• Title/Summary/Keyword: 표준화환자

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Somatic Symptoms after Psychological Trauma (심리외상 이후의 신체증상)

  • Park, Joo Eon;Ahn, Hyun-Nie;Kim, Won-Hyoung
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.43-53
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    • 2016
  • Objectives : Somatic symptoms after the exposure of psychological trauma frequently developed. However, the somatic symptoms are not covered under the diagnostic criteria of posttraumatic stress disorder(PTSD) in detail, although they are often associated with social and occupational functioning and patient-doctor relationships. The aim of this article is to highlight the potential mechanisms, the common manifestations, and the treatment of the somatic symptoms. Methods : This article studied the somatic symptoms searched using academic search engines like PubMed, Scopus, Google Scholar, KoreaMed and KISS from the earliest available date of indexing to March 31, 2016. Results : The mechanism of somatic symptoms after the exposure was described as psychological and physiological aspects. Psychological mechanism consisted of psychodynamic theory, cognitive behavioral theory, and others. Physiological mechanism involved changes in neuroendocrine and immune system, autonomic nervous system and central nervous system. Somatization associated with psychological trauma manifested various health conditions on head and neck, chest, abdominal, musculoskeletal, and dermatological and immune system. Few studies described the standardization of treatment for the somatic symptoms. Conclusions : Clinicians and disaster behavioral health providers should think of the accompanying somatic symptoms during intervention of psychological trauma and PTSD. Further studies are needed on the somatic symptoms seen in psychological trauma and PTSD.

Awareness and Practice of Patients' Health Information Protection of Nursing Students (간호대학생의 의료정보보호에 대한 인식도와 실천도)

  • Kim, Eun-Young;Lim, Kyoung-Suk
    • Convergence Security Journal
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    • v.17 no.5
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    • pp.121-132
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    • 2017
  • This study is a narrative research study to understand the degree of awareness and practice of nursing college students' patients' health information protection and to grasp the relationship between them.. The subjects of this study were 122 nursing college students who experienced clinical practice in two nursing colleges in GwangJu city. Data collection was done from October 13 to 28, 2017. Using SPSS/WIN 21.0 Program, descriptive statistics, t-test, one-way ANOVA and Pearson correlation analysis were performed. As a result of the study, the degree of awareness and practicability of patient' health information protection were 4.44(SD=0.44) and 4.28(SD=0.62), respectively. There was a difference in the awareness of health information protection when they were educated about patients' health information protection at school (t=5.094, p<.001) and hospital (t=2.028, p=.045) in the case of having experience in patients' health information protection in hospitals(t=2.551, p=.012). There was a significant positive(+)correlation between patient's health information protection perception and practicing degree, and the degree of health information protection practitioner's communication domain (r=.420, p<.001). There was a significant positive correlation with the domain (r=.368, p<.001) and the referral domain (r=.304, p=.001). Based on these results, we sought to protect the personal information of patients and to provide necessary basic data to develop for standardized education program.

A Survey on Students' Perception of Clinical Performance Examination (CPX) in College of Korean Medicine Using Student Standardized Patients (학생표준화환자를 사용한 한의과대학 진료수행시험(CPX)에 대한 학생 인식 조사)

  • Jo, Hak-Jun;Roh, Jeong-du;Sung, Hyun Kyung;Park, Jeong-Su
    • Journal of Society of Preventive Korean Medicine
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    • v.24 no.3
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    • pp.1-13
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    • 2020
  • Objectives : The objective of this survey was to examine students' perception of the clinical performance examination (CPX) in college of traditional Korean medicine using student standardized patients. Methods : College of traditional Korean medicine students who completed the first-semester clinical practice education were selected as the subjects, and they participated in a survey asking questions about the following matters: satisfaction with CPX, self-evaluation, difficulties experienced during the CPX course, level of prior knowledge of clinical practice education, and usefulness of and intimacy with Student Standardized Patients (SSP). Results : Satisfaction with CPX was calculated to be 4.10 (5 being the perfect score), and self-evaluation of CPX was calculated to be 4.12. The subjects chose physical examination as the most difficult item relating to CPX. 80.5% responded positively to the question relating to diverse experiences in practice education, and 52.8% responded positively to the question relating to prior knowledge of diverse standardized patients. 55.6% responded positively to the question relating to performance proficiency of SSP, 63.9% responded positively to the question relating to usefulness of SSP to prepare for CPX, and 69.4% responded positively to the question relating to usefulness of SSP in evaluating CPX, and 55.6% responded positively to the questions relating to intimacy with SSP. It was confirmed that there was a strong quantitative correlation between prior knowledge of clinical practice education and usefulness of SSP, and that there was a strong quantitative correlation between performance proficiency of SSP and usefulness of SSP. It was confirmed that there was a middle-level correlation between performance proficiency of SSP and intimacy with SSP, and that there was a middle-level quantitative correlation between intimacy with SSP and usefulness of SSP. Conclusions : It was confirmed that senior students enrolled in college of traditional Korean medicine were mostly satisfied with the clinical performance examination in college of traditional Korean medicine using SSP, and that usefulness of SSP had a quantitative correlation with prior knowledge of diverse clinical practice educations, performance proficiency of SSP, and intimacy with SSP.

