• Title/Summary/Keyword: 다기관 연구

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Identifying Usability Level and Factors Affecting Electronic Nursing Record Systems: A Multi-institutional Time-motion Approach (전자간호기록 시스템의 사용성 수준 및 관련 요인 분석: Time-motion 방법 적용을 통한 다기관 접근)

  • Cho, Insook;Choi, Won-Ja;Choi, WoanHeui;Hyun, Misuk;Park, Yeonok;Lee, Yoona;Cho, Euiyoung;Hwang, Okhee
    • Journal of Korean Academy of Nursing
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    • v.45 no.4
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    • pp.523-532
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    • 2015
  • Purpose: The usability, user satisfaction, and impact of electronic nursing record (ENR) systems were investigated. Methods: This mixed-method research was performed as a time-motion (TM) study and a survey which were carried out at six hospitals between August and November 2013. The TM study involved 108 nurses from medical, surgical, and intensive care units at each hospital, plus an additional 48 nurses who served as nonparticipating observers. In the survey, 1879 volunteer nurses completed the Impact of ENR Systems Scale, the System Usability Scale, and a global satisfaction scale. Qualitative and quantitative analyses were performed. Results: The mean scores for the ENR impact, system usability, and satisfaction were 4.28 (out of 6), 58.62 (out of 100), and 74.31 (out of 100), respectively, and they differed significantly between hospitals (F=43.43, p<.001, F=53.08 and p<.001, and F=29.13 and p<.001, respectively). A workflow fragmentation assessment revealed different patterns of ENR system use among the included hospitals. Three user characteristics-educational background, practice period, and experience of using paper records-significantly affected the system usability and satisfaction scores. Conclusion: The system quality varied widely among the ENR systems. The generally low-to-moderate levels of system usability and user satisfaction suggest many opportunities for improvement.

Effect of Onkyung-tang on Cold Hypersensitivity on Feet: A Multi-center Double-blind Randomized Controlled Trial (온경탕이 족부냉증에 미치는 영향에 대한 다기관 이중맹검 무작위 대조군 연구)

  • Kwon, Na-Yoen;Yoo, Joon-Sang;Kim, Hyeong-Jun;Lee, Dong Nyung
    • The Journal of Korean Obstetrics and Gynecology
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    • v.33 no.3
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    • pp.149-174
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    • 2020
  • Objectives: This study was aimed to figure out the effect of Onkyung-tang (OKT) on cold hypersensitivity on feet in female patients. Methods: This study was designed to implement multi-center randomized clinical trial in three korean medical hospitals. The female patients who were enrolled in this study were 112 women who suffered from cold hypersensitivity on feet. They were randomly allocated into OKT group or control group in 1:1 ratio. The primary outcome was change in score of visual analogue scale of hypersensitivity on feet, and the secondary outcomes were thermometer of LU4, PC8, ST32, LR3, visual analogue scale of hypersensitivity on hands, result of cold stress test, and score of World Health Organization Quality of Life-BREF. Results: In both group, the VAS of hypersensitivity on feet and hands was decreased while taking the medicine, and the effect of decreasing the VAS continues for the 4 weeks after the end of medication (p<0.001, 0.003, 0.001). In OKT group, the body temperature difference in lower extremity (ST32-LR3) was steadily decreased at every visit and it was statistically significant(p=0.003, <0.001). On the other hand, in control group, the body temperature difference in lower extremity was decreased only while taking the medicine (p<0.001). Conclusions: OKT significantly reduced discomfort coldness on feet in patients, and the effect of treatment was maintained at least for four weeks after medication.

