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Biomedical subjects

H A Park

Publications and source records attributed to H A Park.

13 recordsLinked to original sources
PubMed2005

What stroke patients want to know and what medical professionals think they should know about stroke: Korean perspectives.

BACKGROUND AND PURPOSE: Patients and medical professionals are likely to have different perspectives of stroke, making what patients want to know about stroke different from what medical professionals think they should know. We wished to determine these differences for patients and medical professionals in South Korea, as well as to identify patients' characteristics associated with perceptions of stroke education. METHODS: Fifty consecutive patients with acute stroke admitted to Asan Medical Center, Seoul, Korea, and 88 medical professionals (31 doctors and 57 nurses) working in the Departments of Neurology or Neurosurgery were administered a structured questionnaire regarding various aspects of patient education concerning stroke. RESULTS: The average ranking of total items for stroke education was higher in nurses than in doctors or patients (P < 0.01 for each). Patients gave higher rankings than doctors for 'possibility to cure with drug treatment' (P < 0.01), 'stress management' (P < 0.01), and most items concerning 'general medical knowledge' and 'post-stroke diet management,' whereas doctors gave higher rankings than patients for most items concerning risk factor management and treatment with surgery. Items concerning 'post-stroke diet management' were ranked lower by male patients than females patients (P < 0.005), and were ranked lower by doctors than by patients or nurses (P < 0.001). Younger patients gave higher rankings than older patients for items concerning 'medical knowledge regarding stroke,' 'exercise,' and 'post-stroke sexual activities' (P < 0.001 for each). CONCLUSIONS: Perspectives on stroke education differ among doctors, nurses and patients. They also differ according to the situation of the patient. Education of stroke patients should be based on an understanding of these differences.

Activities of Daily Living↗
PubMed2002

Cross-mapping the ICNP with NANDA, HHCC, Omaha System and NIC for unified nursing language system development. International Classification for Nursing Practice. International Council of Nurses. North American Nursing Diagnosis Association. Home Health Care Classification. Nursing Interventions Classification.

Nursing language plays an important role in describing and defining nursing phenomena and nursing actions. There are numerous vocabularies describing nursing diagnoses, interventions and outcomes in nursing. However, the lack of a standardized unified nursing language is considered a problem for further development of the discipline of nursing. In an effort to unify the nursing languages, the International Council of Nurses (ICN) has proposed the International Classification for Nursing Practice (ICNP) as a unified nursing language system. The purpose of this study was to evaluate the inclusiveness and expressiveness of the ICNP terms by cross-mapping them with the existing nursing terminologies, specifically the North American Nursing Diagnosis Association (NANDA) taxonomy I, the Omaha System, the Home Health Care Classification (HHCC) and the Nursing Interventions Classification (NIC). Nine hundred and seventy-four terms from these four classifications were cross-mapped with the ICNP terms. This was performed in accordance with the Guidelines for Composing a Nursing Diagnosis and Guidelines for Composing a Nursing Intervention, which were suggested by the ICNP development team. An expert group verified the results. The ICNP Phenomena Classification described 87.5% of the NANDA diagnoses, 89.7% of the HHCC diagnoses and 72.7% of the Omaha System problem classification scheme. The ICNP Action Classification described 79.4% of the NIC interventions, 80.6% of the HHCC interventions and 71.4% of the Omaha System intervention scheme. The results of this study suggest that the ICNP has a sound starting structure for a unified nursing language system and can be used to describe most of the existing terminologies. Recommendations for the addition of terms to the ICNP are provided.

International Council of Nurses↗
PubMed2001

Nursing students' experience of ethical problems and use of ethical decision-making models.

Using a conceptual framework and method combining ethical enquiry and phenomenology, we asked 73 senior baccalaureate nursing students to answer two questions: (1) What is nursing students' experience of an ethical problem involving nursing practice? and (2) What is nursing students' experience of using an ethical decision-making model? Each student described one ethical problem, from which emerged five content categories, the largest being that involving health professionals (44%). The basic nature of the ethical problems consisted of the nursing students' experience of conflict, resolution and rationale; 85% of the students stated that using an ethical decision-making model was helpful. Although additional research is needed, these findings have important implications for nursing ethics education and practice.

Adult↗
PubMed2000

Efficacy of screening for gastric cancer in a Korean adult population: a case-control study.

