Evidence-based medicine (EBM) is the conscientious, explicit, and judicious use of current best evidence in making decisions regarding the care of individual patients. This concept has gained popularity recently, and its applications have been steadily expanding. Nowadays, the term "evidence-based" is used in numerous situations and conditions, such as evidence-based medicine, evidence-based practice, evidence-based health care, evidence-based social work, evidence-based policy, and evidence-based education. However, many anesthesiologists and their colleagues have not previously been accustomed to utilizing EBM, and they have experienced difficulty in understanding and applying the techniques of EBM to their practice. In this article, the author discusses the brief history, definition, methods, and limitations of EBM. As EBM also involves making use of the best available information to answer questions in clinical practice, the author emphasizes the process of performing evidence-based medicine: generate the clinical question, find the best evidence, perform critical appraisal, apply the evidence, and then evaluate. Levels of evidence and strength of recommendation were also explained. The author expects that this article may be of assistance to readers in understanding, conducting, and evaluating EBM.
Education ; Evidence-Based Medicine* ; Evidence-Based Practice ; Humans ; Social Work

Diabetes is a chronic disease that requires patient self-management. Successful self-care by diabetics includes accepting their diabetes status and learning proper diabetes management, as well as creating and maintaining a lifestyle that enables diabetes management.Recently, in order to improve diabetics’ self-care capability, health education has been shared by trained specialists (doctors, nurses, nutritionists, and medical social workers, etc.) through team access. Under these circumstances, the medical social worker acts as a member of the treatment team and plays a role in helping patients’ stabilize treatment and return to society smoothly by training them in psychological, economic, and social issues that make living with diabetes treatment difficult.The purpose of this study was to examine the role of medical social workers engaged in the treatment of diabetics based on their clinical work.
Chronic Disease ; Health Education ; Humans ; Learning ; Life Style ; Nutritionists ; Self Care ; Social Work ; Social Workers ; Specialization

This study was conducted in order to find out the attitude of housewives toward the home attendants system, the type of institute managing home attendants, the education for home attendants, the basic requisites for home attendants, and home nursing education, and identify the factors influencing on the housewives's attitude. The data were collected through questionnaires obtained from 401 housewives from March 1 to March 31, 1988. The results summarized were as follows; 1) 90.2 percent of total housewives favored the home attendants system, and housewives who had have their family member with health problem especially showed favorable response. 2) The favored types of institution managing home attendants appeared to be private social work agency(33.0%), half-private and half-public agency(32.2%), government agency(19.9%) and profit agency(2.2%). In particular, housewives who had experienced nursing favored half-private and half-public agency(37.6%). 3) As the basic requisites for home attendants, housewives wanted service attitude(37.2%), nursing education(34.4%) and nursing experience(28.4%). But, housewives with nursing experience favored nursing education rather than service attitude. 4) 91.1% of total housewives favored the home nursing education. In particular, housewives of high education level and nursing experience showed more favorable response to the home nursing education.
Education* ; Education, Nursing ; Home Nursing* ; Humans ; Nursing ; Surveys and Questionnaires ; Social Work

OBJECTIVES: This study was attempted to offer the foundation data to develop a specific and practical social service of caregiver-centered. For this purpose we assessed the cognitive functions of a group aged 65 or more using the Korean version of Mini Mental State Examination(MMSE-K) in a Dong area of urban community. And then we reassessed the relationships between the caring burdens of caregivers and the psychopathology of in-home demented elderlies, and the needs of caregivers for the social services. METHODS: Subjects in this study were over the age of 65 and resided in a Dong area of urban community. At first, their cognitive functions were screened by MMSE-K. Subjects, whose total score of MMSE-K were below 24 and met the diagnostic criteria of DSM-IV for dementia, were enrolled in this study and defined to be the patients with dementia. Their psychiatric symptoms were assessed by Brief Psychiatric Rating Scale(BPRS), Hamilton's Rating Scale for Depression(HDRS) and Hamilton's Rating Scale for Anxiety(HARS). At the same time, the caring burdens of caregivers and their needs for social services were assessed by caregiver`s burden inventory(CBI). Total 23 subjects completed all of the assessments and their data were analysed statistically by ANOVA, chi2-test, and Duncan's multiple range test using SAS program. RESULTS: 1) The mean total score of BPRS tended to be correlated positively with the mean score of social activity restriction subscale of caring burden dimensions. 2) Some of religions of the caregivers could affect differently and significantly on the negative changes of relationships between the demented elderlies and their caregivers(p<.05). Especially, the Christians experienced less negative changes of relationships between them than the others did. 3) When the demented elderlies were males, total burdens of caregivers and negative changes of relationships between the demented elderlies and their caregivers, and between the caregivers and their relatives were significantly higher than the other burden dimensions were(p<.05). 4) When the demented elderlies were more educated, the psychological burdens of their caregivers were more severe(p<.05). 5) The more were the total burdens of the caregivers, they wanted more social services for them(p<.05). 6) The more were the psychological and financial burdens of the caregivers, their needs for the education and counselling services were more than the needs for the other social services(p<.05). CONCLUSION: Caregivers living with male demented elderlies, who had more severe psychopathology, had more burdens of caregiving and restricted the social activities of the in-home demented elderlies more severely. As a result, the relationships between them became more worse. Our results suggested that free-home helper services for the severely demented elderlies and education counselling services including information-referral service for their caregivers were in needs. Consequently, we should develop more specific services for in-home demented elderlies and their caregivers according to the needs in their family environments.
Caregivers* ; Dementia ; Diagnostic and Statistical Manual of Mental Disorders ; Education ; Humans ; Male ; Psychopathology* ; Social Work*

