• Title/Summary/Keyword: medical interview

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Relationship of Average Volume of Alcohol Consumption and Binge Drinking to Arterial Stiffness in Community-Dwelling Healthy Adults (지역사회 건강한 성인에서 알코올 섭취량 및 폭음과 동맥경직도의 관련성)

  • Kweon, Sun-Seog;Lee, Young-Hoon
    • Journal of agricultural medicine and community health
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    • v.37 no.1
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    • pp.23-35
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    • 2012
  • Objectives: The purpose of this study was to investigate the association of the average volume of alcohol consumption and binge drinking with arterial stiffness. Methods: The study population consisted of 5944 community-dwelling healthy adults aged 50 years and older. Average volume of alcohol consumption was calculated and frequency of binge drinking defined as the consumption of 7 or more drinks for men and 5 or more for women on a single occasion, was assessed using a structured interview. High brachial-ankle pulse wave velocity (baPWV), a marker of arterial stiffness, was defined as the highest gender-specific quartile of maximal baPWV distribution in the study population. Results: Compared to never drinkers, the multivariate-adjusted odds ratio (OR) of men who consumed 0.1-10.0, 10.1-20.0, 20.1-40.0, and >40.0 g/day was 0.93, 1.18, 1.38, and 2.36, respectively. The OR was 0.90, 0.97, 1.45, and 1.82 in women consuming 0.1-5.0, 5.1-10.0, 10.1-20.0, and >20.0 g/day, respectively. Binge drinking of <1 day/week (OR=1.66, 95% confidence interval [CI]=1.13-2.42) and ${\geq}1$ day/week (OR=1.61, 95% CI=1.04-2.50) were associated with increased risk for high baPWV in men, and binge drinking of ${\geq}1$ day/week (OR=3.12, 95% CI=1.16-8.34) was associated with increased risk for high baPWV in women. Conclusions: A J-shaped relationship between the average volume of alcohol consumption and high baPWV was observed, suggesting the detrimental effects of heavy alcohol drinking on arterial stiffness. Binge drinking was also significant risk factors for increased arterial stiffness, independently of the average volume of alcohol consumption.

Analysis of Nursing Activities and Cost of Nursing Service Based on the ABC System (활동기준원가계산(ABC)을 이용한 간호활동 분석 및 간호서비스 원가분석;일 산부인과 간호단위를 중심으로)

  • Kang, Kyeong-Hwa
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.2
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    • pp.389-400
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    • 1999
  • The purpose of this study is to examine a possibility of applying the ABC system to analyze the cost of nursing service on one obstetrics and gynecology (OB/GYN) unit in a major medical center. The activities of nurses on an OB/GYN unit were analyzed for 4 days for 96 hours. 2 week days and 2 days on weekend. Total cases included in the study were activities of 12 charge nurses and 12 staff nurses. Activities were categorized into direct and indirect activities in order to calculate the cost of activities. Nursing activities were defined multidimesionally in order to utilize the ABC system. The 60 nursing activities were classified into the direct nursing activities and the indirect nursing activities based on a literature review, interview, and survey results. The direct activities were further categorized into the single nursing activities and the multiple nursing activities. The indirect activities were classified into the indirect nursing service activities and the general management activities. The major findings of this study were as follows : 1. There were differences in activities according to the positions and duties of the nurses. The charge nurses mostly performed the indirect nursing service activities and the general management activities. Almost all of their indirect nursing activities spent on each patient were similar. The staff nurses performed the single nursing activities and the multiple nursing activities. 2. The activities of staff nurses included medication, patient assessment, rounding and organizing the unit. patient education, nursing treatment, admission and discharging of patients. There was no differences in types and amount of time spent between the nurses on day-time duty and evening-time duty, but the patient assessment activity increased during the night-time. 3. The cost of post partum nursing services for women who had a normal vaginal delivery using the ABC system included the cost incurred by direct nursing activities provided by the staff nurses (85.9%), indirect nursing activities incurred by the staff nurses(19.0%) and the nursing activities by the charge nurses and the head nurse(14.1%). The ABC system is a relatively new method of cost analysis. The results of this study can provide the nursing and hospital managers with useful information on cost control. It is suggested that more studies should be done using the ABC system and extend the scope of studies to include value analysis to aid the Activity-Based Management(ABM) and/or the reengineering of hospital process.

