PURPOSE: This study was done to describe level of knowledge and performance of pain management by nurses in general hospitals. METHODS: The study was conducted from August 1 to 28, 2014 with 141 nurses from a general hospital in B city. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, and Pearson correlation coefficient with SPSS 20.0. RESULTS: Average correct response rate for knowledge was 62.7%, indicating poor knowledge of pain management. Mean score for knowledge of pain management was 31.33+/-3.24 out of 50(general knowledge about pain 14.02+/-2.18 out of 20, knowledge on use of analgesics 9.21+/-1.97 out of 20, knowledge on analgesic classification 8.16+/-1.00 out of 10). Mean score for performance of pain management was 3.19+/-.44 out of 4. There was significant difference in knowledge of pain management by age. Performance of pain management differed significantly according to age and type of working unit. No significant relationship was found between knowledge and performance of pain management. CONCLUSION: These findings show that nurses who have good knowledge do not always have good performance of pain management. Therefore, it is necessary to develop new strategies to promote performance as well as continued pain management education to increase ability of nurses to manage pain.
Analgesics ; Classification ; Education ; Hospitals, General* ; Pain Management*

PURPOSE: The purpose of this study was to analyze the questions in the hip and pelvis section of the Korean Orthopaedic In-Training Examination (KOITE). MATERIALS AND METHODS: We analyzed all KOITE questions pertaining to hip and pelvis surgery between 2010 and 2014. A thorough analysis of the contents was performed after categorizing as tested topics, imaging modalities used, taxonomic classification, and recommended references. We also analyzed the scores of the hip and pelvis section of the KOITE. RESULTS: Seventy-five of five-hundred questions (weight, 15.0%) were related to the hip and pelvis. Trauma including fracture and dislocation (26/75, 34.7%) was asked more commonly than disease and basics. The description-only questions (65/75, 86.7%) were the most frequently asked. According to taxonomic classification, taxonomy 3 (decision; 39/75, 52.0%) was most frequently asked. Campbell's Operative Orthopedics (52/75, 69.3%) was the reference that covered most of the questions. CONCLUSION: This analysis of the hip and pelvis section of KOITE could be used for resident training programs in teaching hospitals.
Classification ; Dislocations ; Education ; Hip* ; Hospitals, Teaching ; Orthopedics* ; Pelvis*

OBJECTIVES: Delirium is commonly seen in clinical settings, and it can substantially influence the prognosis of patients. In this study, we investigated delirium with respect to its severity, classification and characteristics on each subtype. METHODS: Severity of delirium was examined in delirium patients, who were referred to the department of psychiatry in a general hospital for multidisciplinary treatment. After classification based on subtypes, factors influencing these aspects of delirium were examined. RESULTS: Among the 193 consultation-liaison patients referred to the department of psychiatry in a general hospital, 61 patients (31.6%) were diagnosed with delirium. Compared to patients in the non-delirium group, patients in the delirium group were older, had a shorter education period, and medical history of surgery. Among the delirium patients, the hyperactive subtype was found to be the most common (57.4%) and patients with the mixed subtype showed the highest severity score for delirium symptoms. In addition, the patient with the hypoactive subtype had a higher frequency of medical history of depression compared to those with the other subtypes. CONCLUSION: People with symptoms of hypoactive delirium can be misdiagnosed due to recurrence of depression, therefore, careful examination is required, particularly in patients with a history of depression.
Classification ; Delirium* ; Depression ; Education ; Hospitals, General ; Humans ; Prognosis ; Recurrence

OBJECTIVE: This study was designed to make a comparison of motor function according to the age group after the rehabilitation management in poststroke hemiplegic patients. METHOD: We examined 23 cases of young age stroke with hemiplegia aged < or =50 years and 24 cases of old age stroke aged > or =70 years. Motor power of affected side was measured by Motricity Index (MI) and Trunk Control Test (TCT). Level of ambulation was determined by Massachusetts General Hospital Functional Ambulation Classification (MGHFAC). Scores of each scale at admission and reassessment were obtained after rehabilitation management to compare the level of motor function in each age group and according to the age group. RESULTS: Scores of MI, TCT and MGHFAC scale were significantly increased after rehabilitation management in each group. Although both groups differed regarding to those of MGHFAC, there was no difference for the increment of MI and TCT according to the age group after rehabilitation. CONCLUSION: Both age group showed significant improvement of the motor function and ambulation level after rehabilitation management. Ambulation level improvement of younger patient was greater than that of older patients. However, there was no difference in the extent of motor function improvement of affected side according to the age groups.
Classification ; Hemiplegia ; Hospitals, General ; Humans ; Massachusetts ; Rehabilitation* ; Stroke* ; Walking