While gastric cancer is the most common malignancy in the Korean adult population, little is known of the efficacy of gastric cancer screening among Koreans. To study the efficacy of gastric cancer screening, this case-control study was conducted. From November 1996 to July 1998, 441 newly diagnosed gastric cancer (321 advanced, 120 early) patients were enrolled at the Department of General Surgery and 107 controls were enrolled at the inpatient Department of Family Medicine and Otolaryngology. History of gastric examinations and possible risk factors were collected through interview with a structured questionnaire. Patients with advanced gastric cancer were 61% less likely to have had a gastric examination than those with early gastric cancer (OR 0.39; 95%CI 0.23-0.65). Patients with advanced gastric cancer were 53% less likely to have had a gastric examination within two years of diagnosis (OR 0.47; 95%CI 0.23-0.98) and 69% less likely to have had a gastric examination within three years of diagnosis (OR 0.31; 95%CI 0.11-0.86). The data, showing a significant relationship between the history of gastric examinations and severity of gastric cancer, suggests that gastric cancer screening is effective in catching gastric cancer at early stages. It also suggests less than three years for screening interval.

Adult↗
PubMed1998

Development of a Web-based CAI program for maternity nursing practice.

This quasi-experimental study was conducted to explore what kind of impact a Web-based educational program can have on nursing students and how nursing students react to this educational program. A Web-based computer assisted instruction for maternity nursing practice was developed by researchers using Instruction System Design model and serviced for nursing students on the WWW. To study educational effect of this program on nursing students 30 senior students at a school of nursing were selected. They were assigned into experimental and control groups based on their maternity nursing practice schedule. The effect of the Web-based CAI was measured using Achievement score, attitude toward learning experience and attitude toward computer and Internet, and compared between two groups. There were significant differences between two groups in achievement and attitude score. And students in the experimental group showed positive response to the Web-based CAI program. These results suggest that Web-based CAI is useful as a new teaching tool for maternity nursing practice as well as other nursing courses. Comments on program improvement and operational issues were collected from students. These will be used for program improvement in future.

Attitude to Computers↗
PubMed1997

Development of a computerized patient classification and staffing system.

Korean health care agencies are trying to find ways to survive amid strong competition within the health care industry and pressure to open health care market from abroad. One way to survive is to improve health care quality at present or reduced expenditure. Nursing is the largest manpower in health care agencies and plays an important role in determining quality of care through direct interaction with patients., thus, nursing manpower management is an essential part of survival strategies. If the nursing department can adapt to dynamic changes in the health care environment in terms of quality and quantity of service needed, health care agencies' quality and efficient management will be achieved at the same time. A computerized prototype patient classification and nursing staffing system was developed using Microsoft Visual Basic 3.0. This system allows a user to use GUI(Graphic User Interface) with an icon and a mouse. By applying this computerized system to clinical practice, nursing managers will receive accurate information regarding nursing manpower management at nursing unit level as well as departmental levels. Then nursing managers can achieve effective nursing manpower management, which will improve nursing care by allocating more nursing staff time to direct patient care.

Humans↗
PubMed1995

Development of a nursing diagnosis system using a back-propagation neural network model: an application for stomach cancer patients.

Neural networks have recently attracted considerable attention in the field of classification and in other areas. This paper discusses an experiment using a back-propagation neural network model applied to nursing diagnosis. The network's structure has three layers: 1) an input layer for representing signs and symptoms, 2) an output layer for nursing diagnosis, 3) a hidden layer. A first prototype of a nursing diagnosis system for stomach cancer patients was developed with 87 nodes for the input layer and 5 nodes for the output layer of 23 nursing diagnoses. It turned out that a model that learned 10,000 times as fast and had 5 nodes of hidden layers, a 0.5 momentum, and a 0.5 learning coefficient is the optimal one with a hitting ratio 0.76.

Computer Simulation↗
PubMed1991

Polychotomous multivariate models for coronary heart disease simulation. I. Tests of a logistic model.

Stochastic compartmental modeling techniques have been employed to simulate coronary heart disease morbidity and mortality. In the current paper, polychotomous logistic models are used to describe the relationship between risk of disease and multiple risk factors, effect modification and confounding variables. The process of estimating the parameters for two risk factors and three types of outcomes is described for a population followed for five years. A Statistical Analysis System (SAS) procedure was used to estimate risk factor coefficients based on two partial periods and on the entire five year epoch. Most of the estimated coefficients were found to be statistically significant. The model performance was evaluated by comparing the observational data with simulated outcomes using a micropopulation and Monte Carlo techniques. Two different tests of goodness of fit were used. Satisfactory fits were obtained both for the risk coefficients based on two partial periods and those based on the entire epoch. This indicates that the model is suitable for simulation of the effects of intervention strategies. The use of the entire epoch involved estimates of one half as many parameters as did the use of two partial periods. Accordingly, it is concluded that only the entire epoch need be considered for future studies of this population.

