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Purpose@#This descriptive study investigated the influence of married nurses’ self-efficacy, parenting stress, and organizational culture on their health-promoting behaviors. @*Methods@#Data were collected from 173 married nurses in G and B metropolitan city; the study was conducted from August to September 2019. Data were analyzed using the independent t-test, one-way ANOVA, Pearson correlation coefficient, and multiple regression with SPSS 18.0. @*Results@#The most significant influencing factors on the health-promoting behavior of the subject were self-efficacy (β=.38, p<.001), followed by parenting stress (β=-.21, p=.002), education (β=-.20, p=.001), perceived health status (β=.19, p=.003) and the overall explanatory power was 42.0%. @*Conclusion@#Based on the results, an intervention program that can increase their self-efficacy and reduce parenting stress is needed, considering education level of married nurses and their perceived health status to be developed.
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The purpose of this study was to explore, using topic modeling, the social value of doctors and medicine demanded by society as reflected in published newspaper articles in Korea. Ultimately, this study aimed to reflect social needs in the process of developing the Patient-Centered Doctor’s Competency Framework in Korea. For this purpose, a total of 2,068 newspaper articles published from 2016 to 2020 were analyzed.Through topic modeling of these newspaper articles over the past 5 years, 18 topics were derived and divided into four categories. Focusing on the derived topics and keywords, the topics derived in specific years and the proportion of topics by year were analyzed. The results of this study make it possible to grasp the needs of society projected through the press for doctors and medicine. Due to the nature of the press, topics that frequently appeared in newspaper articles were mainly social phenomena related to requirements for doctors, particularly dealing with economic and legal aspects. In particular, it was confirmed that doctors are now required to have a wider range of competencies that go beyond their required medical knowledge and clinical skills. This study helped to establish doctor’s competencies by analyzing social needs for doctors through the latest research methods, and the findings could help to establish and improve doctor’s competencies through ongoing research in the future.
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The purpose of this study was to establish a model for constructing longitudinal data for medical school, and to structure cohort and longitudinal data using data from Yonsei University College of Medicine (YUCM) according to the established input-environment-output (I-E-O) model. The study was conducted according to the following procedure. First, the data that YUCM has collected was reviewed through data analysis and interviews with the person in charge of each questionnaire. Second, the opinions of experts on the validity of the I-E-O model were collected through the first expert consultation, and as a result, a model was established for each stage of medical education based on the I-E-O model. Finally, in order to further materialize and refine the previously established model for each stage of medical education, secondary expert consultation was conducted. As a result, the survey areas and time period for collecting longitudinal data were organized according to the model for each stage of medical education, and an example of the YUCM cohort constructed according to the established model for each stage of medical education was presented. The results derived from this study constitute a basic step toward building data from universities in longitudinal form, and if longitudinal data are actually constructed through this method, they could be used as an important basis for determining major policies or reorganizing the curricula of universities. These research results have implications in terms of the management and utilization of existing survey data, the composition of cohorts, and longitudinal studies for many medical schools that are conducting surveys in various areas targeting students, such as lecture evaluation and satisfaction surveys.
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With increasing demands for medical care by society, the medical system, and general citizens and rapid changes in doctor’s awareness, the competencies required of doctors are also changing. The goal of this study was to develop a doctor’s competency framework from the patient’s perspective, and to make it the basis for the development of milestones and entrustable professional activities for each period of medical student education and resident training. To this end, a big data analysis using topic modeling was performed on domestic and international research papers (2011–2020), domestic newspaper articles (2016–2020), and domestic social networking service data (2016–2020) related to doctor’s competencies. Delphi surveys were conducted twice with 28 medical education experts. In addition, a survey was conducted on doctor’s competencies among 1,000 citizens, 407 nurses, 237 medical students, 361 majors, and 200 specialists.Through the above process, six core competencies, 16 sub-competencies, and 47 competencies were derived as subject-oriented doctor’s competencies. The core competencies were: (1) competency related to disease and health as an expert; (2) competency related to patients as a communicator; (3) competency related to colleagues as a collaborator; (4) competency related to society as a health care leader (5) competency related to oneself as a professional, and (6) competency related to academics as a scholar who contributes to the development of medicine.
