• Journal of Korean Neurosurgical Society
• /
• v.65 no.3
• /
• pp.370-379
• /
• 2022

Abusive head trauma (AHT) is the most severe form of physical abuse in children. Such injury involves traumatic damage to the head and/or spine of infants and young children. The term AHT was introduced to include a wider range of injury mechanisms, such as intentional direct blow, throw, and even penetrating trauma by perpetuator(s). Currently, it is recommended to replace the former term, shaken baby syndrome, which implicates shaking as the only mechanism, with AHT to include diverse clinical and radiological manifestations. The consequences of AHT cause devastating medical, social and financial burdens on families, communities, and victims. The potential harm of AHT to the developing brain and spinal cord of the victims is tremendous. Many studies have reported that the adverse effects of AHT are various and serious, such as blindness, mental retardation, physical limitation of daily activities and even psychological problems. Therefore, appropriate vigilance for the early recognition and diagnosis of AHT is highly recommended to stop and prevent further injuries. The aim of this review is to summarize the relevant evidence concerning the early recognition and diagnosis of AHT. To recognize this severe type of child abuse early, all health care providers maintain a high index of suspicion and vigilance. Such suspicion can be initiated with careful and thorough history taking and physical examinations. Previously developed clinical prediction rules can be helpful for decision-making regarding starting an investigation when considering meaningful findings. Even the combination of biochemical markers may be useful to predict AHT. For a more confirmative evaluation, neuroradiological imaging is required to find AHT-specific findings. Moreover, timely consultation with ophthalmologists is needed to find a very specific finding, retinal hemorrhage.

• Korean Journal of Psychosomatic Medicine
• /
• v.20 no.1
• /
• pp.14-17
• /
• 2012

There were several documents that might reflect the great concern on the education of psychosomatic medicine in medical school from the 1960s. But the hour of class and proportion of psychosomatic medicine have been quite small among the total lecture time of psychiatry. Notwithstanding the importance of biopsychosocial perspective in practice and research there have been no agreement on the goal and content of teaching psychosomatic medicine in the medical school curriculum. Consultation-liaison psychiatric activity in the hospital were currently under-developed and educational content and process were not systematic. We should have established the goal of psychosomatic education in the medical school that includes making doctor who could not only cure disease but also care the ill patients. And we should develop the curriculum that covers essential area of psychosomatic medicine and checking system to monitor the process of education. With the continuance of psychosomatic perspectives from medical school education to clinical subspecialty we can make progress in this field.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.16 no.2
• /
• pp.232-241
• /
• 2009

Purpose: The purpose of this study was to analyze the importance, difficulty, and frequency of work (duties and tasks) done by nurses' in Outpatient Departments (OPD). Method: Data were collected using structured questionnaires, which included 11 duties and 92 tasks making up the OPD nurse's job. Questionnaires were completed by 286 nurses. Each duty and task was analyzed for importance, difficulty, and frequency (range 1-3). Results: The mean score for importance was $2.58{\pm}0.29$, for difficulty, $2.11{\pm}0.31$, and for frequency, $2.18{\pm}0.31$. OPD nurses recognized 'patient education and consultation' as important and difficult. However, in practice OPD nurses reported the most frequent task as 'support for medical services'. There was a significant difference in importance and difficulty of duties according to OPD nurses' university degree (F=3.693, p=.026; F=4.089, p=.018) and hospital size (F=4.274, p=.006; F=3.154, p=.025). However there were no differences in importance, difficulty, or frequency according to clinical experience in OPD. Conclusion: The findings indicate that OPD nurses must be able to do important and difficult duties and tasks, especially patient education and consultation. To have time for these uniquely nursing tasks, OPD nurses need to delegate 'preparation for medical service', and 'management of facility and environment' to nonmedical health-care workers.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.8
• /
• pp.3723-3730
• /
• 2012

