• Journal of Korean Academy of Nursing
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• v.5 no.2
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• pp.1-10
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• 1975

Every patient, who enters the hospital has a potential for becoming anxious. The control of hospitalization anxiety experienced by hospital patients is considered to be an important factor in the process of recovery from illness. This study was conducted to investigate the relationship between informativeness and hospitalization anxiety in order to give basic data for psycho-social aspect of nursing care for hospitalized patients. One hundred patients admitted to Kyungpook National University Hospital during the period of Jan. to June 1975 were sampled and divided into two groups; fifty of experimental and fifty of control group. The set of informations prepared by the investigator were given additionally to experimental group while the control group only received routine informations. Both groups were rated according to the Hospitalization Informativeness Scale which consisted of 24 questionaries and 4 categories and Hospitalization Anxiety Scale one or two days prior to discharge from the hospital. The results of the study were as follows; 1 . Mean values of Hospitalization Informativeness Scale revealed significant differences at 0.01 level with experimental group showing higher mean value. Age, sex ana educational states aid not influence the mean values of Hospitalization Informativeness Scale in both groups. 2 . The length of hospitalization did not influence significantly on the mean value of Hospitalization Informativeness Scale in both groups. 3. Rank difference correlation coefficiently between mean value of Hospitalization Informativeness Scale and the importance of information the patient's perceived were revealed significant at 0.01 level in all 4 categories such as admission discharge, treatment and nursing activities, diagnostic test, diagnosis and prognosis, health teaching for the patient and family in experimental group. While, only two categories such as treatment and nursing activities and health teaching for the patient and family in control group were revealed significant correlation. 4. Mean value of Hospitalization Anxiety Scale revealed significant difference at 0.05 level with the experimental group showing lower Hospitalization Anxiety Scale. 5. Correlation coefficiently between Hospitalization Informativeness Scale and Hospitalization Anxiety Scale were revealed significant at 0.01 level in experimental group but there was no significant correlation in control group.

• Korean Journal of Clinical Pharmacy
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• v.33 no.1
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• pp.1-7
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• 2023

Background: Along with the increase in the elderly population, concerns about polypharmacy, which can cause medication-related problems, are increasing. This study aimed to find out the association between drug-related factors and readmission in elderly patients within 30 days after discharge. Methods: Data of patients aged ≥65 years who were discharged from the respiratory medicine ward of a tertiary hospital between January and March 2016 were retrospectively obtained. The medication regimen complexity at discharge was calculated using the medication regimen complexity index (MRCI) score, comorbidity status was assessed using the Charlson comorbidity index (CCI), potentially inappropriate medications (PIMs) were evaluated based on the Beer 2019 criteria, and adverse drug events (ADEs) were examined using the ADE reporting system. Multivariable logistic regression analysis was used to evaluate the effect of medication-related problems on hospital readmission after controlling for other variables. Results: Of the 206 patients included, 84 (40.8%) used PIMs, 31 (15%) had ADEs, and 32 (15.5%) were readmitted. The mean age, total medications, MRCI, CCI, and PIMs in the readmission group were significantly higher than those in the non-readmission group. Age significantly decreased the risk of readmission (odds ratio [OR], 0.89; 95% confidence interval [CI], 0.84-0.96) after adjusting for sex, length of hospital stay, and ADEs. The use of PIMs (OR, 2.38; 95% CI, 1.10-5.16) and increased CCI (OR, 1.50; 95% CI, 1.16-1.93) and MRCI (OR, 1.04; 95% CI, 1.01-1.07) were associated with an increased occurrence of readmission. Conclusion: PIMs were associated with a significantly greater risk for readmission than MRCI.

