• Title/Summary/Keyword: Patients satisfaction

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Model Construction of Sexual Adjustment of Patients with Spinal Cord Injury (척수장애인의 성적적응과 관련요인에 관한 모형구축)

  • Kang, Hyun-Sook;Koh, Jung-Eun;Shu, Yeon-Ok
    • Journal of Korean Academy of Nursing
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    • v.30 no.4
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    • pp.1018-1034
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    • 2000
  • The purpose of this study was to construct model of sexual adjustment in people with spinal cord injury and to determine factors that relate to sexual adjustment using methodological triangulation. A total of 134 persons who were registered members of spinal cord injury organization and admitted rehabilitation unit in the hospital were included in the study. Participants answered questionnaire concerning importance of life events, sexual concern, sexual adjustment. Qualitative data were collected through semi-structured indepth interviews from 10 individuals with spinal cord injury who were previously included in the quantitative study. Constant compatative method was used to analyze the data. The results were as follows : 1) With respect to eleven other areas of life, sex life ranked the sixth and economic status ranked the highest in terms of importance. However social life ranked the lowest among the 11areas. 2) Among seven topics related to sexuality were methods and techniques to achieve sexual satisfaction, and helping a partner cope emotionally with limitation on sexual dysfunction was the second greastest. 3) The mean score for sexual adjustment was 19.47 which can be considered. 4) A process on how individuals with spinal cord injury adjust to their changed sexual life immerged from the qualitative data. It includs 4 stages: 'stage of loss' 'stage of endeavoring' 'stage of effort' and 'stage of adjustment'. Categories showing context for the action/interaction strategies were 'steadiness' and 'rediscovery as a sexual being'. There were three factors which may stimulate the adjustment process while the others may interrupt it. Those factors included personal matters, family matters and social matters. The individuals may follow each stage step by step but may go back to the previous step depending on the outcomes of their adjustment. 5) There were three factors which may stimulate the adjustment process while the others may interrupt it. Those factors included personal matters, family matters and social matters.

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The Results of Modified $Brostr{\ddot{o}}m$ Procedure for the Treatment of Chronic Lateral Ankle Instability (만성 족근 관절 외측 불안정성 환자에서 $Brostr{\ddot{o}}m$ 변형 술식의 치료 결과)

  • Jeon, Ho-Seung;Jeon, Seung-Ju;Kim, Jong-Min;Park, Byeong-Mun;Chang, Byung-Keun
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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    • pp.60-65
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    • 2006
  • Purpose: This study was performed to evaluate clinical and radiographical results of treatment of chronic lateral ankle instability with modified Brostrom procedure. Materials and Methods: This is a retrospective study of 22 cases in 22 patients treated with modified $Brostr{\ddot{o}}m$ procedure under the diagnosis of chronic lateral ankle instability from May 2000 to August 2004. Average age was 32.3 years. Average follow-up period was 23 months. Preoperative and postoperative radiographs of ankle anteroposterior view, lateral view and varus stress view were analyzed. The clinical evaluation was performed according to the Americal Orthopaedic Foot and Ankle Society scales. Results: After the modified $Brostr{\ddot{o}}m$ procedure, Americal Orthopaedic Foot and Ankle Society scales score was improved by average 28 points. Among the 22 cases, 13 cases were excellent, 3 cases good, 4 cases fair, and 2 cases poor with satisfaction of 73%. Five cases had intermittent ankle pain of whom 3 cases had difficulty during competitive sports activity. Lateral tilting of talus improved by average 5.4 degrees on varus stress view. Conclusions: The modified $Brostr{\ddot{o}}m$ procedure is one of the most effective methods for treating of chronic lateral ankle instability.

