• Title/Summary/Keyword: the Use of Medical Care

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A Study on the Design of Sustainable App Services for Medication Management and Disposal of Waste Drugs (약 복용 관리와 폐의약품 처리를 위한 지속 가능한 앱 서비스 디자인 연구)

  • Lee, Ri-Na;Hwang, Jeong-Un;Shin, Ji-Yoon;Hwang, Jin-Do
    • Journal of Service Research and Studies
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    • v.14 no.2
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    • pp.48-68
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    • 2024
  • Due to the global pandemic aftermath of the coronavirus, the importance of health care is being emphasized more socially. Due to the influence of these changes, domestic pharmaceutical companies have introduced regular drug delivery services, that is, drug and health functional food subscription services. Currently, this market is continuously growing. However, these regular services are causing new environmental problems in which the number of waste drugs increases due to the presence of unused drugs. Therefore, this study proposes a service that not only promotes health management through regular medication adherence to reduce the amount of pharmaceutical waste but also aims to improve awareness and practices regarding proper medication disposal. As a preliminary survey for service design, a preliminary survey was conducted on 51 adults to confirm their perception of drug use habits and waste drug collection. Based on the Honey Comb model, a guideline for service design was created, and a prototype was produced by specifying the service using the preliminary survey results and service design methodology. In order to verify the effectiveness of the prototype, a first user task survey was conducted to identify the problems of the prototype, and after improving this, a second usability test was conducted on 49 adults to confirm the versatility of the service. Usability verification was conducted using SPSS Mac version 29.0. For the evaluation results of the questionnaire, Spearmann Correlation Analysis was conducted to confirm the relationship between frequency analysis and evaluation items. This study presents specific solutions to the problem of waste drugs due to the spread of drug subscription services.

Prevalence and Risk Factors of Vancomycin-Resistant Enterococci (VRE) Colonization in Neonates (신생아에서 Vancomycin 내성 장구균의 감시 및 위험인자 분석)

  • Lee, Hwa Yun;Kim, Gi Hwan;Choi, Jin Su;Kim, Sun Hee;Choi, Young Youn;Hwang, Tai Ju
    • Clinical and Experimental Pediatrics
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    • v.48 no.9
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    • pp.946-952
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    • 2005
  • Purpose : Vancomycin-resistant enterococci(VRE) are now nosocomial pathogens in Korea. But little is known about the prevalence of stool colonization with VRE in neonates in Korea. So we studied the prevalence and risk factors of VRE colonization in the Neonatal Intensive Care Unit(NICU). Methods : From January 2000 to December 2004, the medical records of 294 neonates(127 cases of VRE group and 167 cases of non-VRE group, according to the results of stool culture) were reviewed retrospectively. We studied the annual prevalence of VRE and risk factors of VRE colonization in neonates. Results : From 2000 to 2003, the prevalence rate of VRE in NICU increased. After preventing VRE transmission, the prevalence rate of VRE has decreased. Conclusion : VRE colonization increased recently. Risk factors of VRE colonization were prematurity, lower birth weight, longer hospitalization and use of vancomycin or 3rd generation cephalosporin, compared with the non-VRE group. To prevent VRE transmission among newborns, aggressive infection control strategies by NICU staffs must be implemented immediately for all babies.

Chest-wall Surface Dose During Post-mastectomy Radiation Therapy, with and without Nonmagnetic Bolus: A Phantom Study

