• The Journal of Korean Medicine
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• v.41 no.1
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• pp.21-44
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• 2020

Objectives: This study was aimed to develop a pharmacovigilance practice training course for future doctors of Korean medicine, the graduate students of a college of Korean medicine, and to verify the educational effect of the curriculum. Methods: Fifty-six students were given a training course designed as follows: 1) pre-class homework (basic theory self-study, online course, causality assessment, and adverse event reporting simulation); 2) in-class: homework submission and case discussion; 3) after-class: homework revision and resubmission. An online survey to assess the change of the level of basic knowledge and attitudes toward pharmacovigilance, the willingness to report adverse events, and self-efficacy for the causality assessment and adverse event reporting was conducted before and after education. Results: The survey participation rate was 96.5% in pre-education and 64.3% in the post-education survey. After education, knowledge level was improved (mean score from 4.3±2.11 to 6.7±1.96 points, modal value from 3 to 8 points) and positive changes were observed in almost all questions on attitudes. In the post-education survey, more students felt that they could do causality assessment (from 13% to 80.5%), could report adverse events to the agency in charge (from 7.4% to 96.2%), and expressed their strong willingness to report adverse events in the future (from 77.8% to 88.9%) than in the pre-education survey. Conclusions: More schools of Korean medicine need to adopt pharmacovigilance training courses in their curriculum to foster future doctors of Korean medicine with pharmacovigilance capabilities. Such efforts will be the basis for achieving an evidence-based, safe use of herbal medicine.

• Health Policy and Management
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• v.30 no.4
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• pp.505-512
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• 2020

Background: In monitoring exposure to environmental smoke (ETS), biomarkers can overcome the subjectivity and inaccuracy of self-reporting measurements, and have the advantage of reflecting ETS exposure in all places. This study aims to evaluate the effectiveness of ETS exposure measurement using biomarkers such as urine cotinine. Methods: This study used the Korea National Health and Nutrition Survey data from 2009 to 2018. A total of 28,574 non-smokers with urine cotinine data were selected for the study. The cotinine concentration and ETS exposure rate using urine cotinine was estimated and then compared with the self-reporting measurements. The degree of agreement among measurements of ETS exposure was confirmed. Results: As a result of measuring ETS exposure with urine cotinine, 23,594 (83.8%) out of 28,574 subjects were classified as to exposure groups. This estimate differs significantly from measurements made by self-reporting. In addition, the average concentration of cotinine in non-smokers has decreased to a 10th level over the past 10 years. Based on the biomarker, the sensitivity of the self-reporting was 8.5%-29.0%, the specificity was 16.4%-19.5%, and the kappa value was 2.0%-5.8%. Conclusion: The findings of our study show that self-reporting measurement does not well reflect the extent to which non-smoker's exposure to smoking materials. Whereas cotinine concentration has decreased significantly over the past 10 years, the ETS exposure rate has not reduced. It strongly suggests the need for intervention in the group of non-smokers exposed to low concentrations of smoke. Therefore, an assessment using biomarkers such as cotinine-based measurement should be made in the Health Plan 2030.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.6807-6812
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• 2013

Background: Lung cancer is a major cause of Korean female mortality and is clearly associated with smoking. The Korean National Health and Nutrition Examination Survey (KNHANES IV-2,3), which included both self-reports of smoking and urinary cotinine data, revealed a significant discrepancy between the prevalence of self-reported and biochemically-verified female smokers. The factors associated with accurate self-reporting of current smoking status remain poorly understood, however. Materials and Methods: We assessed the prevalence of smoking in KNHANES using both self-report and urinary cotinine data. Subsequently, using univariate and multivariate tests, we assessed whether age, intensity of smoking, marital status, relationship with cohabitants, education, occupation, residential area, or annual household income were associated with inaccurate self-reporting in Korean females. We also investigated whether the prevalence of inaccurate self-reports changed over the survey period, 2008-2009. Results: The prevalence of self-reported smoking was 47.8% in males and 6.6% in females. By contrast, the prevalence of smoking as assessed by urinary cotinine levels was 52.2% in males and 14.5% in females. Of the 746 females with urinary cotinine levels >50ng/ml, 407 (56.0%) provided inaccurate self-reports. In a multivariate model, age group(40-49: OR 3.54, 95%CI 1.42-8.86, p=0.007; ref :20-29), cotinine intensity(OR 0.999, 95%CI 0.998-0.999, p<0.001), marital status (married but without spouse: OR 0.37, 95%CI 0.15-0.94, p=0.037; ref :never married), relationship with cohabitants (living with a spouse and unmarried child: OR 2.63, 95%CI 1.44-4.80, p=0.002; living with 2 generations except unmarried child: OR 2.53, 95%CI 1.09-5.87, p=0.030; living with ${\geq}3$ generations: OR 3.25, 95%CI 1.48-7.10, p=0.003; ref :spouse only) and education(college or higher: OR 2.73, 95%CI 1.04-7.18, p=0.042; ref :elementary or less) were independently associated with inaccurate self-reports. Conclusions: The trend of smoking prevalence of Korean females is likely to decrease. However, an elevated prevalence of inaccurate self-reports by females remains. Factors related to the intensity of smoking and family status appear to influence whether a Korean female provides an accurate self-report when asked about smoking behavior.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.4 no.1
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• pp.61-71
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• 1997