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Facial and occlusal esthetic improvements of an adult skeletal Class III malocclusion using surgical, orthodontic, and implant treatment

  • de Almeida Cardoso, Mauricio;de Molon, Rafael Scaf;de Avila, Erica Dorigatti;Guedes, Fabio Pinto;Filho, Valter Antonio Ban Battilani;Filho, Leopoldino Capelozza;Correa, Marcio Aurelio;Filho, Hugo Nary
    • The korean journal of orthodontics
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    • v.46 no.1
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    • pp.42-54
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    • 2016
  • The aim of this clinical report is to describe the complex treatment of an adult Class III malocclusion patient who was disappointed with the outcome of a previous oral rehabilitation. Interdisciplinary treatment planning was performed with a primary indication for implant removal because of marginal bone loss and gingival recession, followed by orthodontic and surgical procedures to correct the esthetics and skeletal malocclusion. The comprehensive treatment approach included: (1) implant removal in the area of the central incisors; (2) combined orthodontic decompensation with mesial displacement and forced extrusion of the lateral incisors; (3) extraction of the lateral incisors and placement of new implants corresponding to the central incisors, which received provisional crowns; (4) orthognathic surgery for maxillary advancement to improve occlusal and facial relationships; and finally, (5) orthodontic refinement followed by definitive prosthetic rehabilitation of the maxillary central incisors and reshaping of the adjacent teeth. At the three-year follow-up, clinical and radiographic examinations showed successful replacement of the central incisors and improved skeletal and esthetic appearances. Moreover, a Class II molar relationship was obtained with an ideal overbite, overjet, and intercuspation. In conclusion, we report the successful esthetic anterior rehabilitation of a complex case in which interdisciplinary treatment planning improved facial harmony, provided gingival architecture with sufficient width and thickness, and improved smile esthetics, resulting in enhanced patient comfort and satisfaction. This clinical case report might be useful to improve facial esthetics and occlusion in patients with dentoalveolar and skeletal defects.

Characteristics of Women Who Have Had Cosmetic Breast Implants That Could Be Associated with Increased Suicide Risk: A Systematic Review, Proposing a Suicide Prevention Model

  • Manoloudakis, Nikolaos;Labiris, Georgios;Karakitsou, Nefeli;Kim, Jong B.;Sheena, Yezen;Niakas, Dimitrios
    • Archives of Plastic Surgery
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    • v.42 no.2
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    • pp.131-142
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    • 2015
  • Literature indicates an increased risk of suicide among women who have had cosmetic breast implants. An explanatory model for this association has not been established. Some studies conclude that women with cosmetic breast implants demonstrate some characteristics that are associated with increased suicide risk while others support that the breast augmentation protects from suicide. A systematic review including data collection from January 1961 up to February 2014 was conducted. The results were incorporated to pre-existing suicide risk models of the general population. A modified suicide risk model was created for the female cosmetic augmentation mammaplasty candidate. A 2-3 times increased suicide risk among women that undergo cosmetic breast augmentation has been identified. Breast augmentation patients show some characteristics that are associated with increased suicide risk. The majority of women reported high postoperative satisfaction. Recent research indicates that the Autoimmune syndrome induced by adjuvants and fibromyalgia syndrome are associated with silicone implantation. A thorough surgical, medical and psycho-social (psychiatric, family, reproductive, and occupational) history should be included in the preoperative assessment of women seeking to undergo cosmetic breast augmentation. Breast augmentation surgery can stimulate a systematic stress response and increase the risk of suicide. Each risk factor of suicide has poor predictive value when considered independently and can result in prediction errors. A clinical management model has been proposed considering the overlapping risk factors of women that undergo cosmetic breast augmentation with suicide.

Osteocutaneous flaps for head and neck reconstruction: A focused evaluation of donor site morbidity and patient reported outcome measures in different reconstruction options

  • Kearns, Marie;Ermogenous, Panagiotis;Myers, Simon;Ghanem, Ali Mahmoud
    • Archives of Plastic Surgery
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    • v.45 no.6
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    • pp.495-503
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    • 2018
  • With significant improvements in success rates for free flap reconstruction of the head and neck, attention has turned to donor site morbidity associated with osteocutaneous free flaps. In this review, we address the morbidity associated with harvest of the four most commonly used osteocutaneous flaps; the free fibula flap, the scapula flap, the iliac crest flap and the radial forearm flap. A comprehensive literature search was performed to identify articles relevant to donor site morbidity for these flaps. We assessed morbidity in terms of incidence of delayed healing, chronic pain, aesthetic outcomes, site specific complications and patient satisfaction/quality of life. Weighted means were calculated when sufficient studies were available for review. The radial forearm and free fibula flaps are associated with high rates of delayed healing of approximately 20% compared to the scapular (<10%) and iliac flaps (5%). The radial forearm flap has higher rates of chronic pain (16.7%) and dissatisfaction with scar appearance (33%). For the majority of these patients harvest of one of these four osteocutaneous does not limit daily function at long-term follow-up. The scapular osteocutaneous flap is associated with the lowest relative morbidity and should be strongly considered when the recipient defect allows. The radial forearm is associated with higher morbidity in terms of scarring, fractures, chronic pain and wrist function and should not be considered as first choice when other flap options are available.

