Effect of a Multicomponent Intervention Program on Community-Dwelling People With Intellectual Disabilities

Objective@#To investigate the effectiveness of a novel and complex intervention in community-dwelling people with intellectual disabilities. @*Methods@#Forty-three participants completed the experiment. The subjects were randomly assigned the experimental (n=33) or control (n=10) groups. The multicomponent intervention program comprised exercise and nutrition management and behavior modification. The intervention was performed for 60 minutes once weekly for 10 weeks. The assessment included anthropometric data, body composition and blood pressure analysis, and blood tests. In addition, pulmonary function, physical function, and health-related quality of life were measured before and after the intervention. @*Results@#No adverse events occurred during the intervention. After the intervention, the experimental group showed a significantly higher increase in high-density lipoprotein cholesterol level than did the control group (effect size=0.152, p=0.019). @*Conclusion@#This innovative intervention was effective in improving cardiovascular health. Even greater effects could be achieved through improvements in implementation strategies to increase compliance.

Stroke Impact Scale 3.0: Reliability and Validity Evaluation of the Korean Version

OBJECTIVE: To establish the reliability and validity the Korean version of the Stroke Impact Scale (K-SIS) 3.0. METHODS: A total of 70 post-stroke patients were enrolled. All subjects were evaluated for general characteristics, Mini-Mental State Examination (MMSE), the National Institutes of Health Stroke Scale (NIHSS), Modified Barthel Index, Hospital Anxiety and Depression Scale (HADS). The SF-36 and K-SIS 3.0 assessed their health-related quality of life. Statistical analysis after evaluation, determined the reliability and validity of the K-SIS 3.0. RESULTS: A total of 70 patients (mean age, 54.97 years) participated in this study. Internal consistency of the SIS 3.0 (Cronbach's alpha) was obtained, and all domains had good co-efficiency, with threshold above 0.70. Test-retest reliability of SIS 3.0 required correlation (Spearman's rho) of the same domain scores obtained on the first and second assessments. Results were above 0.5, with the exception of social participation and mobility. Concurrent validity of K-SIS 3.0 was assessed using the SF-36, and other scales with the same or similar domains. Each domain of K-SIS 3.0 had a positive correlation with corresponding similar domain of SF-36 and other scales (HADS, MMSE, and NIHSS). CONCLUSION: The newly developed K-SIS 3.0 showed high inter-intra reliability and test-retest reliabilities, together with high concurrent validity with the original and various other scales, for patients with stroke. K-SIS 3.0 can therefore be used for stroke patients, to assess their health-related quality of life and treatment efficacy.

A Study on User Satisfaction regarding the Clinical Decision Support System (CDSS) for Medication / 대한의료정보학회지

OBJECTIVES: Many medication errors can occur when ordering and dispensing medicine in hospitals. The clinical decision support system (CDSS) is widely used in an effort to reduce medication errors. This study focused on the evaluation of user satisfaction with the CDSS for medication at a university hospital. Specifically, this study aimed to identify the factors influencing user satisfaction and to examine user requirements in order to further improve user satisfaction and drug safety. METHODS: The study was based on survey data from 218 users (103 doctors, 103 nurses, and 15 pharmacists) at a university hospital that uses the CDSS. In order to identify the factors influencing user satisfaction with the CDSS, a multiple linear regression was performed. In order to compare the satisfaction level among the professional groups, an analysis of variance (ANOVA) was performed. RESULTS: The reliability of information, decision supporting capability, and departmental support were significant factors in influencing user satisfaction. In addition, nurses were the most satisfied group, followed by pharmacists and doctors according to the ANOVA. Areas for further improvement in enhancing drug safety were real time information searching and decision supporting capabilities to prevent adverse drug events (ADE) in a timely manner. CONCLUSIONS: We found that the CDSS users were generally satisfied with the system and that it complements the nationwide drug utilization review (DUR) system in reducing ADE. Further CDSS evaluation in other hospitals is needed to improve user satisfaction and drug safety.

