• Title/Summary/Keyword: Quality of Nursing care

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The effect of Type 2 diabetes management using a smartphone-based blood glucose management training program (모바일 자가혈당관리 교육프로그램을 이용한 2형 당뇨병 관리 효과 분석)

  • Lee, Jung-Hwa;Jung, Jin-Hee;Sim, Kang-Hee;Choi, Hee-Sun;Lee, Jeong-Rim;Kang, Yang-Gyo;Song, Bok-Rye
    • Journal of Industrial Convergence
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    • v.20 no.9
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    • pp.59-70
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    • 2022
  • Background: Diabetes education is an important factor in blood glucose control. Reinforced education is necessary for effective diabetes education. However, it is difficult to provide reinforced diabetes education within Korea's medical environment. Therefore, we want to analyze the effect of continuous diabetes education using mobile health care that can effectively provide repeated education without having to face the patient. Methods: This study is a multicenter, randomized, controlled, pre-post design study conducted to analyze the effect of a continuous diabetes education method. A total of 109 people were registered at five hospitals in south Korea, and they were randomly assigned to the app group (34 people) who received real-time coaching and repetitive training, the logbook group (37 people) who received face-to-face training after writing a blood glucose logbook, and the general group (38 people) who received a one-time diabetes education. The study was conducted for a total of 24 weeks. Twenty-one patients withdrew their consent and failed to perform an HbA1c. A final 88 patients were analyzed. The difference in HbA1c, Self-management behavior, and Quality of life before and after education was analyzed. Results: The study involved 51 (58%) male subjects, mean age was 55.8 years and mean duration of diabetes was 7.6 years. After 24 weeks of intervention, there was no significant difference in self-care behavior and quality of life between the three groups, but the HbA1c of the app group significantly decreased after education compared to the logbook group and the general group (F=4.62, p=.013). Conclusion: It can be seen through the app group that receiving real-time education is more effective in improving blood glucose management and continuous diabetes education is important.

Gender Difference in Quality of Life After Controlling for Related Factors among Korean Young-old and Old-old Elderly (한국 전·후기 노인의 삶의 질 관련요인과 성별 차이)

  • Chung, Younghae;Cho, Yoo Hyang
    • Journal of agricultural medicine and community health
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    • v.39 no.3
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    • pp.176-186
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    • 2014
  • Objectives: As a sequel to the former analysis of the quality of life (QoL) among young-old and old-old in Korea, this research was aimed to identify factors related to the quality of life and the gender difference after controlling for the related factors among Korean elderly. Methods: Selected elderly data of 1,339 subjects from the 5th Korea National Health and Nutrition Examination Survey conducted in 2010 was analyzed. In this survey, QoL was measured using Euro Quality of Life (EQ-5D) instrument. Data were analyzed using complex survey data analysis on IBM-SPSS 20.0. The related factors were identified using general linear models with backward elimination. The gender difference was tested also using general linear models. Results: The distributions of educational level, family income level, and presence of cohabitant were different between male and female elderly in both young-old and old-old age group. So were the health behaviors and perceived health, and experience of stress, depression, and suicidal thoughts. QoL and its subscales- mobility, self care, daily living, pain and discomfort, and anxiety and depression- were consistently better among male elderly regardless of age group. Among the variables considered, education, family income level, presence of cohabitant, perceived health, age group and BMI were found to be related to the QoL at p=.05, and presence of chronic diseases at p=.10. The difference in QoL between male and female elderly after controlling for the variables was statistically significant. Conclusion: Improving QoL is particularly important for the elderly. In order to improve QoL of the elderly, age- and gender- differences need to be considered when developing services and programs for the elderly.

An Importance-Performance Analysis of the Healthcare Reform on a Doctor-Designation System - Focused on the Perception of Medical Providers' at Tertiary Hospital in Seoul - (선택진료제도 개편에 대한 중요도-성취도 분석(IPA) - 서울시내 상급종합병원 의료종사자 인식을 중심으로 -)

