• Title/Summary/Keyword: 환자분류도구

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The Development of Hemodiafiltration Treatment Compliance Indicators and Discriminant Standards, Development of Hemodiafiltration Treatment Compliance Measurement - Convergent Form(HDFTCM-CF) : Focused on On-line Hemodiafiltration (혈액여과투석 환자의 치료이행 지표와 분류기준, 융합형 혈액여과투석 치료이행 측정도구 개발 : 온라인 혈액여과투석을 중심으로)

  • Hur, Jung
    • Journal of Digital Convergence
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    • v.13 no.7
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    • pp.269-282
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    • 2015
  • This study is to define the hemodiafiltration treatment compliance indicators and discriminate standards for hemodiafiltration patients and development of hemodiafiltration treatment compliance measurement-convergent form. Date was collected from 300 on-line hemodiafiltration patients. To verify the hemodiafiltration treatment compliance indicators and discriminate standards, used construct validity and content validity by clinical professional group. Discriminant ability of 3 indicators-interdialysis weight gain rate(IWGR), serum phosphate level, rate of self change of total hemodiafiltration treatment time(SCR-HEFTT)- is 95.6%(wilks ramda=.256, p=.002). And hemodiafiltration treatment compliance measurement-convergent form has 91.7% discriminant accuracy. Hemodiafiltration treatment compliance is important that nurses can aware pre-stage of complication and give appropriate nursing intervention. Also this measurement can be used for foundation data of the nursing intervention development that prevent dialysis patient's complication.

A Systematic Review of Assessment Tools of Activities of Daily Living for Stroke Patients (뇌졸중 환자를 위한 일상생활활동 평가도구에 관한 체계적 고찰)

  • Kang, Jae-Won;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.6 no.2
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    • pp.11-28
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    • 2017
  • Objective: The purpose of this study was conducted to systematic review about assessment tools for Activities of Daily Living (ADL) for stroke patients. Methods: Studies tools was administered by using four electronic databases (Pubmed, Embase, Cochrane and NDSL). For the main key words,"stroke AND activities of daily living AND occupational therapy AND assessment OR evaluation OR measurement"was used. We analyzed the types and frequency of evaluation tools. In addition, the evaluation tools for activities and participation were classified based on the classification criteria of International Classification of Functioning, Disability and Health (ICF). Results: In this study, 111 studies were analyzed and 30 assessment tools were identified. As the number of studies on stroke patients has been increased recently, the types and frequency of evaluation tools have been also increased. The most commonly used evaluation tools were Functional Independence Measure (FIM), Barthel Index (BI) and Canadian Occupational Performance Measure (COPM). In addition, according to classification based on ICF, we found that the types of assessment tools which assess participation were few. Conclusion: Although there were many kinds of assessment tools, the types of evaluation tools which were used in the research or field were very limited. Using various assessment tools, more research should be conducted to support evidence-based occupational therapy. Evaluation tools for participation also should be developed.

Triage Accuracy of Pediatric Patients using the Korean Triage and Acuity Scale in Emergency Departments (한국형응급환자분류도구를 적용한 응급실에서 소아 환자의 중증도 분류 정확성)

  • Moon, Sun-Hee;Shim, Jae Lan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.11
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    • pp.626-634
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    • 2018
  • This retrospective study investigates the accuracy of triage procedures for pediatric patients in emergency departments (EDs) using the Korean Triage and Acuity Scale (KTAS). The study includes 250 randomly selected initial nursing records and clinical outcomes of pediatric patients who visited one regional ED or a local ED from October 2016 to September 2017. The collected data were analyzed by a qualified expert to determine the true triage score. The accuracy of triage was defined as the agreement between the triage score of the emergency nurses (ENs) and the true triage score as determined by the expert. Based on expert comments, the cause of the triage error was analyzed and the KTAS score was compared with the discharge, length of stay (LOS), and medical cost. The results showed that the degree of agreement in the triage score between the experts and the ENs was excellent (weighted kappa=0.77). Among the causes of triage discordance, the most frequent was the incorrect application of vital signs to the KTAS algorithm criteria (n=13). Patients with high severity KTAS levels 1 and 2 were discharged less often (${\chi}=43.25$, p<0.001). There were significant differences in the length of stay (F=12.39, p<0.001) and cost (F=11.78, p<0.001) between KTAS scores when adjusting for age. The results of this study indicate that KTAS is highly accurate in EDs. Hence, the newly developed triage tool is becoming well established in Korea.

