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Gahramani S, Mahmoudi M, Nouri, Valiee S. Factors associated with the quality of dying and death and missed nursing care. Int J Palliat Nurs 2024; 30:190-198. [PMID: 38630644 DOI: 10.12968/ijpn.2024.30.4.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
BACKGROUND Patients in intensive care units need full nursing care due to the high mortality rate. However, some aspects of nursing care can be forgotten. AIMS To investigate the quality of death and dying and its association with aspects of missed nursing care, alongside the overall perception of nurses in intensive care units about factors associated with missed nursing care. METHODS This cross-sectional study used a census sampling method of 105 nurses working in intensive care units. In order to collect data, the Quality of Dying and Death Questionnaire (QODD), missed nursing care (MISSCARE survey) and factors associated with missed nursing care questionnaire were used. Data analysis was performed by using SPSS 16. FINDINGS The quality of death and dying, as perceived by nurses, was found to be lower than the average (Range score: 0 to 100). The range of missed nursing care was average (Range of score: 24 to 96) and the most noticeable reason for this missed nursing care was the shortage of nursing staff. CONCLUSION Managers should ensure that nurses provide complete nursing care for terminally ill patients in intensive care units and eliminate factors that lead to aspects of nursing care being missed, such as staffing levels, material resources and communication between staff members.
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Affiliation(s)
- Shahin Gahramani
- Students Research Committee, Kurdistan University of Medical Sciences, Iran
| | - Mokhtar Mahmoudi
- Assistant Professor, Clinical Care Research Center, Kurdistan University of Medical Sciences, Iran
| | - Nouri
- Associate Professor, Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Iran
| | - Sina Valiee
- Professor, Clinical Care Research Center; Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Iran
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Kasimovskaya N, Geraskina N, Fomina E, Ivleva S, Krivetskaya M, Ulianova N, Zhosan M. Russian nurses' readiness for transcultural care of palliative patients. BMC Palliat Care 2023; 22:87. [PMID: 37407991 DOI: 10.1186/s12904-023-01198-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 06/20/2023] [Indexed: 07/07/2023] Open
Abstract
Palliative care involves an approach aimed at improving the quality of life of patients and their families, who are forced to cope with the problems associated with life-threatening diseases. This definition includes a growing group of patients around the world. It requires an extension of the definition of patients in need of palliative care in countries such as Russia and a significant improvement in the work of nursing personnel with these patients. This study aims to determine the level of preparedness of nursing personnel for specialized care (transcultural care) and the quality of care provided to palliative patients. The presented findings of the study demonstrate the relevance of developing transcultural competence, which enables significant improvement in the quality of life of palliative patients. The analysis of medical workers' assessment of the level of specific training and their intercultural preparedness was conducted based on hospices (Moscow). A survey was conducted among 113 medical workers of the middle level of education aged between 28 and 56 (average of 44.2 years) and experience in palliative care ranged from 3 to 18 years (average of 9.5 years). The Intercultural Readiness Check (IRC) test, widely used to assess nursing staff worldwide, was used for the survey to determine the level of readiness for transcultural care. A strong correlation was found between a number of the test scales and measures of participants' age and experience. The presented material demonstrates the realization of an interdisciplinary approach to the issues of specific training of nursing personnel in the field of "transcultural care" in providing palliative care to incurable patients.
