• Title/Summary/Keyword: 환자 평가

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The Importance of Video Fluoroscopy Swallowing Study for Nasogastric Tube Removal of Rehabilitation Patient (재활치료환자의 비위관(nasogastric tube)제거에 따른 비디오투시연하검사(VFSS)의 중요성 평가)

  • Jung, Myo-Young;Choi, Nam-Gil;Han, Jae-Bok
    • Proceedings of the Korea Contents Association Conference
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    • 2014.11a
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    • pp.189-190
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    • 2014
  • 뇌경색, 뇌 신경장애 및 뇌졸중환자 중 급성기 환자는 의식이 없어 연하기능장애로 인한 흡인성 폐렴을 유발하기 때문에 비위관(nasogastric tube)을 삽입하고 영양공급을 한다. 재활훈련 후 회복기에 침상선별검사를 시행하지만 임상적 검사를 통해서는 무증상흡인은 발견할 수 없다. 그래서 연하장애로 비위관을 삽입한 연하재활치료 중인 환자 10명을 대상으로 VFSS를 시행하여 식이재료에 따른 삼킴 정도, 자세에 따른 삼킴을 재활의학과전문의가 평가 후, 흡인이 있거나 삼킴 곤란 등이 있으면 연하재활치료를 시행하여 환자의 상태에 따라 약 30일 ~ 50일후에 재평가를 시행한 후 흡인이 없을 시 비위관을 제거 하였다. 이때 VFSS 영상을 기능적 연하곤란척도를 이용, 분석하여 부여된 점수를 통계 산출 하였는데 비위관 유지군은 $49.79{\pm}9.431$을 보여 흡인의 위험을 나타내며, 비위관 제거군은 $11.20{\pm}1.932$로 흡인의 위험성이 낮아 비위관 제거관련 의미 있게 낮은 점수를 보였다. 두 군의 유의성을 평가하기 위해 Mann-Whitney test를 시행한 결과 p<0.001로 통계적으로 유의하다고 평가하였다. 결론적으로 VFSS는 구강, 인두, 식도의 구조적 이상과 움직임을 가장 효과적으로 평가, 기도흡인여부를 즉시 확인 및 환자에게 적합한 식이나 연하자세를 결정할 수 있어 비위관 제거를 위한 연하평가에 가장 확실한 표준검사로 제안할 수 있다.

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An Integrative Review of the 'QUality Of care Through patient's Eyes' (환자의 눈을 통한 간호의 질(QUOTE) 평가의 통합적 고찰)

  • Oh, Jina;Kim, Yae Young;Kim, Hyun-Kyoung;Park, Hyun-Jung;Cho, Haeryun
    • Child Health Nursing Research
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    • v.20 no.4
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    • pp.283-293
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    • 2014
  • Purpose: The patient's perspective in the assessment of quality of care has become increasingly important. The purpose of this paper was to introduce the concept of 'QUality Of care Through patient's Eyes (QUOTE)', to analyze the papers using QUOTE through an integrative review method, and to present the attributes of the QUOTE evaluation. Methods: Data were collected from electronic databases. Inclusion criteria were publication in English from 1997 to 2013, as a peer-reviewed research article, with an empirical study focused on QUOTE. Thirty two papers met the criteria and were analyzed. Results: QUOTE had been applied to various groups of patients such as those with various diseases since 1997 in the Netherlands. Four themes were retrieved from synthetic analysis of the thirty-two papers using QUOTE; 1) acceptance of individuation of the patient and family, 2) evaluation of diverse nurses' competencies, 3) evaluation of quality of nursing environments, and 4) participation of patient in the whole process of evaluation. Conclusion: The strengths of QUOTE are that it attempts to overcome the conceptual and methodological problems associated with evaluation of quality of care. Our results imply that QUOTE evaluation could be an effective strategy to improve care of patients in clinical setting.

