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Ahn S, Son TJ, Jang Y, Choi J, Park YJ, Seong J, Kwon HH, Kim MJ, Kwon D. Vaccine effectiveness and the epidemiological characteristics of a COVID-19 outbreak in a tertiary hospital in Republic of Korea. Osong Public Health Res Perspect 2023; 14:188-196. [PMID: 37415436 PMCID: PMC10522825 DOI: 10.24171/j.phrp.2023.0066] [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: 03/07/2023] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Healthcare facilities are high-risk sites for infection. This study analyzed the epidemiological characteristics of a coronavirus disease 2019 (COVID-19) outbreak in a tertiary hospital after COVID-19 vaccination had been introduced in Republic of Korea. Vaccine effectiveness (VE) and shared anti-infection strategies are also assessed. METHODS The risk levels for 4,074 contacts were evaluated. The epidemiological characteristics of confirmed cases were evaluated using the chi-square test. The "1 minus relative risk" method was used to determine VE in preventing infection, progression to severe disease, and death. In the largest affected area (the 8th floor), a separate relative risk analysis was conducted. A multivariate logistic regression analysis (with 95% confidence interval [CIs]) was used to identify transmission risk factors with a significance level <10% via the backward elimination method. RESULTS In total, 181 cases of COVID-19 were confirmed, with an attack rate of 4.4%. Of those cases, 12.7% progressed to severe disease, and 8.3% died. In the cohort isolation area on the 8th floor, where 79.0% of the confirmed cases occurred, the adjusted odds ratio was 6.55 (95% CI, 2.99-14.33) and 2.19 (95% CI, 1.24-3.88) for caregivers and the unvaccinated group, respectively. VE analysis revealed that 85.8% of the cases that progressed to severe disease and 78.6% of the deaths could be prevented by administering a second vaccine. CONCLUSION Caregiver training for infection prevention and control is necessary to reduce infection risk. Vaccination is an important intervention to reduce the risk of progression to severe disease and death.
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Affiliation(s)
- Seonhee Ahn
- Division of Infectious Disease Response, Gyeongbuk Regional Disease Response Center, Korea Disease Control and Prevention Agency, Daegu, Republic of Korea
| | - Tae Jong Son
- Division of Infectious Disease Response, Gyeongbuk Regional Disease Response Center, Korea Disease Control and Prevention Agency, Daegu, Republic of Korea
| | - Yoonsuk Jang
- Division of Infectious Disease Response, Gyeongbuk Regional Disease Response Center, Korea Disease Control and Prevention Agency, Daegu, Republic of Korea
| | - Jihyun Choi
- Epidemiological Investigation Team, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Young Joon Park
- Epidemiological Investigation Team, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Jiseon Seong
- Division of Infectious Disease Control, Daegu Metropolitan City Hall, Daegu, Republic of Korea
| | - Hyun Hee Kwon
- Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | - Muk Ju Kim
- Department of Infectious Disease, Daegu Catholic University Medical Center, Daegu, Republic of Korea
| | - Donghyok Kwon
- Division of Public Health Emergency Response Research, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
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Seale H, Carlson SJ, Maley M, Clezy K, Torda A, Konecny P. Lifting the curtains of silence: Patient perceptions towards needs and responsibilities in contributing to the prevention of healthcare-associated infections and antimicrobial resistance. Am J Infect Control 2022:S0196-6553(22)00814-8. [PMID: 36442687 DOI: 10.1016/j.ajic.2022.11.013] [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: 08/24/2022] [Revised: 11/17/2022] [Accepted: 11/17/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Beyond the use of policy and system-focused approaches, it has been established globally that patients can play a role in enhancing the health care landscape. However, efforts to meaningfully translate patient engagement strategies that promote participation by hospitalized patients in relevant infection prevention and antimicrobial stewardship activities have not yet been realized. This study mapped the key factors acting as barriers and facilitators of patient engagement using a theoretical framework to identify potential new approaches to promote engagement. METHODS Semistructured interviews were conducted with 36 patients from 3 major hospitals in Sydney, Australia, in 2019. Transcripts were inductively analyzed, with the resulting themes categorized into the components of the Capability-Opportunity-Motivation-Behavior model. RESULTS The themes regarding barriers to patient engagement with relevant infection prevention and antimicrobial stewardship activities were: (1) Capability: misunderstanding and knowledge gaps about antimicrobial resistance; (2) Opportunity: strong family/patient support networks and good relationships with nursing staff provide an opportunity to support engagement; (3) Motivation: those who have some level of understanding or experience see the benefit and are most likely to engage actively. CONCLUSIONS Assuming patients are inclined to participate in efforts, a logical starting point would be to build awareness amongst patients and providers; however, education will not suffice. There needs to be a system and policy shift to ensure that patient engagement is recognized as a worthy endeavor.