Key Issues of Hospital Information Systems Management / 대한의료정보학회지

OBJECTIVE: This study was conducted to identify 3 to 5 years of future management issues in hospital information systems (HIS). METHODS: Two rounds of interview surveys were conducted based on the sample survey of 50 managers from 28 hospital information centers utilizing the Delphi method. RESULTS: From the survey, management issues in HIS were identified in the following order: 'top management support', 'close relationship with users', 'PACS', 'disaster recovery', improving IS strategic planning'. Compared with the 1999 survey, the issues that rank within the top 10 management issues were as follows: 'top management support', 'security and control', 'close relationship with users'. Recently surfaced issues are 'disaster recovery' and 'standardization'. The issues that dropped out of the top 10 ranks were 'network management', 'recruiting and developing IS human resource'which were very fundamental issues in the initial state of the introduction of the hospital information system. CONCLUSION: The two main significance of this study involves predicting future management issues based on the comparison of the current issues with the 1999 issues and recommendingmanagement strategies based on the classification of issues by importance and persistence.

The Study on Performance Evaluation and Improvement of the Information System for the Disabled / 재활간호학회지

PURPOSE: The study tried to suggest the ways to improve the national disability welfare information projects with evaluating the present condition of the projects. METHOD: Firstly, the study analyzed the disability information system and disability websites. Secondly, the study found out the problems of the registration of disability and management system through the situation analysis. Finally, the study conducted a survey of the disabled and the information system workers and performance evaluation of the information system. RESULTS: The study offered a proposal of The Disability Unity Management System(DUMS) for the disability registration and management. When the disabled visit the hospital or the public health center, their information is registered automatically in The Disability Unity Management System(DUMS), which helps not to miss out the disability registration. Through this system, they are given the proper service which they need, and the information can be shared with the facilities providing the service for the disabled. CONCLUSION: The Disability Unity Management System(DUMS) contributes significantly in avoiding the repetition of the support for the disabled and improving the quality of service.

ERP System Performance in a Hospital / 대한의료정보학회지

OBJECTIVE: To measure the performance of a hospital enterprise resource planning (ERP) system and suggest various system improvements. METHODS: A survey based on a 5-point Likert scale questionnaire and an exclusive interview was administered to 102 employees with a one-year experience of using an ERP system at one university hospital. In order to analyze the factors affecting the ERP system performance, multiple regression analysis and Chi-square test were conducted. RESULTS: All three examined variables-system quality, information quality and integration of hospital information resources-affected the ERP system performance positively. However, the system quality variable had the lowest mean score indicating that the ERP system was difficult to understand for many users. User characteristics were not significantly associated with information quality satisfaction. CONCLUSION: On the basis of the study results, we recommended some suggestions to improve the ERP system performance. In order to reduce users' dissatisfaction with the new system, hospitals should publicize the needs of the ERP system for the employees, design more effective training programs, and provide more decision-supporting information for managers.

Design and Implementation of a Web-based Portfolio Assessment System for a Family Medicine Residency Program in Korea / 한국의학교육

PURPOSE: Evaluation and feedback are fundamental components in a residency program. A portfolio assessment system is an appropriate option for making formative assessments, particularly for a family medicine resident whose training includes rotations through various disciplines at multiple locations. However, a paper-based portfolio assessment system has limitations when applied to a clinical environment due to how it is managed and cared. This study assessed the satisfaction and utility of a paper-based portfolio assessment system, and then designed and implemented a web-based portfolio assessment system for family medicine residents. METHODS: A self-administered questionnaire focusing on the satisfaction and utility of a paperbased portfolio assessment system was given to 23 family medicine residents. A web-based portfolio assessment system was then designed using the component-based development approach. RESULTS: The overall satisfaction and utility with the paper-based portfolio assessment system were low. Fifteen residents (62.5%) reported that following a paper-based portfolio assessment system was sometimes a waste of time and only three (13.0%) reported having no problems. The web-based portfolio assessment system was successfully designed to be easy to implement and user-friendly. CONCLUSION: The web-based portfolio assessment system is expected to overcome the shortcomings of a paper-based portfolio assessment system and improve the level of satisfaction of medical residents. It is expected that the web-based portfolio assessment system designed in this study will be an additional tool for family medicine residencies.

