• Title/Summary/Keyword: critical care nursing

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Research on Current Execution of Customer Support Knowledge Management System of Medical Appliances Industry

  • Chung, Yi-Chan;Tsai, Chih-Hung;Tien, Shiaw-Wen;Lin, Lin-Yi
    • International Journal of Quality Innovation
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    • v.8 no.3
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    • pp.46-70
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    • 2007
  • Customer Support Knowledge of Customer Support Organization is one of the important assets of enterprises and "Customer Support Knowledge Management" is also the critical aspect of Business Knowledge Management; however, the attributes of Customer Support Knowledge are complicated, diverse, renewed rapidly and difficult to be managed. Thus, in order to design a successful Customer Support Knowledge Management System, apart from the consideration of "human" and "information technology" aspects, the concerns of attributes and Customer Support Knowledge and industry characteristics should be involved for meeting the requirements of Customer Support Organization and allowing the organization to acquire the competitive advantage of "Differentiation Service". This research used the "Customer Support Knowledge Management System" in a high-tech industry as an example and treated the end users of medical instruments in different types of hospitals in Taiwan which have received the support service of our company in recent six months as the population. The end users were mostly the nursing executives or ultrasonic wave technical personnel in intensive care unit and they had similar educational background and incomes and adopted the medical instruments such as physical supervision system, ultrasonic wave system, heart start or ECG machine produced by our company; the research method was to randomly treat the investigation results of the telephone customers' satisfaction from respective 30 end users in the population three months before and after this system execution as the samples and use hypotheses to validate if the end users' customer satisfaction significantly improved in terms of "Remote Support," "On-site Support," "Service Turn Around time," "Technical Competence" and "Manner" in order to understand the influence and managerial significance of execution of "Customer Support Knowledge Management System" on Customer Support Organization.

Effects of Farinelli Breating Exercise on Respiratory Function and Symptoms in Patients with Chronic Obstructive Pulmonary Disease

  • Ittinirundorn, Supawit;Wongsaita, Naiyana;Somboonviboon, Dujrath;Tongtako, Wannaporn
    • Tuberculosis and Respiratory Diseases
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    • v.85 no.2
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    • pp.137-146
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    • 2022
  • Background: Farinelli breathing (FB) exercise is a typical breathing exercise used by singers. This study aimed to compare effects of FB exercise and diaphragmatic breathing (DB) exercise on respiratory function and symptoms in patients with chronic obstructive pulmonary disease (COPD). Methods: Sixteen patients aged 51-80 years with mild or moderate COPD were recruited for this study. They were divided into two groups: DB group (n=8) and FB group (n=8). Both groups received complete breathing exercise training five times per week for 8 weeks. Their respiratory functions, COPD symptoms, cytokine levels, and oxidative stress variables were analyzed during pre- and post-tests. Dependent variables were compared between pre- and post-tests using paired t-tests. An independent t-test was used to compare variables between the groups. Differences were considered significant at p<0.05. Results: The maximal expiratory pressure (MEP), maximum oxygen consumption (VO2max), and COPD Assessment Test (CAT) scores changed significantly in the DB group after the 8-week intervention compared to those at pre-test, whereas force vital capacity, forced expiratory volume in the first second, maximum voluntary ventilation, maximal inspiratory pressure (MIP), MEP, VO2max, CAT score, tumor necrosis factor-α, and malondialdehyde level changed significantly in the FB group at post-test compared to those at pre-test. Moreover, both MIP and MEP in the FB group were significantly higher than those in the DB group. Conclusion: FB exercise improved respiratory functions and COPD symptoms of patients with COPD. It might be an alternative breathing exercise in pulmonary rehabilitation programs for patients with COPD.

The Hospital Life of the Patient with Femoral Neck Fracture (대퇴경부 골절 환자의 입원 생활)

