• Journal of Korean Academy of Nursing Administration
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• v.3 no.1
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• pp.107-118
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• 1997

This study was designed to obtain basic data for development of evaluation tool which would be needed to measure the outcome of general quality nursing care of individual patient. The purpose of this study was to analyze and classify the outcome indicators of quality nursing care. The 29 articles of quality nursing care and outcome measures were selected coveniently, and analyzed to classify the outcome indicators of quality nursing care using open coding method. The results of this study were as follows: 1. Quality nursing care was defined as level of excellence of nursing care to achieve good patient outcome. 2. The 6 domains of which were health status, satisfaction, self care, patient progress and prognosis, and compliance were identified in outcome indicators of quality nursing care 3. Seven indicators of health status domain which were perceived health status, quality of life, well-being, daily activities, physical-physiological status, psychoemotional status, and social role functioning were identified. 4. Two indicators of satifaction domain which were patient satisfaction and family satisfaction were identified. 5. Three indicators of self care domain which were skill, knowledge, and home management were identified. 6. Seven indicators of patient progress and prognosis domain which were change of clinical status, resolution of nursing diagnosis and problem, days of stay, dicahrge state, recovery state, survival were identified. 7. compliance with therapeutic direction compliance was identified as an indicator of compliance domain. 8. It was sugested that studies for development of evaluation tools for outcomes of quality nursing the results of this study could be executed

• Child Health Nursing Research
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• v.10 no.2
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• pp.225-232
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• 2004

The purpose of this article is to describe the overview of current medical treatments of childhood epilepsy in Korea and to review several recent nursing researches related to quality of life problems, especially psychological functioning in children with epilepsy and the stress of the family. The prognosis of childhood epilepsy has been improved considerably and about 80％ of patients can now be expected to achieve complete seizure control by the antiepileptic drug treatment. Even for the intractable epilepsy, with the combination of ketogenic diet program and antiepileptic drug therapy or surgical treatment, the prognosis became very much better than before. The majority of research has reported that children with epilepsy were experiencing quality of life problems. They are at risk for impaired functioning, compared to either general population controls or to other chronic illness groups such as asthma and diabetes. The ultimate goal of providing care to children with epilepsy is to control seizures while facilitating an optimal quality of life for the child as well as the family. Recommendations are included for future research and intervention programs for children, parents and our society.

• Korean Medical Education Review
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• v.22 no.2
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• pp.99-114
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• 2020

The rapid development of artificial intelligence (AI), including deep learning, has led to the development of technologies that may assist in the diagnosis and treatment of diseases, prediction of disease risk and prognosis, health index monitoring, drug development, and healthcare management and administration. However, in order for AI technology to improve the quality of medical care, technical problems and the efficacy of algorithms should be evaluated in real clinical environments rather than the environment in which algorithms are developed. Further consideration should be given to whether these models can improve the quality of medical care and clinical outcomes of patients. In addition, the development of regulatory systems to secure the safety of AI medical technology, the ethical and legal issues related to the proliferation of AI technology, and the impacts on the relationship with patients also need to be addressed. Systematic training of healthcare personnel is needed to enable adaption to the rapid changes in the healthcare environment. An overall review and revision of undergraduate medical curriculum is required to enable extraction of significant information from rapidly expanding medical information, data science literacy, empathy/compassion for patients, and communication among various healthcare providers. Specialized postgraduate AI education programs for each medical specialty are needed to develop proper utilization of AI models in clinical practice.

• International Journal of Heart Failure
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• v.6 no.3
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• pp.107-116
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• 2024

Frailty is highly prevalent among patients with heart failure (HF) and independently predicts adverse outcomes. However, optimal frailty definitions, assessments, and management in HF remain unclear. Frailty is common in HF, affecting up to 80% of patients depending on population characteristics. Even pre-frailty doubles mortality risk versus robust patients. Frailty worsens HF prognosis through systemic inflammation, neurohormonal changes, sarcopenia, and micronutrient deficiency. Simple screening tools like gait speed and grip strength predict outcomes but lack HF-specificity. Comprehensive geriatric assessment is ideal but not always feasible. Exercise, nutrition, poly-pharmacy management, and multidisciplinary care models can help stablize frailty components and improve patient-centred outcomes. Frailty frequently coexists with and exacerbates HF. Routine frailty screening should guide supportive interventions to optimize physical, cognitive, and psychosocial health. Further research on HF-specific frailty assessment tools and interventions is warranted to reduce this dual burden.

• Journal of Hospice and Palliative Care
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• v.27 no.1
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• pp.1-10
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• 2024

This article underscores the importance of integrating comprehensive palliative care for noncancer patients who are undergoing hemodialysis, with an emphasis on the aging populations in Asian nations such as Taiwan, Japan, the Republic of Korea, and China. As the global demographic landscape shifts towards an aging society and healthcare continues to advance, a marked increase has been observed in patients undergoing hemodialysis who require palliative care. This necessitates an immediate paradigm shift to incorporate this care, addressing the intricate physical, psychosocial, and spiritual challenges faced by these individuals and their families. Numerous challenges impede the provision of effective palliative care, including difficulties in prognosis, delayed referrals, cultural misconceptions, lack of clinician confidence, and insufficient collaboration among healthcare professionals. The article proposes potential solutions, such as targeted training for clinicians, the use of telemedicine to facilitate shared decision-making, and the introduction of time-limited trials for dialysis to overcome these obstacles. The integration of palliative care into routine renal treatment and the promotion of transparent communication among healthcare professionals represent key strategies to enhance the quality of life and end-of-life care for people on hemodialysis. By embracing innovative strategies and fostering collaboration, healthcare providers can deliver more patient-centered, holistic care that meets the complex needs of seriously ill patients within an aging population undergoing hemodialysis.