Delay in help-seeking behaviour which is potentially preventable has a major effect on the prognosis and survival of patients with breast cancer. The objective of this study was to explore reasons for delay in seeking help among patients with breast cancer from the East Coast of peninsular Malaysia. A qualitative study using face-to-face in-depth interview was carried out involving 12 breast cancer patients who had been histo-pathologically confirmed and were symptomatic on presentation. Respondents were selected purposely based on their history of delayed consultation, diagnosis or treatment. All were of Malay ethnicity and the age range was 26-67 years. Three were in stage ll, seven in stage lll and two in stage lV. At the time of interview, all except one respondent had accepted treatment. The range of consultation time was 0.2-72.2 months with a median of 1.7 months, diagnosis time was 1.4-95.8 months( median 5.4 months )and treatment time was 0-33.3 months (median 1.2 months). The themes derived from the study were poor knowledge or awareness of breast cancer, fear of cancer consequences, beliefs in complementary alternative medicine, sanction by others, other priorities, denial of disease, attitude of wait and see and health care system weakness. Help-seeking behaviour was influenced by a complex interaction of cognitive, environmental, beliefs, culture and psycho-social factors. Breast cancer awareness and psychological counselling are recommended for all patients with breast symptoms to prevent delay in seeking clinical help.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.20 no.6
• /
• pp.1789-1792
• /
• 2006

To develop the Korean Standard Differentiation of the symptoms and signs for the Stroke(KSDS), the committee on Stroke Diagnosis Standardization of Korean Traditional Medicine was organized by nineteen experts in College of Korean Medicine, The Consensus of the second Consultation Meeting was as follows : First is the definition of the stroke on the Korean Traditional Medicine. Second is the five categories to the Differentiation of the symptoms and signs for the Stroke - fire and heat, dampness and phlegm, blood stasis, qi deficiency, yin deficiency. Third is the indices of the Differentiation of the symptoms and signs for the Stroke respectively. KSDS-1 will be applied to the clinical practice and revised. The Consensus of the third Consultation Meeting had agreed 81 symptoms indexes of KSDS.

• Journal of Endocrine Surgery
• /
• v.18 no.4
• /
• pp.219-227
• /
• 2018

Purpose: The primary objective of the present study was to investigate the course of anxiety and depression in thyroidectomy. The second objective was to investigate the association between somatic symptoms and psychological symptoms, and the final objective was to identify the sociodemographic, clinical, and psychosocial factors that affect psychiatric morbidity. Methods: This prospective study, 101 patients who were admitted to the Endocrine Surgery Clinic of the Department of General Surgery, Istanbul Faculty of Medicine, University of Istanbul, with thyroid pathology were included in the study. Data were collected before surgery, and in the early, and late periods after surgery. Data were collected using a semi-structured interview form, a visual analogue scale, and the Hospital Anxiety and Depression Scale. Results: The average scores of anxiety and depression before surgery were statistically significantly higher compared with the early and late periods after surgery (P<0.001). Psychological morbidity was identified about 10% of patients before surgery and remained after thyroidectomy. A poor positive correlation founded between somatic symptoms and psychological condition in period surgery (P<0.05). Various sociodemographic features and psychosocial parameters affected anxiety and depression level (P<0.05). Conclusion: Anxiety and depression level in thyroid diseases decreased after thyroidectomy. These patients may express psychologic distress through somatic symptoms. Screening of psychological morbidity is suggested in patients planned thyroid surgery, especially in women, low-educated, inadequate social support, attributed to psychological causes.

• Journal of Oriental Neuropsychiatry
• /
• v.29 no.4
• /
• pp.239-253
• /
• 2018

Objectives: This is one of the manuals of East-West integrative medicine, which was created by the Committee on integrative medicine of Chung-Yeon Korean Medicine Hospital. To support clinical decision making and communication in the East-West cooperative treatment of mild cognitive impairment. Methods: Drafting was based on literature review from the MEDLINE, EMBASE, OASIS, and CNKI databases using search terms such as 'mild cognitive impairment', 'mild neurocognitive disorder', 'acupuncture', 'herbal medicine' and 'traditional Chinese medicine'. An amendment reflecting the goal of consultation and detailed treatment contents was made by reviewing the draft and holding discussion with the rehabilitation specialist of western medicine. The committee then agreed to adopt the manual through the process of review and feedback in addition to face-to-face discussions. Results: This manual contains the diagnosis of mild cognitive impairment, the goal of consultation, and the cooperative treatment contents of the East-West medicine for mild cognitive impairment. Conclusions: This manual provides significant information about the decision making process and contents of treatment in one medical institution for East-West cooperative treatment of mild cognitive impairment.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.24 no.4
• /
• pp.384-391
• /
• 2021

