• 보건행정학회지
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• 제22권3호
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• pp.315-346
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• 2012

The legal relationship between patient and physician is legally equal relationship. But, in times past, patients be compelled to sign an unequal contract, substantially. Because of the imbalance between supply and demand in the health care market. Today, the law of supply and demand in the health care market is running well. And as the cognition of citizens' rights grows, the relationship between patient and physician can also get a lot of changes. Patients have the right to know the information about medical care, and to decide whether or not to get treatment including invasions against their own bodies. In other words, Doctors have an obligation to explain to their patients. If doctors did not provide patients sufficient explanation or information, it violates the right of patients. This is a tort, or a breach of contract. To improve the remedy for violation of patient's right, patient is able to be protected by status as consumer. If patient is a kind of consumer in terms of medical consumption, he/she as consumer can enjoy supplementally the consumer's right. The patient as a consumer can exercise now a consumer's right as a constitutional right. In addition, with respect to consumer's rights, Framework Act on Consumers was enacted. This Act is based on constitutional provisions of Article 124 and the Act can be seen as a law that embodies consumer right because the provision of the constitutional law delegates specific contents. In the health care field, patients need to win recognition the statue of the consumer to hold the sovereignty of the consumer. In particular, if patients are consumers, they may be able to make good use of the quickly and efficiently collective dispute resolution and association lawsuit to rescue their damage, the Alternative Dispute Resolution(ADR) of Framework Act on Consumers.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1373-1377
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• 2016

Background: We vigorously reviewed patients' operation record who had adhesion of the Denonvilliers' fascia and found out most of these patients had prostatic bleeding after prostatic gland biopsies. We examined the magnitude of prostatic bleeding and frequency after biopsies and the relationship with oncological outcomes. Materials and Methods: A total of 285 patients were selected for the final analyses. Inclusion criteria were as follows: receiving MRI three weeks after biopsiesand laparoscopic radical prostatectomy within 300 days after biopsy. We divided the patients into two groups with (group A) or without (group B) prostatic bleeding. We examined the magnitude of prostatic bleeding after biopsies and the relationship with operation time (OT), positive surgical margin (PSM), biochemical recurrence (BCR) and other factors. Furthermore, we created a logistic-regression model to derive a propensity score for prostatic bleeding after biopsies, which included all patient and hospital characteristics as well as selected interaction terms, and we examined the relationship with PSM and BCR. Results: In all patients, the OT in the group B was shorter than the group A (p < 0.001). Prostatic bleeding was associated with PSM (p=0.000) and BCR (p=0.036). In this propensity-matched cohort, 11 of 116 patients in the group B had PSM as compared with 36 of 116 patients from group A (match-adjusted odds ratio, 4.30; 95%CI confidence interval, 2.06 to 8.96; P=0.000). In addition, eight of 116 patients in group B encountered BCR, as compared with 18 of 116 patients in group A (match-adjusted odds ratio, 2.48; 95%CI, 1.03 to 5.96; P=0.042). Kaplan-Meier analysis in the propensity matching cohort showed a significant biochemical recurrence-free survival advantage for being free of prostate bleeding after biopsies. Conclusions: Our findings in the present cohort should help equip surgeons to pay attention to careful excision especially for those who experienced deferred prostatic bleeding.

• 성인간호학회지
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• 제13권2호
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• pp.209-222
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• 2001

