all respondents were well aware of the importance of genetic counseling in all steps of PGD including planning, operation, and follow-up. The patient group responded that the possibility of unexpected results (51.7%), genetic risk assessment and recurrence risk (46.7%), the reproduction options (46.7%), the procedure and limitation of PGD (43.3%) and the information of PGD technology (35.0%) should be included as a genetic counseling information. In detail, 51.7% of patients wanted to be counseled for the possibility of unexpected results and the recurrence risk, while 46.7% wanted to know their reproduction options (46.7%). Approximately 96.7% of specialists replied that a non-M.D. genetic counselor is necessary for effective and systematic genetic counseling in PGD because it is difficult for physicians to offer satisfying information to patients due to lack of counseling time and specific knowledge of the disorders. Conclusions: The information from the survey provides important insight into the overall present situation of genetic counseling for PGD in Korea. The survey results demonstrated that there is a general awareness that genetic counseling is essential for PGD, suggesting that appropriate genetic counseling may play a important role in the success of PGD. The establishment of genetic counseling guidelines for PGD may contribute to better planning and management strategies for PGD.

• The Korean Nurse
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• v.35 no.1
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• pp.66-80
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• 1996

Reacently one the main issues has been to develop useful strategies to improve hospital services for patients in the health care delivery system in our rapidly changing society. This study has focused on exploring the perceptions that the clinical nurses have concerning who they are and what they are going to become in the days ahead as medical care reaches a new stage of advancement centered around the patient and hospital services. This study in also based upon the premise that the role of the clinical nurse practitioner. is central to the progress of any patient centered nursing program. This study was carried out by the members of the academic committee of Seoul Branch of Korean Nurses Association from January 1995 to February 1995. The interview method was a semi-structured questionnaire used to collect data from 25 staff nurses who were working more than 3 years at 3 different university hospitals in Seoul. The 6 interviews were selected from each hospital and they were trained for the interviewing techniques. The data were analysed qualitatively and 10 elements of the nurse's responsibilities classified such as caring for the patients (which includes specific medical care as well as general); assessing; diagnosing; coordinating with other health personnel; careful listening; teaching and the patient guiding; administering the prescriptions; giving information and counseling the patient; ward management. Although the premise of this study was based on a wholistic concept, the overall behavioral aspects of hospital clinical nursing were the major thrust of the questionnaire. Broad philosophical questions regarding the nature of nursing need to be further explored. The data gathered for this questionnaire should be useful as a reenforcement tool in educating nursing students as well as in continuing education for clinical nurses. For the future, another study should be done to determine the nursing/patient relationship.

• Journal of Korean Academy of Nursing
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• v.46 no.3
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• pp.463-474
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• 2016

Purpose: For cardiovascular patients, family caregivers play a vital role in daily nursing and cardiac emergencies. This study aimed to evaluate the effect of patient-centered CPR education (PCE) for family caregivers of patients with cardiovascular diseases. Methods: Fifty-four participants were randomly assigned to the PCE or control group. The PCE group received tailored counseling on overall cardiovascular disease information and CPR followed by interactive instructor-guided CPR training and re-education follow-up by telephone 2 weeks later. The control group received only video-based CPR self-education and booklets. Cardiovascular disease and CPR knowledge and self-efficacy were measured before (pre-test), immediately after (post-test 1), and 4 weeks after the PCE (post-test 2). CPR skills and performance were measured pre-test and at post-test1. Results: The PCE group demonstrated significant improvements in knowledge (F=91.09, p<.001), self-efficacy (F=15.19, p<.001) and CPR skills and performance (F=8.10, p=.008), as well as significant differences over time (knowledge: F=364.25, p<.001; self-efficacy: F=1162.28, p<.001; CPR skills and performance: F=1798.81, p<.001). There were significant group-by-time interactions for knowledge (F=8.10, p=.001), self-efficacy (F=4.30, p =.019) and CPR skills and performance (F=4.81, p=.036) by repeated measures ANOVA. Conclusion: This is the first study to demonstrate the effects of a patient-centered intervention with CPR education tailored for patients' and family caregivers' preferences, needs, and lifestyles. The results of this study encourage the use of tailored, patient-centered interventions in cardiovascular nursing practice.

