Background: Pain is one of the most terrifying symptoms for cancer patients. Although most patients with cancer pain need opioids, complete relief of pain is hard to achieve. This study investigated the factors influencing persistent pain-free survival (PPFS) and opioid efficiency. Materials and Methods: A prospective study was conducted on 100 patients with cancer pain, hospitalized at the medical oncology clinic of Akdeniz University. Patient records were collected including patient demographics, the disease, treatment characteristics, and details of opioid usage. Pain intensity was measured using a patient self-reported visual analogue scale (VAS). The area under the curve (AUC) reflecting the pain load was calculated from daily VAS tables. PPFS, the primary measure of opioid efficacy, was described as the duration for which a patient reported a greater than or equal to two-point decline in their VAS for pain. Predictors of opioid efficacy were analysed using a multivariate analysis. Results: In the multivariate analysis, PPFS was associated with the AUC for pain (Exp (B)=0.39 (0.23-0.67), P=0.001), the cumulative opioid dosage used during hospitalisation (Exp (B)=1.00(0.99-1.00), P=0.003) and changes in the opioid dosage (Exp (B)=1.01 (1.00-1.01), P=0.016). The change in VAS score over the standard dosage of opioids was strongly associated with current cancer treatment (chemotherapy vs. others) (${\beta}=-0.31$, T=-2.81, P=0.007) and the VAS for pain at the time of hospitalisation (${\beta}=-0.34$, T=-3.07, P= 0.003). Conclusions: The pain load, opioid dosage, concurrent usage of chemotherapy and initial pain intensity correlate with the benefit received from opioids in cancer patients.
Purpose: This study was conducted to explore the effects of attitude to death in hospice and palliative professionals on their terminal care stress, and to analyze relationships among variables related to the two aforementioned parameters, such as depression and coping strategies. Methods: Participants were 131 hospice and palliative professionals from the cancer units of two tertiary hospitals and two general hospitals, two hospice facilities, two geriatric hospitals, and two convalescent hospitals in J province. Data were collected from April through June 2015 and analyzed using t-test, factor analysis, ANOVA ($Scheff{\acute{e}}$ test), ANCOVA, and Pearson's correlation and a path analysis using the SPSS/WIN 21.0 and AMOS 18.0 programs. Results: The score for attitude to death was low (2.63), and that for depression was 0.45. Among all, 16.0% of the participants showed need for depression management. They scored 3.82 on terminal care stress. The subcategory with the highest mark was inner conflicts on limitation given availability of medical services (4.04). The score on coping strategy was low (3.13). They used passive coping strategies such as interpersonal avoidance (4.03), fulfilling basic needs (3.65) such as sleeping or eating. Attitudes to death had a direct negative effect on the terminal care stress level and indirectly affected through depression and fulfilling basic needs (CS2). Conclusion: It is necessary to provide hospice and palliative professionals with education on death and dying, as well as access to programs that provide emotional support and promote positive cognition of death and dying.
As the radiological medical instruments have been competitively developed in recent years, its utilization for the patient treatment has been expanded. The medical examination using the radiation has been gradually increased, so that it is recognized as a significant factor of increasing the radiation exposure. In this study, the recognition about the radiation exposure was analyzed for 555 gynecologic patients in 8 secondary and tertiary medical centers in Gyeongbuk from November 17 to April 19, 2007. The results are followed. There was a significant difference on the recognition for the radiation by age and education (p<0.05), There was the significant difference in the recognition about the radiological instruments by age and occupation (p<0.05), and there was the significant difference in the information identification & analysis by age and occupation (p<0.05). As the result of analyzing a correlation of the radiation's harmfulness, recognition, psychological state and exposure prevention, there was the correlation of 0.572 between the harmfulness and recognition, the correlation of 0.740 between the harmfulness and the psychological state, and the correlation of 0.477 between the harmfulness and the exposure prevention. It was statistically very significant (p<0.01). But, there was no significance with the radiological instrument and information identification (p>0.05). As the result of the study, it could be known that the mental threat factor was more included than the physical threat from the position of gynecologic patients who were sensitive to the radiation. Accordingly, radiological technologist who manages the radiation needs to let the patient or its guardians recognize the degree of physical harmfulness exactly.