The environment in the ICU leads to negative changes in a patient's usual sleep pattern and so contributes negatively to the patient's health condition as compared to patients in general wards. Therefore, it is thought that an important nursing intervention would be to identify the relation between noise and sleep patterns which play an important role in illness recovery. The purpose of the present study was to explore the relationship between noise in the ICU and the sleep pattern of patients admitted to the ICU. A descriptive correlation design was used to examine the relationship. Thirty-four subjects were recruited from a Medical ICU (MICU), Surgical ICU (SICU) and Coronary Care Unit (CCU) at a large university hospital in Suwon. Data were collected from September 28 to October 31 in 1999. In the present study, noise was categorized into noise level and patients' perception of noise. The objective noise level was measured using the A-Weighted Sound Level Meter. The patients' preception of noise was measured using a self-reported questionnaire developed by the researcher. Sleep patterns in this study includes both quantity and quality of sleep. These were measured using open ended questionnaires and the 'Korean Sleep Scale A' developed by Oh, Song, Kim(1998). The data was analyzed using the SPSS-WIN to test the research question, Pearson product moment correlation coefficient was run. Ancillary analysis were conducted with demographic variables to determine their relation to the main study variables. For the ancillary analysis, t-test and one-way ANOVAs were performed. The results of the present study are summerized as follows : 1. The total mean of objective noise level (10pm-6am) was 56.2dB. The means for night time noise level in individual ICUs for the SICU, MICU and CCU, were 58.7dB, 58.6dB and 48.3dB, respectively. The total mean for patients' noise perception was 42.8 out of a maximum possible score of 76. For item means of noise perception, the one ranked highest was "conversations between doctors and nurses" (3.2). The one ranked lowest was "noise from the radio" (1.2). Regarding the degree of perception for each type of noise source, the one ranked highest was "equipment noise" (2.6), the second was "conversation between medical staff" (2.4), the third was "conversation between patients, caregivers and visitors" (2.3), and the one ranked lowest was "environment noise" (1.8). 2. Looking at quantity of sleep of ICU patients, the mean nocturnal sleep time was found to be 4.9 hours. The total mean of sleep quality for ICU patients was 21.0 out of a maximum possible score of 40. 3. The relationship between perception of noise and quantity of sleep was statistically significant(r= - .41, p<.05). The relationship between perception of noise and quality of sleep was also statistically significant(r= - .47, p<.01). The results of the study indicate that personal perception of noise is related to sleep patterns. Therefore, it is suggested that nursing interventions be developed to reduce the degree of personal perception of noise and, thus, decrease sleep pattern disturbances in patients in the ICU.

• Clinical and Experimental Pediatrics
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• 제60권2호
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• pp.38-44
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• 2017

Purpose: Kawasaki disease (KD) is an immune-related multisystemic vasculitis that occurs in children, especially ensuing from a coronary artery abnormality. Sodium level is known to be related to vascular injury, which could affect the progress of KD. The purpose of this study was to determine the serum sodium levels that could predict the occurrence of cardiac and coronary artery events in KD. Methods: We conducted a retrospective review of medical records for 104 patients with KD from January 2015 to December 2015. Patients with serum Na levels of <135 mEq/L at the time of initial diagnosis were assigned to the hyponatremia group. Laboratory findings and echocardiographic data were analyzed for various aspects. Results: Among the 104 patients with KD, 91 were included in the study, of whom 48 (52.7%) had hyponatremia. The degree of fever, white blood cell count, percentage of neutrophils, percentage of lymphocytes, total bilirubin level, brain natriuretic peptide level, erythrocyte sedimentation rate, and C-reactive protein level were higher in the patients with hyponatremia. They also demonstrated a trend of larger coronary artery diameters based on Z scores. Conclusion: The severity of vascular inflammation in acute KD with hyponatremia might worsen the prognosis of coronary vasculature. Although no statistically significant correlation was found between the initial serum sodium levels and coronary arteriopathy in the patients with KD in this study, a long-term follow-up study with a larger number of enrolled patients should be designed in the future to elucidate the relationship between serum sodium level and coronary arteriopathy in patients with KD.

