• Title/Summary/Keyword: 환자중심의료

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Application of Molecular Diagnostics Technology in the Development of a Companion Diagnostics for Malignant Solid Tumors (악성 고형암의 항암제 동반진단 기술에서 분자진단기술의 적용)

  • Kim, Jin-Hee
    • The Journal of the Korea Contents Association
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    • v.19 no.3
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    • pp.365-374
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    • 2019
  • Unlike benign tumors, malignant tumors are capable of metastasis, easy to relapse, poor survival, and low quality of life. In Korea, here is a tendency to treat the tumors collectively according to the General Principles of Cancer Chemotherapy(GPCC) of the Health Insurance Review & Assessment Service (HIRA). But recently, companion diagnostics(CDx) is recommended rather than unilateral medication because biomarker-based molecular diagnostics is possible to predict the drug response of patients before drug treatment. Not only domestic but also overseas Food and Drug Administratio (FDA) recommends the development of the CDx system at the stage of drug development to ensure the responsiveness and safety of medicines. In this study, I focused on the necessity of CDx development direction as well as CDx development status through literature review. Furthermore I also discussed CDx types according to the molecular diagnostic technology such as immunohistochemistry (IHC), polymerase chain reaction (PCR), in situ hybridization (ISH), and next-generation sequencing (NGS) not only in the approved CDx but also in the developing one by US FDA. And I suggested the technology issue of CDx development process such as a selection of molecular diagnostics at the time of release, a clear understanding of the CDx mechanism, and a convergence of drug with CDx development. The necessity of social insurance system also was proposed for CDx development.

Effects of Innovativeness on Customer Satisfaction in Long-Term Care Hospitals: The Effect of Internal Capacity and Location Strategy in Hospital (요양병원의 혁신성이 고객만족도에 미치는 영향 : 내부역량과 입지전략의 매개효과)

  • KIM, Duck-Ki;KIM, Woo-Jong;KIM, Mi-Ran
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.3
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    • pp.110-124
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    • 2019
  • In recent years, over-supply of hospitals has made hospital management more difficult and hospitals have introduced innovative hospital management to enhance customer satisfaction. The purpose of this study is to investigate the effect of innovativeness of hospitals on customer satisfaction by using mediating effects of hospital capacity and location strategy. The subjects of this study were selected from 120 patients and caregivers who were hospitalized in Seoul and Metropolitan area hospitals and conducted questionnaire and statistical analysis. The results of this study are as follows: Firstly, this paper shows hospital Innovativeness does not significantly affect customer satisfaction. Unlike private companies, it is urgent to develop innovativeness measuring tools that are unique to hospitals differentiated from those of general companies. Secondly, although the impact of Innovativeness on hospital internal competency and location strategy was similar, location strategy(${\beta}=0.357$) had a greater impact on customer satisfaction than internal competency(${\beta}=0.283$). This suggests that the medical institution should take precedence over the detailed preparations based on its location marketability, traffic infrastructure, building sales and medical concentration from the time of its opening. Thirdly, this paper confirms through empirical analysis that the relationship between hospital Innovativeness and customer satisfaction is completely mediated by internal capacity and location strategy. The hospital's Innovativeness is affecting customer satisfaction by enhancing the hospital's internal competencies and inducing an active attitude toward establishing a location strategy.

Implementing an Adaptive Neuro-Fuzzy Model for Emotion Prediction Based on Heart Rate Variability(HRV) (심박변이도를 이용한 적응적 뉴로 퍼지 감정예측 모형에 관한 연구)

  • Park, Sung Soo;Lee, Kun Chang
    • Journal of Digital Convergence
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    • v.17 no.1
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    • pp.239-247
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    • 2019
  • An accurate prediction of emotion is a very important issue for the sake of patient-centered medical device development and emotion-related psychology fields. Although there have been many studies on emotion prediction, no studies have applied the heart rate variability and neuro-fuzzy approach to emotion prediction. We propose ANFEP(Adaptive Neuro Fuzzy System for Emotion Prediction) HRV. The ANFEP bases its core functions on an ANFIS(Adaptive Neuro-Fuzzy Inference System) which integrates neural networks with fuzzy systems as a vehicle for training predictive models. To prove the proposed model, 50 participants were invited to join the experiment and Heart rate variability was obtained and used to input the ANFEP model. The ANFEP model with STDRR and RMSSD as inputs and two membership functions per input variable showed the best results. The result out of applying the ANFEP to the HRV metrics proved to be significantly robust when compared with benchmarking methods like linear regression, support vector regression, neural network, and random forest. The results show that reliable prediction of emotion is possible with less input and it is necessary to develop a more accurate and reliable emotion recognition system.

