• Title/Summary/Keyword: 환자의 편의성

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Development of Geometrical Quality Control Real-time Analysis Program using an Electronic Portal Imaging (전자포탈영상을 이용한 기하학적 정도관리 실시간 분석 프로그램의 개발)

  • Lee, Sang-Rok;Jung, Kyung-Yong;Jang, Min-Sun;Lee, Byung-Gu;Kwon, Young-Ho
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.77-84
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    • 2012
  • Purpose: To develop a geometrical quality control real-time analysis program using an electronic portal imaging to replace film evaluation method. Materials and Methods: A geometrical quality control item was established with the Eclipse treatment planning system (Version 8.1, Varian, USA) after the Electronic Portal Imaging Device (EPID) took care of the problems occurring from the fixed substructure of the linear accelerator (CL-iX, Varian, USA). Electronic portal image (single exposure before plan) was created at the treatment room's 4DTC (Version 10.2, Varian, USA) and a beam was irradiated in accordance with each item. The gaining the entire electronic portal imaging at the Off-line review and was evaluated by a self-developed geometrical quality control real-time analysis program. As for evaluation methods, the intra-fraction error was analyzed by executing 5 times in a row under identical conditions and procedures on the same day, and in order to confirm the infer-fraction error, it was executed for 10 days under identical conditions of all procedures and was compared with the film evaluation method using an Iso-align$^{TM}$ quality control device. Measurement and analysis time was measured by sorting the time into from the device setup to data achievement and the time amount after the time until the completion of analysis and the convenience of the users and execution processes were compared. Results: The intra-fraction error values for each average 0.1, 0.2, 0.3, 0.2 mm at light-radiation field coincidence, collimator rotation axis, couch rotation axis and gantry rotation axis. By checking the infer-fraction error through 10 days of continuous quality control, the error values obtained were average 1.7, 1.4, 0.7, 1.1 mm for each item. Also, the measurement times were average 36 minutes, 15 minutes for the film evaluation method and electronic portal imaging system, and the analysis times were average 30 minutes, 22 minutes. Conclusion: When conducting a geometrical quality control using an electronic portal imaging, it was found that it is efficient as a quality control tool. It not only reduces costs through not using films, but also reduces the measurement and analysis time which enhances user convenience and can improve the execution process by leaving out film developing procedures etc. Also, images done with evaluation from the self-developed geometrical quality control real-time analysis program, data processing is capable which supports the storage of information.

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The Consideration of the Region of Interest on $^{99m}Tc$-DMSA Renal Scan in Pediatric Hydronephrosis Patients (수신증을 진단 받은 소아 환자의 DMSA 신장 검사에서 정확한 관심영역 설정에 대한 고찰)

  • NamKoong, Hyuk;Lee, Dong-Hyuk;Oh, Shin-Hyun;Cho, Seok-Won;Park, Hoon-Hee;Kim, Jung-Yul;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.1
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    • pp.27-33
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    • 2012
  • Purpose: Most of diagnosis in the pediatric hydronephrosis patients have been performed $^{99m}Tc$-DMSA renal scan. Then the region of interest (ROI) is set for comparative analysis of uptake ratio in left-right kidney after acquiring the image. But if the equipment set an automatic ROI, the ROI could include expanded renal pelvis due to hydronephrosis and the uptake ratio of left-right kidney will be incorrect result. Therefore this study compared both ROIs including expanded renal pelvis and excluding renal pelvis through experiment using normal kidney phantom and expanded renal pelvis phantom and suggested setting method of improved ROI. In addition, this study have been helped by readout doctor for investigate distinction radiopharmaceutical uptake between renal cortex and remained urine by expanded renal pelvis. Materials and Methods: The both of renal phantoms were filled with water and shacked with $^{99m}TcO_4$ 111 MBq. In order to describe the expanded renal pelvis, the five latex balloon were all filled with 10 mL water and each of balloon was mixed with $^{99m}TcO_4$ 18.5, 37, 55.5, 74, 92.5 MBq. And we made phantom with fixed $^{99m}TcO_4$activity of 37 MBq and mixed water 5, 10, 15, 20, 25 mL in each balloon. The left kidney was fixed its shape and the right kidney was modified like as hydronephrosis kidney by attached the latex balloons. And the acquiring counts were 2 million. After acquisition, we compared the image of ROI with Expanded renal pelvis and the image of ROI without renal pelvis for analyzing difference in the uptake ratio of left-right kidney and for reproducibility, set the ROI 5 times in the same images. Patients were injected $^{99m}Tc$-DMSA 1.5~1.9 MBq/kg and scanned 3 to 4 hours after injection. The each of 3 skillful radio technologists performed the comparing estimation by setting ROI. To determine statistical significance between two data, SPSS (ver. 17) Wilcoxon Signed Ranks Test was used. Results: As a result of renal phantom's experiment, we compared with average of counts Background (BKG) ratios in the setting of ROI including expanded renal pelvis and setting of excluding expanded renal pelvis. Therefore, they can obtain changed counts and changed ratios. Patient also can obtain same results. In addition, the radiopharmaceutical uptake in expanded renal pelvis was come out the remained urine that couldn't descend to ureter by the help of readout doctor. Conclusion: As above results, the case of setting ROI including expanded renal pelvis was more abnormally increasing uptake ratio than the case of setting ROI excluding expanded renal pelvis in analysis the uptake ratio in left-right kidney of hydronephrosis. Because of the work convenience and prompted analysis, the automatic ROI is generally used. But in case of the hydronephrosis study, we should set the manual ROI without expanded renal pelvis for an accurate observation of the uptake ratio of left-right kidney since the radiopharmaceutical uptake in expanded renal pelvis is the remained urine.

