The purpose of this study was to identify the effect of follow-up care for stroke survivors on primary caregivers' quality of life. Quasi-experimental research was conducted in which an experimental group and a control group-each of 15 stroke survivors and their primary caregivers-were consecutively sampled. Data collected from July to September, 1999 by interview using a structured questionnaire with both the experimental and the control groups. After a month, the two groups were given the same questionnaire. The experimental group was also given a telephone follow-up every week for a month, as well as a home visit. The survey instruments used in this study were Saha and Cooper's "Modified Barthel Index" (11 items) for checking the stroke survivors' level of activities of daily living, and a modified form of Jeong's "Quality of life" (18 items) for primary caregivers' QOL level. The obtained data were analyzed by percentage, t-test, $X^2$-test, Kruscal-Wallis test, Spearman correlation coefficient by SAS/PC program. The results were as follows: 1. There was no significant difference in the stroke survivors' ADL level, though the level of the experimental group was higher than that of the control group. 2. There was a statistical difference in the before and after treatment of the primary caregivers' QOL level. In conclusion, the follow-up care program had a useful effect on the quality of life of primary caregivers.
Purposes: This study was performed to understand the recognition about accreditation motives, support within the hospital and accreditation survey process for the hospitals that participated in the accreditation program and to find out whether these factors are related to hospital management performances, so that the study can suggest plans for activation and development of the accreditation program. Methodology: This study was performed targeting 98 hospitals answered th the survey among 189 acute care hospitals that acquired accreditation from December 2010 to February 2014. For data analysis, frequency analysis, ${\chi}^2$-test, reliability analysis, ANOVA, Kruskal-Wallis H test and multiple regression analysis with SPSS 21.0 were used. Findings: The hospitals that had staff in charge of patient safety had bigger hospital culture change than those that didn't have(p<.05). In addition, the hospital culture change was bigger as internal motives were bigger, and as CEO's will was bigger(p<.05). Meanwhile, as maintenance rate of internal management after accreditation was higher, and as CEO's will was bigger, process improvement level was higher(p<.05). The quality improvement and patient satisfaction level were higher as CEO's will was bigger, and as suitability of survey process was recognized to be high(p<.05). As a result of analyzing the factors that affect hospital management performances with hospital culture change, process improvement and quality improvement combined, as internal management maintenance rate was higher, as CEO's will was bigger, and as suitability of survey process was higher, performances were higher(p<.05). Practical Implications: Hospitals need to reinforce internal motives to improve internal competences such as the whole system maintenance opportunity and staff training. In addition, the will of hospital director is most important, and if there is hospital director's interest in quality improvement and improvement intention definitely, employees voluntarily participate in and cooperate with the accreditation program, so that prompt medical service provision and high quality of medical services can be guaranteed, leading to hospitals' management performances.
Journal of Fisheries and Marine Sciences Education
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v.23
no.2
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pp.221-233
/
2011
The purpose of this research was made to suggest the improvement for problems of indication subject of Fisheries & Maritime High School teacher's certificate issued by the operation of the 7th national curriculum in 2000. After analyzing the integrated indication subjects related with fisheries & Maritime high school, among the middle school teacher's 24 subjects of industrial world, the problems and improvements can be arranged as followed. Firstly, the subjects of fisheries & Maritime high school teacher's certificates are fishing industry, aquiculture, sailing, engine and freezing and new subjects are ocean shipping and ocean logistics. Because the teacher's certificate was changed to integrated indication subjects, there were problems of teacher cultivation, teacher hiring, etc. So, in the actual field of school, teacher cultivating university and related department are necessary to strengthen high-quality majoring education/subjects and practical education as well as need to establish teacher cultivating system by teacher cultivating organization's evaluation system and teacher cultivating education program related by differentiation and easiness of majoring characterization. Secondly, teacher cultivating for new departments and new subjects can apply related major system, free major system, etc. Thirdly, if professional high schools find majoring areas whose content is same one another and introduce common indication subject system, it will be helpful to improve the quality of teachers, teacher certification examination, etc. of professional area.