This survey was done to identify the self esteem of nurses in Korea. Data was collected from 700 nurses in hospital setting. These data were collected by self-reporting questionnaire, Rosenberg's self-esteem scale, Professional self-concept of nurses instrument, from Dec. 1994 to Jan. 1995. The data was analyzed using descriptive statistics with SAS program. The results of this study were as follows : 1. The mean of self-esteem was 30.74. 2. The correlation between self-esteem and PSCNI was slightly moderate(r=.5739). 3. The self-esteem of nurses was found to be significant by age(P=.0245), religion(P=.0004), position(P=.0186). This study suggested that we need to identify the factors influencing self-esteem and to design the program increasing self-esteem.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.6
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• pp.3865-3869
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• 2013

Background: Cigarette per day (CPD) use is a key smoking behaviour indicator. It reflects smoking intensity which is directly proportional to the occurrence of tobacco induced cancers. Self reported CPD assessment in surveys may suffer from digit bias and under reporting. Estimates from such surveys could influence the policy decision for tobacco control efforts. In this context, this study aimed at identifying underlying factors of digit bias and its implications for Global Adult Tobacco Surveillance. Materials or Methods: Daily manufactured cigarette users CPD frequencies from Global Adult Tobacco Survey (GATS) - India data were analyzed. Adapted Whipple Index was estimated to assess digit bias and data quality of reported CPD frequency. Digit bias was quantified by considering reporting of '0' or '5' as the terminal digits in the CPD frequency. The factors influencing it were identified by bivariate and logistic regression analysis. Results: The mean and mode of CPD frequency was 6.7 and 10 respectively. Around 14.5%, 15.1% and 15.2% of daily smokers had reported their CPD frequency as 2, 5 and 10 respectively. Modified Whipple index was estimated to be 226.3 indicating poor data quality. Digit bias was observed in 38% of the daily smokers. Heavy smoking, urban residence, North, South, North- East region of India, less than primary, secondary or higher educated and fourth asset index quintile group were significantly associated with digit bias. Discussion: The present study highlighted poor quality of CPD frequency data in the GATS-India survey and need for its improvement. Modeling of digit preference and smoothing of the CPD frequency data is required to improve quality of data. Marketing of 10 cigarette sticks per pack may influence CPD frequency reporting, but this needs further examination. Exploring alternative methods to reduce digit bias in cross sectional surveys should be given priority.

• Quality Improvement in Health Care
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• v.18 no.1
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• pp.57-70
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• 2012

Background : The purpose of this study was to understand healthcare workers' perception of patient safety culture and medical error reporting to provide basic resources for the settlement of patient safety culture in medical institutions in Korea. Methods : For this purpose, convenience sampling by self-selection was applied to healthcare workers at a university hospital in Gyeonggi-do and a total of 482 people responded. The survey used the translated version of AHRQ in Korean and distributed through the Intranet system of the hospital. Result : The ratio of positive response was low overall. Among the responses, the response for 'Nonpunitive Response to Error' was the lowest at 17.7%, followed by the responses for 'Staffing' at 21.3%, 'Handoffs & Transitions' at 32.9%, and 'Communication Openness' at 44.3%. In result of surveying whether the responders have reported patient safety incidents during the past 12 months, 68.3% responded 'not once.' Conclusion : The perception of healthcare workers' patient safety culture and medical error reporting, when compared to AHRQ, was lower overall. It is important for healthcare workers to pay greater attention to patient safety to create a safe hospital culture where they do not punish or criticize related individuals or departments.