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The Phenomenological Study of Kidney Donors학 Experiences (신 공여자 경험의 현상학적 연구)

  • 김정화;유인숙;김명희
    • Journal of Korean Academy of Nursing
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    • v.25 no.2
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    • pp.222-243
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    • 1995
  • The purpose of this study was to present basic data in the nursing practice for the management of living kidney donor by understanding the nature and meaning of kidney donors, experiences. The research subjects were 11 living kidney donors who had donated from Mar 1991 to Feb. 1994 and discharged from the 3 hospitals in Pusan. Data has been collected by Intensive interview with donors. The data analysis has made by phenomenological method of Van Kaam for understanding the phenomenon and meaning of their experiences. The experiences of kidney donors were analyzed into the 4 situations, that is,'motivation of kidney donor', 'decision time to make kidney donation', 'pre-opperation','after donation'. The descriptive expression and common elements were drawn from original data of each situation on the basis of subjects' own words. From each situation, the com-mon elements of kidney donors' experiences were integrated, summarized and described as follows 1. Motivation of kidney donation They wanted to donate their kidney because of empathy of pain on the groung of love to the recipient and with exppectation of successful kidney transplant or as a solution of economic difficulty. 2. Experiences in deciding to make kidney do-nation In deciding to make kidney donation, donors had love toward the recipients. But they experienced conflict too. 3. Experiences before being operated on donated kidney In experiences from deciding to make kidney do nation to preoperation, donors had love toward the recipients. But they also felt anxiety or dissatisfaction. Therefore, they controlled their mind by their faith, support of medical staff or support of society. And they experienced regret for the sociological cognition or financial apprehension. 4. Experiences after kidney donation After kidney donation, donors experienced satis-faction and accompplishment in spite of mental and physical discomfortness, while they felt sense of loss / disappointment, repentance, regret, and apprehension of progress toward their condition. Thus, kidney donors donated their kidney on the ground of empathy and love to the recipient and with expectation of successful kidney transplant. But during the process of kidney donation, they ex perienced conflict, love, anxiety, regret, apprehension of economy. And after donation, they felt sense of satisfaction and accomplishment, while they felt sense of discomfortness, loss / disappointment, re-gret, repentance, or apprehension of progress toward their condition. This result contribute to nurses' role not only for the management of living kidney donors but also for the management of cadaver donors' family.

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A Study on the Rank of Stressful Events Related to the Experience of Hospitalization (입원환자가 경험한 입원스트레스 순위에 관한 연구)