Comparison between denture wearer's evaluation and clinician's rating for complete denture (총의치 사용에 대한 환자와 술자간 평가 비교)

  • Byun, Jin-Soo;Huh, Yoon-Hyuk;Cho, Lee-La;Park, Chan-Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.4
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    • pp.364-369
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    • 2016
  • Purpose: The aim of this study was to compare denture wearer's evaluation and clinician's technical rating for complete denture used on edentulous patients. Materials and methods: Total 43 edentulous patients who had complete denture fabricated more than one year ago were recalled. The questionnaire based on the various literatures was modified and applied to patients for subjective assessments. Functional aspects related to retention, stability, occlusion and denture condition were included in operator's evaluation. In addition, correlations were evaluated between patient's subjective and operator's objective assessments. Friedman test and Cohen's Kappa value were used for statistical analysis. Results: It was found that denture wearers' evaluations were slightly or fairly agree to clinician's rating for complete denture. More differences were found in maxillary denture than mandibular denture and moderate difference was found in esthetic, occlusion aspects. Conclusion: There were slightly or fairly agreement between subjective and objective evaluations.

Preliminary Study on Developing Test Items of Swallowing & Communication Screening Protocols for Patients with Head and Neck Burns (안면부 및 경부 화상 환자의 삼킴 및 의사소통능력 선별 프로토콜 개발을 위한 예비 연구)

  • Kim, JungWan;Lee, HyoJin;Lee, Hyun-Joung
    • 재활복지
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    • v.21 no.2
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    • pp.217-231
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    • 2017
  • We have to consider two parts of the evaluation and treatment for the patients with head and neck burns. The primary consideration is swallowing function for nutrition supply for them and the next is speech function for efficient communication and aesthetic impression of them. The purpose of this study is to summarize the preliminary questions of Communication Screening Protocols which can help understand comprehensively on swallowing disorder, motor speech disorder and voice disorder of patients with head and neck burns. We divided the evaluation into 4 evaluation areas including 'oral mechanism', 'respiration/voice', 'articulation', and 'swallowing' by referring to overseas studies dealing with various communication disorders caused by burns, and prepared the final questionnaires by conducting the content validity verification by five expert (speech & language pathologist). The range of Content Validity Index was shown relatively appropriate with .50~.84. There was a conflict of opinions in experts whether the items in the areas of respiration/voice and swallowing may be appropriate, whereas there was no different view of the oral mechanism and articulation area. Through the different characteristics of communication difficulties of patients with head and neck burns, we expect it will be modified appropriately according to the patients through evaluation of burn patients by type and severity.

Evaluation of Quality of Life in Patient with Temporomandibular Disorders (측두하악관절장애를 가진 환자에서의 삶의 질의 평가)

  • Jung, Jin-Suk;Hur, Yun-Kyung;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.31 no.2
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    • pp.127-139
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    • 2006
  • Objectives: To explore the quality of life in patients with temporomandibular disorders and to evaluate it in terms of source and duration of the pain. Methods: A total of 61 patients with temporomandibular disorders participated in this study. According to pain source, they were divided into 2 groups, masticatory muscle pain (MMP) group and intracapsular pain (ICP) group. And each group was divided into acute phase group (pain duration <6 months) and chronic phase group (pain duration=6 months). The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) was used to measure patients' quality of life. The scores for eight-scale profile and the physical component summary (PCS) and mental component summary (MCS) of the SF-36 were compared between groups (MMP vs. ICP and acute vs. chronic). Student t-test was used to analyze the difference of the scores of the SF-36 between MMP and ICP groups. Results: MMP group showed significantly lower score in the 3 scales of the SF-36 (Role limitations due to emotional problems, Vitality, Bodily pain) when compared to ICP group. In acute phase there was no significant difference between MMP and ICP group in PCS as well as MCS scores, but in chronic phase MMP group showed significantly lower MCS score than ICP group. Conclusions: The masticatory muscle pain in patients with temporomandibular disorders,negatively influences the quality of life especially in chronic phase, and the mental components of quality of life are significantly interfered in the TMD patients with chronic masticatory muscle pain.

