• Title/Summary/Keyword: 임상지침

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Theoretical Substruction: Fatigue in Cardiac Arrhythmia Patients (Theoretical substruction : 심부정맥 환자의 피로감)

  • Kang Youn-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.8 no.3
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    • pp.430-437
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    • 2001
  • 모든 질병에서 피로감은 환자가 경험하는 매우 흔한 증상으로서 임상간호현장에서 쉽게 간과 되어져왔다. 최근까지 건강관련 학문분야에서 피로감에 관한 수많은 연구가 진행되어져 왔지만. 임상간호현장에 도움이 될 만한 연구결과, 즉 임상 간호사의 간호사정과 간호중재에 지침이 되는 연구는 부족한 현실이다. 구체적인 연구 계획에 앞서, 연구의 이론적인 배경과 근거, 이론에서 추출된 개념, 변수와 연구 도구들간의 전체적인 일관성이 매우 중요하다. 추상적인 이론으로부터 개념과 변수를 거쳐 연구에 직접 사용될 구체적인 연구도구를 일관성 있게 선택하는 일련의 과정을 'Theoretical Substruction'이라 한다. 심부정맥환자가 지각하는 피로감에 관한 연구에 앞서, 본 글을 통해 심부정맥과 피로감의 이론적인 연관성과 이 연구를 위한 개념과 변수, 구체적인 연구도구를 선택하는 과정, Theoretical Substruction에 대해 토의될 것이며, 이에 따른 연구질문도 제의 될 것이다.

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Comparison of the Perceptions between Investigators and Clinical Research Associates in Role Performances of Clinical Research Coordinators (임상연구코디네이터의 역할수행에 대한 연구자와 임상시험모니터요원의 인식비교)

  • Ko, Il-Sun;Hwang, Youn-Sun;Kim, Ho-Kon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.8
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    • pp.5095-5108
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    • 2014
  • The aim of this study was to compare the perceptions of the role performance of a clinical research coordinator (CRC) between the investigators and clinical research associates (CRAs). Data was collected using a structured questionnaire from 39 investigators and 68 CRAs in 4 hospitals from March 7 to November 30, 2011 and analyzed using descriptive statistics and a t-test. The investigators and CRAs were aware of the importance of CRC's role and they all gave the highest values for patients care management. On the other hand, the score of the role performance items showed perceptional differences between investigators and CRAs. Therefore, the development of detailed job descriptions and manuals will be needed to reduce the perceptional differences in the role performance of the CRC.

Inflammatory Bowel Disease 환자에 있어서 유가공식품 섭취

  • Im, Byeong-U;Jo, Yeo-Won
    • Bulletin of Food Technology
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    • v.14 no.4
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    • pp.87-94
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    • 2001
  • Inflammatory bowel disease (IBD)환자의 유가공품 내성에 대한 병력과 의사나 영양학자로부터 받은 지침은 IBD환자들의 관리에 있어서 중요한 주안점이 된다. 대부분의 환자들이 불편 없이 매일 우유를 마실 수 있지만 부가적인 고찰에서는 개인적 요소와 크게 관련이 있는 특정요소가 있다는 것이다. 유가공품에 민감한 IBD 환자들의 진단으로 lactose의 내성과 흡수 장애, long- chain 지방산, 우유에 대한 알러지, 유가공품에 대한 심리적인 요소와 부정적인 인식 등이 있다. 유당 흡수장애의 발생빈도는 결장이나 ulcerative colitis (UC)를 포함하는 Crohndisease (CD)환자에서보다 소장의CD환자에서 더 높다. 유당 흡수장애의 후천적인 발생빈도는 유전적 요소에 기인하는 인종적 요인에 의해 주로 결정된다. 게다가 소장의 CD에서 유당 흡수장애는 lactase 효소보다도 세균성 이상증식이나 소장에서 통과하는 시간(small bowel transit time) 과 같은 요소에 의해 결정된다. 의사들이 IBD환자에게 내리는 지침에 있어서의 의견은 매우 다양하며, 진단이 내려지면 유가공품을 회피하라는 극단적인 충고가 있는 반면에IBD의 조절에 있어서 유가공품의 섭취를 줄이라는 제안을 내리는 경우도 있다. IBD환자들은 대중적인 식이요법 책의 저자들이나 의사들로부터 임의적인 제안과 환자들의 부정적 인식 때문에 우유 불내증이나 유당 흡수장애의 발병율의 근거가 거의 없는데도 필요이상으로 유가공품을 피한다. 따라서, 충분한 과학적.임상적 정보의 축적은 IBD환자들에게 유가공품의 섭취에 대한 지침을 설정하는 데에 유용하다.