  • Kim, Kyung-Ja;Chi, Sung-Ai
    • Journal of Korean Academy of Nursing Administration
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    • v.2 no.1
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    • pp.35-56
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    • 1996
  • Nowerdays, the increase of traffic accidents and old age population make the Femoral Neck Fracture(FNF) patients increase. By the improvement of education and standard of living the patients demand better medical service than before. This study is designed to give practical help for the FNF patients by observing their hospital life and establish practical nursing strategies for the FNF patients. For these purposes the Ethnographic Participant Observation was adopted. By this study is focused on the hospital life patient's view. For this end, the field study adopted orthopedic ward in the C University Hospital with 400 beds in Seoul. The object patients of the study were twelve patients. The patients experienced five stages : Embarrassment, Conflict, Stability, Independent, and Extension Stage. The findings and prepared nursing strategies are stated as follows. First, in the Embarrassment Stage they suffered embarrassment, anxiety, pain, they could not do ordinary things. The patients who accidental fractures had anxiety from unfamiliar tests and from hospitalization itself. They lamented that they could not ordinary things, and do nothing but obeying the hospital, and endure the pain. They recognized the changed environment and resigned themselves to life in the ward. In this stage, full openness by the nurses is needed. Second, the attribute of the Conflict Stage were conflict, fear, curiosity, belief, reflection. When they sign the consentment form, they experience conflicts about the possibility of complication, fear of recovery from anesthesia, curiosity about the operation procedure, post - operation state, reflection on their past life, and promise to care for their family members after discharge and keep their religious life faithfully. And they accepted the operation depending on God, believing in modern medicine, and the surgeon. Asking for their changed informations, they expected positive results from the operation. In this stage, an empathic attitude by the nurses is needed. Third, the attribute of the Stability Stage were relief, gratitude, difficulty with excretion, and pain. When they awoke from anesthesia, they felt relief because of a the end of the operation, but they experienced extreme pain, difficulty of excretion in bed. They accepted the changed environment and expected recovery. In this stage, support by the nurses is needed. Fourth, the attributes of the Independence Stage were freedom, exercise, nurturing, anxiety, and discomfort. When they ambulated and exercised, they experienced freedom. They showed exhibited weakness of the digestive organs and discomfort hospital's space, structure, and facilities, the delay of medical certificate issue the lack of prompt response by the medical agents. They ate nurturious food and felt anxiety on the end of hospital life and returning to their ordinary life. They showed the independence of overcoming their environment by increasing exercise and expected their discharges. In this stage, respect by the nurses is needed for the patients to, overcome their environment and prepare for their independence. Fifth, the attributes of the Extension Stage were pessimism, isolation, dissatisfaction, and pain. Accompanied injury and old age made their ward life extend to over seven weeks. They exhibited weariness, melancholy, skeptisis, general pessimistic feeling, and desperation caused by their isolated life. They experienced the digestive discomfort caused by the prolonged medication and psycological pain caused by long-time hospitalization. As a, result, their dissatisfaction on the human, physical, and systematic environments had been increased. They acquired critical power and sought for something to do spending their time. They expected vaguely about the returning of their ordinary life. In this stage, counseling is needed by the nurse to overcome positively their psychological, social, and physical problems. The process of the FNF patient's ward life starts from the dependent state, when they are hospitalized, and gradually progresses to self-fulfillment in order to keep independent life. As a result, the FNF patients showed "Response in Challenge" or "Adaptation in Conflict" through their experiences of social, physical, and psychological difficulties.

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Development of Case Management System and Analysis of Economic Feasibility under the Fee-For-Service Reimbursement (행위별 수가 지불제도 하에서의 사례관리시스템 개발 및 경제성 분석)

  • Choi, Mi Young;Chae, Young Moon;Tark, Kwan Chul;Kim, In Suk;Chun, Ja Hae
    • Quality Improvement in Health Care
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    • v.11 no.1
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    • pp.46-60
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    • 2004
  • Background : Recently, we have experienced various changes in the healthcare environment. Healthcare organizations are facing a financial crisis due to more competitive relationships among themselves as well with low health insurance fees. The purposes of the current study were: (1) to develop a data warehouse-based system for evaluating and monitoring the case management activities, and (2) to measure and analyze its effects. Methods : In order to collect the data for the study, the database on discharged patients was utilized at a university hospital located in Seoul from June 1, 2002 through December 31, 2002. Initially, a data warehouse was built for the case management system. The case management activities were analyzed using structured methodology to establish the case management system. Results : The findings of this study were as follows: (1) A case management system was developed to make it possible to monitor of healthcare quality and resource utilization. The Case management System included monitoring functions regarding utilization reviews, critical pathways, and clinical indicators. (2) Utilizing the case management system, unplanned readmissions were documented among total discharged patients during two months from November 1, 2002 through December 31, 2002. The unplanned readmission rate was 2.3%(276 patients) in total of 11,960 discharged patients. Among them 81 patients(0.7% of total discharges, 29.3% of unplanned readmission) were readmitted to the same physician in charge under the same diagnosis. No significant differences were found in the demographic variables such as gender and age among the patients. (3) After implementing the case management system, 2.9% of average length of stay reduced. Applying cost-benefit analysis, the 2.9% reduction of length of stay represents net profit of ${\backslash}$ 279,592,000 in the year of 2004. In addition, applying value acceleration analysis, cumulative net benefit of ${\backslash}$ 1,481,000,000 was expected by the year of 2007. Also we were able to expect ${\backslash}$ 247,800,000 of cumulative benefit for the prospective 5 years in value linkage analysis. It represents average ${\backslash}$ 787,700,000 of pure net benefit a year. Conclusion : The value of present study would be not only implementing the knowledge management system into the existing case management activities, but also evaluating its effects and estimating its financial benefits. This study suggested that the case management system would be a supportive tool for monitoring and improving the quality of healthcare, and a cost-effective tool for increment of healthcare organization's financial benefit.

