BACKGROUND: Elderly patients receiving long-term care are at high risk for pressure ulcers. This study was done to identify histories of pressure ulcers and to evaluate the risk of pressure ulcers using the Braden scale. METHODS: We enrolled 103 subjects receiving nursing homecare from a university hospital in Gyeongju or admitted to nursing homes in Pohang between April 1, 2010 and June 30, 2010. Assessment tools included demographic information, level of care, activities of daily living (ADL), presence of pressure ulcer, history of pressure ulcers and the Braden scale scores. RESULTS: Twenty-six subjects (25.2%) had previous pressure ulcers. The mean Braden scale score was 15.02+/-4.23 (range, 6 to 23). And categorized into two groups based on previous pressure ulcers, the mean score was 11.92+/-3.59 for the group with previous pressure ulcers and 16.06+/-3.93 for the group without previous (p<0.001). The number of subjects with a risk for pressure ulcers according to the Braden scale was 71 (69.9%). The Braden scale had a positive correlation with level of care (p<0.001) and a negative correlation with ADL (p<0.001). Factors related to the history of pressure ulcers were homecare services (p=0.010), concurrent diabetes (p=0.023) and a low Braden scale score (p=0.028). CONCLUSION: We recommend that a pressure ulcer risk assessment be done routinely in elderly patients receiving long-term care services to minimize their occurrence.
Activities of Daily Living ; Aged ; Humans ; Long-Term Care ; Nursing Homes ; Pressure Ulcer ; Risk Assessment

BACKGROUND: Gastroscopy is the useful method to detect the upper gastrointestinal condition, but examinee have recognized it as the procedure causing the discomfort and anxiety. This study was conducted to identify the factors related to pre-procedural anxiety for gastroscopy . METHODS: From 9th March to 12th June 2009, Data were collected from 463 examinee undergone gastroscopy at a health promotion center of a university hospital by self-administered questionnaires about general characteristics (age, sex, education state, economic state, family history of gastric cancer), gastrointestinal symptom, histroy of gastrointestinal disease, sedated gastroscopy and previous experience of gastroscopy. Before gastroscopy procedure, pre-procedural anxiety was assessed using 20-items by Korean version of Spielberger State Triat Anxiety Inventory Form-Y (STAI-Y). RESULTS: The mean score of pre-procedural state anxiety was 38.1 +/- 10.2 in all participants. The mean score was the most highest in participants who had no previous experience of gastroscopy and would perform non-sedated gastroscopy as 42.1 +/- 10.3. Factors related to pre-procedural anxiety were female (odds ratio [OR], 3.00; 95% confidence interval [CI], 1.94 to 4.64), low education state (OR, 1.68; 95% CI, 1.05 to 2.71) and the previous experience of gastroscopy (OR, 0.46; 95% CI, 0.24 to 0.88). Among participants who had the previous experienced gastroscopy, female (OR, 3.20; 95% CI, 1.97 to 5.22), low education state (OR, 1.79; 95% CI, 1.06 to 3.02) and the good tolerance at previous gastroscopy (OR, 0.35; 95% CI 0.21 to 0.59) were related to pre-procedural anxiety. CONCLUSION: In health check examinee, female, low education state and the no previous experience of gastroscopy were related to pre-procedural anxiety. Endoscopists should be provide efforts to lower pre-procedural anxiety in those subjects as to increase effectiveness of interventions.
Anxiety ; Female ; Gastrointestinal Diseases ; Gastroscopy ; Health Promotion ; Humans ; Surveys and Questionnaires