A Study on the Practice Model for Practical Education for Health and Medical Information Management (보건의료정보관리 실습교육을 위한 실습모델 연구)

  • Choi, Joon-Young
    • Journal of the Health Care and Life Science
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    • v.8 no.2
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    • pp.83-93
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    • 2020
  • In this study, a practical model for health information management education using the EMR education system at universities for nurturing health care information managers was studied. Currently, there is no practical training course for health care information management in the standards for evaluation and certification of health care information management education introduced to strengthen the job competency of health care information managers. Accordingly, the program was constructed so that the practice program suggested as an educational environment in the Health and Medical Information Management Education Evaluation and Certification Manual can be practiced in the EMR education system. In addition, a practical model that can be performed according to the on-site practice guidelines for health and medical information management for each program was studied. Using the health care information management education EMR system, master data management, patient registration, doctor prescription, medical cost calculation, health insurance claim management, form management, discharge registration, cancer registration, unrecorded management, health care data management, health care statistics, A practice model was studied so that practice on information protection/security management can be performed. It will be possible to play a role as a health care information management expert by raising the quality level of health care information management education through systematic and standardized health care information management practice courses at universities. Accordingly, it is necessary to cultivate health care information management experts who develop and manage medical services based on medical data analysis through practical training of health care information managers.

Validation of the Korean Version of the Neck Dissection Impairment Index in Patients Who Underwent Neck Dissection (경부청소술을 시행한 환자를 대상으로 한 경부청소술 후 장애지수에 대한 한글화 버전 표준화)

  • Lim, Won Sub;Lee, Chang Wook;Lee, Yoon Se;Jo, Min-Woo;Jung, Young Ho;Choi, Seung-Ho;Kim, Sang Yoon;Nam, Soon Yuhl
    • Korean Journal of Head & Neck Oncology
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    • v.37 no.2
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    • pp.43-50
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    • 2021
  • Background/Objectives: Shoulder function is an important aspect of health related quality of life (QOL). Neck dissection impairment index (NDII) is a simple shoulder-specific questionnaire. This study aimed to evaluate the association between QOL and NDII in patients who underwent neck dissection to validate the Korean version of NDII. Materials & Methods: This study enrolled 74 patients with head and neck cancer who underwent neck dissection from December 2013 to April 2014. Patients completed questionnaires on QOL including the European Organization of Research and Treatment of Cancer 30-item Core QOL questionnaire (EORTC QLQ-C30) and NDII which was translated into Korean. Validity was evaluated by calculating the Pearson correlation coefficient between NDII and EORTC QLQ-C30. Results: We compared preoperative, postoperative within a week, 1st and 3rd months NDII scores. The total NDII scores were 14.7, 47.4, 33.7 and 34.3 each. Clinical variables including gender, site of primary tumor, performing revision neck dissection, radiotherapy and flap reconstruction were not significantly associated with NDII. However NDII mean score of patients who underwent unilateral neck dissection over 3 levels is most increased after operation. During all periods NDII scores were significantly associated with functioning score. Although other scores are lower correlation than function scores, global health status scores and symptom scores are also correlation with NDII. Conclusion: NDII was valid instrument and can be used not only in the clinical practice to assess shoulder dysfunction but also in the simple instrument to evaluate global QOL in Korea patients with having neck dissection.