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Affiliation(s)
- Holly Seale
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia.
| | - Samantha J Carlson
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia; School of Social Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Michael Maley
- Department of Microbiology and Infectious Diseases, New South Wales Health Pathology, Liverpool, New South Wales, Australia
| | - Kate Clezy
- Department of Infectious Diseases, Clinical Excellence Commission, NSW Health, Prince of Wales Hospital, Sydney New South Wales, Australia
| | - Adrienne Torda
- School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia; Department of Infectious Diseases, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Pamela Konecny
- School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia; Department of Infectious Diseases, Immunology & Sexual Health, St George Hospital, Kogarah, New South Wales, Australia
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Ji EJ, Lee EK. Factors Influencing the Educational Needs and Nursing Intention Regarding COVID-19 Patient Care among Undergraduate Nursing Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15671. [PMID: 36497743 PMCID: PMC9736728 DOI: 10.3390/ijerph192315671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
PURPOSE This study examines final-year undergraduate nursing students to determine the educational needs for Coronavirus disease 2019 (COVID-19), knowledge of COVID-19, attitude toward COVID-19 patient care, and nursing intention toward COVID-19 patients. METHODS A structured questionnaire was used to collect data from 21 April to 6 May 2022. The participants included 144 final-year (4th year) undergraduate nursing students in Gangwon-do, Daegu-si, and Chungcheong-do. The SPSS/WIN 21.0 program was used to analyze the data; Pearson's correlation coefficients and multiple regression were further performed. RESULTS The attitude toward COVID-19 patient care (β = 0.38, p = 0.001), a cohabitant formerly infected with COVID-19, and the intention to study COVID-19 patient care (β = 0.16, p = 0.018) were found to influence nursing intention toward COVID-19 patients. These variables had a 27% explanatory power for nursing intention (F = 14.23, p < 0.001). CONCLUSIONS To foster undergraduate nursing students' nursing intention toward patients with emerging infectious diseases (EIDs), a program focused on cultivating a positive attitude toward EID patient care should be developed and implemented. The curriculum should further include education on EID patient care.
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Affiliation(s)
- Eun-Joo Ji
- Department of Nursing, Catholic Kwandong University, Gangneung 25601, Republic of Korea
| | - Eun-Kyung Lee
- College of Nursing, Daegu Catholic University, Daegu 42472, Republic of Korea
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Park JY, Pardosi JF, Islam MS, Respati T, Chowdhury K, Seale H. What does family involvement in care provision look like across hospital settings in Bangladesh, Indonesia, and South Korea? BMC Health Serv Res 2022; 22:922. [PMID: 35841023 PMCID: PMC9286761 DOI: 10.1186/s12913-022-08278-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 06/30/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Family members provide care whilst staying in the patient's room across a range of cultural settings, irrespective of resource availability in many Asian countries. This has been reported as a contributing factor to the spread of several outbreaks, including COVID-19. Despite these reports, very little is known about the risk of healthcare-associated infection (HAI) transmission related to the involvement of family and private carers in the clinical setting. As a starting point to understanding this issue, this study aimed to provide insights regarding the patient care activities undertaken by family and private carers and the guidance provided to these carers around infection control measures in hospitals located in Bangladesh, Indonesia, and South Korea. METHOD A qualitative study involving 57 semi-structured interviews was undertaken in five tertiary level hospitals across the selected countries. Two groups of individuals were interviewed: (1) patients and their family carers and private carers; and (2) healthcare workers, including doctors, nurses, hospital managers and staff members. Drawing upon the principles of grounded theory, an inductive approach to data analysis using thematic analysis was adopted. RESULTS Five main themes were generated from the analysis of the data: (1) expectation of family carers staying with a patient; (2) residing in the patient's environment: (3) caring activities undertaken by family carers; (4) supporting and educating family carers and (5) communication around healthcare-associated infection and infection prevention and control. CONCLUSION Based on the types of activities being undertaken, coupled with the length of time family and private carers are residing within the clinical setting, coupled with an apparent lack of guidance being given around IPC, more needs to be done to ensure that these carers are not being inadvertently exposed to HAI's or other occupational risks.
