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Content analysis on online non-face-to-face adult nursing practice experienced by graduating nursing students in the ontact era (온택트 시대의 졸업학년 간호대학생이 경험한 온라인 비대면 성인간호학실습에 대한 내용분석)

  • Lim, So-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.4
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    • pp.195-205
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    • 2021
  • As Coronavirus disease 2019 (COVID-19) became a pandemic, most nursing departments in Korea implemented online non-face-to-face practices rather than the existing practice method. This study was a qualitative study that analyzed the reflection diaries written by participants to understand what they experienced in the online non-face-to-face adult nursing practice process. The online non-face-to-face adult nursing practice was 90 hours for two credits and nine hours per day for a total of 10 days. This online practice consisted of computer-based simulation practice, computer-based nursing skills practice, video and educational material production, real-time online quiz, online lecture video, and discussion. As a result of analyzing the reflection diary, six categories, 13 subcategories, and 33 codes were derived. The six categories were 'Experience of various situations', 'Experience of new study', 'Fulfillment for the clinical practice', 'Building relations with professors', 'Fear of being a pre-nurse', and 'Ambivalence for the non-face-to-face practice'. These results are significant in that in the post-corona era, adult nursing practice was conducted as a non-face-to-face practice rather than a clinical practice institution, and various educational methods were operated. This study is expected to provide important basic data for the development and operation of non-face-to-face adult nursing practice.

Computer-Assisted Navigation in Total Knee Arthroplasty (내비게이션 장치를 이용한 슬관절 전치환술)

  • Jeong, Hwa-Jae;Park, Yong-Beom;Lee, Han-Jun
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.478-489
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    • 2018
  • Total knee arthroplasty has become a standard procedure for advanced knee arthritis to relieve pain and improve function. Computer-assisted navigation systems have been used in total knee arthroplasty to improve the mechanical axis of the limb as well as the alignment and position of the components. A computer-assisted navigation system has the advantage of real-time feedback during surgery, such as mediolateral balance in extension and flexion gap, alignment of the lower limb, and components. On the other hand, the computer-assisted navigation system requires an additional stab wound for tracker fixation, which can increase the likelihood of superficial wound infection and stress fractures and increase the operation time and cost of surgery. The clinical efficacy of computer-assisted navigation in total knee arthroplasty is also controversial. Compared to the conventional technique, computer navigation improves the accuracy of the postoperative mechanical axis within outliers of $3^{\circ}$ varus or $3^{\circ}$ valgus. This paper reviews the surgical technique, pitfalls, clinical and radiological outcomes, useful clinical cases, and future perspectives in computer-assisted navigation total knee arthroplasty.

The development and evaluation of curriculum for developing physician's competencies in public health (한국 공공보건의료 의사역량 개발을 위한 교육과정 개발 및 평가)

  • Kim, Sang Hyun;Park, Jeong Hun
    • Journal of agricultural medicine and community health
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    • v.45 no.4
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    • pp.194-207
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    • 2020
  • Purpose: The purpose of this study is to develop and evaluate the curriculum, that was the continuing professional development program, for cultivating physician's competencies in public health. Methods: This study was conducted through in-depth interview and survey in the frame of ADDIE, from 2 May to 30 June in 2019. Participants were 7 physicians by in-depth interview and Respondents were 46 physicians worked in public health by survey. Results: The results were analyzed and described in the frame of ADDIE model. In the stage of Analysis, physician's core competencies in public health was presented to practical education, management of organization and labor force, communication with community, and director' role of public health center in the community as core competencies by in-depth interview. The skill - knowledge-attitude competencies were highest in order in the survey for placing priority (by Borich score) of 29 core competencies. In design stage, the educational objective of curriculum was established, that is to develop the competencies of knowledge, skills, and attitude needed for physician of public health in 21th century. In development and implementation stage, it is important to decide to lecturer, to get in advance educational materials to do the maintenance and management of curriculum. In the stage of evaluation, the educational satisfaction was high on the whole and educational effect was statistically significant. Conclusions: This study was an initial study of Korean doctors, and it aims to pursue competency-based education as a continuing professional development (CPD) beyond continuing medical education (CME) including knowledge, skills, and attitudes.