• 성인간호학회지
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• 제14권3호
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• pp.378-389
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• 2002

Purpose: The purpose of this study was to identify the relationship of fatigue and quality of sleep in patients with cancer. Method: The data was collected from January to February 2001. Study objects were recruited K university hospital in Busan, Korea. Their fatigue was measured using the Revised Piper Fatigue Scale developed by Piper et. al(1998), and quality of sleep was measured using Quality of Sleep Questionare by Oh et. al(1998). Result: 1) The fatigue score was mean $114.80{\pm}34.88$(range: 22-220). The sub dimension that showed behavior/severity score at $33.70{\pm}13.89$, affective score at $24.23{\pm}3.33$, sensory score at $27.74{\pm}12.51$, and cognitive/mood score at $29.11{\pm}3.71$. And sleep quality score was mean $37.32{\pm}8.18$. 2) There was a significant difference in religion(F=4.157, P= .008), present therapy(F=2.536, P= .043), past therapy(F=6.625, P= .000), major caregiver(F=3.133, P= .028), and change of weight(F=7.965, P=.006), according to general characteristics in the fatigue in patients with cancer. 3) There was a significant difference in present pain(t=-2.103, P= .037) and change of weight(F=5.484, P=.005), according to general characteristics in the sleep quality in patients with cancer. 4) There was a significant negative correlation between fatigue and quality of sleep(r=- .340, P= .000). Conclusion: Patients with cancer experience in fatigue. Increase in fatigue are associated with decreases in quality of sleep. Nurses must provide patients with nursing care about the occurrence of fatigue and interventions to deal with sleep disturbance.

• Asian Pacific Journal of Cancer Prevention
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• 제15권18호
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• pp.7737-7740
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• 2014

Background: The neutrophil-to-lymphocyte ratio (NLR) is a strong predictor of mortality in patients with pancreatic, colorectal, lung, gastric cancer and renal cell carcinoma. The aim of this study was to determine the relationship between pathological complete response (pCR) and pretreatment NLR values in locally advanced breast cancer (BC) patients receiving neoadjuvant chemotherapy (NACT). Materials and Methods: Datawere collected retrospectively from the Akdeniz University School of Medicine Database for locally advanced BC patients treated with NACT between January 2000-December 2013. Results: A total of 78 patients were analyzed. Sixteen (20%) patients achieved pCR. Estrogen receptor (ER) positivity was lower in pCR+ than pCR-cases (p=0.011). The median NLR values were similar in both arms. The optimum NLR cut-off point for BC patients with PCR+ was 2.33 (AUC:0.544, 95%CI [0.401-0.688], p=0.586) with sensitivity, specificity, positive predictive value and negative predictive value (NPV) of 50%, 51,6%, 21,1%, and 80%, respectively. Conclusions: This study showed no relationship between the pCR and pretreatment NLR values. Because of a considerable high NPV, in the patients with higher NLR who had luminal type BC in which pCR is lower after NACT, such treatment may not be recommended.

• 성인간호학회지
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• 제13권2호
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• pp.233-246
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• 2001

Spiritual health is an important indicator in the quality of life of patients with cancer. The purpose of this study was to validate a Spiritual Health Inventory (SHI) for patients with cancer developed by Highfield (1989). The SHI was translated into Korean, back-translated into English. The study sample was 96 patients with cancer. The data were collected from September, 1999 to February, 2000 for 6 months. Statistic analysis was done with the SPSS PC+ (Version 10.0) program: descriptive statistics, factor analysis, Pearson correlation coefficient, and one-way ANOVA. The results are as follows : 1. The reliability score was examined using Cronbach's ${\alpha}$ and found to be .79. 2. Construct validity was examined using factor analysis. Four factors were identified and named : (1) Peace of mind (19.1% of variance), (2) Hope (9.7%), (3) Self-esteem (6.4%), (4) Trust (6.0%). The total of 41.2 percent of the variance. 3. The Pearson correlation coefficient score of 4 factors was between r = .24~ .42. 4. SHI was identified as multidimension, that is (1) The relationship with GOD, as absolute being, (2) the relationship with others, (3) the relationship within oneself. 5. There were differences in response in items especially related to GOD. The following recommendations can be made on the above findings : 1. Replicate with a minimum sample of 150 and test for concurrent validity. 2. Since spirituality is a dynamic concept, longitudinal study is also necessary. 3. Concept analysis using a qualitative study based on religious preference is recommended. 4. The items such as 12, 13, 15, 17, 19, 22, 24, 26 indicated conceptual ambiguity for Korean populations and further study is needed on item deletion or new items.