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Content Analysis of Nurse Images Perceived by Nursing Students (간호 대학생이 인식하는 간호사 이미지에 관한 내용 분석)

  • Park, Sun-Jung;Park, Byung-Jun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.6
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    • pp.3696-3705
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    • 2014
  • This study examined the nurse images perceived by nursing students. The study was specifically meant to determine what images grade 2 and 3 nursing students had about nurses before and after their clinical practice to define the nurse's image. The selected nursing students were interviewed to obtain their opinions on the definition and necessity of a nurse and what a great nurse should be like as well as their prejudice about nurses, and content analysis was carried out to categorize their statements. As a result, 48 significant statements and 14 categories were selected. The findings of the study might not be generalizable because the subjects in this study were selected by convenience sampling from two different nursing departments located in Gangwon Province and Gyeonggi Province. More concrete and reliable results are expected if more students from more geographic regions are investigated.

A Study on User Satisfaction and Demand Survey of Libraries in Hospitals (병원 내 도서관의 이용자 만족도 및 수요조사에 관한 연구)

  • Shin, Youngji;Noh, Younghee
    • Journal of the Korean BIBLIA Society for library and Information Science
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    • v.30 no.3
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    • pp.291-314
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    • 2019
  • In this study, to improve the satisfaction of library users in the hospital and to examine how to activate the library in the future, the satisfaction of library, facilities and environment, staff, service, We conducted a demand survey and searched for the operation plan of the library that satisfied the user. As a result, in order to revitalize the library in the hospital, first, in the case of the collection, it is necessary to expand the number of collections of various topics with the latest contents. Second, it is urgent to expand the number of library staff in the hospital. In addition, it is necessary to improve communication expertise based on medical expertise and ability to respond quickly to user requests. Third, it is necessary to expand the size of library and convenience facilities in the hospital by facilities and environment. Fourth, in case of service, it is necessary to improve service quality and provide various services. Experts should provide subject search service, medical information source service, general health information service (patient and carer) according to the user. Finally, in the case of programs, it is necessary to expand the infrastructure for program operation, to diversify the targets, and to extend the program continuity.

Effects of Integrated Palliative Care Intervention on Quality of Life in Terminal Cancer Patients: A Meta-analysis (통합적 완화 돌봄 중재가 말기암환자의 삶의 질에 미치는 효과: 메타분석)

