The aims of this study is to investigate the status of nursing care delivery systems and nurse staffing levels and to analyze differences in the quality of nursing care by the type of nursing care delivery system. This research was based on data from 723 nurses working in 55 medical and surgical units in 26 general hospitals. Descriptive statistics on nurse staffing levels and the nursing care delivery system, and multi-level logistic regression were used to estimate the determinants of quality of nursing care. The number of patients per nurse is 17.74 patients in functional nursing care and 15.56 patients in total nursing care. In comparison to hospitals adopting total nursing care, hospitals with functional nursing care had greater patients. The nurses rated units using total nursing care as significantly better quality of nursing care than the units with functional nursing care. Total nursing care or modified total nursing care, rather than functional nursing care, could lead to improvement in the quality of care(total nursing care OR=3.895, modified total nursing care OR=2.475). Patient-centered approaches under proper circumstances can be successfully implemented and the positive effects demonstrated.
Lee, Yun Jong;Kim, Sang-Hwan;Chung, Sang Wan;Lee, Young-Kyun;Koo, Kyung-Hoi
Journal of Korean Medical Science
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v.33
no.52
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pp.339.1-339.11
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2018
Background: Hip pain is a common musculoskeletal complaint in general practice. Although comprehensive diagnostic approach on hip pain is mandatory for adequate treatment, un- or mis-diagnosis is not rare in primary care. The aim of this study was to analyze descriptively un- or mis-diagnosed hip pain cases referred from primary care to a tertiary hospital, especially in young adults ${\leq}50years\;old$. Methods: We retrospectively analyzed a consecutive cohort of 150 patients (${\leq}50years\;old$) with chronic hip pain (${\geq}6weeks$), which was not diagnosed or misdiagnosed based on the information provided on the referral form. Results: Overall an average 32 cases/month were referred due to hip pain without a diagnosis or with an incorrect diagnosis. Among them, 150 patients were enrolled in this study and 146 (97.3%) could be allocated to a specific disease by using data from routine clinical practice. Four common final diagnoses were femoroacetabular impingement (FAI) syndrome (55.3%), hip dysplasia (HD, 13.3%), referred pain from the lumbar spine (9.3%), and spondyloarthritis (SpA, 7.3%). In patients with FAI syndrome, 37 (44.0%) had pincer-type FAI and 33 (39.8%) had combined-type. Although the pain site or gender was not tightly clustered, the distribution of final diagnosis was significantly different according to hip pain location or gender. Especially, SpA or HD was not observed in younger women subgroup or elder men subgroup, respectively, when stratified by the mean age of participants. Conclusion: Most (> 80%) young patients with hip pain, a difficult issue to diagnosis for many primary physicians, had FAI syndrome, HD, spine lesions, and SpA. This study could give a chance to feedback information about cases with un- or mis-diagnosed hip pain, and it suggests that primary physicians need to be familiar with the diagnostic approach for these 4 diseases.
Purpose: This study examined the quality of life (QoL) and quality of care (QoC) in inpatient hospice settings in Korea before and during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Data were obtained from three institutions that participated in two prospective cohort studies. The primary outcomes measured were the QoL of patients with terminal cancer and their family caregivers (FCs), as well as the QoC as perceived by the FCs. Results: Multivariable regression analysis revealed that during the COVID-19 pandemic, both patients and FCs experienced better QoL than before the pandemic, and FCs reported a higher QoC. Conclusion: Health policymakers should consider our findings when planning for future pandemics.