An Analysis of the Trends of Aromatherapy Researches in Chinese Literatures

  • Sun, Jiao-Jing;Kim, Kyeong-Ran
    • Journal of the Korea Society of Computer and Information
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    • v.26 no.1
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    • pp.239-251
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    • 2021
  • Traditional Chinese medicine has treated diseases and improved health in nature-based experience. Advanced nations began to be interested in naturopathic therapy in the late 19th century and it led China to research aromatherapy. This study searched previous researches related with aromatherapy and generally analyzed aroma oil, applied body parts, methods of use, and period of use. For research contents, scientific and society journals from 2000 to 2019 related with aromatherapy were searched in CNKI(www.cnki.com) and WANFANG DATE(www.wanfang.com). Finally, 30 papers were selected through 5-step qualitative evaluation and expert review and analyzed. Frequency and percentage(%) were calculated by means of the Excel 2013 Program and represented by a chart. The results of analyzing aromatherapy trends are as follows. All 30 papers were researched in the medical society. The most common symptom was irritation and anxiety that appeared in 13 papers. Lavender oil and bergamot oil were commonly used aroma oil. Commonly applied part and method were nose and nasal inhalation. For aroma oil associated with symptoms, lavender oil was the best in irritative, anxious, and negative emotion, depression, labor pain, sleep disorder, migraine, tension, and vomiting, pain, and fatigue after operation. Lemon, ginger, and peppermint oil was good for nausea. Based on the findings, this study derived applied body parts, methods of use, and period of use in aromatherapy. However, most aromatherapy was used for patients in the nursing and medical fields in the simple form of inhalation and local massage. This study will suggest a standard ground that aromatherapy is good for pain, colic pain, and tension in a short period but needs a long period for the efficacy of psychological and neurological symptoms.

A Case Report of a Disorientation and Dizziness with Acute Anterior Circulation Region Cerebral Infraction Improved by Korean Medical Treatment: Focusing on Sunghyuangjunggi-san-gamibang (Xingxiang zhengqi san) (성향정기산가미방을 중심으로 한 한의약 치료를 통해 단기간에 호전을 보인 전순환계 뇌경색 후 발생한 지남력장애 및 현훈을 주소로 한 환자 1례에 대한 보고)

  • Chu, Hongmin;Kim, Kwang-ho;Lee, Young-ung;Lim, Hyeon-seo;Shin, Hee-Ra;Yang, Mu-hack;Kang, Gun-hui;Park, Chanjong;Kim, Cheol-hyun;Sung, Kang-keyng;Lee, Sang-kwan
    • The Journal of Internal Korean Medicine
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    • v.41 no.6
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    • pp.1245-1254
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    • 2020
  • Introduction: The aim of this study was to report the effect of Korean medicine treatments on a stroke patient with acute cerebral infarction. Method: A 63-year-old male with anterior and middle cerebral artery infarction had symptoms of dizziness and disorientation. The patient was treated with Korean medicine therapy, including the herbal medicine "Sunghyuangjunggi-san-gamibang." Treatment progress was assessed using the Korean version of the Modified Barthel Index (K-MBI) and the Korean dizziness handicap inventory (K-DHI). Results: After 14 days of treatment, the K-DHI score decreased from 78 to 7 and the K-MBI score increased from 18 to 24. The patient's main symptoms were improved after the treatment, and no side effects were observed. Conclusion: Korean medicine treatment, including Sunghyuangjunggi-san, might be a recommended therapeutic option for dizziness and disorientation in stroke patients.

