• Title/Summary/Keyword: 임상진료지침

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An Investigation of Current Status of the Clinical Practice Guidelines in Korea (국내 임상진료지침의 개발 현황)

  • Chun, Pusoon;Lee, Young Sook
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.3
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    • pp.178-186
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    • 2015
  • Objective: Clinical practice guidelines (CPGs) are systematically developed statements aimed at helping optimal care of the patient in a given clinical circumstance. Because of the increasing evidence that active implementation of CPGs improve health outcomes, there is a growing awareness of the importance of guideline development and dissemination. The objective of this study was to investigate the status of CPG development and availability of the CPGs in Korea. Method: We searched in the Web sites of 180 organizations to identify CPGs which were developed and/or published in Korea until 1 July 2014. The data of titles, published year, publisher, distributer, and accessibility at the internet web of all CPGs were collected and analyzed. Results: A total of 172 CPGs were developed and 80% had been released since 2009. Most (51.2%) were developed for management of 4 diseases: 28 for digestive system disease; 27 for infectious disease; 18 for endocrine and metabolic diseases; and 15 for neoplasms. Of the 172 CPGs, 150 CPGs were publicly available. Among the 150 CPGs, 78.7% (118/150) were developed by only one organization. Conclusion: To ensure the production of high-quality CPGs, it is necessary to collaborate with other relevant professional societies in guideline development process. In addition, stronger efforts on wider dissemination of CPGs must be employed at the country levels to promote implementation of CPGs in clinical settings.

The Effects and Variances of the Critical Pathway of Laparoscopic Colon Resection in Colon Cancer Patients (일 병원의 대장절제술 환자를 위한 표준진료지침의 임상적용 효과와 변이분석)

  • Jung, Hye-Jeong;Choi, Mo-Na;Kim, So-Sun;Kim, Nam-Kyu;Lee, Kang-Young
    • Asian Oncology Nursing
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    • v.12 no.3
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    • pp.204-212
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    • 2012
  • Purpose: To investigate the effectiveness and variance of a critical pathway (CP) for laparoscopic colon resection in colon cancer patients, and nurses'satisfaction with the CP. Methods: A CP for laparoscopic colon resection was applied to the CP-group that included 50 patients, who underwent elective colon resection between March and May, 2011. The non-CP group included 51 patients who had the same operation without the CP applied from March to May, 2010. Results: The means of length of hospital stay were 11.7 and 7.3 days (p<.001) and the lengths of postoperative hospital stay were 8.6 and 5.1 days (p<.001) in the non-CP group and CP group, respectively. There was no significant difference between two groups for total healthcare costs, pain score, complications, or emergency room visits within 30 days after discharge. By examining variances of the CP, there were 162 variances and the most frequent cause was patient's condition. Nurses'satisfaction with the use of CP was favorable and the mean score of satisfaction was 3.76 on the 5 point Likert scale. Conclusion: There are clear benefits to use of CP, resulting in standardized and effective patient care. In conclusion, analysis of variance data can assist in evaluating and revising CP for optimal care and reducing variances.

Internet Gaming Disorder Treatment Options in the Hospital Setting (임상환자를 대상으로 한 인터넷 게임장애의 치료방법 고찰)

  • Park, Jeong Ha;Hyun, Gi Jung;Son, Ji Hyun;Lee, Young Sik
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.26 no.2
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    • pp.75-85
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    • 2015
  • Internet gaming disorder (IGD), one of the common subtypes of internet addiction, is now classified in Section 3 of DSM-5 and is increasingly regarded as a growing health concern in many parts of the world. Consequently, many psychotherapeutic and psychopharmacological approaches have been considered and some research regarding therapeutic strategies has been conducted. However, treatment of IGD is in its early stages and therefore is not yet well established. This article reviews multiple therapeutic modalities including our own treatment model for IGD according to clinical and biological effects, thus providing suggestions for standard treatment strategies. The two main streams are psychopharmacological treatment and cognitive-behavior treatment, and the cognitive-behavior approach includes cognitive reconstruction, psychoeducation, and parenting coach. Many other non-pharmacological treatments are also recommended for personalized treatment of IGD.