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Affiliation(s)
- J Y Park
- School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
| | - J F Pardosi
- School of Public Health & Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - M S Islam
- School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.,International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - T Respati
- Faculty of Medicine, Universitas Islam Bandung, Bandung, Indonesia
| | - K Chowdhury
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - H Seale
- School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
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Kim C, Choi G, Park SY, Kim J, Park YJ, Kim K. Experience of a COVID-19 outbreak response in a general hospital in Gyeonggi Province, Korea. Epidemiol Health 2021; 43:e2021083. [PMID: 34902235 PMCID: PMC8863612 DOI: 10.4178/epih.e2021083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 10/18/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Coronavirus disease 2019 (COVID-19) outbreaks in general hospitals are particularly risky because they not only overburden the regional healthcare delivery system, but also increase the possibility of community transmission. This study shares an experience of a COVID-19 outbreak response in a general hospital in Gyeonggi Province, Korea. METHODS Since the first COVID-19 confirmed case was recognized in Hospital A on March 29, 2020, the Immediate Response Team of Gyeonggi Province and Korea Disease Control and Prevention Agency devised a plan to conduct an epidemiological investigation and minimize the paralysis of hospital functions. Apart from the epidemiological investigation, a risk assessment of the hospital and management of contacts, including patients and workers, were also undertaken. RESULTS In total, 72 confirmed cases were identified, including 26 hospitalized patients, 16 healthcare personnel, 7 visitors, and 22 cases identified externally. The majority of the confirmed cases were exposed in Ward B or were contacts of people exposed in Ward A (58.3% of 72 cases). Among healthcare personnel, caregivers were found to be the most vulnerable to COVID-19 in this outbreak. CONCLUSIONS Preparation for all possible situations in medical facilities is important because it is difficult to find alternative resources. The findings of this study provide information on controlling the further transmission of COVID-19 and furnish evidence of the importance of ordinary management skills to be prepared for COVID-19.
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Affiliation(s)
- Chanhee Kim
- Infectious Disease Control Center, Gyeonggi Provincial Government, Suwon, Korea
| | - Gawon Choi
- Infectious Disease Control Center, Gyeonggi Provincial Government, Suwon, Korea
| | - Shin Young Park
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Jieun Kim
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Young Joon Park
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Kyungnam Kim
- Korea Disease Control and Prevention Agency, Cheongju, Korea
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Islam MS, Rahman KM, Sun Y, Qureshi MO, Abdi I, Chughtai AA, Seale H. Current knowledge of COVID-19 and infection prevention and control strategies in healthcare settings: A global analysis. Infect Control Hosp Epidemiol 2020; 41:1196-1206. [PMID: 32408911 PMCID: PMC7253768 DOI: 10.1017/ice.2020.237] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 05/05/2020] [Accepted: 05/08/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE In the current absence of a vaccine for COVID-19, public health responses aim to break the chain of infection by focusing on the mode of transmission. We reviewed the current evidence on the transmission dynamics and on pathogenic and clinical features of COVID-19 to critically identify any gaps in the current infection prevention and control (IPC) guidelines. METHODS In this study, we reviewed global COVID-19 IPC guidelines by organizations such as the World Health Organization (WHO), the US Centers for Disease Control and Prevention (CDC), and the European Centre for Disease Prevention and Control (ECDC). Guidelines from 2 high-income countries (Australia and United Kingdom) and from 1 middle-income country (China) were also reviewed. We searched publications in English on 'PubMed' and Google Scholar. We extracted information related to COVID-19 transmission dynamics, clinical presentations, and exposures that may facilitate transmission. We then compared these findings with the recommended IPC measures. RESULTS Nosocomial transmission of SARS-CoV-2 in healthcare settings occurs through droplets, aerosols, and the oral-fecal or fecal-droplet route. However, the IPC guidelines fail to cover all transmission modes, and the recommendations also conflict with each other. Most guidelines recommend surgical masks for healthcare providers during routine care and N95 respirators for aerosol-generating procedures. However, recommendations regarding the type of face mask varied, and the CDC recommends cloth masks when surgical masks are unavailable. CONCLUSION IPC strategies should consider all the possible routes of transmission and should target all patient care activities involving risk of person-to-person transmission. This review may assist international health agencies in updating their guidelines.