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To analyze medical professors’ evaluation of their online education experiences in an attempt to support faculty members and indicate the future direction of medical education. Faculty members who taught online in the first semester of 2020 at Yonsei University College of Medicine in South Korea were surveyed. The results of the survey were analyzed in June 2020. There were 88 respondents (35.1% of 251): 59 professors (67.0%), 16 associate professors (18.2%), and 13 assistant professors (14.8%). Their specialties lay in basic medicine (25.0%), clinical medicine (65.9%), and research and special purposes (9.1%). Sixteen participants (18.2%) had previous experience in online lectures; 23 (26.1%) reported that preparation time for online lectures was the same as before; 65 (73.9%) reported that the preparation time had increased; 38 (43.2%) faced difficulties in preparation and lecturing online, and among them 16 (42.1%) indicated inadequate interaction with students; 11 (28.9%) needed extra preparation time; and 11 (28.9%) attributed their difficulties to technical issues with the online platform. Participants’ satisfaction with online lectures was low (p<0.001). In the free response question on overall experience with online education, 38.3% mentioned the need for an instructional design that allows students to actively participate and interact with professors, 29.5% mentioned the need for the establishment of an information & communications technology system, and 17.0% mentioned the necessity of faculty development. To prepare for the current pandemic and more in the long term, an appropriate educational support system must be constructed, and a learner-centered instructional design that enables wider interactions and active learning is needed.
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The accreditation process (AccP) is both an opportunity and a burden for medical schools—which one it becomes depends on how medical schools recognize and utilize the AccP. In other words, if a medical school recognizes the AccP only as a formal procedure or as a means for continuing medical education, it will be a burden for the medical school. However, if a medical school recognizes the real and positive value of the AccP, it can be both an opportunity and a tool for developing medical education. The educational value of the AccP is to improve the quality, equity, and efficiency of medical education, along with increasing the options of choice. In order for the AccP to contribute to the development of medical education, accrediting agencies and medical schools must first be recognized as part of an “educational alliance” working together towards common goals. Secondly, clear guidelines on the accreditation standards should be periodically reviewed and shared. Finally, a formative evaluation using self-evaluation as a system that can utilize the AccP as an opportunity to develop medical education must be introduced. This type of evaluation system could be developed through collaboration among medical schools, academic societies for medical education, and the accrediting authority.
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Background@#Patients undergoing cardiac surgery require postoperative chest drainage. However, the drain is difficult to keep in place in children with congenital heart disease. Since 2015, at Kyungpook National University Hospital, the chest tube is removed on postoperative day 1 in patients who have undergone simple congenital cardiac surgery (i.e., closure of an atrial or ventricular septal defect). In this study, we evaluated the relationship between the duration of drain placement and the likelihood of pericardial effusion after congenital cardiac surgery. @*Methods@#The medical records of patients who underwent closure of an atrial or ventricular septal defect at our hospital between January 2014 and December 2016 were reviewed. In total, 162 patients who received follow-up echocardiography and had information available on postoperative pericardial effusion after the repair procedure were enrolled. @*Results@#Echocardiography was performed at a median of 5 days (range, 4 to 6 days) postoperatively before discharge from the hospital. Pericardial effusion occurred in 21 patients (13.0%), of whom only 3 (1.9%) had moderate or greater pericardial effusion, regardless of the drain duration. All patients improved during outpatient follow-up without invasive management. No patient had severe complications because of pericardial effusion. The duration of drain placement did not affect the incidence of postoperative pericardial effusion (p=0.069). Operative survival was 100%. @*Conclusion@#Based on our study, we recommend removing the drain as soon as its role is complete, generally on postoperative day 1, because early removal does not increase the incidence of pericardial effusion in patients undergoing simple congenital cardiac surgery.
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Purpose@#This study aims to identify the mediating effect of health promoting behavior in the relationship between depression and health-related quality of life, and between social support and health-related quality of life among migrant workers. @*Methods@#Data were collected from 152 migrant workers working at companies in K and B metropolitan cities. The study conducted a survey from August 1 to September 30, 2019, and used self-report structured questionnaires that were translated into English and Korean. The data were analyzed using descriptive statistics, Pearson correlation coefficient, simple and multiple regression, Baron and Kenny’s method, and Sobel test. @*Results@#Depression was significantly negatively correlated with social support (r=-.29, p<.001), health promoting behavior (r=-.30, p<.001) and health-related quality of life (r=-.44, p<.001). And social support was significantly positively correlated with health promoting behavior (r=.50, p<.001) and health-related quality of life (r=.44, p<.001). And health promoting behavior was significantly positively correlated with health-related quality of life (r=.51, p<.001). Furthermore health promoting behavior showed partial mediating effects in the relationship between depression and health-related quality of life (Z=3.26, p<.001), and showed partial mediating effects in the relationship between the social support and health-related quality of life (Z=3.98, p<.001). @*Conclusion@#In this study, depression and social support were shown to mediate health promotion behavior to improve health-related quality of life. Therefore, in order to improve the health-related quality of life of migrant workers, it is necessary to focus on the health promotion behaviors, and effective strategies are needed to reduce depression, and support social support.