• Journal of Physiology & Pathology in Korean Medicine
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• v.30 no.6
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• pp.458-465
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• 2016

The information relating to the health of person has been increasing. The information is such as medical information and personal health record and the information collected by utilization and dissemination of mobile devices. Therefore, the interest and demand for systems that can integrate and manage the Personal Health Record(PHR) is increasing. Quantity and quality of information that is collected from the patient can have a major impact on the diagnosis and treatment of Korean Medicine(KM) in clinical practice. Because closely observe the usual clinical symptoms of patients to utilize the treatment. But if the interview when memories are not sure of the correct answer does not get much easier to find exactly the symptoms. So when recording original symptom(素證) and daily subjective symptom can be helpful for care. Therefore, the personal health care services that can record and manage and own is necessary based on KM. In this paper, we propose Korean Medicine Personal Health Record Platform(KM PHR Platform). We have selected the significant symptoms that mean to the personal records from symptom information required for diagnosis in KM. And classifying and scoring as the symptoms were used as personal health care indicators. And significant symptoms were easily configure a screen that can be recorded. simple operation is recorded as a symptom. It was designed to reflect these functions. So KM PHR Platform helps to Personal health care. Doctor may be able to help in the diagnosis and prognosis observation by reference to shared symptom. We look forward to a variety of health services based on KM using a symptom, a medical record, personal health device information.

• Journal of Hospice and Palliative Care
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• v.22 no.2
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• pp.67-76
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• 2019

For hospice palliative care that provides comprehensive and general care, it is necessary to use assessment tools to objectively list issues and detail care plans. The initial assessment is a process of establishing an overall direction of care by identifying the patient's symptoms, social and spiritual issues and palliative care needs on the admission day or within one day of admission. This process is also used to identify the patients' and families' awareness of the illness, prognosis, treatment options and if the Physician Orders for Life-Sustaining Treatment (POLST) has been drafted. Consisting of 13 simple questions regarding the physical, mental, social, and spiritual domains, the Needs at the End-of-Life Screening Tool (NEST) is recommended as an initial assessment tool. Using specific assessment tools, a care plan is established for the issues identified in the initial assessment within three days of admission. A multidisciplinary assessment tool can be helpful in the physical domain. The psychosocial domain evaluates psychological distress, anxiety and depression. The social domain examines an ability to make decisions, understanding of the socioeconomic circumstance, family relationship, and death preparedness. A spiritual evaluation is also important, for which the Functional Assessment of Chronic Illness Therapy-Spiritual WellBeing Scale (FACIT-Sp) or the Spiritual Health Inventory (SHI) can be used. The use of an assessment tool could not only contribute to pain mitigation a better quality of life for patients, but also provide systematic training for a multidisciplinary team; And the process itself could be a stepping stone for the better care provision.

• Journal of Hospice and Palliative Care
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• v.10 no.3
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• pp.137-144
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• 2007

Purpose: The purpose of this study is to identify and assess the needs of the cancer patients and their families and provide basic data to meet with their needs. Methods: This is a descriptive study using questionnaire method. Questionnaire were collected by mail from 76 discharged patients from a hospice ward from May until the end of October, 2004, and data were analyzed by SPSS 10.0. Results: Admitted patients had needs of pain control (85.5%), non-pain symptoms (63.2%) such as vomiting, dyspnea, ascites, etc, and emotional and spiritual problem solving (28.9%, 14.5%). Interests of patients were health care of himself/herself (65.8%), concern for their spouses left alone (32.9%), and future of their children (15.8%). In families' needs of care of 5 areas, "information on patient's status and treatment/nursing care" was shown most high score ($3.48{\pm}0.62$). In detailed questions, they request most 'to inform the prognosis of patients' and the next is 'to inform the reasons that nursing care was required'. The next highest score was to 'inform family roles' ($3.39{\pm}0.64$), and next was spiritual support ($3.11{\pm}0.79$), and emotional support ($3.08{\pm}0.72$). Expectations of family on the treatment were comfortable dying (73.4%) scored the highest. Patients' families were satisfied with volunteer service most in service area (97.4%). The next was pain control (89.5%) and nursing service (77.6%). Conclusion: Health care staff should identify the actual needs of families caring cancer patients and they should operate realistic programme which can give continuous and assistance by reflecting individual needs and characteristics. With these srategies, the quality of life of patients and families can be improved. And then the intervention programme should be developed to measure subjective nursing care needs of terminally ill cancer patients and their families.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.14
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• pp.5551-5556
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• 2014