BACKGROUND: A previous Korean study recommended minimal 50 cases of Esophgogastroduodenoscopy (EGD) to achieve technical competency, based on director's opinion. Therefore, this study was conducted to evaluate the achievement of EGD's technical skills during the first 50 EGD cases. METHODS: The data were collected from the first 50 EGDs consecutively performed by six family medicine residents trained the EGD procedure in one residency program from 2004 to 2006. Technical competency of the EGD procedure was evaluated in 4 steps divided with anatomical landmarks (the gastroesophageal junction, the antrum, the fundus of the stomach, and the second portion of the duodenum). Authors measured the procedure time of EGDs performed by residents in 4 steps and calculated the rate of success cases satisfied with author's own criteria made by procedure time. RESULTS: The success rate of EGD procedure in all steps was 26.7% at 10 EGDs, but sharply increased to 80.0% at 30 EGDs, reached 88.0% at 50 EGDs. Fail to perform esophageal intubation and retroversion to the fundus of the stomach was none after 30 EGDs. However, in steps from gastroesphageal junction to the antrum of the stomach and from the antrum of the stomach to the second portion of the duodenum, the failure rate kept up less than 10% during the first 50 EGDs. A statistically significant reduction of the procedure time in success cases was observed between 20 and 30 EGDs in all steps. CONCLUSION: The technical competency of EGD was achieved approximately 90% during the first consecutive 50 EGDs.
Achievement ; Duodenum ; Esophagogastric Junction ; Gastroscopy ; Humans ; Internship and Residency ; Intubation ; Stomach

PURPOSE: Knowledge of nutritional support and attitudes of medical staff both affect patient care. We identified attitudes regarding nutritional support among medical staff as well as changes in attitudes when a nutritional support team is present. METHODS: Data were collected from 172 medical staff members who served at a university hospital located in Gyeongju by self-administered questionnaire from June 12~August 30, 2013. The questionnaire inquired about importance of nutritional support, self-confidence about nutritional support, consideration of nutritional support for patient care, consideration of nutritional support when a nutritional support team is present, and nutritional knowledge training during the past year. RESULTS: A total of 169 subjects (98.3%) thought that nutritional support is important for patient care. Only 19 subjects (11.0%) were highly self-confident about nutritional support. In total, 147 subjects (85.5%) considered nutritional support for some or all patients, whereas 169 (98.3%) considered nutritional support for patient care when a nutritional support team is present. Thirty-eight subjects (22.1%) received nutritional knowledge training during the past year. High self-confidence for nutritional support was related to nutritional knowledge training and service part. Positive changes regarding nutritional support when a nutritional support team is present were associated with nutritional knowledge training and high self-confidence for nutritional support. CONCLUSION: No differences in nutritional support attitudes for patient care were observed among the medical staff. Nutritional knowledge training and service part affected self-confidence of nutritional support and induced positive changes in attitudes for nutritional support.
Gyeongsangbuk-do ; Humans ; Inpatients ; Medical Staff* ; Nutritional Status ; Nutritional Support* ; Patient Care* ; Surveys and Questionnaires

BACKGROUND: Freshmen maladaptation to university life has brought a lot of attention recently. Therefore, we intended to investigate about the relationship between anxiety, depression, stress and freshmen adaptation to university life. METHODS: We recruited 861 freshmen of a university located in Gyeongju, Gyeongbuk, and measured their degree of anxiety, depression, and stress by questionnaire from March 10 to 14, 2008. After 8 weeks, we examined their adaptation to university life by questionnaire and finally, analyzed the data of 600 freshmen. RESULTS: Among the freshmen, 285 (47.5%) had anxiety, 95 (15.8%) depression, and 70 (11.7%) stress. Adaptation to university life significantly associated with college-entrance exam experience, the number of close friends in class, willingness to join the club, major satisfaction and distance from the university to hometown, in addition to anxiety, depression, and stress. Risk factors of maladaptation to university life were stress (odds ratio: 2.66, 95% confidence interval: 1.60 to 4.45), depression (2.45; 1.56 to 3.84), one experience of college entrance exam (1.83; 1.24 to 2.69), anxiety (1.73; 1.27 to 2.37) and fewer than 5 close friends (1.60; 1.17 to 2.20). Short distance from the university to hometown (0.72; 0.53 to 0.98), willingness to join the club (0.60; 0.41 to 0.87) and major satisfaction (0.42; 0.29 to 0.61) were identified as lowering the risk of maladaptation to university life. CONCLUSION: Anxiety, depression, and stress closely related to freshmen adaptation to university life. During freshmen's health examination, we need to identify the degree of anxiety, depression and stress in order to predict maladaptation to university life.
Anxiety ; Depression ; Friends ; Humans ; Risk Factors

