• Asian Pacific Journal of Cancer Prevention
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• v.16 no.11
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• pp.4609-4614
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• 2015

Background: In recent decades, the prognosis for childhood leukemia has improved, especially for acute lymphoblastic leukemia (ALL). In Thailand, though, the survival rate for ALL is unimpressive. In 2006, standard national protocols for childhood leukemia treatment were implemented. We herein report the outcome of the ALL national protocols and explanations behind discrepancies in outcomes between institutions. Materials and Methods: Between March 2006 and February 2008, 486 children with ALL from 12 institutions were enrolled in the Thai national protocols. There were 3 different protocols based on specific criteria: one each for standard risk, high risk and Burkitt's ALL. We classified participating centers into 4 groups of institutions, namely: medical schools in Bangkok, provincial medical schools, hospitals in Bangkok and provincial hospitals. We also evaluated supportive care, laboratory facilities in participating centers, socioeconomics, and patient compliance. Overall and event-free survival were determined for each group using the Kaplan Meier method. Statistical differences were determined using the log-rank test. Previous outcomes of Thai childhood ALL treatment between 2003 and 2005 served as the historic control. Results: Five-year overall survival of ALL treated using the Thai national protocol was 67.2%; an improvement from the 63.7% of the 12-institute historical control (p-value=0.06). There were discrepancies in event-free survival of ALL between centers in Bangkok and up-country provinces (69.9% vs 51.2%, p-value <0.01). Socioeconomics and patient compliance were key elements in determining the outcome (65.5% vs 47.5%, 59.4% vs 42.9%) (p-value < 0.02). Conclusions: Implementation of standard national protocols for childhood leukemia in Thailand did not significantly improve the outcome of ALL. Factors leading to better outcomes included (a) improvement of treatment compliance (b) prevention of treatment abandonment and (c) financial support to the family.

• Quality Improvement in Health Care
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• v.21 no.1
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• pp.36-49
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• 2015

In Intensive Care Units (ICUs), where severely ill patients are treated, importance of reducing Hospital Acquired Infection (HAI) cannot be overstated. One of the simplest and most effective actions against HAI is proper hand hygiene (HH) behavior of Health Care Workers (HCWs). However, compliance varies across different cultures and different job types of HCWs (physicians, residents and nurses). This study aims to understand determinants of HH behavior by HCWs' job types in Korea. Qualitative analysis was performed based on Reasoned Action Approach style interviews with staff physicians, residents and nurses across 7 teaching hospitals. We found that all HCWs strongly believe HH is important in reducing HAI. There were, however, job type-specific HH behavior modifying factors; staff physicians stated feeling pressure to be HH behavior role model. Residents identified Quality Improvement team that measured compliance as a facilitator; a notable barrier for residents was senior physicians not washing their hands, because they were afraid of appearing impudent to their seniors. Nurses designated their chief nurse as a key referent. All participants mentioned heavy workload and lack of access to alcohol-based sanitizer as situational barriers, and sore and dry hand as deterrents to HH compliance.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.5
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• pp.1897-1904
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• 2010

The administration data of the national health insurance and health insurance bills were utilized in this study. The data of 432,915 patients who were at the age of 30 and up and used the out-patient departments of every medical institution located in some regions involving two southern and northern provinces once or more during a 184-day period from July to December. As a result of analyzing their prescription compliance and factors affecting it, the following findings were given: The average rate of the prescription compliance of the patients stood at 61.5 percent. It denoted that they were prescribed to take medicine for approximately 113 days during the six-month(184 days) period of time, and the rate of the patients who complied with the prescriptions just stood at 13.0 percent. They used out-patient department for 4.3 days on the average due to hypertension and they visited 1.1 medical institutions on the average. 94.9 percent just used a medical institution. The largest group (11.6%) suffered from diabetes as co-morbidity, and 23.3 percent of the hypertensives had co-morbidity. Concerning the relationship between their characteristics and prescription compliance, those who were male, who were beneficiaries of the national health insurance, who mainly used general hospitals and who suffered from co-morbidity complied better with the prescription they got. Their prescription compliance got better at the age of 65 to 74 and got worse afterwards. As for factors affecting their prescription compliance, the patients who were male, who were aged between 55 and 64 and who were beneficiaries of the national health insurance, who mainly used specialized general hospitals, general hospitals and public health centers and who had heart diseases and diabetes as co-morbidity complied better with the prescriptions. The above-mentioned findings of the study suggested that it's needed to make a factor analysis of the poor prescription compliance of patients from diverse angles, and that existing hypertension care plans should carefully be reviewed to improve the prescription compliance of patients and to find a feasible alternative. As hypertensives are easily likely to develop co-morbidity like diabetes, systematic health education should be provided for them to get into the right life habits such as taking low-salt meals or quitting smoking. In addition, the development of health care programs is required.

