Assessment of Objective Audiometry to Predict Subjective Satisfaction in Patients With Hearing Aids

Objectives@#. To investigate the correlation of objective audiometry with user satisfaction as measured with the questionnaire scores. @*Methods@#. Twenty patients with hearing loss, who agreed to wear a hearing aid and were referred for hearing aid fitting, were included in this prospective clinical study. All patients used the in-the-canal type of Wide7 hearing aid provided by BSL Co., Ltd. We performed the Korean version of the Hearing Handicap Inventory for the Elderly (K-HHIE) and the International Outcome Inventory for Hearing Aids (K-IOI-HA) before and 1, 3, and 6 months after wearing the hearing aid. We also performed pure tone audiometry (PTA), speech audiometry (SA), functional gain (FG), hearing in noise test (HINT), and central auditory processing disorder tests, such as frequency pattern test (CA-f), duration pattern test (CA-d), and dichotic test (CA-Di). Patients were divided into two groups (group A-HHIE, improved; group B-HHIE, same or worse) by comparing the score of K-HHIE before and 6 months after wearing the hearing aid. In the 6-month K-IOI-HA questionnaire, 21 points were considered as the average score. Based on this, we further divided patients into two groups (group A-IOI, >21 points; group B-IOI, ≤21 points). @*Results@#. Group A-HHIE included six patients and group B-HHIE included 14 patients. In PTA, SA, HINT, CA-d, and CA-Di, group A-HHIE showed higher improvements than group B-HHIE, which were not statistically significant. Group A-IOI included 12 patients and group B-IOI included eight patients. No statistically significant difference was noted in the improvement of audiometric results over a period of 6 months after wearing the hearing aid between groups A-IOI and B-IOI. @*Conclusion@#. There were no significant and consistent audiometric results to reflect patient’s satisfaction with the hearing aid. Therefore, when analyzing the hearing aid-fitting outcome, both the objective audiometric tests and subjective questionnaire should be performed together for validating hearing aid performance.

Structural Equation Modeling for Public Hospital Quality of Care, Image, Role Performance, Satisfaction, Intent to (Re)visit, and Intent to Recommend Hospital as Perceived by Community Residents

PURPOSE: The study purposes were to construct and test structural equation modeling on the causal relationship of community residents' perceived quality of care, image, and role performance with satisfaction, intention to (re)visit and intention to recommend hospital. METHODS: A cross-sectional survey was conducted with 3,900 community residents from 39 district public hospitals. The questionnaire was designed to collected information on personal characteristics and community awareness of public hospitals. Community awareness consisted of 6 factors and 18 items. The data were collected utilizing call-interview by a survey company. Research data were collected via questionnaires and analyzed using SPSS version 20.0 and AMOS version 20.0. RESULTS: Model fit indices for the hypothetical model were suitable for the recommended level: chi2=796.40 (df=79, p <.001), GFI=.93, AGFI=.90, RMSR=.08, NFI=.94. Quality of care, image, and role performance explained 68.1% of variance in community awareness. Total effect of quality of care process factors on satisfaction (path coefficients=3.67), intention to (re)visit (path coefficients=2.67) and intention to recommend hospital (coefficients=2.45) were higher than other factors. CONCLUSION: Findings show that public hospitals have to make an effort to improve community image through the provision of quality care, and excellent role performance. Support for these activities is available from both Central and Local Governments.

Post-Traumatic Stress Disorder, Depression, and Heart-Rate Variability among North Korean Defectors

OBJECTIVE: This study evaluated the symptoms of post-traumatic stress disorder (PTSD) among North Korean defectors and their level of suicidal ideation and the correlation between these and heart-rate variability (HRV) to explore the possibility of using HRV as an objective neurobiological index of signs of autonomic nervous system disorder. METHODS: A total of 32 North Korean defectors (nine men, 23 women) were selected as subjects, and their HRV was measured after they completed the Minnesota Multiphasic Personality Inventory-PTSD (MMPI-PTSD) scale and the Beck Depression Inventory (BDI). RESULTS: 1) Low-frequency (LF)/high-frequency (HF) ratios in the HRV index and MMPI-PTSD scores were correlated (r=0.419, p<0.05), as were BDI item 9 (suicidal ideation) and MMPI-PTSD scores (r=0.600, p<0.01). 2) A regression analysis of LF/HF ratios and MMPI-PTSD scores revealed an R-value of 13.8% (Adj. R2=0.138, F=4.695, p=0.041), and a regression analysis of BDI item 9 and MMPI-PTSD scores showed an R-value of 32.8% (Adj. R2=0.328, F=11.234, p=0.003). In other words, the LF/HF ratio (beta=0.419) and BDI item 9 (beta=0.600) appear to be risk factors in predicting MMPI-PTSD scores. CONCLUSION: The LF/HF ratio, a standard index of autonomic nervous system activity, can be used as an objective neurobiological index to analyze PTSD among North Korean defectors presenting with various mental and physical symptoms, and the approximate level of suicide -ideation can act as a predicting factor for PTSD.