PURPOSE: In this study, we evaluated the effects of training for survival prediction of terminally ill patients in terms of medical professionals' confidence, accuracy and knowledge of survival prediction. METHODS: Twenty-nine participants completed a self-administered questionnaire where they scored their confidence, accuracy and knowledge of survival prediction before and after the training session. The training was provided in July 2009 at a university hospital located in Gyeonggi province, Republic of Korea. The participants were instructed by a professor of family medicine specialized in hospice palliative medicine to predict survival of a case using the palliative prognostic score and objective prognostic score. The training was provided in the form of a PowerPoint presentation for 40 minutes. RESULTS: Participants' confidence in survival prediction significantly increased from 4.00+/-1.73 (mean+/-SD) (0~10, visual analogue scale) to 5.83+/-1.71 after the training (P<0.001). Before training, participant's level of confidence significantly correlated with their age (P=0.04). The training significantly improved the correlation between the confidence level and the number of terminal cancer patients whom they have experienced (P=0.005 before training, P=0.017 after training). Participant's accuracy in survival prediction also significantly improved from 14 of 29 (48%) to 27 of 29 (93.1%) (P<0.001). The change in knowledge of survival prediction was too small to be statistically analyzed. CONCLUSION: After training, the confidence and accuracy scores significantly improved. Further study with a greater number of participants is needed to generalize this finding.
Hospices ; Humans ; Palliative Care ; Prognosis ; Republic of Korea ; Terminally Ill ; Surveys and Questionnaires

BACKGROUND: On the point of entering into the aged society, frailty will be recognized as a new geriatric problem in Korea. This study was conducted to identify clinical factors related to frailty in the community dwelling elderly. METHODS: This was a cross-sectional study comprised of 515 participants among 834 potential subjects who were residents of three towns in Gyeong-ju and had health check-ups at a university hospital in the same region. Using the Korean Frailty Index, those with a total score of 5 or more were considered frail and those with scores 3 to 4 as prefrail. Socio-demographics, anthropometry and laboratory data were the selected clinical factors. Those younger than 65 years or with incomplete data were excluded. Finally, 447 participants were analyzed. RESULTS: Among the participants, those identified as frail were 20 (4.5%), prefrail 72 (16.1%) and robust 355 (79.4%). By gender, the percentage of frail, prefrail and robust individuals were 3.2%, 17.4% and 79.5%, respectively, in men and 5.4, 15.2% and 79.4% in women (p=0.447). On ordinal logistic regression analysis, factors related to frailty were increased age (odds ratio [OR], 1.08; 95% confidence interval [CI], 1.01 to 1.17), functional disability (OR, 8.88; 95% CI, 4.46 to 17.68), chronic disease such as pulmonary disease (OR, 4.69; 95% CI, 1.47 to 14.99) or hypertension (OR, 2.23; 95% CI, 1.15 to 4.32), increased waist circumference (OR, 1.06; 95% CI, 1.01 to 1.11), decreased serum cholesterol (OR, 0.98; 95% CI, 0.97 to 0.99) and elevated blood urea nitrogen (OR, 1.07; 95% CI, 1.01 to 1.14). CONCLUSION: Clinical factors related to frailty were age, functional disability, chronic disease, waist circumference, serum cholesterol and blood urea nitrogen. Primary physicians should assess frailty when seeing elderly patients who have these factors.
Aged ; Anthropometry ; Blood Urea Nitrogen ; Cholesterol ; Chronic Disease ; Cross-Sectional Studies ; Female ; Humans ; Hypertension ; Korea ; Logistic Models ; Lung Diseases ; Male ; Waist Circumference