  • 이소우;하양숙;박은숙
    • Journal of Korean Academy of Nursing
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    • v.15 no.1
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    • pp.17-29
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    • 1985
  • This study was to explore on the rank of stressful events related to the experience of hospitalization. 180 hospitalized patients on surgical and medical wards were asked to rate 49 stress-producing events associated with the experience of hospitalization. Two university hospitals was used as the setting for this study. Because the nature of the events in the stress scale pertain mainly to general short term hospitalizations, patients in the rehabilitation and psychiatric units of the hospital were not included. Prior to the beginning of the study, three times meeting were held with 12 head nurses and 3 investigators for discussing with the ethics subject related to the study. The pretest was done to determine whether items to use were pertinent or not. According to the result of the pretest, Volicer's Hospital Stress Rating Scale was selected as a study tool for this study. Data collection was used an interview and a card-sorting method. The interviewing was done by two authors and three graduate nursing students. A total 125 completed the card-sorting procedure. The stressful items were ordered from most to least stressful within the categories. Additional information such as: age, sex, marital status, and diagnosis was obtained from the kardex file. The ordered list of items, with mean values, as scored by the total of 125 respondents was significantly accepted at 1% level by Friedman test. (X²=1448.339) The event,“knowing you have a serious illness.”was rated highest stressful and (M=41.54) “Being awakened in the night by the nurse”least stressful. (M=14.73) Highly rated items were orderly “Thinking you might have cancer”“Thinking you might lose a kidney or some other organ”“Not being told what your diagnosis is. “Not knowing for sure what illness you have,”five lowerly rated items were orderly “Having to eat at different times than you usually do”“net being able to call family or friends on the phone”“Not having friends visit you,”“Having strangers sleep in the same room with you.”Futher analysis of the data was done to ascertain tao degree of similarity of judgment between different groups in the sample as to how events should be rated. The sample was divided into two groups according to the demographic characteristics and the degree of seriousness of illness. The rank order correlation was calculated for the two sets of ranks as a measure of consensus between the two groups. The correlations ranged from .85∼.99 all indicating a high degree of consensus.

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The Revised Korean Practice Parameter for the Treatment of Attention-Deficit Hyperactivity Disorder (II) - Diagnosis and Assessment - (주의력결핍 과잉행동장애 한국형 치료 권고안 개정안(II) - 진단 및 평가 -)

  • Lee, Moon-Soo;Park, Su-Bin;Kim, Gyung-Mee;Kim, Hyun-Jin;Park, Sangwon;Kim, Yunsin;Lee, Young Sik;Kweon, Yong-sil;Shin, Dongwon
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.28 no.2
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    • pp.58-69
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    • 2017
  • Attention-deficit hyperactivity disorder (ADHD) is a highly prevalent, impairing, and comorbid disorder that persists into adulthood. ADHD should be diagnosed in the same manner as other common adult mental health disorders. The three most important components in the comprehensive evaluation of patients with ADHD are the clinical interview, medical examination, and completion and scoring of behavior rating scales. The diagnostic evaluation of ADHD should include questions about the symptoms, family history, prior evaluation and treatment of ADHD, as well as other problems including alcohol and drug use. Screening interviews or rating scales, as well as interviews, should be used. When it is feasible, clinicians may wish to supplement these components of the evaluation with the objective assessments of the ADHD symptoms, such as through psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. As comorbidity is the rule rather than the exception, clinicians should carefully screen for comorbid disorders as part of a comprehensive assessment of ADHD. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in his or her daily functioning, and must not meet the criteria for other mental disorders which might better account for the observed symptoms, such as mental retardation, autism or other pervasive developmental disorders, mood disorders and anxiety disorders. This report aims to suggest practice guidelines for the assessment and diagnosis of children, adolescents and adults with ADHD in Korea.

Survey on the Discharge Planning of Occupational Therapists (국내 작업치료사의 퇴원계획 개입에 대한 실태 조사연구)

  • Hwang, Na-Kyoung;Yoo, Eun-Young
    • Therapeutic Science for Rehabilitation
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    • v.9 no.2
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    • pp.55-71
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    • 2020
  • Objective : The purpose of this study was to investigate the necessity of occupational therapist's involvement in patient discharge planning, the areas that should be considered for discharge screening and planning, and to provide the basic data required for the development of a discharge assessment tool. Methods : We conducted an online questionnaire survey of 60 occupational therapists who were working at medical institutions and had agreed to participate in the study. The questionnaire was composed of 36 questions regarding the general characteristics of the current discharge planning process and the necessity of discharge assessment and planning. Descriptive statistics, an independent t-test, and a one-way ANOVA were conducted using SPSS 20.0. As for the post-hoc test, Scheffe's test was used. Results : The awareness of occupational therapist's role in discharge planning and the necessity of a discharge assessment tool were high, but the occupational therapist's awareness of discharge-related knowledge was low. The difficulties in discharge planning showed high response rate in the absence of adequate fee-for-service in the patient interview and assessment and the lack of team approach and appropriate assessment tools for discharge planning. The high-needs areas for evaluation during discharge were fall risk and BADL, and the low-needs areas were well-being and functional level prior to onset. Conclusion : This study is expected to provide preliminary information necessary for the development of a discharge assessment tool for effective discharge planning.