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Affiliation(s)
- M. Saiful Islam
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
- Program for Emerging Infections, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Kazi M. Rahman
- North Coast Public Health Unit, New South Wales Health, Lismore, New South Wales, Australia
- The University of Sydney, University Centre for Rural Health, Lismore, New South Wales, Australia
| | - Yanni Sun
- Centre for Population Health, New South Wales Health, Sydney, Australia
| | - Mohammed O. Qureshi
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Ikram Abdi
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Abrar A. Chughtai
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Holly Seale
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
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Park JY, Pardosi JF, Seale H. Examining the inclusion of patients and their family members in infection prevention and control policies and guidelines across Bangladesh, Indonesia, and South Korea. Am J Infect Control 2020; 48:599-608. [PMID: 31919010 PMCID: PMC7132722 DOI: 10.1016/j.ajic.2019.10.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 10/02/2019] [Accepted: 10/02/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Although familial involvement during inpatient care is not uncommon in western countries, the types of caring activities that family members in Asian countries provide are significantly different. These activities may place the family member at risk from a health care-associated infection. This study aimed to examine whether the role of patients' families has been accounted for in the infection prevention and control (IPC) guidelines and policy, using examples from Bangladesh (low-income country), Indonesia (middle-income country), and South Korea (high-income country). METHODS The World Health Organization website and Institutional Repository for Information Sharing, Centers for Disease Control and Prevention website, Australian Government Web Archive, Open Grey, Grey Matters, World Bank, and advanced Google search, as well as the Health Department/Ministry of Health websites for each target country and 4 western countries (Australia, Canada, England, and the United States) were searched. Other databases, such as Embase, Medline, CINAHL, Global Health, ProQuest databases, Google scholar, Web of Science, and Scopus were also searched. This was to review the reflection of the cultural influence in IPC policies/guidelines by reviewing those from the global organizations, which are often used as a blueprint for policy development, as well as those from western countries, which hold different cultures in care arrangement. Search was conducted with attention to the key areas: definition and role of carer in the acute health care facility, involvement of patients/family members in IPC activities, patient and family member hand hygiene, and IPC education. RESULTS Ninety-two articles were identified based on the criteria for the study. Only 6 acknowledged that care is provided to hospitalized patients by their family members, and only 1 recommended that family members receive the same level of training as health care workers on IPC precautions. Other guides recommended the provision of information on IPC measures as means of patient involvement in the IPC program. Recognition of family caregivers or inclusion of them in the IPC strategies was not included in the target countries' guidelines. CONCLUSIONS Although health care workers are the primary actors when it comes to providing care in acute health care settings, it is important to expand the IPC guides by considering the role of other caregivers. Policies and guidelines should reflect the cultural influence over healthcare. This is especially true when cultural values strongly influence over healthcare arrangements and the healthcare accommodates these cultural influences in the practice. Further work needs to be undertaken on the level of training/education provided to family members in Bangladesh, Indonesia, and South Korea.