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Analysis of Changes in Skin Dose During Weight Loss when Tomotherapyof Nasopharynx Cancer (비인두암 토모테라피 시 체중 감소에 따른 피부선량 변화 분석)

  • Jang, Joon-Young;Kim, Dae Hyun;Choi, Cheon Woong;Kim, Bo-Hui;Park, Cheol-Soo
    • Journal of the Korean Magnetics Society
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    • v.26 no.3
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    • pp.99-104
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    • 2016
  • For patients receiving chemotherapy and radiation therapy treatment progresses as vomiting, nausea, weight of the patient because of a loss of appetite it is reduced. The patient's weight and the distance from the skin and the treatment site is expected to be closer, thereby reducing the change in the skin because of this dose. This study tests using a loose see the difference between the volume change appears as the weight of the patient using the same phantom and the phantom body of the patient. To using the same as the position EBT film is attached to the skin of the treatment site and was adjusted to the thickness of the Bolus. And using a computerized treatment planning only tomotherapy equipment was passed under the conditions according to the thickness of the radiation dose. To baseline for accurate reproduction position using the MVCT was applied to treated with verification. By passing a total of three dose reduced the error, it was a measure of the film by using a dedicated scanner, EBT VIDAR scanner. Got an increase in the skin dose is displayed each time the thickness of the bolus reduced, in a bolus was completely removed with the highest value. If the changes appeared dose was greater weight loss patients to chemotherapy and therefore bolus thickness variation considering the weight loss of the patient when applying the tomotherapy of nasopharynx cancer was found that the increase in skin dose be increased. This large patient before treatment due to weight loss over the image verification is considered to be established should consider how to re-create your mask and treatment plan for fixing it.

Elderly Residents' Behavior Problems as Experienced by Volunteers Working in Low-Income Welfare Facilities (자원봉사자가 경험한 저소득층 복지시설 거주노인의 문제행동)

  • Lee, In-Soo
    • Journal of Families and Better Life
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    • v.25 no.1 s.85
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    • pp.127-144
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    • 2007
  • This study was conducted for the purpose of analyzing volunteer workers' perceptions of and attitudes toward the behavior problems of the elderly residents after caring for the residents voluntarily at low-income nursing homes. Eleven male and female volunteers ranging from age 19 to 52 were asked how they felt about the elderly residents' behavior problems and what kind of behavioral problems they had experienced after doing volunteer works in the three chosen facilities. In particular, they were expected to explain what emotional changes they experienced during their volunteer service. In this study, it was observed that most of the elderly subjects experienced three categories of behavior problems: habitual, repetitious and unreasonable activities caused by the elderly residents' life span backgrounds, unexpected and/or abrupt behaviors resulting from gradual cognitive impairments, and physiological, awkward activities caused from gradual senility. The volunteers tend to believe that the elderly residents are naturally expected to act positively, since they have been provided with well- planned, regular care services such as bathing, counseling, activity programs, and religious guidances. On the other hand, some respondents stated that their experiences at the nursing homes caused them to form negative images of the elderly; they feel that the elderly are not helpful for giving advices on critical decisions, guiding and encouraging their daily lives, and offering any positive influences toward their own lives. Rather, they find themselves getting too much stressed as a result of their intimate contacts with demented or senile residents. Overall, in this study, it is proposed that education for confronting sudden abrupt behavior problems should be intensified more for female volunteers, since they tend to be more susceptible to emotional harassment resulting from the problem behaviors. It is also proposed that young volunteers who have not been systematically trained for confronting aggressive behaviors need to be separately assigned their roles in order to minimize the potential of confronting unseemly situations resulting from male residents whose mental health has deteriorated. Furthermore, it is also suggested that the combination of leisure-related activities for healthy residents and stressful intimate services for the frail residents be systematically planned and implanted for the volunteer program so that the volunteers can lessen the chances of suddenly finding themselves confronted with extremely abrupt agitations.