Journal of The Korean Society of Clinical Toxicology
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v.13
no.1
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pp.25-32
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2015
Purpose: The aim of this study was to investigate the independent factors associated with the registration rate for the community-based post suicidal care program in the emergency department (ED). Methods: This prospective observational study was conducted between March and December 2013 at the academic ED at the tertiary urban hospital. During the study period, the pre-designed registry was recorded. The variables examined included the following: patients' demographic data (Sex, age, address, type of insurance, marital status, level of education, and history of previous psychiatric disease), suicide-related data (suicidal methods, combined drink of alcohol and number of previous attempts), and management-related data (disposition at ED, physician's training level, etc.). Univariated and multivariated logistic regression analyses were performed for identification of factors affecting the registration rate for the community-based post suicidal care program. Results: A total of 163 suicides were included during the study period. Of these, 33 (20.2%) patients were registered in the post-suicide care program. Factors including a patient's address (OR: 14.92, 95% CI: 3.606-61.711), immediate intervention by psychiatric healthcare center (OR: 5.05, CI: 1.688-15.134), admissions in hospital (OR: 3.69, CI: 1.286-10.605), and history of previous psychiatric disease (OR: 3.52, CI: 1.216-10.201) showed significant association with registration for the program. Conclusion: The community-based post-suicidal care program, which is available 24 hours a day, should be operated in each district in order to increase the registration rate. Emergency physicians should actively consider the inpatient treatment program for suicidal patients and strongly recommend registration to the program, particularly for patients without previous history of psychiatric disease.
The current status of Korean hospitals on foodservice hygiene was evaluated by a survey in the March of 2000 from 96 hospitals in terms of general sanitation management, education and training, and from 35 hospitals on the observance of hygienic practices in the whole stages of foodservice, personal hygiene, and kitchen equipment and facility hygiene. The questionnaire was filled directly by the dietitian working in the subject hospital. The status of general sanitation management was satisfactory overall; however, the record-keeping or documentation of the practices was the weak point which needs to be improved. only 4% of the subjects appeared to have implemented HACCP for the hospital foodservice. Comparison of the hospitals in their observance rate of hygienic practice by the type of hospital, the location of hospital, the number of bed, and the separation of dietitian's duties as clinical nutrition and foodservice showed characteristic trends among the groups. General hospitals often showed better scores than tertiary hospitals in their observance rates. As the location of hospital moved from large cities to small towns, the observance rate for hygienic practice decreased. Hospitals with entrusted foodservice system showed better scores in hygienic practice than those with owner-operated one in the stage of planning and equipment/facility hygiene (p<0.05). And the scores of the hospitals having dietitian's duties separated into clinical and food services were higher than the ones with un-separated duties. Detailed information obtained in this study would serve for the development of guidelines or programs to improve the hygienic level of Korean hospital foodservice.
Yeo, Kwang Hee;Park, Chan Yong;Kim, Ho Hyun;Park, Soon Chang;Yeom, Seok Ran
Journal of Trauma and Injury
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v.28
no.2
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pp.60-66
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2015
Purpose: Cultivator accidents are frequent and often lead to abdomino-perineal organ injury and, if severe, to death. This study presents the clinical characteristics, outcomes, and factors associated with mortality in patients who sustained an abdomino-perineal organ injury in cultivator accidents. Methods: We retrospectively analyzed the records of 53 patients who visited the emergency department of a tertiary hospital with abdomino-perineal organ injuries caused in cultivator accidents from April 2005 to March 2010. Results: All 53 patients had visited other medical institutions before visiting our hospital. Their mean age was $64.0{\pm}11.1$ (range, 20-80) years and 32 (60.4%) patients were 65 or older. The male-to-female ratio was 46:7. The chief complaint was abdominal pain (38 cases, 71.7%). The 53 patients included 41 cultivator operators (77.4%), 11 passengers (20.8%), and 1 passerby (1.9%). The causes of the injuries included a direct impact of the handlebar in 20 cases (37.7%), a rollover in 21 cases (39.6%), a fall in 10 cases (18.9%), and a wheel in two cases (3.8%). Several of the 53 patients had injuries to multiple abdomino-perineal organs, and the injured organs included the liver (23 cases, 26.4%), spleen (16 cases, 18.4%), pancreas (7 cases, 8.0%), small bowel (7 cases, 8.0%), mesentery (6 cases, 6.9%), adrenal gland (5 cases, 5.8%), and other organs. According to the abbreviated injury scale (AIS) dictionary, a thoracic injury was the most frequent co-injury (33 of 53 cases, 62.3%). Abdomino-perineal surgery was performed in 31 cases (58.8%) and angio-embolization was performed for six liver and two kidney injuries. Thirteen patients died (24.5%); all were males. The Injury Severity Scale (ISS) was lower in the survivors ($17.8{\pm}8.5$ vs. $27.0{\pm}16.0$; p=0.010). Conclusion: With the aging of agricultural workers, safety education programs should be implemented. Furthermore, the patient transfer system in agricultural areas must be improved.
