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

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

BACKGROUND: Cystic neoplasms of the pancreas are being recognized with increased frequency. In 1993, a report on 123 cases of cystic neoplasms of the pancreas diagnosed over a period of 32 years was published in Korea. Many changes on the concept of cystic neoplasms of the pancreas have been made, including classification and diagnostic criteria. The present study was conducted wherein a new survey on cystic neoplasms of the pancreas in Korea. METHODS: Cystic neoplasms of the pancreas diagnosed over a period of 12 years, from 1993 to 2004 in 25 university hospitals throughout Korea were collected. They were classified according to the World Health Organization classification of cystic neoplasms of the pancreas. RESULTS: A total of 1264 cases of cystic neoplasms of the pancreas were diagnosed. The diagnoses and frequencies are as follows: intraductal papillary mucinous neoplasm, 499 (39.5%); mucinous cystic neoplasm, 318 (25.2%); serous cystic neoplasm, 232 (18.4%); solid pseudopapillary neoplasm, 192 (15.2%); cystic endocrine neoplasm, 11 (0.8%); lymphoepithelial cyst, 8 (0.6%); acinar cell neoplasm, 3 (0.2%); mature teratoma, 1 (0.1%). Increase in the annual number of diagnoses was evident. In intraductal papillary mucinous neoplasm and mucinous cystic neoplasm, a significant increase in mean age was seen in patients with malignant neoplasms. CONCLUSIONS: Cystic neoplasms of the pancreas are diagnosed with increasing frequency in Korea, the most common being intraductal papillary mucinous neoplasm of the pancreas. In intraductal papillary mucinous neoplasm and mucinous cystic neoplasm, the grade of dysplasia increased with mean age, suggesting an adenoma-carcinoma sequence.
Acinar Cells ; Classification ; Diagnosis ; Hospitals, University ; Humans ; Korea* ; Mucins ; Pancreas* ; Teratoma ; World Health Organization

BACKGROUND: The committee of tuberculosis(TB) survey planning for the year 2000 decided to construct the Korean Tuberculosis Surveillance System (KTBS), based on a doctor's routine reporting method. The successful keys of the KTBS rely on the precision of the recorded TB notification forms. The purpose of this study was to determine that the accuracy of the TB notification form written at a private general hospital given to the corresponding health center and to improve the comprehensiveness of these reporting systems. MATERIALS AND METHODS: 291 adult TB patients who had been diagnosed from August 2000 to January 2001, were enrolled in this study. The lists of TB notification forms were compared with the medical records and the various laboratory results; case characteristics, history of previous treatment, examinations for diagnosis, site of the TB by the international classification of the disease, and treatment. RESULTS: In the list of examinations for a diagnosis in 222 pulmonary TB patients, the concordance rate of the 'sputum smear exam' was 76% but that of the 'sputum culture exam' was only 23%. Among the 198 cases of the sputum culture exam labeled 'not examined', 43(21.7%) cases proved to be true 'not examined', 70 cases(35.4%) were proven to be 'culture positive', and 85(43.0%) cases were proven to be 'culture negative'. In the list of examinations for a diagnosis in 69 extrapulmonary TB patients, the concordance rate of the 'smear exam other than sputum' was 54%. In the list of treatments, the overall concordance rate of the 'type of registration' in the TB notification form was 85%. Among the 246 'new' cases on the TB notification form, 217(88%) cases were true 'new' cases and 13 were proven to be 'relapse', 2 were proven to be 'treatment after failure', one was proven to be 'treatment after default', 12 were proven to be 'transferred-in' and one was proven to be 'chronic'. Among the 204 HREZ prescribed regimen, 172(84.3%) patients were taking the HREZ regimen, and the others were prescribed other drug regimens. CONCLUSION: Correct recording of the TB notification form at the private sectors is necessary for supporting the effective TB surveillance system in Korea.
Adult ; Classification ; Diagnosis ; Hospitals, General* ; Humans ; Korea ; Medical Records ; Private Sector ; Sputum ; Tuberculosis*

