• PNF and Movement
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• v.14 no.3
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• pp.157-176
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• 2016

Purpose: The purpose of this study was to share an experience about processes and lessons learned to execute evidence-based practice (EBP) in neurological physical therapy. Methods: The most important thing in applying EBP to practice is to search, find, and appraise the existing evidence. Many evidence databases are available, such as CENTRAL, PEDro, PUBMED, and EMBASE. However, the knowledge represented in these databases is not always perfect. The practice model is a set of processes to resolve client problems. Therapists should make hypothesis-focused decisions through EBP. Integrating clinical reasoning and evidence is most important when it comes to the execution of EBP. Results: The process of EBP consisted of following: coming up with clinical questions, followed by searching for, appraising, evaluating, and integrating evidence. To integrate EBP into practice, it is necessary to consider clinical expertise, patient value and preferences, as well as research wth the best evidence. We provided an example of a clinical case with a stroke patient to show how this process and framework concerning clinical reasoning through evidences can be integrateds. During this process, we also utilized information technology to improve EBP ability. Conclusion: We should recognize what manner of information is needed to resolve eash patient's problem, and we should search for this information efficiently. Then, we should judge the value of the information obtained as it applies, to the clinical setting.

• Journal of Digital Convergence
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• v.15 no.7
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• pp.271-284
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• 2017

This study was performed to examine that convergence-based integrated simulation practice program curriculum effects the clinical decision making, problem solving competence, clinical competence and confidence of core fundamental nursing skill performance for nursing students. After the convergence-based integrated simulation practice program, there were significant increased in problem solving process(t=-3.052, p<.01), clinical competence(t=-4.279, p=.000), and confidence of core fundamental nursing skill performance(t=-2.416, p<.05). The finding of this study verified that the integrated simulation practice program curriculum can be used for improvements of problem solving competence, clinical competence and confidence of core fundamental nursing skill performance for nursing students. It is necessary to develop a scientific analytical evaluation tool and program, and it would be necessary to have a system for scientifically analyzing the integration of simulation practical courses by nursing college students by grade level and subjects.

• Journal of Korea Multimedia Society
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• v.23 no.2
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• pp.174-185
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• 2020

Leukemia induced death has been listed in the top ten most dangerous mortality basis for human being. Some of the reason is due to slow decision-making process which caused suitable medical treatment cannot be applied on time. Therefore, good clinical decision support for acute leukemia type classification has become a necessity. In this paper, the author proposed a novel approach to perform acute leukemia type classification using sequential neural network classifier. Our experimental result only cover the first classification process which shows an excellent performance in differentiating normal and abnormal cells. Further development is needed to prove the effectiveness of second neural network classifier.

• Journal of Home Health Care Nursing
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• v.15 no.1
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• pp.22-28
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• 2008

Purpose: The aim of this study was to analyze the effects of time management on the clinical nurse's organizational commitment and job satisfaction. Methods: Subjects were recruited in two general hospitals in Seoul and Incheon. Data collection was done using a self-report questionnaire. Time management was measured using the questionnaire developed by Han (1992). Organizational commitment and job satisfaction were measured using the questionnaire developed by Yoon (2000), based on Mowday et al. (1979) and Stamps et al. (1978). The data were analyzed using the SAS statistical package program, version 10.0. Specifically, descriptive statistics and stepwise multiple regression were performed. Results: The predictive time management factors for organizational commitment included deadline decision, simplification, and goal-setting. The predictive time management factors for job satisfaction included planning/making the priority order, deadline decision, simplification, asking for help, and responsibility reduction. Conclusion: Time management factors are highly correlated with organizational commitment and job satisfaction in clinical nurses. Deadline decision and simplification are common predictive factors for organizational commitment and job satisfaction. These results can be used to develop more effective time management strategies for increasing organizational effectiveness in clinical nurses.

• Journal of Chest Surgery
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• v.54 no.6
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• pp.449-453
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• 2021

The 2020 American College of Cardiology focused update on the mitral regurgitation (MR) pathway provides an excellent summary of the decision-making trees in the treatment of severe MR, in which 2 main branches of the flowchart are suggested depending on whether MR is primary or secondary. Surgery is suggested as preferable over transcatheter edge-to-edge repair (TEER) in primary MR that needs intervention. The decision-making for secondary MR generally prioritizes TEER over surgery according to the guidelines, but further stratification is necessary based on the pathophysiologic mechanisms of MR. TEER is probably the more suitable option in secondary MR caused by left ventricular dysfunction or dilatation, given the high perceived surgical risks, despite the lack of sufficient evidence in support of overt clinical benefits from surgical therapy in these patients. In atrial functional MR associated with atrial fibrillation (AF), however, concomitant ablation of AF seems to be a desirable option, as it has been demonstrated to be a key factor leading to improved survival, reduced stroke risk, and more durable mitral and tricuspid function in patients undergoing mitral surgery. Therefore, atrial functional MR requiring intervention may be best treated by surgical therapy that combines mitral repair and AF ablation in the majority of patients. This particular issue, however, needs further research to obtain scientific evidence to guide optimal management strategies.

