This study analyzes use and operation of silver ambulance with 110 patients who had used silver ambulance in Gwangju and Jeonnam regions from June of 2006 to June of 2007 and 53 paramedics who are involved directly in ambulance operation and the results of this analysis are as follows. 1. Users' health conditions, 69.1% of users answered as bad and 67.3% suffered from chronic diseases over 3 months and it was found that they used silver ambulance due to their bad health conditions. 2. Cronbach's alpha was 0.630 and family function index was generally reliable and solution was high as 1.60, but total points were low as 7.11 and it was considered that they had family troubles. 3. On the question of ambulance use, 44.5% answered they used it because it is free, 53.6% used it for appointed medical examination and treatment and 18.1% used it for emergency. 4. Degrees of satisfaction with ambulance and paramedics were 95.4% and 76.4% respectively and 80.0% of ambulance users answered ambulance arrived quickly within 15 min. 5. Correlation($x^2 $) between family or relative's residence and frequency of visits was 86.367 and its significance probability was 0.00 and it was found that it was significant in the level of 0.1%, but correlation($x^2 $) between visitors other than family or relatives and frequency of visits was 14.768 and its significance probability was 0.25 and it was found that it was not significant in the level of 5%. 6. Correlation($x^2 $) between transfer operation speed and mobilization time was found that it was not significant in the level of 5%. Correlation($x^2 $) between their own health condition purpose of ambulance use was 13.802 an 5.696 and its significance probability was 0.93 and it was found that it was not significant in the level of 1%, and it was considered because paramedics carried patients with safe operation.
Purpose : This purpose of this study is to make a better public hospital patient room to reflect the views of the patient. Methods: Survey to examine patient experience on healing environment in public hospital have been conducted for the data collection. 229 open-ended answers have been analysed statistically by MS Excel program. Results : 1) If there is no toilet space in the six-patient room, installation of toilet in the patient room is necessary. 2) The most Frequently used patient furnitures are necessary to accomodate the patients needs. Depending on the patient condition, installation of a portable or fixed the room furniture for the convenience to the using furniture. 3) According to the flow of modern times, wireless internet access is required to install of expand the space. Also be used to establish a regulations of internet space. 4) To create healing environment infection free environment should be provided. 5) Need for improvements of patient room for relatives of patient. It is necessary to secure a comfortable space to stay. 6) Separation is needed among the patients through therapeutic classification. Implication : In order to provide a better patient room environment, it is necessary to reflect the patient's opinion.
Subramanian, Pathmawathi;Oranye, Nelson Ositadimma;Masri, Azimah Mohd;Taib, Nur Aishah;Ahmad, Nora
Asian Pacific Journal of Cancer Prevention
/
제14권11호
/
pp.6783-6790
/
2013
Background: Breast cancer is the commonest type of cancer among women, and in Malaysia 50-60% of the new cases are being detected at late stages. Do age, education level, income, ethnicity, relationship with breast cancer patients and knowledge of breast cancer risk factors influence breast screening practices? This study revealed interesting but significant differences. Objectives: To assess the knowledge of breast cancer risk factors and early detection measures among women in a high risk group. Materials and Methods: A cross sectional survey of one hundred and thirty one women relatives of breast cancer patients was carried out. Participants were selected through purposive sampling, during hospital visits. A self-administered questionnaire was used for data collection. Results: The majority of the respondents (71%) had poor knowledge of the risk factors for breast cancer. Income, relationship with a patient and practise of breast cancer screening predicted performance of mammography, $R^2$=0.467, F=12.568, p<0.0001. Conclusions: The finding shows inadequate knowledge of breast cancer risk factors and poor cancer screening practise among women with family history of breast cancer. Poor knowledge and practise of breast screening are likely to lead to late stage presentation of breast cancer disease. Some important predictors of breast cancer screening behaviour among women with positive family history of breast cancer were identified. An understanding of the strengths and significance of the association between these factors and breast screening behaviour is vital for developing more targeted breast health promotion.