ERRATUM: Patient's Perception for Developing Research Questions of a Clinical Practice Guideline of Korean Medicine for Degenerative Lumbar Spinal Stenosis: A Descriptive Cross-Sectional Survey (ERRATUM: 퇴행성 요추 척추관 협착증의 한의표준임상진료지침 핵심질문 설정에 대한 환자 인식 설문 조사: 단면 설문 연구)

ANALYSIS ON THE OUTPATIENT ANESTHESIA AT DENTAL CLINIC FOR DISABLED IN SEOUL NATIONAL UNIVERSITY DENTAL HOSPITAL (서울대학교 치과병원 장애인진료실의 외래환자마취 실태 분석)

  • Park, Chang-Joo;Jung, Jun-Min;Kim, Hyun-Jeong;Jang, Ki-Taeg;Lee, Sang-Hun;Yum, Kwang-Won
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.1
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    • pp.19-25
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    • 2004
  • Dentally disabled person means one who have difficulty in cooperating voluntarily with a dentist for routine dental care. Seoul National University Dental Hospital (SNUDH) Dental Clinic for Disabled has worked for them under outpatient anesthesia concept. The aim of this study was to determine the anesthetic characteristics of the patients attending for dental treatment at SNUDH Dental Clinic for Disabled in order to establish better future treatment plans. The data were drawn from the patients who visited SNUDH Dental Clinic for Disabled from January 1999 to October 2002. Total 93 dental treatments for 83 patients were enrolled in this study. Most patients had mental retardation and the conservative treatments were carried out under general anesthesia. Thiopental and vecuronium were mostly used for induction agent and neuromuscular blocker, respectively. Enflurane, with oxygen and nitrous oxide, was mostly used to maintain the anesthesia. Mean total anesthetic time was $164.4{\pm}57.2$ minutes and mean duration at the post-anesthetic care unit was $106.2{\pm}50.5$ min. Serious postoperative complications were not observed. These results showed our successful anesthetic outcomes without any severe side effect or complication and the needs of more outpatient centers for dental care for disabled.

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Update in Diagnosis of Idiopathic Pulmonary Fibrosis and Interstitial Lung Abnormality (특발폐섬유증 진단의 최신 지견과 간질성폐이상)

  • Bo Da Nam;Jung Hwa Hwang
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.770-790
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    • 2021
  • Idiopathic pulmonary fibrosis (IPF), based on the 2018 international clinical practice guidelines, can be diagnosed with a usual interstitial pneumonia (UIP) pattern on high-resolution computed tomography (HRCT) and compatible clinical findings. Given that imaging is pivotal for IPF evaluation and diagnosis, more emphasis should be placed on the integration of clinical, radiological, and pathologic findings for multidisciplinary diagnosis. Interstitial lung abnormality (ILA), on the other hand, has a purely radiological definition based on the incidental identification of CT abnormalities. Taken together, differentiation between ILA and clinically significant interstitial lung disease (ILD) must be based on proper clinical evaluation. With this review, the recent updates in IPF diagnosis and the radiologic considerations for ILA can be well understood, which can be helpful for the proper diagnosis and management of patients with diffuse interstitial pulmonary fibrosis.

Barriers on Development of Clinical Practice Guidelines for Cardiopulmonary Resuscitation (임상진료지침 개발과정의 장애요인 - 심폐소생술을 중심으로 -)

  • Park, Seong-Hi
    • Quality Improvement in Health Care
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    • v.7 no.1
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    • pp.46-58
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    • 2000
  • Background : Despite favorable effects of guidelines on patient care, guidelines often fail to achieve their objectives. Poorly implemented medical practice guidelines can produce only weak effects on the process of health care delivery. Therefore, we performed this study to investigate barriers related development of clinical practice guidelines. Methods : Cardiopulmonary resuscitation was selected as a target problem. Self questionnaires about management of cardiopulmonary resuscitation were developed by a researcher with advisory 8 experts. The questionnaires were designed as a unstructured methods. The data were collected from March 1 to May 31, 1999. A total 50 death case admitted inpatient to Inha University Hospital were subjected to evaluate the development and application of clinical practice guidelines for cardiopulmonary resuscitation. The data were examined by frequency, t-test with SPSS. Result : The article reviewed several common barriers that might limit successful implementation of guidelines in clinical practice, as illustrated by evaluating recommendations for cardiopulmonary resuscitation clinical practice guidelines. Some major problems with guidelines were characterized as follows (1) ethical problem : euthanasia, (2) occurrence on various emergency event and setting, (3) non-medical problems (4) unreliable of medical record etc. Conclusion : Careful analysis of guideline attributes, anticipated effect on medical care, and organizational factors revealed several barriers to successful guideline implementation that should be addressed in the design of future guideline-based interventions.