Purpose : This study aimed to present the incidence of pressure ulcers and identify different associated factors according to the time of occurrence of pressure ulcers in intensive care unit (ICU) patients. Methods : The participants were 313 patients who reported pressure ulcers among 2,908 patients in ICUs at a large tertiary hospital in Gyeonggi-do. Among them, 220 patients (70.3%) had a pressure ulcer before admission, and 93 patients (29.7%) reported newly developed pressure ulcers after admission to the ICU. Data were collected between August 2018 and April 2019. Along with the time of occurrence and characteristics of pressure ulcers, diverse associated factors were gathered through electronic medical records. Data were analyzed using descriptive statistics, independent t-tests, and 𝑥2-tests. Results : Different risk factors associated with pressure ulcers in ICU patients according to the time of occurrence were main diagnosis, score of acute physiology and chronic health evaluation, score of Richmond agitation sedation scale, level of consciousness, administered sedatives, use of a ventilator, insertion of a feeding tube, and the duration of fasting period. Conclusion : Based on the results of this study, healthcare providers, especially ICU nurses, should try to detect early signs and symptoms of pressure ulcers, taking into account the derived factors associated with pressure ulcers in ICU patients. Practical intervention programs and strategies considering the factors associated with pressure ulcers must be developed to prevent and alleviate such ulcers in ICU patients in the future.
The purpose of this study was to know the difference in pain, sleep, self-care behavior in patients performed by sternotomy and robotic minimally invasive cardiac surgeries. The participants were 64 patients with sternotomy and 64 patients with minimal thoracotomy in heart valve surgeries at a tertiary hospital in Seoul. Data were analyzed using descriptive statistics, ${\chi}^2$ test, paired t-test. with SPSS/WIN(22.0). The participants with minimally invasive thoracotomy felt severe pain than the patients with thoracotomy at post operation day 2 & 5. The severe pain site were the surgical site in both groups. The participants with sternotomy had better sleep than minimally invasive thoracotomy patients. Self-care behavior was higher in the minimally invasive thoracotomy group. Therefore, despite the many advantages of robotic surgery such as rapid recovery and shortening of length of stay in hospital, accurate pain assessment and application of differentiated protocols are needed for the management of pain in the patients with robotic minimally invasive cardiac surgeries. In addition, a structured education program intervention is needed to improve comfort by considering gender, age, and method of operation.
Journal of the Korea Society of Computer and Information
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v.25
no.12
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pp.235-242
/
2020
This is descriptive research aimed at identifying the factors for nursing productivity in nurses at a tertiary hospital. The data were collected from a survey conducted in 257 nurses at a single hospital in Seoul from May to June 2020. The collected data were analyzed through t-test, ANOVA, Scheffe test, Pearson's correlation, and multiple regression analysis by using an SPSS 25.0 program. The total score was an average of 25.40±5.49 (range: 6-36) for gratitude disposition, 65.15±9.18 (range: 21-105) for job satisfaction, 87.64±12.05 (range: 23-115) for nursing performance, and 35.68±6.79 (range: 0-45) for nursing productivity. Nursing productivity was positively correlated with gratitude disposition (r=.219, p<.001), job satisfaction (r=.440, p<.001), and nursing performance (r=.494, p<.001). Nursing productivity was affected by gratitude disposition (β=.144), nursing performance (β=.394), and job satisfaction (β=.278). On the basis of these results, it is necessary to develop and apply education programs aimed at promoting work productivity for nursing manpower.
Since 2020, the GuangXi government of China has focused on the deep integration of tea industry with leisure and cultural tourism, popular science education, health care and elderly care industries. Among the output value targets of the tertiary industry, the GuangXi government plans to achieve 25 billion yuan, and the tea industry is developing rapidly. Through questionnaire survey, field research and interview, this paper studies the differences of demand behavior and selection attributes of tea products among consumers in different years, and finally studies the evolution pattern of service mode of tea industry in GuangXi. The results show that there are obvious differences in life and work style, shopping habits, service design, user experience, social needs and personality needs of each generation consumers in different years. Based on the analysis of demand and behavior habits of tea products, the evolution pattern of service mode of tea industry in GuangXi is studied. Based on the above results, according to the differences of consumers' choice of tea products in different years, the service mode of tea industry in GuangXi is improved The development of tea industry in service design, user experience level is worthy of in-depth attention.
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