OBJECTIVES: A group therapy includes various types: group psychotherapy, psychodrama, activity therapy including occupational therapy as well as recreation therapy, art therapy of drawing, music, dancing and drama. It has long been in use for in-patients, and became more trendy at day hospitals and community mental health centers after the enactment of a mental health law. It was surprising that a few researches have been made in the field, including a basic fact finding and that a few Korean psychiatrists have been inclined toward it. Meanwhile, we finished a research work on: how a group therapy has been conducted so far, its current status across the country, possibly the best way to heal, and deal with, psychiatric patients. METHODS: The 1997 annual report by Korean Neuropsychiatric Association, has been available for random sampling in the following categories: training hospital, general hospital, psychiatric hospital, clinic with admissions, clinic without admissions, day hospital, community mental health center. Telephone polls were conducted on contents of frequency and status of a group therapy available with psychodrama, main therapists, co-therapists, duration & times of therapy, size of group therapy recipients etc. RESULTS: The group therapy is broken down into the order of percentage; Art therapy(30.9%), Activity therapy(28.4%), Group psychotherapy(27.2%), Others(24.1%), Large group therapy(23.2%), with the psychodrama(10.9) least of all. Against in-patients(61.6%), the group psychotherapy shows its greatest diagnosis for a combined gorup(51.4%), and finds its biggest type in a general group(83.2%), Against in-patients(65.3%), the psychodrama diagnosis is mostly conducted for a combined group (69.4%). For a main therapist, the group psychotherapy is taken care of by boardmen(31.1%), and social workers(29.5%), while psychodrama by psychiatric boardmen(36.1%), and social workers(36.1%). On the other hand, for a co-therapist, the group psychotherapy is done by nurse(40.8%), while psychodrama by social workers(25.9%), and volunteers(23.5%). At a time most group psychotherapies takes some 60 minutes, psychodrama 120 minutes. Group therapies take place each once a week. Its participation amounts to 26.0(+/-17.8) for a psychodrama, and to 11.0(+/-5.8) for a group psychotherapy. Clinics with admission rooms(83.6%), exceedingly enjoy more group therapy than ones without (2.2%). CONCLUSION: The group therapy is run at most hospitals as the main part of a psychiatric treatment. However, the job has been undertaken on a small scale by outpatient clinics as well as psychiatric boardmen. Therefore, more attention is urged toward a group therapy, its professional training, plus its more brisk business at outpatient clinics.
Ambulatory Care Facilities ; Art Therapy ; Commerce ; Community Mental Health Centers ; Dancing ; Diagnosis ; Drama ; Hand ; Hospitals, Community ; Hospitals, General ; Hospitals, Psychiatric ; Humans ; Jurisprudence ; Korea* ; Mental Health ; Music ; Occupational Therapy ; Psychiatry ; Psychodrama ; Psychotherapy ; Psychotherapy, Group* ; Recreation Therapy ; Telephone

Background: A drug-drug interaction (DDI) is a pharmacologic or clinical response to the administration of a drug that can result in adverse outcomes. DDIs are considered preventable adverse drug reactions because these interactions can be learned, predicted and recognized. Objective: To determine potential drug-drug interactions (pDDI) among medications prescribed to adult patients consulting at a primary care clinic in a government teaching hospital. Methods: This was a 6-month retrospective cross-sectional study of drug prescriptions based on medical records of adult Filipinos who were seen and managed at a primary care clinic in a government teaching hospital. Medical charts were systematically selected based on a sampling frame with inclusion and exclusion criteria. Results: A total of 1,490 medical records of adult Filipino patients were included in the study. There were a total of 261 unique prescriptions based on generic formulations and an overall total of 5,978 drugs for a 6-month period of clinic consultations. An average of 4 medications (SD±1.63) were prescribed for every consultation recorded in the medical chart. From the charts that were reviewed, 23% of all adults were given a prescription of 4 drugs (N=348/1490), 26% had 3 drug prescriptions (N=386/1490) and 18% had two drugs, respectively, per clinic visit. Overall, 714/9054 (7.88%) medication pairs were seen to have potential drug interactions. The top three most common drug pairs with pDDI were amlodipine-simvastatin, losartan/hydrochlorothiazide-metformin and aspirin-furosemide. Five hundred twenty-five drug pairs had pharmacodynamic interactions (525/714) while 94 drug pairs (15%) had pharmacokinetic interactions. Conclusion Potential drug-drug interactions were observed in 8% of medications prescribed to adult Filipinos seen at Family Medicine Clinic in a government hospital. Seventy-four percent (74%) of the drug pairs with pDDIs were pharmacodynamic and 15% were pharmacokinetic interactions.
Ambulatory Care Facilities

In the multidisciplinary cancer treatment (MCT), it is necessary that radiologists participate in the patients' care, and they might be directly involved to the new practice methods including outpatient clinics. Face-to-face MCT is the most desirable practice method because satisfaction and compliance of the patients is high. However, it should be restrictively expanded due to practical problems such as lack of manpower. As a practical alternative, there is non-face-to-face MCT, like a tumor board, and it has many advantages to overcome the limitations of face-to-face MCT. Therefore, it is necessary to establish policies to support that both two types of MCT are stimulated so that the patients are able to get the optimized cancer management.
Ambulatory Care Facilities ; Compliance ; Humans

