• Title/Summary/Keyword: 환자관련요소

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Analysis of the Impact of Organizational Safety Culture on Radiology Technologists Awareness of Patient Safety and Safety Behavior (조직안전문화가 방사선사의 환자 안전에 대한 의식 및 안전 행동에 미치는 영향분석)

  • Won-Tae Kim;Hyeon-Jin Kim
    • Journal of the Korean Society of Radiology
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    • v.17 no.4
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    • pp.615-623
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    • 2023
  • This study was conducted to examine the effect of organizational safety culture on radiologists' awareness of patient safety and safety behavior. The study was conducted based on the results of the survey, and the survey was divided into three factors: general characteristics, efforts for patient safety, and patient safety culture. As a result of the study, age, work experience, and work satisfaction were influencing factors in general characteristics, and gender, academic background, and work type were not included as factors affecting differences in patient safety awareness. In efforts for patient safety, hospital support and education, patient safety activities, and how to respond to errors were all influencing factors, especially how to respond to errors were more relevant than other items. The patient safety culture was analyzed on two items: teamwork and open communication, and both items were highly related to radiologists' awareness of patient safety.

Analysis of Intraoral Squamous Cell Carcinoma Reconstructed with Radial Forearm Flap (전완부 유리 피판으로 재건한 구강내 편평상피암환자의 예후분석)

  • Park Myong-Chul;Soutar David S.
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.1
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    • pp.53-62
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    • 1994
  • 미세외과 수술에 의한 유리 피판술의 도입은 두경부 종양제거후 재건에 괄목할 만한 진보를 가져왔다. 특히 광범위한 종양의 제거가 필요하며 인근의 조직으로 수복이 어렵고 기능 및 외모상의 재건이 문제가 되는 경우 유리 피판은 절대적인 적응이 된다. 구강은 언어구사 와 연하(deglutition)기능을 담당하므로 재건을 위해서는 얇고 부드러운 조직으로 수복하여 주어야 한다. 전완부 유리피판은 혈관경의 위치가 대부분 일정하고 종양 제거후 결손의 모양에 따라 피판을 계획할 수 있기 때문에 구강암 제거후 가장 많이 이용되는 유리피판이다. 저자는 1982년 부터 1988년까지 영국 글라스고우 소재 서부 스코틀랜드 성형 및 구강외과 병원에서 구강의 편평상피암환자로 암종제거 후, 전완부 피판에 의한 재건 및 방사선 치료를 받은 151명의 치료결과(재발율 및 생존율)를 분석하였다. 절제연의 종양조직의 양성(P<0.05), 경부 임파절의 extracapsular node spread여부(P<0.001), 경부 임파절 곽청술의 종류(P<0.05) 등은 재발율과 관련하여 통계적으로 유의하였다. 반면에 종양의 구강내 위치, 하악골의 침범여부등은 통계적의의가 없었다. 생존율에 관하여는 종양의 구강내 위치 (P<0.05), 종양절제연 종양여부(P<0.005), 하악골의 침범여부(P<0.05), 경부 임파절의 extracapsular node spread여부(P<0.001) 등이 통계적으로 유의할 만한 요소로 밝혀졌다. 젊은 나이의 환자들에서(50세이하) 특징적으로 높은 사망률을 보였다. 하악골절제방법의 차이는 환자의 생존예후에 통계적으로 유의할 만한 영향을 주지 못했다.

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Predictors on In-hospital Mortality Following In-hospital Diagnosis of Tuberculosis (결핵으로 입원한 환자의 병원내 사망과 관련된 인자)