PURPOSE: The purpose of this study was to analyze death attitudes of students majoring in the human service area, such as nursing science, education, and social welfare. METHOD: The Q-methodology which provides a method of analyzing the subjectivity of each item was used. The 38 selected Q-statements from each of 42 subjects were classified into a shape of normal distribution using a 9 point scale. The collected data was analyzed using a QUANL PC program. RESULT: Four types of death attitudes for research subjects in nursing, education, and social welfare areas were identified. Type I is fatalistic admission, Type II is pursuit of existential life, Type III is uncertainty of life after death, and Type IV is separation-connection between life and death. CONCLUSION: The results of the study indicate that different approaches of death educational programs are recommended based on the four types of death attitudes.
Teaching ; Students, Nursing/*psychology ; Students/*psychology ; Social Work/*education ; Male ; Humans ; Female ; *Attitude to Death ; Adult

OBJECTIVES: In this study we performed an analysis of the stress associated with the working conditions of 6,764 workers based on 'A survey of healthy condition of workers on 1999'by the Korean Occupational Safety and Health Agency. The Purpose of this study was to provide basic data for health education and management for industrial workers'health promotion. METHODS: Collected data were analyzed using the t-test, ANOVA and multiple regression analysis, using the SPSS 10.0 program. RESULTS: When the degrees of stress were analyzed according to demographic characteristics, females were found to have higher levels of stress than males (p<0.001). Furthermore, as age was lowered and as the work space became larger, the degrees of a stress were also found to be higher (p<0.001 and p<0.01, respectively). When the degrees of stress were analyzed according to working conditions, longer working hours (p<0.001) and reduced break times (p<0.05), gave rise to higher degrees of stress. Also, as the work space was reduced in size and as the work intensity was augmented, the degrees of a stress were made higher (p<0.01). In terms of physical working conditions, humidity and a lack of sense of security resulted in higher degrees of stress (p<0.01). When the workers sense that their environment is noisy or dusty has poor lighting or ventilation or that the rest room and cafeteria facilities are inadequate, the degrees of stress are found to be higher. As regards the social environment, when the workers sensed that the degree of job demand or job control was higher or that the degree of social support was lower, the degrees of stress were increased (p<0.001). Among those factors which influenced physical stress in the stepwise multiple regression analysis, the primary factor was found to be the safety of the working place (5.1 %). Other factors which influenced physical stress were degree of job demand, age, work intensity, humidity, sexual discrimination, length of working hours, size of work space and the existence or not of a regular break time in this order. Total R2 due to these factors was 12%. Among those factors which influenced mental stress in the stepwise multiple regression analysis, the primary factor was the degree of job demand (4.8 %). Other factors which influenced mental stress were humidity, age, sexual discrimination, the degree of a job control, safety of the working place, degree of social support, a working site, size of the work space, quality of lighting, the existence or not of a regular break time and length of working hours in this order. Total R2 due to these factors was 13.1 %. CONCLUSIONS: The above results shows that working conditions are strongly related to stress. Furthermore, when both physical and social working conditions are continuously managed and improved, workers may not only reduce their levels of stress but also maximize their working efficiency.
Analysis of Variance ; Discrimination (Psychology) ; Female ; Health Education ; Humans ; Humidity ; Male ; Occupational Health ; Social Environment ; Social Work ; Ventilation

OBJECTIVES: Using recidivism rate, we investigated the outcome after our substance abuse treatment program had been implemented. METHODS: Our target population was substance abuse criminals referred by probational office. They either received the parole and probation order, treatment order or social service order from the court. We divided 104 substance abuse criminals into treatment group and non-treatment group. We examined their recidivism rate. RESULTS: We reached a conclusion that treatment group had lower recidivism rate than non-treatment group (p<.05). We examined the effectiveness of short-term and long-term programs. However, no effectivess of long-term program was found because the sabject number was too small. CONCLUSION: We suggest that the strategies for substance abuse should be changed to more educative ones. The Government and Ministry of Justice must provide education and treatment to the substance abuse criminals.
Criminals ; Education ; Follow-Up Studies* ; Health Services Needs and Demand ; Humans ; Social Justice ; Social Work ; Substance-Related Disorders*

