• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.11
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• pp.126-136
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• 2018

The purpose of this study was to develop a severity-adjustment model for predicting mortality in acute stroke patients using machine learning. Using the Korean National Hospital Discharge In-depth Injury Survey from 2006 to 2015, the study population with disease code I60-I63 (KCD 7) were extracted for further analysis. Three tools were used for the severity-adjustment of comorbidity: the Charlson Comorbidity Index (CCI), the Elixhauser comorbidity index (ECI), and the Clinical Classification Software (CCS). The severity-adjustment models for mortality prediction in patients with acute stroke were developed using logistic regression, decision tree, neural network, and support vector machine methods. The most common comorbid disease in stroke patients were hypertension, uncomplicated (43.8%) in the ECI, and essential hypertension (43.9%) in the CCS. Among the CCI, ECI, and CCS, CCS had the highest AUC value. CCS was confirmed as the best severity correction tool. In addition, the AUC values for variables of CCS including main diagnosis, gender, age, hospitalization route, and existence of surgery were 0.808 for the logistic regression analysis, 0.785 for the decision tree, 0.809 for the neural network and 0.830 for the support vector machine. Therefore, the best predictive power was achieved by the support vector machine technique. The results of this study can be used in the establishment of health policy in the future.

• The Mathematical Education
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• v.38 no.2
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• pp.165-172
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• 1999

$\sub$e/$\^$2/, that were results from those three sources of such imperfection. Especially to eliminate the differences in severity among many raters the randomization procedure of raters sample was very effective in enhancing the reliability of ratings with comparatively small groups of examinees and raters. And we also introduced the new rating methods, i.e. the 2-step diagnostic procedures to check the sizes of the reliability stability of raters and the sore adjustment method to enumerate the optimal mean values in rating the examinees.

• The Korean Nurse
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• v.36 no.4
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• pp.88-99
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• 1997

Applying effective coping strategies and reducing powerlessness for the chronic pain adjustment of musculoskeletal patients were researched for basic data in the development of nursing intervention. The subjects were 99 musculoskeletal patients with chronic pain. Data was gathered with direct interview using a questionnaire. With the SAS tool. data were analyzed for percentage. Pearson correlation. t-test. and ANOVA according to characteristics of variables. Internal consistency(alpha) coefficients were .91 for coping scales and .71 for powerlessness scales. The results are as follows: 1. Pain duration was mainly 6 - 12 months(52. 5%). 2. Primary pain site was mainly lower limbs(58.6%) and pain severity was a moderate level. 3. The preference of coping strategies was decreased in the order named in resting. seeking social support. exercise or stretch. guarding. and asking for assistance. 4. The longer pain duration. the more the coping strategies of asking assistance used. This was stastically significant(F=3. 35. p<.05). 5. The group with the experience of hospital admission was more powerless than the group without that(F=3. as. p<.01). 6. Pain severity and powerlessness were significantly positively correlated(r=.444. p<.001). Coping strategy applying and powerlessness were significantly negatively correlated(r=-. 288. p<.01). In consequence. the nurse should playa role as the supporter of patient's maximal usage of his resources in pain relief. adjustment, and control. The nurses should also develop for the nursing intervention of physical therapy and educational programs.

• Journal of Korean Academy of Nursing
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• v.30 no.3
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• pp.694-708
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• 2000

The main purpose of this study was to identify the relationship of self efficacy and social support to the psychosocial adjustment in people with epilepsy. Data were collected from October 1 to October 15, 1999 from 101 people with epilepsy who were being treated regularly at one of the university hospitals located in Seoul. The research instruments were a questionnaire to gather demographic and disease-specific data, the Epilepsy Psycho- Social Effects Scale developed by Chaplin et al(1990), the Epilepsy Self Efficacy Scale developed by DiIorio et al(1992a) and translated by Park(1999), the Norbeck Social Support Questionnaire developed by Norbeck et al(1981) and translated by Oh(1985). Data were analyzed using the SPSS program. The results are as follow : 1. Of the 14 psychosocial adjustment areas, 75 of 101 subjects experienced problems in ten or more areas and 28 in all 14 areas. The severity of the psychosocial adjustment problem was moderate or more in six areas. 2. The score for self efficacy was an average of 1103.86 out of a possible 1800, for social support 117.57 for total functional out of a possible 720, and 48.21 for total network out of a possible 264. There were an average of five people on the network. The main network people were parents, brothers and sisters, spouse, friends. 3. Of the 14 psychosocial adjustment areas, six areas correlated with self efficacy and 'problems with taking medication' area had a negative correlation with social support. In conclusion, people with epilepsy have various problems in psychosocial adjustment. Nursing interventions using self efficacy should be developed to improve psychosocial adjustment in people with epilepsy. Also, instruments and interventions for regimen-specific supports which are suitable for epilepsy should be developed.