• Korea Journal of Hospital Management
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• v.6 no.2
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• pp.138-155
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• 2001

This study was designed to find out the factors which influence on the financial performance of the hospital. Out of 32 provincial hospitals which were established by the government, 10 hospitals were selected as sample hospitals. Ten hospitals were divided into two groups(5 hospitals each), one of which was profit-making and the other loss-making. The criteria in selecting profit or loss-making hospitals was net profit to total revenue. The major finding of the study was as follows; 1. Whether or not a hospital had specialized in certain departments was proved to be the major factor influencing on the financial performance. Three out of five profit-making hospitals could harvest following results by operating specific departments. (1) Man powers needed for the operation of specific departments were 14.6 persons per 100 bed, which was only 1/7 of the general hospital. (2) The number of doctors has not increased in proportion to the increase of the number of beds. (3) Ratio of total revenue to MD.'s payroll expenses of the profit-making hospitals was 75.0% higher than the loss-making hospitals. (4) The average length of stay of specific department was very long(388.1 days). However, the specific departments were found to have contributed much to the financial performance because the occupancy rate of such departments was very high(94.5%). 2. The headcount per 100 bed of the profit-making hospitals was 23.9 persons(24.0%) less than the loss-making hospitals and the ratio of payroll expenses to total revenue 15.1% less. 3. Averagel revenue per specialist of the profit-making hospitals was 100 million(25.1%) more than loss-making hospitals and the ratio of total revenue to MD's payroll expenses of profit-making hospital was 75.0% higher. 4. Profit-making hospitals have introduced new systems or renovation in 36 fields, such as incentive payment system, utilization of contracted man powers, change of the payroll structure of the nurses, specialization in certain departments, etc; however, loss-making hospitals introduced only 25 new systems or renovations. These kind of renovation could not be achieved without the cooperation of the labor union and the strong will of the top management. Therefore, it could be said that the labor union of the profit-making hospitals seems to have been very cooperative compared with that of loss-making hospitals.

• Women's Health Nursing
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• v.6 no.2
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• pp.234-257
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• 2000

At present in the medical care, the study and effort for producing health service to consider efficiency, effectiveness, and quality are urgently called for because of the difficulty in the keen competition according to the inter- nationalization and opening, the operation in the medical institution service testing system, the change in the medical policy of KDRGs, and the lack of the health care cost increasing rate. As an alternative, the case management for the new management system is introduced in the U.S., and the Critical Pathway that is the method designing the contents of activity and its result has been developed and applied in order to anticipate and manage the patient-outcome for the realization of the cost-effective case-management. Thus, this study intended to analyze the effectiveness to obtain by developing the Critical Pathway presented as the method to improve the quality-betterment and cost effectiveness through the continuous and consistent patient management for the hysterectomy patient and applying it to the real practice. As a study method, this author formed a conceptual framework through considering five Critical Pathway used in the current U.S. and three Critical Pathway presented in the literature to develop the Critical Pathway for the hysterectomy patient, and made out the preliminary Critical Pathway through reviewing the old chart. This author made the verified the validity of the expert group about the developed Critical Pathway, and to confirm the possibility of practice application, completed and settled the final Critical Pathway after using the Critical Pathway to the hysterectomy patient from March 1st to 15th, 1997. Finally, to analyze the application-effect of the developed Critical Pathway, this author offered health care service applying the Critical Pathway to the hysterectomy patient from April 15th to August 31th, 1997. The guide for the Critical Pathway was carried out in advance by outpatient setting nurse for outpatient setting visit before the operation, and after hospitalization the primary nurse monitored the execution degree on the every duty. After discharge this author surveyed the complication through phone visiting, and one month after discharge surveyed the patient's reaction about the offered service when outpatient setting visit and analyzed the result. The source for health care cost was obtained by the statistics about the hospital charge which was offered by the General Business Department. The results were as follows. 1. It was decided that the vertical line of the Critical Pathway was made up of eight items such as monitoring/assessment, treatment, line/drains, activity, medication, lab test, diet, patient teaching, and the horizontal line of the Critical Pathway was made up of from hospitalization to discharge. 2. After the analysis of service contents through reviewing the old chart, it was decided that the horizontal line of the preliminary Critical Pathway was made up of from hopitalization to fourth postoperative day, and the vertical line of it was divided into eight items which were the contents to occur with the time frame of the horizontal line. 3. After the verifying the validity of the expert group about the preliminary Critical Pathway, the horizontal line was amended from hopitalization to third postoperative day, and taking their consensus, some contents of the horizontal line was amended and deleted. 4. From March 1st to 15th, 1997, to confirm the clinical suitability, this author offered eight hysterectomy patients the medical service through the Critical Pathway. The result was that three of them could be discharged at the expected discharge day, and the others later than that day. Supplementing the preliminary Critical Pathway through analyzing the cause of that delay- case, this author developed the final Critical Pathway. 5. There were no significant differences between the experimental and the control group in the incidence of complication(P > 0.05). 6. The 92.4% of experimental group was satisfied with the Critical Pathway service. 7. The length of hospital stay of the experimental group offered with the Critical Pathway service was 4.6 days and there was a significant difference that it was 1.3 days shorter than that of the control group(t=-29.514, P=0.000). 8. There wsa a significant difference that the mean medical charge per one patient of the experimental group offered the Critical Pathway service was cheaper \124,150 than that of the control group(t=-9.826, P=0.000). 9. The result that the author assumed and analyzed hospital income with the rate of turning bed was assumed that the increase of hospital income was \63,245,072 for that study, and the income increase was expected with \68,704,864 for a year. The result that this author applied the Critical Pathway to the hysterectomy patient have no differences in the incidence of complication, high satisfaction with that service, and the length of hospital stay decreased in the experimental group, and the mean hospital charge per one patient decreased, but hospital income increased. Suggestions for further study and nursing practice are as follows. 1. The study to apply the Critical Pathway for a year, verify the validity, and measure the effect repeatedly is needed. 2. To apply and manage the Critical Pathway effectively, the study to computerize it is needed. 3. The study to develop hospital-based Critical Pathway about other diseases or procedure, and measure the effect is needed.