BACKGROUND: One of the factors that affect the anesthetic risk is preoperative status especially in geriatric patients. So we studied about followings; 1) Can we use APACHE scoring index when we assess the physical status of geriatric patients preoperatively? 2) Is it meaningful in saying the risk of anesthesia? 3) Which one is more significant in predicting the morbidity and mortality: acute physiologic status vs chronic health status? METHOD: Preoperative status of the geriatric patients (above 65 years old), who were received operation from June 1994 to March 1996 at Hanil General Hospital, were assessed by APACHE scoring index and ASA classification. Age, sex, type of operation, emergency or elective, method of anesthesia, duration of procedure, APACHE scoring index, ASA classification, perioperative complication, postoperative complication is coded by grading or type. RESULT: Perioperative complication was showed statistically significant with acute physiologic score (APS) and duration of procedure. Postoperative complication was showed statistically significant with APACHE score or ASA class. Total complication was affected by duration of procedure and APS score. There was also correlation between ASA class and total complication. Among 265 cases, 1 case expired during operation and 7 cases expired after operation. Causes of postoperative death were pneumonia, hemorrhagic shock etc. CONCLUSION: In geriatric patients, 1) APACHE scoring index is available for preoperative assessment. 2) APACHE scoring index is meaningful in predicting the risk of anesthesia. 3) Perioperative complication was more correlated with acute physiologic status than chronic health evaluation.
Anesthesia ; APACHE* ; Classification ; Emergencies ; Hospitals, General ; Humans ; Mortality ; Pneumonia ; Postoperative Complications ; Shock, Hemorrhagic

PURPOSE: Since fine needle localization biopsy has been introduced, surgeons can have performed biopsies for nonpalpable microcalcified breast lesions, but there are many controversies in determining the disease characteristics and guideline for biopsy with only the findings on mammography. This study was designed to determine the breast cancers according to microcalcification type. MATERIALS AND METHODS: We reviewed 91 cases with only microcalcifications on mammography and with performing localization biopsies from January 1995 to June 1998 at department of surgery, Korea University Hospitals. We subdivided the type of microcalcifications into casting-type, crushed stone like-type and amorphous-type. RESULTS: The mean age was 49 years old (25-82 years). 16 patients (17.6%) among the 91 patients were diagnosed as 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 were detected in the breast cancer. The incidence of breast cancers by mammographic microcalcificated breast lesions was more prevalent in casting and crushed stone-like types than amorphous types. The mean size of the benign and malignant lesions was 13.11+/-10.89mm, 13.13+/-.51mm, and there was no difference in the size of microcalcifiations between benign and malignant lesions. CONCLUSIONS: Patients who have had clustered microcalcifications of more than 5 within 1 cm circle in diameter on mammography should be undergone biopsies especially in case of casting or crushed stone-like type to detect early breast cancers.
Biopsy ; Breast Neoplasms* ; Breast* ; Classification* ; Hospitals, University ; Humans ; Incidence* ; Korea ; Mammography* ; Middle Aged ; Needles

Currently, there are 100 community emergency centers which expect to provide professional emergency care like Level 1 trauma centers in U.S.A. To evaluate Performance of emergency center, most studies have been widely adopted death rate based methods such as Trauma and Injury Severity Score(TRISS) and A Severity Characterization of Trauma(ASCOT). However, these methods are only applicable in situation where registration process of trauma patients is well established. Therefore, an alternative method should be applied to evaluate performance of emergency centers in Korea which does not have well-developed registration scheme. This study aims to develop new performance measures which are applicable to Korea and evaluate performance of 35 community emergency centers through new measures. The new measures are included that 'W-statistic' ; death rate calculated on the basis of International Classification based Injury Severity Score(ICISS), and 'the degree of severity' ; rate of severe trauma patients of each emergency medical centers. The study results can be summarized as follows. First, about 34% of sample emergency centers show they provide proper care in terms of their function. Second, tertiary hospitals, university hospitals, and hospitals located in Seoul show higher severity degree of patients and lower severity-adjusted death rate.
Classification ; Emergencies* ; Emergency Medical Services ; Hospitals, University ; Humans ; Korea ; Mortality ; Seoul ; Tertiary Care Centers ; Trauma Centers