Classification of Cancer-related Gene Expression Data Using Neural Network Classifiers (신경망 분류기를 이용한 암 관련 유전자 발현정보를 분류)

  • 권영준;류중원;조성배
    • Proceedings of the Korean Information Science Society Conference
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    • 2001.04b
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    • pp.295-297
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    • 2001
  • 최근 생물 유전자 정보를 효과적으로 분석하기 위한 적절한 도구의 필요성이 대두되고 있다. 본 논문에서는 백혈병 환자의 골수로부터 얻어낸 DNA Microarray 유전 정보를 분류하여 환자가 가지고 있는 암의 종류를 예측하기 위한 최적의 특징추출방법과 분류 방법을 찾고자 한다. 이를 위해 피어슨 상관관계, 유클리디안 거리, 코사인 계수, 스피어맨 상관관계, 정보 이득, 상호 정보, 신호 대잡음비의 7가지 특징 추출 방법을 사용하였으며, 역전과 신경망, 의사결정 트리, 구조 적응형 자기구성 지도, $textsc{k}$-최근접 이웃 등 가지의 기계학습 분류기를 이용하여 분류 실험을 하였다. 실험결과, 피어슨 상관관계와 역전파 신경망을 이용한 분류 방법이 97.1%의 인식률을 보임을 알 수 있었다.

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Empirical Evaluation of Ensemble Approach for Diagnostic Knowledge Management (진단지식관리를 위한 앙상블 기법의 실증적 평가)

  • Ha, Sung-Ho;Zhang, Zhen-Yu
    • The Journal of Information Systems
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    • v.20 no.3
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    • pp.237-255
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    • 2011
  • 지난 수십 년 간 연구자들은 효과적인 진료지원시스템을 개발하기 위해 다양한 도구와 방법론들을 제안하였고 지금도 새로운 방법론과 도구들을 계속적으로 개발하고 있다. 그 중에서 흉통으로 응급실에 내원한 노인환자에 대한 정확한 진단은 중요한 이슈 중의 하나였다. 따라서 많은 연구자들이 의사의 진단 능력을 향상시키기 위한 지능적인 의료의사결정과 시스템 개발에 투신하고 있지만 전통적인 의료시스템에 따른 대부분의 진료의사결정이 단일 분류기(classifier)에 기반하고 있어 만족스런 성능을 보여주지 못하고 있는 것이 현실이다. 따라서 이 논문은 앙상블 전략을 활용하여 의사들이 노인환자들의 흉통을 더 정확하고 빠르게 진단하는데 있어 도움을 줄 수 있게 하였다. 의사결정나무, 인공신경망, SVM 모델을 결합한 앙상블 기법을 실제 응급실에서 수집한 응급실 자료에 적용하였고, 그 결과 단일 분류기를 사용하는 것에 비해 월등히 향상된 진단 성과를 보이는 것을 관찰 할 수 있었다.