• Journal of Gastric Cancer
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• v.22 no.2
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• pp.135-144
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• 2022

Purpose: This study aimed to compare the surgical and oncological outcomes between totally laparoscopic pylorus-preserving gastrectomy (TLPPG) with intracorporeal anastomosis and laparoscopy-assisted pylorus-preserving gastrectomy (LAPPG) with extracorporeal anastomosis. Materials and Methods: A retrospective analysis was performed in 258 patients with cT1N0 gastric cancer who underwent laparoscopic pylorus-preserving gastrectomy using two different anastomosis methods: TLPPG with intracorporeal anastomosis (n=88) and LAPPG with extracorporeal anastomosis (n=170). The following variables were compared between the two groups to assess the postoperative surgical and oncological outcomes: proximal and distal margins, number of resected lymph nodes (LNs) in total and in LN station 6, operation time, postoperative hospital stay, and postoperative morbidity including delayed gastric emptying (DGE). Results: The average length of the proximal margin was similar between the TLPPG and LAPPG groups (2.35 vs. 2.73 cm, P=0.070). Although the distal margin was significantly shorter in the TLPPG group than in the LAPPG group (3.15 vs. 4.08 cm, P=0.001), no proximal or distal resection margin-positive cases were reported in either group. The average number of resected LN was similar in both groups (36.0 vs. 33.98, P=0.229; LN station 6, 5.72 vs. 5.33, P=0.399). The operation time was shorter in the TLPPG group than in the LAPPG (200.17 vs. 220.80 minutes, P=0.001). No significant differences were observed between the two groups in terms of postoperative hospital stay (9.38 vs. 10.10 days, P=0.426) and surgical complication rate (19.3% vs. 22.9%), including DGE (8.0% vs. 11.8%, P=0.343). Conclusions: The oncological safety and postoperative complications of TLPPG with intracorporeal anastomosis are similar to those of LAPPG with extracorporeal anastomosis.

