SIGNIFICANCE OF THE STUDY: Acute myocardial infarction (AMI) is a major cause of death in Korea. Delay in seeking treatment may cause unnecessary exacerbation of the disease and early mortality from AMI. Patients' recognition of symptoms of an AMI and response to those symptoms may influence the delay time. Bystanders' role in patients' seeking treatment after AMI has not been studied in previous research. Understanding reasons for delay in seeking treatment is important in developing interventions for reducing these delays and increasing survival rate from AMI. PURPOSE OF THE STUDY: A retrospective survey was conducted with 144 AMI patients to: (1) investigate time from symptom onset to arrival at the first hospital for treatment of AMI; (2) describe patient's and bystander's response to the patient's symptoms; (3)examine whether patient's and bystander's responses affect delay time. RESULTS: The mean of overall pre-hospital delay time was 13.64 (21.86) hours and it consisted of patients' delay of 13.64 (22.32) hours and transportation time of 24.86 (19.41) minutes. People living in rural area delayed longer than people living in urban area. Pre-hospital delay time was associated with the bystander: patients delayed longer when they were with their spouse, family and friends than when with colleagues at work. Calling 119 saved transportation time, but did not reduce overall pre-hospital delay time. CONCLUSION AND SUGGESTIONS: Patients delay longer than the time window for a successful reperfusion therapy when they experience symptoms of AMI; and calling 119 does not diminish this delay. Bystanders' adequate response to the patients' symptom may reduce the delay time in seeking treatment. Findings from this study may suggest that health education and public campaigns are needed to increase people's recognition of symptoms of an AMI and to promote adequate response from bystanders to the AMI symptoms. In addition, public campaigns urging car operators to yield to the emergency vehicle are needed in order to reduce transportation time.
Cause of Death ; Emergencies ; Friends ; Health Education ; Humans ; Korea ; Mortality ; Myocardial Infarction* ; Reperfusion ; Retrospective Studies ; Spouses ; Survival Rate ; Transportation

PURPOSE OF THE STUDY: A retrospective and descriptive survey was conducted to investigate the level of anxiety that patients experience in early stage of AMI and to examine whether anxiety independently predict inhospital complications. SIGNIFICANCE OF THE STUDY: AMI is a major cause of death and disability. Anxiety may contribute to developing complications and mortality. However, the association between anxiety and complications has not been examined. RESULTS: Data were analyzed for 424 AMI patients enrolled for MICA (Myocardial Infarotion Complication and Anxiety) project. The mean score of the state anxiety inventory (SAI) measured within 72 hours after admission for the whole sample was 39.14 (+/-12.77) and ranged from 18 to 80. Overall, 161 patients (38.0%) experienced at least one episode of in-hospital complication (i.e. VT, VF, reinfarction, recurrent ischemia or cardiac death). Incidence of in-hospital complications was higher in the high anxiety group than in the low anxiety group (45.4% vs. 31.2%). There were significant differences in the incidence of recurrent ischemia between groups with low level of anxiety and high level of anxiety (27.5% vs. 18.9%). According to the Ward criterion from the logistic regression, anxiety reliably predicted the occurrence of in-hospital complications. Anxiety (odds ratio = 1.75, 95% CI 1.01-3.01, p= 0.04) significantly contributed to the model. Patients who were in the high anxiety group were 1.8 times more likely to have in-hospital complications than those who were in the low anxiety group. CONCLUSION AND SUGGESTION: This finding confirms that patients experience significant level of anxiety early after AMI, and this anxiety, after controlling other risk factors for the complications, is a reliable predictor of in-hospital complications.
Anxiety* ; Cause of Death ; Humans ; Incidence ; Ischemia ; Logistic Models ; Mortality ; Myocardial Infarction* ; Retrospective Studies ; Risk Factors