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Affiliation(s)
- Ji Yeon Park
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
| | | | - Holly Seale
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
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Park S, Kang JE, Choi HJ, Kim CJ, Chung EK, Kim SA, Rhie SJ. Antimicrobial Stewardship Programs in Community Health Systems Perceived by Physicians and Pharmacists: A Qualitative Study with Gap Analysis. Antibiotics (Basel) 2019; 8:E252. [PMID: 31817468 PMCID: PMC6963390 DOI: 10.3390/antibiotics8040252] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 11/21/2019] [Accepted: 12/03/2019] [Indexed: 11/16/2022] Open
Abstract
Antimicrobial stewardship program (ASP) is one of the most important strategies for managing infectious disease treatment and preventing antimicrobial resistance. The successful implementation of ASP in the community health system (CHS) has been challenging. We evaluated perceptions of current ASP, potential setbacks of ASP implementation, and future demands on ASP services among physicians and pharmacists in the CHS. The qualitative research was conducted through in-depth individual interviews and focus group discussions with 11 physicians and 11 pharmacists. In addition, a quantitative gap analysis was conducted to assess the different awareness and demands on services of ASP and preferred antimicrobial-related problems (ARP). In overall, perceptions of ASP varied by profession. The identified setbacks were unorganized institutional leadership, the undefined roles of healthcare professionals, a lack of reimbursement, the hierarchical structure of the health system, and the labor-intensive working environment of pharmacy services. Although demands for ASP improvement were similar among professionals, they had different preferences in prioritizing each service item of ASP/ARP development and the profession responsible for each service. Continuous administrative and financial investments, understanding ASP contents, ASP-specific information technology, and interdisciplinary collaboration with good communication among healthcare professions are needed to continue the progression of ASP.
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Affiliation(s)
- Sohyun Park
- Graduate School of Pharmaceutical Sciences, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea
| | - Ji Eun Kang
- College of Pharmacy, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea;
- Department of Pharmacy, National Medical Center, Seoul 04564, Korea
| | - Hee Jung Choi
- College of Medicine, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea; (H.J.C.); (C.-J.K.)
- Department of Internal Medicine, Ewha Womans University Mokdong Hospital, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Korea
| | - Chung-Jong Kim
- College of Medicine, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea; (H.J.C.); (C.-J.K.)
- Department of Internal Medicine, Ewha Womans University Seoul Hospital, 260, Gonghang-daero, Gangseo-gu, Seoul 07804, Korea
| | - Eun Kyoung Chung
- College of Pharmacy, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea;
- Department of Pharmacy, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul 05278, Korea
| | - Sun Ah Kim
- Department of Pharmacy, Ewha Womans University Mokdong Hospital, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Korea;
| | - Sandy Jeong Rhie
- Graduate School of Pharmaceutical Sciences, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea
- College of Pharmacy, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea;
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Sohn KH, Nam S, Joo J, Kwon YJ, Yim JJ. Patient-Centeredness during In-Depth Consultation in the Outpatient Clinic of a Tertiary Hospital in Korea: Paradigm Shift from Disease to Patient. J Korean Med Sci 2019; 34:e119. [PMID: 31001936 PMCID: PMC6473096 DOI: 10.3346/jkms.2019.34.e119] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Accepted: 03/27/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Patient-centered care (PCC) and integrative care approach are widely advocated. However, their implementation usually requires an extended consultation time. Despite significant advances in medical diagnosis and treatment, no studies have examined consultation time and patient centeredness in Korea. METHODS We conducted a "15-Minute Consultation" for first-time patients in outpatient clinics of 13 departments. A control group was selected from the same physicians' first-time patients, adjusting for age and gender. A total of 275 patients were selected for receiving in-depth consultation and 141 control patients were selected for regular consultation. Data were collected from patients using a questionnaire comprising a patient-centeredness scale and items on potential predictors such as socio-demographic and clinical factors. We also investigated the participating physician's professionalism. RESULTS As compared to the control group, the in-depth consultation group scored higher on 5 variables associated with PCC, including (patients' perception of) medical professionals, wait and consultation times, treatment, patient advocacy, and patient satisfaction. While 92.4% of patients in the in-depth consultation group reported that the consultation time was sufficient, only 69.0% of those in the control group reported the same (P < 0.01). In the in-depth consultation group, scores on satisfaction level were the highest for the department of internal medicine, followed by departments of surgery and pediatrics. Participating physicians' improved satisfaction following the intervention proved that in-depth consultation facilitated building a rapport with patients. CONCLUSION This study illustrated that the provision of sufficiently long consultation for serious and rare diseases could improve PCC and physicians' professionalism. Health authorities should reshuffle the healthcare delivery system and provide sufficient consultation time to ensure PCC and medical professionalism.