  • Jo, Kae Hwa;Park, Ae Ran;Lee, Jin Ju
    • Journal of Hospice and Palliative Care
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    • v.18 no.2
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    • pp.136-147
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    • 2015
  • Purpose: This study was conducted to evaluate the effects of integrated palliative care intervention on quality of life in terminally ill patients. Methods: A comprehensive literature search was performed via PubMed, Cochrane Library CENTRAL, LWW (Ovid), CINAHL and several Korean databases. The main search strategy was to combine terms indicating palliative care intervention, presence of terminal illness and study design. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non-randomized studies. Data were analyzed by the Stata 10 program. Results: Eight clinical trials met the inclusion criteria with a total of 356 participants. Integrated palliative care interventions were administered for a mean of 6.5 weeks, 5.6 sessions and an average of 47.8 minutes per session. Effect sizes were heterogeneous, and subgroup analysis was done. Integrated palliative care interventions had a significant effect on quality of life (ES=1.83, P=0.018, $l^2=92%$), spiritual well-being (ES=0.78, P=0.040, $l^2=0$), depression (ES=0.86, P<0.001, $l^2=32$) and anxiety (ES=0.69, P=0.041, $l^2=71.1$). But integrated palliative care interventions had no significant effect on pain (ES=0.365, P=0.230, $l^2=69.8$). Conclusion: Results support findings that integrated palliative care interventions were helpful in lessening depression and anxiety and improving quality of life and spiritual well-being, however, the interventions did not assist pain management in terminal cancer patients. These findings suggest that various integrated palliative care interventions can assist terminal cancer patients with better quality of life in the socio-psycho-spiritual dimension.

Coronoid view: A New Radiograph for the Evaluation of the Coronoid Fractures (Coronoid view: 구상돌기 골절을 평가하는 새로운 방사선 촬영법)

  • Song, Joo-Hyoun;Lee, Joo-Yup;Yang, Sung-Cheol;Lee, Han-Yong;Kim, Jong-Ik
    • Clinics in Shoulder and Elbow
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    • v.10 no.2
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    • pp.199-203
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    • 2007
  • Purpose: It is very important to evaluate and fix coronoid process fractures because they are a critical element for a stable, effective elbow function. The lateral view of the elbow joint is used for a radiographic evaluation of the coronoid but an understanding of the fracture pattern is often difficult because of overlap of the radial head and obliquity of the fracture line. We developed the coronoid view, which is a new radiograph for an evaluation of the coronoid process fracture, and discuss its advantages for a postoperative follow-up. Materials and Methods: The coronoid view was designed for an evaluation of the anteromedial fragment of the coronoid process. After the patient sat on his side, the shoulder was abducted $45^{\circ}$ and the elbow was flexed $90^{\circ}$. The X-ray beam was shot perpendicular to the table. Since shoulder was abducted $45^{\circ}$ the fracture line of the coronoid process can be parallel to the X-ray beam, and the radial head can be cleared. Conclusion: The coronoid view can be a good alternative radiograph for an evaluation of a coronoid process fracture because the beam is parallel to the fracture line. The coronoid view can be particularly useful in postoperative patient follow-up where computed tomography is impractical due to metal implants and cost.

Meta-analysis of the effects of Lavender Aromatherapy on pain (라벤더향기요법이 통증에 미치는 효과에 대한 메타분석)

  • Park, Yang-Sook;Lee, Mi-Kyung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.5
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    • pp.300-310
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    • 2019
  • This study is a systematic review of randomized experimental and non-randomized studies on the effects of lavender scent therapy on pain and a meta-analysis to provide evidence-based data. The data included in the meta-analysis are 18 studies published from 2000 to 2018, with interventional subjects being surgical, maternal, arthritis and dialysis patients, and the types of interventions were massage, application, hot-pack, and taking medication. RESULTS: The effect size (Hedges' g) for pain was -0.16 [95% CI:-1.40: -0.72], which was statistically significant. The effect size according to intervention type was -1.36 [95% CI: -1.96, -0.77], local application -1.11 [95% CI:-1.57-0.66], inhalation -1.05 [95% CI:-1.54, -0.56 ], and massage -0.92 [95% CI:-1.62, -0.23], all of which were statistically significant. To explore the possible causes of heterogeneity ($I^2=88%$), meta-ANOVA was conducted with covariates of intervention type or study design, and the results revealed it was statistically insignificant (intervention type Q=0.25, df=3, p=.968, study design Q=0.22, df=1, p=.642).