SIGNIFICANCE OF THE STUDY: Acute myocardial infarction (AMI) is a major cause of death. Most of the deaths from AMI, if diagnosed and treated early enough, can be prevented. Delay in treatment may cause unnecessary exacerbation of the disease and even death in AMI patients. PURPOSE OF THE STUDY: A retrospective survey was conducted to (1) investigate the delay time in AMI patients' seeking treatment from symptom onset to arrival at the first hospital (overall pre-hospital delay), the length of time taken for decision-making (patients' delay) and transport (transportation time); (2) to identify factors associated with delay times; (3) to compare delay times between the group who called 119 and the group who did not. RESULTS: The mean of overall pre-hospital delay time was 17.42 (+/-24.03) hours and it was consisted of patients' delay, 17.07(+/-24.45), and transportation time, .84 (+/-2.34). None of socio-demographic variables such as age, sex, marital status, monthly income, education, and living environment was associated with either the patients' delay or the overall delay time. Living rural area (F=4.483, p=.016), having previous MI (F=35.252, p=.000), and other heart disease (F=69.435, p=.000) decreased transportation time; having previous heart disease decreased overall pre-hospital delay(F=4.489, p=.039); and having angina (F=92.907, p=.000) and CAD (F=9.724, p=.003) increased transportation time. Place of symptom attack, bystander, whether patients or bystander called 119, modes of transportation, intensity of pain, presence of typical chest pain and anxiety perceived by patients were not associated with any of delay times. No significant differences appeared between the group who called 119 and the group who did not in any of delay times. CONCLUSION AND SUGGESTIONS: Although number of patients who arrive at the hospital early enough for treatment tend to be increasing, considerable number of patients still delayed longer than desired when they experienced symptoms of AMI, and calling 119 did not diminish this delay because patients delayed mostly before they decided to call. Living urban area, having previous MI, and heart disease decreased transportation time whereas having previous heart disease decreased the overall pre-hospital delay time and having previous angina and CAD increased transportation time. Further studies to identify reasons for real late arrivals as well as public campaigns to reduce delay time in treatment are needed.
Anxiety ; Cause of Death ; Chest Pain ; Education ; Heart Diseases ; Humans ; Marital Status ; Myocardial Infarction* ; Retrospective Studies ; Transportation

OBJECTIVE: This study aimed (1) to investigate the utilization of the reporting system for the medical errors among Korean hospitals. (2) to investigate the utilization of computerized reporting system for the medical errors among Korean hospitals. METHODS: Among 283 Chairs of the nursing department surveyed, 99(34.98%) returned the completed self-report questionnaire. A questionnaire devised by researchers was used for a survey through mail. Data were analyzed using SPSS 10.0. RESULTS: Seventy four hospitals(75.51%) had official reporting systems, and 46 hospitals(47.42%) had official reporting procedures of medical error. The responsible staffs reporting to the president include department head(91.14%), administrative officer(8.86%), and the involved person(s)(5.06%). Forty four hospitals(44.90%) did not guarantee anonymity in reporting or recording medical errors. Medical errors were reported mostly on the paper(75hospitals, 76.53%) or verbally, and only three hospitals(3.06%) used the computerized reporting system. CONCLUSION: Systemic evaluation of the medical errors based on the prompt and voluntary report is an essential step to reduce systemic errors and improve patient safety. To guarantee anonymity and non-punitive treatment to the reporting, a computerized reporting system should be actively utilized in Korea.
Anonyms and Pseudonyms ; Humans ; Korea ; Medical Errors* ; Nursing ; Patient Safety* ; Postal Service ; Surveys and Questionnaires

PURPOSE: This study was done to investigate oncology nurses' perception, attitude, knowledge and practice of CAT and to describe nurses' needs for education on CAT. METHOD: A cross-sectional descriptive study was conducted. A total of 270 oncology nurses working at four medical centers in Seoul and Kyungki participated in this study. They completed the questionnaire between December 2005 and February 2006. RESULTS: Oncology nurses perceived CAT as possible nursing interventions, but felt that there was no conclusive evidence on effectiveness/safety. Of the participants 44.4% have used CAT for themselves, and 73.9% of them were satisfied after using CAT. Two biggest reasons for CAT use were symptom control and emotional support. However, 80.8% of the participants had not had any training related to CAT. Both nurses who have used CAT and those who have been trained to practice CAT represented a more positive perception toward CAT (p=.000). The biggest perceived obstacles to the practice of CAT were concerns about side effects (71.2%) and lack of knowledge and skill (69.6%). The most favorable CAT modalities in both practice and training were mind-body medicine. CONCLUSION: Overall oncology nurses' perception toward CAT was encouraging. However a high number of the nurses reported lack of knowledge and skill in CAT. Education and training strategy for CAT need to be developed.
Animals ; Cats ; Complementary Therapies* ; Education ; Mind-Body Therapies ; Nursing ; Oncology Nursing ; Surveys and Questionnaires ; Seoul