• 산업융합연구
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• 제18권5호
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• pp.42-53
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• 2020

본 연구는 국내 노인을 대상으로 가상현실 프로그램 중재가 균형에 미치는 효과를 알아보기 위한 체계적 고찰 연구로, 가상현실 프로그램에 대한 근거자료를 제공하고자 하였다. 2005년 1월부터 2020년 5월까지 출판된 문헌을 대상으로 데이터베이스 누리미디어(DBpia), 학술교육원(earticle), 한국학술정보(KISS), 국가과학기술정보센터(NDSL), 한국교육학술정보원(RISS), 교보문고스콜라, 학지사뉴논문을 통해 총 94편의 논문이 검색되었고, PRISMA flow chart를 사용한 문헌선정과정을 바탕으로 최종 6편의 문헌이 분석에 사용되었다. 문헌의 질적수준은 근거수준 I이 3편(50.0%), II가 1편(16.7%), III이 2편(33.3%)으로 나타났고, 가상현실 프로그램 종류는 wii fit 밸런스가 4편(66.7%)으로 가장 많았으며, 균형능력 및 보행능력에 대한 평가도구를 통해 가상현실 프로그램 중재의 효과는 전반적으로 유의미하게 나타났다. 이는 일반 노인을 대상으로 가상현실 프로그램을 효과적으로 적용할 수 있을 것으로 기대하며 임상적 적용 근거를 제공하였으며, 앞으로 다양한 가상현실 프로그램 중재를 적용한 연구가 많이 다루어져야 할 필요가 있다.

• 성인간호학회지
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• 제18권1호
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• pp.81-91
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• 2006

Purpose: The purpose of this study was to investigate foot ulcer risk factors, foot care knowledge, and foot care practice in patients with type 2 diabetes. Method: One hundred fifty type 2 diabetic patients were in and out-patients in a large urban hospital. The data were collected using a self-report questionnaire, chart review and foot examination. The questionnaires were developed by the researchers through the experts consultation and literature review. High risk for foot ulcer was evaluated by peripheral neuropathy(PN), peripheral vascular disease(PVD), and prior foot ulcer. Foot risk scores(FRS) means numbers of present risk factors. Results: 31.3% of subjects show 1 FRS, and 13.3% showed 2 FRS. Mean foot care frequency was 3.5 times per week. There were significant differences in foot care knowledge according to DM education (t=2.96, p=.004) and foot care education (t=3.65, p=.001). There were significant differences in the foot care practice activities according to duration of DM (t=3.48, p=.010) and educational levels. Conclusion: There were high proportion of foot ulcer risk among the patients. It is necessary to screen high risk foot ulcer patients and provide practical education for foot care practice of diabetic patients.

• 성인간호학회지
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• 제18권4호
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• pp.533-542
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• 2006

Purpose: The purposes of this study were to investigate medical records and to develop care records for management of patients with chest pain in the emergency department. Method: Retrospective review of the 42 medical chart of patients presented to the emergency department with chest pain were used. The collected data were analyzed with a frequency of items in the medical records. Results: In a frequency analysis of recorded items for doctors' chest pain assessment during history taking, the history/risk factors was the highest rank. The following ranks were 'commenced with when/timing, extra symptoms, place, nature, stay/radiate, alleviate/aggravate, intensity' in sequence. In a frequency of recorded items in nurse's progress notes according to nursing actions, the 'checking/monitoring' was the highest rank. The following ranks were 'performing, administering/injecting, referring/arranging, testing, preparing/catheterizing, teaching/informing' in sequence. Chest pain care records for the emergency department was designed, based upon data analysis and literature review. Conclusion: The designed records can be a rapid and effective approach tool for assessment and recording of patients with chest pain. Further research is necessary for evaluating the designed chest pain care records.