  • Shin, Su Rin;Kim, Chang Hwan;Kim, Sung Eun;Park, Yong Bum;Lee, Jae Young;Mo, Eun Kyung;Kim, Cheol Hong;Eom, Kwang Seok;Jang, Seung Hun;Kim, Dong Gyu;Lee, Myung Gu;Jung, Ki Suck
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.3
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    • pp.233-238
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    • 2006
  • Study objectives: To determine the factors associated with mortality after an in-hospital diagnosis of tuberculosis in a region with low levels of HIV coinfection. Methods: From January 2003 to December 2004, all subjects who were > 15 years of age and had received a diagnosis of tuberculosis were registered. The clinical, radiological and laboratory aspects of the patients who died (n=27) were compared with those of an age and gender matched control population(n=54). Logistic regression analyses were carried out, which included age, gender, hospital admission source, initial site of admission, dyspnea, general weakness and initial laboratory data. Results: The mean age of the patients was $60{\pm}16$ years and male patients outnumbered female patients. Univariate analysis identified hemoglobin, blood urea nitrogen, albumin, cholesterol, aspartate aminotransferase (AST), C-reactive protein and the risk factors for tuberculosis to be significantly associated with mortality. Among the characteristics of disease presentation and treatment, emergency department admission, intensive care unit, disease severity, general weakness and dyspnea at the time of admission were associated with mortality. Multiple regression analysis revealed the initial management in the intensive care unit and lower serum albumin to be independently associated with mortality. Conclusion: The markers of disease chronicity and severity appear to be associated with in-hospital mortality. Identifying potentially reversible factors such as malnutrition and respiratory failure suggests specific intervention that might lead to an improvement in the patients' outcomes.

The Perception and Emotional Experiences of Rare and Intractable Diseases in Caregivers and Pediatric Patients with Mitochondrial diseases (미토콘드리아 질환 소아 환자 보호자에서의 질환 인식 및 정서변화)

  • Eom, Soyong;Lee, Joo Young;Hyun, Jiah;Lee, Young-Mock
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.17 no.1
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    • pp.1-10
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    • 2017
  • Purpose: This study aimed to investigate the perception and emotional experiences in rare and intractable diseases for caregivers of pediatric patients with mitochondrial diseases in order to provide therapeutic interventions for patients, caregivers, and families. Methods: A total of 83 caregivers of pediatric patients with mitochondrial diseases were recruited from the pediatric mitochondrial disease clinics of the Gangnam Severance Hospital in South Korea. Participants completed the survey about their perception of mitochondrial disease and emotional experiences after the diagnosis, and these clinical data were analyzed accordingly. Results: Surveys from a total of 83 caregivers of patients were analyzed, and the patients' age ranged from 6 to 12 years (33%), followed by ages 1 to 6 years (30%). Children with mitochondrial diseases were between 0 and 0.5 years of age at the time of first symptom onset (43%), and the duration of illness lasted more than 10 years in most cases (42%). Prior to diagnosis of mitochondrial diseases, the amount of awareness the caregivers had was 'Not at all' for both rare and intractable diseases and mitochondrial diseases in 44 cases and 68 cases, respectively. For the caregivers' emotional experiences, the most common initial responses were 'Discouraged/despair', 'Helpless/lethargic', and 'Disconcerted'. 'Anxious', 'Committed to treatment', and 'Responsibility as family members' were the most common emotional responses from the caregivers, followed by 'Disconcerted' and 'Helpless/lethargic'. Conclusion: It is important to consider the level of perception and emotional experiences of caregivers and patients with rare and intractable mitochondrial diseases for planning treatment programs.

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The Effect of Second-Generation Antipsychotics Administration for 1-Year on the Platelet Activities in Patients With Schizophrenia: Retrospective Study (조현병 환자에서 1년간의 2세대 항정신병약물 지속적 투여가 혈소판 활성도에 미치는 영향: 후향적 연구)

  • Yoon-Seok, Oh;Jong Wook, Lee;Hong-Seok, Oh;Seung-Jun, Kim;Na-Hyun, Lee;Woo Young, Im;Ji-Woong, Kim
    • Korean Journal of Psychosomatic Medicine
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    • v.30 no.2
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    • pp.165-171
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    • 2022
  • Objectives : This study was conducted to investigate the effect of 1-year administration of second-generation antipsychotics (SGAs) on the platelet activity in patients with schizophrenia through a retrospective review of the medical records. Methods : The mean platelet component (MPC) value was used as an index of the platelet activity. The included subjects (N=24) were the patients who were confirmed to have taken SGAs continuously for one year after the first MPC measurement had been performed. The change of MPC was verified through a paired sample t-test. Results : The result revealed that the mean MPC value was significantly decreased from 26.5±1.4 g/dL to 25.6±1.8 g/dL after 1-year administration of SGAs from the time of the first MPC measurement. Conclusions : This study suggests that 1-year administration of SGAs may be related with increased platelet activity, and that close monitoring for risks such as cerebrovascular/cardiovascular or thromboembolic diseases may be necessary during SGAs treatment in clinical practice.