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EVIDENCE-BASED PEDIATRIC DENTISTRY : CONCEPTS AND APPLICATIONS (근거중심 소아치과학의 개념과 응용)

  • Lee, Kwang-Hee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.33 no.2
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    • pp.269-280
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    • 2006
  • The purpose of this study is to establish the concept of the evidence-based pediatric dentistry and to investigate the application methods of it. The definition of the evidence-based pediatric dentistry was suggested as 'the integration of the best scientific research evidence with the professional expertise of pediatric dentist and the value of pediatric patients and their caregivers in dental practice for the child and adolescent'. The methods of practising evidence-based pediatric dentistry were investigated, the recent conclusions of the evidence-based pediatric dentistry were summarized by topics, the research methods of systemic review and clinical practice guidlines were analyzed, and the individual research methods as randomized controlled trials were investigated. The author proposed increasing the understanding and consensus of the necessity of evidence-based pediatric dentistry, education about the evidence-based pediatric dentistry, computerization of all published articles of Korean pediatrtic dentistry, continuing research and popularization of systemic research and clinical practice guidlines, production of Korea's own evidences of pediatric dentistry, and the improvement of soical environment of pediatric practice.

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New Medical Device Regulations (MDR) in Europe (유럽의 새로운 의료기기 규제제도 MDR)

  • Jeong, Hyun-Woo;Yeom, Hojun;Park, Sangsoo
    • The Journal of the Convergence on Culture Technology
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    • v.8 no.5
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    • pp.29-37
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    • 2022
  • MDR, a new European medical device regulation newly enacted in 2017, requires that medical device products that have received CE conformity certification through MDD be re-certified by May 2024 in line with the new CE MDR regulation. The new MDR requires more stringent medical device clinical evaluation and clinical investigation than the previous MDD required, and also require the submission of documented post-marketing surveillance data. Korean medical device makers also need to meet the new MDR requirements and obtain conformity certification, but the industry is still confused because they do not understand the new regulations thoroughly. In this study, medical device regulations in Korea, the United States, and Europe are compared, and the European MDR is further compared with the previous European Medical Device Directive MDD to help understand the requirements of the new European Medical Device Act.

Cognition and Practice of Standard Precautions towards Hospital Infection Control in Emergency Medical Technology Students (응급구조학과 학생의 병원감염관리 표준지침의 인지와 수행에 관한 연구)

  • Kim, Jin-Uk;Kim, Yoon-Shin;Ji, Hyun-Kyung;Bae, Ki-Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.1
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    • pp.264-273
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    • 2014
  • The aim of the study is to investigate the awareness and practice of Standard Precautions towards Hospital Infection Control in Emergency medical technology students. Data were collected from 289 questionnaires from March 20, 2012 to April 25, 2012. The data were analyzed using SPSS 18.0 for window(SPSS Inc, USA) with the level of significance as 0.05. According to the results, significant differences were shown in gender, infection control education and infection control educational institutions. The factors influencing the practice of standard precautions were found to be the times of the contact to blood, body fluid, mucus, or the skin with lesions and the cognition of standard precautions. Cognition level of the EMT students was high but the practice level was low. Based on the results of this study, it is proposed to develop an effective educational program to improve the cognition and practice, and to improve the cognition and practice of the standard precaution through the systematic and repetitive education and training.

A Clinical Therapeutic Guideline of Antipsychotic Drugs (항정신병약물의 임상치료지침)

  • Yoon, Doh-Joon
    • Korean Journal of Biological Psychiatry
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    • v.1 no.1
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    • pp.7-16
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    • 1994
  • I will try to serve as the basis for the development of a clinical therapeutic guideline of antipsychotic drugs. Knowing that many patients fail standard treatment recommendations, either because of insufficient efficacy or intolerance to adverse effects, led us to emphasize the importance of the guideline. The clinicians continually assimilate new information about recent advances, including : novel agents targeted to impact specific components of various neurotransmitter systems ; combination strategies ; alternative uses of existing agents ; and specialized requirements of a growing number of identified diagnostic subtypes. The cost to benefit ratio must always be considered when developing a therapeutic guideline.