Background: The prognostic value of human epidermal growth factor receptor-2 (HER-2/neu) for survival of patients with colorectal cancer (CRC) is still ambiguous. We therefore performed a meta-analysis to evaluate its prognostic significance. Materials and Methods: We searched the MEDLINE and EMBASE databases for published literature investigating associations between HER-2/neu status and overall survival of patients with CRC. A meta-analysis was performed using a DerSimonian-Laird model and publication bias was investigated by Begg's and Egger's tests. Subgroup analysis was also conducted according to the study design type, study quality score, cut-off value for HER-2/neu overexpression, publication region, patient number and publication year. Results: A total of 17 eligible studies involving 2,347 patients were identified for this meta-analysis. The combined hazard ratio (HR) was 1.31 (95% confidence interval (CI): 0.96-1.79), suggesting that HER-2/neu overexpression was not significantly associated with overall survival of patients with CRC. However, subgroup analysis revealed that HER-2/neu overexpression had an unfavorable impact on survival when the analysis was restricted to subgroups of study quality score ${\leq}5 $(HR=1.56, 95%CI: 1.17-2.10), Asian patients (HR=1.74, 95%CI: 1.22-2.49), patient number ${\leq}106$ (HR=1.57, 95%CI: 1.01-2.44), publication year before 2003 (HR=1.59, 95%CI: 1.02-2.49), and prospectively designed study (HR=3.62, 95%CI: 1.42-9.24). The effect disappeared in subgroups of study quality scores > 5 (HR=0.69, 95%CI: 0.33-1.44), non Asian patients (HR=1.14, 95%CI: 0.77-1.70), patients' number > 106 (HR=1.07, 95%CI: 0.67-1.72), publication year after 2003 (HR=1.13, 95%CI: 0.76-1.69), and retrospectively designed study (HR=1.22, 95%CI: 0.89-1.67). Conclusions: Our meta-analysis suggests that HER-2/neu overexpression might not be a significantly prognostic indicator for patients with CRC. Further studies are required to confirm these results.

• Journal of Korean Academy of Nursing
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• v.22 no.4
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• pp.636-652
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• 1992

This study identified the impact of childhood cancer on the Korean family. The purpose was to contribute knowledge for family nursing and pediatric hospice care practice with sick children and their families. This descriptive study was conducted during a 6 month period with children who were being treated for cancer at six university hospitals in Seoul. The data were gathered from members of 68 families ; 24(Group A), with a child newly diagnosed with cancer : 27(Group B), with a child under treatment and without complications, and 17 (Group C), with a child in relapse. Medical records, structured questionnaires and interviews were used for data collection. The questionnaires and interview schedules had been used previously in Martinson's research in the USA and China. The findings, conclusions, and suggestions are as follows. 1. The impact of childhood cancer on the family. Members of the family experienced fear, helplessness, guilty feelings, and anger at the time of the initial diagnosis and at relapse. Mothers complained of headache, anorexia and poor appetite, weight loss, sleep disturbance, and bad dreams. Many of the fathers either lost or changed jobs, and all working mothers stopped working. Half the parents reported changes in their marital relationships such as frequent quarrels but also stronger unity. Family members perceived cancer as the most frightening disease. Change in their world view was expressed as living on faith understanding suffering, determining to live a better life, wanting to live an upright life and valuing health as the most important. Religious activities are found most helpful through this difficult experience. Financial debt due to the treatment and care of the sick child, burdened 22 families. The above mentioned impact was most evidant in Group B(those presently undergoing treatment) and Group C(those in relapse). Findings indicate that nursing care should embrace the family of a child who is being treated for cancer. 2. Characteristics of the child with cancer The majority of the children in this sample had a diagnosis of leukemia. Their mean age was 6.8 and the ratio of boys to girls was 1.12 ; 1. The mean hospitalization frequency was 13.5 times and the mean duration of illness was 16.8 months. Most of 1.he children perceived cancer as the most frightening disease ; 32.7% of the children described their sickness as serious. Children in Group C were hospitalized more frequently, stayed in hospital for longer periods, and expressed their sickness as quite serious more often than the other two groups. These findings indicate how much comprehensive pediatric hospice nursing care services are needed along with relevant research and nursing education. 3. Characteristics of the families. The mean age of the father was 39.5 and the mother, 36,6 ; they are in their most productive life period. Mothers especially expressed feelings of financial uneasiness and powerlessness about giving up their jobs, and guilty feelings for not providing enough care and concern to other children due to taking care of the sick one. The burden of caring for the sick child can bring negative changes in family dynamics which they think provoke potential health problems in members of the family These findings suggest a need for nursing support and counselling resources. Findings also suggest the need for ethical inquiry about such questions as who should give information to the child in regard to diagnosis and prognosis, when, and how. Other suggestions included : 1) Quality health care for childhood cancer such as home care and pediatric hospice programs should be established. 2) Special and practical consideration for long-term patients should be made in the present insurance coverage. The reimbursement period for long-term patients should be lengthened. 3) Further in-depth qualitative studies are needed. 4) Education programs including guided practice experience for pediatric hospice care practitioners are needed.