• Korean Journal of Clinical Pharmacy
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• v.18 no.2
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• pp.114-119
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• 2008

Alendronate is a bisphosphonate that selectively inhibits osteoclast-mediated bone resorption. Dosing convenience is an important element for the enhancement of patient compliance and the effective management of osteoporosis. The purpose of this study was to compare the effectiveness and compliance among alendronate pharmaceutical products (oral once-weekly alendronate 70 mg, daily alendronate 10 mg, and once-weekly alendronate 70 mg with Vitamin $D_3$ 2800 IU) in terms of the change in bone mineral density (BMD), biochemical markers, and compliance estimates. A retrospective chart review was conducted in patients with osteoporosis who received alendronate 70 mg (Group 1), alendronate 10 mg (Group 2), or alendronate 70 mg with Vitamin D3 2800 IU (Group 3) at the endocrinology department of a hospital in Korea from Jan. 1, 1998 to Mar. 31, 2008. The primary endpoints were the increases in spine antero-posterior BMD T-score and femur trochanter BMD T-score, and the compliance of alendronate products. Secondary endpoints included changes in bone turnover-related biochemical markers including bone-specific alkaline phosphatase, urinary N-terminal telopeptides (NTX) and osteocalcin, and in serum vitamin $D_3$ concentration. There was no statistical difference in the BMD increase among the three alendronate products; spine BMD T-score increased by $0.49{\pm}0.52$, $0.39{\pm}0.48$ and $0.50{\pm}0.41$, and femur trochanter BMD T-score by $0.29{\pm}0.42$, $0.21{\pm}0.53$ and $0.24{\pm}0.22$ in Group 1, 2 and 3, respectively. With respect to the increases in femur trochanter BMD T-score and the decreases in NTX and osteocalcin, 70 mg once-weekly group was remarkably superior to 10 mg daily group (p < 0.05) The compliance of 70 mg once-weekly group was significantly higher than that of 10 mg daily treatment group (p < 0.001). In conclusion, all three alendronate treatment groups were equivalent in effectiveness, and the compliance of 70 mg once-weekly group was better than that of 10 mg daily treatment group.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.4
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• pp.415-422
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• 2011

The study on correlation between the parents' character of orthodontic patients and patients cooperation. Although dentists have excellent skill and technique, patients' cooperation is always demanded. Patients' poor cooperation results in poor treatment result. Cooperation between psycho-social state of parents and patient's cooperation was studied. The parent's psychosocial state is evaluated with scl-90-r. The cooperation is measured by appointment time compliance, appliance taking rate, breakage of appliance, and fee paying. Parents' psychosocial contents are somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic-anxiety, paranoid ideation, psychoticism, and additional item. Statistics was done by SPSS WINDOW version 12.0 program. The result showed no correlation between patients' cooperation and their parents' psychosocial state. There is no correlation between father's psychosocial state and patients' cooperation except psychoticism. There is no correlation between mother's psychosocial state and patients' cooperation. However, there was correlation among cooperation variables: appointment time compliance, appliance taking rate, breakage of appliance, cost paying. Appliance taking rate and cost paying showed positive correlation. Our findings suggest that patients' cooperation does not followed their parents' pychosocial state. Other combined factors should be considered like pychosocial state of patient and doctor-patient relationship.