Purpose: The purpose of this study was to determine the effects of water exercise program on physical fitness, pain and quality of life(QoL) in patients with osteoarthritis. Methods: Thirty-four old women were divided into the exercise(EG, n=18) and control groups(CG, n=16) after 6-week self-help education program. The EG carried out 6-week supervised water exercise program(60min/day, 2days/wk). Physical fitness, pain, and QoL were assessed by Senior Fitness Test Manual(Rikli & Jones, 2005), Pain rating scale(0-10) and World Health Organization QoL BREF(Min et al., 2000), respectively. Results: Both EG and CG increased upper and lower-body strength(all, p<.05), which were measured by arm curl and chair stand, respectively. For flexibility test, the EG increased upper and lower body(all, p<.05). Balance of the EG increased(p<.05), but not in the CG. Pain significantly decreased in the EG post training(p=.000). However, both EG and CG did not significantly improve for QoL. Conclusion: Six weeks of water exercise program did induce significant improvement in physical fitness and pain control in patients with osteoarthritis.
Objectives: The purpose of this study is to investigate the effects of the M&L Trauma Psychotherapy Program on: Impact of Event Scale - Revised (IES-R-K); Euro QOL-5 Dimension (EQ5D); Five-facet Mindfulness Questionnaire (FFMQ); and psychological tests. Methods: Eight middle-aged women subjected to domestic violence participated in the two-day M&L Trauma Psychotherapy Program. The Program was executed 5 times 2 days for about 3 hours. We evaluated IES-R-K, EQ5D, FFMQ, Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), State-Trait Anger Expression inventory (STAXI) and SUDS before the Program and for four weeks afterwards, to analyze the effects of the M&L Trauma Psychotherapy Program. Results: The scores of IES-R-K, BDI, STAI-S, STAI-T, Hwa ST and Hwa CT decreased significantly (p<0.05). EQ5D scores increased significantly (p<0.05) and overall physical condition scale (VAS) increased. In the FFMQ scores, all five facet scores increased slightly. Scores of SUDS decreased significantly right after the program, and remained decreased four weeks later, rather than before the Program (p<0.05). Conclusions: The results suggested that the M&L Trauma Psychotherapy Program improved post-traumatic stress, quality of life and mindfulness skills, and had positive responses to psychological problems - depression, anxiety, anger and distress.
Journal of The Korean Society of Integrative Medicine
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v.9
no.4
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pp.19-28
/
2021
Purpose : The purpose of this study was to apply manual lymphatic drainage (MLD) and high-frequency diathermy (HFD) to patients with axillary web syndrome (AWS), one of the side effects of breast cancer surgery, and to treat upper extremity pain, volume, function of the upper extremity, (joint range of motion; ROM, disabilities of the arm, shoulder and hand; DASH) and quality of life before and after treatment. It is to determine the effect of treatment by checking the level change. Methods : This study is a case series. A total of 5 patients diagnosed with AWS after breast cancer surgery voluntarily participated in this study. The intervention program consisted of stretching, MLD and HFD. It was conducted 3 times a week for 30 minutes for 4 weeks. In order to compare the effects of pain (numeric pain rating scale; NPRS), volume, upper limb function (ROM, DASH) and quality of life (the European organization for research and treatment of cancer quality of life questionnaire-breast, EORTC QLQ-BR23) evaluations were compared before and after 4 weeks of intervention. All measured variables were analyzed and expressed as mean, standard deviation and percentage. Results : The shoulder NPRS level of the subjects in all case groups decreased, the volume decreased and the shoulder flexion, abduction ROM increased. It showed improvement in DASH and quality of life, QLQ-BR23. Conclusion : After breast cancer surgery, we confirmed the possibility that MLD and HFD treatments could be effective in improving pain, decreasing volume, increasing upper extremity function, and quality of life for patients who have difficulties with AWS. The possibility has been confirmed, and additional research is needed by increasing the number of participants in the experiment in the future.