Adult↗
PubMed1989

Using serum cholesterol to identify high risk and stimulate behavior change: will it work?

If the measurement of serum cholesterol is to be used to identify a sub-population at high risk of subsequent disease and to stimulate behavior change in this group to lower serum cholesterol, the test must be able to both discriminate and motivate the group. The ability of the test to motivate has been documented in a randomized trial. This paper therefore tests, in a cohort of United States men ages 40-59 at entry, the ability of serum cholesterol to discriminate between individuals who would and would not die from coronary heart disease. While risk of death increased with increasing serum cholesterol, the values for men who developed coronary heart disease overlapped the values of the men who did not develop the disease. Overall test accuracy declined from 92% correctly classified when 5% of the population was defined as "at high risk" to 55% when 50% of the population was defined as "at high risk". On a receiver operating curve, defining 5% of the men as "high risk" yielded a false positive rate of 5% and a true positive rate of 8%. Increasing the proportion of men defined as "at high risk" to 50% increased the true positive rate to 75% but also increased the false positive rate to over 50%. Monte Carlo simulation demonstrated that lowering mean serum cholesterol 0.78 mmol/l in the entire population would lower deaths from coronary heart disease by 28%. The same effect could be achieved by lowering the serum cholesterol of all people in the top 20% of the distribution to 4.66 mmol/l.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Preventing heart disease: is treating the high risk sufficient?

Monte Carlo simulation was used to assess the effects of several intervention strategies on coronary heart disease mortality rates in a Finnish and a North American cohort. Lowering total serum cholesterol by 4%, smoking by 15%, and diastolic blood pressure by 3% for the whole cohort would be expected to reduce the incidence of non-fatal myocardial infarction by at least 13% and coronary heart disease deaths by at least 18%. Lowering serum cholesterol by 34%, diastolic blood pressure to 90 mmHg, and reducing smoking by 20% in the subset of the population with all three risk factors in the highest quartile would result in a 6-8% reduction in non-fatal myocardial infarction and a 2-9% reduction in deaths from coronary heart disease in these cohorts. These data demonstrate that in populations with a relatively high incidence of heart disease, treating the entire population will produce larger effects than focusing only on high-risk populations.

Adolescent↗
PubMedDate not supplied

Polychotomous multivariate models for coronary heart disease simulation. II. Comparisons of risk functions.

This is the second in a series of papers dealing with models of coronary heart disease. Three different types of statistical models are considered as risk functions: the multivariate logistic model, the Cox proportional hazard model and the Neyman exponential risk avoidance model. The types of models differ in the form hypothesized for the probability of occurrence of coronary heart disease outcomes: incident myocardial infarct, cardiac death, and death from other causes. Although the three risk functions are strikingly different, they can all be tested using the CRISPERS chronic disease simulation system. Simulations were performed using data from North Karelia, Finland. The polychotomous multivariate logistic risk function is convenient for studies involving increasing numbers of risk factors. The Cox proportional hazard regression model is shown to be unsuitable for the cohort dataset used as well as for some of the intended uses of the simulation models. The Neyman exponential risk avoidance model involves time in a quite different fashion. It has the inherent advantage of being easier to relate to underlying biological mechanisms because it is the integral of first order rate equations. It is concluded that more than one risk function should be evaluated for simulations of coronary heart disease.

Adult↗
PubMedDate not supplied

Collaborative efforts for representing nursing concepts in computer-based systems: international perspectives.

Current nursing terminology efforts have converged toward meeting the demand for a reference terminology for nursing concepts by building on the foundation of existing interface and administrative terminologies and by collaborating with terminology efforts across the spectrum of health care. In this article, the authors illustrate how collaboration is promoting convergence toward a reference terminology for nursing by briefly summarizing a wide range of exemplary activities. These include: 1) the International Classification of Nursing Practice (ICNP) activities of the International Council of Nurses (ICN), 2) work in Brazil and Korea that has contributed to, and been stimulated by, ICNP developments, 3) efforts in the United States to improve understanding of the different types of terminologies needed in nursing and to promote harmonization and linking among them, and 4) current nursing participation in major multi-disciplinary standards initiatives. Although early nursing terminology work occurred primarily in isolation and resulted in some duplicative efforts, the activities summarized in this article demonstrate a tremendous level of collaboration and convergence not only in the discipline of nursing but in multi-disciplinary standards initiatives. These efforts are an important prerequisite for ensuring that nursing concepts are represented in computer-based systems in a manner that facilitates multi-purpose use at local, national, regional, and international levels.

Medical Informatics Applications↗