The Role of Bone Scans in Routine Preoperative Evaluations of Non-Small Cell Lung Cancer Patients. (비소세포 폐암의 병기에 있어 통상적인 골 스캔의 역할)

  • 김영태;홍장미;이재익;이정상;성숙환;김주현
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.659-663
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    • 2002
  • The objective of this study was to assess the usefulness of bone scans in routine preoperative examinations of patients with newly diagnosed non-small cell lung carcinoma. Material and Method: We reviewed the medical records of 258 patients who were newly diagnosed with non-small cell lung cancer in our hospital between January 2000 and December 2000. More than half of the patients (132) were deemed to be inoperable due to their advanced stage based on the CT scans. The remaining 126 patients were considered potentially operable. For these patients, clinical evaluation including the presence of bone pain, serum alkaline phosphatase, and calcium levels was used as clinical predictors of bone metastasis. All patients received bone scans. Bone X-rays, MRI or bone biopsy were performed to confirm the presence of bone metastasis. The usefulness of the bone scan was evaluated by comparing its power of predicting bone metastasis to that of the clinical information. Result: In all patients, the positive and negative predictive values of bone scans for the bone metastasis were 44%, and 99%, respectively. Those of the clinical information were 38% , and 94%. However, in potentially operable patients, the negative predictive value of the clinical information was as high as 99%. Conclusion: If newly diagnosed non-small cell lung cancer patients are presented as potentially operable on the basis of CT scan with no clinical evidence of distant metastases, curative resection could be considered without performing routine bone scans because of the low probability of bone metastasis. However, if there are positive clinical findings, further evaluations, including bone scan should be followed as metastasis will be documented in more than 30% of patients.

A Research of Prehospital 119 Emergency Medical Service for Stroke Patients (병원 전 뇌졸중 환자의 구급의료 실태 분석)

  • Song, Hyun-Mok;Roh, Sang-Gyun
    • Fire Science and Engineering
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    • v.26 no.3
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    • pp.14-20
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    • 2012
  • This study analyzes the influencing factors of prehospital 119 Emergency Medical Service for Stroke Patients in prehospital. From July, 2010 to June, 2011, 123 patients were diagnosed with Stroke in Emergency Medical Center. Among 123 patients, the prehospital assessment rates were as follows : blood pressure checked 73.2 %, pulse checked 73.2 %, respiratory checked 64.2 %, $SpO_2$ checked 79.7 %, pupil reflex test 88.6 %, Electrocardiogram checked 14.6 %, blood sugar checked 19.5 %. Prehospital emergency medical care, Oropharyngeal airway insertion 2.4 %, Manual airway maneuvers 17.1 %, endotracheal intubation 2.7 %, oxygen supply 35.4 %, and suction and intravenous fluid therapy 0 %. The property of mental status evaluation by 119 Emergency Medical Service was nearly perfect, but the patients assessment and emergency medical care were not.

Measurement of Ambulatory Patients' Satisfaction and Its Influencing Factors in a Tertiary Hospital (병원 외래 방문 환자의 만족도 평가 및 관련 요인에 대한 연구 - 한 3차 병원 방문 환자를 중심으로 -)

