• 대한간호학회지
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• 제50권3호
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• pp.333-348
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• 2020

Purpose: The present study investigated the association between nurse staffing and health outcomes among psychiatric inpatients in Korea by assessing National Health Insurance claims data. Methods: The dataset included 70,136 patients aged 19 years who were inpatients in psychiatric wards for at least two days in 2016 and treated for mental and behavioral disorders due to use of alcohol; schizophrenia, schizotypal and delusional disorders; and mood disorders across 453 hospitals. Nurse staffing levels were measured in three ways: registered nurse-to-inpatient ratio, registered nurse-to-adjusted inpatient ratio, and nursing staff-to-adjusted inpatient ratio. Patient outcomes included length of stay, readmission within 30 days, psychiatric emergency treatment, use of injected psycholeptics for chemical restraint, and hypnotics use. Relationships between nurse staffing levels and patient outcomes were analyzed considering both patient and system characteristics using multilevel modeling. Results: Multilevel analyses revealed that more inpatients per registered nurse, adjusted inpatients per registered nurse, and adjusted inpatients per nursing staff were associated with longer lengths of stay as well as a higher risk of readmission. More adjusted inpatients per registered nurse and adjusted inpatients per nursing staff were also associated with increased hypnotics use but a lower risk of psychiatric emergency treatment. Nurse staffing levels were not significantly associated with the use of injected psycholeptics for chemical restraint. Conclusion: Lower nurse staffing levels are associated with negative health outcomes of psychiatric inpatients. Policies for improving nurse staffing toward an optimal level should be enacted to facilitate better outcomes for psychiatric inpatients in Korea.

• 대한간호학회지
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• 제38권4호
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• pp.533-540
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• 2008

Purpose: This study was designed to examine the effects of a weight control program on body weight and the sense of efficacy for control of dietary behavior in psychiatric inpatients. Methods: A quasi-experimental design was used. Data were collected from March 1 to September 30, 2007. Female mentally ill patients in closing psychiatry ward of H University Hospital participated in the study (16 persons in the experimental group and 13 in the control group). Results: The weight control program including diet therapy, exercise, education and behavior modification therapy decreased the rate of weight gain in female mentally ill patients taking atypical anti psychotics, and effectively increased a sense of efficacy for control of dietary behavior. Conclusion: Weight control program had a positive effect as a nursing intervention to decrease obesity and to increase the sense of efficacy for control of dietary behavior of psychiatric inpatients in psychiatric inpatients.

• 임상간호연구
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• 제28권3호
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• pp.270-276
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• 2022

Purpose: The purpose of this study was to validate the Edmonson psychiatric fall risk assessment tool (EPFRAT) for psychiatric inpatients. Methods: Data from retrospective study were collected from 670 adult inpatients in two departments of mental health medicine of a tertiary general hospital by reviewing their electronic medical records. There were 41 patients who experienced falls and 629 patients who did not experience falls during the period from January to December 2019. Data were analyzed by sensitivity, specificity, positive predictive value, negative predictive value, and a receiver-operating characteristic curve (ROC) for validity assessment using the IBM SPSS/WIN 26.0 program. Results: Factors affecting falls were the participant's age, guardian's residence, high-risk determination at the time of admission, and comorbidity. At the 85 points where the point of sum of the sensitivity and specificity was largest, the sensitivity, specificity, positive predictive value, and negative predictive value of EPFRAT were 92.7%, 79.7%, 22.9%, and 99.4%, respectively. The area under the ROC to assess the overall validity of the tool was .92 (95% CI 0.89~0.94). Conclusion: The EPFRAT was proved to be valid and reasonable for predicting falls in psychiatric inpatients. Based on the results of this study, it could be used for the assessment of high-risk patients for falls in psychiatric units.