An ICF-Core Sets for Children and Youth With Cerebral Palsy Based Approach From a Physical Therapist Perspective: A Single Case Study (물리치료사의 관점에서 뇌성마비 아동과 청소년을 위한 ICF-Core Set을 기반으로 한 접근법의 효과: 단일 사례 연구)

  • Kim, Jeong-hui;Kim, Tae-ho
    • Physical Therapy Korea
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    • v.23 no.1
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    • pp.55-64
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    • 2016
  • Background: The International Classification of Functioning, Disability, and Health-core set (ICF-core set) for children and youth (CY) with cerebral palsy (CP) provides a useful conceptual framework and a guide for health care planning and measuring the changes brought by interventions across a multitude of dimensions from body functions to personal activities, social participation, and environmental factors for them. Objects: This single case study was reported to illustrate the use of a goal directed approach in applying the ICF-core set for CY with CP from a physical therapist perspective. Methods: An eleven year old boy with spastic CP, Gross Motor Function Classification System (GMFCS) level V, and his mother participated in an evaluation of his functioning state. The intervention goal was set through an interview using the ICF-core set, Canadian Occupational Performance Measure (COPM) and Goal Attainment Scale (GAS). Physical therapy was carried out on an outpatient basis using a goal directed approach for 30 min, 1 time/week during 12 weeks and the boy's gross motor function was assessed using the Gross Motor Function Measure (GMFM)-66 version (item set 2) before and after the intervention. Results: As measured by the boy's mother, the COPM score showed a meaningful clinical change (performance=mean 3.5, satisfaction=mean 2.5) and the T-score of GAS changed 34.4 after the goal directed approach. The GMFM-66 (item set 2) score changed from 31.8 to 38.7 and evaluation using the ICF-core set displayed improvement in 6 items of activity level between before and after the intervention. Conclusion: The ICF-core set for CY with CP is useful for understanding the overall functioning of CY with this condition and provides an opportunity to share and integrate information and opinions from different disciplines. We consider it as a useful tool in the universal language for the therapy and education of CY with CP.

A Study of Awareness and Implementation of OBP(Occupation-Based Practice) (작업기반 중재(Occupation-Based Practice)에 대한 인식 및 실행 조사연구)

  • Chang, ki-yeon
    • The Journal of Korean society of community based occupational therapy
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    • v.7 no.2
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    • pp.19-31
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    • 2017
  • Objective : This study was to learn the Korean Occupational Therapists' awareness and current state of implement of Occupation-Based Practice and to use it as a baseline data. Methods : After 300 Korean clinical occupational therapists were conveniently sampled, the structured 293 questionnaires were released, the answered 293 questionnaires were analyzed. Results : Awareness of OBP was 5.7 points on average and the awareness, increased with age and clinical experience. The opportunity that Occupational Therapists know OBP was through major subjects, articles & seminars, through peers and so on. The differences depended on age, level of education, location of work, clinical experience. 152 Occupational therapists(52.8%) answered that they apply OBP in their clinical work. There was no significant difference in the use of OBP based on gender, age, clinical experience, education background with exception of work location. It was shown that during practice,The most frequently used OBP was as follow in order: interview, practice, goal setting, assessment and documentation. The goal of using OBP was to find out a meaningful occupation for client's living, to promote client's participation in family or community, to treat for function recovery of clients. The biggest difficulty faced during OBP was lack of understanding of OBP for the clients and their guardian. Other difficulties were limitations of treatment environment, lack of occupational instruments, related knowledge, utilization method, preparation time and difficulty in handling insurance and medical expenses in order. Conclusion : Level of awareness of OBP was at intermediate level and it was related to education level and treatment environment. Based on this result, it is need to support institutional and academical discusstion in order to promote OBP.