• Journal of Korean Academy of Nursing
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• v.31 no.1
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• pp.81-93
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• 2001

The purpose of this study was to develop a continuing nursing care program for cancer patients and the caregivers staying at their home and to test its effects on patients' symptom distress, caregiver burden, and satisfaction of life. The continuing nursing care program was based on the homecare needs of cancer patients, and was provided by three clinical nurses who took care of the patients while they were hospitalized. The program consisted of discharge education about selfcare using education materials(book and handout) and provisions of direct care. These were counselling and education during which visiting patients' home one week after discharge and telephone counseling two weeks after discharge. Counseling by telephone was always available during the research period. A quasi-experimental research design was used to test the effects of the program. Subjects for this study were 53 cancer patients discharged from the hospital and caregivers. These subjects were assigned to an experimental group (n=23) receiving continuous nursing care, or to a control group (n=30) not receiving continuous nursing care. Data from control group was collected first to protect from contamination. Data collection was done from October of 1998 to February of 2000. The collected data was analysed using mean, t-test, and chi-square test computed by SPSS software. The summary of results was as follows: 1) The symptom distress was a little decreased at posttest, but there were no significant differences between the experimental and the control group in symptom distress. 2) The score of caregiver burden was significantly decreased in experimental group at posttest, but no differences in control group. 3) There were no significant differences between the experimental and control group in the satisfaction of life. 4) The score of satisfaction of continuing nursing care program in experimental group at posttest was 2.321 of 3. In conclusion, even though this study did not obtain evidence of effectiveness of continuing nursing care program on patients, such as. It is still expected to be effective by a more improved program. Therefore we want to give some suggestions for further studies. 1) It is needed to make a communication channel with the patient's doctor to response promptly and appropriately to patient's conditions. 2) The research is necessary on patients in terminal stage or early stage of cancer diagnosis who have many nursing needs. 3) It is needed to readjust the roles and job assignment of clinical nurse to implement effectively as a program provider.

• Journal of Korean Academy of Nursing
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• v.30 no.4
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• pp.1045-1054
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• 2000

As cost pressures have escalated, policy makers, politicians, health care providers and families have tried to devise ways to reduce health care costs. While originally developed to enhance patient control and to provide better care at the end of life, hospice care has recently received significant attention as a mean of reducing health care costs. As a program providing care for patients who are dying at their homes, hospice has expanded slowly since the opening of the first hospice in Korea in 1963. Therefore, a variety of services that responds to the needs and concerns of many dying people and their families is limited The purpose of this study was to determine the potential cost savings at the end of life among patients who used home hospice compared with the patients who received institutional care in Korea. This study used a retrospective, descriptive design. The sample for this study included 46 patients who died of lung cancer: 25 patients who received home hospice care and 21 patients who received institutional care. Data on patient characteristics, kinds and frequencies of provided treatment and nursing services, and hospice and hospital charges during the last month before death were collected. Cost of care was measured by the average cost per patient per day in the last month of life. The results of the study indicated that there were significant differences in average cost of care between home hospice sample and institutional care sample (t=9.956, p<.001; home hospice sample: M=18,102 won, institutional care sample: M=317,578 won). The cost of the home hospice sample was approximately 6% of the cost of institutional care. The majority of the home hospice nursing services were education (35.7%) and supportive counseling (25.2%), followed by medication management (13.6%), assessment (12.1%), basic nursing (7.2%), treatment (5.5%) and others. In institutional care sample, basic nursing and treatment were more emphasized than education or supportive counseling among the nursing services provided. The results of this study showed the potential for hospice to reduce costs and implications for policymakers and clinicians to incorporate hospice program into the formal health care delivery system in Korea.

• Korean Journal of Clinical Pharmacy
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• v.27 no.3
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• pp.119-126
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• 2017

Background: As the demands of pharmacist's role and quality performance have increased, the verification of pharmacist's ability has been required. In this study, we aimed to select appropriate items for assessment of pharmacist's knowledge, attitude and performance. Methods: Based on the pharmacist job analysis, we selected duties and tasks in consideration of applying pharmacy practical examination through brainstorming of internal researchers and group discussion with experts. Survey was conducted to evaluate the tasks according to the criteria detailed below: Realistic, Understandable, Measurable, Behavioral and Achievable (RUMBA). The subjects included professors at colleges of pharmacy and instructors of institutional or community pharmacy settings. Results: Nine duties including 41 tasks were drawn for the survey through primary internal researchers. Of the 90 respondents, 95.6% were professors or preceptors who was engaged in practical training, and 62.2% had more than five years of practical experience. As a result of survey and discussion with expert panel, selected seven duties were selected as followings: 'Patient (customer) reception', 'Drug preparation and distribution', 'Patient care', 'Administration', 'Patient counseling', 'Non-prescription medication counseling', and 'Provision of drug information'. The final 20 tasks from seven duties were chosen to assess skills that a pharmacist should be able to perform. Conclusion: This is the first study to select the items that can be included in pharmacist practical examination in the future, based on the RUMBA criteria. As a next step, it is necessary to study how to implement these items.