Purpose: The Cow's Milk-related Symptom Score (CoMiSS^TM) was developed as an awareness tool for evaluating cow's milk-related symptoms in otherwise healthy children. Using a convenience sample of participants, this cross-sectional study aimed to determine CoMiSS^TM values of symptomatic infants based on retrospectively or prospectively obtained information. Methods: CoMiSS^TM values were determined in infants aged <12 months with symptoms suggestive of cow's milk protein allergy or functional gastrointestinal disorders. The exclusion criteria were previous diagnosis with acute or chronic disease, treatment with a therapeutic formula, and in case of breastfeeding, an elimination diet followed by the mother. Two CoMiSS^TM values were assessed. A retrospective collection was defined as the collection of data after initial contact with the medical center but before the first medical consultation. A prospective collection was defined as the collection of data within 24 hours from the time of medical consultation but before starting any therapeutic intervention. The CoMiSS^TM total and individual component scores obtained retrospectively or prospectively were compared between groups using the Wilcoxon signed-rank test. Results: This study was performed between August and November 2019. Data of 110 children (62 males and 48 females), with a mean±standard deviation age of 18.2±11.7 weeks, were obtained. The total CoMiSS^TM value (p<0.001) and some individual component scores (crying, regurgitation, and stool) were significantly lower when collected prospectively than when collected retrospectively. Conclusion: CoMiSS^TM values were retrospectively and prospectively determined. Lower CoMiSS^TM values were obtained during prospective evaluation. Possible differences should be considered when using CoMiSS^TM in clinical practice.

• Journal of East-West Nursing Research
• /
• v.28 no.2
• /
• pp.151-159
• /
• 2022

Purpose: This study was conducted to identify the performance and need of professional nursing care among nurses in a neurosurgery department at a tertiary hospital. Methods: This study used a descriptive design using a questionnaire with 77-item. The participants were 58 nurses with more than 3 years of clinical experience in both the neurosurgery intensive care unit and ward at a tertiary hospital in Gangwon province. Data collection was conducted from January to February of 2021. The performance and need for each workforce were analyzed with the mean and standard deviation, and the effectiveness of the difference between the performance and the need were analyzed with a paired t-test using SAS 9.4. Results: The recognition for work performance level was in order of direct nursing activities (3.20±.54), consultation and coordination (3.18±1.15), education (2.55±.85), administration (1.92±.86), and research (1.57±.89). The recognition for need level was in order of consultation and coordination (3.95±.83), education (3.91±.87), direct nursing practice (3.83±.55), research (3.49±.87), and administration (3.45±.54). The results showed a statistically significant differences between work performance and need (p<.001). Conclusion: It is required to hire professional nursing personnel who can bridge the gap between the performance and need of professional nursing workforce in a neurosurgery department at a tertiary hospital. A professional nurse may be a good alternative.

• Journal of the Korean Dietetic Association
• /
• v.18 no.1
• /
• pp.59-71
• /
• 2012

The purpose of this study was to evaluate the patient perception of clinical nutrition service. The research was performed by using questionnaires and conducted from February 14 to March 15 at 42 hospitals (over 400 beds). 41.7% of patients experienced nutritional education and counseling. The mean score of the patients' perception on clinical nutritional service was 4.62/5.00 for "nutrition care is important for treatment of the disease", 4.49/5.00 for "diet therapy is necessary for treatment of the disease", 4.16/5.00 for "nutritional counseling call-centers are necessary", 4.13/5.00 for "nutritional consultation fee is required to apply insurance benefits", 4.12/5.00 for "one-to-one nutrition system is necessary", and 3.56/5.00 for "nutrition services I am willing to pay". The patients who had no past experience in nutritional education and counseling showed significantly higher scores for "nutrition care is important for treatment of the disease", "one-to-one nutritional care system is necessary", and "nutritional counseling call-centers are necessary" (P<0.05). The mean scores for the importance (4.26/5.00) and performance (3.88/5.00) of nutrition counseling service were significantly different (P<0.01). "Nutritional counseling is available whenever I want" had the highest gap score between performance and importance among nutrition counseling service items. The importance and performance grid showed that highly important items had high performance (doing great area) and less important items have low performance (low priority).