• 대한안전경영과학회지
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• 제15권2호
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• pp.243-253
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• 2013

This research paper introduces the application and implementation of medical decision metrics that classifies medical decision-making into four different metrics using statistical diagnostic tools, such as confusion matrix, normal distribution, Bayesian prediction and Receiver Operating Curve(ROC). In this study, the metrics are developed based on cross-section study, cohort study and case-control study done by systematic literature review and reformulated the structure of type I error, type II error, confidence level and power of detection. The study proposed implementation strategies for 10 quality improvement activities via 14 medical decision metrics which consider specificity and sensitivity in terms of ${\alpha}$ and ${\beta}$. Examples of ROC implication are depicted in this paper with a useful guidelines to implement a continuous quality improvement, not only in a variable acceptance sampling in Quality Control(QC) but also in a supplier grading score chart in Supplier Chain Management(SCM) quality. This research paper is the first to apply and implement medical decision-making tools as quality improvement activities. These proposed models will help quality practitioners to enhance the process and product quality level.

• 대한한의학회지
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• 제39권4호
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• pp.16-29
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• 2018

Introduction: We aimed to investigate the predictive factors and optimal age for response to herbal medicine treatment for height gain in children. Methods: This retrospective chart review included 61 children (age range, 5-16 years) treated for height gain between 2011 and 2015. A predictive model was established by multiple linear regression analysis. Dependent variables were defined by the differences in percentile before and after herbal medicine treatment. The optimal cutoff value of patient age was determined by receiver operating curve analysis. Results : The age of initiation of herbal medicine therapy (p = 0.012) and administration of Forsythiae fructus (p = 0.002) were significant variables for treatment response. The adjusted R2 value was 0.231. The mean ages of the responder and non-responder groups were significantly different (p = 0.023). The optimal cutoff value of age for predicting treatment response was 9.75 years. Treatment response was better among children below 9.75 years of age. Conclusions: Patient age and administration of Forsythiae fructus were identified as determinants of response to herbal medicine treatment. Treatment of rhinitis and initiation of height gain treatment at an early age are critical for better response. These findings will provide fundamental data for further research.

• 한국의료질향상학회지
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• 제2권2호
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• pp.32-45
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• 1996

Background : A critical path defines an optimal sequencing and timing of interventions by physicians, nurses, and other staff for a particular diagnosis or procedure, designed to better utilize resources, maximize quality of care, and minimize delays. It can be thought of as a visualization of the patient care process. In this study, a review of appendectomy patient records was undertaken to identify a critical path for the management of this treatment. Methods: For this study, records of patients under 15 or over 65 years of age were excluded ; cases where the patient was pregnant, or where complications developed were also excluded. The remaining 21 cases were divided into two categories according to the indication for appendectomy : for acute appendicitis, and for perforated appendix or drainage of periappendical abscess. The time frame for the review was from patient examination immediately prior to operation, through discharge. The study team was composed of a surgeon, research head nurse, education head nurse, surgical part head nurse, and medical recorder. Following their review of the 21 charts, the team determined an appropriate progression and schedule for an appendectomy. Result : Through the chart and literature review, the following aspects of the care process were identified as typical and tracked : monitoring/assessment, treatment, lines/drains, medication, activity, diet, tests and patient education. Conclusion : From this study, the design team determined two separate critical paths : one for appendectomy only, and one for appendectomy plus drainage. Next, these paths must be validated and fine-tuned through clinical implementation. In addition, a comparison of our design with the critical paths determined at other hospitals would be extremely valuable for advancing research in this area. Lastly, the critical path approach to improving patient care and maximizing hospital resources should be applied to other procedures.

• 중환자간호학회지
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• 제13권1호
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• pp.44-62
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• 2020

Purpose : The purpose of this study was to systematically review the measurement tools that are used to assess the pain of intensive care unit (ICU) patients. Method : In this systematic review, the studies published between 2009 and 2018 were selected based on the PRISMA flow chart. Data sources included MEDLINE, EMBASE, CINAHL, and Cochran. We assessed the quality of pain assessment tools reported in individual studies using Terwee et al.'s the Quality Criteria for Measurement Properties. Results : We reviewed 67 studies and 12 pain assessment tools that included two self-reported, seven observational, and three multifaced tools with observations and physiological indicators. The most frequently used tool was the Critical Care Pain Observation Tool. The Multidimensional Observational Pain Assessment Tool was rated the highest quality. Nine of the ten tools that included observations reported content validity, four reported construct validity and nine reported correlation coefficient. Conclusion : It was found that observational tools are appropriate for assessing pain in ICU patients with limited communication skills. To increase the validity and reliability of pain assessment in ICU patients, further research on the physiological indicators of pain is needed.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제20권1호
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• pp.34-40
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• 2017