A Study on The Extent of Alienation Revealed among A Group of Aged People in Seoul City (서울시내 일부 노인들의 소외정도에 관한 조사연구)

  • 김행자
    • Journal of Korean Academy of Nursing
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    • v.4 no.2
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    • pp.32-43
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    • 1974
  • A steady increase in the aged population poses a great challenge to nurses with their diversities of health care needs, especially of psychological nature, such as an alienation problems among the aged. The purpose of this study is to examine the nature of alienation problems among the aged in urban areas to provide basic informations for a better understanding of aged people. In this study, the investigator has tried to identify causes of alienation in the aged, and to determine the extent of alienation in relation to sex, family structure, religion, economic status and participation in social activities. The survey was done during the period from the last part of August to the end of September 1973. After a day's training, 10 interviewers have interviewed 210 stratified random samples of people over the age of 65 residing in Seoul with the free-ended questionnaire prepared by the investigator. The result of the study was tested by Critical Ratio. Following Hypothesis have guides formulation of the study: I. The extent of alienation in old man would be higher than in old woman, II. The extent of alienation in the aged who live alone would be higher than those living with their family. III. The extent of alienation in the aged who have no spouse would be higher than who live with their spouse. IV. The extent of alienation in the people without religious beliefs would be higher than the people with religious biles. V. The extent of alienation in the aged would be higher in proportion to decreased level of their economic productivity. Ⅵ. The extent of alienation in the aged who do not participate in social activities would be higher than that of the aged who actively participate. The analytic results of the study are as fellows: 1. The extent of alienation in woman was revealed higher than that of man by showing significant difference at P〈0.01 level. (CR=3.66) Accordingly hypothesis I was denied. 2. The extent of alienation in the aged wile live alone was revealed higher than that of the aged who live with their family by showing a significant difference at P<0.01 level. (CR=7.31) So hypothesis II was supported. 3. The extent of alienation of the aged who have no spouse was revealed higher than that of the aged who live with their spouse at the significant level of P <0.01. CR=4.65) Accordingly hypothesis III was supported, 4. There was no significant difference in the extent of alienation between the people with and-without religion. Thus hypothesis IV was rejected. 5. The extent of alienation in the aged was found to be higher in proportion to decreased level of their economic ability. a. The aged with greatest income showed least alienation b. The aged with no income had a greater extent of alienation than the aged with minimal income by showing significant difference at P <0.01 level . (CR=4.82) c. The difference between the greatest income group and the minimal income group was. found to be less significant than the difference between minimal income group and the-people without income. Thus hypothesis V was positively supported. 6. The extent of alienation in the aged who do not participate in social activities was higher than that of the aged who actively participate. (P <0.01, CR=6.24) According1y hypothesis Ⅵ was supported.

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Factors Affecting Suicidal Ideation in Elderly Attending Community Senior Centers (노인정을 이용하는 지역사회 노인들의 자살생각에 대한 영향 요인)

  • Shin, Jin-Ui;Baek, Seolhyang
    • Journal of agricultural medicine and community health
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    • v.38 no.2
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    • pp.71-84
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    • 2013
  • Objectives: As suicide among the elderly population has been a critical issue in Korea, this study aimed to evaluate correlations of suicidal ideation with protective and risk factors among elderly who reside in a rural community. Methods: A total of 157 elders from Gyeongju city, who had attended senior centers in, were enrolled to answer questionnaires including the Geriatric Depression Scale Short Form-Korea and the Scale for Suicidal Ideation. Data were analyzed using SPSS 18.0K for Windows, and included t-test, Pearson correlation, and a three-step hierarchical multiple regression analyses. Results: Using the hierarchical regression analyses for predicting the elderly's suicidal ideation, male gender and social group variables were entered as predictors in the first step(adjusted $R^2$=0.107, P<0.05). Pain, ADLs, family support variables were not entered in the second step. Depression variable was the only predictor in the third step(adjusted $R^2$=0.384, P<0.001). Conclusions: Although this study confirmed the impact of depression on the suicidal ideation, elderly with risk factors including male gender and social isolation should receive a special attention from community health care professionals.

Older Parents with Disabled Adult Children in Later Life: Health and Welfare Needs (성인장애자녀를 돌보는 저소득 노인부모의 보건복지 욕구)

  • Kim, Eunhye;Suk, Min-Hyun;Youn, Jung-Hye
    • 한국노년학
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    • v.30 no.4
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    • pp.1213-1223
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    • 2010
  • The purpose of this study is to explore and describe the health and welfare needs experienced by old parents living with disabled adult children, and to help generate research interest and public policy attention on this critical issue. For the purpose of this study, the survey was conducted with older parents who are living with dependent adult children with physical or mental disability. Among collected data for this study, data for 105 older parents were analyzed. The results showed that older parents have suffered with care responsibilities for their disabled adult children as well as special needs resulted from their old age. And older parents have little or even nothing prepared for later life because of lifetime economic, physical and social difficulties related to their disabled children. Also these difficulties had a significant impact on their idea of health and welfare needs in later life. It showed that older parents had mainly concerned and wanted to have the direct cash benefits and medical provisions but hardly recognised the importance of other services such as leisure activities. Preliminary suggestions of this study therefore may be helpful to improve the public policy approach in order to better serve older parents with disabled adult children in the coming aging society.