The author studied the mental status of 497 patients admitted in non-psychiatric wards and 42 patients diagnosed as mental disorders by DSM-III-R criteria and admitted in three general hospitals located in Pusan city, using NADS and PSCS. The assessment were obtained from October, 1991 to March, 1992 and the results as follows: The mean±SD of Anxiety-Depression scores were 34.4±10.4 in non-psychiatric patients and 50.0±18.3 in psychiatric patients. The psychiatric group had significantly higher scores than non-psychiatric group. The mean±SD of Psychosis scores were 3.9±4.4 in non-psychiatric patients and 20.3±9.8 in psychiatric patients. The psychiatric group had significantly higher scores than non-psychiatric group. In the psychosocial factors, dissatisfaction in family atmosphere and acquaintanceship with parents (P<0.001, relatively), pessimistic in future, present and past self-images (P<0.001, relatively), and yes in previous psychiatric treatment of admission (p<0.01, relatively) had common significant relationships to Anxiety-Depression and Psychosis scores. There were correlationships between NADS scores and PSCS scores (γ=0.74), past and present self-images (γ=0.45), present and future self images (γ=0.45), past and future self-images (γ=0.34) and family atmosphere and acquaintanceship with parents (γ=0.49) The regression analysis revealed that present self-image, acquaintanceship with parents, future self-image, past self-image, and family atmosphere, in order of significance were to be descriptive or predicable variances for Anxiety-Depression status. The discriminant analysis according to Anxiety-Depression scores showed that the cases of incorrect classification were 22 for non-psychiatric patient group and 2 for psychiatric patient group.
Anxiety ; Atmosphere ; Busan ; Classification ; Depression ; Hospitals, General ; Humans ; Mental Disorders ; NAD ; Parents ; Psychology ; Psychotic Disorders

OBJECTIVES: This study examined the validity of the principal diagnoses on discharge summaries and coding assessments. METHODS: Data were collected from the National Health Security Office (NHSO) of Thailand in 2015. In total, 118,971 medical records were audited. The sample was drawn from government hospitals and private hospitals covered by the Universal Coverage Scheme in Thailand. Hospitals and cases were selected using NHSO criteria. The validity of the principal diagnoses listed in the “Summary and Coding Assessment” forms was established by comparing data from the discharge summaries with data obtained from medical record reviews, and additionally, by comparing data from the coding assessments with data in the computerized ICD (the data base used for reimbursement-purposes). RESULTS: The summary assessments had low sensitivities (7.3%–37.9%), high specificities (97.2%–99.8%), low positive predictive values (9.2%–60.7%), and high negative predictive values (95.9%–99.3%). The coding assessments had low sensitivities (31.1%–69.4%), high specificities (99.0%–99.9%), moderate positive predictive values (43.8%–89.0%), and high negative predictive values (97.3%–99.5%). The discharge summaries and codings often contained mistakes, particularly the categories “Endocrine, nutritional, and metabolic diseases”, “Symptoms, signs, and abnormal clinical and laboratory findings not elsewhere classified”, “Factors influencing health status and contact with health services”, and “Injury, poisoning, and certain other consequences of external causes”. CONCLUSIONS: The validity of the principal diagnoses on the summary and coding assessment forms was found to be low. The training of physicians and coders must be strengthened to improve the validity of discharge summaries and codings.
Clinical Coding* ; Diagnosis* ; Hospitals, Private ; International Classification of Diseases* ; Medical Records ; Poisoning ; Sensitivity and Specificity ; Thailand* ; Universal Coverage

PURPOSE: Since needle localization biopsy was introduced, it is widely performed for nonpalpable microcalcified breast lesions, but there are many controversies in determining the disease characteristics and guidelines of the biopsy for microcalcifications detected mammographically in the absence of any palpable mass. This study was designed to detennine the breast cancers according to microcalcification types. MATERIALS AND METHODS: We reviewed 91 patients, who underwent breast biopsies between January 1995 and June 1998 for only microcalcified lesions detected by mammography at the Department of Surgery, Korea University Hospitals. Microcalcifications were defined as calcifications less than 1.0 mm. The needle localization biopsy was performed only on patients who were found to have five or more microcalcifications. We classified the mictocalcifications into three types; casting type, crushed-stone-like type, and amorphous type. RESULTS: The mean age was 49 years (25 82 years). Sixteen patients (17.6%) among the 91 patients were diagnosed with the breast cancer; four (22.2%) of 18 patients with casting type, eight (21.6%) of 37 patients with crushed-stone-like type, and four (11.1%) of 36 patients with amorphous type microcalcifications. Breast cancers were more prevalent in casting and crushed-stone-like types than in amorphous types. There was no difference in the size of microcalcifiations between benign and malignant lesions 13.11+-10.89 rnm vs 13.13+-9.51 mm. CONCLUSIONS: The patients who have more than 5 microcalcifications clustered within 1 cm circle detected at mammographic evaluation, especially in case of casting or crushed-stone-like type, should be advised to have localization biopsy to detect early breast cancer.
Biopsy ; Breast Neoplasms* ; Breast* ; Classification* ; Hospitals, University ; Humans ; Incidence* ; Korea ; Mammography* ; Needles

