Biomedical subjects

Hyeoun-Ae Park

Publications and source records attributed to Hyeoun-Ae Park.

At least 19 recordsLinked to original sources

PubMed2006

Modeling a terminology-based electronic nursing record system: an object-oriented approach.

OBJECTIVE: The aim of this study was to present our perspectives on healthcare information analysis at a conceptual level and the lessons learned from our experience with the development of a terminology-based enterprise electronic nursing record system - which was one of components in an EMR system at a tertiary teaching hospital in Korea - using an object-oriented system analysis and design concept. METHODS: To ensure a systematic approach and effective collaboration, the department of nursing constituted a system modeling team comprising a project manager, systems analysts, user representatives, an object-oriented methodology expert, and healthcare informaticists (including the authors). A rational unified process (RUP) and the Unified Modeling Language were used as a development process and for modeling notation, respectively. RESULTS: From the scenario and RUP approach, user requirements were formulated into use case sets and the sequence of activities in the scenario was depicted in an activity diagram. The structure of the system was presented in a class diagram. CONCLUSION: This approach allowed us to identify clearly the structural and behavioral states and important factors of a terminology-based ENR system (e.g., business concerns and system design concerns) according to the viewpoints of both domain and technical experts.

Computer Simulation↗

PubMed2006

Evaluation of the expressiveness of an ICNP-based nursing data dictionary in a computerized nursing record system.

This study evaluated the domain completeness and expressiveness issues of the International Classification for Nursing Practice-based (ICNP) nursing data dictionary (NDD) through its application in an enterprise electronic medical record (EMR) system as a standard vocabulary at a single tertiary hospital in Korea. Data from 2,262 inpatients obtained over a period of 9 weeks (May to July 2003) were extracted from the EMR system for analysis. Among the 530,218 data-input events, 401,190 (75.7%) were entered from the NDD, 20,550 (3.9%) used only free text, and 108,478 (20.4%) used a combination of coded data and free text. A content analysis of the free-text events showed that 80.3% of the expressions could be found in the NDD, whereas 10.9% were context-specific expressions such as direct quotations of patient complaints and responses, and references to the care plan or orders of physicians. A total of 7.8% of the expressions was used for a supplementary purpose such as adding a conjunction or end verb to make an expression appear as natural language. Only 1.0% of the expressions were identified as not being covered by the NDD. This evaluation study demonstrates that the ICNP-based NDD has sufficient power to cover most of the expressions used in a clinical nursing setting.

Dictionaries as Topic↗

PubMed2006

Decision-tree model of treatment-seeking behaviors after detecting symptoms by Korean stroke patients.

PURPOSE: This study was performed to develop and test a decision-tree model of treatment-seeking behaviors about when Korean patients visit a doctor after experiencing stroke symptoms. METHODS: The study used methodological triangulation. The model was developed based on qualitative data collected from in-depth interviews with 18 stroke patients. The model was tested using quantitative data collected from interviews and a structured questionnaire involving 150 stroke patients. The predictability of the decision-tree model was quantified as the proportion of participants who followed the pathway predicted by the model. RESULTS: Decision outcomes of the model were categorized into immediate and delayed treatment-seeking behavior. The model was influenced by lowered consciousness, social-group influences, perceived seriousness of symptoms, past history of hypertension or stroke, and barriers to hospital visits. The predictability of the model was found to be 90.7%. CONCLUSIONS: The results from this study can help healthcare personnel understand the education needs of stroke patients regarding treatment-seeking behaviors, and hence aid in the development of educational strategies for stroke patients.

Decision Making↗

PubMed2006

Factors affecting the implementation of telenursing in Korea.

The purpose of this study is to deduce and prioritize the factors affecting the implementation of telenursing in Korea. For this study, Delphi methods were used. Thirty professors and specialists in the field of nursing informatics and telemedicine contributed to two rounds of Delphi survey. The factors necessary for the introduction of telenursing were divided into systematic, economical, societal and technical aspects. The critical factors of each aspect were prioritized to produce a guide to support the feasible implementation plan for telenursing. They are: Governmental support to control the regulatory issues, verification of telenursing as a cost-effective health care delivery system, value verification of telenursing versus on-site consultation, social trust building, and development of characteristic telenursing content which consumers willingly pay for. The results of this study will enable health professionals to understand the prospect and necessity of telenursing implementation. In addition, they will be used efficiently in a variety of e-health milieus as a practical strategy for the improvement of health care in Korea.

Diffusion of Innovation↗

PubMed2006

Classification of nursing statements based on the ICNP, the HHCC, and the nursing process for use in electronic nursing records.