This study analyzed the different needs between the after-school programs of elementary schools in metropolitan and non-metropolitan areas to understand the areas that need addressing to meet with the requisites of the programs. To this end, this study conducted a survey among teachers with experience in after-school management (n=233), and the needs and performance recognized by teachers were analyzed in the IPA model matrix. To sum up the results, 'Online educational infrastructure', 'Efficient administrative operation', and 'Supply of professional after-school instructors' were identified as the prior needs in metropolitan area. On the other hand, non-metropolitan area, 'Supply of professional after-school instructors', 'Quality educational contents', and 'Online educational infrastructure' were identified as the prior requisites to be addressed. Based on research findings, the study suggested implications in developing and implementing related policies. Research findings will be expected to refer as baseline data for activating after-school online program operations and improving its programs to meet with the different needs of regions.
One Diagnosis Related Group(DRG) pilot study participating hospital was measured and analyzed to see if there were any changes after the DRG program. It was implemented in consideration of medical service utilization, hospital charges, and non-covered medical service charges by insurance in all Cesarean section cases by reviewing medical records for 3 years, including 1 year before pilot study as well as 1 and 2 years after, respectively. The results were as follows: First, the use of intramuscular antibiotics decreased statistically significantly, whereas intravenous use did not. Second, the administration period and charges of antianemic medication decreased significantly, where the prescription was appropriate. Third, the length of hospital stay decreased statistically significantly. Fourth, there were significant statistical differences in cost sharing between the insured and the insurer: cost sharing of the insured was reduced, whereas the share of the insurer increased. However, there was no change in the quality of care. Fifth, there were no statistically significant changes in the Cesarean section rate. As a result, if the fee schedule is reasonably high, hospitals can provide quality care. This DRG pilot study resulted expected outcomes: by paying a higher fee schedule than fee-for-service, then hospitals can provide quality care to their patients and increase hospital profits.
Purposes: This study purposed to evaluate the effect of a value incentive program(VIP) on the in-hospital mortality of acute stroke. Methodology: Study period was from January 2010 to December 2018. This study included 63 hospitals for acute hemorrhagic stroke that the mortality rate per month was more than one during study period. Independent variables were time variables and hospital characteristics such as hospital type, district and bed number. Interrupted time series analysis was applied to analyze the data. Findings: In case of general hospitals, the in-hospital mortality rate per month for acute hemorrhagic stroke tends to be increased by 0.03% in overall study periods but decreased by 0.32% after the implementation of the policy. On the other hand, tertiary hospital changes are not statistically meaningful. Conclusion: This study provides evidences how the VIP was effective in improving quality of acute hemorrhagic stroke care. General hospitals showed higher policy effect compare to that of tertiary hospitals.
Tran, Bao Ngoc N.;Chen, Austin D.;Kamali, Parisa;Singhal, Dhruv;Lee, Bernard T.;Fukudome, Eugene Y.
Archives of Plastic Surgery
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v.45
no.5
/
pp.418-424
/
2018
Background Complication rates after flap coverage for pressure ulcers have been high historically. These patients have multiple risk factors associated with poor wound healing and complications including marginal nutritional status, prolonged immobilization, and a high comorbidities index. This study utilizes the National Surgical Quality Improvement Program (NSQIP) to examine perioperative outcomes of flap coverage for pressure ulcers. Methods Data from the NSQIP database (2005-2015) for patient undergoing flap coverage for pressure ulcers was identified. Demographic, perioperative information, and complications were reviewed. One-way analysis of variance and Pearson chi-square were used to assess differences for continuous variables and nominal variables, respectively. Multivariate logistic regression was performed to identify independent risk factors for complications. Results There were 755 cases identified: 365 (48.3%) sacral ulcers, 321 (42.5%) ischial ulcers, and 69 (9.1%) trochanteric ulcers. Most patients were older male, with some degree of dependency, neurosensory impairment, high functional comorbidities score, and American Society of Anesthesiologists class 3 or above. The sacral ulcer group had the highest incidence of septic shock and bleeding, while the trochanteric ulcer group had the highest incidence of superficial surgical site infection. There was an overall complication rate of 25% at 30-day follow-up. There was no statistical difference in overall complication among groups. Total operating time, diabetes, and non-elective case were independent risk factors for overall complications. Conclusions Despite patients with poor baseline functional status, flap coverage for pressure ulcer patients is safe with acceptable postoperative complications. This type of treatment should be considered for properly selected patients.
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