Extent of Work Satisfaction of Telephone Advisers in Emergency Medical Information Center: Focus on the Content of Work and the Working Environment

PURPOSE: This research investigated the extent of telephone advisers'satisfaction with respect for giving telephone advice and the working environment at 12 emergency medical information centers. METHODS: During July 2004, we approached 12 emergency medical information centers. We sent a three page postal questionnaire to each worker. The questionnaire had three parts questions about the working environment, giving telephone advice, and demographic characteristics. RESULTS: The response rate was 81.8%. The hundred (100) workers selected for this study were telephone advisers. As to the working environment, they were unsatisfied with the small workspace and the poor ventilation. Sixty-three (63) workers had telephone advice education. They felt that 'callers' overstatements' and 'not seeing the patients' left them stressed when giving telephone advice. They anticipated that 'protocol' and 'education about medical knowledge' were necessary for improving telephone advice. Seventy-three (73) workers had experienced burnout syndrome. CONCLUSION: Based on this survey on the extent of satisfaction with giving telephone advice and with the working environment, we think that improvements in the working environment and in the professional education for telephoneadvice skills are necessary. Also, we suggest that education to improve advisers'medical knowledge, development of advice protocols, and a program to prevent and manage burnout syndrome are required for enhanced work satisfaction in the future.

Methodological Assessment of Medical Records Reviews in Articles in the Journal of the Korean Society of Emergency Medicine

PURPOSE: The purpose of this study is to enhance the quality of data by performing a methodological assessment of medical records reviews. METHODS: We reviewed the articles published in the Journal of the Korean Society of Emergency Medicine between January 2001 and December 2003 that used a retrospective medical records review as the study method. We assessed data collector's training, descriptions of inclusion/ exclusion criteria, definitions of important variables, use of standardized case record forms, monitoring the data collectors' performance, blind data collecting, inter-rater reliability/ test of inter-rater agreement, intra-rater reliability/test of intra-rater agreement, selection bias from consent, and rules regarding management of missing data. RESULTS: There were 111 articles that used retrospective medical records reviews during the study period. In 111 (100%) articles, inclusion/exclusion criteria were described, in 98 (88.3%), important variables were defined, and in 4 (3.6%), standardized case record forms were used. However no articles addressed the other items on the checklist. CONCLUSION: Study conductors should design studies to enhance the quality of data, and detailed descriptions are necessary to improve the reproducibility of the study.

Statistical Methods in the Articles in the Journal of the Korean Society of Emergency Medicine Published from 1998 to 2002

PURPOSE: The purpose of this study was to assess the statistical methods used in the Journal of the Korean Society of Emergency Medicine (JKSEM) and to identify the types of errors in statistical analysis. METHODS: We reviewed quantitative articles that were published in the JKSEM from January 1998 through December 2002. Editorials, review articles, and case reports were not included in this analysis. A total of 319 articles was reviewed. We focused on the methods of inferential statistics in these articles. We evaluated the adequacy and the validity of the statistical techniques with our criteria, which were established by modifying Ahn's checklist. RESULTS: Of the 319 articles, 222 used inferential statistics. The t-test was the statistic of choice overall (45.1%), followed by the chi-square test (23.9%). Errors of omission (70.3%) were more frequent than errors of commission. Of the errors of omission, incomplete description of the basic data was the most common. CONCLUSION: We found various mistakes or misuses in the applications of statistical methodologies in the articles published in the JKSEM. The present study suggests that additional efforts should be focused on the appropriateness of the statistical analysis used in JKSEM articles to improve their value, and during the review process, editorial attention should be paid to the validity of the statistical methodologies used in the articles.

Visual Analogue Scale in Acute Pain measurement: Its Usefulness as a Pain Measurement Tool in an Emergency Setting

PURPOSE: The Visual Analogue Scale (VAS), as a pain measurement tool, has been shown to be a reliable measurement for chronic pain. However, the reliability and the validity of the VAS have not been demonstrated in an acute setting where pain fluctuations might be greater than they would be for chronic pain. This study assessed the usefulness of the VAS in an emergency setting. METHODS: Patients 16 years of age or older who presented with acute pain resulting from trauma or non-traumatic diseases were enrolled in this prospective, observational study. A 100-mm non-hatched, horizontal visual analogue scale was used to measure the pain severity. VAS measurements were obtained 1 minute apart at admission, 30 minutes after admission, and 1 hour after treatment. Intraclass correlation coefficients (ICCs) with 95% confidence intervals (95% CIs) and a Bland-Altman analysis were used to assess the reliability and the validity of the VAS measurements. RESULTS: The ICCs for paired VAS scores at admission, 30 minutes after admission, and 1 hour after treatment were 0.988 (95% CI=0.98 to 0.99), 0.968 (95% CI=0.95 to 0.98), and 0.989 (95% CI=0.98 to 0.99), respectively. The Bland-Altman analysis showed that 95% of the paired measurements at admission, 30 minutes after admission, and 1 hour after treatment were within 7 mm. CONCLUSION: The VAS appears to be a highly reproducible instrument for measurement of acute pain in the emergency department. This study suggests that the VAS is sufficiently reliable to be used to assess acute pain.