The purposes of this study were to identify nursing-phenomena-related statements and nursing-action- related statements for use in nursing records, to link nursing statements for the nursing process, to develop integrated nursing terms using the ICNP, to identify new terms for inclusion, and to group statements using the HHCC in a user interface. We extracted 5,133 nursing-phenomena-related statements and 3,844 nursing-action-related statements, with the former including 233 nursing diagnoses. A total of 2791 nursing terms were mapped and 287 new terms were developed. Synonyms of 827 standard nursing terms were extracted. We developed trees of nursing statements using the HHCC for the user interface in an electronic nursing record. The quality of nursing documentation and the nursing performance improved with the standardization process.

Humans↗

PubMed2006

The development and evaluation of a Web-site for patients undergoing spinal fusion.

The purposes of this study are to develop a Web-based information program for patients undergoing spinal fusion, and to evaluate the effect on patients' anxiety and knowledge through a Web-based information program. There was significant difference in the levels of anxiety and knowledge between the two groups after program implementation. There was significant difference in the level of knowledge between before and after education of preadmission patients.

Humans↗

PubMed2006

Standardization of Korean nursing terminology.

Korean nursing terminology was standardized to improve sharing and exchange of nursing data and information. English nursing terms were collected from existing nursing terminology, journal articles, nursing records, text books, and nursing/medical dictionaries, translated into Korean and were tested for their validity. More than 9000 terms were standardized and published on a website for further feedback from the users. This study will contribute to communication within the nursing community and with other health care professionals.

Humans↗

PubMed2005

Analysis of nursing records of cardiac-surgery patients based on the nursing process and focusing on nursing outcomes.

This study analyzed what nurses wrote in narrative nursing notes for cardiac-surgery patients. The nursing notes of 46 patients were analyzed based on the nursing process. Eight patterns were extracted according to different combinations of nursing process components, of which an assessment alone was the most frequent nursing phrase (45.8%), followed by assessment or diagnosis-intervention-outcome (25.9%). The content of the nursing notes was also classified into 15 categories, of which nursing outcomes were recorded more frequently in nursing care driven mainly by physician's order such as disease-related symptom management, insomnia care, respiratory care, and pain control, than in independent nursing care such as education and emotional care. A survey on the attitudes of nurses toward the nursing record revealed that they do not document nursing outcomes as much as they think they do. The main reasons for this discrepancy were insufficient time for recording and lack of knowledge about why, how, and what to evaluate. Even though there is room for improvement, nursing notes represent a useful resource for determining nursing contributions to patient outcomes.

Cardiac Surgical Procedures↗

PubMed2005

Nurses' willingness to maximize opioid analgesia for severe cancer pain, and its predictor.

GOALS OF WORK: The effectiveness of cancer pain management (CPM) is influenced by nurses' willingness to maximize opioid analgesia for severe cancer pain. The purposes of this study were to identify the willingness of nurses to provide maximum-dose opioids whenever needed for CPM and to determine its associated predictors. METHODS: This multicenter study was conducted among the entire total of registered nurses in seven large hospitals in Korea. Its overall response rate was 41.6%, and the data from 930 who responded (40.1%) were analyzed. We utilized a three-step, multidimensional, multiple logistic regression to identify the predictors of nurses' willingness. MAIN RESULTS: Only 255 nurses (27.4%) indicated that they recommended the maximum dose of opioids whenever it was needed. The respondents who were more likely to recommend morphine showed the following characteristics: older nurses (odds ratio, OR, 1.57; confidence interval, CI, 1.13-2.19); they knew the effectiveness of opioids for CPM (OR 1.53; CI 1.06-2.20); rarely concerned about a patient's addiction to opioids (OR 2.16; CI 1.48-3.15), or to a family member's addiction (OR 1.81; CI 1.20-2.73); prior experience with pain assessment tools (OR 1.62; CI 1.11-2.37); practical experience caring for cancer patients with pain over 51% (OR 1.55; CI 1.09-2.19). CONCLUSIONS: Our multicenter study suggested that in order to improve nurses' willingness to recommend opioids liberally in CPM: (1) attitudes about fear of opioid addiction must be changed; (2) the efficiency of opioids in CPM must be taught; and (3) implementation of pain assessment tools must be undertaken.

Adult↗

PubMed2005

Nursing outcome documentation in nursing notes of cardiac-surgery patients.