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Affiliation(s)
- Kyoung-Hee Sohn
- Division of Pulmonary and allergy, Department of Internal Medicine, Kyung Hee University Medical Center, Seoul, Korea
- Institute of Public Health Medical Service, Seoul National University Hospital, Seoul, Korea
| | - Sarah Nam
- Institute of Public Health Medical Service, Seoul National University Hospital, Seoul, Korea
- Division of Health Policy & Management, Department of Health Policy, Graduate School of Public Health, Yonsei University, Seoul, Korea
| | - Jungmin Joo
- Institute of Public Health Medical Service, Seoul National University Hospital, Seoul, Korea
| | - Yong Jin Kwon
- Institute of Public Health Medical Service, Seoul National University Hospital, Seoul, Korea
| | - Jae-Joon Yim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Lee YS, Kim TH, Kim J. Association between missed appointment and related factors of patients with cancer in a tertiary hospital. Int J Health Plann Manage 2018; 33. [PMID: 29862558 DOI: 10.1002/hpm.2551] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 04/25/2018] [Accepted: 04/26/2018] [Indexed: 11/10/2022] Open
Abstract
For the hospital administration, 1 major responsibility is to prevent the outflow of existing patients and minimize losses because of the failure of patients with cancer to attend appointments. We analyzed the association between no-show rates and characteristics of patients with cancer at a tertiary hospital in Seoul using patient affair data. Among the 680 190 patients, no-show rates were 4.39% and 3.37% for males and females, respectively. Male patients with colon and rectum, pancreas, and liver cancer had higher no-show rates (5.81%, 5.8%, and 5.1%). Among females, pancreas, colon and rectum, and liver cancer were associated with high no-show rates (5.65%, 5.44%, and 4.92%). For both males and females, liver (males: OR = 2.02; 95% CI: 1.68-2.44; females: OR = 1.91; 95% CI: 1.60-2.28) and pancreas (males: OR = 1.98; 95% CI: 1.57-2.50; females: OR = 1.97; 95% CI: 1.61-2.42) cancer were associated with high no-show rates. To reduce the rate of no-shows, hospitals should establish and enforce "missed appointment" policies as well as its effect upon health outcome.
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Affiliation(s)
- Ye Seol Lee
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Tae Hyun Kim
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Hospital Administration, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
| | - Juyeong Kim
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
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11
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Ha BH, Park JY. Triage and Length of Stay in a Cancer Center Emergency Department. ASIAN ONCOLOGY NURSING 2017. [DOI: 10.5388/aon.2017.17.4.246] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Bok Hee Ha
- Department of Nursing, National Cancer Center, Goyang, Korea
| | - Jeong Yun Park
- Department of Clinical Nursing, University of Ulsan, Seoul, Korea
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Knowledge, Attitudes and Behaviours of Healthcare Workers in the Kingdom of Saudi Arabia to MERS Coronavirus and Other Emerging Infectious Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13121214. [PMID: 27929452 PMCID: PMC5201355 DOI: 10.3390/ijerph13121214] [Citation(s) in RCA: 98] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 11/14/2016] [Accepted: 11/25/2016] [Indexed: 12/14/2022]
Abstract
Background: The Kingdom of Saudi Arabia has experienced a prolonged outbreak of Middle East Respiratory Syndrome (MERS) coronavirus since 2012. Healthcare workers (HCWs) form a significant risk group for infection. Objectives: The aim of this survey was to assess the knowledge, attitudes, infection control practices and educational needs of HCWs in the Kingdom of Saudi Arabia to MERS coronavirus and other emerging infectious diseases. Methods: 1500 of HCWs from Saudi Ministry of Health were invited to fill a questionnaire developed to cover the survey objectives from 9 September 2015 to 8 November 2015. The response rate was about 81%. Descriptive statistics was used to summarise the responses. Results: 1216 HCWs were included in this survey. A total of 56.5% were nurses and 22% were physicians. The most common sources of MERS-coronavirus (MERS-CoV) information were the Ministry of Health (MOH) memo (74.3%). Only (47.6%) of the physicians, (30.4%) of the nurses and (29.9%) of the other HCWs were aware that asymptomatic MERS-CoV was described. Around half of respondents who having been investigated for MERS-CoV reported that their work performance decreased while they have suspicion of having MERS-CoV and almost two thirds reported having psychological problems during this period. Almost two thirds of the HCWs (61.2%) reported anxiety about contracting MERS-CoV from patients. Conclusions: The knowledge about emerging infectious diseases was poor and there is need for further education and training programs particularly in the use of personal protective equipment, isolation and infection control measures. The self-reported infection control practices were sub-optimal and seem to be overestimated.