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Development of Clinical Practice Guideline for Hwabyung (2) - Tools for Development - (화병 임상진료지침 개발 연구 (2) - 지침 개발에 활용되는 도구 -)

  • Chung, Sun-Yong;Kim, Jong-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.20 no.2
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    • pp.153-162
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    • 2009
  • Objectives : The approach to Hwabyung from all angles is needed to develop the clinical practice guideline. To achieve this approach, various tools should be used practically and systematically. Methods : We gather the tools based on multi aspects of Hwabyung's characteristics. The tools will be used to each steps of clinical practice guideline development. Results : For the clinical practice guideline, there should be applied many kinds of tools, such as for decision and assesment, survey with oriental medicine property, collecting individual stress information, mental and psychological trait, and related or following disease. Conclusions : Application of many objective tools provides the evidence-based medical approaches for development of clinical practice guideline for Hwabyung.

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Comparative Study of the Clinicopathologic Characteristics between Gastrointestinal Stromal Tumors Arising from the Stomach and Small Bowel (위와 소장에 생긴 위장관 간질종양의 임상병리학적 비교)

  • Heo, Geon-Woong;Shin, Dong-Woo;Paik, So-Ya;Kim, Il-Dong;Kim, Ki-Ho;Suh, Byung-Sun;Park, Jin-Soo;Kim, Sang-Wook
    • Journal of Gastric Cancer
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    • v.7 no.4
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    • pp.254-260
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    • 2007
  • Purpose: The purpose of this study is to compare the clinicopathological characteristics of stomach and small bowel gastrointestinal stromal tumors and to determine the risk factors and treatment guidelines. Materials and Methods: Among 38 patients who were diagnosed with a gastrointestinal stromal tumor from August 1998 to May 2006, 29 patients at the Pundang Jesaeng General Hospital, Daejin Medical Center were evaluated. The clinicopathological characteristics of gastrointestinal stromal tumors arising from stomach and small bowel were compared. Immunohistochemical staining for CD117, CD34, smooth muscle actin, desmin, and S-100 protein was performed and classified according to NIH criteria. Prognosis between groups was analyzed according to NIH criteria. Results: There was no significant difference in the clinicopathological characteristics and prognosis between gastrointestinal stromal tumors arising from the stomach and small bowel. Recurrence of the disease occurred in four (13.8%) patients. Classification of gastrointestinal stromal tumors according to NIH criteria was predictive of recurrence (P=0.030). Conclusion: NIH criteria were predictive of recurrence, but the location of the primary site was not predictive of recurrence. A further study involving multi center data and a long-term follow-up will be needed for formulating diagnostic and therapeutic guidelines.

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A Case Series of Polycystic Ovary Syndrome with Improved Hyperandrogenism Treated with Korean Medicine (한방 치료로 고안드로겐혈증을 개선한 다낭성 난소 증후군 연속증례연구)

  • Shin, Haegue;Bae, Ji-Yong;Ji, Young-Geun;Ahn, Hae In;Yoon, Youngheum;Kim, Namkwen
    • The Journal of Korean Obstetrics and Gynecology
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    • v.34 no.3
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    • pp.175-191
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    • 2021
  • Objectives: This study aims to analyze the medical record of eight cases of polycystic ovary syndrome (PCOS) in a local Korean medicine clinic, in order to provide evidence on Korean medicine treatment of PCOS and to suggest the direction of future studies. Methods: The medical records of eight cases diagnosed with PCOS based on 2003 Rotterdam Criteria and whose total testosterone level was 0.53 ng/ml and over were retrospectively analyzed. The primary outcome was total testosterone level, and the secondary outcomes included luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels, LH/FSH ratio, weight, last mentrual period (LMP), numerical rating scale (NRS) score of dysmenorrhea, and other associated symptoms pre- and post-treatment. Korean medicine treatment consists of the complex herbal prescription consisting of Yukmijihwang-tang, Baekho-tang, Daesiho-tang, and Gyejibokryeong-hwan, modified according to symptoms; acupuncture and electroacupuncture on 中脘 (CV12), 下脘 (CV10), 關元 (CV4), 石門 (CV5), 合谷 (LI4), 太衝 (LR3), 三陰交 (SP6), and 懸鍾 (GB39); and indirect moxibustion on 神闕 (CV8). Results: The average total testosterone level lowered statistically significantly after the treatment. The average FSH and LH levels lowered with insignificance, while the average LH/FSH ratio and weight lowered statistically significantly. During the treatment period of three to six months, every patient had the menstrual cycle shortened except for one case; and two cases with infertility problem succeeded in being pregnant. There was no adverse event. Conclusions: The Korean medicine treatment was found effective in treating PCOS, especially regarding hyperandrogenism, amenorrhea or oligomenorrhea, and infertility.