  • Choi, Cheon Woong;Hong, Joo Wan;Park, Cheol Soo;Ahn, Jae Ouk
    • Journal of Magnetics
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    • v.21 no.2
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    • pp.293-297
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    • 2016
  • For mastectomy patients, sufficient doses of radiation should be delivered to the surface of the chest wall to prevent recurrence. A bolus is used to increase the surface dose on the chest wall, whereby the surface dose is confirmed with the use of a virtual bolus during the computerized treatment-planning process. The purpose of this study is an examination of the difference between the dose of the computerized treatment plan and the dose that is measured on the bolus. Part of the left breast of an Anderson Rando phantom was removed, followed by the attainment of computed tomography (CT) images that were used as the basis for computerized treatment plans that were established with no bolus, a 3 mm-thick bolus, a 5 mm-thick bolus, and a 10 mm-thick bolus. For the computerized treatment plan, a prescribed dose regimen was dispensed daily and planning target volume (PTV) coverage was applied according to the RTOG 1304 guidelines. Using each of the established computerized treatment plans, chest-wall doses of 5 points were measured; this chest-wall dose was used as the standard for the analysis of this study, while the level of significance was set at P < 0.05. The measurement of the chest-wall dose with no bolus is 1.6 % to 10.3 % higher, and the differences of the minimum average and the maximum average of the five measurement points are -13.8 and -1.9, respectively (P < 0.05); however, when the bolus was used, the dosage was measured as 3.7 % to 9.2 % lower, and the differences of the minimum average and the maximum average are 7.4 and 9.0, -1.2 and 17.4, and 8.1 and 19.8 for 3 mm, 5 mm, and 10 mm, respectively (P < 0.05). As the thickness of the bolus is increased, the differences of the average surface dose are further increased. There are a variety of factors that affect the surface dose on the chest wall during post-mastectomy radiation therapy, for which verification is required; in particular, a consideration of the appropriate thickness and the number of uses when a bolus is used, and which has the greatest effect on the surface dose on the chest wall, is considered necessary.

A Study on Social Support and the Quality of Life in the Elderly(The comparative analysis between home residents and institution residents) (노인의 사회적 지지와 삶의 질에 관한 연구 -일반가정노인과 양로원노인을 대상으로-)

  • 채수원;오경옥
    • Journal of Korean Academy of Nursing
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    • v.22 no.4
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    • pp.552-568
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    • 1992
  • Recent improvements in the standard of living, national income and medical care, and a decline in the infant death rate which have occurred related to economic growth and modernization, have led to a longer average life-span and a higher ratio of elderly people in the total population, Therefore, not only in the field of nursing science, but also in the field of many other discipline, issues concerning the elderly have been given increasing interest. A great deal of effort has been spent on increasing the quality of life for elderly people. This study was conducted to analyze the correlation between social support and quality of life. The sample consisted of III subjects residing at home and 107 subjects residing in institutions all of whom were over 65 years of age. The data collection period was from October 23, 1990 to January 26, 1991. Social support was measured using the Norbeck social Support Questionnaire developed by Norbeck, translated by Oh, Ka Sil and quality of life was measured using the QOL scale developed by No, You Ja. Data were analyzed using pereentages, t-test, Pearson Correlation Coefficient and ANOVA. The results of this study are as follows : 1. There was a statistically signifivant difference in the level of social support between the two groups (t=-8.83, p<.001), The elderly at home reported a much higher level of social support. 2. There was a statistically significant difference in the level of QOL between the two groups (t=-5.77, p<.001) . The elderly at home reported a much more positive quality of life. 3. There was a positive correlation between social support and QOL for the elderly at home ard it was statistically significant (r=.32, p<.001). 4. There was a postitive collealtion between social support and QOL for the elderly in institutions and it was also statistically significant (r=.19, p<.05). 5. The relationship between the general characteristics of the elderly at home and the variables of social support and of QOL were as follows ; 1) according to sex(t=10.57, p<.01) and the number of offspring(F=6.19, p<.01), there was a statistically significant difference in social support. 2) according to amount of Pocket money, there was a statistically significant difference in QOL(F=2.98, p<.05). 6. The relationship between the general characteristics of the elderly in institutions and the two variables were as follows ; 1) according to sex(t=6.24, p<.05), the number of offspring(F=6.16, p<.001) and religion (F=2.58, p<.05), there was a statistically significant difference in social support. 2) according to religion, there was a statistically significant difference in QOL(F=2.90, p<.05). In conclusion, it can be said that social support is an important variable related to QOL in the elderly and that social support levels are higher for the elderly residing at home. Therefore, more specific and objective approaches and efforts are needed to effectively use resources to maintain the elderly at home and to enhance social support available to the elderly in institutions and thereby increase QOL regardless of residence.