• Journal of Hospice and Palliative Care
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• v.10 no.2
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• pp.78-84
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• 2007

Purpose: The prevalence of lung cancer is increasing continuously these days. We studied clinical characters of the terminal lung cancer patients who had died in hospice units and our study is the basic report for efficient hospice and palliative care to the lung cancer patients. Methods: We retrospectively reviewed the medical records of 129 terminal lung cancer patients who had died in Sam Anyang Hospice Unit from March 2003 to December 2006. The survival days during the hospice and palliative care were analyzed using Kaplan-Meier method of SPSS 13.0. Results: There were 93 males (72%) and 36 females (28%), and median age of patients was 68 years (range $37{\sim}93$). Eighty two patients (64%) took analgesics, the others 47 (36%) not. The most prevalent reason for admission was dyspnea (47 patients, 36%) and it was different from the terminally ill cancer patients being hospitalized because of pain. And the most common symptom was general weakness (103 patients, 80%). One hundred twenty of the paitents (93%) were administered opioid analgesics, and IV morphine shots were mostly used (103 patients, 80%). Sedation was used in 87 patients (67%), and midazolam was mostly used (68 patients, 53%). The median survival in hospice and palliative care was 35 days and the median hospitalization was 24 days. Conclusion: It is very important to manage dyspnea in terminal lung cancer patients. The length of hospice and palliative care for the terminal lung cancer patients is still short. Therefore continuous education and promotion of hospice and palliative care is needed for an effective care for the patients, their families and doctors.

• PNF and Movement
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• v.17 no.1
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• pp.47-56
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• 2019

Purpose: This study investigated the effects of neck pattern of proprioceptive neuromuscular facilitation (PNF) on balance and walking ability in patients with chronic stroke. Methods: Fourteen participants with chronic stroke were randomly assigned to vestibular rehabilitation and then divided into two groups: the neck pattern group or treadmill group. Each group underwent 20 sessions (20 minutes/day, five days/week, for four weeks). Patients were assessed with the Berg balance scale (BBS) and gait parameters (gait speed, cadence, step length, and double-limb support period) using a GAITRite system. Results: Vestibular rehabilitation for the neck pattern group and the treadmill group showed significant intragroup improvement on the BBS and in terms of gait speed, cadence, step length, and double-limb support period (p < 0.05). Vestibular rehabilitation was more effective for the neck pattern group than for the treadmill group in terms of the BBS (p = 0.00; 95% CI, 1.49-5.94), gait speed (p = 0.01; 95% CI, 0.05-0.16), cadence (p = 0.02; 95% CI, 0.54-4.99), and step length (p = 0.00, 95% CI, 1.55-4.62). Conclusion: This study used the neck pattern of PNF for vestibular rehabilitation in patients with chronic stroke. The results showed significant improvement in the patients' balance and walking ability. Therefore, the neck pattern of PNF for vestibular stimulation may be more effective than treadmill training to improve balance and walking ability in patients with chronic stroke.

• Journal of Trauma and Injury
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• v.37 no.1
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• pp.60-66
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• 2024