Direction of Emergency Rescue Education Based on the Experience of New 119 Paramedics for National Health Promotion (국민건강증진을 위한 응급구조학 교육의 나아갈 방향 -신임 119구급대원의 출동경험을 바탕으로-)

  • Kim, Jung-Sun
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.1
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    • pp.207-220
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    • 2021
  • The purpose of the study is to investigate the application and utility of emergency rescue education and derive limitations, improvements and development directions of university education based on the field experience of 119 emergency medical technician(EMT)s. The research subjects were six new 119 emergency medical technician(EMT)s within three years of starting their first-aid service in the field. After conducting in-depth narrative interviews, the analysis was performed using Colaizzi method. The 82 formulated meanings were derived from significant statements. From formulated meanings, 23 themes, 4 theme clusters, 2 categories were identified. The four theme clusters were 'The effectiveness of university education', 'The limitations of university education', 'The direction of improvement in educational methodology' and 'The direction of improvement in educational contents. University education has been helpful overall, but limitations are observed at the same time, suggesting that it should be developed through the improvement of educational methodologies (i.e. problem-based learning, field case review, education through role-playing, simulation education, strengthening skill ect.) and educational content (i.e. training tailored to the field, education focused on trauma or cardiac arrest, expansion of triage education in disaster management, reinforcement of education on-site safety, education on special patients, diverse guidance and faculty for different perspectives).

Treatment Methods for Functional Recovery after Total Knee Arthroplasty (슬관절 전치환술 후 기능 회복을 위한 치료법)

  • Kim, Young-mo;Joo, Yong-bum;Park, Il-young
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.2
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    • pp.117-126
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    • 2020
  • Total knee arthroplasty is performed widely in degenerative arthritis of the knee joint, and the frequency of use is increasing. Efforts should be made to achieve functional recovery, such as returning to daily life, and the recovery of strength and range of motion after surgery. The procedure should be approached from a range of perspectives, such as patient factors, surgical technique and rehabilitation. The patient's age, degree of obesity, sex, and strength of the quadriceps muscle can affect the functional recovery after surgery. In addition, the patient's mental state, such as expectation value and satisfaction, can also have an effect. For functional recovery, patient education, pain control, and strengthening of the quadriceps muscle can be performed prior to surgery. Postoperative physiotherapy, such as icing and compression, transcutaneous electrical nerve stimulation therapy, neuromuscular electrical stimulation therapy, low frequency low intensity magnetic field therapy, strengthening of quadriceps muscle, and range of motion exercise can also be applied. In recent years, hydrotherapy, which restores the strength and balance of the leg, is being performed increasingly. These treatments are not only performed shortly after surgery, but are also performed continuously. In addition, the surgeon should apply it appropriately considering the patient's condition, compliance, and social and psychological conditions.

A Narrative of Medical School Professors' International Medical Experience: Applicability of Medical Humanities Curriculum (의과대학 교수의 국제진료 경험에 대한 내러티브: 의료인문학 교육과정의 적용 가능성)

  • Kim, Yura;Park, Hye jin;Kim, Byunghee
    • Journal of the International Relations & Interdisciplinary Education
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    • v.1 no.1
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    • pp.1-12
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    • 2021
  • This study is a study on the applicability of the medical humanities curriculum through a narrative study on international treatment of foreign patients. Korea's medical system and standards are world-class, and it can be seen that the knowledge and skills for patient care are sufficient, which shows that the competence for patient care emphasized by Korean doctors is sufficient. In terms of social responsibility for doctors in Korea, the importance of volunteering is learned from medical school education, and through medical field experiences in various cultures, it can be seen that volunteering is important to lead to lifelong work as a doctor. In the field of professionalism, professionalism could be expressed as a doctor, and in all processes, the medical staff understood and empathized with the pain of the patient, and it was found that the sincerity was conveyed to the patient. Professionalism is an area that is being emphasized more recently, and it is necessary to provide educational opportunities for professionalism to doctors as well as medical school education. This international medical experience can be applied to the medical humanities curriculum of the medical school, and a harmonized and integrated medical humanities curriculum can be operated throughout the six-year curriculum.