Educational Needs for Consideration in Developing Curriculum for Staff in Charge of Public Health Services in Public Hospitals

PURPOSE: This study was done to assess the educational needs that should be considered in developing curriculum for staff in charge of public health services in public hospitals. METHODS: The participants in this study were staff in charge of public health services in 130 public hospitals. The Borich's Needs Assessment Model which analyzed the relation of 'required competence level' and 'present competence level', was utilized. Data were collected from October to November 2007 using a structure self-report questionnaire. The return rate was 66.9%. The Cronbach's alpha score was 0.959. RESULTS: The mean scores for 'required competence level', 'present competence level' and Borich's need were 4.02, 3.44, and 2.30 respectively. According to public health service items, 'strategies to recognize the present condition and analyze problems' had the highest score for Borich's need, but 'establishment of annual or monthly objectives' had the lowest score for Borich's need. CONCLUSION: Education was found to be very important for staff carrying out public health services. Ultimately the results of this study may be utilized to develop education program for staff carrying out public health services in public hospitals.

Factors Associated with Work-Related Injuries of Nurses in Small and Medium Sized Hospitals / 간호행정학회지

PURPOSE: This study was conducted to examine the factors associated with work related injuries of nurses in small and medium sized hospitals. Method: A cross-sectional survey was conducted with nurses in eight hospitals from October 2007 to January 2008. A questionnaire was designed to collect information on nurses' work related injuries, and individual and job related characteristics. The response rate was 65.1%. Data from 294 nurses were analyzed. Multiple logistic regression analysis was performed to determine factors associated with work related injuries. Result: Of the 294 nurses, 19.1% (n=56) responded as having at least one injury during their job performance. The logistic regression analysis revealed that the significant factors influencing work related injuries were job satisfaction, stress recognition, and hospital's location. Nurses with a higher job satisfaction were less likely to experience work related injuries (OR=0.58). Nurses with a higher stress recognition (OR=2.57) and those working at hospitals in metropolitan cities (OR=3.28) were more likely to experience work related injuries. CONCLUSIONS: The result of this study indicated that a substantial proportion of nurses in small and medium sized hospitals had experienced injuries related to nursing job. Interventions to prevent work related injuries among nurses should take into account the job satisfaction, stress recognition, and hospital characteristics.

Related Factors of Treatment Success of Patients with Tuberculosis Managed in Public Health Centers / 農村醫學 地域保健

OBJECTIVES: This retrospective study is to identify related factors of treatment success of patients with tuberculosis at community health centers. METHODS: The subjects of this study were 1,417 patients with tuberculosis treated in 28 community health centers. The predictors of tuberculosis treatment success were analyzed in terms of 2 areas, which were characteristics of patients and health centers(TB control program). The characteristics of patients consist of 2 factors, such as demographic & diagnosis and treatment. The present conditions of health centers consist of 3 factors, location of centers, resources, and community activities. Data were analysed using chi-square-test and logistic regression methods. RESULTS: The significant differences between success group and failure group were sex(p=0.003), age(p=0.013), job(p=0.000), type of patients(p=0.001), past history(p=0.029), BCG injection(p=0.009), sputum culture examination(p=0.017), period of treatment(p=0.000), location of center(p=0.001), population per staff(p=0.015), FTE(p=0.027), education days of staff(p=0.005), BCG injection rate(p=0.001), case detection rate (p=0.003), and health education provision rate(p=0.044). Then these variables were analysed using logistic regression analysis. Significant positive factors of treatment success were occupation(95% CI:1.3-6.1), periods of treatment(95% CI:1.5-2.2), center in large city(95% CI:1.2-16.7), center in middle city(95% CI:2.1-24.3), job education related TB(95% CI:1.02-1.3), and BCG injection rate(95% CI:1.1-303.4). Significant negative factors of treatment success were male(95% CI:0.1-0.5) and treatment after default(95% CI:0.005-0.5). CONCLUSIONS: Tuberculosis is still one of serious diseases in Korea, because it causes highest mortality rate among OECD countries. This study may provide information to improve treatment effectiveness of tuberculosis at community health centers.

The Effects of a Self-Help Empowerment Strategy Program on the Empowerment and Health Status of Rheumatoid Arthritis Patients / 성인간호학회지

PURPOSE: The purpose of this study was to examine the effects of a six week self-help empowerment strategy program on the empowerment status, pain intensity, physical function, joint flexibility and depression status in rheumatoid arthritis patients. METHOD: The subjects of the study consisted of a convenience sample thirteen rheumatoid arthritis patients. Data was collected from July to November, 2001. All patient received a self-help empowerment strategy program, once a week for six weeks. RESULT: After receiving the self-help empowerment strategy program, the empowerment status increased significantly, the pain intensity and the depression score decreased significantly and the level of physical function significantly improved but the flexibilities of shoulders, knees and ankles were not significantly changed. CONCLUSION: Further studies need to be done to determine the feasibility of implementing empowerment strategy and its possibility as an effective intervention program for decreasing pain intensity and depression score and improving the physical function.