No abstract available.
Ambulatory Care Facilities* ; Stomach Neoplasms*

No abstract available.
Ambulatory Care Facilities* ; Humans ; Outpatients*

A retrospective study on all deaths in the district health centers and provincial hospital from 1/1/1995 to 31/12/1999 has shown that the mortality rate/inpatients: 0,47%, this rate in men higher than this in women, mainly: Kinh Nation. Ages of 15 -60 account for high rate; dead rate in infant accounts for 20% in total mortality rate. The average time from admission to death was 30,30 minutes. The rate of dead patient received the concentrated diagnosis is very low; the rate of correct diagnosis between the examination department and emergency department: 50%; use of paraclinical: 0.8 time/patient.10,57% nurse and sister did not implement correctly the medical command of medical doctor
mortality ; Ambulatory Care Facilities ; therapy

No abstract available.
Ambulatory Care Facilities* ; Humans ; Outpatients*

Background. Telemedicine provides access to health care services during pandemics. It can be utilized to screen asymptomatic persons, follow up close contacts of confirmed cases, monitor individuals with symptoms, conduct specialty consultations, and offer health services to patients during pandemics. Objective. To describe the telemedicine processes, good practices, and areas for improvement in the University of the Philippines Health Service (UPHS) during the COVID-19 pandemic. Methods. This was a cross-sectional study to document telemedicine processes in UPHS. All teleconsultations of employees and students of Philippine General Hospital (PGH) and UP Manila (UPM) during the two-week study period in October 2020 were included. Quantitative data was collected from different modes of patient entry into the UPHS telemedicine services: email, Online Consultation Request and Appointment (OCRA) System, and phone hotlines. Qualitative information was gathered as narrative descriptions of observations in the clinic’s service delivery areas. A focus group discussion was also conducted to illustrate the different steps of the pathway used for telemedicine. Results. The telemedicine services of UPHS consisted of virtual triage, COVID-19/non-COVID-19 consultation, and telemonitoring. The UPHS virtual triage received patient concerns through OCRA or the hotline numbers. On the other hand, the COVID-19 teleconsultation service provided care to employees and students who contacted the clinic regarding symptoms or exposure via email. The non-COVID-19 service had teleconsultation for patients with other medical concerns. Coordination among staff and presence of a consultant were identified as good practices, while the areas for improvement include the lack of written protocols in issuing fit-to-work clearance for difficult cases and the optional use of OCRA for UPHS consult. Conclusion. Telemedicine services at the UPHS included tele-triaging, teleconsultations, and telemonitoring with use of phone calls, short messaging service (SMS), emails, and OCRA. Timely coordination, on-site duty consultants, and use of technology were identified as good practices. Lack of protocols and inconsistent OCRA use are areas for improvement.
Pandemics ; Telemedicine ; Ambulatory Care Facilities

PURPOSE: This randomized study was done to compare the effects of a 6 month Tai Chi exercise and a self-help program on balance, flexibility and muscle strength in women with osteoarthritis (OA). METHOD: In this experimental study, 82 women with OA recruited from outpatient clinics or community health centers were randomly assigned either to a Tai Chi group or a self-help group. Thirty women (mean age = 62 years) in the Tai Chi group and 39 (mean age = 59 years) in the self-help group completed posttest measures (balance, flexibility, oxygen consumption, abdominal muscle strength, back muscle strength, and grip strength) at 6 months. RESULTS: After the 6 month, Tai Chi participants had significantly greater balance (mean difference = 2.9 vs. 0.9 for the self-help), grip strength (mean difference = 4.6 vs. 0.9 for the self-help), and back muscle strength (mean difference = 4.1 vs. -0.3 for the self-help). However, flexibility, oxygen consumption, and abdominal muscle strength were not significantly different between the groups. CONCLUSION: Tai Chi increased balance, grip strength and back muscle strength in older women with osteoarthritis compared to the self-help program. Whether these changes improve physical functioning and fall prevention requires further study.
Abdominal Muscles ; Ambulatory Care Facilities ; Community Health Centers ; Female ; Hand Strength ; Humans ; Muscle Strength ; Muscles ; Osteoarthritis ; Oxygen ; Oxygen Consumption ; Pliability ; Postural Balance ; Self-Help Groups ; Tai Ji

Multidisciplinary care service has started on August 1, 2014 after Korean health authority's decision of its approval and reimbursement. However, despite its early success, it raises some issues caused by less flexibility of the model, which might limit further expansion and development of the model or even establishment of a new model. It has only two types of 4-expert and 5 or more-expert services. It is also reimbursed only when given in outpatient clinic, and much worse, as of face-to-face service. Then, I will review the issues raised so far and try to suggest possible solutions, for example, sort of multidisciplinary consultation service for in-patient multidisciplinary care service. The issues and solutions will engender a lot of controversy, but to discuss about them might be the first step to further develop the service. In addition, I will briefly touch on expected effects of the service, including improvement of cancer care, such as shortening the time from the first visit to diagnosis and treatment or speed-up of diagnosis process, enhancement of cancer patients' satisfaction and so on, which might be helpful to guide future direction of the multidisciplinary care service. The commencement of multidisciplinary care service is an important milestone in cancer care as well as medical system of Korea. However, it is not the best and perfect one but was just chosen as one of champion models. It has much room for improvement or there is still more work to be done to make it better.
Ambulatory Care Facilities ; Diagnosis ; Korea ; Pliability