Analysis of the Use of Insured Herbal Extracts and Korean Medicinal Treatments in Patients with Allergic Rhinitis : Data from Health Insurance Review and Assessment Service (알레르기 비염 환자의 보험 한약 제제 및 한의 처치 이용 현황 : 건강보험심사평가원 자료 분석)

  • Kim, Jeong-Hun;Ryu, Ji-In;Kang, Chae-Yeong;Hwang, Jin-Seub;Lee, Dong-Hyo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.34 no.2
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    • pp.38-52
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    • 2021
  • Objectives : The purpose of this study is to analyze the use of insured herbal extracts and Korean medicinal treatments, which are mainly used to treat allergic rhinitis in Korean medicine. Methods : Among all HIRA(Health Insurance Review and Assessment Service) claims data in 2016, we included all statements that included J30(vasomotor and allergic rhinitis) or a subcategory of J30(J30.0, J30.1, J30.2, J30.3, or J30.4) as the main disease, using the Korean Standard Classification of Diseases(KCD-7). This study analyzed the most frequently used insured herbal extracts and Korean medicinal treatments for allergic rhinitis in Korean medicine. We performed a frequency analysis on subgroups based on treatment type(inpatient or outpatient), sex, age, insurance type, and medical institution type. Results : The result shows the 10 most frequently used insured herbal extracts and Korean medicinal treatments for allergic rhinitis. The total number of insured herbal extracts prescriptions was 82,533, and the most commonly prescribed insured herbal extracts was socheongryong-tang(35,131 prescriptions), followed by hyeonggaeyeongyo-tang(18,157 prescriptions), samsoeum(6,257 prescriptions), and galgeun-tang(4,465 prescriptions). The total number of Korean medicinal treatments prescriptions was 1,878,541, of which the most common Korean medicinal treatments was acupuncture(922,977 prescriptions), followed by moxibustion(372,120 prescriptions), cupping(242,094 prescriptions), and segmental acupuncture(161,553 prescriptions). Conclusions : It is expected that the results of this study can be used as a basis for establishing the priorities of evidence-based clinical research topics in the field of Korean medicine and making health care policy decisions to strengthen coverage in the future.

Family Members' Caregiving Experience for Middle-aged and Elderly Breast Cancer Survivors at Early Stages (중·고령 초기 유방암 생존자를 돌보는 가족의 경험)

  • Park, So-Young;Park, Hyangkyung;Koo, Hyang Na;Baek, Jung Yun;Noh, Eunjeong
    • 한국노년학
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    • v.40 no.1
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    • pp.111-130
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    • 2020
  • This qualitative study aims to understand family members' caregiving experience for middle-aged and elderly breast cancer survivors at early stages. A total of four families of breast cancer survivors were given focus group interviews(FGI), and an additional family was interviewed individually. The thematic analyses of the FGI and individual in-depth interview discussions revealed the following four themes: first, day-to-day feelings like walking on thin ice (entangled emotions with each treatment stage, regret of watching a survivor's pain, fear of recurrence and death, concerns of changes in family relationships, and various feelings experienced as a daughter), second, caregiving has become a mainstay in my life (unfamiliar and unskilled care, losing my life), third, beginning to recover and different experiences between a survivor and a family caregiver (not understanding a survivor's pain from the abyss, forgetting that the survivor is still a cancer patient and that treating him or her casually), and fourth, moving forward (hope that things will be better, taking care of myself to prevent exhaustion). Based on the results of this study, we proposed social welfare services and policy measures to reflect the psychosocial needs of family caregivers of breast cancer survivors and support family caregivers during the care process.

Factors Influencing the Quality of Life (EQ-5D) of Patients with Diabetes Mellitus: Study Based on Data from the Second Annual Korea Health Panel survey (2019) (당뇨병 환자의 삶의 질(EQ-5D)에 미치는 영향 요인 : 2019년도 제2기 한국 의료패널 조사를 중심으로)