Association Between Cognitive Impairment and Oral Health Related Quality of Life: Using Propensity Score Approaches (인지기능과 구강건강관련 삶의 질의 연관성에 대한 연구: 성향점수 분석과 회귀모델을 중심으로)

  • Cha, Suna;Bae, Suyeong;Nam, Sanghun;Hong, Ickpyo
    • Therapeutic Science for Rehabilitation
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    • v.12 no.3
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    • pp.61-77
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    • 2023
  • Objective : This study analyzed the correlation between cognitive function and oral health-related quality of life (OHQoL). Methods : Demographic and clinical characteristics were extracted and utilized for subjects aged 45 years or older who participated in the 8th Korean Longitudinal Study on Aging in 2020. The dependent variable was the Geriatric Oral Health Assessment Index, and the independent variable was the level of cognitive function classified by the Mini-Mental State Examination scores. The analysis method used inverse probability of treatment weighting (IPTW). Then, the association between cognitive function and OHQoL was analyzed by multiple regression analysis. Results : Among the participants, 4,367 (71.40%) had normal cognition, 1,155 (18.89%) had moderate cognitive impairment, and 594 (9.71%) had severe cognitive impairment. As a result of analysis by applying IPTW, there was a negative correlation between the cognitive function group and OHQoL (normal vs. moderate: β = -2.534, p < .0001; normal vs. severe: β = -2.452, p < .0001). Conclusion : After propensity score matching, mild cognitive impairment showed a more negative association than severe cognitive impairment. Therefore, patients with cognitive impairment require oral health management education to improve OHQoL regardless of the level of cognitive impairment.

Trends in Saliva Research and Biomedical Clinical Applications (타액 연구의 최신 지견과 임상 응용)

  • Soyoung Park;Eungyung Lee;Jonghyun Shin;Taesung Jeong
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.1
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    • pp.1-12
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    • 2023
  • Function of salivary gland and saliva composition can be an indicator of individual's health status. Recently, saliva has been thought to have a high potential for usage in the biomedical field to diagnose, evaluate, and prevent systemic health due to the technological advances in analyzing and detecting small elements such as immunological and metabolic products, viruses, microorganisms, hormones in saliva. As a diagnostic specimen, saliva has some useful advantages compared to serum. Because of simple non-invasive method, saliva sampling is quite comfort for the patient, and it doesn't require specialists to collect samples. The possibility of infection during the collection process is also low. For this reason, proteins, genetic materials, and various biomarkers in saliva are actively being utilized on studying stress, microbiomics, genetics, and epigenetics. For the research on collecting big data related to systemic health, the needs on biobank has been focused. Regeneration of salivary gland based on tissue engineering has been also on advancement. However, there are still many issues to be solved, such as the standardization of sample collection, storage, and usage. This review focuses on the recent trends in the field of saliva research and highlight the future perspectives in biomedical and other applications.

Imaging for Multiple Myeloma according to the Recent International Myeloma Working Group Guidelines: Analysis of Image Acquisition Techniques and Response Evaluation in Whole-Body MRI according to MY-RADS (International Myeloma Working Group의 최신 가이드 라인에 따른 다발성 골수종의 영상검사법 및 MY-RADS에 따른 전신 MRI에서의 영상 획득과 반응 평가 소개)

  • A Yeon Son;Hye Won Chung
    • Journal of the Korean Society of Radiology
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    • v.84 no.1
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    • pp.150-169
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    • 2023
  • Multiple myeloma (MM) is a malignant hematologic disease caused by the proliferation of clonal plasma cells in the bone marrow, and its incidence is increasing in Korea. With the development of treatments for MM, the need for early diagnosis and treatment has emerged. In recent years, the International Myeloma Working Group (IMWG) has been constantly revising the laboratory and radiological diagnostic criteria for MM. In addition, as whole-body MRI (WBMR) has been increasing used in the diagnosis and treatment response evaluation of patients with MM, the Myeloma Response Assessment and Diagnosis System (MY-RADS) was created to standardize WBMR image acquisition techniques, image interpretation, and response evaluation methods. Radiologists need to have a detailed knowledge of the features of MM for accurate diagnosis. Thus, in this review article, we describe the imaging method for MM according to the latest IMWG guidelines as well as the image acquisition and response evaluation technique for WBMR according to MY-RADS.