  • Park, Hye Jin;Kim, Hyo Jeong;Kim, Young Hoon
    • Korea Journal of Hospital Management
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    • v.23 no.1
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    • pp.28-40
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    • 2018
  • Purpose: The purpose is to understand the perception of medical providers at tertiary hospitals in Seoul on the importance-performance of the reform on a doctor-designation system, and to provide the policy suggestion of the perception on such a system. Methodology: To achieve the purpose, this study utilized structured survey tools to conduct a questionnaire survey of nursing, administrative and medical technology professionals at six tertiary hospitals in Seoul. An importance-performance analysis was utilized for an analysis that showed the perception of the reform on a doctor-designation system. Findings: First, it was identified that those medical providers had the highest perception of the importance about the performance of the reform on a doctor-designation system. Second, according to the result of action grid of an importance-performance analysis (IPA), it can be identified that in the 2nd stage of 'Concentrate here' included are the items as to design and effect of medical care quality and subsidies & patient infection and safety and control fees, effect of income security of the method for compensating for loss established by the government and offering sufficient information on general medical services and doctor-designation medical services. In the 1st stage of 'Keep up the Good Work', and the 2nd stage of 'Concentrate here' included is the item as to the performance of patients of the reform on a doctor designation system. Practical Implications: There could be identified the effect of the reform bill on the perception of medical providers. It is expected that a better environment would be provided for patients to use a hospital and for medical providers to offer medical services, if the goverment makes efforts to improve methods for compensating for loss and continuous monitoring of the performance of patients.

Study of the Drugs Prescribed on Alzheimer's Disease: from the Insurance Claims Data of Korea National Health Insurance Service (우리나라 건강보험 청구자료를 이용한 알츠하이머성 치매 치료제의 사용현황 분석)

  • Kim, Jungeun;Lee, Jonghyuk;Jeong, Ji Hoon;Kang, Minku;Bang, Joon Seok
    • Korean Journal of Clinical Pharmacy
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    • v.24 no.4
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    • pp.255-264
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    • 2014
  • Objective: The aims of this study are to investigate the total volume of prescribed medicines against Alzheimer's disease (AD) and the trends of usage by analyzing the claims-data from the Korea National Health Insurance Service. Method: The demographic and claims-data were included the major AD treating medicines such as donepezil, galantamine, rivastigmine and memantine, and analyzed during the period of 2010~2012. The assessing criteria were gender, age, habitation, types of medical institution, code of ingredients, outcomes of treatment, volume and amount of claims, and the numbers of patients with dementias. After trimming the data, it were analyzed by the market size, demographic traits, characteristics of medical service, characteristics of each anti-AD medicine, etc. Results: Among the chosen 4 medicines, donepezil had the top prescription volumes. Most prevalent prescribing preparations of donepezil were conventional types. However, among the non-conventional types, oro-dispersible formulation is the fast increasing one in both volume and growth rate. This specialized preparations to improve both toleration and adherence, tend to being prescribed generally at the tertiary medical institutions. While the younger patients with mild-to-moderate AD mostly treated by expensive medicines in resident at the tertiary hospitals, the rest older patients with severe AD have been treated non-expensive one at long-term care facilities. Conclusion: AD is a chronic illness therefore, long-term use of therapeutic medications are highly important. If an anti-AD treatment was applied steadily in the earlier stages, it would be achieved not only improving the quality of life of patient but also reducing the expenses in the medical and nursing cares. As the socioeconomical impacts of AD is expanding, healthcare professionals need to aware the importance of pharmacotherapy and to improve sociopolitical fundamentals.

Clinical Guidelines to Diagnose and Manage Dental Patients with Hyposalivation and Xerostomia

  • Jeong-Kui Ku;Pil-Young Yun;Sungil Jang;Won Jung;Kyung-Gyun Hwang
    • Journal of Korean Dental Science
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    • v.16 no.1
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    • pp.9-22
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    • 2023
  • Xerostomia is defined as the subjective complaint of dry mouth with or without hyposalivation, which is insufficient salivary secretion from salivary gland. Xerostomia can lead to multiple oral symptoms such as dental caries, halitosis, burning mouth syndrome, and oral candidiasis, which can significantly impact the well-being of patients, especially in geriatric patients who may already have compromised health. Clinical findings of xerostomia include decreased salivary flow and alterations in salivary composition. These changes can lead to various oral health problems such as dental caries, periodontitis, swallowing and speaking difficulties, taste disturbances, halitosis, mucosal diseases, and burning mouth syndrome. Recognizing these clinical manifestations is essential for early diagnosis and appropriate management. Although several reasons and risk factors have been suggested for xerostomia such as aging, chemo-radiation therapy, systemic disease, and Sjögren's syndrome, the polypharmacy is recently highlighted especially in elderly patients. Understanding the etiology and risk factors associated with xerostomia is crucial for effective management. To manage xerostomia patients, a multidisciplinary guideline should be established beyond dental care. Through this literature review, we summarized consideration for diagnostic, therapeutic, nursing essentials for the clinical guideline. By addressing the underlying causes and implementing appropriate treatment strategies, healthcare professionals can improve the quality of life for individuals suffering from xerostomia.