Purpose: This study was performed to review the outcomes of gastrostomy insertion in children at our institute during 10 years. Methods: A retrospective chart review was performed on 236 patients who underwent gastrostomy insertion from October 2005 to March 2015. We used our algorithm to select the least invasive method for gastrostomy insertion for each patient. Long-term follow-up was performed to analyze complications related to the method of gastrostomy insertion. Results: Out of 236 patients, 120 underwent endoscopic gastrostomy, 79 had laparoscopic gastrostomy, and 37 had open gastrostomy procedures. The total major complication rates for endoscopic gastrostomy insertion, laparoscopic gastrostomy insertion, and open gastrostomy were 9.2%, 8.9%, and 8.1%, respectively. The most common major complication was gastroesophageal reflux requiring Nissen fundoplication (3.8%), and other complications included peritonitis (1.3%), hiatal hernia (1.3%), and bowel perforation (0.8%). Gastrostomy removal was successful in 8.6% and 5.0% of patients in the endoscopic and surgical gastrostomy groups, respectively. Gastrocutaneous fistula occurred in 60% of surgically inserted cases, requiring a second operation. Conclusion: This retrospective study was performed to review the outcome of gastrostomy insertion, as well as to introduce an algorithm that can be used for future cases. Further studies should be conducted to make a consensus on choosing the most appropriate method for gastrostomy insertion.

• 한방재활의학과학회지
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• 제26권2호
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• pp.133-144
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• 2016

Objectives This study was designed to find out influential factors associated with Hospitalization of the patients from traffic accident by Groups. Methods Based on the medical charts, we analyzed statistical study of 486 patients putting them into two groups to identify the factors associated with the duration of hospitalization involving age, sex, elapse day (Interval between time of injury and visit to hospital), and the types of accident. Patients in group A were diagnosed with a mere 'sprain', and patients in Group B had other symptoms accompanied by 'sprain'. Results 1. In group A, cervical sprain was the most and male patients with the symptom outnumbered female patients. In group B, headache was most where female patients had the symptom 1.7 times more than male patients. 2. Female patients in group B were found to stay for a longer period of time in the hospital than the male counterparts (p<0.05). 3. Both group A and B have positive correlation between length of hospital stay and age though group B exhibited stronger correlation. 4. Patients who had accident while riding bus in group A and those who were pedestrians in group B were found to stay in the hospital for a significantly longer period of time than those who had any other types of accident (p<0.05). Conclusions We noticed that hospital stay lengthened when the patients were older and when they had accidents while riding bus in Group A whereas in Group B, patients stayed longer when they were females and older as well as when they were pedestrians in accidents.

• 한국지구과학회지
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• 제29권7호
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• pp.567-578
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• 2008

온대저기압화는 중위도 기압계에 큰 영향을 주고 때로는 악기상의 원인이 되기도 한다. 그러나 온대저기압화에 대한 예보와 연구 양쪽 모두 많은 과제가 남아있다. 왜냐하면 태풍으로부터 변질된 온대저기압 자체의 모호한 형태 때문이다. 또한, 온대저기압화의 정의가 예보나 연구 양쪽 모두 만족시켜줄 만큼 정확하지도 않다 따라서 기상청은 2007 년에 "온대저기압화 현엽매뉴얼"을 개발하여 온대저기압화의 일련의 과정과 구조 변화 진단에 사용하였다. 이 매뉴얼에서는 1단계 최대풍속과 해수면온도, 2단계 위성영상, 3단계 단열선도, 그리고 최종단계인 4단계에서 지상일기도를 분석하였다. 이 현업매뉴얼은 온대저기압화가 일어날 때 구조변화의 이해와 감시에 도움이 될 것이다.