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Kim KH, Tandi TE, Choi JW, Moon JM, Kim MS. Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in South Korea, 2015: epidemiology, characteristics and public health implications. J Hosp Infect 2016; 95:207-213. [PMID: 28153558 PMCID: PMC7114867 DOI: 10.1016/j.jhin.2016.10.008] [Citation(s) in RCA: 184] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 10/07/2016] [Indexed: 12/31/2022]
Abstract
Background Since the first case of Middle East respiratory syndrome coronavirus (MERS-CoV) in South Korea was reported on 20th May 2015, there have been 186 confirmed cases, 38 deaths and 16,752 suspected cases. Previously published research on South Korea's MERS outbreak was limited to the early stages, when few data were available. Now that the outbreak has ended, albeit unofficially, a more comprehensive review is appropriate. Methods Data were obtained through the MERS portal by the Ministry for Health and Welfare (MOHW) and Korea Centres for Disease Control and Prevention, press releases by MOHW, and reports by the MERS Policy Committee of the Korean Medical Association. Cases were analysed for general characteristics, exposure source, timeline and infection generation. Sex, age and underlying diseases were analysed for the 38 deaths. Findings Beginning with the index case that infected 28 others, an in-depth analysis was conducted. The average age was 55 years, which was a little higher than the global average of 50 years. As in most other countries, more men than women were affected. The case fatality rate was 19.9%, which was lower than the global rate of 38.7% and the rate in Saudi Arabia (36.5%). In total, 184 patients were infected nosocomially and there were no community-acquired infections. The main underlying diseases were respiratory diseases, cancer and hypertension. The main contributors to the outbreak were late diagnosis, quarantine failure of ‘super spreaders’, familial care-giving and visiting, non-disclosure by patients, poor communication by the South Korean Government, inadequate hospital infection management, and ‘doctor shopping’. The outbreak was entirely nosocomial, and was largely attributable to infection management and policy failures, rather than biomedical factors.
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Affiliation(s)
- K H Kim
- Institute for Occupational and Environmental Health, Korea University, Seoul, Korea
| | - T E Tandi
- Institute for Occupational and Environmental Health, Korea University, Seoul, Korea; Graduate School of Public Health, Korea University, Seoul, Korea; Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea; Ministry of Public Health Yaounde, Yaounde, Cameroon
| | - J W Choi
- Institute for Occupational and Environmental Health, Korea University, Seoul, Korea; Graduate School of Public Health, Korea University, Seoul, Korea; Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea; MERS Policy Committee of the Korean Medical Association, Seoul, Korea.