Purpose: This study investigated changes in interpersonal violence and utilization of trauma recovery services during the COVID-19 pandemic. At an urban level I trauma center, trauma recovery services (TRS) provide education, counseling, peer support, and coordination of rehabilitation and recovery to address social and mental health needs. The COVID-19 pandemic prompted considerable changes in hospital services and increases in interpersonal victimization. Methods: A retrospective analysis was conducted between September 6, 2018 and December 20, 2020 for 1,908 victim-of-crime patients, including 574 victims of interpersonal violence. Outcomes included length of stay associated with initial TRS presentation, number of subsequent emergency department visits, number of outpatient appointments, and utilization of specific specialties within the year following the initial traumatic event. Results: Patients were primarily female (59.4%), single (80.1%), non-Hispanic (86.7%), and Black (59.2%). The mean age was 33.0 years, and 247 patients (49.2%) presented due to physical assault, 132 (26.3%) due to gunshot wounds, and 76 (15.1%) due to sexual assault. The perpetrators were primarily partners (27.9%) or strangers (23.3%). During the study period, 266 patients (mean, 14.9 patients per month) presented before the declaration of COVID-19 as a national emergency on March 13, 2020, while 236 patients (mean, 25.9 patients per month) presented afterward, representing a 74.6% increase in victim-of-crime patients treated. Interactions with TRS decreased during the COVID-19 period, with an average of 3.0 interactions per patient before COVID-19 versus 1.9 after emergency declaration (P<0.01). Similarly, reductions in length of stay were noted; the pre-COVID-19 average was 3.6 days, compared to 2.1 days post-COVID-19 (P=0.01). Conclusions: While interpersonal violence increased, TRS interactions decreased during the COVID-19 pandemic, reflecting interruption of services, COVID-19 precautions, and postponement/cancellation of elective visits. Future direction of hospital policy to enable resource and service delivery to this population, despite internal and external challenges, appears warranted.

• Asian Oncology Nursing
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• v.4 no.2
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• pp.110-123
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• 2004

The purpose of this study was to develop a clinical pathway for the allogeneic bone marrow transplantation donor. For this study, a conceptual framework was developed through a review of the literature including six steps which are using in Jones Hopkins Hospital. USA. The researcher reviewed 129 medical re-cords of donor who had bone marrow donation between January 2002 to January 2004, to identify the overall service contents required by these patients and to make a preliminary clinical pathway. A content validity test was done for the preliminary clinical pathway, a professional group screened 51 medical re-cords and adopted with 3 hospitalization days as the clinical pathway framework. In the fifth step, clinical pathway test was also done to 7 donors from April 28th to July, 2004. After these processes the final clinical pathway was developed. The results of this study are as follows: 1. The vertical axis of the clinical pathway Includes the following 9 items: vital signs, nursing assessment, activity, diet, intervention, medication, test, consultation and patient teaching. The duration of the horizontal axis was 3days from admission to discharge 2. Analysis of the 129 medical records indicated that the average length of stay was 3 4 days. The medical performance according to the vertical axis in the preliminary clinical pathway consisted of 51 items After clinical validity test, it steel consisted of 51 items in the final form. 3. Clinical Validity test was done to 7 bone marrow donors. During these process, The first patient was deleted because he was out of the criteria the investigate set and 6 patients were used, finally The result of this study indicated all of 7 donors were discharged on expected day. 4. Clinical pathway enables to improve the quality of care, multidisciplinary team work It also helps nursing bone marrow donor, effective education to donor or medical member. The results of this study suggest that clinical pathway may be able to improve the quality of nursing care for bone marrow transplantation donors.

• Journal of Korean Academy of Nursing Administration
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• v.20 no.1
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• pp.117-127
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• 2014

Purpose: In order to provide a systematic and standardized treatment course for MVD patients, a critical pathway (CP) program was developed and the results of its long term application were analyzed. Methods: This was a methodological study. The CP was established and applied to 75 (step I) and 1,216 (step II). Another group of 56 with similar features was used as a control group. Results: The application of CP turned out to be useful in many regards: the rate of hearing loss was reduced from 1.8% to 0% (step I) and 0.5% (step II), and low cranial nerve palsy was reduced from 1.8% to 1.3% and 0.7%, respectively. The length of hospitalization decreased by 2.56 days (25.2%) for step I and 3.05 days (30.0%) for step II. Days of ICU stay were reduced by 7.9% and 1.8%. The total cost per patient was reduced by 14.8% (step I). The cost per day was increased by 13.7% and 52.4%. An increase in the patient satisfaction index was noted, as shown in the ICU information guide (p=.002). Conclusion: The development and application of CP was found to improve the quality of medical treatment and the efficacy of hospital management in MVD patients. Well organized and efficient system and multidisciplinary teamwork are the key component of the successful application of CP.