• Journal of Korean Clinical Nursing Research
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• v.20 no.3
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• pp.290-302
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• 2014

Purpose: The purpose of this study was to identify sexual activities of males with spinal cord injury (SCI) and influential factors of sexual adjustment. Methods: A correlational survey was conducted among a total of 135 males with SCI. Results: After SCI, patients maintained low levels of sexual adjustment, and a main obstacle of sexual rehabilitation was decreased erectile function (65.2%). Sexual desires recovered in 84.4%, with 62.4% patients reporting more than once intercourse experiences. The erectile function of participants with normal, decreased or no erectile function were 13.0%, 62.6% and 24.4%, respectively. 8.1% of the participants reported no problem with ejaculation. Patients with incomplete SCI had better preserved erectile function than those with complete SCI (t=-4.627, p<.001). Patients with upper motor neuron injury had better preserved erectile function than those with lower motor neuron injury (t=2.446, p =.016). Sexual adjustment was relevant to age, job, degree of injury, post-injury period, sexual desire, intercourse experience, erection therapy, erectile function, and sexual health. Sexual adjustment was a factor of sexual health with a power of 24.2%. Conclusion: The main obstacle of sexual rehabilitation for males with SCI decreased erectile function. Erection and ejaculation are dependent on the severity and level of SCI. The major influence on sexual adjustment is sexual health.

• Journal of Korean Society for Quality Management
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• v.39 no.3
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• pp.391-399
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• 2011

Our study was carried out to analyze the variation factors of severity-adjusted length of stay(LOS) in coronary artery bypass graft(CABG). The subjects were 932 CABG inpatients of the Korean National Hospital Discharge In-depth Injury Survey from 2004 through 2008. The data were analyzed using $x^2$ test and the severity-adjusted model was developed using data mining technique. The results of the study were as follows: male(71.1%), older than 61 years of age(61.6%), more than 500 beds(92.8%) and admitting via ambulatory care(70.0%) appeared to have higher rate than otherwise. In-hospital mortality of CABG inpatients was 2.8%. In addition, 46.4% of the patients received their care in other residence. The angina pectoris(45.6%) was found to be the highest in principle diagnosis, followed by chronic ischemic heart disease(36.9%) and acute myocardial infarction(12.0%). We developed severity-adjusted LOS model using the variables such as gender, age and comorbidity. Comparison of adjusted values in predicted LOS revealed that there were significant variations in LOS by location of hospital, bed size, and whether patients received the care in their residences. The variations of LOS can be explained as the indirect indicator for quality variation of medical process. It is suggested that the severity-adjusted LOS model developed in this study should be utilized as a useful method for benchmarking in hospital and it is necessary that national standard clinical practice guideline should be developed.

• Journal of Korean Academy of Nursing
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• v.34 no.4
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• pp.636-645
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• 2004

Purpose. A natural disaster negatively affects children's emotional and behavioral adjustment. The purpose of this paper was to examine the prevalence, symptoms, and correlates of PTSD after the occurrence of Typhoon Rusa. Method. 261 elementary school children living in Kimcheon, which was a devastated rural area in South Korea by Typhoon Rusa, were selected. Data were collected 4 months after the disaster using the PTSD Reaction Index categories recommended by Frederick, severity of PTSD. Results. 12.3% of the children had either moderate or severe PTSD symptoms; 22.7% reported mild symptoms; and the remaining 65% had sub-clinical symptoms of PTSD. The most frequent symptom was recurrenct fear(67.0%). 13% to 17.2% of children exhibited difficulty in concentration, sleep disturbance, and guilt feeling. The regression model of severity of PTSD was composed of the level of exposure to traumatic experiences, grade in school, gender, negative coping style, and social support, and explained 34.3% for PTSD symptoms. Exposure to traumatic experiences was the strongest factor of all predictors. Conclusion. Emotional support from friends and coping style were correlated with PTSD severity. School-based interventions that emphasizes coping with disaster related problems and problem-solving may prove to be useful, and may aid in building close and supportive ties with teachers, classmates, and friends.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.6
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• pp.2668-2676
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• 2011