A Study on the Effect of Unit Design for Patient-Centered Care on Family Members and Caregivers - A Case Study of the Intensive Care Unit (ICU) for Patient-Centered Care in the United States (환자중심의료를 위한 병동디자인이 환자가족 및 의료진에 미치는 효과에 대한 연구 - 미국의 환자중심의료를 위한 중환자병동 사례를 중심으로)

  • Choi, Young-Seon
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.21 no.3
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    • pp.37-45
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    • 2015
  • Purpose: The main objective of this paper is, to evaluate the unit design for patient-centered care and to draw lessons-learned for further improvement. Methods: This study conducted a case study of the intensive care unit, designed to fulfill patient-centered care in the US. It evaluated the effectiveness of the unit by incorporating several study methods such as plan analyses, direct observations through nursing tracking and behavior mapping, and focus group interviews. Results: The major design decision made in this patient-centered unit was the use of patient rooms with designated family areas and distributed nursing stations. Both design features appeared to be a success on a variety of research metrics and outcomes. The study identified that the patient rooms ultimately help family members to spent more time with their loved ones, which leads to increased satisfaction of family members and nurses also report that they generally enjoy the distributed nurses' stations, which provide a comfortable environment to complete their regular lines of work such as charting, monitoring patients, and collaborating with their colleagues. Implications: Certain design features in intensive care units such as patient rooms with designated family areas and distributed nursing stations could appropriately support hospitals to fulfill patient-centered care.

Surgical Treatment of Pectus Excavatum (누두흉의 외과적 치료)

  • 윤경찬;박창권;유영선;이광숙;최세영;금동윤
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.286-290
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    • 1998
  • The pectus excavatum is the most common deformity of chest wall. The most common cause of surgical correction is cosmetic problem. From January 1981 to July 1996, 24 patients had undergone surgery for pectus excavatum and they were corrected by Ravitch operation(n=4) or modified Wada operation(n=20) respectively. We analyzed each surgical cases according to age, sex, chief complaint, degree of deformity, EKG findings, complications and satisfaction degree of patient. In some cases, we measured Welch index preoperatively and postoperatively. The postoperative complications were wound infection in two, pneumothorax in two and reccurrence in one. The average value of Welch index was significantly improved from 5.86$\pm$0.51 preoperatively to 4.10$\pm$0.51 postoperatively(P<0.05). The results by Humphreys' criteria were satisfiable in 88%(excellent 71%, good 17%). The findings of this study suggest that surgical correction of pectus excavatum with modified Wada rocedure and submammary s in incision is effective method in physical and psychiatric aspect.

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Current Status of Pain Clinics in Korea (한국 통증치료실의 현황)

  • Moon, Dong-Eon;Yang, Nae-Yun;Choi, Young-Kook;Ryu, Keon-Hee;Shim, Jae-Yong;Yoon, Keon-Jung;Kim, Wook-Sung;Min, Jin-Hye
    • The Korean Journal of Pain
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    • v.11 no.2
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    • pp.273-282
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    • 1998
  • Background: Twelve years have passed since the Korean Pain Society was organized. Nowadays, there are so many problems to be solved in pain clinics including health insurance, pain education and public information etc. in Korea. The present study was designed to evaluate the current status of pain clinics in Korea. Methods: Eight hundred twenty regular members of Korean Pain Society were surveyed by questionnaire in October 1997. We compared the general characteristics, contents of diseases in pain clinic, treatment Methods, patients satisfaction, pain educations, problems in pain treatments, requests to Korean Pain Society among the 138 respondents. Results: Thirty seven percents of the respondents worked at university hospitals, 39% at non-university hospitals and 24% at private pain clinics. The most common diseases treated in pain clinics was low back pain(32% in university and non-university hospital and 28% in private pain clinic respectively). However, cancer pain was 10% in university and non-university hospital and 0.7% in private pain clinic. Epidural block was the most frequently used procedure in chronic pain treatments. And 74.6% of the respondents were studied and learned in Korea and Japan. And then, current problems in pain management and requests to Korean Pain Society were medical insurance problems, pain education and public information of pain clinics. Conclusions: These results suggest that the Korean Pain Society should make an effort to solve these current problems in order to activate pain medicine and increase the quality of life for those suffering from pain.