A Case of Multiple Basal Cell Carcinomas in Nevoid Basal Cell Carcinoma Syndrome

  • Ji, So Young;Lee, Seong Pyo;Suhk, Jeong Hoon;Yang, Wan Suk
    • Archives of Craniofacial Surgery
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    • v.11 no.1
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    • pp.23-27
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    • 2010
  • 목적: 모반양 기저세포암 증후군 (Nevoid basal cell carcinoma syndrome) 또는 골린-골츠 증후군은 한국에서는 흔하지 않은 증후군으로 주로 상염색체 우성으로 유전하고 다기관 장애가 나타날 수 있으며 높은 표현율과 다양한 표현도를 특징으로 한다. 모반양 기저세포암 증후군의 진단 기준에는 다발성 기저세포암, 이소성 석회화(ectopic calcification), 손 또는 발바닥 오목 (palma or plantar pits), 치성 각화 낭종(odontogenic keratocysts), 가족력 및 골격계, 신경계, 안, 비뇨생식계 및 심장혈관의 이상 등이 있다. 본원에서 주로 두부의 다발성 기저세포암을 가진 모반양 기저세포암 증후군 환자를 경험하여 보고하고자 한다. 방법: 환자는 2007년 4월 두부의 색소성 모반으로 피부과에서 시행한 펀치 생검에서 기저세포암을 진단받고 의뢰되었으며, 이후 2009년 7월까지 14회의 추가적인 절제 및 조직 검사를 시행하였다. 환자는 갑상샘 유두암종의 재발로 인해 갑상샘 절제술을 2회 시행한 과거력이 있었으며 이학적 검사와 일반 혈액, 소변, 간 기능 및 갑상선 기능 검사를 시행하였고, 흉부와 늑골 방사선 검사, 심전도와 안면부 및 두부 컴퓨터단층촬영과 유전자 검사를 시행하였다. 결과: 두부와 안면부에서 절제한 27개의 병변 중 23개(85%)가 기저세포암으로 진단되었으며, 치성 각화 낭종과 대뇌겸 석회화, 이학적 검사에서 손바닥 오목이 발견되었다. 하복부 초음파에서 난소 낭종이 발견되었으나 조직 검사는 시행되지 않았다. 결론: 한국에서 모반양 기저세포암 증후군에 대한 연구는 주로 치과와 피부과 영역에서 국한되었으며, 특히 치과 영역에서의 보고는 치성 각화 낭종 및 손바닥 오목에 초점을 둔 것이 대부분이었다. 이에 본원에서는 주로 두부의 다발성 기저세포암을 가진 모반양 기저세포암의 환자를 경험하였으며, 초기에 발견된 작은 병변의 제거 시 2mm의 정상 조직을 포함하여 절제하였어도 3년간의 경과관찰 중 재발없이 좋은 결과를 얻을 수 있어 이를 보고하는 바이다.

The Clinical Study on the Ordinary and Pathological Symptoms according to Sasang Constitution (사상체질에 따른 소증 및 병증지표의 임상적 연구 : 다기관 약진 대상자를 중심으로)

  • Jang, Eun-Su;Kim, Ho-Seok;Lee, Hae-Jung;Baek, Young-Hwa;Lee, Si-Woo
    • Journal of Sasang Constitutional Medicine
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    • v.19 no.3
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    • pp.144-155
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    • 2007
  • 1. Objectives The purpose of this study was to find the difference of ordinary and pathological symptoms according to Sasang Constitution. 2. Methods We recruited 418 subjects in the five oriental hospitals and researched normal symptoms and illness ones through a paper, who were diagnosed by the Sasang Constitution specialist in oriental hospital, who had remarkable improvement in their chief complain after Sasang Constitution medication. 3. Results 1) In ordinary symptoms, amount, speed and appetite items of Digestion are significantly different according to Sasang Constitution statistically(p<0.05). Feeling after evacuation of Feces, feeling after urination and yellow color of Urine, amount, feeling after sweat, location in hand/feet of Sweat, and in the others, Tireness in head, Drinking water, sensitivity, coldness in hand/feet, warmness in belly of Coldness/Warmness are also significantly different(p<0.05). 2) In pathological symptoms, palpitation, swelling and lack of appetite items are significantly different according to Sasang Constitution statistically(p<0.05). 3) In diseases, Hypertension and DM items are significantly different according to Sasang Constitution statistically(p<0.05). 4. Conclusions There were significantly difference items in ordinary, pathological symptoms and diseases according to Sasang Constitution.

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Multicentric retrospective clinical study on the clinical application of mini implant system (미니 임플란트 시스템의 적용에 대한 다기관 후향적 임상연구)

  • Kim, Young-Kyun;Yeo, In-Sung;Yi, Yang-Jin;Kim, Un-Kyu;Moon, Kyung-Nam;Jeon, Seung-Joon;Cho, Yong-Seok;Yun, Pil-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.4
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    • pp.325-330
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    • 2010
  • Introduction: Mini-implant system is applicable to areas of narrow space and area requiring temporary loading support. The purpose of this study was to evaluate the clinical outcome of a mini-implant system as well as the application of mini-implant system in the dental clinical field. Materials and Methods: The patients who had been operated from Jan 2007 to Dec 2007 in the four dental facility including Seoul National University Bundang Hospital were enrolled. To evaluate the factors associated with the clinical outcome, the patients were classified according to gender, age, area of surgery, type of implant, diameter and length of the implant, and the purpose of the mini-implant system application. Results: From 147 implants, only three implants failed, one of them was for temporary loading. There were no serious surgical or prosthetic complications in this study. Conclusion: An analysis of the preliminary data revealed a satisfactory clinical outcome. However, more long-term evaluation of narrow ridge type as well as the patient’s satisfaction on the use of a provisional type mini-implant system is needed.