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Affiliation(s)
- Nataliya Kasimovskaya
- Department of Nursing Management and Social Work, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Natalia Geraskina
- Department of Nursing Management and Social Work, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation.
| | - Elena Fomina
- Department of Nursing Management and Social Work, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Svetlana Ivleva
- Department of Nursing Management and Social Work, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Maria Krivetskaya
- Department of Nursing Management and Social Work, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Nina Ulianova
- Department of Nursing Management and Social Work, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Marina Zhosan
- Department of Nursing Management and Social Work, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
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A systematic review of instruments measuring the quality of dying and death in Asian countries. Qual Life Res 2022:10.1007/s11136-022-03307-8. [DOI: 10.1007/s11136-022-03307-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2022] [Indexed: 11/29/2022]
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Paiva BSR, Valentino TCDO, Mingardi M, de Oliveira MA, Franco JO, Salerno MC, Palocci H, de Melo TC, Paiva CE. Translation, Validity and Internal Consistency of the Quality of Dying and Death Questionnaire for Brazilian families of patients that died from cancer: a cross-sectional and methodological study. SAO PAULO MED J 2022; 141:e202285. [PMID: 36417658 PMCID: PMC10065093 DOI: 10.1590/1516-3180.2022.0085.r2.09082022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 08/09/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The Quality of Dying and Death Questionnaire (QoDD) may prove to be an important evaluation tool in the Brazilian context, and, therefore, can contribute to a more precise evaluation of the dying and death process, improving and guiding the end-of-life patient care. OBJECTIVE To translate and cross-culturally adapt the QoDD into Brazilian Portuguese and measure its validity (convergent and known-groups) and internal consistency. DESIGN AND SETTING A cross-sectional, methodological study was conducted at the Hospital de Câncer de Barretos, Brazil. METHODS A total of 78 family caregivers participated in this study. Semantic, cultural, and conceptual equivalences were evaluated using the content validity index. The construct validity was assessed through convergent validation and known groups analysis [presence of family members at the place of death; feel at peace with dying; and place of death (hospital versus home; hospital versus Palliative Care)]. Internal consistency was evaluated using Cronbach's alpha. RESULTS The questionnaire was translated into Brazilian Portuguese and presented evidence of a clear understanding of its content. Cronbach's alpha values were ≥ 0.70, except for the domains of treatment preference (α = 0.686) and general concerns (α = 0.599). The convergent validity confirmed a part of the previously hypothesized correlations between the Palliative Care Outcome Scale-Brazil (POS-Br) total scores and the QoDD domain scores. The QoDD-Br domains could distinguish the patients who died in palliative care and general wards. CONCLUSION The QoDD-Br is a culturally adapted valid instrument, and may be used to assess the quality of death of cancer patients.
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Affiliation(s)
- Bianca Sakamoto Ribeiro Paiva
- PhD. Researcher and Professor, Palliative Care and Quality of
Life Research Group (GPQual), Postgraduate Program, Hospital de Câncer de
Barretos, Barretos (SP), Brazil
| | - Talita Caroline de Oliveira Valentino
- MSc. Nurse and Doctoral Student, Palliative Care and Quality of
Life Research Group (GPQual), Postgraduate Program, Hospital de Câncer de
Barretos, Barretos (SP), Brazil
| | - Mirella Mingardi
- RN. Nurse and Master's Student, Palliative Care and Quality of
Life Research Group (GPQual), Postgraduate Program, Hospital de Câncer de
Barretos, Barretos (SP), Brazil
| | - Marco Antonio de Oliveira
- MSc. Biostatistics, Palliative Care and Quality of Life
Research Group (GPQual), Postgraduate Program, Hospital de Câncer de Barretos,
Barretos (SP), Brazil
| | - Julia Onishi Franco
- MD. Physician, Dr. Paulo Prata, School of Health Sciences of
Barretos and Palliative Care and Quality of Life Research Group (GPQual),
Postgraduate Program, Hospital de Câncer de Barretos, Barretos (SP),