Comparative Study of Hazardous Heavy Metal Contents by Cosmetic Type (화장품 유형별 유해 중금속 함량 비교 연구)

  • Lee, Jin hee;Kim, Ji Yeon;Park, Sang Gyu;Lee, Jae Ho;Yoon, Jong Ho;Kim, Gyoung Tae;Kim, Hae Jung
    • Journal of Environmental Health Sciences
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    • v.45 no.2
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    • pp.154-163
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    • 2019
  • Objectives: The hazardous heavy metal contents of cosmetics were investigated and the resulting values were compared by type of cosmetics: skin care preparations (SCP), hair preparations (HP), makeup preparations (MP), and eye makeup preparations (EMP). Methods: The hazardous heavy metal contents (Pb, As, Cd, Sb, Ni and Hg) were analyzed for 358 cosmetics products (187 SCP, 82 HP, 56 MP, and 33 EMP). Hg was measured by the amalgamation method, and other hazardous heavy metals were measured by inductively coupled plasma optical emission spectrometer (ICP-OES) after decomposition using the microwave method. Results: The mean contents of Pb, As, Cd, Sb, Ni, and Hg in cosmetics were 0.424, 0.068, 0.024, 0.398, $0.567{\mu}/g$, and Not Detected, respectively. All of the hazardous heavy metals were detected in most products, but below the recommended maximums of the Ministry of Food and Drug Safety. The level of Cd was the lowest at 14.8%, and Sb was the highest at 41.2%. Pb, Sb and Ni showed the highest mean value and detection rate in EMP. As, Cd, and Hg showed the highest in SCP, HP, and MP, respectively. Conclusion: Hazardous heavy metals were detected in most products. In particular, Pb, Sb, and Ni were broadly detected in EMP, meaning more stringent quality control is required.

Clinical Usefulness of Critical Patient Severity Classification System(CPSCS) and Glasgow coma scale(GCS) for Neurological Patients in Intensive care units(ICU) (Glasgow coma scale의 임상적 유용성 평가 - 중환자 중증도 분류도구 -)

  • Kim, Hee-Jeong;Kim, Jee-Hee;Roh, Sang-Gyun
    • Proceedings of the Korea Institute of Fire Science and Engineering Conference
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    • 2012.04a
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    • pp.190-193
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    • 2012
  • The tools that classify the severity of patients based on the prediction of mortality include APACHE, SAPS, and MPM. Theses tools rely crucially on the evaluation of patients' general clinical status on the first date of their admission to ICU. Nursing activities are one of the most crucial factors influencing on the quality of treatment that patients receive and one of the contributing factors for their prognosis and safety. The purpose of this study was to identify the goodness-of-fit of CPSCS of critical patient severity classification system(CPSCS) and Glasgow coma scale(GCS) and the clinical usefulness of its death rate prediction. Data were collected from the medical records of 187 neurological patients who were admitted to the ICU of C University Hospital. The data were analyzed through $x^2$ test, t-test, Mann-Whitney, Kruskal-Wallis, goodness-of-fit test, and ROC curve. In accordance with patients' general and clinical characteristics, patient mortality turned out to be statistically different depending on ICU stay, endotracheal intubation, central venous catheter, and severity by CPSCS. Homer-Lemeshow goodness-of-fit tests were CPSCS and GCS and the results of the discrimination test using the ROC curve were $CPSCS_0$,.734, $GCS_0$,.583, $CPSCS_{24}$,.734, $GCS_{24}$,.612, $CPSCS_{48}$,.591, $GCS_{48}$,.646, $CPSCS_{72}$,.622, and $GCS_{72}$,.623. Logistic regression analysis showed that each point on the CPSCS score signifies1.034 higher likelihood of dying. Applied to neurologically ill patients, early CPSCS scores can be regarded as a useful tool.