Decreased Concentration of Plasma Brain-Derived Neurotrophic Factor in Suicide Attempters (자살 시도자에서 혈장 Brain-Derived Neurotrophic Factor 농도 저하)

  • Won, Seong-Doo;Shim, Se-Hoon;Yang, Jong-Chul;Lee, Heon-Jeong;Lee, Bun-Hee;Han, Chang-Su;Kim, Kye-Hyun;Kim, Yong-Ku
    • Korean Journal of Biological Psychiatry
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    • v.12 no.2
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    • pp.189-195
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    • 2005
  • Objects:Some studies have suggested that brain-derived neurotrophic factor(BDNF), one of the most important neurotrophins, is involved in pathophysiology of depression and suicide. This study was performed to determine whether there is an abnormality in plasma BDNF concentration in suicidal attempters. Methods:The subjects were 71 suicidal attempters who visited emergency rooms in multi-medical centers. All subjects had been interviewed by using Structured Clinical Interview for DSM-IV(SCID), Hamilton Depression Rating Scale(HDRS), Young Mania Rating Scale(YMRS), and Positive And Negative Syndrome Scale(PANSS). The severity of the suicidal behavior was measured by Lethality of Suicide Attempt Rating Scale(LSARS) and Risk-Rescue Rating(RRR) system. Seventy-one age, sex, and diagnosis matched non-suicidal psychiatric patients who were consecutively admitted to a psychiatric ward during the same period recruited as psychiatric controls. They were drug-naive or drug-free at least more than 2 months. In addition, 80 healthy controls were randomly selected as normal controls. Plasma BDNF level was measured by the enzyme linked immunosorbent assay(ELISA) methods. Results:In overall F-test, differences of the plasma BDNF levels among the groups were statistically significant(F=20.226, p<0.001). In the multiple comparisons(Scheffe), while mean levels of plasma BDNF between normal controls and non-suicidal psychiatric patients were similar(p=0.984), the BDNF levels of suicidal attempters were lower than those of other two groups(p<0.001). LSARS and RRR did not reveal any significant correlations with BDNF levels in suicidal attempters. Conclusion:These results suggest that reduction of plasma BDNF level is related to suicidal behavior and BDNF level may be a biological marker of suicidal behavior.

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Lipomatous Tumors in Hand (수부에 발생한 지방종성 종양)

  • Lee, Kwang-Hyun;Lee, Bong-Gun;Bong, Hyun-Jong
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.131-139
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    • 2008
  • Purpose: Lipomatous tumor occurred in hand is very rare. There is a broad spectrum of lipomatous tumors including lipomas, variants of lipomas, lipomatosis, liposarcomas and so on. We report the clinical features of 11 cases of lipomatous tumor which occurred in hand. Materials and Methods: Between 1992 and 2008, 11 cases were histologically diagnosed as lipomatous tumor in hand. We reviewed all medical records and clinical photographs retrospectively and ascertained recurrence by telephone interview. Results: Eight cases were ordinary lipomas. Three cases were angiolipoma, fibrolipoma and atypical lipoma respectively. Four cases occurred in finger, two cases in thenar area, two cases in hypothenar area, one case in palm, two cases in wrist. All cases were situated on volar surface. All patients complained of palpable masses. One patient with subungal angiolipoma felt pain. There was no neurologic sign or vascular symptom preoperatively. In one case, postoperative complication (hypoesthesia in $5^{th}$ finger) was developed. There was no local recurrence. Conclusion: In our study, lipomatous tumors occurred in hand did not recur. Patients mainly complained of feeling of lump. Pain was uncommon symptom. Postoperative complication was rare if operation was performed carefully.

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