OBJECTIVES: This study is conducted to estimate the cost paid by the public suffering from disease possibly caused by chemical and to examine the effect on public health. METHODS: Cost-benefit analysis is an important factor in analysis and decision-making and is an important policy decision tool in many countries. Cost-of-illness (COI), a kind of scale-based analysis method, estimates the potential value lost as a result of illness as a monetary unit and calculates the cost in terms of direct, indirect and psychological costs. This study estimates direct medical costs, transportation fees for hospitalization and outpatient treatment, and nursing fees through a number of patients suffering from disease caused by chemicals in order to analyze COI, taking into account the cost of productivity loss as an indirect cost. RESULTS: The total yearly cost of the diseases studied in 2012 is calculated as 77 million Korean won (KRW) per person. The direct and indirect costs being 52 million KRW and 23 million KRW, respectively. Within the total cost of illness, mental and behavioral disability costs amounted to 16 million KRW, relevant blood immunological parameters costs were 7.4 million KRW, and disease of the nervous system costs were 6.7 million KRW. CONCLUSIONS: This study reports on a survey conducted by experts regarding diseases possibly caused by chemicals and estimates the cost for the general public. The results can be used to formulate a basic report for a social-economic evaluation of the permitted use of chemicals and limits of usage.
Cost of Illness ; Cost-Benefit Analysis ; Efficiency ; Fees and Charges ; Hospitalization ; Humans ; Nervous System ; Nursing ; Outpatients ; Public Health ; Transportation

OBJECTIVES: To protect public health from risk, the Minister of Environment in Korea legislated an act concerning the registration and evaluation of chemical substances. In this study, we estimated the value of a statistical life (VSL) of carcinogenic chemicals to evaluate the socioeconomic analysis in Korea. METHODS: The estimation of the health benefit can be calculated through an individual's VSL and willingness to pay (WTP). To estimate the VSL and WTP, we used a contingent valuation method through a web-based survey. RESULTS: The survey is conducted with 1434 people living in Seoul and six large cities. An analysis of the survey is essential to review the distribution of the characteristics of the target population. The statistically significant variables affecting the WTP are location, age, household income, quality of life. Through the review of data, we secured statistical validity. The WTP was estimated as 41205 Korean won (KRW)/person, and the estimated VSL appeared as 796 million KRW/person. CONCLUSIONS: There is a case in which the amount of statistical life value is estimated in connection with domestic environmental policy, fine dust, etc. However, there are no cases of evaluation for chemical. The utilization of this result is possible for conducting other study with chemicals.
Dust ; Environmental Policy ; Family Characteristics ; Health Services Needs and Demand ; Insurance Benefits ; Korea* ; Public Health ; Quality of Life ; Seoul

Purpose: The purpose of this study was to develop a novel mouth contactless breathing exercise solution based on virtual reality (VR), and to test its feasibility. Methods: We developed the Virtual Reality-based Breathing Exercise System (VR-BRES), a self-regulating biofeedback breathing exercise with gaming characteristics and a soft stretch sensor. The feasibility and efficacy of the VR-BRES prototype were investigated through a randomized crossover trial. Fifty healthy adults participated in the trial, and their respiratory parameters and user evaluation of the VR-BRES were compared with conventional deep breathing (CDB) exercises. Results: The respiratory parameters, forced vital capacity (Z = 4.82, 4.95, p < .001), forced expiratory volume in one second (t = 6.02, 6.26, p < .001), and peak expiratory flow (t = 5.35, 5.68, p < .001) were significantly higher during breathing exercises using the VR-BRES. User evaluation was also significantly higher for the VR-BRES in terms of efficiency (Z = 3.86, p < .001), entertainingness (Z = 5.00, p < .001), and intention to use (Z = 3.22, p = .001) compared to CDB. However, there was no difference in convenience between the two methods (Z = −0.90, p = .369). Conclusion The VR-BRES has the potential to be an efficient breathing exercise solution. We recommend a clinical study that evaluates the effects of the VR-BRES for a certain period of time for people who need breathing exercises.

