• 제목/요약/키워드: Clinical Practice Guidelines

검색결과 471건 처리시간 0.023초

안면주름과 안면이완 개선을 위한 매선요법 시술 방법 고찰과 제안 (Narrative Review and Propose of Thread Embedding Acupuncture Procedure for Facial Wrinkles and Facial Laxity)

  • 윤영희;김태열;임태정;황용호;최인화
    • 한방안이비인후피부과학회지
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    • 제28권1호
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    • pp.119-133
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    • 2015
  • Objective : Thread embedding acupuncture has become popular as a minimally invasive treatment for facial wrinkles and laxity. However, there is little published clinical practice guidelines. This study is to developing a specific procedure of thread embedding acupuncture for facial wrinkles and laxity. Method : We reviewed and summarized 6 studies on thread embedding acupuncture for facial wrinkles and laxity. And, four practitioners who have more than four year of clinical experience and one hundred of cases were participated in developing a thread embedding acupuncture procedure for facial wrinkles and laxity. Result and conclusion : We developed a thread embedding acupuncture procedure for facial wrinkles and laxity which consists of correction of lower jaw, facial laxity, nasolabial fold and eye wrinkles.

노인요양시설의 신체적 억제대 프로토콜 개발 (Protocol for Physical Restraints of Patients in Nursing Homes)

  • 임미혜;고일선
    • 기본간호학회지
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    • 제20권4호
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    • pp.345-358
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    • 2013
  • Purpose: The purpose of this study was to develop a protocol that would help prevent accidents, apply physical restraints properly, and reduce the use of physical restraints in nursing homes. Method: A review of the literature and analysis of existing statutes and regulations were used to develop the preliminary protocol. To test the validity of this preliminary protocol, ten experts were selected from academia and clinical practice to review the protocol. The initial protocol was finalized after it had been reviewed by experts and tested for clinical validity in five different nursing homes. Result: The protocol consists of objectives, definitions and accident probability assessment, principle of using physical restraints, monitoring and documentation of physical restraints. Conclusion: The findings of this study can be used as guidelines to focus on preventing accidents arising out of use of physical restraints, assessing the probability of accidents, and reducing the use of physical restraints through preventive interventions. This will be helpful to prevent ethical, physical, or psychological problems arising from use of physical restraints and to protect the rights of elderly people in nursing homes.

가치기반 체계에 근거한 의료기술평가: 영국 NICE의 신뢰 지향적 가치판단 과정을 중심으로 (Health Technology Assessment and Appraisal: Lessons from Reliability-Based Health Technology Appraisal in NICE, England)

  • 이현주;권영대
    • 보건의료산업학회지
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    • 제7권4호
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    • pp.273-288
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    • 2013
  • This paper is a general review contextualizing the state of the domestic health technology assessment. The aim of the paper is to present an overview of health technology assessment in Korea based on examining clinical efficacy as well as cost-benefit analysis, and to suggest the issue of appraisal based on social value. We have included a discussion of a major case study of the technology appraisal process of NICE (the National Institute for Clinical Excellence) in the UK. The review of the existing process of NICE shows that the appraisal both gives interest in health technology a sense of value perspective and raises methodological issues in terms of reliability. Details of the appraisal process and several guidelines for best practice have emerged. Suggestions are listed and their role in assessing is explained as a conclusion.

약학대학 학생들의 학습 포트폴리오에 대한 경험과 인식 (Pharmacy Students' Experiences and Perceptions of the Use of Learning Portfolio)

  • 제남경;이인향
    • 한국임상약학회지
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    • 제24권2호
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    • pp.90-97
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    • 2014
  • Learning portfolio is a collection of evidence that learning has taken place. It has gained its reputation as a useful assessment tool in the education of health professionals. The purpose of this study is to describe the pharmacy students' experiences and perceptions upon the introduction of a learning portfolio into the Introductory Pharmacy Practice Experience course. Methods: Fifty five students from one pharmacy school who used a learning portfolio to document their progress in the IPPE course participated in 16-item questionnaire exploring opinions and experiences of learning portfolio preparation, assessment, and personal and professional development and reflection. Results: Most students agree that a learning portfolio is a valuable tool in promoting self-directed and reflective learning. However most of them (46/55) also feel developing a portfolio is time-consuming, and when compared to their effort, an appropriate reward has not been given. Conclusion: To make the use of learning portfolios successful students should receive clear guidelines on their purpose, content and structure. Also the assessment criteria should be provided before the introduction of learning portfolio and their effort in developing learning portfolio should be rewarded.