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Clinical Practice Guideline for Soeumin Disease of Sasang Constitutional Medicine: Greater Yin Symptomatology (소음인체질병증 임상진료지침: 태음병)

  • Hwang, Min-Woo;Park, Hye-Seon;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.26 no.1
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    • pp.45-54
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    • 2014
  • Objectives This research was proposed to present Clinical Practice Guideline(CPG) for Soeumin Disease of Sasang Constitutional Medicine(SCM): Greater Yin Symptomatology. This CPG was developed by the national-wide experts committee consisting of SCM professors. Methods First, it was performed that search and collection of literature related SCM such as "Dongeuisusebowon", Textbook of SCM, Clinical Guidebook of SCM and Fundamental research to standardize diagnosis of Sasang Constitutional Medicine. And journal search related clinical trial or Human complementary medicine of SCM was performed domestic and overseas. Finally, 1 article was selected and included in CPG for Greater Yin Symptomatology of Stomach Cold-based Interior Cold disease in Soeumin disease. Results & Conclusions CPG of Greater Yin symptomatology in Soeumin Disease include classification, definition and standard symptoms of each pattern. Greater Yin symptomatology is classified into mild and moderate pattern by severity. Greater Yin Symptomatology Mild pattern is classified into Greater Yin Symptomatology accompanied abdominal pain and bowel irritability and Greater Yin pattern accompanied Epigastric stuffiness and fullness. And Greater Yin Symptomatology moderate pattern is classified into Greater Yin pattern accompanied Jaundice, Greater Yin pattern accompanied Edema and Greater Yin pattern by Yin toxin.

Clinical Practice Guideline for Soeumin Disease of Sasang Constitutional Medicine : Congestive Hyperpsychotic symptomatology (소음인체질병증 임상진료지침 : 울광병)

  • Bae, Hyo-Sang;Kim, Yun-Hee;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.26 no.1
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    • pp.27-36
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    • 2014
  • Objectives This research was proposed to present Clinical Practice Guideline(CPG) for Soeumin Disease of Sasang Constitutional Medicine(SCM): Congestive Hyperpsychotic symptomatology. This CPG was developed by the national-wide experts committee consisting of SCM professors. Methods First, it was performed that search and collection of literature related SCM such as "Dongeuisusebowon", Textbook of SCM, Clinical Guidebook of SCM and Fundamental research to standardize diagnosis of Sasang Constitutional Medicine. And journal search related clinical trial or Human complementary medicine of SCM was performed domestic and overseas. Finally, no article was selected and included in CPG for Congestive Hyperpsychotic symptomatology of Kidney Heat-based Exterior Heat disease in Soeumin disease. Results & Conclusions CPG of Congestive Hyperpsychotic symptomatology in Soeumin Disease include classification, definition and standard symptoms of each pattern. Congestive Hyperpsychotic symptomatology is classified into mild and severe pattern by severity. Congestive Hyperpsychotic symptomatology mild pattern is classified into initial pattern. Congestive Hyperpsychotic symptomatology severe pattern is classified into intermediate and advanced pattern and Greater Yang disease Reverting Yin pattern.

Clinical Practice Guideline for Soeumin Disease of Sasang Constitutional Medicine: Yang Depletion Symptomatology (소음인체질병증 임상진료지침: 망양병)

  • Joo, Jong-Cheon;Shin, Mi-Ran;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.26 no.1
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    • pp.37-44
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    • 2014
  • Objectives This research was proposed to present Clinical Practice Guideline(CPG) for Soeumin Disease of Sasang Constitutional Medicine(SCM): Yang Depletion Symptomatology. Methods This CPG was developed by the national-wide experts committee consisting of the society of Sasang Constitutional Medicine. it was performed by search and collection of literature related SCM, opinion of SCM experts and journal search. And it was followed by CPG's guideline. Results & Conclusions No article was selected and included in CPG for Yang Depletion Symptomatology of Kidney Heat-based Exterior Heat disease in Soeumin disease. CPG of Yang Depletion symptomatology in Soeumin Disease include classification, definition and standard symptoms of each pattern. Yang Depletion symptomatology is classified into severe and critical pattern by severity. Yang Depletion Symptomatology severe pattern is classified into initial phase pattern and intermediate phase pattern. And Yang Depletion Symptomatology critical pattern is classified into advanced phase pattern.