  • So-Hyun Kim;Sung-Hyoun Cho
    • Journal of The Korean Society of Integrative Medicine
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    • v.11 no.3
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    • pp.99-114
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    • 2023
  • Purpose : The purpose of this study was to determine factors that affect the quality of life (QoL) of people with diabetes. We hope to provide a basis for intervention strategies for health promotion and related research among patients with diabetes in the field of physical therapy. Methods : We selected individuals diagnosed with diabetes who were aged 19 years or higher by using data from the 2019 Korean Health Panel survey and analyzed the results of 1,527 people. The influencing factors were sex, age, household income, marital status, age, education level, subjective health status, body mass index (BMI), smoking, drinking, regular exercise, experience of depression and anxiety, suicidal thoughts, stress, and frequency of walking (days/week). Frequency analysis, descriptive statistics, independent sample t-test, one-way analysis of variance, and multiple regression analysis were performed. Results : The EQ-5D score for QoL was .87 ± .12, with pain and discomfort being the most detrimental to the QoL of people with diabetes. In terms of patients characteristics, the QoL was lower among participants who were female, older, and separated/widowed/divorced; had an education level below middle school; had a poor subjective health status; were non-smokers and drinkers; and did not walk and exercise regularly, experienced a lot of stress, and experienced depression and anxiety; and had suicidal thoughts (p<.001). Being separated/bereaved/divorced; experiencing a lot of stress, depression, and anxiety; and having suicidal thoughts were negatively associated with QoL in people with diabetes (p<.01). On the other hand, age of 65 years or younger; graduation from high school, fair or better subjective health, regular exercise and alcohol consumption, and walking (days/week) were positively associated with QoL (p<.05). Conclusion : Regarding the QoL of patients with diabetes, intervention strategies should be formulated by considering general characteristics and disease-related characteristics. Among the various factors affecting QoL, the number of walking and regular exercise were found to be the factors that improved the QoL of patients with diabetes. These results can be used as a basis for the education and management of patients with diabetes in the field of physical therapy.

A Systematic Review on Intervention of Interactive Metronome: Focus on Single-Subject Research Design in Korean Academic Journals (상호작용식 메트로놈(Interactive Metronome)의 중재에 대한 체계적 고찰: 국내 단일대상연구를 중심으로)

  • Son, Yeong Soo;Choi, Yoo Im
    • Therapeutic Science for Rehabilitation
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    • v.12 no.1
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    • pp.7-22
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    • 2023
  • Objective : This study aimed to confirm the research characteristics and quality of single-subject literature among domestic studies that applied interactive metronome (IM) intervention. Methods : Regarding literature search, 11 single-subject studies using IM were selected from an online database from January 2011 to June 2022. Moreover, the general characteristics and quality of the research method were analyzed. Results : The qualitative level of the analyzed literature was above the moderate level. However, intervention blindness and reliability showed low compliance. The ABA design accounted for the largest proportion of methods. Most of the study participants had attention deficit hyperactivity disorder. Attention, balance, bilateral coordination, and timing were checked as dependent variables. The IM-SFT was used most frequently as an evaluation method. The mediation session applied more than 8-10 interventions for 3-11 weeks. The intervention results in all studies indicated functional improvement after intervention. Conclusion : It might be necessary to expand the application of IM interventions to diverse diseases. In addition, there is a need to study the effect on the participants' quality of life and changes in daily life along with dependent variables such as attention and balance

Application Feasibility Study of Non-local Means Algorithm in a Miniaturized Vein Near-infrared Imaging System (정맥 관찰용 소형 근적외선 영상 시스템에서의 비지역적평균 알고리즘 적용 가능성 연구)

  • Hyun-Woo Jeong;Youngjin Lee
    • Journal of the Korean Society of Radiology
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    • v.17 no.5
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    • pp.679-684
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    • 2023
  • Venous puncture is widely used to obtain blood samples for pathological examination. Because the invasive venipuncture method using a needle is repeatedly performed, the pain suffered by the patient increases, so our research team pre-developed a miniaturized near-infrared (NIR) imaging system in advance. To improve the image quality of the acquired NIR images, this study aims to model the non-local means (NLM) algorithm, which is well known to be efficient in noise reduction, and analyze its applicability in the system. The developed NIR imaging system is based on the principle that infrared rays pass through dichroic and long-pass filters and are detected by a CMOS sensor module. The proposed NLM algorithm is modeled based on the principle of replacing the pixel from which noise is to be removed with a value that reflects the distances between surrounding pixels. After acquiring an NIR image with a central wavelength of 850 nm, the NLM algorithm was applied to segment the final vein area through histogram equalization. As a result, the coefficient of variation of the NIR image of the vein using the NLM algorithm was 0.247 on average, which was an excellent result compared to conventional filtering methods. In addition, the dice similarity coefficient value of the NLM algorithm was improved by 62.91 and 9.40%, respectively, compared to the median filter and total variation methods. In conclusion, we demonstrated that the NLM algorithm can acquire accurate segmentation of veins acquired with a NIR imaging system.