• 대한간호학회지
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• 제45권6호
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• pp.783-801
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• 2015

Purpose: The purpose of this study is to provide a comprehensive overview of the various measures available for assessment of oxaliplatin-induced peripheral neuropathy (OXLIPN) and to evaluate the measurement properties of each assessment tool. Methods: A systematic review was conducted to identify existing measures for OXLIPN found in the databases of PubMed, Cochrane Library, Embase, RISS and KoreaMed. The quality of the 24 identified tools was evaluated based on their properties of measurement including content validity, internal consistency, criterion validity, construct validity, reproducibility, responsiveness, floor-ceiling effects and interpretability. Results: Ten (41.7%) of the 24 tools were identified as specific measures for assessing OXLIPN and the most popular type of measures were clinical grading systems by clinicians (58.3%) and only 29.2% of measures were identified as patient reported outcomes. The most frequently used tool was National Cancer Institute-Common Toxicity Criteria (NCI-CTC), but the validity of NCI-CTC has not been reported appropriately. Overall, the Neuropathic Pain Symptom Inventory (NPSI) received the best psychometric scores, and the Chemotherapy-induced Peripheral Neuropathy Assessment Tool (CIPNAT) and Functional Assessment of Cancer Therapy/Gynaecologic Oncology Group-neurotoxicity-12 (FACT/GOG-Ntx-12) followed NPSI. Conclusion: To select appropriate measure, evidences should be accumulated through the clinical use of tools. Therefore, practitioner and researchers are urged to report relevant statistics required for the validation of the currently used measures for assessment of OXLIPN.

• 품질경영학회지
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• 제51권4호
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• pp.531-550
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• 2023

Purpose: The unique nature of life-and-death healthcare services sets them apart from other service industries. While many studies exist on the relationship between healthcare services and customer satisfaction, most of them focus on mildly ill patients, ignoring the differences between critically ill and non-seriously ill patients. This study discusses the actual quality of healthcare services for patients who are facing life-threatening illnesses and are on life support, as well as their right to protection and dignity. Methods: The survey conducted to 149 patients with the four major illnesses: cancer, heart disease, brain disease and rare and incurable disease, those who have experiences with senior general hospitals. Results: The basic statistics of this study are adequate to represent the four major critical illnesses, and the reliability and validity of this study's hypotheses, which were measured by multiple items, were analyzed, and the internal consistency was judged to be high. In addition, it was found that the convergent validity was good and the discriminant validity was also secured. When examining the goodness of fit of the hypotheses, the SRMR, which is the standardized root mean square of residuals that measures the difference between the covariance matrix of the data variables and the theoretical covariance matrix structure of the model, met the optimal criteria. Conclusion: The academic implications of this study are differentiated from other studies by moving away from evaluating the quality of healthcare services for mildly ill patients and focusing on the rights and dignity of patients with life-threatening illnesses in four senior general hospitals. In terms of academic implications, this study enriches the depth of related studies by demonstrating the right to protection and dignity as a factor of patient-centeredness based on physical environment quality, interaction quality, and outcome quality, which are presented as sub-factors of healthcare quality. We found that the three quality factors classified by Brady and Cronin (2001) are optimized for healthcare quality assessment and management, and that the results of patients' interaction quality assessment can be used to provide a comprehensive quality rating for hospitals. Health and human rights are inextricably linked, so assessing the degree to which rights and dignity are protected can be a superior and more comprehensive measurement tool than traditional health level measures for healthcare organizations. Practical implications: Improving the quality of the physical environment and the quality of outcomes is an important challenge for hospital managers who attract patients with life and death conditions, but given the scale and economics of time, money, and human inputs, improving the quality of interactions and defining them as performance indicators in hospital quality management is an efficient way to create maximum value in the short term.

• 환경영향평가
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• 제28권4호
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• pp.373-386
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• 2019

본 연구는 금강 수계 주요 지류인 미호천수계를 대상으로 수계의 공간적 특성을 조사하고, 수질분석과 통계분석을 이용하여 수질에 영향을 주는 주요인을 파악하였다. 조사 대상은 미호천 수계의 본류에서 수질측정망을 운영 중인 7개 지점으로 선정하였고, 2012년부터 2017년까지 6년간 측정망 수온 등 16개 항목, 기상자료 등을 사용하여 다변량 통계분석을 실시하였다. 수질 분석 결과, 유기물질 지표인 BOD와 COD의 6년간 평균 농도는 환경부 수질 및 수생태계 생활환경기준(하천)과 비교하여 III등급(보통)으로 나타났다. 지점별 비교 결과 질소계열과 인계열의 농도는 상류 지점에서 가장 높게 나타났으며, 이후 감소하는 경향을 보이다 수리적, 지형적 영향으로 다시 증가하는 것으로 나타났다. 공간 및 수질 특성을 고려한 계층적 군집분석 결과, 총 3개의 군집으로 평가되었으며, 수계에 유입되는 오염원의 영향이 큰 것으로 나타났다. 각 군집과 본류 전체를 대상으로 실시한 주성분 및 요인분석 결과, 각각 3~4개의 주성분이 추출되었다. 요인분석 결과 제1요인은 본류와 Cluster1,3에서 질소계열 요인과 계절적 요인, Cluster2에서 질소계열 요인과 수온으로 나타나 미호천 수계의 수질에 가장 큰 영향을 미치는 인자는 질소계열의 농도인 것으로 나타났다.