Brazil
| | - Michelle Couto Salerno
- RN. Research Nurse, Palliative Care and Quality of Life
Research Group (GPQual), Postgraduate Program, Hospital de Câncer de Barretos,
Barretos (SP), Brazil
| | - Helena Palocci
- MD. Physician, Dr. Paulo Prata, School of Health Sciences of
Barretos and Palliative Care and Quality of Life Research Group (GPQual),
Postgraduate Program, Hospital de Câncer de Barretos, Barretos (SP),
Brazil
| | - Tais Cruz de Melo
- MD. Physician, Dr. Paulo Prata, School of Health Sciences of
Barretos and Palliative Care and Quality of Life Research Group (GPQual),
Postgraduate Program, Hospital de Câncer de Barretos, Barretos (SP),
Brazil
| | - Carlos Eduardo Paiva
- PhD. Physician and Professor, Palliative Care and Quality of
Life Research Group (GPQual), Postgraduate Program, Hospital de Câncer de
Barretos, Barretos (SP), Brazil
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Change in perception of the quality of death in the intensive care unit by healthcare workers associated with the implementation of the "well-dying law". Intensive Care Med 2022; 48:281-289. [PMID: 34973069 PMCID: PMC8866363 DOI: 10.1007/s00134-021-06597-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/27/2021] [Indexed: 12/02/2022]
Abstract
Purpose The importance of dying with dignity in the intensive care unit (ICU) has been emphasized. The South Korean government implemented the “well-dying law” in 2018, which enables patients to refuse futile life-sustaining treatment (LST) after being determined as terminally ill. We aimed to study whether the well-dying law is associated with a significant change in the quality of death in the ICU. Methods The Quality of Dying and Death (QODD) questionnaires were prospectively collected from the doctors and nurses of deceased patients of four South Korean medical ICUs after the law was passed (January 2019 to May 2020). Results were compared with those of our previous study, which used the same metric before the law was passed (June 2016 to May 2017). We compared baseline characteristics of the deceased patients, enrolled staff, QODD scores, and staff opinions about withdrawing LST from before to after the law was passed. Results After the well-dying law was passed, deceased patients (N = 252) were slightly older (68.6 vs. 66.6, p = 0.03) and fewer patients were admitted to the ICU for post-resuscitation care (10.3% vs. 20%, p = 0.003). The mean total QODD score significantly increased after the law was passed (36.9 vs. 31.3, p = 0.001). The law had a positive independent association with the increased QODD score in a multiple regression analysis. Conclusion Our study is the first to show that implementing the well-dying law is associated with quality of death in the ICU, although the quality of death in South Korea remains relatively low and should be further improved. Supplementary Information The online version contains supplementary material available at 10.1007/s00134-021-06597-7.
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Wang Y, Liu M, Chan WCH, Zhou J, Chi I. Validation of the Quality of Dying and Death Questionnaire among the Chinese populations. Palliat Support Care 2021; 19:694-701. [PMID: 36942576 DOI: 10.1017/s1478951521001413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study reports the evaluation of the original 31-item Quality of Dying and Death Questionnaire (QODD) using a sample of caregivers of recently deceased older adults in China, and the validation of a shortened version (QODD-C) derived from the original scale. METHODS The translation was performed using a forward and back method. The full scale was tested with 212 caregivers of decedents in four regions of China. Confirmatory factor analysis tested the model fit between the full Chinese version and the original conceptual model and generated the QODD-C. The psychometric analysis was performed to evaluate the QODD-C's internal consistency, content validity, construct validity, and discriminant validity. RESULTS A five-domain, 18-item QODD-C was identified with excellent internal consistency reliability (Cronbach's α = 0.933; split-half Pearson's value = 0.855). The QODD-C total score was significantly associated with constructs related to five domains. The caregiver's relationship with the decedent, the decedent's age at death, death reason, and death place was significantly associated with the QODD-C total score. SIGNIFICANCE OF RESULTS The QODD-C is a valid and reliable instrument for assessing the quality of dying and death among the Chinese populations.