PURPOSE: A new strain of the H1N1 subtype of influenza A virus resulted in a pandemic outbreak. In South Korea, cases of pandemic influenza have increased. Therefore, we explored perception or preventive behaviors for this virus in hospital employees and outpatients. MATERIALS AND METHODS: Data was collected from hospital employees and outpatients at three university hospitals located in Daegu, Gyeongju in South Korea between the 21st and 30th of September, 2009 using a self-administrated questionnaire. We estimated perception by components of The Health Belief Model (HBM), preventive behaviors consisted of avoidance behaviors, and the recommended behaviors by the Korea Center of Disease Control and Prevention (KCDC). Desire for vaccination was identified. RESULTS: The 1,837 participants comprised hospital employees (n = 880, 47.9%) and outpatients (n = 957, 52.1%). Of all hospital employees, 491 (55.8%) and 708 (80.5%) perceived susceptibility of the pandemic influenza and benefits of the preventive behaviors, respectively. Among all outpatients, 490 (51.2%) and 651 (68.0%) perceived susceptibility of the pandemic influenza and benefits of the preventive behaviors, respectively. Recommended preventative behaviors were adopted by 674 (76.6%) of hospital employees and 631 (65.9%) of outpatients. Vaccination was desired by 479 (54.4%) of hospital employees and 484 (50.6%) of outpatients. Factors influencing preventative behaviors included gender, economic status (for hospital employees) and educational level (for outpatients). All HBM components except perception of barriers were associated with the preventive behaviors in both groups. CONCLUSION: The majority of the surveyed hospital employees and outpatients perceived the benefits of preventive behaviors for pandemic influenza and performed them.
Adolescent ; Adult ; Female ; Hospitals/statistics & numerical data ; Humans ; *Influenza, Human ; Male ; Middle Aged ; Outpatients/*psychology/*statistics & numerical data ; *Pandemics ; Personnel, Hospital/*psychology/*statistics & numerical data ; Republic of Korea ; Young Adult

PURPOSE: A new strain of the H1N1 subtype of influenza A virus resulted in a pandemic outbreak. In South Korea, cases of pandemic influenza have increased. Therefore, we explored perception or preventive behaviors for this virus in hospital employees and outpatients. MATERIALS AND METHODS: Data was collected from hospital employees and outpatients at three university hospitals located in Daegu, Gyeongju in South Korea between the 21st and 30th of September, 2009 using a self-administrated questionnaire. We estimated perception by components of The Health Belief Model (HBM), preventive behaviors consisted of avoidance behaviors, and the recommended behaviors by the Korea Center of Disease Control and Prevention (KCDC). Desire for vaccination was identified. RESULTS: The 1,837 participants comprised hospital employees (n = 880, 47.9%) and outpatients (n = 957, 52.1%). Of all hospital employees, 491 (55.8%) and 708 (80.5%) perceived susceptibility of the pandemic influenza and benefits of the preventive behaviors, respectively. Among all outpatients, 490 (51.2%) and 651 (68.0%) perceived susceptibility of the pandemic influenza and benefits of the preventive behaviors, respectively. Recommended preventative behaviors were adopted by 674 (76.6%) of hospital employees and 631 (65.9%) of outpatients. Vaccination was desired by 479 (54.4%) of hospital employees and 484 (50.6%) of outpatients. Factors influencing preventative behaviors included gender, economic status (for hospital employees) and educational level (for outpatients). All HBM components except perception of barriers were associated with the preventive behaviors in both groups. CONCLUSION: The majority of the surveyed hospital employees and outpatients perceived the benefits of preventive behaviors for pandemic influenza and performed them.
Adolescent ; Adult ; Female ; Hospitals/statistics & numerical data ; Humans ; *Influenza, Human ; Male ; Middle Aged ; Outpatients/*psychology/*statistics & numerical data ; *Pandemics ; Personnel, Hospital/*psychology/*statistics & numerical data ; Republic of Korea ; Young Adult