A Review on the Report about Drug-induced Hepatitis published by the National Institute of Toxicological Research (국립독성연구원 보고서 '식이유래 독성간염의 진단 및 보고체계 구축을 위한 다기관 예비연구'에 대한 분석 및 고찰)

  • Jang Insoo
    • The Journal of Korean Medicine
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    • v.25 no.3
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    • pp.78-89
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    • 2004
  • Background : A report published by the National Institute of Toxicological Research (NITR) in January 2004 about toxic hepatitis in Korea contained the result of analysis on 55 cases of severe toxic hepatitis from 7 university hospitals for 8 months. NITR claimed that the extrapolated annual frequency of severe toxic hepatitis in Korea was 1904 cases per year. They also claimed that the most frequent etiology of severe toxic hepatitis were herbal medications and similar plant preparations (61.7%), contrasted with traditional therapeutic preparations and healthy foods (29.1%). I have investigated that report to be certain of the result because it is a very important subject for public health and society in Korea. Results : The NITR report has too many problems to have faith in its results. They include the following: 1. The report uses only 55 cases to estimate annual prevalence rate of severe toxic hepatitis in Korea. 2. There was a large regional preponderancy in the NITR report (2 cases in Seoul from a population of 10.17 million, 19 cases in Gwangju from a population of 1.4 million) 3. There was another preponderancy that selected much fewer cases caused by western medication (9.1%) than other reasons. 4. The NITR report used a modified scale than that officially recognized to diagnose toxic hepatitis. 5. There was a mistake using the scale to adapt the right indications. 6. They collected cases before beginning the study, although it was a prospective study. There was also not any questionnaire or other materials concerned with alcohol, drugs, or history of past liver disease. Conclusions : NITR is one of the important official arms of the government of Korea. Nevertheless, there is a severe problem in validity because of selection bias, uncertain accuracy, and insufficiency of raw materials in the report. Therefore it seems incorrect to generalize the results of the report and there is a lack of confidence in it as a national study publishing by the NITR.

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Korean Children with Infantile Pompe Disease Presenting with Hypertrophic Cardiomyopathy: Experiences in a Single Institution (단일 기관에서 경험한 비후성 심근병증으로 발현된 영아형 폼페병)

  • Ko, Jung Min;Lee, Young Ah;Kim, Gi Beom;Park, Sung Sup;Song, Jung-Han
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.12 no.1
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    • pp.42-48
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    • 2012
  • Pompe disease is a rare lysosomal glycogen storage disorder caused by a total or partial deficiency of the acid ${\alpha}$-glucosidase (GAA) enzyme due to the GAA gene mutations. The classic infantile form of Pompe disease is a rapidly progressive multi-organ disease with hypotonia, generalized muscle weakness, and hypertrophic cardiomyopathy, usually leading to death in the first 2 years of life. Enzyme replacement therapy with recombinant human GAA has been shown to be effective and subsequently yielded promising results. Here, we present clinical and genetic characteristics of three Korean non-classic infantile Pompe patients, and the short term efficacy of enzyme replacement therapy. Considering that enzyme replacement therapy can change the natural course of infantile Pompe disease, early diagnosis and early initiation of treatment is critical to improving patient outcomes.

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Study of Korean Medicine's Pathological Symptoms and Health-Related Quality of Life among Normal, Overweight, and Obese Groups from Multi-Center Case Report (다기관 증례 수집을 통한 정상, 과체중, 비만군에서의 한의 병증 및 건강과 관련된 삶의 질에 대한 연구)