공존이환(Comorbidity)이 있는 암환자에서의 항암약물치료 (Chemotherapy in Cancer Patients with Comorbidity)

  • 문용화;정희철
    • Journal of Gastric Cancer
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    • 제4권2호
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    • pp.59-74
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    • 2004
  • This report attempts to explain the (i) implications of comorbidity for research and practice in the fieldo of oncology, (ii) the approach for dosing of anti-cancer drugs in the presence of comorbidity, as an example of its clinical application, and finally (iii) the dosing guidelines for the anticancer drugs clinically active in gastric cancer in the presence of renal or liver dysfunction. This has resulted from the idea of approaching comorbidity in a systematic way and of integrating it with oncologic decisions. Various methods have been used to assess comorbidity. However, significant work remains to be done to analyze how various diseases combine to influence the oncologic outcome. The main end-point explored so far has been mortality, but a largely open challenge remains to correlate comorbidity with treatment tolerance and functional and quality of life, as well as to integrate it in clinical decision-making. Cancer chemotherapy in comorbidity should be considered as an example of the need for dose optimization in individual patients, and it should be determined by considering the basic principles of the pharmacokinetics and the pharmacodynamics of the agents. This review analyzes the available data on the pharmacokinetics and the toxicities of anti-cancer agents in the comorbidity population.

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Effects of Therapeutic Exercise on Pain, Physical Function, and Magnetic Resonance Imaging Findings in a Patient with Multilevel Lumbar Disc Herniation: A Case Report

  • Kim, Ahram;Lee, Hoseong
    • 국제물리치료학회지
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    • 제10권1호
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    • pp.1725-1733
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    • 2019
  • Background: In some clinical guidelines followed in clinical practice, nonsurgical treatments are recommended as the primary intervention for patients with lumbar disc herniation (LDH). However, the effect of a therapeutic exercise program based on stabilization of the lumbar spine for treatment of multilevel LDH has not been evaluated thoroughly. Objective: To investigate the effects of therapeutic exercise on pain, physical function, and magnetic resonance imaging (MRI) findings in a patient with multilevel LDH. Design: Case Report Methods: A 43-year-old female presented with low back pain, radicular pain and multilevel LDH (L3-L4, L4-L5, L5-S1). The therapeutic exercise program was conducted. in 40-min sessions, three times a week, for 12 weeks. Low back and radicular pain, lumbar disability, and physical function were measured before and after 6 and 12 weeks of the exercise program. MRI was performed before and after 12 weeks of the program. Results: After 6 and 12 weeks of the therapeutic exercise, low back and radicular pain and lumbar disability had decreased, and lumbar range of motion (ROM) was improved bilaterally, compared with the initial values. Also improved at 6 and 12 weeks were isometric lumbar strength and endurance, and the functional movement screen score. The size of disc herniations was decreased on MRI obtained after 12 weeks of therapeutic exercise than on the pre-exercise images. Conclusions: We observed that therapeutic exercise program improved spinal ROM, muscle strength, functional capacity, and size of disc herniation in LDH patient.

Bone loss-related factors in tissue and bone level dental implants: a systematic review of clinical trials

  • Mortazavi, Hamed;Khodadoustan, Amin;Kheiri, Aida;Kheiri, Lida
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제47권3호
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    • pp.153-174
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    • 2021
  • Dental implants are popular for dental rehabilitation after tooth loss. The goal of this systematic review was to assess bone changes around bone-level and tissue-level implants and the possible causes. Electronic searches of PubMed, Google Scholar, Scopus, and Web of Science, and a hand search limited to English language clinical trials were performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines up to September 2020. Studies that stated the type of implants used, and that reported bone-level changes after insertion met the inclusion criteria. The risk of bias was also evaluated. A total of 38 studies were included. Eighteen studies only used bone-level implants, 10 utilized tissue-level designs and 10 observed bone-level changes in both types of implants. Based on bias assessments, evaluating the risk of bias was not applicable in most studies. There are vast differences in methodologies, follow-ups, and multifactorial characteristics of bone loss around implants, which makes direct comparison impossible. Therefore, further well-structured studies are needed.