Analysis of the Risk Factors for Posterior Migration of Single Cage after Transforminal Lumbar Interbody Fusion (경추간공 요추 추체간 유합술 후 단일 케이지 후방이동의 위험인자에 대한 분석)

  • Ko, Young-Chul;Ha, Dong-Jun;Park, Man-Jun;Huh, Jung-Wook;Park, Joon-Hyung;Lee, Woo-Myung
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.237-243
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    • 2019
  • Purpose: To analyze the risk factors for posterior migration of a single cage after transforminal lumbar interbody fusion (TLIF). Materials and Methods: This study was conducted retrospectively on 48 patients (60 discs) who were followed-up for 1 year after TLIF from January 2015 to January 2017. The patients were divided into two groups: group 1 containing 16 patients (17 discs) with cage migration and group 2 containing 32 patients (43 discs) without it. Information related to cage migration, such as the demographic factors, shape of disc, level and location of the cage inserted, and disc height change, was acquired from the medical records and radiologic images, and the possibility for generating posterior migration of cage was evaluated statistically. Results: The demographic factors and cage-inserted level were similar in the two groups (16 patients in group 1, 32 patients in group 2). In the migration group, number of patients with a pear-type disc, 9 patients, was significantly larger; the disc height change, 1.8 mm, was significantly smaller; and the cage was located frequently on non-center in the anteriorposterior view and center in the lateral view in 9 and 15 out of 16 patients, respectively. Conclusion: A pear-type disc shape, small disc height change, cage with non-center on the anteriorposterior view and non-anterior on the lateral view are the risk factors for posterior migration. These factors are important for preventing posterior migration of the cage.

Lung Biopsy after Localization of Pulmonary Nodules with Hook Wire (Hook Wire를 이용한 폐결절의 위치선정 및 생검)

  • Kim, Jin-Sik;Hwang, Jae-Joon;Lee, Song-Am;Lee, Woo-Surng;Kim, Yo-Han;Kim, Jun-Seok;Chee, Hyun-Keun;Yi, Jeong-Geun
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.681-686
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    • 2010
  • Background: A chest computed-tomography has become more prevalent so that it is more common to detect small sized pulmonary nodules that have not been found in previous simple chest x-ray. If those detected nodules are undersized or located in pulmonary parenchyma, it is difficult to accomplish a biopsy since it is vulnerable to explore them either grossly or digitally. Thus, in our hospital, a thoracoscopic pulmonary wedge resection was performed after locating a lesion by means of hook wire with CT-guided. Material and Method: 31 patients (17 males and 14 female patients) from December in 2006 to June in 2010 became our subjects; their 34 pulmonary nodules were subjected to the thoracoscopic pulmonary wedge resection after locating a lesion by means of hook wire with CT-guided. Also we analyzed a possibility of hook wire dislocation, a frequency of conversion to open thoracotomy, time consumed to operation after location of a lesion, operation time, post operation complication, and histological diagnosis of the lesion. Result: 12 of 34 cases were ground glass lesion, whereas 22 cases of them were solitary pulmonary lesion. The median value of the lesion was 8mm in size (range: 3 to 23 mm), while the median value was 12.5 mm in depth (range: 1 to 34 mm). The median value of time consumed from location of the lesion to anesthetic induction was 86.5 minutes (41~473 minutes); furthermore the mean value of operation time was 103 minutes (25~345 minutes). Intrathoracic wire dislocation was found in one case, but a target lesion was successfully excised. Open thoracotomy was performed in four cases due to pleural adhesion. However, there was no case of conversion to open thoracotomy due to failure to detect a target lesion. In histological diagnosis, metastatic cancer were found in 15 cases, which were the most common, primary lung cancer were in 9 cases, non-specific inflammation were in 3 cases, tuberculosis inflammation were in 2 cases, lymph nodes were in 2 cases, active tuberculosis were in 1 case, atypical adenomatous hyperplasia was in 1 case and normal lung parenchymal finding was in 1 case, respectively. Conclusion: In our hospital, in order to accomplish a precise histological diagnosis of ground-glass lesion and pulmonary nodules in lung parenchyma, location of pulmonary nodules were exactly located with hook wire under chest computed-tomography, which was followed by lung biopsy. We concluded that this was an accurate, minimally invasive and valuable method to minimize the complications and increase of cost of medical service provided.