Bektas-Kayhan, Kivanc;Karagoz, Gizem;Kesimli, Mustafa Caner;Karadeniz, Ahmet Nafiz;Meral, Rasim;Altun, Musa;Unur, Meral
Asian Pacific Journal of Cancer Prevention
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제15권5호
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pp.2225-2229
/
2014
Background: Carcinoma of the tongue is the most common intra-oral malignancy in Western countries. Incidence and mortality rates have increased in recent years, and survival has not improved. This study aimed to determine etiologic factors for tongue cancer with age-sex matched case-control data. Materials and Methods: 47 patients with carcinoma of the tongue referred to our oral medicine clinic between years 2005-2006 were analyzed and compared with control group data. The medical records, including family history of cancer, dental trauma, and history of abuse of alcohol and tobacco products was recorded for all subjects. Chi square comparison tests and linear regression analysis were performed using the SPSS program for statistics. Results: Patient and randomly selected control groups each consisted of 30 male and 17 female subjects with mean ages 53.2 (${\pm}12.6$) and 52.6 (${\pm}11.5$) years respectively. Smoking and alcohol abuse proportions were significantly higher in the patient group (p=0.0001, p<0.0001 respectively). Chronic mechanical trauma was observed in 44.7% of the patients and 17.0% of the control group (p=0.004). Similarly, family history of cancer of any type (for the first degree relatives) was found to be more common in the patient group (p=0.009). On regression analysis, alcohol abuse, family history of cancer, smoking, chronic mechanical traumas appeared as significant etiologic factors (p=0.0001). Conclusions: We believe that field cancerization may become evident in oral and oropharyngeal mucosa with multiple steps of molecular changes starting from the first sign of dysplasia with chronic exposure to etiological factors. Chronic trauma cases need particular attention to search for very early signs of cancer.
This study aimed at summarizing published study findings on the diagnostic value of rectal bleeding (RB) and informing clinical practice, preventive interventions and future research areas. We searched Medline and Embase for studies published by September 13, 2013 examining the risk of colorectal cancer in patients with RB using highly inclusive algorithms. Data for sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and positive predictive value (PPV) of RB were extracted by two researchers and analyzed applying Meta-Disc (version 1.4) and Stata (version 11.0). Methodological quality of studies was assessed according to QUADAS. A total of 38 studies containing 5,626 colorectal cancer patients and 73,174 participants with RB were included. The pooled sensitivity and specificity were 0.47 (95% CI: 0.45-0.48) and 0.96 (95% CI: 0.96-0.96) respectively. The overall PPVs ranged from 0.01 to 0.21 with a pooled value of 0.06 (95% CI: 0.05-0.08). Being over the age of 60 years, change in bowel habit, weight loss, anaemia, colorectal cancer among first-degree relatives and feeling of incomplete evacuation of rectum appeared to increase the predictive value of RB. Although RB greatly increases the probability of diagnosing colorectal cancer, it alone may not be sufficient for proposing further sophisticated investigations. However, given the high specificity, subjects without RB may be ruled out of further investigations. Future studies should focus on strategies using RB as an "alarm" symptom and finding additional indications to justify whether there is a need for further investigations.
Purpose: This study tries to identify experience of verbal abuse, emotional response, and ways to deal with verbal abuse against nurses in hospitals. Methods: This study was a descriptive research and conducted from April to July 2011. One hundred and seventeen nurses with over one-year experience in general wards were selected and evaluated. The data were analyzed using descriptive analysis, independent t-tests, and one-way ANOVA. Results: The nurses' experience rate of verbal abuse during the entire period of work in hospitals was 98.3%. The majority of the nurses were verbally abused by patients (70.9%), followed by patients' relatives (65.8%), physicians (61.5%), and coworkers (58.1%). Overall negative emotional response score of nurses after verbal abuse was $38.82{\pm}8.28$. Ways to deal with verbal abuse were as follows: suppression was 74.4%, complaining of an injustice to close people, 67.5%, and ignoring, 43.6%. Conclusion: Nurses have significantly been exposed to verbal abuse while working in hospitals. Therefore, hospital managers and nurse managers are required to inform other staff and visitors in hospitals the real condition of verbal abuse against nurses and provide a safe work environment by developing the report and disposal system of verbal abuse.