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Purpose@#This study aims to identify related factors of psychological well-being of migrant workers in Korea. @*Methods@#The subjects were 138 migrant workers residing legally in K or B Cities. Data were collected from July 1 to August 31, 2018, using self-report structured questionnaires that were translated into English, Chinese, Vietnamese, and Korean, and were analyzed with descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients and multiple regression. @*Results@#The most important influencing factors on the psychological well-being of migrant workers were social support (β=.36, p<.001), followed by perceived health status (β=.25, p=.001), education (β=−.18, p=.015), and spouse support (β=.16, p=.032). The overall explanatory power was 28.9%. @*Conclusion@#In order to improve the psychological well-being of migrant workers, it is required to develop a nursing approach that may promote the social support, health status, and spouse support, and consider the educational level of migrant workers.
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The accreditation process is both an opportunity and a burden for medical schools in Korea. The line that separates the two is based on how medical schools recognize and utilize the accreditation process. In other words, accreditation is a burden for medical schools if they view the accreditation process as merely a formal procedure or a means to maintain accreditation status for medical education. However, if medical schools acknowledge the positive value of the accreditation process, accreditation can be both an opportunity and a tool for developing medical education. The accreditation process has educational value by catalyzing improvements in the quality, equity, and efficiency of medical education and by increasing the available options. For the accreditation process to contribute to medical education development, accrediting agencies and medical schools must first be recognized as partners of an educational alliance working together towards common goals. Secondly, clear guidelines on accreditation standards should be periodically reviewed and shared. Finally, a formative self-evaluation process must be introduced for institutions to utilize the accreditation process as an opportunity to develop medical education. This evaluation system could be developed through collaboration among medical schools, academic societies for medical education, and the accrediting authority.
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Purpose@#This study aims to identify the mediating effect of health promoting behavior in the relationship between depression and health-related quality of life, and between social support and health-related quality of life among migrant workers. @*Methods@#Data were collected from 152 migrant workers working at companies in K and B metropolitan cities. The study conducted a survey from August 1 to September 30, 2019, and used self-report structured questionnaires that were translated into English and Korean. The data were analyzed using descriptive statistics, Pearson correlation coefficient, simple and multiple regression, Baron and Kenny’s method, and Sobel test. @*Results@#Depression was significantly negatively correlated with social support (r=-.29, p<.001), health promoting behavior (r=-.30, p<.001) and health-related quality of life (r=-.44, p<.001). And social support was significantly positively correlated with health promoting behavior (r=.50, p<.001) and health-related quality of life (r=.44, p<.001). And health promoting behavior was significantly positively correlated with health-related quality of life (r=.51, p<.001). Furthermore health promoting behavior showed partial mediating effects in the relationship between depression and health-related quality of life (Z=3.26, p<.001), and showed partial mediating effects in the relationship between the social support and health-related quality of life (Z=3.98, p<.001). @*Conclusion@#In this study, depression and social support were shown to mediate health promotion behavior to improve health-related quality of life. Therefore, in order to improve the health-related quality of life of migrant workers, it is necessary to focus on the health promotion behaviors, and effective strategies are needed to reduce depression, and support social support.
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Purpose@#This study aims to identify related factors of psychological well-being of migrant workers in Korea. @*Methods@#The subjects were 138 migrant workers residing legally in K or B Cities. Data were collected from July 1 to August 31, 2018, using self-report structured questionnaires that were translated into English, Chinese, Vietnamese, and Korean, and were analyzed with descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients and multiple regression. @*Results@#The most important influencing factors on the psychological well-being of migrant workers were social support (β=.36, p<.001), followed by perceived health status (β=.25, p=.001), education (β=−.18, p=.015), and spouse support (β=.16, p=.032). The overall explanatory power was 28.9%. @*Conclusion@#In order to improve the psychological well-being of migrant workers, it is required to develop a nursing approach that may promote the social support, health status, and spouse support, and consider the educational level of migrant workers.