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Factors Associated with the Long-Stay Admissions in Geriatric Hospitals - Focused on Dementia's Inpatients - (요양병원 치매노인의 장기입원 관련 요인)

  • Lee, Yun Jin;Lee, Sang Gyu;You, Chang Hoon;Kim, Bomgyeol;Kim, Tae Hyun
    • Korea Journal of Hospital Management
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    • v.25 no.3
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    • pp.29-37
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    • 2020
  • Purposes: The purpose of this study was to identify the factors related to the long-stay hospitalization of dementia patients aged 65 years or older who had received inpatient care at geriatric hospitals according to the minute facility characteristics and patient features. Methodology: This study was conducted on 317,353 cases of 1,512 geriatric hospitals using the Health Insurance Review and Assessment Service dataset. The data collected were processed using the SAS Enterprise Guide 4.3 for descriptive statistics, the chi-square test, and the binary logistic regression analysis. Findings: As a result of the study, in the facility characteristics of geriatric hospitals, the long-stay hospitalization of the aged with dementia were found to be related to the type of facility establishment, the number of hospital beds, the number of medical specialists, the number of nursing personnel, and the number of geriatric hospitals by region and province. In the personal features of patients, the long-stay hospitalization was found to be associated with the gender, age, insurance, and the patient classification groups. Practical Implication: Considering the results of this study, it seems that securing the sufficient medical personnel in a geriatric facility, providing the good quality medical services, and preparing the appropriate discharge plan can reduce the unnecessary long-stay hospitalization and spend the medical expenses for the older patients.

Prerequisites on Smart Healthcare in the Perspective of Service Design : Focusing on the Elderly Experience Case (서비스 디자인 관점에서 본 스마트 헬스케어의 선행 조건 : 고령자 경험 사례를 중심으로)

  • Kim, Ho-Da;Joo, Ae-Ran
    • Journal of Information Technology Applications and Management
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    • v.28 no.3
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    • pp.49-58
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    • 2021
  • Due to the increasing interest in wellness aroused by the aging population and the pursuing feature of active old age, Korean elderly set importance on long life with their healthy condition. Following the change in the paradigm of the medical delivery system from hospital-oriented, treatment-oriented to personal-centered and self-care, Service design application of Smart Healthcare for the elderly became valuable. Smart Healthcare is a healthcare service provided through the fusion of ICT technologies including mobile/wearable devices, IoT, big data, and information technology, and it is utilized to prevent diseases managing abundant health information and living habits. As a methodology for delivering such Smart Healthcare to the elderly, Service design can be adopted. Therefore, this study would like to present the perquisites of Smart Healthcare design for the elderly through analyzing the results from in-depth interview methods between the elderly and medical staff. As a result of this study, guidelines for Service design application of health vulnerability management for the elderly utilizing smart phones were presented. Therefore, this study presented four prerequisites composed of 'high level of supplementation and ethical decision making', 'improvement of inequality in accessibility and experience', 'resolving problems in policy implementation' and 'user-friendliness' for the Smart Healthcare service design for the elderly. Overall, Service design is expected to play an innovative role in improving the quality of life for the elderly through the process of collecting and delivering information on Smart Healthcare centered on the experience of the elderly.

Development of Easily Chewable and Swallowable Pan-fried Flat Fish for Elderly (가자미 구이 저작·연하 용이 노인식 개발)

  • Kim, Soojeong;Joo, Nami
    • The Korean Journal of Food And Nutrition
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    • v.28 no.1
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    • pp.153-159
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    • 2015
  • This study was conducted to develop food for the elderly, which are well-shaped and easy to chew and swallow. The amounts of water and gelatin were adjusted to facilitate breaking down of the food with the tongue. In the aging society, it is necessary to support the development of a variety of products that can ease the intake functions of swallowing and chewing, while complementing with the essential nutrients supplements; such products can be actively commercialized in the elderly industry. Various types of food, for elderly with difficulties in chewing and swallowing, were used for sensory assessment. Sensory panel consisted of 10 dietitians (10 women) in nursing care facilities. The sensory optimal composite recipes were determined by central composite design (CCD). The sensory measurements were significantly different in the appearance (p<0.01), saltiness (p<0.01) and overall quality (p<0.01). The optimum formulation of pan fried flat fish, calculated by numerical and graphical method, was 8.54 g of salt and 6.34 g of olive oil. Moisture content, hardness, and adhesiveness of pan fried flat fish were 84.77%, 250, and -1.20, respectively. The result showed that easily chewable and swallowable pan fried flat fish for the elderly will have sufficient competitiveness, considering its safety, taste, and preference. This study may provide the basic materials for the development of easily chewable and swallowable foods for elderly.