Financial Hardship Factors affecting the Cancer Patient's Quality of Life (암 환자의 삶의 질에 영향을 미치는 재정 관련 어려움 요인)

  • Rhee, Young-Sun;Kim, Su-Yeon;Park, Jeong-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.10
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    • pp.299-307
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    • 2020
  • Purpose: The purpose of this study was to investigate the financial hardships affecting the quality of life of cancer survivors. Method: Data were collected from five convalescent hospitals using self-administered questionnaires, and 422 questionnaires were used for the final analysis. We used a 5-step hierarchical multiple-regression analysis by entering each sociodemographic variable, medical variable, and three types of financial hardship (a material situation, the psychological response, and coping behavior coming from cancer treatment cost) into each step. Results: The results of statistical analysis indicate that the most influential factor in the quality of life was the financial difficulty, which was the frustration that they could not work as usual or support their family financially. In addition, the performance of physical activity, accompanying diseases, women patients, psychological burden on cancer treatment cost, the satisfaction of communication with medical staff for medical expenses, and the feeling unsuccessful financial coping strategy were predictors for the quality of life of cancer survivors. Conclusion: This study provides a blueprint for the development of intervention programs in practice to improve the quality of life of cancer patients, clinical intervention plans, and health policies.

Clinical pharmacogenetics (임상약물유전학)

  • 권준택
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1997.11a
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    • pp.81-85
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    • 1997
  • 인체에 투여된 약물의 반응은 개체간에 현저한 차이가 있으며 특히 환자에게 투여된 약물의 효과가 상이하게 나타남으로써 치료의 실패나 흑은 약물의 유해작용으로 나타나기도 한다. 이러한 개체 상호간의 약물반응의 차이는 환경적인 요소, 영양학적인 요소, 연령, 병용한 다른 약물 및 이미 앓고 있는 질병 등에 의해서도 영향을 받으나 특히 유전적으로 결정된 약물대사 능력의 차이에 의해서도 기인된다. 이러한 측면에서 약물 대사의 유전적인 다양성과 비정상적인 반응을 다루는 약물유전학의 중요성은 최근 두드러지게 대두되고 있다. 특히 유전적인 요인으로 개체간의 차이는 효소의 유전적인 결핍과 관련이 있으며 이 결핍은 생체이물질에 대한 반응의 다양성을 설명할 수 있는 약물대사 능력의 다형성에 기인한다. 또한 약물반응의 다양성은 인종간, 특히 동양인과 서양인에서의 약물반응에서도 차이가 있어 각 인종간의 약물반응의 차이에 대한 연구와 이의 원인규명에 대하여 많은 관심이 집중되고 있다. 이와 같은 견지에서 약물용량과 약물반응, 특히 약동학적 변화의 인종간의 차이와 각 개인의 차이 및 이의 원인에 대하여 살펴보고자 한다.

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The Study of Life Event Stress, Coping Strategy, and Type A Behavior Pattern of Alopecia Areata Patients - Comparison with Fungal Infection Patients - (원형탈모증 환자의 생활 사건 스트레스, 대처방식, A형 행동 패턴에 관한 연구)

  • Hyun, Sang-Bae;Song, Su-Kil;Lee, Dong-Soo;Lee, Eil-Soo;Park, Kyung-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.2
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    • pp.165-171
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    • 2000
  • Objectives : Alopecia areata has been known to be closely related to stress. The purpose of this study is to examine the relationship between stress and alopecia areata investigating how life events(which alopecia areata patients experience), amount of stress, coping strategy, and their personality type affect the oneset and aggravation of the disease. Methods : The subjects were 43 alopecia areata patients who visited the department of dermatology outpatients clinic, and 36 fungal infection diseases patients as the control group. They all completed Scale of Life Events, Coping Style Cheklist, Eysenck A-type Personality Inventory. The analysis of covariance with the age as covariate was carried out. Results : Compared to the control group, alopecia areata patients had significantly more stressful life events, and higher amount of stress, but there was no significant difference in coping strategy. Type A Personality is also resulted to have no significant relationship to alopecia areata. Conclusions : Alopecia areata patients had significantly higher amount of stress than the control group, and this result is consistent with the previous studies which suggest that stress contributes to the oneset of alopecia areata. The causual relationship between stress and alopecia areata should be further examined in order to be applied in clinical setting.