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The accreditation process is both an opportunity and a burden for medical schools in Korea. The line that separates the two is based on how medical schools recognize and utilize the accreditation process. In other words, accreditation is a burden for medical schools if they view the accreditation process as merely a formal procedure or a means to maintain accreditation status for medical education. However, if medical schools acknowledge the positive value of the accreditation process, accreditation can be both an opportunity and a tool for developing medical education. The accreditation process has educational value by catalyzing improvements in the quality, equity, and efficiency of medical education and by increasing the available options. For the accreditation process to contribute to medical education development, accrediting agencies and medical schools must first be recognized as partners of an educational alliance working together towards common goals. Secondly, clear guidelines on accreditation standards should be periodically reviewed and shared. Finally, a formative self-evaluation process must be introduced for institutions to utilize the accreditation process as an opportunity to develop medical education. This evaluation system could be developed through collaboration among medical schools, academic societies for medical education, and the accrediting authority.
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BACKGROUND: Cardiovascular diseases of chronic dialysis patients are often undertreated because of their higher surgical risk. This study aimed to assess mortality and morbidity after open heart surgery in chronic dialysis patients compared to those with normal renal function and identify risk factors for postoperative outcomes. METHODS: We retrospectively analyzed 2,432 patients who underwent open heart surgery from 2002 to 2017 and collected data from 116 patients (38 patients on dialysis and 78 age-, sex-, and diabetes mellitus status-matched control patients with normal kidney function). We assessed comorbidities, New York Heart Association (NYHA) class, laboratory data, surgical methods, and postoperative outcomes. RESULTS: The dialysis group had more comorbidities, higher NYHA classes, and greater need for urgent surgeries compared to the control group. They exhibited significantly higher postoperative mortality (18.4% vs. 2.6%, P = 0.005) and more overall complications (65.8% vs. 25.6%, P < 0.001). Dialysis itself significantly increased relative risk for in-hospital mortality after adjustment. EuroSCORE II was not as useful as in the general population. Multivariate logistic regression analysis demonstrated that total (adjusted odds ratio [AOR], 10.7; P = 0.029) and in-hospital death risk (AOR, 14.7; P = 0.033), the durations of postoperative hospitalization (AOR, 4.6; P = 0.034), CRRT (AOR 36.8; P = 0.004), and ventilator use (AOR, 7.6; P = 0.022) were significantly increased in the dialysis group. CONCLUSION: The dialysis group exhibited a higher risk for mortality and overcall complications after open heart surgery compared to the patients with normal renal function. Therefore, the benefit of surgical treatment must be balanced against potential risks.
Subject(s)
Humans , Cardiovascular Diseases , Comorbidity , Diabetes Mellitus , Dialysis , Heart , Hospital Mortality , Hospitalization , Kidney , Kidney Failure, Chronic , Logistic Models , Mortality , Odds Ratio , Renal Insufficiency , Retrospective Studies , Risk Factors , Thoracic Surgery , Ventilators, MechanicalABSTRACT
PURPOSE: The present study aimed to evaluate progression and prognosis according to the palliation method used in neonates and early infants aged 3 months or younger who were diagnosed with pulmonary atresia with ventricular septal defect (PA VSD) or tetralogy of Fallot (TOF) with severe pulmonary stenosis (PS) in a single tertiary hospital over a period of 12 years. METHODS: Twenty with PA VSD and 9 with TOF and severe PS needed initial palliation. Reintervention after initial palliation, complete repair, and progress were reviewed retrospectively. RESULTS: Among 29 patients, 14 patients underwent right ventricle to pulmonary artery (RV-PA) connection, 11 palliative BT shunt, 2 central shunt, and 2 ductal stent insertion. Median age at the initial palliation was 13 days (1–98 days). Additional procedure for pulmonary blood flow was required in 5 patients; 4 additional BT shunt operations and 1 RV-PA connection. There were 2 early deaths among patients with RV-PA connection, one from RV failure and the other from severe infection. Finally, 25 patients (86%) had a complete repair. Median age of total correction was 12 months (range, 2–31 months). At last follow-up, 2 patients had required reintervention after total correction; 1 conduit replacement and 1 right ventricular outflow tract (RVOT) patch enlargements. CONCLUSION: For initial palliation of patients with PA VSD or TOF with severe PS, not only shunt operation but also RV-PA connection approach can provide an acceptable outcome. To select the most proper surgical strategy, we recommend thorough evaluation of cardiac anomalies such as RVOT and PA morphologies and consideration of the patient's condition.