Surgical Result of the Modified Blalock-Taussig Shunt in Early Infancy (조기 영아기에서의 변형 블라록-타우시히 단락술의 수술 결과)

  • 이정렬;곽재건;최재성
    • Journal of Chest Surgery
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    • v.35 no.8
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    • pp.573-579
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    • 2002
  • Background: In this study, the role and the surgical outcome of the modified Blalock-Taussig shunt in the treatment of the infants with cyanotic complex congenital heart diseases were investigated. Material and Method: Over the last 12 years, 105 modified BT shunts were performed in 100 infants. Postoperative course, shunt patency rate, complications, mortality and its risk factors were reviewed restrospectively. Result: The mean age at operation was 43.0$\pm$36.6 days. Sex ratio was 60:40(M:F). The postoperative oxygen saturations were lowest after mean duration of 11 hours after the shunt procedure. The operative mortality was 8%(8) with 3 late deaths. Causes of operative death included failure of maintenance of minimum oxygenation during the procedure(2), immediate postoperative shunt occlusion(2), respiratory failure(2), low cardiac output due to heart failure and pericardial effusion(2) and sepsis(2). Late deaths resulted from acute cardiac arrest during the follow up cardiac catheterization, hypoxic myocardial failure, and arrhythmia. Year of surgery, shunt size, age at operation, and complexity of the anomalies were not the risk factors for mortality. Six month shunt patency rate was 97% and overall patency rate was 96%. Postoperative complications comprised of shunt occlusion(6), phrenic nerve palsy(3), and wound infection(2). Conclusion: We demonstrated that modified Blalock-Taussig shunt was a useful tool to palliate the infants with complex cyanotic heart disease in whom early complete repair was not feasible with acceptable mortality and patency rate. An adequate postoperative management and a meticulous surgical technique may be key factors for the better results.

Surgical Treatment of Giant Cell Tumor of the Spine (척추 거대세포종의 수술적 치료)

  • Kang, Yong-Koo;Rhyu, Kee-Won;Rhee, Seung-Koo;Bahk, Won-Jong;Chung, Yang-Guk;Park, Chang-Goo
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.2
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    • pp.138-145
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    • 2009
  • Purpose: Giant cell tumor of the spine is very rare, and the treatment is very difficult. However, surgical techniques and diagnostic modalities are developed, and postoperative functional results are improved. To evaluate the efficacy of total spondylectomy for giant cell tumor of the spine, the clinical results of the surgical treatments for the giant cell tumor of the spine with intralesional curettage or total spondylectomy were evaluated. Materials and Methods: From April 1987 to March 2006, 10 patients who were underwent surgical treatments using total spondylectomy or intralesional curettage were studied. There were 3 men and 7 women. The mean age of the patients was 32 years (range, 25~44 years). The mean duration of follow-up was 8 years (range, 3~15 years). Locations of the tumor were 2 cervical spines, 4 thoracic spines, 2 lumbar spines and 2 sacrum. Initial main symptom of 10 patients was pain, and 7 patients had neurologic impairments too. Four patients were treated with total spodylectomy using anterior and posterior combined approach, 1 patient was treated with total sacrectomy using posterior approach only, and 5 patients were treated with intralesional curettage using anterior approach. Results: Nine patients improved pain and neurologic impairments. Local recurrences developed in 4(40%) patients (2 cervical spines, 1 thoracic spine, 1 sacrum). While a local recurrence developed from 5 total spondylectomy, 3 local recurrences developed from 5 intralesional curettage. Conclusion: Local recurrence rate after surgical treatment with intralesional curettage for the giant cell tumor of the spine was very high. Total spondylectomy using anterior and posterior approach is advisable to prevent the local recurrence after surgical treatment.

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