This study analyzed what nurses wrote in narrative nursing notes for nursing outcome of cardiac-surgery patients. The nursing notes of 46 patients were decomposed into phrases and analyzed based on the nursing process. Eight patterns were extracted according to different combinations of nursing-process components, of which 29.2% have nursing outcome phrases. The content of the nursing notes was also classified into 15 categories, of which nursing outcomes were recorded more frequently in nursing care driven mainly by physician's order, such as disease-related symptom management, insomnia care, respiratory care, and pain control, than in independent nursing care such as education and emotional care. A survey on the attitudes of nurses toward the nursing record revealed that they do not document nursing outcomes as much as they think they do. The main reasons for this discrepancy were insufficient time for recording and lack of knowledge about why, how, and what to evaluate. Even though there is room for improvement, nursing notes represent a useful resource for determining nursing contributions to patient outcomes.

Cardiac Surgical Procedures↗

PubMed2004

Development of a provisional domain model for the nursing process for use within the Health Level 7 reference information model.

OBJECTIVE: Since 1999, the Nursing Terminology Summits have promoted the development, evaluation, and use of reference terminology for nursing and its integration into comprehensive health care data standards. The use of such standards to represent nursing knowledge, terminology, processes, and information in electronic health records will enhance continuity of care, decision support, and the exchange of comparable patient information. As part of this activity, working groups at the 2001, 2002, and 2003 Summit Conferences examined how to represent nursing information in the Health Level 7 (HL7) Reference Information Model (RIM). DESIGN: The working groups represented the nursing process as a dynamic sequence of phases, each containing information specific to the activities of the phase. They used Universal Modeling Language (UML) to represent this domain knowledge in models. An Activity Diagram was used to create a dynamic model of the nursing process. After creating a structural model of the information used at each stage of the nursing process, the working groups mapped that information to the HL7 RIM. They used a hierarchical structure for the organization of nursing knowledge as the basis for a hierarchical model for "Findings about the patient." The modeling and mapping reported here were exploratory and preliminary, not exhaustive or definitive. The intent was to evaluate the feasibility of representing some types of nursing information consistently with HL7 standards. MEASUREMENTS: The working groups conducted a small-scale validation by testing examples of nursing terminology against the HL7 RIM class "Observation." RESULTS: It was feasible to map patient information from the proposed models to the RIM class "Observation." Examples illustrate the models and the mapping of nursing terminology to the HL7 RIM. CONCLUSION: It is possible to model and map nursing information into the comprehensive health care information model, the HL7 RIM. These models must evolve and undergo further validation by clinicians. The integration of nursing information, terminology, and processes in information models is a first step toward rendering nursing information machine-readable in electronic patient records and messages. An eventual practical result, after much more development, would be to create computable, structured information for nursing documentation.

Feasibility Studies↗

PubMed2004

Information technology as an infrastructure for patient safety: nursing research needs.

This article describes the process utilized to create research questions which promote technology as an infrastructure to enable safe nursing practice. Beginning with scenarios of safety problems related to nursing practice, the team identified information technology including hardware, software, and organizational and operational components to help improve the safety aspects addressed in the scenarios. Further discussed are characteristics of technology necessary at each step in the nursing process and finally recommendations are presented for various research questions that would be needed to enable research on the use of the proposed technologies.

Computers↗

PubMed2004

Development of a cancer pain assessment tool in Korea: a validation study of a Korean version of the brief pain inventory.

OBJECTIVE: The aim of this study was to validate the Korean version of the Brief Pain Inventory (BPI-K), a pain assessment tool that has been validated in several languages. METHODS: The sample consisted of 132 patients in Seoul who had recurrent or metastatic cancer and who expressed pain. The Korean version of the Beck Depression Inventory (BDI-K), the Eastern Cooperative Oncology Group (ECOG) performance status score, the Pain Management Index (PMI), and the PMI-Revised (PMI-R) were used to further validate the BPI-K. RESULTS: Cronbach alphas, computed for the pain interference and pain severity item, were 0.93 and 0.85, respectively. Confirmatory factor analysis of the BPI-K items showed a two-common-factor solution for the BPI-K, consistently demonstrated in other language versions of the BPI. The mean pain interference score was more correlated with the BDI-K scale (r = 0.44) and ECOG (r = 0.39) than the mean pain severity score. Seventy-four percent of the patients in the Seoul sample had inadequate analgesia using the PMI. CONCLUSION: The BPI-K is a valid and useful instrument for assessing cancer pain and pain impact in Korea.

Adolescent↗

PubMed2003

Korean nursing students' ethical problems and ethical decision making.

This Korean study replicated a previously published American study. The conceptual framework and method combined ethical enquiry and phenomenology. The research questions were: (1) What is nursing students' experience of ethical problems involving nursing practice? and, (2) What is nursing students' experience of using an ethical decision-making model? The participants were 97 senior baccalaureate nursing students, each of whom described one ethical problem and chose to use one of five ethical decision-making models. From 97 ethical problems, five content categories emerged, the largest being health professionals (69%). The basic nature of the ethical problems was the students' experience of conflict, resolution and rationale. Using an ethical decision-making model helped 94% of the students. A comparison of the Korean and American results yields important implications for nursing ethics education, practice and research.