• Journal of Preventive Medicine and Public Health
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• 제47권4호
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• pp.206-215
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• 2014

Objectives: The hospital standardized mortality ratio (HSMR) has been widely used because it allows for robust risk adjustment using administrative data and is important for improving the quality of patient care. Methods: All inpatients discharged from hospitals with more than 700 beds (66 hospitals) in 2008 were eligible for inclusion. Using the claims data, 29 most responsible diagnosis (MRDx), accounting for 80% of all inpatient deaths among these hospitals, were identified, and inpatients with those MRDx were selected. The final study population included 703 571 inpatients including 27 718 (3.9% of all inpatients) in-hospital deaths. Using logistic regression, risk-adjusted models for predicting in-hospital mortality were created for each MRDx. The HSMR of individual hospitals was calculated for each MRDx using the model coefficients. The models included age, gender, income level, urgency of admission, diagnosis codes, disease-specific risk factors, and comorbidities. The Elixhauser comorbidity index was used to adjust for comorbidities. Results: For 26 out of 29 MRDx, the c-statistics of these mortality prediction models were higher than 0.8 indicating excellent discriminative power. The HSMR greatly varied across hospitals and disease groups. The academic status of the hospital was the only factor significantly associated with the HSMR. Conclusions: We found a large variation in HSMR among hospitals; therefore, efforts to reduce these variations including continuous monitoring and regular disclosure of the HSMR are required.

• 한국응급구조학회지
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• 제22권2호
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• pp.79-91
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• 2018

Purpose: To assess the satisfaction of continuing education and need assessment according to job characteristics in emergency medical technicians (EMTs). Methods: A self-reported questionnaire was completed by 222 EMTs from May 28 to July 6, 2018. It consisted of questions on the method and need of continuing education, and satisfaction regarding education time, assessed using a 5-point Likert scale. Descriptive statistics, a chi-square test, and ANOVA were used to analyze the data. Results: The responses to questions on the method of continuing education (${\rho}=.000$), satisfaction of regarding the duration of continuing education (${\rho}=.029$), method (${\rho}$< .001), and topic (${\rho}=.000$) varied according to the differences in job characteristics of EMTs. Assessment and management of patients with multiple trauma ($4.17{\pm}.735$) emerged as the most important while license examination protocol for EMTs ($3.33{\pm}.968$) was rated the least important among topics for continuing education. Separation of continuing education (${\rho}$< .001), education method (${\rho}$< .001), education topic (${\rho}$< .001), and necessity of quality management of continuing education (${\rho}$< .001) differed according to the job characteristics of EMTs. Conclusion: It is important to provide a suitable program catering to the diverse requirements of EMTs. The education programs must be tailored to the needs of level 1 and level 2 EMTs separately. To improve the quality of education, it is necessary to evaluate the continuing effects.

• 한국문헌정보학회지
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• 제45권3호
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• pp.327-343
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• 2011

본 연구는 국회전자도서관의 품질을 평가하고 개선방안을 수립하기 위하여 평가 도구를 설계하여 품질을 측정하였고, 개선방안 도출을 위해 ISA(Importance-Satisfaction Analysis) 기법을 적용하였다. 국회전자도서관 품질 평가 도구는 선행연구들에 기반하여 콘텐츠, 서비스, 그리고 시스템의 품질 차원으로 구성하였고 각 차원의 세부적인 항목은 선행연구 및 이용자들의 요구사항 분석을 통해 설계되었다. 각 세부 항목에 대한 측정지표에는 DigiQUAL에서 사용하고 있는 중요도와 만족도가 사용되었다. 국회전자도서관 품질 평가는 질문지법을 통해 수집된 이용자 270명의 응답을 사용하여 Excel 2007과 PASW Statistics 18로 분석하였다. 그리고 측정된 품질 평가 값을 사용하여 국회전자도서관 개선방안 수립을 위해 ISA기법을 적용하였고 그 결과 국회전자도서관 품질 차원 및 세부항목들 중에서 유지, 집중, 저순위, 그리고 과잉 품질 영역을 도출하였다.