Journal of agricultural medicine and community health
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v.12
no.1
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pp.5-27
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1987
It is widely recognized that primary health care in the community is one of the most important and effective health measures in these days. However, it is reality that unsatisfactory health care system, ineffective utilization of health care by the community people in the rural area are hampering better understanding for primary health care. Therefore promoting health for the rural people and increasing understanding about primary health care, the baseline survey in the community focused in examination for safe community water supply was carried out. The survey was conducted through August 25-31, 1986 in order to find out health problems and relevant factors and to define the demographic characteristics of $^*$Sanpuk village, Kumsa-Myun, Yuju-Gun, Kyunggi-Do, Korea. Household survey was carried out for every home by trained interviewers. The major results are found out as follows : 1) 84.2%(400 houses) of total households were surveyed because 15.8%(75 houses) were unable to survey due to either refusal against interview or absence of family. These 400 households were composed of 1,697 residents(male:830, female 867). Educational level of respondents showed 34.1% as elementary school graduated. Religion distribution showed Buddism(23.8%) as the most dominant. 50.7% of respondents married in the area. 2) Most households(91.5%) have lived in their own house in Sanpuk area. Average family size showed 4.3. More than half of residents(64.2%) have used public supplied water tap. Only 1.5% of the households had a flush toliet. The rest of households have still used primitive insanitary latrines. 3) 32.5% of residents have used gas burner for cooking and for heating in the house, and the coal briquet were used for boiler. Lack of convenient public transportation was the chief complaint for their day life. 4) Each household occupied 1,990 pyungs of rice paddy and 1,170 pyungs of ordinary field in average. Beside farming products, mushroom was the highest product. 5) Sixth percent of households in the survey area regularly participated in community meeting one hand and on the other hand 39.5% never participated. Most of respondents closely contacted with their neighbours and they seemed very friendly each other. 6) The prevalence rate of illness and injury during recent 15 days showed 48.3 per 1,000. The prevalence rate of chronic illnesses during the past one year showed 74 per 1,000. Injury and accident lead the higher portion(22.0%) in the former and in the latter pain(arthritis, back-pain) showed 27.0% as the dominant sickness. 87.8% of the ill residents in the former received medical treatment. As the most frequently utilized medical facility, the clinic or hospital were counted. Among the residents suffering from chronic illnesses, 77.3% in Sanpuk area get some kind of medical treatments and they rarely utilized the clinic or hospital. The reason why the patient did not receive any medical care was found out the fact that symptoms of illness was light or mild and economic problems was serious. 7) Average age of marriage showed 21.6 years old in the women and the average duration of marital period was shown for 15.1 years. The married woman in reproductive age in Sanpuk area had experienced pregnancies 4 times in the aver-age including 0.7 time of pregnancy in average were interrupted by induced abortion and 0.3 time by spontaneous abortion respectively. The practicing rate of the family planning of the married woman during reproductive ages showed 70.7% and the tuballigation was found out as the most frequently used contraceptives. 8) Among woman who has children under 2 years old, 70.0% had received the prenatal care for the last pregnancy. However, the average number of prenatal care visitis per woman showed 3.3 times. Fifty-two % of woman who received the postnatal care for the last delivery showed only 37.5%. 9) Immunization rate of the children under 2 years old showed relatively high and looked successful. The breast feeding for these children showed dominantly in the most. Most of the mothers in Sanpuk area had started the supplementary diet during weaning period of their infants of 6th and 7th month after birth. * : Sanpuk area is a demstration area for community development which has been supported by the Community Development Foundation during the part 10 years. The village is relatively closer to urban area such as Seoul, However, it has a similar characteristics shown as a remote village because of geographical location and inconvenient transportation at present.
Background: Breast cancer is one of the leading causes of death among cancer patients in Saudi Arabia. It is known that nurses play a key role in promoting breast cancer awareness among women in any society. Nurses in primary health care centres (PHCC) have more direct contact with general population. This study aimed to investigate nurse knowledge of breast cancer and practice of early screening in PHCC in Jeddah city. Methods: A cross-sectional study was conducted using a self-administered questionnaire to assess the general knowledge of breast cancer, risk factors, and practice of 210 PHCC nurses. Data were analysed using SPSS v.16. Results: The mean age of the PHCC Nurses was 36.9 (SD ${\pm}8.6$). Only 11% percent scored <50% of the total score for general epidemiological knowledge on breast cancer, about 35% scored <50% of the total score for breast cancer risk factors. Sixty seven percent scored >75% of the total score on breast cancer signs. Majority of nurses 62.8% practiced BSE, but only 4% practiced regularly every month. Some 28% practiced once per year. About 81% of the nurses had not had a clinical breast examination and only 14% had had a mammography. The results of the study failed to show any correlation between the knowledge scores with age, education, year of experience, family history of BC and marital status of the nurses. Conclusion:The results from the study reflect that there is a need to provide continuing nursing education programmes for PHCC nurses to improve their breast cancer knowledge and practice.
Purpose: This study examined the definition of care coordination, and the activities and roles of nurse care coordinators. The study also proposed suggestions for establishing and expanding the role of nurse care coordinators in community health practice. Methods: This study derived its conclusions by conducting a literature review. Results: The definition of care coordination is a comprehensive concept that includes case management and transitional care, and can be summarized as organizer and integrator of care. According to the literature review, 12 activities and 6 roles of nurse care coordinator were identified such as a collaborator, an individualized care planer, an educator/counselor, a direct nursing care providers, a population care coordinator, and a program evaluator. Training for nurse care coordinators is currently addressed in the Primary Medical Chronic Disease Management Program. Visiting nurses working at the Eupyeong-dong visiting health and welfare service are expected to act as nurse care coordinators, and the role of nurse care coordinators will, in the future, gradually increase in various nursing facilities. Conclusion: In addition to developing competencies to act as a nurse care coordinator, there is need for approaches to health policy that develop both independent role and population focused role as care coordinators.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.44
no.5
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pp.220-224
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2018
Objectives: The aim of this study was to determine the incidence and characteristics of second primary malignancy (SPM) in patients with head and neck squamous cell carcinoma treated at a tertiary care hospital. Materials and Methods: We retrospectively reviewed the medical records of 221 patients who underwent surgery with or without adjuvant treatment for head and neck cancer from 2000 to 2002. Data of age, sex, risk factors, sites of primary and SPM, TNM stage of primary tumor, incidence of SPM, and survival were collected from medical charts. Results: Eighteen patients developed SPM during a median follow-up of 67 months, with an overall incidence of 8.14%. In addition, 77.7% of SPMs occurred in the oral cavity, followed by 11% in the lungs. The 5-year overall survival after the diagnosis of SPM in the head or neck was 70%, compared to 30% for SPM in other body regions. Conclusion: Considering a high incidence of SPM, i.e., 8.14%, in a mean follow-up period of 67 months suggests the need for long-term follow-up. Since treatment of SPM has shown an acceptable survival rate, early detection and curative therapy should be emphasized.