병원 성인 환자의 사후 간호 프로토콜 개발 (Development of a Protocol for Nursing Care after Death for Adult Patients in Hospitals)

  • 김기경;김앵도;안경아;천주영
    • 임상간호연구
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    • 제29권1호
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    • pp.75-84
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    • 2023
  • Purpose: This study developed a protocol for nursing care after death for adult patients in hospitals. Methods: This was a methodological study to develop a care after death protocol. The preliminary protocol was developed based on a literature review, guidelines, and practice recommendations from groups of experts and clinical nurses. Content validity was evaluated by a group of experts (n=6) and nurses (n=30) in two hospitals. Results: The preliminary protocol recommendations were modified by validation and the open-question analysis results. The final protocol comprised three general recommendations and 43 recommendations in five steps that are verification and notification of a death, personal care of the body, viewing the patient, patient transfer, and documentation and self-care. Conclusion: This study result provides nurses with a consensus information on patient care after death and family support in a hospital setting. This nursing protocol is expected to improve the quality of care after death for adult patients and their families, and can be used for developing educational and emotional support for nurses to accomplish their important role.

The burdens faced by parents of preschoolers with type 1 diabetes mellitus: an integrative review

  • Sunyeob Choi;Hyewon Shin
    • Child Health Nursing Research
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    • 제29권3호
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    • pp.166-181
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    • 2023
  • Purpose: This study examined the literature concerning the burdens of parents of preschool-aged children diagnosed with type 1 diabetes mellitus. Methods: We employed an integrative review methodology based on Whittemore and Knafl's framework. The literature search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines across four electronic databases: PubMed, Web of Science, the Cumulative Index to Nursing Allied Health Literature (CINAHL), and PsycINFO. Ultimately, 18 articles were included in the review. Results: The review yielded four themes: (1) parental burdens, (2) factors related to the burdens, (3) coping strategies, and (4) implications for clinical practice. Parents experienced psychological, physical, and social burdens due to the diabetes care of their children. Several factors influenced burdens, including child-related characteristics such as age, severity of diabetes, and hospitalization experience, as well as parental factors like family income, race, and residential area. Parents initially felt burdened when their child was diagnosed with type 1 diabetes, but over time, they often adapted to the situation through support and sharing of responsibilities. Parents desired education and interventions reflecting the unique characteristics of preschoolers. Conclusion: This integrative literature review revealed that parents experience numerous burdens when their child is diagnosed with diabetes. Future research should focus on developing interventions to address parents' psychological difficulties, including tracking parental psychological changes over time. Tailored nursing interventions should also be provided to parents of preschool-aged children, as opposed to the more generic nursing interventions traditionally applied across all age groups of children in clinical settings.

Identifying and Solving Gaps in Pre- and In-Hospital Acute Myocardial Infarction Care in Asia-Pacific Countries

  • Paul Jie Wen Tern;Amar Vaswani;Khung Keong Yeo
    • Korean Circulation Journal
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    • 제53권9호
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    • pp.594-605
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    • 2023
  • Acute myocardial infarction (AMI) is a major cause of morbidity and mortality in the Asia-Pacific region, and mortality rates differ between countries in the region. Systems of care have been shown to play a major role in determining AMI outcomes, and this review aims to highlight pre-hospital and in-hospital system deficiencies and suggest possible improvements to enhance quality of care, focusing on Korea, Japan, Singapore and Malaysia as representative countries. Time to first medical contact can be shortened by improving patient awareness of AMI symptoms and the need to activate emergency medical services (EMS), as well as by developing robust, well-coordinated and centralized EMS systems. Additionally, performing and transmitting pre-hospital electrocardiograms, algorithmically identifying patients with high risk AMI and developing hospital networks that appropriately divert such patients to percutaneous coronary intervention-capable hospitals have been shown to be beneficial. Within the hospital environment, developing and following clinical practice guidelines ensures that treatment plans can be standardised, whilst integrated care pathways can aid in coordinating care within the healthcare institution and can guide care even after discharge. Prescription of guideline directed medical therapy for secondary prevention and patient compliance to medications can be further optimised. Finally, the authors advocate for the establishment of more regional, national and international AMI registries for the formal collection of data to facilitate audit and clinical improvement.