Review of Patient Satisfaction with Case Management (사례관리 만족도 측정에 관한 고찰)

  • Park, Eun-Jun
    • Journal of Korean Academy of Nursing Administration
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    • v.13 no.3
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    • pp.311-320
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    • 2007
  • 연구 목적: 사례 관리(CM) 환자 만족도 측정에 관한 연구 결과를 고찰하여 사례관리 실무에서 활용할 수 있는 근거를 제공하고자 한다. 연구 방법: MedLine, CINAHL에서 주요용어로 case management, care management, 주제어로 patient satisfaction, client satisfaction을 이용해 문헌 검색을 실시하였다. 연구 결과: 만족도에 대한 개념은 관련 연구가 매우 부족하며, 서로 다른 이론적 접근을 하고 있으므로 그 측정에 어려움이 있다. 신뢰할 만한 만족도 측정을 위해서는 설문 문항을 서술하는 여러 가지 방법들, 측정 척도의 종류, 만족도에 영향을 미치는 혼란변수들을 주의 깊게 고려하여야 한다. 만족도는 사례관리 연구에서 흔히 측정되는 성과이지만 대부분의 관련 연구에서 사례관리의 특징이 반영된 측정 도구를 사용하지 않고 있었다. 따라서 본 논문은 다섯 개의 사례관리 만족도 측정 도구를 제시하고 그 특징을 소개하였다. 또한, 간호성과분류체계(The Nursing Outcomes Classification)에 제시된 만족도 측정항목들 중 사례관리와 관련이 높은 약 40%의 항목들을 발견하였다. 결론: 사례관리 만족도 측정 도구가 매우 부족하므로 표준 사례관리 측정도구 개발이 시급하다. 한편 사례관리사들은 만족도 측정에 대한 이해를 높이고 기존 연구 결과를 활용함으로써 보다 정확한 사례관리 만족도 평가가 이뤄지도록 노력해야 한다.

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Reliability and Validity Tests of Patient Classification System Based on Nursing Intensity (간호강도에 의한 환자분류도구의 신뢰도 및 타당도 검증)

  • Park, Jung-Ho;Kim, Eun-Hye
    • Journal of Korean Academy of Nursing Administration
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    • v.13 no.1
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    • pp.5-16
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    • 2007
  • Purpose: This study is to verify the validity and reliability of classified items and criteria of the patient classification system(PCS) based on Park's definition of nursing intensity. Methods: An expert group of 8 persons verified the content validity of the tools. The 1817 inpatients at a tertiary hospital in Seoul, Korea were classified into 4 groups according to two tools for verifying concurrent validity and interraters' reliability. These verifications were performed from September to October, 2004. Results: Nursing domains of the tools have been divided into 12 items: hygiene, nutrition, elimination, exercise & activity, education & counseling, emotional support, communication & consciousness, treatment & examination, medication, measurement & observation, coordination of multidisciplinary team, admission & discharge & transfer management. Content validity was verified by the content validity index(above 0.75 in all 12 areas). Interraters' reliability was no significant difference in the results of the patient classification between the two raters(A group 93.75%. B group 88.24%). Concurrent validity was also verified by the agreement of two tools(73.7%). Conclusion: These results showed that the reliability and validity of the PCS based on the nursing intensity were verified. These will use an data for nursing productivity in the future.

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Validation of the Developed Nutritional Screening Tool for Hospital Patients (입원환자를 위해 개발된 영양검색 도구의 타당성 검증)

  • Lee, Jeong-Sook;Cho, Mi-Ran;Lee, Geum-Ju
    • Journal of Nutrition and Health
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    • v.43 no.2
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    • pp.189-196
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    • 2010
  • Malnutrition has been associated with higher hospital costs, mortality, rates of complications and longer length of hospital stay. Several nutritional screening tools have been developed to identify patients with malnutrition risk. However, many of those require much time and labor to administer and may not be applicable to a Korean population. Therefore, the aim of this study was to develop nutritional screening tool for Korean inpatients. Then we compare nutritional screening tools that developed and previously described. Seven hundred sixty-four patients at hospital admission were screened nutritional status and classified as well nourished, malnutrition stage 1 or stage 2 by the KNNRS (Kyunghee Neo Nutrition Risk Screening), PG-SGA (Patient-Generated Subjective Global Assessment) and NRS-2002 (Nutritional Risk Screening-2002). The KNNRS, PG-SGA and NRS-2002 respectively classified 28.7%, 51.3%, 48.5% of patients as malnourished status. Compared to the PG-SGA, the KNNRS had sensitivity 60.7% (95% CI 54.2-67.0) and specificity 81.2% (95% CI 75.3-85.2). Agreement was fair between KNNRS and PG-SGA (k = 0.34). Compared to the NRS-2002, the KNNRS had sensitivity 57.8% (95% CI 53.4-60.9) and specificity 64.4% (95% CI 60.2-69.8). Agreement was poor between KNNRS and NRS-2002 (k = 0.18). These result should include that the KNNRS and PGSGA have clinical relevance and fair concordance. However the rate of malnourished patients by KNNRS were less than by PG-SGA. For more effectivity of nutritional screening and management, the criteria of KNNRS would be better revised.