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Humans , Infant , Infant, Newborn , Follow-Up Studies , Heart Septal Defects, Ventricular , Heart Ventricles , Methods , Palliative Care , Prognosis , Pulmonary Artery , Pulmonary Atresia , Pulmonary Valve Stenosis , Retrospective Studies , Stents , Tertiary Care Centers , Tetralogy of FallotABSTRACT
Despite the importance of how the premedical education curriculum is organized, the basic direction of the curriculum has not been evaluated at a fundamental level. In order to explore the basic directions of the premedical education curriculum, this study examined medical education as a university education, the historical basis of premedical education, and the direction of the premedical education curriculum. Historically, as medical education was incorporated into the university education system, premedical education developed based on basic science and liberal arts education. Accordingly, the direction of the premedical education curriculum began to split into two approaches: one believing in a basic science-based education intended to serve as the foundation of medical training, and the other believing in a liberal arts-based education intended to cultivate the qualities of a doctor. In recent years, however, the binary division in the direction of premedical education has ceased to exist, and the paradigm has now shifted to an agreement that premedical education must cultivate the basic scientific competence required for learning medical knowledge as well as the social qualities that a doctor should have, which are cultivated through the liberal arts. Furthermore, it has been asserted that the direction of premedical education should move toward the qualities that will be required in the future. With the fourth industrial revolution underway, the role of doctors is now being re-examined. This means that today's medical education must change in a future-oriented way, and the direction of the premedical education curriculum must be on the same page.
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Curriculum , Education , Education, Medical , Education, Premedical , Humanities , Learning , Mental CompetencyABSTRACT
BACKGROUND: The benefits of video-assisted thoracoscopic surgery (VATS) have been demonstrated over the past decades; as a result, VATS has become the gold-standard treatment for primary spontaneous pneumothorax (PSP). Due to improvements in surgical technique and equipment, single-port VATS (s-VATS) is emerging as an alternative approach to conventional three-port VATS (t-VATS). The aim of this study was to evaluate s-VATS as a treatment for PSP by comparing operative outcomes and recurrence rates for s-VATS versus t-VATS. METHODS: Between March 2013 and December 2015, VATS for PSP was performed in 146 patients in Kyungpook National University Hospital. We retrospectively reviewed the medical records of these patients. RESULTS: The mean follow-up duration was 13.4±6.5 months in the s-VATS group and 28.7±3.9 months in the t-VATS group. Operative time (p<0.001), the number of staples used for the operation (p=0.001), duration of drainage (p=0.001), and duration of the postoperative stay (p<0.001) were significantly lower in the s-VATS group than in the t-VATS group. There was no difference in the overall recurrence-free survival rate between the s-VATS and t-VATS groups. CONCLUSION: No significant differences in operative outcomes and recurrence rates were found between s-VATS and t-VATS for PSP. Therefore, we cautiously suggest that s-VATS may be an appropriate alternative to t-VATS in the treatment of PSP.
Subject(s)
Humans , Drainage , Follow-Up Studies , Medical Records , Operative Time , Pneumothorax , Recurrence , Retrospective Studies , Survival Rate , Thoracic Surgery, Video-AssistedABSTRACT
Extensive tumoral calcinosis affecting a large joint is uncommon in patients with systemic sclerosis. We report the case of a 52-year-old female patient referred for a growing calcified mass in the shoulder. She was diagnosed with interstitial lung disease and progressive systemic sclerosis. Although the pain and disability associated with the affected joint was not severe, the patient underwent surgical excision because the mass continued to grow and was likely to produce shoulder dysfunction and skin ulceration. The patient appeared well 10 months after surgery with no signs of recurrence. This report highlights the timing and indication of surgical excision in similar cases.
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Female , Humans , Middle Aged , Calcinosis , Joints , Lung Diseases, Interstitial , Quality of Life , Recurrence , Scleroderma, Diffuse , Scleroderma, Systemic , Shoulder , Skin UlcerABSTRACT
Spontaneous pneumomediastinum is a very uncommon entity that is defined as the presence of free air in the mediastinum without an obvious etiology. The presence of air in the spinal canal, known as concurrent pneumorrhachis, is an extremely rare epiphenomenon of spontaneous pneumomediastinum. We report a rare case of spontaneous pneumomediastinum with pneumorrhachis associated with influenza. The patient was diagnosed without invasive procedures, was managed with supportive treatment, and recovered without any complications.