• Quality Improvement in Health Care
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• v.22 no.2
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• pp.43-73
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• 2016

Purpose: The aims of this study were to assess the presence of core patient safety practices in Korean hospitals and assess the differences in reporting and learning systems of patient safety, infrastructure, and safe practices by hospital characteristics. Methods: The authors developed a questionnaire including 39 items of patient safety staffing, health information system, reporting system, and event-specific prevention practices. The survey was conducted online or e-mail with 407 tertiary, general and specialty hospitals. Results: About 90% of hospitals answered the self-reporting system of patient safety related events is established. More than 90% of hospitals applied incidence monitoring or root cause analysis on healthcare-associated infection, in-facility pressure ulcers and falls, but only 60% did on surgery/procedure related events. More than 50% of the hospitals did not adopted present on admission (POA) indicators. One hundred (80.0%) hospitals had a department of patient safety and/or quality and only 52.8% of hospitals had a patient safety officer (PSO). While 82.4% of hospitals used electronic medical records (EMRs), only 53% of these hospitals adopted clinical decision support function. Infrastructure for patient safety except EMRs was well established in training, high-level and large hospitals. Most hospitals implemented prevention practices of adverse drug events, in-facility pressure ulcers and falls (94.4-100.0%). But prevention practices of surgery/procedure related events had relatively low adoption rate (59.2-92.8%). Majority of prevention practices for patient safety events were also implemented with a relatively modest increase in resources allocated. Conclusion: The hospital-based reporting and learning system, EMRs, and core evidence-based prevention practices were implemented well in high-level and large hospitals. But POA indicator and PSO were not adopted in more than half of surveyed hospitals and implementation of prevention practices for specific event had low. To support and monitor progress in hospital's patient safety effort, national-level safety practices set is needed.

• Wind and Structures
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• v.14 no.6
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• pp.537-557
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• 2011

While there are a number of guidelines used throughout the world in the assessment of acceptability of tall building accelerations, none are based on systematically conducted surveys of occupant reaction to wind-induced motion. In this study, occupant response data were gathered by both a self-reporting mechanism and by interviewer-conducted surveys in control tower structures over a period of four years. These two approaches were designed in conjunction with experimental psychologists to ensure unbiased reporting. The data allowed analysis of perception thresholds and tolerability at different building frequencies and in different wind climates. The long-term nature of the studies also allowed an investigation of the causes and effects of adaptation to building motion. As the surveys were designed to allow multiple use during single storms, the effects of exposure duration were investigated. A final exit survey was conducted at the primary survey location to investigate views of the acceptability of wind-induced motion and the factors underlying these views. The findings of the field studies indicate that none of the currently used acceleration guidelines address all of the factors that contribute to occupant dissatisfaction. An alternative framework for assessing acceleration acceptability is proposed.

• Journal of East-West Nursing Research
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• v.18 no.1
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• pp.18-24
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• 2012

Purpose: The purpose of this study was to identify the factors influencing nursing students' professional self-concept. Methods: This study was conducted through a survey on 365 nursing students. The data were collected by self-reporting questionnaires and analysed by the SPSS WIN 17.0 program using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient and stepwise multiple regression. Results: The mean score of professional self-concept was 2.83. Professional self-concept showed that there were differences according to grade, satisfaction on college life, motivation on choice of nursing, satisfaction on nursing, school work credit, interpersonal relationship, health status. There was a significant positive correlation between professional self-concept and between satisfaction with clinical practice. Significant positive correlations between professional self-concept and self-esteem, satisfaction with clinical practice and self-esteem were found. The significant factors influencing professional self-concept were self-esteem, satisfaction on clinical practice, satisfaction on nursing, interpersonal relationship, which explained 45.1% of the variance. Conclusion: This study suggests that a strategy increasing self-esteem is needed to enhance nursing students' professional self-concept.

• Quality Improvement in Health Care
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• v.22 no.2
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• pp.75-90
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• 2016

Objectives: This study measures the level of cognition of employee's patient safety culture and evaluates the current level through comparing the results to external levels. Ultimately it is performed to construct a strategic improvement plan through the basic database for patient's safety culture. Methods: A questionnaire survey of self reporting type was carried out using structured questionnaire of the patient's safety culture for employees currently employed in a hospital. Total responders was 1,129 and a response rate was 54.6%. The survey results were calculated with a percent positive response, and the current level was evaluated by comparing with the survey results of a hospital (2009 and 2014) and the survey result of The Agency for Healthcare Research and Quality(2014). Results: Sub-dimension of high percent positive response for each area were 'teamwork within hospital units' (80%), 'feedback & communication about error' (73%) and 'supervisor/manager expectations & actions promoting safety' (67%). Meanwhile, 'teamwork across hospital units' (31%), 'hospital management support for patient safety' (29%), 'staffing' (27%) and 'non-punitive response to error' (17%) were relatively low percent positive response. Compared to the survey results of AHRQ (2014) for each area, 'teamwork within hospital units' (80%), 'feedback & communication about error' (73%), 'frequency of event reporting' (66%) were at the top 50% percentile level and the remaining sub-dimensions showed a very low level in the lower 10% percentile area. Conclusion: In order to establish a system for patient safety culture within the hospital and evaluate the effect on this, it is necessary to periodically evaluate the patient's safety culture and establish regulations on hospital safety culture to comply with this.