• The Journal of Korean Physical Therapy
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• 제16권1호
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• pp.14-31
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• 2004

The Purpose of this study was to investigate the change of lumbar extensor strength according to lumbosacral angle on chronic lumbar back pain patients. For this investigation lumbar extensor strength was administered to 60 patients who were diagnosed chronic lumbar back pain The subjects was to investigate lumbosacral angle in standing position and it were calculated lumbar extensor strength by using Medex. The result of this study summarized are as follows ; 1. Total experimental group exhibited significantly higher difference than control group in lumbar extensor strength among all degree lumbosacral angle. 2. In the relationship between experimental group and control group in lumbar extensor strength among lumbosacral angle, all degree difference was revealed II, I, III order. 3. In the relationship between experimental group and control group in lumbar extensor strength among lumbosacral angle, I group difference was did not. 4. In the relationship between experimental group and control group in lumbar extensor strength among lumbosacral angle, all degree among II group was noted significantly difference except 24, 72 angle. 5. In the relationship between experimental group and control group in lumbar extensor strength among lumbosacral angle, control group was revealed higher muscle strength 48, 60, 72 angle, however no significantly difference was noted 0, 12, 24 angle. The study was objected difference of other group in both of experimental and control group. Because lumbar extensor weakness with bad position was gradually increased back pain, to Maintain normal lumbosacral angle befor exercising lumbar extensor strength was most important.

• 종양간호연구
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• 제7권2호
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• pp.150-161
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• 2007

Purpose: This study was to assess the degree of infection prevention behaviors at home, and a relationship between those behaviors and barrier factors among cancer patients undergoing chemotherapy. Method: The data were collected from 92 cancer patients who were undergoing chemotherapy with more than two kinds of immunosuppressive agents at G university hospital in J city from February 17 to April 4, 2003. The instruments were the infection prevention behavior scale developed by researchers and the barrier factor scale by Gu et al. (2003). The data were analysed using mean, standard deviation, t-test, ANOVA, and Pearson's correlation coefficient by SPSS program. Results: The mean score of the behaviors for infection prevention was 2.61 of 4. The highest score was on the subscale 'rest and exercise', and the lowest score was on the subscale 'monitoring sign and symptom of infection'. And a negative correlation(r= -.208, p= .023) was found between infection prevention behaviors and barrier factors. The barriers correlated to infection prevention behaviors were mainly 'no habits' and 'no interest'. Conclusion: It seems that the degree of the behaviors for infection prevention was not performed enough to prevent infection among cancer patients. And there was negative relationship between infection prevention behaviors and barriers. We suggest to develop a nursing intervention program to enhance infection prevention behaviors through reducing the barrier factors.

• 종양간호연구
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• 제8권2호
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• pp.86-92
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• 2008

Purpose: This study was designed to investigate the body-image and quality of life in breast cancer patients with mastectomy. Methods: Data were obtained by self-reported questionaries from 110 patients undergone mastectomy from August 1 to 31, 2007. And data were analyzed using SPSS/PC WIN 12.0 program and frequency, percentage, mean, minimum, maximum, t-test, ANOVA, Scheffe test, Pearson's Correlation Coefficient were used. The results of the study were as follows; 1) Mean of Body image of the subjects was $52.54{\pm}6.67$ (range of scale; 17 to 85). Mean of quality of life was $118.01{\pm}34.37$ (range of scale; 0 to 10). 2) There was no significant difference with the score of body image by demographic and disease-related characteristics of subjects. 3) There was significant difference with the score of quality of life by the work type and economic status of subjects. 4) Relationship between body image and quality of life showed moderately strong positive correlation (r=0.408, p<0.0001). Conclusion: Mean of body image and of quality of life in mastectomy patients were moderate. Relationship between body image and quality of life showed moderately strong positive correlation. Therefore, for improving the quality of life, it is needed to improve body image in breast cancer patients with mastectomy.