• Journal of Home Health Care Nursing
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• v.29 no.2
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• pp.216-224
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• 2022

Purpose: This study aimed to investigate the influence of the perception of the importance of patient safety management and culture on employees' safety performance in small and medium -sized hospitals. Methods: The participants comprised 119 hospital employees, including nurses, doctors, and medical technicians. Data were analyzed through descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and multiple regression analysis using the SPSS program. Results: The mean safety performance was 4.09±0.34, mean safety compliance was 4.12±0.44, and safety participation was 4.06±0.38. There were significant differences in safety performance by gender and job. Safety performance and its assocation with both perception of importance on patient safety management and, perception of patient safety culture showed a positive correlation. Safety performance was influenced by the perception of patient safety culture. The explanatory power was 15.7%. Conclusion: Based on these results, improving the perception of patient safety culture is necessary to increase safety performance. To this end developing and applying an interprofessional safety performance education program for employees in small and medium-sized hospitals is vital.

• 대한상한금궤의학회지
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• v.14 no.1
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• pp.81-93
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• 2022

Objective : This study reports on the case of a patient with irritable bowel syndrome (IBS) diagnosed by the Shanghanlun disease pattern identification diagnostic system (DPIDS). We tried to verify the therapeutic effects of Soseunggi-tang (SSGT) administration and pathological character. Methods : The patient was administered SSGT for 31 days. We observed the progression of symptoms, patient compliance, and the presence of side effects. The progression of IBS was evaluated based the on Gastrointestinal Symptom Rating Scale (GSRS). Abdominal pain, flatus, visual findings, and patient statements were also assessed. Results : According to the DPIDS, the patient was diagnosed with Yangmingbing (陽明病). As a result, his GSRS score dropped from 15 to 5, the visual analog scale (VAS) score for abdominal pain lowered from 9 to 4, and the VAS score for flatus decreased from 8 to 4. The stool type changed from diarrhea to a loose stool form. Conclusions : SSGT showed therapeutic effects on the patient diagnosed with IBS and Yangmingbing.

• Journal of Korean Academy of Nursing
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• v.24 no.1
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• pp.47-57
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• 1994

The purpose of this study was to examine nurses’ perceptions of medication treatment for psychiatric patients and to compare these perceptions with the perceptions held by the patients. The methodology used in this study was a descriptive design with semi-structured and open-ended interviews. This study used a convenience sample of 112 nurses who worked in, and 209 patients who were under psychiatric treatment, in four hospitals attached to a university and one national mental hospital in the city of Seoul. The collected data were analyzed by SAS, using percentages for descriptive purposes, and t-test or x$^2$ for comparing the variables. The results were as follows : 1. There was no significant differences between nurses’ and patients’ perceptions on the extent to which patients complied with their medication treatment. Generally speaking, the mean compliance scores for both nurses and patients was high(nurse : (equation omitted)=3.70, Patient : (equation omitted)=3.76). 2. There was a significant difference in nurses’ and patients’ perceptions on the reasons why patients do not take medication. The nurse group indicated that the patients did not take medication because of the “worry about side effects or habituation(49.53%)”, “boredom from long-term use of medication(26.17%)” and “distrust toward medical staff(12.15% )”, but the patient group indicated that they “did not want to be dependent on medication (25%)”, “forgot to take medication(19.7%) and “worried about side effects or habituation(15.91%). 3. As for the necessity of medication, both groups showed some different responses. Even though both groups were aware of the necessity of taking medication, the patient group(21.53%) showed a more negative response. As (or the effects of medication, both groups (nurses and patients ) showed positive responses. However, the nurse group showed a higher positive response (91.07% ) than the patient group(74.16%), 5. Both the patient and nurse group indicated that the most helpful element for the patient’s life under psychiatric treatment was interviews and conversations with therapists and nurses. However, the nurse group showed a higher response(70.15%) than the patients group(47.15%). According to the patient group, family support for the patient was another important factor for psychiatric treatment and daily struggles. In conclusion, as there were differences between the perception of nurses and patients, the nurse must consider the patients’ subjective perceptions first. They should also revaluate their false belief and prejudice concerning the patients’ perceptions. Such information can provide a base to be applied by the nurses in devloping effective mutual relationships with patients which can in turn help in compliance with medication regimen. As it was confirmed that medication was the most important factor in the patients’ recovery, a thorough education program on the therapeutic effect of medication and the necessity of their continued use after discharge is also needed.