• The Journal of Society for e-Business Studies
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• v.22 no.1
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• pp.37-49
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• 2017

In order to maximize the efficiency and the quality of care in a hospital, hospitals in general operate by appointments. Patient no-shows or missed appointments waste the time of staffs who prepare for appointments, deprive patients of needed care, and increase burden on clinic capacity. The purpose of this study is to examine the importance and significance of factors that affect patient no-shows. The actual data of 50,000 outpatient appointments is compiled and analyzed from a VAMC in the United States with aims to identify the factors that contribute to outpatient no-shows and to draw meaningful implications. Random forest along with logistic regression analysis identify the factors affecting no-shows; appointment leadtime, show-up rate, travel distance, no-show rate in previous period, patient age, severity, complexity of disease, chronic pain, depression, drug dependence. The appointment leadtime, show-up rate, travel distance and previous no-show rate can be improved by enhancing SMS pre-notification and by improving afterwards telephone counseling. For other factors, it needs to study on the service differentiation with the characteristics of each patient group.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.2
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• pp.114-123
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• 2017

Purpose: The goal of this study was the early diagnosis of ABCB11 spectrum liver disorders, especially those focused on benign recurrent intrahepatic cholestasis and progressive familial intrahepatic cholestasis. Methods: Fifty patients presenting neonatal cholestasis were evaluated to identify underlying etiologies. Genetic analysis was performed on patients suspected to have syndromic diseases or ABCB11 spectrum liver disorders. Two families with proven ABCB11 spectrum liver disorders were subjected to genetic analyses to confirm the diagnosis and were provided genetic counseling. Whole exome sequencing and Sanger sequencing were performed on the patients and the family members. Results: Idiopathic or viral hepatitis was diagnosed in 34%, metabolic disease in 20%, total parenteral nutrition induced cholestasis in 16%, extrahepatic biliary atresia in 14%, genetic disease in 10%, neonatal lupus in 2%, congenital syphilis in 2%, and choledochal cyst in 2% of the patients. The patient with progressive familial intrahepatic cholestasis had novel heterozygous mutations of ABCB11 c.11C>G (p.Ser4*) and c.1543A>G (p.Asn515Asp). The patient with benign recurrent intrahepatic cholestasis had homozygous mutations of ABCB11 c.1331T>C (p.Val444Ala) and heterozygous, c.3084A>G (p.Ala1028Ala). Genetic confirmation of ABCB11 spectrum liver disorder led to early liver transplantation in the progressive familial intrahepatic cholestasis patient. In addition, the atypically severe benign recurrent intrahepatic cholestasis patient was able to avoid unnecessary liver transplantation after genetic analysis. Conclusion: ABCB11 spectrum liver disorders can be clinically indistinguishable as they share similar characteristics related to acute episodes. A comprehensive genetic analysis will facilitate optimal diagnosis and treatment.

• Korean Journal of Adult Nursing
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• v.27 no.2
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• pp.170-179
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• 2015

Purpose: To examine the relationships between self-care, social support, and biological markers in liver transplant recipients. Methods: The participants included 118 liver transplant recipients who visited outpatient clinic at Y University Hospital in Seoul from April to May, 2013. Questionnaires consisted of self-care and social support scales. The biological markers were collected by reviewing electronic medical records. Data were analyzed with descriptive statistics, t-test, ANOVA with Scheff$\acute{e}$ post-hoc test, and Pearson's correlation. Results: The self-care score was significantly higher in a patient group within 6 months post-transplant when compared to a patient group post-transplant 3 to 5 years (F=3.10, p=.018). The self-care showed positive correlation with social support with statistical significance (r=.36, p<.001). Conclusion: As the self-care in liver transplant recipients had a positive correlation with social support from family and healthcare providers, the development of comprehensive long-term nursing intervention systems including counseling, education, and support in consideration of progress of time period after transplantation is necessary to enhance self-care behaviors among this population.