Quality Evaluation of the Occupational Therapy Guidelines for Stroke (뇌졸중 작업치료 지침의 질 평가)

  • Lee, Eun-Young;Han, Dae-Sung;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.10 no.3
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    • pp.57-69
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    • 2021
  • Objective : The purpose of this study was to identify occupational therapy guidelines for patients with stroke according to the clinical guidelines, and to investigate the quality and characteristics of the identified guidelines. Methods : This involved a review of domestic and foreign rehabilitation treatment guidelines from 2008 to 2019. These guidelines were searched using, the search terms: 'stroke', 'guideline', 'practice guideline', 'recommendation', 'protocol compliance', 'practice guideline', and 'stroke guidelines'. Results : A total of 708 papers were identified from the search. Eight guidelines met the selection criteria and were included in this review. The selected guidelines were developed in Canada, Australia, the United States, the United Kingdom, and Korea. One of the eight guidelines was occupational therapy guidelines, and the other seven were rehabilitation guidelines. The guidelines were categorized into a total of 36 topics, including 28 guidelines for stroke rehabilitation in Australia, 24 guidelines for the British and American Heart Association, and 23 guidelines for stroke rehabilitation developed in Korea. Conclusion : In this study, the guidelines for occupational therapy for existing stroke patients were identified, and the quality and characteristics of the guidelines were compared. The results of this study will provide important basic data for the development of occupational therapy guidelines for stroke in the future.

An Analysis of the Rationale and Format of Music Intervention Studies With Patients Receiving Hospice or Palliative Care in Korea (국내 호스피스·완화의료 환자 대상 음악중재연구 내 중재 제시 방법 및 논거 분석)

  • Oh, Joo Eun
    • Journal of Music and Human Behavior
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    • v.20 no.2
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    • pp.1-32
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    • 2023
  • The purpose of this study was to analyze the rationale and format of music therapy interventions with patients receiving hospice or palliative care in Korea. Through this analysis, I examined whether the music intervention used was based on a valid rationale and represented the professionalism expected of today's music therapy interventions. A total of 12 studies that met the selection criteria were identified, and the overall characteristics of each study and its format were analyzed. As a result of the analysis, it was confirmed that the rationale for each study and its format were influenced by the author's research field. The analysis also showed that the research on music-based interventions in hospice or palliative care settings was insufficient and involved a mix of professional and nonprofessional interventions. The results of this study suggest that importance of researchers possessing professional competence which requires offering a clear justification for their choice of interventions, music, and instruments. Additionally, these results emphasize the need for further development of evidence-based music therapy approaches in hospice and palliative care settings as the role of music in supporting patients in these environments has gained increasing recognition and validation.

An Evaluation of the Accuracy of Mini-Wright Peak Flowmeters in Patients with Asthma and Chronic Obstructive Pulmonary Disease (천식 및 만성폐쇄성폐질환 환자에서 Mini-Wright Peak Flowmeter로 측정한 최대호기유속의 정확도)

  • Choi, Won-Il;Han, Seung-Beom;Jeon, Young-June
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.3
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    • pp.310-319
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    • 2001
  • Background : The peak flowmeter is very useful in monitoring of out-patients as well as those in emergency departments because of its convenience and simplicity with low cost. There have been many studies aimed at determining the accuracy and reproducibility of the peak flow meter in normal population. However, there is a paucity of reports regarding its accuracy in patients with chronic obstructive pulmonary disease(COPD) or asthma. The accuracy of the peak expiratory flow(PEF) measured with a mini-Wright peak flowmeter was assessed by a comparison with the results of a mass flow sensor. Methods : The PEF measurements were performed in 108 patients aged 19-82 years presenting with either a chronic obstructive lung disease or asthma before and after inhaling salbutamol. The PEF measurements from the mini-Wright flowmeter were compared with those obtained by the calibrated mass flow sensor. Results : The average of the readings taken by the mini-Wright meter were 37-39 l/min higher than those taken by the mass flow sensor. The average percentage error of the mini-Wright meter were higher, ranging less than 300 l/min. The mean of the differences between the values obtained using both instruments (the bias)$\pm$limits of agreement(${\pm}2$ SD) were $37.1{\pm}90\;l/min$ for the PEF(p<0.001). Conclusions : The mini-Wright peak flowmeter overestimated the flows in patients with COPD or asthma. It was also found that the accuracy of the mini-Wright peak flowmeter decreased in its mid to low range. The limits of agreement are wide and the difference between the two instruments is significant. Therefore, the measurements made between the two types of machines in patients with asthma or COPD cannot be used interchangeably.

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