  • Lee, Jaechul;Dong, Sang Oak;Lee, Siwoo
    • Journal of Korean Medicine for Obesity Research
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    • v.13 no.1
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    • pp.10-16
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    • 2013
  • Objectives: This work aimed to investigate differentiations of Korean medicine's pathological symptoms and SF-12 sub scales among normal, overweight and obese subjects from multi-center case report. Methods: From 2009 to 2011 survey were carried out to 1,589 subjects who took treatment or were hospitalized in 7 Korean medicine hospitals and 3 Korean medicine clinic. Survey include Korean medicine's pathological symptoms and SF-12. Whole survey were obtained from subjects with interviewers. Obesity degree was divided into three groups by body mass index: Normal group is from 18.5 below 23, overweight from 23 below 25 and obese group is over 25. Chi-square test was performed to reveal differentiation response rate of pathologic symptoms among obesity groups. ANOVA test was carried out for compare each group's SF-12 sub scales. Results: Patients of overweight or obesity have more symptoms such as skin itching, swelling, weakness in lower legs, and feverish with swollen joints. Contrary, normal weight group responded symptoms of dry skin more than those of obese group. As a fatigue, obese group have more fatigue feeling at afternoon and evening, compared to high frequency response of normal weight groups' morning fatigue. Obese groups shows low physical scores of health related quality of life, in contrast, high mental scores of that. Conclusions: This is first work of pathologic symptoms shown by obese groups. This would contribute to standardization of Korean medicine's pattern identification as suggestion of classification point for obese groups.

Effects and Safety of Electroacupuncture on Cold Hypersensitivity on Hands and Feet by Sasang Constitution: A Multi-center, Randomized Controlled Trial (수족냉증에 대한 전침치료의 사상체질별 효과 및 안전성: 다기관 무작위 대조군 연구)

  • Kwon, Na-Yoen;Yu, Jun-Sang;Kim, Dong-Il;Kim, Hyeong-Jun;Lee, Dong-Nyung
    • Journal of Sasang Constitutional Medicine
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    • v.33 no.2
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    • pp.47-64
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    • 2021
  • Objectives The purpose of this study was to figure out the effect and safety of electro-acupuncture and acupuncture on cold hypersensitivity on hands and feet(CHHF) by Sasang constitution. Methods 72 subjects were recruited from three Korean medical hospitals from October 2019 to October 2020. Subjects were randomly allocated in 1:1:1 ratio to electro-acupuncture group(EA group), acupuncture group(AC group), and control group. The EA and AC group received treatment twice a week for 5 weeks. We tried to confirm the effectiveness of electro-acupuncture and acupuncture treatment by checking changes in Visual analogue score(VAS), body temperature of LU4, PC8, ST32, LR3, and WHOQOL-BREF score. Results The VAS score of CHHF was reduced after treatment, and the effect continued for 4 weeks after the end of treatment in all Sasang constitution, all treatment groups. In all Sasang constitution, the body temperature of the electro-acupuncture group or acupuncture grouop was higher than that of the control group except LU4 in visit 11. And no clinically significant adverse events have been identified. Conclusions Electro-acupuncture and acupuncture treatment are effective on hypersensitivity on hands on feet, and the effect was shown regardless of Sasang constitution.

The Nurse Staffing in Intensive Care Units based on Nursing Care Needs: A Multicenter Study (중환자 간호요구도에 근거한 중환자실 간호사 배치수준 산정 : 다기관 연구)

  • Park, Miok;Yang, Eunjin;Lee, Mimi;Cho, Sung-Hyun;Shim, Miyoung;Lee, Soon Haeng
    • Journal of Korean Critical Care Nursing
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    • v.14 no.2
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    • pp.1-11
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    • 2021
  • Purpose : The aim of this study was to propose appropriate nurse staffing of adult intensive care units considering patients' nursing care needs according to the Workload Management System for Critical Care Nurses (WMSCN). Methods : In a cross-sectional survey conducted in September 2017, 1,786 patients' WMSCN scores, surveys from 2,145 nurses, and administrative data from 118 units in 41 hospitals were analyzed. The means (standard deviations) of the aforementioned scores and nursing hours per patient day were presented. Nurse-to-patient ratios and nurse-to bed ratios for staffing to meet patients' nursing care needs were calculated. Results : The mean WMSCN scores were 109.50±17.17 in tertiary hospitals and 96.38±19.26 in general hospitals. Nursing hours per patient day were 12.47±2.80 in tertiary hospitals and 11.01±2.45 in general hospitals. Nursing hours per patient day correlated with WMSCN scores. Nurse-to-bed ratios required for the provision of ICU nursing care ranged from 1: 0.36 to 1: 0.48. Conclusion : Our findings provide evidence that current ICU nurse staffing is insufficient for meeting patients' nursing care needs. We suggest adjusting the legal standards for adequate nurse staffing considering these needs.