Ovarian and Endometrial $^{18}F$-FDG Uptake During the Menstrual Cycle in Normal Premenopausal Patients: Evaluation by PET/CT (월경주기에 따른 $^{18}F$-FDG PET/CT의 자궁 내 섭취에 관한 연구)

  • Bahn, Young-Kag;Park, Hoon-Hee;NamKoong, Hyuk;Kim, Sang-Kyoo;Lim, Han-Sang;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.43-47
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    • 2009
  • Purpose: The menstrual cycle of normal premenopausal patients was divide into menstrual flow phase, proliferative phase, ovulatory phase, secretory phase. The aim of this study was to ovarian and endometrial $^{18}F$-FDG uptake during the menstrual cycle in normal premenopausal patients. Materials and Methods: We identified 200 incidental $^{18}F$-FDG uptake in the ovary. The patient fasted at least 6 hours before receiving an intravenous injection of 370-592 MBq (10-16mCi) of $^{18}F$-FDG. Scanning from the base of the skull though the mid thigh was performed using the Discovery Ste PET/CT system (GE Healthcare, Milwaukee, WI, USA). Ovarian and endometrial $^{18}F$-FDG uptake (expressed as standardized uptake value) was measured on PET/CT image. Results: Two peaks of increased endometrial $^{18}F$-FDG uptake were identified during the menstrual cycle. The $SUV_{avg}$ and $SUV_{max}$ was $2.89{\pm}1.04$ and $3.17{\pm}1.59$ in menstruating patients, $2.4{\pm}0.88$ and $2.98{\pm}1.14$ in proliferative phase patients, $3.59{\pm}1.76$ and $3.17{\pm}1.67$ in ovulatory phase patients, $2.58{\pm}1.39$ and $3.1{\pm}1.8$ in secretory phase patients. Conclusions: Increased ovarian and endometrial $^{18}F$-FDG uptake could be found the time of menstrual flow and ovulatory phase of menstrual cycle. Increased uptake in endometrial adjacent to a cervical tumor does not necessarily reflect endometrial tumor invasion. Since increased uptake was dependent on the menstrual cycle, it can be avoided by scheduling PET/CT just after menstruation. Non-menstrual-related endometrial uptake may be instrumental in establishing a diagnosis in a premenopaual patient.

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Laparoscopic Gastric Surgery in Early Gastric Cancer: the Analysis of Early 25 Cases (조기 위암에서 복강경하 위 절제술: 초기 25예에 대한 경험)

  • Sung Jung Youp;Park Tae Jin;Jeong Chi Young;Joo Young Tae;Lee Young Joon;Hong Soon Chan;Ha Woo Song
    • Journal of Gastric Cancer
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    • v.4 no.4
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    • pp.230-234
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    • 2004
  • Purpose: The use of laparoscopic surgery for gastric disease has been gaining popularity. However, there has been the controversy over the indications and the standard techniques of laparoscopic gastric surgery in the early gastric cancer (EGC). The purposes of this study were to compare the clinical outcomes among a hand-assisted laparoscopic distal gastrectomy (HALDG), a laparoscopy-assisted distal gastrectomy (LADG), and an open distal gastrectomy (ODG) and to discuss the role of these procedures in the treatment of EGC. Materials and Methods: Between August 2001 and July 2004, laparoscopic surgery was performed in our institution on 25 patients, LADG (n=7) and HALDG (n=18) with EGC. Analysis was performed on clinical data such as the operative time, the hospital stay, the start of oral intake, and the number of harvested lymph nodes. Patients were categorized into early and late groups by using the date of surgery and were also grouped by surgical procedure. To evaluate the feasibility and efficacy of laparoscopic surgery for EGC, we compared the clinical data with those for ODGs performed during the same period. Results: There was no difference in the number of harvested lymph nodes between the laparoscopic group and the open group, but the operation time in the laparoscopic group was longer than that in the open group (P<0.05). Also, no significant differences in other clinical data were found between the two groups. Comparing the early and the late periods of the series, the number of harvested lymph nodes for a HALDS increased from $22.31\pm4.29\;to\;29.40\pm3.21$ (P<0.05). Conclusion: Our early experience with laparoscopic gastric surgery shows that a wide range of possibilities exist for applying laparoscopic gastric surgery to selected gastric cancer patients. However, the surgical procedure should be standardized, and the outcomes of laparoscopic surgery, in comparison to those of open surgery, need to be confirmed based on a large randomized study. (J Korean Gastric Cancer Assoc 2004;4:230-234)

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