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Relationships between Job Characteristics and Turnover Intention of the Physical Therapists of Hospitals (병원에 근무하는 물리치료사의 직무특성과 이직의도와의 관련성 연구)

  • Lee, Suk-Min;Choi, Man-Kyu
    • Journal of Korean Physical Therapy Science
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    • v.10 no.2
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    • pp.145-152
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    • 2003
  • Recruiting and maintaining capable physical therapists in hospitals is crucial to provide patients with better quality's physical therapy and to achieve hospital business objectives. This study is to provide basic data for effective personnel management of physical therapists in the hospital. For this, this study was conducted to confirm the relationship between turnover intention and job characteristics(task importance, job autonomy, job feedback, task identity, skill diversity), and to find out factors affecting the turnover intention of hospital physical therapists in Korea. The sample used in this study consisted of 173 physical therapists who were working in hospitals located in Seoul from June 18 to 29. The data for analysis were collected by questionnaire survey. The dependent variable of this study was turnover intention and the independent variables were job characteristics(task importance, job autonomy, job feedback, task identity, skill diversity), demographic characteristics of respondents(sex, age, education level, marital status, working hospital, working career). The major statistical methods used for the analysis were factor analysis, t-test, ANOVA, correlation, and hierarchical multiple regression analysis. Turnover intention according to demographic characteristics of respondents was significantly high in the graduate school above group. As the result of hierarchical multiple regression analysis of turnover intention, R2 of job characteristics was much more powerful than demographic characteristics. The factors had significant negative effect on turnover intention were job autonomy, task identity, and skill diversity. And in demographic characteristics factors, there were not significant factors on turnover intention. In considering above findings, for decreasing turnover intention of physical therapists, hospitals need to develop strategies for enhancing job satisfaction by improving job autonomy, task identity, and skill diversity from the adequate job environment.

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A Study on Cognition of Oriental Medical Hospital Employees on the Oriental Medical Institution Assessment (한방의료기관평가에 대한 한방의료기관 근무자의 인지도)

  • Jeon, Hyun-Sook;Jung, Sang-Hyuk;Yu, Seung-Hum;Jung, Woo-Sang
    • The Journal of Korean Medicine
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    • v.29 no.4
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    • pp.114-122
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    • 2008
  • Objectives: To determine the factors affecting the assessment of Oriental medical institutions under the Oriental Medical Institution Assessment System and thereupon, provide for some basic data and alternative measures for assessment of Oriental medical institutions. Methods: The researcher sampled 320 people employed by 26 Oriental medical institutions designated as model Oriental medical institutions subject to assessment in 2008 and 2009 and thereupon, used a structured and open-ended survey table for them to collect the data. The size of the final sample was n=302. Results: The Oriental medical institution staff were highly aware of the Oriental medical institution assessment (OMIA), After adjusting the other factors by multiple regression, the factors affecting such recognition were different significantly depending on age (those in their 30's), types of job (nurses and treatment assistants) and locations of hospital (GyeongSang-do). The staff expected the OMIA could helpful for improving facilities and system of hospitals, thus promoting satisfaction of patients. To do so, they felt it necessary to develop an assessment scale reflecting the special conditions besetting the Oriental medical institutions as well as the indices for improvement of Oriental medical service quality. Conclusion: It is hoped that this study will be followed up by future studies which will comparatively analyze Oriental medical institution staff's perception of the assessment system before and after its operation and thereby, suggest some ideal policy alternatives for assessment of the Oriental medical institutions. Furthermore, future studies are requested to research into Oriental medical institution staff's needs and consumers' needs as well in consideration of the characteristics of the Oriental medical institutions and thereupon, suggest some alternatives for continued education, development of the assessment tools, methods and policies.

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