BACKGROUND: The aim of this study was to evaluate antibiotic consumption by adult patients at a single university hospital in Korea between 2001 and 2012. METHODS: We used the 2004 World Health Organization Anatomical Therapeutic Chemical Classification System definition of defined daily doses (DDD) per 1,000 patient-days to calculate the annual antibiotic consumption for 18 antibiotic groups. Chi-square linear-by-linear analysis was performed to evaluate antibiotic consumption trends for each group. RESULTS: Average annual antibiotic consumption during 2001-2012 was 644.6 DDD/1,000 patient-days (standard deviation, 33.3 DDD/1,000 patient-days). Although no statistically significant change was observed during the study period, consumption of first- and second-generation cephalosporins, and aminoglycosides was significantly decreased, while that of beta-lactam/beta-lactamase inhibitors, fourth-generation cephalosporins, carbapenem, glycopeptide, linezolid, colistin, and quinolone increased significantly. CONCLUSION: The total amount of prescribed antibiotics did not change, but the use of broad-spectrum antibiotics increased during the study period.
Adult ; Aminoglycosides ; Anti-Bacterial Agents ; Cephalosporins ; Classification ; Colistin ; Hospitals, University ; Humans ; Korea ; World Health Organization ; Linezolid

BACKGROUND: It has been reported that nontuberculosis mycobacterium(NTM) isolates account for approximately 10% of patients with a positive Acid-Fast Bacilli(AFB) smear. Therefore, it is necessary to consider NTM pulmonary disease when such a positive test is encountered. The aim of this study was to evaluate the etiologies and clinical characteristics of patients with NTM pulmonary disease who had been treated at a national tuberculosis hospital. METHODS: The NTM isolates were recovered from the sputum or bronchial washing specimens submitted to a clinical laboratory of National Masan TB Hospital from August 2002 to July 2003. All samples were identified using a polymerase chain reaction-restriction fragment length polymorphism analysis method, which amplifies the rpoB gene. The patients were diagnosed with NTM disease according to the American Thoracic Society diagnostic criteria. RESULTS: One hundred NTM isolates were recovered from 57 patients. Of the 100 isolates, M. avium complex(MAC) was the most common species, which was found 55%(n=55) of patients, followed by M. abscessus(n=25), and M. fortuitum(n=9). 26(45.6%) patients had NTM disease. Twenty-six (45.6%) patients had NTM disease according to The American Thoracic Society classification. The main organisms involved in NTM disease were MAC(n=19, 73.1%) and M. abscessus(n=5, 19.2%). The pathogenic potential was 67.9% in M. intracellulare and 41.7% in M. abscessus. The predictive factors related to NTM disease were a positive sputum smear (OR 6.4, p=0.02) and the isolation of either MAC or M. abscessus(OR 6.9, p=0.007). Fifteen patients(57.7%) were cured. There were no significant factors associated with the treatment success. CONCLUSION: There was a relatively high proportion of NTM disease in NTM isolates and the common species were MAC and M. abscessus. The predictive factors for NTM disease were a positive sputum smear and the isolation of either MAC or M. abscessus.
Classification* ; Hospitals, Chronic Disease* ; Humans ; Lung Diseases* ; Mycobacterium avium Complex ; Nontuberculous Mycobacteria ; Sputum ; Tuberculosis*

PURPOSE: To develop staffing levels for nursing personnel (registered nurses and nursing assistants) to provide inpatients with integrated nursing care that includes, in addition to professional nursing care, personal care previously provided by patients' families or private caregivers. METHODS: A time & motion study was conducted to observe nursing care activities and the time spent by nursing personnel, families, and private caregivers in 10 medical-surgical units. The Korean Patient Classification System-1 (KPCS-1) was used for the nurse manager survey conducted to measure staffing levels and patient needs for nursing care. RESULTS: Current nurse to patient ratios from the time-motion study and the survey study were 1:10 and 1:11, respectively. Time spent in direct patient care by nursing personnel and family/private caregivers was 51 and 130 minutes per day, respectively. Direct nursing care hours correlated with KPCS-1 scores. Nursing personnel to patient ratio required to provide integrated inpatient care ranged from 1:3.9 to 1:6.1 in tertiary hospitals and from 1:4.4 to 1:6.0 in general hospitals. The functional nursing care delivery system had been implemented in 38.5% of the nursing units. CONCLUSION: Findings indicate that appropriate nurse staffing and efficient nursing care delivery systems are required to provide integrated inpatient nursing care.
Caregivers ; Classification ; Hospitals, General ; Humans ; Inpatients* ; Nurse Administrators ; Nursing Care* ; Nursing* ; Patient Care ; Tertiary Care Centers