• 한국콘텐츠학회논문지
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• 제14권11호
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• pp.308-317
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• 2014

본 연구는 입원정신질환자의 자살사고에 영향을 미치는 요인을 규명하는 서술적 조사연구이다. 연구대상자는 C 대학병원 정신과 병동에 입원한 정신질환자 186명이었다. 구조화된 자가 보고식 설문지를 이용하여 자료를 수집하였으며, 자료 분석은 SPSS WIN 프로그램을 사용하여 빈도와 백분율, 평균과 표준편차, t-test, ANOVA, Pearson correlation coefficient, hierarchical multiple regression analysis를 실시하였다. 연구결과, 자살사고는 결혼상태, 진단명, 자살시도 과거력에 따라 유의한 차이가 있었고 우울, 자아존중감, 영성과 유의한 상관관계가 있었다. 일반적 특성 중 자살사고에 유의한 차이를 보였던 결혼상태, 진단명, 자살시도 과거력을 통제한 상태에서 위계적 회귀분석을 실시한 결과, 자살사고에 영향을 미치는 요인으로는 우울과 영성이 유의한 것으로 나타났으며 이들 변수의 자살사고에 대한 설명력은 52.4%이었다. 결론적으로, 입원정신질환자들의 자살사고를 감소시키기 위해서 이들의 우울을 감소시키고 영성을 증진하는 중재 프로그램을 개발하여 적용할 필요가 있다.

• 생물정신의학
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• 제16권4호
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• pp.246-255
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• 2009

Objectives : The aims of this study are to estimate the prevalence of polydipsia and water intoxication and to identify risk factors of polydipsia and water intoxication in psychiatric inpatient. Methods : 1,108 Psychiatric inpatients at 2 mental hospitals in Yongin city were studied from September, 2008 to January, 2009. We diagnosed 'polydipsia' using staff reports(fluid intake>3L/day) or by specific gravity of urine(SPGU<1.008) and diagnosed 'at risk for water intoxication' using normalized diurnal weight gain (NDWG>4%). We attempted to identify clinical characteristics of patients by reviewing their medical records. Results : Two hundred forty seven patients(22.3%) were polydipsic. Sixty eight patients(6.1%) were at risk for water intoxication. The factors associated with polydipsia were lithium, smoking, younger age and increased smoking amounts. The factors associated with risk for water intoxication were valproic acid and polydipsia. Conclusion : Polydipsia and water intoxication in psychiatric inpatients are not rare conditions. Therefore, clinicians' attention should be paid to these conditions.

• 동서간호학연구지
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• 제17권2호
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• pp.110-116
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• 2011

Purpose: This study aimed to examine the effects of education program by illness on perception of illness and knowledge of medication in psychiatric inpatients. Methods: The research design was a non-equivalent and non-synchronized control group design. For this research, a total of 50 subjects was selected at a psychiatric unit of C university hospital in U-city. The experimental group consisted of 24 subjects and they received education program by illness 1 session per a week for 4 weeks. The remaining 26 subjects were assigned to the control group and they received standard services except the education program by illness. In data analysis, SPSS/WIN 15.0 program was used. Results: The experimental group significantly improved compared to the control group in perception of illness and knowledge of medication. Conclusion: This study results suggest that education program by illness could be effective to improve perception of illness and knowledge of medication in psychiatric inpatients.

• Journal of Preventive Medicine and Public Health
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• 제36권1호
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• pp.33-38
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• 2003

Objectives : To assess the difference in the volume of psychiatric treatments provided to health insurance inpatients, compared with those on medical assistance(the medical aid program) Korean psychiatric hospitals, and to determine factors which affect the volume of the services. Methods : 21 psychiatrists, from 3 Korean psychiatric hospitals recorded the frequencies psychiatric treatments provided to inpatients in one week (February 18-24, 2002). The records of 329 patients were analyzed through t-tests, and random effectmixed model analyses to define the difference between the two groups, and to find other factors affecting the volume of service. Results : A significant difference in the volume of psychiatric treatments provided was observed between the health insurance and medical assistance groups. The variation in the volume of service between hospitals was prominent, and other factors (gender, agegroup, length of stay and mental disorder)were also found to be significant. The patients on medical assistance received only 70% of the psychiatric treatments of those on health insurance. Conclusions : More effort is required to improve the methods of payment to increase the level of fee scheduling for medical assistance. Further studies on the mechanisms causing these differences in the volume of service are required.

• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.579-582
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• 2013

Background: In this study our aim was to determine the rate of smoking in a sample of psychiatric in-patients with diagnoses of schizophrenia, bipolar disorder and major depression and to examine factors related to smoking status and the level of dependence in this population. Materials and Methods: A total of 160 people were included in this descriptive study. 80 were inpatients with schizophrenia, bipolar disorder and major depression and 80 people without any psychiatric diagnoses were included as a control group. The participants were interviewed face-to face using a semi-structured questionnaire and Fagerstrom Test for Nicotine Dependence was used to define smoking habits. Results: The mean age of the participants was $37.24{\pm}12.19$ years ranging from 18 to 81 years, 54.4% of the participants were (n=87) female, and 45.6% cases (n=73) were male. 70% (n=56) of the patients and 55% of the control group were smoking and the difference was statistically significant (p<0.01). Total score of Fagerstrom Test for Nicotine Dependence in the patient group was statistically significantly higher than in the control group (p<0.01). Conclusions: In our sample, the frequency of cigarette smoking and nicotine dependence among psychiatric inpatients was high, posing a high risk for smoking related diseases including cancers; therefore there should be counseling on tobacco control and smoking cessation programming targeting this population.

• 대한간호학회지
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• 제50권2호
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• pp.200-209
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• 2020

Purpose: The purpose of this study was to examine the effects of oral gargling with an aromatic solution on xerostomia, objective oral status, and oral health-related quality of life in psychiatric inpatients. Methods: A nonequivalent control group with a non-synchronized design was used in this study. The experimental group (n=34) received oral gargling with an aroma solution, while the control group (n=33) gargled with 0.9% normal saline. Dependent variables were measured at pre-, post-, and follow-up test. Data were analyzed using an χ²-test, Fisher's exact probability test, t-tests, and repeated measures ANOVA using SPSS/WIN v.21.0. Results: After the intervention, significant differences were revealed in xerostomia (F=15.30, p<.001), objective oral status (F=38.44, p<.001), and oral health-related quality of life (F=62.70, p<.001) with an interaction effect between group and time. Conclusion: These findings indicate that gargling with an aroma solution is more effective than 0.9% normal saline for the oral health of psychiatric inpatients. Therefore gargling with an aroma can be safely recommended as a brief, economical, and positive intervention in clinical settings.

• 대한간호학회지
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• 제30권6호
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• pp.1580-1591
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• 2000

This study was conducted to assess the amount of nursing services for psychiatric inpatients and to estimate psychiatric nursing costs by using the RBRVS. Full details of medical services, including physician and nursing services, for psychiatric inpatients were surveyed and data of general characteristics of hospitals and patients were also collected. The cost of nursing activities was estimated by the multiple conversion factor which was drawn from the Korean RBRVS Development Project to the RBRVS score of each nursing activities, which was drawn from the results of Korean Nurses Association (KNA)'s projects about nursing RBRVS development and cost of nursing activities. The data about 89 inpatients from 3 general hospitals with psychiatric departments were analyzed. The total cost of nursing activities for each patient per admission day was from KRW 22,185 to KRW 27,954 by hospital, and KRW 25,220 in average. The percent of nursing cost to the total cost of medical services was from 36% to 48% by characteristics of patients and 41.4% in average. The cost of nursing activities estimated in this study was between the existing NHI fee schedule and the one suggested by KNA. It is considered as appropriate and acceptable level compared to the total amount of medical services. In the process of KNA's activities to get nursing fee in NHI fee schedule, results of additional studies to estimate the cost of nursing activities balanced with total cost of medical services in every departments should be found and utilized.