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MANAGEMENT OF ORAL MUCOSITIS OWING TO CHEMICAL BURN BY INTOXICATION OF AGRICULTURAL CHEMICALS(GRAMOXON) : REPORT OF CASES (농약(Gramoxon)중독에 의한 화상으로 발생된 구강점막염 치험)

  • Yoo, Jae-Ha;Kang, Sang-Hoon;Kim, Hyun-Sil;Baek, Sang-Hum;You, Tae-Min;Lee, Ji-Woong;Chung, Won-Gyun;Kim, Jong-Bae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.2
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    • pp.123-127
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    • 2003
  • Chemical burns onto oral mucosa which are infrequent, may result from contact with a wide variety of chemical agents. The degree of injury depends on the chemical, its concentration, duration of contact, and the natural penetrability and resistance of the tissues involved. Chemicals do not usually "burn" in that they do not cause destruction by hyperthermic activity. Rather, they damage tissue by causing coagulation of protein by one of several processes, reduction, oxidation, desiccation, corrosion, or vesication. Paraquat(Gramoxon) is the most frequently agricultural chemicals that induce the severe toxic reactions onto the organs of human body in Korea. The toxic reaction are composed of pulmonary edema and fibrosis, formation of hyaline membrane, inflammatory reaction and bleeding tendency, owing to the cell damage by the production of superoxide radicals. The contents of essential treatment in paraquat intoxication are commonly airway and breathing maintenance, gastric lavage, much hydration and diuresis, hemoperfusion and medications for the removal of the chemicals and the prevention of various complications. The sedative oral dressings, such as, orabase ointment application, warm saline gargling, lidocaine viscous gargling and oral gargling by the mixed solutions(tetracycline, prednisolone and 10% dextrose water) are important for the improvement of chemical oral mucositis and the comfortable feeding of diet. The authors managed properly two cases of oral chemical mucositis that were occurred by the incorrect use of agricultural chemicals(paraquat) and report the cases with the review of literatures about care of the chemical intoxication and oral mucositis.

The Effect of Height of Cane for Health Promotion on Mobility of Patients with Stroke (뇌졸중 환자의 건강증진을 위한 지팡이 높이가 보행과 체중지지율에 미치는 영향)

  • Seo, Tae-Hwa;Kwon, Sang-Min;Jeong, Yeon-Woo
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.1
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    • pp.207-215
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    • 2019
  • This study examines the effect of the height of cane that hemiplegic patients due to stroke use on their plantar pressure in standing position, gait speed. The study suggests a new standard for appropriate cane height that considers the change of average height of population. Research subjects included 12 patients hospitalized in S Medical Care Hospital located in Gwangju Metropolitan City in South Korea who were diagnosed with stroke. Group A uses a cane of the height of the greater trochanter of femur, group B uses a cane of 5cm above the height of the greater trochanter of femur, and group C is a cane of 10cm above the height of the greater trochanter of femur. In the study result, non-affected side plantar pressure and affected side plantar pressure showed a significant difference among the cases where the cane height was the same as the A group, B group, C group. In the post-hoc analysis result, a significant difference was observed between the case of A group and C group. Gait speed showed no significant difference among the case of the A group, B group, C group. The asymmetry of the stroke affects not only the posture but also the walking that is related to daily life. Changes in the height of the cane did not affect walking speed. The change in the height of the cane showed a change in the weight support ratio, which is thought to have a positive effect on the asymmetry. In future clinical setting, this study result will be able to provide fundamental data regarding the cane height in the standing or walking therapy for hemiplegic patients due to stroke with cane application.