A Systematic Review of the Rehabilitation Motivation Evaluation Tool for Stroke Patients (뇌졸중 환자의 재활동기 평가도구에 관한 체계적 문헌고찰)

  • Lee, Eun-Young;Park, Kang-Hyun
    • Therapeutic Science for Rehabilitation
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    • v.12 no.2
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    • pp.43-53
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    • 2023
  • Objective : In this study, the rehabilitation motivation evaluation tool for stroke patients was identified, and the characteristics of the evaluation tool were analyzed to analyze the conceptual framework and characteristics used in the composition of the evaluation contents. Methods : From 2000 to May 2022, documents registered in major domestic and foreign databases (PubMed, NDSL, Medline, and EMbase) were searched and selected according to the selection and exclusion criteria. The evaluation tools used in the selected documents were analyzed, and the characteristics of this evaluation tool were analyzed. Results : A total of 30 documents were selected, and they were classified into a total of five rehabilitation motivation evaluation tools. The most widely used in Korea was the measurement tool for rehabilitation motivation for the disabled, and the most widely used overseas was the intrinsic motivation inventory. Three evaluation tools constructed the evaluation contents based on the self-determination theory, and two constructed the evaluation contents through expert agreement. The number of evaluation items and 8 to 45 items were varied, and the evaluation scale was also used in various ways from 4 to 7 point scale. Conclusion : It was possible to identify the evaluation tools mainly used for the evaluation of rehabilitation motivation, and to identify the main conceptual framework based on the development of the rehabilitation motivation evaluation tool. The results of this study are expected to be used as basic data for research on the development of rehabilitation motivation evaluation tools for stroke patients in the future.

Estimation of the steps of cardiovascular disease by machine learning based on aptamers-based biochip data (기계학습에 의한 압타머칩 데이터 기반 심혈관 질환 단계의 예측)

  • Kim Byoung-Hee;Kim Sung-Chun;Zhang Byoung-Tak
    • Proceedings of the Korean Information Science Society Conference
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    • 2006.06a
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    • pp.85-87
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    • 2006
  • 압타머칩은 (주)제노프라에서 개발한 새로운 개념의 바이오칩으로서, 압타머(aptamer)를 이용하여 혈액중의 특정 단백질군의 상대적인 양의 변화를 측정할 수 있으며, 질병 진단에 바로 응용할 수 있는 도구이다. 본 논문에서는 압타머칩 데이터 분석을 통해 심혈관 질환 환자의 질병 진행 단계를 예측할 수 있음을 보인다. 정상, 안정/불안정성 협심증, 심근경색의 네 단계로 표지된 환자의 혈액 샘플로부터 제작한 (주)제노프라의 3K 압타머칩 데이터를, 일반 DNA 마이크로어레이 분석과 동일한 과정을 거쳐 분류한 결과, 각 단계별 환자샘플이 확연히 구분되는 것을 확인하였다. 분산분석 결과 P-Value를 이용하여 자질 선택을 수행하고, 분류 알고리즘으로는 신경망, 결정트리, SVM, 베이지안망을 적용한 결과. 각 알고리즘별로 50대 남성환자 31개의 샘플에 대하여 $77{\sim}100%$의 정확도로 심혈관 질환의 단계를 구분해내었다.

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