Objective: Familial intracranial aneurysms (FIAs) are found in approximately 6%-20% of patients with intracranial aneurysms (IAs), suggesting that genetic predisposition likely plays a role in its pathogenesis. The aim of this study was to identify possible IA-associated variants using whole exome sequencing (WES) in selected Korean families with FIA. Materials and Methods: Among the 26 families in our institutional database with two or more IA-affected first-degree relatives, three families that were genetically enriched (multiple, early onset, or common site involvement within the families) for IA were selected for WES. Filtering strategies, including a family-based approach and knowledge-based prioritization, were applied to derive possible IA-associated variants from the families. A chromosomal microarray was performed to detect relatively large chromosomal abnormalities. Results: Thirteen individuals from the three families were sequenced, of whom seven had IAs. We noted three rare, potentially deleterious variants (PLOD3 c.1315G>A, NTM c.968C>T, and CHST14 c.58C>T), which are the most promising candidates among the 11 potential IA-associated variants considering gene-phenotype relationships, gene function, co-segregation, and variant pathogenicity. Microarray analysis did not reveal any significant copy number variants in the families. Conclusion: Using WES, we found that rare, potentially deleterious variants in PLOD3, NTM, and CHST14 genes are likely responsible for the subsets of FIAs in a cohort of Korean families.
The study was intended to identify the nurses' experiences, understanding, and attitudes on DNR. Also, the study was to provide the data base for a standard of DNR decision-making and practice. The sample consisted of 347 nurses in eight general hospitals. The data were collected between August 1 and August 31, 2000. The data were analyzed using descriptive statistics and $x^2-test$. The results of the study were as follows : 1. Regarding DNR-related experience, 74.6 percent of the participants experienced DNR situations. Eleven percent of the participants received DNR education. DNR was most frequently (81.5%) requested by family members and relatives of patients. The decision-making on DNR was most frequently (76.8%) made by agreement between family members and medical staff. The DNR order was recorded at 81.9 percent on charts. Problems after DNR order were negligence in treatment and nursing care (30.6%) and guilty feelings due to doing the best (22.1%). CPR (cardiopulmonary resuscitation) was performed about 49.8 percent of DNR cases. 2. Regarding understanding and attitude on DNR, most of the participants (93.1%) thought DNR was necessary. The major reasons for the necessity of DNR were impossible recovery (44.4%) and death with dignity (41.1%). The decision-making on DNR was most frequently made by patient and family members (47.8%) and followed by agreement between family members and medical staff (25.6%), and patients themselves (16.4%). Most of the participants thought that medical staff must explain DNR to critical and end-of-life patients and their family members. Forty four percent of the participants thought that the most appropriate time for DNR explanation was when patients with critical disease were admitted to hospitals. Most of the participants (90.2%) thought a guide book for DNR is necessary to be made in hospitals. 3. There were significant differences in the participants' understanding and attitudes on DNR according to religion career education and experience of DNR. Of the participants those who have religions and education experience on DNR thought that there would be more DNR requests after DNR is explained to patients and family members (p<.05). In addition, there was higher understanding on the necessity of DNR in those who have more career and DNR experience(p<.01). The findings of the study suggest that a guide book for DNR need to be made with inclusion of legal, ethical, and cultural aspects. Also, there needs to be more education on DNR in medical ethics to health care professional and to provide more information on DNR to the general public.