Analysis on the Relationship between the Number of Clinics and the Use of Preventable Hospital Service: focusing on asthma patients (지역 내 의원 수와 예방 가능한 병원 서비스 이용 간의 관계분석: 천식 환자를 중심으로)

  • Lee, Hyun-Ji;Park, You-Hyun;Cho, Hyung-Kyung;Seol, Jin-Ju;Kwak, Jin-Mi;So, Ye-Kyeong;Park, Su-Jin;Lee, Kwang-Soo
    • Korea Journal of Hospital Management
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    • v.25 no.4
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    • pp.94-102
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    • 2020
  • Purposes: The purpose of this study was to analyze the trends of hospitalization and emergency room visits of asthma patients over the three years in 25 districts of Seoul. And analyzed the relationship between preventable hospital service uses and number of clinics for asthma patients. Methods: Data was collected from a customized database of the NHI(National Health Insurance) for 2016 to 2018. The number of clinics means Internal Medicine, Pediatrics, Ear-Nose-Throat, and Family Medicine clinics. The hospital service means the number of adults admission for asthma and the number of total asthma emergency visits. This study used kappa analysis to assess the agreements of indicators between years, and structural equation modeling analysis was applied to analyze the relationship. Findings: The kappa value of the number of adults admission for asthma was compared between 2016 and 2017(kappa score=0.68), and was lowered when compared between 2016 and 2018(kappa score=0.26). And the value of kappa in the number of total asthma emergency visits due to asthma between 2016 and 2017(kappa score=0.51) was lower than that of between 2016 and 2018(kappa score=0.60). And the results showed that the number of clinics significantly negatively related to the uses of hospital services in asthmatic patients(β=-0.5, p=0.005). Practical Implication: This research could provide policy implications for strengthening primary care services that can contribute to the reduction of preventable hospital services.

Through analyzing the health insurance data provided by Health Insurance Review & Assessment Service (HIRA) of Korea, understanding the characteristic of patient who were diagnosed somatic dysfunction and analysis of the current local status of the usage of code M99 (건강보험심사평가원 데이터의 분석을 통한 체성기능부전 환자의 특성 및 M99 진단명의 사용현황 분석)

  • Shin, Jae-Kwon;Joo, Han-Soo;Lee, Seong-Yup;Shin, Ye-Sle;Ko, Won-Il;Park, Ki-Byung;Kim, Min-Kyu;Ha, In-Hyuk
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.11 no.1
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    • pp.53-64
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    • 2016
  • Objectives : The aim of this study is to assess the usage of diagnosis codes for somatic dysfunctions and the general characteristics of patients diagnosed with the code, by analyzing health insurance data provided by the Health Insurance Review & Assessment Service(HIRA) of Korea. This investigation is intended to outline future and willing to contribute to further use of diagnosis code and the approach of Oriental Medicine to somatic dysfunction. Materials and Methods : By analyzing HIRA data, those diagnosed with M99 codes, a code attributed to somatic dysfunction, were selected for analysis. Patients included were assessed for the relevant general characteristics, and the specific diagnostic criteria. The current usage rates and noteworthy characteristics of diagnostic codes of somatic dysfunctions were assessed. A comparative analysis between clinical departments and subcategories, and a comparative analysis to data of 2014 was conducted. Results : Patients given M99 codes constituted a small minority of all patients diagnosed in 2011 as shown by HIRA data. The codes were more frequently to older patients, females, outpatients, and those who filed for Health Insurance compensation. Medical institutions participating in the diagnosis were mostly primary care facilities, usually specializing in orthopedic(Western medicine sector) and internal medicine (Oriental Medicine sector). The most registered code in 2011 and 2014 was M995. The same trend can be observed in Oriental/Western medicine institutions and Public health center, on the other hand, between them, have some different patterns both 2nd and 3rd. Conclusions : This investigation is that of current usage of diagnostic codes of somatic dysfunction. HIRA insurance claim data was analyzed. Based on the current results, more precise diagnostic standards of somatic dysfunction are warranted. This study will provide a foundation for future Oriental Medicine approach to somatic dysfunctions.