• Journal of Korean Clinical Nursing Research
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• v.15 no.2
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• pp.47-56
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• 2009

Purpose: The purpose of this study was to identify the impacts of professional socialization perceived by nursing students on role conflict and professional self-concept. Methods: Using a structured questionnaire, data were collected from 683 nursing students. For data analysis, descriptive statistics, Pearson correlation coefficient, stepwise multiple regression were conducted using SAS program. Results: The mean score of total professional socialization was 3.74 followed by the scores of 'independence', 3.98, 'commitment', 3.80, 'decision making', 3.60, and 'maturity', 3.53. The mean score of total role conflict was 3.72, and professional self-concept was 2.75. Total professional socialization, commitment, and independence perceived by nursing students were positively related to role conflict. Also total professional socialization and total subcategories of professional socialization were positively related to professional self-concept. As a result of stepwise multiple regression analysis, the key determinants of role conflict were found to be 'independence', 'motivation with admission', 'sex', 'desire with working', 'grade' and 'decision making'. The key determinants of professional self-concept were 'decision making', 'commitment', 'satisfaction about nursing', and 'interpersonal relationship'. Conclusion: Through this results, it is necessary to improve professional socialization in order to increase professional self-concept among nursing students.

• Journal of Dental Rehabilitation and Applied Science
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• v.19 no.3
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• pp.239-245
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• 2003

The occurrence and pattern of tooth wear are related to cultural, dietary, occupational, and geographic factors, Excessive occlusal wear can result in pulpal exposure, occlusal disharmony, functional inability. Surface loss can be differentiated into 3 general causal categories: i) mechanical loss, which includes attrition, ii) abrasion chemical loss including erosion, and finally iii) a proposed biomechanical category described as abfraction. Considering that mechanical wear is frequently asymptomatic, patients may have parafunctional habit. Structured clinical decision analysis in fixed prosthodontics, as other branches of dentistry do, allows the practitioner to consider the patient's problems more thoroughly based on the clinical data and extenuation factors. This discipline of decision making is intended to complement the experience level and educational background of the clinician in assisting the patient through the decision process. Additionally, CDA helps the clinician define not only the pre-existing condition of the patient prior to irreversible therapy, but also better treatment strategies for the patient over an extended period. The systematic nature of decision analysis stimulates the dentists to pay further attention to those factors, which is germane to the overall complexity of the case, and exclude factors, which have little influence on its final outcome. Further implementation of computerized databases, procedural outcome probabilities based on clinical and laboratory studies and the clinical experience of those who use it, may provide quite a promising future in the field of structured and formalized clinical decision analysis.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.25 no.2
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• pp.38-48
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• 2012

Background : The atopic dermatitis patient and their families are looking for safer herb-medicine treatments that possess therapeutic effects, but without the recurrence of symptoms and long-term harmful consequences that can result from other treatment. However, for many reasons, including methodological difficulties and lack of high quality study like randomized clinical study and systematic review, there are no consistent clinical guide line for atopic dermatitis in Traditional Korean Medicine. Objectives : Evidence-based clinical practice guidelines support clinical decision-making by making recommendations to guide clinical practice. The purpose of this study was to develop Traditional Korean Medicine clinical practice guideline for atopic dermatitis Result : The future guide should be based on scientific evidence and include the followings: (1) diagnosis of atopic dermatitis (2) the pattern identification of atopic dermatitis (3) classification of Sasang Constitution (4) efficacy assessment (5) treatment guideline (6) education for patients and care givers Conclusion : The development of Traditional Korean Medicine clinical practice guideline for atopic dermatitis is needed.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.18 no.2
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• pp.284-310
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• 2024

Identifying clinical pathways for disease diagnosis and treatment process recommendations are seriously decision-intensive tasks for health care practitioners. It requires them to rely on their expertise and experience to analyze various categories of health parameters from a health record to arrive at a decision in order to provide an accurate diagnosis and treatment recommendations to the end user (patient). Technological adaptation in the area of medical diagnosis using AI is dispensable; using expert systems to assist health care practitioners in decision-making is becoming increasingly popular. Our work architects a novel knowledge-based recommender system model, an expert system that can bring adaptability and transparency in usage, provide in-depth analysis of a patient's medical record, and prescribe diagnostic results and treatment process recommendations to them. The proposed system uses a set of parallel discrete fuzzy rule-based classifier systems, with each of them providing recommended sub-outcomes of discrete medical conditions. A novel knowledge-based combiner unit extracts significant relationships between the sub-outcomes of discrete fuzzy rule-based classifier systems to provide holistic outcomes and solutions for clinical decision support. The work establishes a model to address disease diagnosis and treatment recommendations for primary lung disease issues. In this paper, we provide some samples to demonstrate the usage of the system, and the results from the system show excellent correlation with expert assessments.

• The Korean Journal of Emergency Medical Services
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• v.28 no.2
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• pp.63-75
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• 2024

Purpose: This study investigated career identity, decision-making, and preparation behaviors among emergency medical service (EMS) students after clinical practice, aiming to enhance their career guidance by identifying influential factors. Methods: This study targeted 178 students enrolled in the Department of Paramedicine in K-do, G-do, and D metropolitan cities. Data were collected between March 14th and April 30, 2024. The collected data were analyzed using SPSS 25.0, employing techniques such as frequency, correlation, and multiple regression analyses. Results: The findings indicated that components of career identity, encompassing affective and cognitive aspects, exerted significant effects on career decision levels (career assurance and career indecision) (p<.01, p<.001), whereas behavioral factors influenced aspects of career preparation, such as tool preparation, information collection, and practical effort(p<.001). Moreover, career decision levels (career assurance and career indecision) were found to affect information collection, a subcomponent of career preparation(p<.05, p<.01). Conclusion: Considering these factors and actively empathizing with and counseling students would lead to effective career guidance in the field of Emergency Medical Services.