Fifteen-year Experience with Telemedicine Services in Gangwon Province in Korea / 대한의료정보학회지

OBJECTIVES: This study attempted to identify the factors that contribute to successful telemedicine service. This was done by analyzing the operational state of successful telemedicine services offered in Gangwon Province of Korea and their outcome for the last fifteen years. METHODS: A comparative analysis was made based on reports and a thesis on the satisfaction rate of patients and providers, patient compliance to treatment, and economic assessment of Gangwon telemedicine service, which were carried out in three periods: the years 2006, 2010, and 2012. RESULTS: The satisfaction surveys in all three periods showed similar results for patients (4.46+/-0.70 point) and healthcare practitioners, including nurses (3.82+/-0.62 point) and physicians (3.60+/-0.56 point), in decreasing order from the year 2012. Through the survey of patients' compliance with treatment, it was confirmed that telemedicine services increased patients' compliance with drug administration, facilitated improvement of lifestyle habits, improved glycated hemoglobin for patients with diabetes mellitus, and enhanced the rate of blood pressure control. In the survey conducted on patients' willingness to pay for telemedicine services in 2007, it was found that those patients were willing to pay about $3.5 for services. CONCLUSIONS: The telemedicine services of Gangwon Province increased patients' compliance with drug administration, improved blood glucose control, enhanced blood pressure control for patients with hypertension, and provided economic advantage.

Vitamin C and D Insufficiency in Burn Patients Undergoing Rehabilitative Therapy-Preliminary Result

PURPOSE: The burn increase the requirement for the antioxidative vitamin C and decrease the plasma concentration of vitamin D due to the loss of skin body surface area. We investigated the vitamin C and D status and the prevalence of vitamin C and D insufficiency in adult burn patients undergoing rehabilitative therapy. METHODS: 256 burn patients admitted to the department of rehabilitation medicine from April 2013 to September 2014 were tested for the plasma level of vitamin C and D[25(OH)D]. Vitamin C insufficiency was considered as or =20%, mean plasma concentration of vitamin C and vitamin D[25(OH)D] were significantly lower (P=0.023, P<0.001). With adjusting for potential confounder such as age, sex, burn type, mean serum 25 (OH)D levels was significantly decreased 0.07 ng/ml per one percent of burned surface area (beta=-0.07, P<0.001), but with adjusting for age, sex, burn type, length of ICU stay and duration from burn injury to sampling, vitamin C and vitamin D[25(OH)D] were not significantly decreased (P=0.221, P=0.142). CONCLUSION: Vitamin C and D insufficiency were common nutrient problems in burn patients undergoing rehabilitative therapy. Further studies will be needed to establish the effective way to improve vitamin C and D status and prevent nutritional complications.

Aspects of Patients Injured While Attending Street Rallies in Seoul During the Period of the 2002 World Cup

PURPOSE: An appropriate emergency medical support system is required at sites of large-scale congregations because different kinds of emergencies may be encountered. My colleagues and I initiated this project to present the information required for the process of devising an onsite plan for large crowds. The basic structure is based on an analysis of patients who were injured while attending large scale street-cheering demonstrations in Seoul during the period of the 2002 World Cup. METHOD: The analysis concentrated on the period from May 31, 2002, to June 30, 2002, during the 2002 Korean-Japan World Cup. Seven soccer games involving the Korean team and 8.91 million people from 116 places were considered. The following report was generated from the supporting schedules and the activity reports of emergency rescue crews from fire departments. It is largely based on rescue activity journals and transportation records. RESULT: There were 796 patients among the in 8.91 million people. Male patients were 383 (42.8%) and female 413 (51.2%). Patients in their 20's were 267, and that was the largest age group. In Korean game against Germany, 183 patients were treated, and that was the largest among the seven games involving Korean's team. There was one patient in every 10,000 people on average. Sicknesses were not that serious, and most of them were headaches, stomachaches and exhaustion. CONCLUSION: The frequency and pattern of generation of patients were affected by the scale of the cheering crowd, the sex and age composition of the crowd, and the weather. In planning future medical support for similar events, the structure of the plan should be based on the site and the size of the crowd, after which the plan can be finalized by considering details such as the importance of the game and the weather.

The Effects of a Rehabilitation Program Including Koryo Hand-Acupuncture on Elderly People Post-stroke / 기본간호학회지

PURPOSE: This study was done to investigate the effects of a rehabilitation program including Koryo Hand-Acupuncture on physical function, self-esteem, and quality of life of post-stroke elderly patients. METHOD: A nonequivalent control group pre-post test research design was used. Participants in the study were 44 post-stroke elderly people (22 in an experimental group, 22 in a control group) enrolled in a social welfare center and a hospital in K city. Data were collected from April 6 to August 20, 2004. The program consisted of Koryo Hand-Acupuncture, ROM exercise, health education and supportive care. The analyses were carried using frequencies, percentages, x -test, Fisher exact and t-test with SPSS 10.0. RESULTS: The patients in the experimental group, who took part in the 10-weeks rehabilitation program including Koryo Hand-Acupuncture, had significant increases in shoulder joint flexion, shoulder joint abduction, elbow joint flexion, hip joint flexion, knee joint flexion, knee joint extension, flexibility, self-esteem and quality of life as compared to the control group. CONCLUSION: These results suggest that a rehabilitation program including Koryo Hand-Acupuncture may be utilized as an effective nursing program to improve physical function, self-esteem and quality of life for post-stroke elderly patients.