BACKGROUND: This study was conducted to develop a pre-discharge group education program for liver transplant patients, and to contribute to improving the knowledge and performance of self-management after discharge. METHODS: This investigation was a methodological study consisting of analysis, design, development, operation, and evaluation stages. RESULTS: The constituent items of the pre-discharge group education program for liver transplant patients include medication management, infection management, emergency management, outpatient management, complication management, nutrition management, exercise management, wound and drainage management, disability registration, and sex life. The pre-discharge group education program for liver transplant patients was conducted once a week, 30 minutes for the coordinator, 40 minutes for the clinical nurse specialist (including 10 minutes for wound and drainage management), 30 minutes for pharmacists, 20 minutes for the nutritionist, and 20 minutes for social workers. Additionally, the contents of the lecture announced by PowerPoint were made the same as the booklet. The overall knowledge level before and 3 months after the pre-discharge group education program for liver transplantation patients increased significantly from 17.32±1.53 to 19.74±0.89. At the 3-month time point, the overall compliance was 77.39±3.04 out of 80. Overall satisfaction was 9.32±0.93 on a scale of 10. Finally, the need for medication was the highest at 3 months. CONCLUSIONS: It is expected that this program can be utilized in the clinical field as an effective nursing education intervention.
Compliance ; Drainage ; Education* ; Education, Nursing ; Emergencies ; Humans ; Liver Transplantation ; Liver* ; Methods ; Nurse Clinicians ; Nutritionists ; Outpatients ; Pamphlets ; Pharmacists ; Self Care ; Social Work ; Social Workers ; Wounds and Injuries

PURPOSE: Disaster is defined as hazards that impact on human lives, causing adverse physical, social, economic or even political effects that exceed abilitiesto rapidly and effectively respond. The purpose of this study, conducted in 2003 and in 2005, was to improve regional disaster plans through a disaster-recognition survey conducted among medical personnel and rescuers in Daegu, Korea. METHODS: This study was carried out using a questionnaire to gauge disaster awareness among medical personnel and 119 rescuers in the Daegu area. We compared responses obtained from medical personnel with those obtained from 119 rescuers. One way ANOVA was used for comparisons. Statistical significance attributed to a pvalue less than 0.05. RESULTS: Many medical personnel and 119 rescuers showed a poor understanding of the disaster response system with regard to activities and triage systems at disaster sites, communication between facilities emergency response exercises in mock disasters, and laws and regulations related to regional governments and facilities. This lack of understanding was especially evident among medical personnel. CONCLUSION: This study revealed that medical personnel and rescuers in Daegu had little understanding of and ability to cope with actual disaster conditions. In view of the close cooperation required in disaster situations between regional medical facilities, rescue workers and government agencies, disaster training and education are imperative. If these groups can work together well, any disaster can be dealt with rapidly and effectively.
Daegu* ; Disasters* ; Education ; Emergencies ; Exercise ; Government Agencies ; Humans ; Jurisprudence ; Korea ; Surveys and Questionnaires ; Railroads* ; Rescue Work ; Social Control, Formal ; Triage

OBJECTIVES: This article aims to describe the development of smartphone application for the case management of patients with schizophrenia. METHODS: Gwangju Bukgu-Community Mental Health Center developed and launched a smartphone application (HYM) for cognitive-behavioral case management and symptom monitoring. The development of the application involved psychiatrists, nurses, social workers, psychologists, and software technicians from a software development company (Goosl Corp.). RESULTS: The HYM application for clients includes six main modules including Thought record, Symptom record, Daily life record, Official notices, Communication, and Scales. The key module is the 'Thought Record' for self-directed cognitive-behavioral treatment (CBT). When the client writes and sends the self-CBT sheet to the case manager, the latter receives a notification and can provide feedback in real time. 'Communication' and 'Official notices' are useful for promoting communication between case managers and clients with schizophrenia. Ratings in 'Symptom record', 'Daily life record', and 'Scales' modules are stored in graphic or table form representing changes in them and shared with case managers. CONCLUSION: The interactive function of this application is the key characteristics that distinguishes it from other mobile self-treatment tools. This smartphone application may contribute to the development of a youth- and customer-friendly case management system for individuals with early psychosis.
Case Management* ; Cognitive Therapy ; Early Intervention (Education) ; Gwangju ; Humans ; Mental Health ; Psychiatry ; Psychology ; Psychotic Disorders ; Schizophrenia* ; Smartphone* ; Social Work ; Social Workers ; Weights and Measures