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Affiliation(s)
- Ying Wang
- School of Philosophy and Sociology, Lanzhou University, Lanzhou, China
| | - Mandong Liu
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA
- Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, CA
| | - Wallace Chi Ho Chan
- Department of Social Work, Chinese University of Hong Kong, New Territories, Hong Kong
| | - Jing Zhou
- School of Law, Shanghai Lixin University of Accounting and Finance, Shanghai, China
| | - Iris Chi
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA
- Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, CA
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Han XP, Mei X, Zhang J, Zhang TT, Yin AN, Qiu F, Liu MJ. Validation of the Chinese Version of the Quality of Dying and Death Questionnaire for Family Members of ICU Patients. J Pain Symptom Manage 2021; 62:599-608. [PMID: 33388383 DOI: 10.1016/j.jpainsymman.2020.12.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/10/2020] [Accepted: 12/25/2020] [Indexed: 10/22/2022]
Abstract
CONTEXT The quality of end-of-life care services directly affects the end-of-life quality of life of patients and their families. At present, there are no standard tools in China for assessing the quality of dying and death (QODD) of critical intensive care unit (ICU) patients. OBJECTIVES This study aimed to introduce the Chinese version of the QODD questionnaire for family members of ICU patients, after transcultural adaptation and validation, to provide an effective instrument for assessing the quality of end-of-life care of ICU patients in China, fill the gap in the evaluation of the quality of end-of-life care of critical ICU patients in China, and offer a theoretical basis and practical guidance during purposeful intervention. METHODS This study involved the main adult caregivers or principal family members of 149 dying critically ill patients. The original QODD scale was translated using the double forward and backward method. Nine cultural adaptation experts adapted the Chinese version of the QODD scale for completion by family members of ICU patients. Then, we carried out content validity, structural validity, internal consistency, confirmatory factors, and item correlation analysis of the modified scale. RESULTS The Chinese version of the QODD for family members of ICU patients was developed after some items were deleted or modified. The content validity index was 0.93, indicating that all items were correlated with the measurement of death quality. The Kaiser-Meyer-Olkin value was 0.797, suggesting that the correlations between items were high. The Cronbach's α was 0.865, indicating good internal consistency. In confirmatory factor analysis, the fit indices were χ2 = 207.327, non-normed fit index = 0.916, root mean square error of approximation = 0.033, and comparative fit index = 0.93, indicating a good fit of the five-factor model of the Chinese version of the QODD questionnaire for family members of ICU patients. CONCLUSION The Chinese version of the QODD questionnaire for family members of ICU patients is a reliable and effective instrument for evaluating the quality of death among patients who die in the ICU and can be applied to clinical practice and research.
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Affiliation(s)
- Xing-Ping Han
- Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Xu Mei
- School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Jing Zhang
- Department of Thoracic Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
| | - Ting-Ting Zhang
- School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Ai-Ni Yin
- School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Fang Qiu
- School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Meng-Jie Liu
- Department of Nursing, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
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Factors Associated with Quality of Dying and Death in Korean Intensive Care Units: Perceptions of Nurses. Healthcare (Basel) 2021; 9:healthcare9010040. [PMID: 33466252 PMCID: PMC7824749 DOI: 10.3390/healthcare9010040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/30/2020] [Accepted: 12/30/2020] [Indexed: 11/16/2022] Open
Abstract
The objective of this study was to investigate the factors affecting the quality of dying and death among terminally ill patients in an intensive care unit in Korea using a cross-sectional, online survey. A total of 300 nurses in the intensive care unit who had cared for a terminally ill patient for at least 48 h prior to death in the past six months were chosen to participate. The person-centered critical care nursing (PCCN) score and quality of dying and death (QODD) had a positive correlation. The QODD score increased when the consultation was conducted between the terminally ill patients and their doctors when CPR was not performed within 48 h of death, and when the PCCN score increased. The quality of death of patients is affected by whether they have sufficiently consulted with healthcare providers regarding their death and how much respect they receive. It is important for nurses to practice and improve patient-centered nursing care in order to ensure a good quality of death for terminally ill patients.
