Achievements, Problems, and Future Direction of the Quality Control Program for Special Periodic Health Examination Agencies in Republic of Korea

The ultimate goal of the quality control program for special periodic health examination agencies is to diagnose the health condition of a worker correctly, based on accurate examination and analysis skills, leading to protect the worker’s health. The quality control program on three areas, chemical analysis for biological monitoring since 1995, and pneumoconiosis, audiometric testing since 1996, has contributed to improve the reliability of occupational health screenings by improving the issues including standardization of testing methods, tools, diagnostic opinions, and reliability of analysis for biological monitoring. It has contributed to improving the reliability of occupational health monitoring by rectifying the following issues associated with previous monitoring: absence of standardized testing methods, testing tools that are not upgraded, mismatching diagnostic opinions, and unreliable results of biological specimen analysis. Nevertheless, there are issues in need of further improvement such as lack of expertise or the use of inappropriate method for health examination, and passive and unwilling participation in the quality control. We suggested solutions to these problems for each area of quality control program. Above all, it is essential to provide active support for health examiners to develop their expertise, while encouraging all the health screening agencies, employers, and workers to develop the desire to improve the system and to maintain the relevance.

A Study on the Health Status, Burnout, and Burden of Primary Family Caregivers of the Elderly In-Patients

PURPOSE: This study was to explore the level of health status, burnout, and burden of primary family caregivers of the elderly inpatients, and to identify the relations among the factors. METHOD: The subjects were a total of 232 primary family caregivers of elderly in-patients at K and E Medical Center, and were surveyed from March 1 to April 10, 2007. Measures were a health status measuring tool based on CMI developed by Brodman et al. (1945), the burnout measuring tool developed by Pines et al. (1981), and the burden measuring tool revised by Jung, Soo-Jin (1998). Data were analyzed by SPSS-WIN 12.0. RESULTS: Firstly, the mean of health status was 1.69, which means that they were mostly healthy, and the mean of burnout was 2.66, which means that they were a little burned out. The mean of burden was 2.71, which means that they were a little burdened. Second, there were high correlations between health status and burnout, between health status and burden, and between burnout and burden. Third, there were significant difference in health status and burnout according to sex and relationship, and in burden according to sex, education level and relationship. CONCLUSIONS: Nurses need to consider the characteristics, health status, burnout, and burden of primary family caregivers.

Pulmonary Thromboembolism following Mastectomy with Immediate TRAM in the Patients with Breast Cancer : a Prospective Study / 한국유방암학회지

PURPOSE: : Skin-sparing mastectomy with immediate reconstruction provides psychological satisfaction and a good cosmetic effect for patients with breast cancer. However, this procedure takes longer operation time than mastectomy, and the risk of pulmonary thromboembolism (PTE) and deep vein thrombosis may be increased. The purpose of this study was to evaluate the incidence of PTE. METHODS: Between January and May in 2005, 54 breast cancer patients who underwent skin-sparing mastectomy with immediate transverse rectus abdominalis myocutaneous flap (TRAM) at Asan Medical Center were prospectively investigated according to the clinicopathologic data. Patients were placed in compression stockings on the day of operation, and lung perfusion, inhalation scans,and serum D-dimer assays were performed on the first three postoperative days. If findings were suspicious, we performed embolism computed tomography. We compared patient age, body mass index (BMI), clinical risk factors, operative findings, pathologic results, and the clinical course between PTE patients and non-PTE patients. RESULTS: There were 9 cases of intermediate probability and 6 cases of high probability for PTE according to lung perfusion and inhalation scans, and they underwent embolism CT. Eleven patients (20.4%) were diagnosed with embolism CT or with lung perfusion and inhalation scans;2 patients were symptomatic and 9 patients were asymptomatic. There was significant difference between PTE and non-PTE patients for age, but none for BMI, clinical risk factors, operation time, serum D-dimer, or stage. CONCLUSION: The incidence of PTE after mastectomy with immediate TRAM is relatively high, and a strategy for the prevention and treatment of PTE is required. Although age is a risk factor for PTE on this study, future studies are needed to determine the risk factors for and to confirm proper treatment and prevention of PTE.