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Long-term Clinical Consequences in Patients with Urea Cycle Disorders in Korea: A Single-center Experience (요소회로대사 질환 환자들의 장기적인 임상 경과에 대한 단일 기관 경험)

  • Lee, Jun;Kim, Min-ji;Yoo, Sukdong;Yoon, Ju Young;Kim, Yoo-Mi;Cheon, Chong Kun
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.21 no.1
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    • pp.15-21
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    • 2021
  • Purpose: Urea cycle disorder (UCD) is an inherited inborn error of metabolism, acting on each step of urea cycle that cause various phenotypes. The purpose of the study was to investigate the long-term clinical consequences in different groups of UCD to characterize it. Methods: Twenty-two patients with UCD genetically confirmed were enrolled at Pusan National University Children's hospital and reviewed clinical features, biochemical and genetic features retrospectively. Results: UCD diagnosed in the present study included ornithine transcarbamylase deficiency (OTCD) (n=10, 45.5%), argininosuccinate synthase 1 deficiency (ASSD) (n=6, 27.3%), carbamoyl-phosphate synthetase 1 deficiency (CPS1D) (n=3, 13.6%), hyperornithinemia-hyperammonemia-homocitrullinuria syndrome (HHHS) (n=2, 9.1%), and arginase-1 deficiency (ARG1D) (n=1, 4.5%). The age at the diagnosis was 32.7±66.2 months old (range 0.1 to 228.0 months). Eight (36.4%) patients with UCD displayed short stature. Neurologic sequelae were observed in eleven (50%) patients with UCD. Molecular analysis identified 37 different mutation types (14 missense, 6 nonsense, 6 deletion, 6 splicing, 3 delins, 1 insertion, and 1 duplication) including 14 novel variants. Progressive growth impairment and poor neurological outcomes were associated with plasma isoleucine and leucine concentrations, respectively. Conclusion: Although combinations of treatments such as nutritional restriction of proteins and use of alternative pathways for discarding excessive nitrogen are extensively employed, the prognosis of UCD remains unsatisfactory. Prospective clinical trials are necessary to evaluate whether supplementation with BCAAs might improve growth or neurological outcomes and decrease metabolic crisis episodes in patients with UCD.

Clinical Characteristics of Patients with Taste Disorders (미각 장애 환자의 임상적 특성에 관한 연구)

  • Lee, Eun-Jin;Park, Won-Kyu;Nam, Jin-Woo;Yun, Jong-Il;Kho, Hong-Seop
    • Journal of Oral Medicine and Pain
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    • v.34 no.4
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    • pp.341-351
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    • 2009
  • There is tremendous variability in the ways patients present with taste problems. Because of complex and multifactorial etiological background, it is not simple to evaluate patients with taste disorders. Accurate assessment of patients' status by prudent, thorough history taking and symptom analysis is the most essential for exact diagnosis of taste disorders. The aim of this study was to investigate the clinical characteristics of patients with taste problems as a primary complaint. Consecutive series of 50 patients (12 males and 38 females, mean age $53.6\;{\pm}\;14.7$ years) were included for the present study. All subjects were requested to complete a comprehensive questionnaire. Clinical evaluation procedures included oral examination, interview, questionnaire analysis, panoramic radiography, blood test and measurement of salivary flow rate. The obtained results were as follows: 1. Among the patients, 36 patients (72%) complained of oral mucosal pain or burning sensation. Of these patients, 18 patients (36%) were diagnosed as burning mouth syndrome. 2. Nineteen patients (38%) complained of subjective oral dryness. The flow rate of unstimulated whole saliva was less than 0.1 mL/min in 14 patients (28%) and 17 (34%) had a stimulated whole salivary flow rate of less than 0.5 mL/min. 3. Among the types of taste disorders, hypogeusia, the most frequently reported, was found in 25 patients (50%), dysgeusia in 18 patients (36%), phantogeusia in 15 patients (30%), hypergeusia in 10 patients (20%), and ageusia in 5 patients (10%). Nineteen patients (38%) reported more than one type of taste disorder and the most frequent combination was dysgeusia + hypogeusia (n=6, 12%). 4. Based on data from the medical and dental histories and examinations, the patients were assigned to 12 probable causal categories. Taste disorders due to oral mucosal diseases and idiopathic taste disorder were the most frequent (n=9; 18%, each), followed by psychogenic taste disorder (n=8; 16%), drug-induced taste disorder (n=7; 14%), and taste disorder due to dry mouth (n=6; 12%). These 5 categories of taste disorder accounted for 78% of all cases in this study.