• 한국전문물리치료학회지
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• 제28권2호
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• pp.146-153
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• 2021

Background: Researchers have previously commenced examining the degree of concordance between parent proxy and child self-reports on health-related quality of life (HRQOL) of many disease and impairment populations. Objects: To explore the differences between parent proxy and child self-reports on the HRQOL using Korean version of KIDSCREEN-10 questionnaires for applying to elementary school children and their parents who participated for a school-based wellness program. Methods: The focus groups were recruited for a school-based wellness program by implementing the following wellness services: 1) referring to a screening session for detecting potential posture-related musculoskeletal problems and 2) recommending home exercise programs. Before a primary field testing for the program, two focus groups were formed with a group of 9 parents and their 9 elementary school children aged 8-10 years of age. The parent proxy and child self-report versions of KIDSCREEN-10 questionnaires were administered to both groups after completion of the wellness program. Item level Rasch rating scale analysis was applied to compute logit scales of KIDSCREEN-10 questionnaire. Intraclass correlation coefficients (ICCs) and scatterplot of item difficulty between two reports were analyzed. Results: For fit statistics of parent proxy report, all items except 4 items (i.e., psychological well-being, mood/emotions, self-perception, parent relation) were found to be acceptable. For fit statistics of child self-report, all items except 3 items (i.e., psychological well-being, autonomy and home life) were acceptable. The relationship between two reports using ICCs were ranging from weak to very strong at p = 0.05 (i.e, ICCs = 0.011 to 0.905). Scatterplot analysis between two reports showed a major disparity on self-perception item at 95% confidence intervals. Conclusion: Both item level analyses and ICC comparisons provided a disparity between parent proxy and child self-reports of the HRQOL on self-perception item after competing a school-based wellness program. Therapist should consider the item as part of the HRQOL assessment.

• 디지털융복합연구
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• 제18권9호
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• pp.265-275
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• 2020

손상부담은 우리사회에서 매우 심각한 것으로 널리 인식되고 있다. 그럼에도 불구하고 손상감시에 필요한 데이터가 충분하지 않다. 이 연구의 목적은 손상감시를 위해 핵심 데이터를 선택하고 보완하는 것이다. 이를 위해 본 연구에서는 통계품질 6가지 차원에 따라 '사망원인통계', '건강보험통계', '퇴원손상조사'에 대한 품질평가보고서 등의 문헌을 분석 하였다. 분석결과는 '사망원인통계'와 '건강보험통계'가 손상감시를 위한 핵심데이터로서 유용성이 있다는 것이다. 그러나 '건강보험통계'에는 손상외인에 대한 데이터가 부족하다는 단점이 있다. 단점을 보완하기 위해, 본 연구에서는 국민건강보험 의료비 청구 시 의료기관이 손상외인을 의무적으로 신고하도록 하는 제도를 제안한다. 이 제도의 결과로서 우리는 '손상 피라미드 구축', '국민연금과의 데이터 연계', '손상 데이터의 시의성 향상'을 기대할 수 있다. 그리고 이 제도 실현을 위한 후속 연구를 기대한다.

• 한국의료질향상학회지
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• 제10권2호
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• pp.164-175
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• 2003

Objectives: To evaluate the performance of models to predict AMI patients death using severity adjustment measures in Korea. Methods: Medical records of 861 patients treated by AMI in 7 general hospitals during 1996 and 1997 were reviewed by trained nurses. We measured the severity of patients by APACHE III, MedisGroups, CSI and DS. Using each severity method a predictive mortality for each patient was calculated from a logistic regression model including the severity score. The statistical performance of each severity method model was evaluated by using c-statistics and R2. For each hospital, z scores compared actual and expected mortality rates. Results: The overall in-hospital mortality was 14.5%, ranged from 10.0% to 22.2%. The distributions of severity scores for each method was significantly different by hospitals. The four severity-adjusted models to predict AMI patients death varied in their statistical performance for discrimination power of patients death. Order of Severity-adjusted mortality rates and z scores by four severity measures was different. Conclusion: Severity-adjusted mortality rates of AMI patients might be applied as an indicator for hospital performance evaluation in Korea. Because different severity methods frequently produce different impressions about relative hospital performance, more studies has to be done to use it as quality indicator and more attention should be paid to select appropriate severity measures.

• 기본간호학회지
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• 제16권2호
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• pp.153-161
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• 2009

Purpose: The purpose of this study was to identify the predictors of Quality of Life (QOL) among workers in public health corporations. Methods: Data were composed of 213 office workers in three public enterprise in Seoul. Data were collected from February 11 to March 20, 2007. Data were analyzed with descriptive statistics, t-test, ANOVA, Pearson correlation and stepwise multiple regression using SPSS Win 12.0 program. Results: The mean QOL of the study participants was 82.60. The QOLs of the workers were significantly different according to perceived health status of workers and working hours per week. The QOL of the workers was negatively related to working hours, job stress, and depression, and positively related to the health status, self-esteem, and health promotion lifestyle (HPLS). Significant predictors of QOL were HPLS ${\beta}=.420$), depression (${\beta}=-.291$), self-esteem (${\beta}=.261$), and hours of work per week (${\beta}=-.114$), which explained 63% in the variance of QOL. Conclusion: These results suggest that strategies to enhance HPLS could improve the level of QOL. Further investigations of the direct relationship between QOL and health promotion program is warranted.