Purpose: The purpose of this study is to understand the social perceptions of nurses in the context of the COVID-19 outbreak through analysis of media articles. Methods: Among the media articles reported from January 1st to September 30th, 2020, those containing the keywords ‘[corona or Wuhan pneumonia or covid] and [nurse or nursing]’ are extracted. After the selection process, the text mining and topic modeling are performed on 454 media articles using textom version 4.5. Results: Frequency Top 30 keywords include ‘Nurse’, ‘Corona’, ‘Isolation’, ‘Support’, ‘Shortage’, ‘Protective Clothing’, and so on. Keywords that ranked high in Term Frequency-Inverse Document Frequency (TF-IDF) values are ‘Daegu’, ‘President’, ‘Gwangju’, ‘manpower’, and so on. As a result of the topic analysis, 10 topics are derived, such as ‘Local infection’, ‘Dispatch of personnel’, ‘Message for thanks’, and ‘Delivery of one’s heart’. Conclusion Nurses are both the contributors and victims of COVID-19 prevention. The government and the nurses’ community should make efforts to improve poor working conditions and manpower shortages.

PURPOSE: This article is a comprehensive review for concept clarification of critical thinking, clinical reasoning, and clinical judgment, which still lack a consensus and are of mixed use. METHODS: Norris's method of concept clarification was used to review concepts that have no clear definition or conceptualization yet. RESULTS: This review summarized literature from various disciplines, classified each concept based on similarities and differences, and provided hypothetic conceptual schema. CONCLUSION: Clinical reasoning and clinical judgment are clinical situation specific concepts, while critical thinking is a concept applied in general situations. Critical thinking is a broader concept and serves as a foundation for clinical reasoning and clinical judgment. Clinical reasoning precedes clinical judgment. Clinical judgement implies the end point or conclusion of clinical reasoning. Each of critical thinking, clinical reasoning, and clinical judgment is a cognitive and affective process not a psychomotor process. The concept of clinical competency involves action taken after the cognitive processes of clinical reasoning and clinical judgment.
Clinical Competence ; Consensus ; Education, Nursing ; Judgment ; Methods ; Nursing ; Thinking

The clinical cases presented here involve skeletal Class III malocclusion cases treated with maxillary protraction in a relaticely short period of time with good results. When used on young patients, satisfactory results were obtained in a short period of time, but even for those with less growth potential remainig, skeletal enhancement was still evident. However, data on the criteria of diagnosis or relapse following maxillary protraction is limited despite the number of studies on the subiect. The present study could not incude the observations on retention and relapse, and further studies in the future may include such observations.
Diagnosis ; Humans ; Malocclusion ; Orthopedics ; Recurrence

PURPOSE: The purpose of this study was to investigate effects of providing written information for coronary artery disease on health behavior compliance related self-efficacy, knowledge of disease, anxiety, and educational satisfaction depending on patients' health literacy.METHODS: The participants in this study were 40 patients who underwent coronary angiography or coronary intervention, and depending on the level of health literacy 30 patients were high group and 10 patients were low group. Each group was evaluated on health behavior compliance related self-efficacy, knowledge of disease, anxiety, and educational satisfaction with providing written information.RESULTS: By providing written information in the group with high health literacy, there was a significant difference in health behavior compliance related self-efficacy, knowledge of disease, but there was no significant difference in anxiety variable. On the other hand, there was no significant difference in health behavior compliance related self-efficacy, knowledge of disease, and anxiety by providing written information in the group with low health literacy. Also, there was no significant difference in the educational satisfaction between high and low group of health literacy after providing written information.CONCLUSION: It is necessary to develop educational materials that can be applied to clinical nursing field with considering health literacy of patients with coronary artery disease. In addition to providing written information, it is also necessary to develop other educational intervention programs such as video and personalized counseling that may be helpful for coronary patients with low health literacy and investigate their effectiveness.
Anxiety ; Compliance ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Counseling ; Hand ; Health Behavior ; Health Literacy ; Health Status ; Humans ; Literacy ; Nursing