  • Lee, Sang-Il
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.2 s.46
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    • pp.366-376
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    • 1994
  • Patients' evaluation of hospital care is one of the most important aspects of quality assessment. Survey allows patients to judge sujectively the events that occur during their hospital visit if performed properly. This study describes the result of a research effort to develop outpatient questionnaire that has sufficient validity and reliability to be used to measure patients' perception of satisfaction in Korea and to investigate influencing factors on patients' satisfaction. Self-administered questionnaire was developed for outpatient and the survey was conducted covering 827 outpatients in a tertiary hospital. It was confirmed by factor analysis that patients evaluate several components of ambulatory care distinctly ; hospital environment, administration and ancillary services, and medical care. We found strong evidence of construct validity and internal consistency for the above three dimensions of hospital process. On the contrary, reliability of overall outcome measures was low. It suggests that three items concerning overall outcome measures have some different meanings in patients' perception. Using logistic regression analysis it was found that previous health status, cost evaluation, and improvement in health status have significant influences on the level of patients' overall satisfaction and that patient's sex, experience of previous visit, expectation for improvement, cost evaluation, and improvement in health status are strongly related with intention to recommend hospital. In spite of some limitations the results of this study can be used helpfully as baseline informations for developing self-administered questionnaire and for exploring the influencing factors on patients' satisfaction. Further comprehensive research efforts should be made on the measurement of ambulatory patients' satisfaction and its related factors in current Korean situation.

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Development of quantification software for assessing thyroid nodule in ultrasound images and its clinical application in benign nodules (갑상선 초음파 의료영상을 이용한 정량분석 소프트웨어 개발과 양성 결절 환자에서의 임상 적용)

  • Ryu, Young Jae;Hur, Young Hoe;Kwon, Seong Young;Chae, Il-Seok;Kim, Min Jung;Kim, Tae-Hoon
    • Proceedings of the Korea Information Processing Society Conference
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    • 2021.11a
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    • pp.443-445
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    • 2021
  • 갑상선 결절(thyroid nodule)은 검진 인구에서 빈번하게 진단되는 질환이지만 현재까지 진단방법은 경험적이며 정성적 판단에 의존하고 있는 실정이다. 본 연구는 갑상선 결절을 평가하기 위하여 시행한 초음파 의료영상을 이용하여 정량 분석할 수 있는 소프트웨어를 개발하였으며 갑상선 양성 결절환자에서의 임상활용 가능성을 평가하고자 한다. 임상 연구는 총 13명의 갑상선 양성 결절 환자를 대상으로 하였다. 환자별 갑상선 초음파영상을 이용하여 정상부위와 병변부위에서 정량 지표인 변동계수를 각각 측정하였다. 환자별 정상부위와 병변부위의 변동계수 차이는 대응표본 T 검정을 사용하여 비교하였으며 유의한 차이를 확인할 수 있었다. 본 연구를 통하여 개발한 정량분석 소프트웨어를 실제 갑상선 양성 결절 환자에서 갑상선 결절을 분석·평가하는데 활용할 수 있을 것으로 판단된다.

Postural Control During Virtual Moving Surround Stimulation in Patients with Brain Injury (뇌기능 장애 환자의 가상 환경 움직임(Virtual Moving Surround) 자극에 따른 자세 균형 제어)

  • 김연희;최종덕;이성범;김종윤;이석준;박찬희;김남균
    • Science of Emotion and Sensibility
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    • v.5 no.4
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    • pp.67-75
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    • 2002
  • The purpose of this study is to assess the ability of balance control in virtual moving surround stimulation using head mount display (HMD) device and force platform in patients with brain injury. Fifteen patients with stroke (mean age 54.47 yrs) and fifteen healthy normal persons participated. COP parameters were obtained total path distance, frequency of anterior-posterior and medial-lateral component by FFT analysis, weight-spectrum analysis in the two different conditions; (1) during comfortable standing with opened or closed eyes, (2) during virtual moving surround stimulation delivered using HMD with four different moving pattern. Moving patterns consisted of close-far, superior-inferior lilting (pitch) , right-left tilting (roll) and horizontal rotation (yaw) movement. In all parameters, the test-retest reliability was high. Also, the construct validity of virtual moving surround stimulation was excellent (p<0.05). A posturographic balance assessment system equiped with virtual moving surround stimulation using HMD is considered clinically useful in evaluation of balance control in patients with brain injury.

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