In order to analyze the variation in length of stay(LOS) of injury inpatients, we developed severity-adjusted LOS model using Korean National Discharge In-depth Injury Survey data of Center for Disease Control. Appling this model, we calculated predicted values and, after standardizing LOS using the differences from the actual values, analyzed the variation in LOS. Major factors affecting severity-adjusted LOS of injury inpatients were found to be severity, surgery(or no surgery), age, injury mechanism and channel of hospitalization. Result of analysis of the differences between the actual values and predicted values adjusted by decision tree model suggested that there were statistically significant differences by hospital size(number of beds), type of insurance and location of institution. In order to reduce the variation in LOS, efforts should be exerted in developing nationwide treatment protocol, inducing medical institutions to utilize it, and furthermore systematically evaluating it to reduce the variation continually.

• Journal of Preventive Medicine and Public Health
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• v.34 no.1
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• pp.21-27
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• 2001

Objectives : To develop a model that will predict the mortality of patients undergoing Coronary Artery Bypass Graft (CABG) and evaluate the perfermance of hospitals. Methods : Data from 564 CABGs peformed in six general hospitals were collected through medical record abstraction by registered nurses. Variables studied involved risk factors determined by severity measures. Risk modeling was performed through logistic repression and validated with cross-validation. The statistical performance of the developed model was evaluated using c-statistic, $R^2$, and Hosmer-Lemeshow statistic. Hospital performance was assessed by severity-adjusted mortalities. Results : The developed model included age, sex, BUN, EKG rhythm, Congestive Heart Failure at admission. acute mental change within 24 hours, and previous angina pectoris history. The c-statistic and $R^2$ were 0.791 and 0.001, respectively. Hosmer-Lemeshow statistic was 10.3(p value=0.2415). One hospital had a significantly higher mortality rate than the average mortality rate, while others were net significantly different. Conclusion : Comparing the quality of service by severity adjusted mortality rates, there were significant differences in hospital performance. The severity adjusted mortality rate of CABG surgery may He an indicator for evaluating hospital performance in Korea.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.32 no.4
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• pp.144-153
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• 2021

Objectives: Anxiety disorders are the most common psychiatric disorders in adolescents and seem to occur the earliest among all forms of psychopathology. The aim of this study was to investigate the association of anxiety severity with health risk behaviors and mental health in adolescents. Methods: Data from the 2020 Korean Youth Risk Behavior Web-Based Survey were analyzed. A total of 54948 adolescents responded to the 7-item Generalized Anxiety Disorder Scale (GAD-7) for the assessment of their anxiety severity as well as to the mental health and health risk behavior survey. Logistic regression analysis, t tests, and variance analysis of a complex sample general linear model were used to examine the association of anxiety severity with health behaviors and mental health. Results: After statistical adjustment for sociodemographic characteristics, the subjects in the severe anxiety group were significantly more likely to be current smokers (odds ratio [OR]: 2.08, 95% confidence interval [CI]: 1.72-2.50), current drinkers (OR: 1.91, 95% CI: 1.67-2.19), experience habitual substance use (OR: 10.89, 95% CI: 8.22-14.42), have sexual intercourse (OR: 2.10, 95% CI: 1.76-2.51), and have unprotected intercourse (OR: 2.21, 95% CI: 1.67-2.92) than those in the normal group. Anxiety severity negatively correlated with sleep satisfaction and happiness, but positively correlated with stress perception, loneliness, depressive symptoms, and suicidality. Conclusion: Adolescent anxiety is associated with health risk behaviors and poor mental health. Thus, early screening and intervention for anxiety in adolescents could contribute to the management and coping of youth health risk behaviors in the community.