A Q-Methodological Study of Suicidal Attitudes in Male Baby Boomers / 정신간호학회지

Purpose@#The purpose of this study was to identify attitudes of male baby boomers towards suicide. @*Methods@#Q-Methodology which provides a method of analyzing the subjectivity of each item was used. Thirty-five q-statements were selected from total 110 statements. The recruited P-sample consisted of thirty-three male baby boomers in 1 town and 4 cities. Q-statements were classified into a shape of normal distribution of a 9-point scale. Collected data were analyzed using PQMethod Program 2.11. @*Results@#Three types of attitudes towards suicide were identified. The first type was self-overcoming type that oppose suicide. The second type was burden recognition type with ambivalence toward suicide. The third type was social support-seeking types that oppose suicide. @*Conclusion@#The results of this study suggest that it is necessary to apply a suicide prevention program differentiated according to the three types for suicide prevention among male baby boomers in Korea.

A Q-Methodological Study of Suicidal Attitudes in Male Baby Boomers / 정신간호학회지

Purpose@#The purpose of this study was to identify attitudes of male baby boomers towards suicide. @*Methods@#Q-Methodology which provides a method of analyzing the subjectivity of each item was used. Thirty-five q-statements were selected from total 110 statements. The recruited P-sample consisted of thirty-three male baby boomers in 1 town and 4 cities. Q-statements were classified into a shape of normal distribution of a 9-point scale. Collected data were analyzed using PQMethod Program 2.11. @*Results@#Three types of attitudes towards suicide were identified. The first type was self-overcoming type that oppose suicide. The second type was burden recognition type with ambivalence toward suicide. The third type was social support-seeking types that oppose suicide. @*Conclusion@#The results of this study suggest that it is necessary to apply a suicide prevention program differentiated according to the three types for suicide prevention among male baby boomers in Korea.

Development of Warfarin Talk: A Messenger Chatbot for Patients Taking Warfarin

Background@#Despite the increased use of direct-acting oral anticoagulants, warfarin is still recommended as first-line therapy in patients with mechanical valves or moderate to severe mitral stenosis. Anticoagulation management services (AMSs) are warranted for patients receiving warfarin therapy due to the complexity of warfarin dosing and large interpatient variability. To overcome limited health care resources, we developed a messenger app-based chatbot that provides information to patients taking warfarin. @*Methods@#We developed “WafarinTalk” as an add-on to the open-source messenger app KakaoTalk. We developed the prototype chatbot after building a database containing seven categories: 1) dosage and indications, 2) drug-drug interactions, 3) drug-food interactions, 4) drug-diet supplement interactions, 5) monitoring, 6) adverse events, and 7) precautions. We then surveyed 30 pharmacists and 10 patients on chatbot reliability and on participant satisfaction. @*Results@#We found that 80% of the pharmacists agreed on the consistency of chatbot responses and 44% agreed on the appropriateness of chatbot. Furthermore, 47% of pharmacists said that they were willing to recommend the chatbot to patients. Of the seven categories, information on drug-food interaction was the most useful; 90% of patients said they were satisfied with the chatbot and 100% of patients said they were willing to use it when they were unable to see a pharmacist. We updated the prototype chatbot with feedback from the survey. @*Conclusion@#This study showed that warfarin-related information could be provided to patients through a messenger applicationbased chatbot.

Development of Warfarin Talk: A Messenger Chatbot for Patients Taking Warfarin

Background@#Despite the increased use of direct-acting oral anticoagulants, warfarin is still recommended as first-line therapy in patients with mechanical valves or moderate to severe mitral stenosis. Anticoagulation management services (AMSs) are warranted for patients receiving warfarin therapy due to the complexity of warfarin dosing and large interpatient variability. To overcome limited health care resources, we developed a messenger app-based chatbot that provides information to patients taking warfarin. @*Methods@#We developed “WafarinTalk” as an add-on to the open-source messenger app KakaoTalk. We developed the prototype chatbot after building a database containing seven categories: 1) dosage and indications, 2) drug-drug interactions, 3) drug-food interactions, 4) drug-diet supplement interactions, 5) monitoring, 6) adverse events, and 7) precautions. We then surveyed 30 pharmacists and 10 patients on chatbot reliability and on participant satisfaction. @*Results@#We found that 80% of the pharmacists agreed on the consistency of chatbot responses and 44% agreed on the appropriateness of chatbot. Furthermore, 47% of pharmacists said that they were willing to recommend the chatbot to patients. Of the seven categories, information on drug-food interaction was the most useful; 90% of patients said they were satisfied with the chatbot and 100% of patients said they were willing to use it when they were unable to see a pharmacist. We updated the prototype chatbot with feedback from the survey. @*Conclusion@#This study showed that warfarin-related information could be provided to patients through a messenger applicationbased chatbot.

The Effect and Safety of Dapagliflozin in Patients with Type 2 Diabetes: A Single-Institution Pharmacovigilance Review / 임상당뇨병

BACKGROUND: Dapagliflozin, a selective sodium-glucose co-transporter 2 (SGLT2) inhibitor, lowers blood glucose by reducing glucose reabsorption at the proximal renal tubule in an insulin-independent manner. We aimed to evaluate the efficacy and safety of dapagliflozin and to identify the risk factors of adverse drug events in patients with type 2 diabetes. METHODS: As an institutional pharmacovigilance review activity, we reviewed data from medical records of 455 patients with type 2 diabetes who received dapagliflozin therapy from July 2014 to August 2015 in Seoul National University Hospital. We analyzed the changes in laboratory data and examined the characteristics of dapagliflozin users who showed adverse effects. RESULTS: Mean changes in HbA1c and fasting serum glucose level from baseline to second visit were −0.42% (8.07 ± 1.51% to 7.65 ± 1.31%, P < 0.001) and −22.9 mg/dL (167.8 ± 48.5 mg/dL to 144.9 ± 37.6 mg/dL, P < 0.001), respectively. Adverse drug events observed during this study were lower urinary tract symptoms (7.7%), dehydration-related symptoms (6.1%), ketonuria (3.4%), hypoglycemia (3.4%), and urogenital infection (4.2%). Thiazide use, age, insulin use, number of anti-diabetic drugs, gender and history of urogenital infection were the risk factors for adverse drug events (P < 0.05). CONCLUSION: Dapagliflozin significantly improved hyperglycemia in patients with type 2 diabetes without serious adverse drug events. The incidences of adverse drug events were was similar to those ofthat in the previous studies.

Impact of Central Line Insertion Bundle on the Adherence of Bundle and Central Line-Associated Bloodstream Infections in the Operating Room

BACKGROUND: This study purposed to examine how the incidence of the central line-associated bloodstream infection (CLABSI) in a operating room (OR) is affected by bundle application on central line insertion (CLI) practice. METHODS: The study design was a pretest-posttest experimental trial. The subjects were 83 patients before the bundle application on CLI and 70 patients after. RESULTS: The compliance(%) of bundle on CLI of among those who observed all of the five items increased from 7.2% before the intervention to 72.9% after. By items, compliance with the maximal barrier precaution was 100% for the use of a mask and cap before and after the intervention, but increased from 73.5% before the intervention to 88.6% after for the hand hygiene, from 73.5% to 88.6% for the use of a sterile gown, and from 9.6% to 75.7% for the use of a sterile large drape covering the whole body. CLABSI did not happen on CLI either before or after the application of the bundle intervention. CONCLUSION: Bundle application increased compliance with the use of a sterile gown and the use of a sterile large drape. However, its effect in the prevention of CLABSI was not clear probably due to the short period of intervention in a single hospital.