• Korean Journal of Occupational Health Nursing
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• v.7 no.2
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• pp.143-154
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• 1998

The purpose of this research is to suggest basic materials for the practical infection precaution program to protect health care workers from hospital infection by grasping their compliance level of Universal Precautions and examining the factors affecting them. The number of the health care workers we studied were 486, including the doctors, the nurses, and the lab technicians who were working in a university hospital. The period of this research was from Aug. 18th, 1997 to Aug. 30th, 1997. The method of the study was to measure the compliance level of Universal Precautions with the item of "Universal Precautions" established by CDC in 1987, and examine the questionnaire of 52 questions dividing related factors into socio-populational, individual, socio-psychological and organizational management ones. The data was analyzed by t-test. ANOVA, and chi-square test. The results were as follows : 1. An the compliance level of Universal Precautions, hand washing had the highest score(85.4%), and doctors(18.9%), nurses(44.0%), and lab technicians(7.6%), had a low compliance level in the safe handling of an injection syringe, and item not to handle patients and their samples when the subject suffered from dermatitis or injury had the lowest score of 17.1%. 23.3% of them said that they wear protection gown, goggles and mask. 2. Female's Compliance level of Universal Precautions Was higher than male. 3. The health care workers who had high recognition on Universal Precautions got significantly higher compliance level of Universal Precautions than those have low recognition on Universal Precautions(P<0.001). 4. The health care workers experienced a needle stick injury had a significantly higher compliance level of Universal Precautions than those who had not(P<0.000). 5. The health care workers who had infection protection education got a significantly higher compliance level of Universal Precautions than those who didn't(P<0.000). 6. The health care workers who had a firm belief in the effect of Universal Precautions got a higher compliance level of Universal Precautions than those who didn't. 7. The health care workers who had less conflicts between treating patient arid protecting them-selves got a higher compliance level of Universal Precautions than others with many conflicts. 8. The health care workers who had a high score in organizational management factors got a significantly higher compliance level of Universal Precautions than those with a low score(P<0.000). 9. Only 16.9 percent of the all respondents(82 in number) answered that they knew well or a little about the Universal Precautions, which is very low rate of recognition. 10. The variables which affected the score in organizational management factors were age, sex, education period, work experience, the kind of work, recognition on Universal Precautions, the experience of needle stick injury, revealing dangerous circumstance related to infection, and training on precaution again infection. According to the result above, compliance level of Universal Precautions showed high correlation with sex, the recognition on Universal Precautions, the experience of needle stick injury, training on precaution against infection, the belief in the effect of Universal Precautions, the recognition degree of conflicts and organizatinal management factors. These results could be used as the basic materials for the developing infection protection programs. Also, There should have a systematic training course to elevate a effective compliance level of Universal Precautions as well as the manageeent of infection protection programs.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.22 no.3
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• pp.178-187
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• 2009

Background : Atopic dermatitis is chronic exzemaous dermatitis and the recurrence rate of atopic dermatitis is high. Many patients are suffering from pruritus. Objective : This study compared ambulatory care with hospitalization for atopic dermatitis treatment of one patient, and investigated the effect of Oriental medicine program for atopic dermatitis patients during short term hospitalization. Method : We treated a 5 year-old boy with uncontrollable atopic dermatitis by ambulatory care and hospitalizaion. Herbal medication and herbal dressing was done samely during ambulatory care and hospitalization. Intensive life management, education for compliance was done only during hospitalization. Results : Even though he had been treated for 5 months by ambulatory care, he still suffered from severe itching, erythema, oozing and insomnia. Admission duration was 10 days. During admission, the SCORAD scores and subjective scores were decreased rapidly. Conclusion : We concluded that effects of the treatments can be different due to compliance of the patient and in that view the short term hospitalization program could be more helpful than ambulatory care for uncontrollable atopic dermatitis patients.