본 연구의 목적은 간경변증 환자의 자가간호 행동 관련 요인, 특히 질병지식과 가족지지와의 관련성에 대해 조사하기 위함이었다. 연구대상자는 2015년 6월부터 8월까지 2개월 동안 U 광역시 1개 종합병원 내과 외래를 이용하는 120 명의 간경변증 환자를 대상으로 조사하였다. 자료는 SPSS (Version 21) 통계 프로그램을 사용하여 분석하였다. 그 결과, 대상자의 간경변증에 대한 질병 지식 점수는 18점 만점에 평균 $12.64{\pm}2.16$점이었고, 가족 지지는 32점 만점에 평균 $23.28{\pm}5.68$, 자가간호 행동은 60점 만점에 평균 $35.66{\pm}8.67$점이었다. 즉, 대상자들은 질병에 관한 지식과 가족지지 정도는 보통수준이었으나 자가간호 행동은 낮았다. 또한 간경변증 환자의 자가간호 행동은 질병지식 (r=.675, p<.001)과 가족지지(r=.804, p<.001)와 긍정적 상관관계가 있었다, 자가간호 행동의 가장 좋은 예측요인으로는 가족지지, 질병 지식, 음주회수, 친지 중 간경변증이 있는 경우, 대상자의 교육 수준이었으며, 이들 요인들이 자가간호 행동을 69.7% 설명하였다. 결론적으로 간경변증 환자의 자가간호 행동을 향상시키기 위해서는 대상자의 교육수준, 질병지식 수준과 가족지지 수준을 고려하여 계획하여야 할 것이다.
Background: Breast cancer is known to be one of the most prevalent cancers among women in both developing and developed countries. The incidence of breast cancer in Pakistan has increased dramatically within the last few years and is the second country after Israel in Asia to have highest proportional cases of breast cancer. However, there are limited data for breast cancer available in the literature from Pakistan. Objectives: The study was conducted to bring to light the common clinical presentation of breast cancer and to evaluate the frequency of established risk factors in breast carcinoma patients and furthermore to compare the findings between premenopausal and postmenopausal women in Pakistan. Materials and Methods: A 6 months (from July 2012 to Dec 2012) cross sectional survey was conducted in Surgical and Oncology Units of Civil Hospital, Karachi. Data were collected though a well developed questionnaire from 105 female patients diagnosed with carcinoma of breast and analyzed using SPSS version 17. Institutional ethical approval was obtained prior to data collection. Results: Out of 105 patients, 43 were premenopausal and 62 were postmenopausal, 99 being married. Mean age at diagnosis was $47.8{\pm}12.4years$. A painless lump was the most frequent symptom, notived by 77.1%(n=81). Some 55.2% (n=58) patients had a lump in the right breast and 44.8%(n=47) in the left breast. In the majority of cases, the lump was present in upper outer quadrant 41.9% (n=44). Mean period of delay from appearance of symptoms to consulting a doctor was $5.13{\pm}4.8months$, from the shortest 1 month to the longest 36 months. Long delay (> 3 months) was the most frequent figure 41.9%. Considering overall risk factors most frequent were first pregnancy after 20 years of age (41%), physical breast trauma (28.6%), lack of breast feeding(21.9%), and early menarche <11 years (19%), followed by null parity (16.2%), consumption of high fat diet (15.2%), family history of breast cancer or any other cancer in first degree relatives (9.5% and 13.3%, respectively). Some of the less common factors were late menopause >54 years (8.6%), use of oral contraceptive pills (10.5%), use of hormone replacement therapy (4.7%),smoking (4.7%) and radiation (0.96%). Significant differences (p<0.005) were observed between pre and post menopausal women regarding history of physical breast trauma, practice of breast feeding and parity. Conclusions: A painless lump was the most frequent clinical presentation noted. Overall age at first child > 20 years, physical breast trauma, lack of breast feeding, early menarche <11 were the most frequent risk factors. Physical breast trauma, lower parity, a trend for less breast feeding had more significant associations with pre-menopausal than post-menopausal onset. Increase opportunity of disease prevention can be obtained through better understanding of clinical presentation and risk factors important in the etiology of breast cancer.
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