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Factors Associated With Quality of Death in Korean ICUs As Perceived by Medical Staff: A Multicenter Cross-Sectional Survey. Crit Care Med 2020; 47:1208-1215. [PMID: 31149962 DOI: 10.1097/ccm.0000000000003853] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Facilitating a high quality of death is an important aspect of comfort care for patients in ICUs. The quality of death in ICUs has been rarely reported in Asian countries. Although Korea is currently in the early stage after the implementation of the "well-dying" law, this seems to have a considerable effect on practice. In this study, we aimed to understand the status of quality of death in Korean ICUs as perceived by medical staff, and to elucidate factors affecting patient quality of death. DESIGN A multicenter cross-sectional survey study. SETTING Medical ICUs of two tertiary-care teaching hospitals and two secondary-care hospitals. PATIENTS Deceased patients from June 2016 to May 2017. INTERVENTIONS Relevant medical staff were asked to complete a translated Quality of Dying and Death questionnaire within 48 hours after a patient's death. A higher Quality of Dying and Death score (ranged from 0 to 100) corresponded to a better quality of death. MEASUREMENTS AND MAIN RESULTS A total of 416 completed questionnaires were obtained from 177 medical staff (66 doctors and 111 nurses) of 255 patients. All 20 items of the Quality of Dying and Death received low scores. Quality of death perceived by nurses was better than that perceived by doctors (33.1 ± 18.4 vs 29.7 ± 15.3; p = 0.042). Performing cardiopulmonary resuscitation and using inotropes within 24 hours before death were associated with poorer quality of death, whereas using analgesics was associated with better quality of death. CONCLUSIONS The quality of death of patients in Korean ICUs was considerably poorer than reported in other countries. Provision of appropriate comfort care, avoidance of unnecessary life-sustaining care, and permission for more frequent visits from patients' families may correspond to better quality of death in Korean medical ICUs. It is also expected that the new legislation would positively affect the quality of death in Korean ICUs.
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Choi Y, Park M, Kang DH, Lee J, Moon JY, Ahn H. The quality of dying and death for patients in intensive care units: a single center pilot study. Acute Crit Care 2019; 34:192-201. [PMID: 31723928 PMCID: PMC6849018 DOI: 10.4266/acc.2018.00374] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 04/16/2019] [Accepted: 05/03/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND To identify the necessary care for dying patients in intensive care units (ICUs), we designed a retrospective study to evaluate the quality of dying and death (QODD) experienced by the surrogates of patients with medical illness who died in the ICU of a tertiary referral hospital. METHODS To achieve our objective, the authors compared the QODD scores as appraised by the relatives of patients who died of cancer under hospice care with those who died in the ICU. For this study, a Korean version of the QODD questionnaire was developed, and individual interviews were also conducted. RESULTS Sixteen people from the intensive care group and 23 people from the hospice care group participated in the survey and completed the questionnaire. The family members of patients who died in the ICU declined participation at a high rate (50%), with the primary reason being to avoid bringing back painful memories (14 people, 87.5%). The relatives of the intensive care group obtained an average total score on the 17-item QODD questionnaire, which was significantly lower than that of the relatives of the hospice group (48.7±15.5 vs. 60.3±14.8, P=0.03). CONCLUSIONS This work implies that there are unmet needs for the care of dying patients and for the QODD in tertiary hospital ICUs. This result suggests that shared decision making for advance care planning should be encouraged and that education on caring for dying patients should be provided to healthcare professionals to improve the QODD in Korean ICUs.
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Affiliation(s)
- Yanghwan Choi
- Department of Burn and Critical Care, Bestian Hospital, Osong, Korea
| | - Myoungrin Park
- Department of Internal Medicine, Daejeon Veterans Hospital, Daejeon, Korea
| | - Da Hyun Kang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Jooseon Lee
- Hospital Ethics Committee, Chungnam National University Hospital, Daejeon, Korea
| | - Jae Young Moon
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Heejoon Ahn
- Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
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