Study on the Development of Critical Pathway for the Cesarean Section using Data Mining Technique / 대한의료정보학회지

The objectives of this study was to discover knowledge in predicting lengths of stay of Cesarean Section by patients characteristics and treatment method using data mining technique and to suggest the approach to the development of critical pathway. The findings suggest that data mining technique from the large pool of accumulated patients data can be utilized to systematize newly observed correlations, patterns and trends and to develop critical pathway for the treatment and management. The results of the study can be contributed to aid developing the clinical pathway for cesarean section suitable to Korean patients. And the application of the developed critical pathway in clinical practice will produce the actual effect and value.

An Application of Data Mining Approach to CQI Using the Discharge Summary / 대한의료정보학회지

This study provides an application of datamining approach to CQJ using the discharge summary. First, we found a process variation in hospital infection rate by SPC (Statistical Process Control) technique. Second, importance of factors influencing hospital infection was inferred through the decision tree analysis which is a classification method in data -mining approach. The most important factor was surgery followed by comorbidity and length of operation. Comorbidity was further divided into age and principal diagnosis and the length of operation was further divided into age and chief complaint. 24 rules of hospital infection were generated by the decision tree analysis. Of these, 9 rules with predictive prover greater than 50% were suggested as guidelines for hospital infection control. The optimum range of target group in hospital infection control were identified through the information gain summary.Association rule, which is another kind of datamining method, was performed to analyze the relationship between principal diagnosis and comorbidity. The confidence score, which measures the degree of association, between urinary tract infection and causal bacillus was the highest, followed by the score between postoperative wound disruption and postoperative wound infection.This study demonstrated how datamining approach could be used to provide information to support prospective surveillance of hospital infection. The datamining technique can also be applied to various areas for CQI using other hospital databases.

Data Mining Application for Knowledge Management in Medical Field / 대한의료정보학회지

The purpose of this study are to find useful knowledge through discovering relations and patterns of unknown facts from large data using data mining technique and to introduce a scheme of knowledge management concept in medical field. The application areas of data mining in medical fields include the medical utilization review analysis, disease pattern analysis, analysis related with health promotion and hospital management analysis. Among those areas, we selected the disease pattern analysis and studied on prediction of the diagnosis of hypertension patients. Three data mining techniques of the statistical analysis, decision tree analysis and C4.5 were performed on the health examination data from Korea Medical Insurance Corporation. From the experiments, the levels of importance of factors to hypertension were inferred and the specifications between hypertensive group and normotensive group was classified and identified. These results can be applied not only to the prediction of the diagnosis of hypertension patients but also to the medical decision support system for the management of hypertension. From now on, the data mining techniques that reproduce valuable information to help decision support will provide and be applied to various areas; clinical epidemiological study, useful information of health promotion project, health care policy support information. And the technique will also give the additional efficiency of national projects related health and the realization of scientific health social management resulting the much more national welfare service.

Structural modeling of differential diagnosis, treatment, and results for allergic rhinitis

This paper analyzed the relationship among the differential diagnosis, treatment, and results for allergic rhinitis using the covariance structural model. The data were collected from 274 patients with suspected allergic rhinitis who visited the Otorlaryngology Department of the Paik Hospital during 1991-1993. After each patient's characteristics was categorized and combined into several common factors, covariance structure analysis was performed to analyze the structural relationships among the differential diagnosis, treatment, and results of treatment using the significant factors obtained from discriminant analysis. The significant characteristics influenced the diagnosis were the results of skin test from mite/animal, and from mugworts, the results from laboratory tests, rhinorrhea and sneezing, and nasal polyps. The significant characteristics that influenced the method of treatment were: nasal polyps, headache/general symptom, family history/medication, and septal deviation. Headache/general symptom was the only significantly influencing factor for the treatment results.