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A Study on the Knowledge and Attitude about Emplyee's Health Management in the Provinces (경기지역 일 산업장 근로자의 건강관리에 대한 지식 및 실태에 관한 연구)

  • Kim, Eun-Hee
    • Research in Community and Public Health Nursing
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    • v.6 no.2
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    • pp.299-318
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    • 1995
  • This study was conducted in order to grasp the condition of the Worker's knowledge and attitude about health management. And to offer the basic materials for the health promotion in industrial field. The objects were comprised 336 of volunteered who work in E.shoemaking factory. The material of this study was the questionair (chronbach a=.8871) suited to the purposed of this research which has been made through studying references. All the guestionaire were collected inmediately without explanation. The data collected from 18th September to 1st Octover. Analysis of the data was done utilizing SAS program for percentage, mean, ANDVA. The result are as follows: 1. General features of the objects of study. Male was highest (58.6%), mean age was 30.07 years, graduated high school was highest(59.2%), producer in present place of employment was highest (76.2%), mean career was 7.45 years. 2. The conditions of attitude about health man agement. Correct answer of health examination was 77.8%. Having experience of health examination was 69.5%, among them have regularity was 70.9%. Think it too much trouble to do not health examination was 69.7%. Have got to do health examination was 95.6%. The reason of set up health clinic was emergency care 58.9%, health education 22.1%. Using health clinic was 70.4%, by monthly was 53.0%. The reason of think it too much trouble to use not health clinic was 65.2% The need of health clinic was 96.4% 3. The conditions of knowledge about health management. When 5 points was given to 'very affirming' and 1 point was given to 'very deny', the total average was 3.67, the range was 2.96-4.54. Exactly, company must given to employee put in operative health examination was highest, worked 34 hours per week on harmful worked place was lowest. And knowing about kind of harmful work was 2.86, dangerous work was 2.90. 4. Correlation between the general features and attitude variables. Female group may have more knowledge on reason of health examination. Over 50 years aged group, middle school graduated group, white colored group, less then 1 year career group may have more knowledge on health examination. White colored group may have more attitude on health examination$(\chi^2=5.210,\;P<.07)$. High careered group may have more using on health clinic $(\chi^2=12.08,\;P<.007)$. 5. Difference between the general features and knowledge of health management. High educated group were highest score in knowledge (F=5.214, P<.002). White colored group were highest score in knowledge (F=23.019, P<.000). 6. Difference between the attitude and knowledge of health management. Needing of health examination group were highest score in knowledge. (t=2.54, P<.011). Using of health clinic group were highest score in knowledge(t=190, P<.048). Needing of health clinic group were highest score in knowledge(t=5.13, P<.000).

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A Study on the Interest in Hospice According to the Perception of Happiness (행복 인식에 따른 호스피스 준비의 관심에 관한 연구)

  • Chang, Kyung-Hee;Lee, Seo-Hui;Kim, Kwang-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.5
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    • pp.489-498
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    • 2018
  • The purpose of this study is to examine whether there is a difference in the awareness of death based on happiness (since attitude or way of life differs among the general public, depending on the perception of death), and to investigate whether there is a difference in the interest in hospices between a group with a high happiness index and a group with a low happiness index. A survey was conducted on 200 men and women aged over 20 who participated in a walking event held in a metropolitan city on April 22, 2017. The survey consisted of eight demographic items: gender, age, education, occupation, marital status, family cohabitation, religion, and health status. It included 29 questions regarding happiness and nine questions regarding the perception of death. For the statistical tests, a chi-square test, an independent sample t-test, correlation analysis, and canonical correlation analysis were performed on the items of the survey based on a happiness index. The results of the study showed that, for a suitable place for death, medical institutions was the highest score (46.3%) for the group with a low happiness index, and own house was highest (59.4%) for the group with a high happiness index. This was a significant difference. It is thought that management systems should be supplemented by professional manpower, educating people so as to increase the utilization rates of home-based hospice as a way for patients to die in a comfortable and familiar place because, for Korea, death is much more common in hospitals. It is also necessary to increase the awareness of death and to make effective use of hospices through individual and various other approaches, considering the demographics of the subjects.