PURPOSE: The purpose of this study was to investigate the degree of post-traumatic stress disorder (PTSD) symptoms and the effect of PTSD on quality of life (QoL) among coronary artery disease (CAD) patients.METHODS: The participants were 135 CAD patients who visited outpatient clinics in a university hospital in B city of Korea. Their PTSD symptoms and QoL were measured by structured questionnaires and analyzed with multiple hierarchical regression analysis.RESULTS: Among the 135 participants, 20.7% were classified as moderate risk, and 3.7% as high risk for PTSD. PTSD symptoms were significantly higher in participants who were diagnosed with CAD within 6 months (t=26.02, p < .001). The physical component of health-related QoL was influenced by gender (β=-.25, p=.003), recurrence of CAD (β=.21, p=.008), and PTSD symptoms (β=-.33, p < .001). The mental component of health-related QoL was influenced by religion (β=-.17, p=.044), body mass index (β=.17, p=.033), and PTSD symptoms (β=-.37, p < .001).CONCLUSION: Patients who had had a CAD diagnosis for less than 6 months were found to be vulnerable to PTSD, and PTSD was found to have a negative impact on the physical and mental components of their QoL. It is necessary to develop an intervention program for the effective prevention and management of PTSD symptoms in patients with CAD.
Ambulatory Care Facilities ; Body Mass Index ; Coronary Artery Disease ; Coronary Vessels ; Diagnosis ; Humans ; Korea ; Quality of Life ; Recurrence ; Stress Disorders, Post-Traumatic

Purpose: Cancer patients need ongoing care from healthcare providers to maintain continuity of treatment. Much research has been conducted on digital health services for providing continuous management of discharged cancer patients. This review aimed to identify nurse-led digital health interventions for discharged cancer patients. Methods: This scoping review was conducted using JBI methodology. The population was post-discharge adult cancer patients, the concept was nurse-led digital health intervention, and the context was open. Databases including PubMed, Embase, CINAHL, Cochrane Library, KoreaMed, and RISS were searched.Data were summarized about the general characteristics of the article, participants, interventions, and outcomes. Results: Fifty-seven studies were included, with ten studies that focused on the elderly. One third of the participants included in this review had colorectal cancer (32.7%). Telephone was the most frequently used format, while the others were applications, the internet, and telemonitoring. The nurses’ main roles consisted of counseling, symptom monitoring, and education. Conclusion The development of nurseled digital health intervention for the elderly will be necessary, and studies using more diverse technologies will need to be conducted. Digital health interventions for post-discharge colorectal cancer patients could be applied in practice. Nurses should provide emotional support while providing digital health interventions.

BACKGROUND: Adult with congenital heart disease represents a new category of specialized cardiovascular interest that requires the cooperation of a number of medical and surgical disciplines, and also requires the interactions among traditional departmental jurisdiction. Uninterrupted, long-term continuity care is essential if the concerns inherent in this new and increasing patient population are to be addressed. The purpose of this study was to analyze the clinical characteristics of congenital heart disease in adolescents and adults. METHODS: Between October 1994 and July 1996, retrospective follow-up records and registry chart of 229 consecutive patients with congenital heart disease for over 16 years in GUCH (grown-up congenital heart) clinic were reviewed by a physician and a nurse specialist. RESULTS: There were 126 female and 103 male GUCH patients with the mean age of 34+/-14.6 years old. Among the 229 patients, there were 179 natural survivors, those without cardiac repair, and 50 postoperative survivors. Congenital heart defects were 167 shunt legions, 17 obstructive and valvular legions, 14 tetralogy of Fallot, 15 complex congenital heart anomalies and 16 others. Among the 179 natural survivors; 122 (68%) required heart surgery or continuous medical surveillance, and among the 50 surgically repaired survivors; 37 (74%) required reoperation for residual heart defects, constant medical treatment or consultation from other medical divisions. The reasons for the hospital vistis were:cardiac operation or cardiac diagnosis in 128 (56%) patients, symptomatic heart conditions in 43 (19%), routine heart examinations since childhood in 31 (14%) and others in 27 (11%). Also, the patient compliances were higher in the GUCH clinic than the traditional departmental jurisdiction (p<0.001). CONCLUSIONS: To achieve continuing care for the patients with congenital heart disease in adolescents and adults, it is important to develope a specialized clinic addressing the specific needs of the congenital heart disease in adolescents and adults.
Adolescent* ; Adult* ; Diagnosis ; Female ; Follow-Up Studies ; Heart ; Heart Defects, Congenital* ; Humans ; Male ; Reoperation ; Retrospective Studies ; Specialization ; Survivors ; Tetralogy of Fallot ; Thoracic Surgery