Recently, demographic studies of veterinary medical database have been conducted to understand patterns of disease occurrence. Understanding incidence of breed-related disease would provide appropriate guidance for future health care strategies and offer useful information for early diagnosis of disease. However, in veterinary medicine, theses research has not yet been investigated in the Republic of Korea. The purpose of this study was to investigate the prevalence of common medical disorders among dog breeds examined at primary-care veterinary clinics in Jeollabuk-Do, Republic of Korea. The data were analyzed based on World Health Organization's International Classification of Disease. A total 13,176 medical records of canine patients were analyzed from six primary veterinary clinics in Jeollabuk-Do from January to December 2016. Results showed that the most common health problems were 'disease of skin' (17.7%); followed by 'diseases of digestive system' (12.26%), 'preventive medicine' (10.08%), and 'diseases of ear and mastoid process' (10.4%). In seven out of ten breeds, the most common medical disorder was skin disease. For poodle such as Pomeranian and Chihuahua, digestive system disease was most prevalent. On the other hand, respiratory system disease was found to be higher in Pomeranian than other breeds; while ear and mastoid process disease was most common for Maltese and Poodle. This study can help owners, breeders, and veterinarians prevent and manage various diseases of popular breeds in Jeollabuk-Do in the future.
Medical clinics are core institutes that cover the primary medical care in Korea. Financial viability of the clinics is essential for them to conduct their roles and functions, and can be improved by increasing their operating profitability. On this ground, this study aimed at finding important factors that affect the operating profitability, and thereby at suggesting strategic alternatives that can contribute to the improvement of the profitability. Operating margin was set as a dependent variable, and such factors as general management conditions, number of visits, medical revenue, marketing activities, input resources, medical cost as independent variables. Nineteen hypotheses related to the variables were established and tested using data collected from 138 sample clinics for the year 2003. The results of the study are as follows : Firstly, such variables as percent ratio of the depreciation plus rent costs to total administration costs, type of clinical department manifested whether medical, surgical, or quasi-surgical, percent ratio of the interior facility investment to total fixed assets, and total number of outpatient visit are important factors that affect, positively or negatively, the medical profitability of the clinics. Secondly, following measures are needed to be established and implemented to improve the medical profitability. (1) Administration costs share 53.2% of the total medical costs, and depreciation plus rent costs 16.3% of the total administration costs. This implies that such measures as reinforcement of marketing activities, establishment of the cooperative utilizing system of the facility and equipment, or group practice are needed to increase cost-effectiveness. (2) Occupancy rate of the clinics with inpatient bed is as low as 45.5%, causing high fixed costs and low medical profitability. For its improvement, the resource input structure should be reorganized. Thirdly, in the future, a study that can increase sample representativeness of the study and explanation power of the variables should be performed for each type of clinical department to find more specific determinant factors and to contribute to the improvement of the medical profitability of the clinics.
Yong Sauk Hau;Min Cheol Chang;Jae Chan Park;Young Joo Lee;Seong Su Kim;Jae Min Lee
Journal of Yeungnam Medical Science
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v.40
no.2
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pp.156-163
/
2023
Background: Interest in digital medical information has increased because it allows doctors to easily access a patient's medical records and provide appropriate medical care. Blockchain technology ensures data safety, reliability, integrity, and transparency by distributing medical data to all users over a peer-to-peer network. This study attempted to assess pediatricians' thoughts and attitudes toward introducing blockchain technology into the medical field. Methods: This study used a questionnaire survey to examine the thoughts and attitudes of 30- to 60-year-old pediatricians regarding the introduction of blockchain technology into the medical field. Responses to each item were recorded on a scale ranging from 1 (never agree) to 7 (completely agree). Results: The scores for the intentions and expectations of using blockchain technology were 4.0 to 4.6. Pediatricians from tertiary hospitals responded more positively (4.5-4.9) to the idea of using blockchain technology for hospital work relative to the general population (4.3-4.7). However, pediatricians working in primary and secondary hospitals had a slightly negative view of the application of blockchain technology to hospital work (p=0.018). Conclusion: When introducing the medical records of related pediatric and adolescent patients using blockchain technology in the future, it would be better to conduct a pilot project that prioritizes pediatricians in tertiary hospitals. The cost, policy, and market participants' perceptions are essential factors to consider when introducing technology in the medical field.
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