| | - J M Moon
- Institute for Occupational and Environmental Health, Korea University, Seoul, Korea; Graduate School of Public Health, Korea University, Seoul, Korea
| | - M S Kim
- Institute for Occupational and Environmental Health, Korea University, Seoul, Korea; Graduate School of Public Health, Korea University, Seoul, Korea
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Choi JS, Kim JS. Factors influencing emergency nurses’ ethical problems during the outbreak of MERS-CoV. Nurs Ethics 2016; 25:335-345. [DOI: 10.1177/0969733016648205] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Whenever there has been a worldwide contagious disease outbreak, there have been reports of infection and death of healthcare workers. Particularly because emergency nurses have contact with patients on the front line, they experience ethical problems in nursing while struggling with infectious diseases in an unfavorable environment. Objective: The objective of this study was to explore emergency nurses’ ethical problems and to identify factors influencing these problems during the outbreak of Middle East respiratory syndrome–coronavirus in Korea. Design and sample: For this cross-sectional study, a questionnaire survey was conducted with emergency nurses working in six hospitals selected through convenience sampling from the hospitals designated for Middle East respiratory syndrome–coronavirus patients in the capital area. Methods: Data were collected from 169 emergency nurses in Korea during August 2015. Ethical considerations: This research was approved by the Institutional Review Board of G University in Korea. Results: The findings of this study suggest that during the Middle East respiratory syndrome–coronavirus outbreak, emergency nurses experienced ethical problems tied to a mind-set of avoiding patients. Three factors were found to influence emergency nurses’ ethical problems (in order of influence): cognition of social stigmatization, level of agreement with infection control measures, and perceived risk. Conclusion: Through this study, we obtained information on emergency nurses’ ethical problems during the Middle East respiratory syndrome–coronavirus outbreak and identified the factors that influence them. As found in this study, nurses’ ethical problems were influenced most by cognitions of social stigmatization. Accordingly, to support nurses confidently care for people during future health disasters, it is most urgent to promote appropriate public consciousness that encourages healthcare workers.
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Choi JW. Lessons learned from Middle East respiratory syndrome coronavirus cluster in Korea. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2015. [DOI: 10.5124/jkma.2015.58.7.595] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Jae Wook Choi
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
- Institute for Occupational and Environmental Health, Korea University, Seoul, Korea
- Research Institute for Healthcare Policy, Korean Medical Association, Seoul, Korea
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Choi JW, Lee JS, Kim KH, Kang CH, Yum HK, Kim Y, Lee KH, Seo IS, Rim IG, Oh DH, Lee JC, Seo KH, Kim SY. Proposed Master Plan for Reform of the National Infectious Disease Prevention and Management System in Korea. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2015. [DOI: 10.5124/jkma.2015.58.8.723] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Jae Wook Choi
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
- Research Institute for Healthcare Policy, Korean Medical Association, Seoul, Korea
- Institute for Occupational and Environmental Health, Korea University, Seoul, Korea
- MERS Policy Communittee of the Korean Medical Association, Seoul, Korea
| | - Jin Seok Lee
- Research Institute for Healthcare Policy, Korean Medical Association, Seoul, Korea
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
- MERS Policy Communittee of the Korean Medical Association, Seoul, Korea
| | - Kye Hyun Kim
- Research Institute for Healthcare Policy, Korean Medical Association, Seoul, Korea
- MERS Policy Communittee of the Korean Medical Association, Seoul, Korea
| | - Cheong Hee Kang
- Korean Medical Association, Seoul, Korea
- MERS Policy Communittee of the Korean Medical Association, Seoul, Korea
| | - Ho Kee Yum
- Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
- MERS Policy Communittee of the Korean Medical Association, Seoul, Korea
| | - Yoon Kim
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
- MERS Policy Communittee of the Korean Medical Association, Seoul, Korea
| | - Kang Hyun Lee
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
- MERS Policy Communittee of the Korean Medical Association, Seoul, Korea
| | - In Seok Seo
- Korean Medical Association, Seoul, Korea
- MERS Policy Communittee of the Korean Medical Association, Seoul, Korea
| | - Ick Gang Rim
- Korean Medical Association, Seoul, Korea
- MERS Policy Communittee of the Korean Medical Association, Seoul, Korea
| | - Dong Ho Oh
- Korean Medical Association, Seoul, Korea
- Seoul Jungnanggu Medical Association, Seoul, Korea
- MERS Policy Communittee of the Korean Medical Association, Seoul, Korea
| | - Jung Chan Lee
- Research Institute for Healthcare Policy, Korean Medical Association, Seoul, Korea
- MERS Policy Communittee of the Korean Medical Association, Seoul, Korea
| | - Kyung Hwa Seo
- Research Institute for Healthcare Policy, Korean Medical Association, Seoul, Korea
- MERS Policy Communittee of the Korean Medical Association, Seoul, Korea
| | - Seok Yeong Kim
- Research Institute for Healthcare Policy, Korean Medical Association, Seoul, Korea
- MERS Policy Communittee of the Korean Medical Association, Seoul, Korea
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