Adult↗

PubMed2002

Impact of a physician's order entry (POE) system on physicians' ordering patterns and patient length of stay.

OBJECTIVE: To investigate the impact of a physician's order entry (POE) system on physicians' ordering patterns and patient length of stay. DESIGN: Prospective time series study at pre-POE, 3 months and 6 months after POE at a tertiary teaching hospital in Korea. The study period was from June 1999 to May 2000. MEASUREMENTS: The number of orders (doctor's, PRN, medication, changed, canceled orders), number of tests (complete blood count, chemistry, chest X-ray, stat laboratory, serum electrolytes tests), appropriateness and length of patient stay were measured through chart review of 171 in-patients (liver disease, renal disease, gastrectomy, simple mastectomy). RESULTS: The number of doctors' orders, PRN, and medication orders significantly increased after POE. The numbers of changed and canceled orders were not significantly different between pre- and post-POE. The number of stat lab tests significantly decreased after POE. There was no change in appropriateness of patients' hospital stay between pre- and post-POE. Length of stay significantly decreased (P=0.049). CONCLUSION: POE contributed to improving the quality of care in two ways: improvement of auditability by recording the medical services for patients in more precise and transparent manner, and more appropriate utilization of resources by decreasing the number of stat diagnostic tests and length of stay.

Analysis of Variance↗

PubMed2002

Prevalence of adverse reactions to latex gloves in Korean operating room nurses.

This study was conducted to determine the prevalence rate of adverse reactions to latex gloves. Among hospital personnel working in operating rooms, 41.4% reported adverse reactions to latex. Especially among OR nurses, the prevalence rate of adverse reactions was 80.3%, and that of latex allergy was 9.8%. Common symptoms were rash, skin itching, dizziness, and eye itching. Atopics had more latex allergy than the non-atopics. There was no difference in the incidence rate of latex allergy among the five gloves by the prick test. But with the exposure test, ordinary gloves had a higher latex allergy incidence than hypoallergenic gloves.

Adult↗

PubMedDate not supplied

Development and evaluation of a terminology-based electronic nursing record system.

The present study was conducted to develop and evaluate a terminology-based electronic nursing record system. The narrative nursing notes of 63 obstetric patients collected over 395 hospital days were decomposed and cross-mapped with the Korean version of the beta version of the International Classification for Nursing Practice (ICNP). The terminology-based nursing record system was developed with a terminology server to manage nursing concepts and nursing phrases, and a user application system to document nursing notes. The system was evaluated in two Korean hospitals by 20 nurses documenting nursing notes of 57 patients. Patterns were found in nursing notes reflecting the nursing process. A total of 14,727 phrases were used for documenting nursing notes, with these phrases consisting of 237 unique phrases. Among the 259 unique nursing concepts extracted from the 237 unique phrases, 103 concepts (39.8%) did not map onto the ICNP. The users were able to find nursing phrases with a success rate of 89.4%. The mean time required for documentation at each input session decreased significantly from 276 to 158 s as the users became more experienced.

Computational Biology↗

PubMedDate not supplied

Decision tree model of the treatment-seeking behaviors among Korean cancer patients.

The purpose of this study was to develop and test a decision tree model of the treatment-seeking behaviors among Korean cancer patients. The study used methodological triangulation, applying the cognitive ethnographic decision tree modeling approach. The model was developed based on qualitative data collected from in-depth interviews with 29 cancer patients. The model was tested using qualitative and quantitative data collected from interviews and a structured questionnaire involving 165 cancer patients. The predictability of the decision tree model was quantified as the proportion of participants who followed the pathway predicted by the model. Two models were developed, the first for decision making about when to visit a doctor after detecting symptoms, and the second for decision making about treatment type following the diagnosis. Decision outcomes for the first model were categorized into immediate visit and delayed visit. The first model was influenced by the perceived seriousness of symptoms, the experiences of visiting a doctor previously with similar symptoms, social-group influences on visiting a doctor, and barriers to visiting a doctor. Decision outcomes for the second model were hospital treatment only, and a mixture of hospital treatment and alternative therapies. The second model was influenced by curability, social-group influences on alternative therapies, and confidence in alternative therapies. The predictabilities of the 2 models were 90.3% and 94.5%, respectively. This study result can help nurses understand the treatment-seeking behaviors of cancer patients, and hence develop nursing intervention strategies.

Adult↗