Early Aberration Reporting System Modelling of Korean Emergency Syndromic Surveillance System for Bioterrism

PURPOSE: This study were designed to supply the opportunity to make a base of emergency syndromic surveillance warning system to detect the bioterrors through the construction of predictive models which were made by reported patients in 'Emergency Syndromic Surveillance System' who were diagnosed as waterborne contagious diseases. METHODS: On this study, we used the neural network analysis methods among the data mining to analyze the reliable variables which was extracted from the reported data bases in the Emergency Syndrome Surveillance System. RESULTS : In this study, we were using the patients data pools from 13th May 2002 to 13th May 2003 in Emergency Syndrome Surveillance System. So we could get the reliable variables - clinical symptoms, severity of patient, humidity and temperature - to predict the waterborne infections. This study shows the successful predictation rate of 96% in error rate of 0.4 with sensible variables through Chisquare analysis and the construction of one hidden layer which is near linearity. CONCLUSION: Early emergency syndromic surveillance warning models made by the neural network in Emergency Syndrome Surveillance System could make the early detection of waterborne infections, could also stop the transmission of waterborne infections in early stage, and furthermore could be used as the preventive and detective methods of bioterror attacks.

A Study on Nurses' Ability to Perform Endotracheal Suction / 기본간호학회지

The purpose of this study was to survey the ability of nurses to perform endotracheal suction to provide basic data on correct endotracheal suction. The participants in this study were 181 intensive care unit nurses in two university hospitals and one general hospital located in Daegu, one university hospital and two general hospitals located in Pohang, one university hospital located in Gyeongju. These data were collected from February 1, 2001 to March 10, 2001 using self reported questionnaires.The study instrument, which was developed by these investigators, included questions on general characteristics and performance of endotracheal suction. The results of this study are as follows : 1.Of the participants 71.3% recognized correct endotracheal suctioning and 23.2% did not. 2.The greatest number, 57.5%, acquired knowledge about endotracheal suctioning at conferences on practice or education for staff. 3.There were significant differences in scores on performance of endotracheal suction according to department (F=2.60, P=.05) and hospitals (F=3.24, P=.01) among the general characteristics. 4. Slightly less than half of the participants, 47.8%, averaged correct scores for endotracheal suctioning procedures. Ventilator O2 supply had the highest score (84.0%), normal saline exchange time, the lowest (14.4%). From the results, we suggest that education is needed to increase the knowledge and correct performance of endotracheal suction. Further study including direct observation of performance of endotracheal suction is also needed.

Correlations among Family Support, Self-Esteem and Compliance with Preventive Health Behavior in Elderly People / 기본간호학회지

The purpose of this study was to identify correlations among family support, self-esteem and compliance in preventive health behavior in elderly people. The results will provide valuable data for nursing interventions towards help the elderly lead better lives. Those who lived with elderly people in Kimchun were interviewed by the researcher and an assistant. The subjects were 191 elderly people over the age of 65. The study method used was a structured questionnaire and the data were collected from September 17th to September 31th in 1998. The tools for this study were the family support scale designed by Gang Hyun Sook, the self-esteem scale designed by Rosenberg and the preventive health behavior scale designed by Gang Yune Sook. The data were analyzed by the SAS program, Mean, SD, T-test, ANOVA, Pearson Correlation Coefficients. The results of this study are as follows ; 1. The mean score for family support was 40.49. The score of family support of the elderly showed significant differences according to age(F=2.66, p<.05), spouse presence(t=4.20, p<.001), family pattern(F=4.56, p<.01), economic status(F=10.47, p<.001) and pocket money(F=10.46, p<.001). 2. The mean score for self-esteem was 29.01. The score of self-esteem of the elderly showed significant differences according to educational level (F=3.47, p<.01), spouse presence(t =2.49, p<.05), family pattern(F=3.79, p< 01), economic staus(F=15.65, p<,001) and pocket money(F=14.04, p<.001). 3. The mean score for compliance with preventive health behavior was 53.15. The score of compliance of preventive health behavior of the elderly showed significant differences according to economic status(F=9.34, p<.001) and pocket money(F=8.13, p<.001). 4. The relation between family support and self-esteem was significantly different (r= .57, p<.001). The relation between family support and compliance with preventive health behavior was significantly different(r=.44, p<.001). The relation between self-esteem and compliance with preventive health behavior was significantly different (r=.51, p<.001). In conclusion, the correlations among family support, self-esteem and compliance with preventive health behavior in elderly people showed significant differences.