• 대한한방부인과학회지
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• 제35권2호
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• pp.70-86
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• 2022

Objectives: This study attempted to provide prescriptions that can be used according to the classification of menopausal disorders in order to increase the clinical utilization of CaPSPI (Diagnostic System for Climacteric and Postmenopausal Syndrome Pattern Identification). Methods: Delphi method survey was conducted for expert consensus on the Pattern Identification that could be used for each prescription by selecting frequent prescriptions based on the literature researched on the prescription of Korean medicine used for women with menopausal disorders. 11 experts participated in the questionnaire for posterity and 7 experts for sasang constitution. The survey was divided into the main prescription that can be mainly used for the patterns and the minor prescription that can be used although the suitability is somewhat low. Expert consensus was obtained through the second survey, and the pattern classification of prescriptions that were not confirmed here was confirmed through a face-to-face meeting. Results: There were 56 prescriptions mainly used for treatment for menopause, 45 for posterity and 11 for Sasang constitution. There were 69 identifications of 45 posterity prescriptions and 17 classifications of 11 Sasang constitutional prescriptions including major and minor patterns. By pattern identifications, the number of major/minor prescriptions was as follows. 肝鬱 14/5, 腎陰虛 8/2, 腎陽虛 4/1, 肝腎陰虛 2/7, 腎陰陽兩虛 3/1, 心腎不交 6/3, 心脾兩虛 15/2, 心火 7/6. Conclusions: In the future, by accumulating and analyzing the data on the diagnosis and treatment using CaPSPI, the clinical status of Korean medicine for menopausal disorders can be reviewed, and it can be used as the basis for the clinical practice guidelines for menopausal disorders. In addition, it is thought that analyzing the results of the diagnosis of pattern identifications and the prescription of Sasang constitution can be helpful in research on the posterity and Sasang constitution.

• 대한족부족관절학회지
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• 제25권4호
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• pp.149-156
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• 2021

Purpose: Given the lack of definite evidence-based guidelines in clinical practice, there may be a wide variation in treatment protocols for osteochondral lesions of the talus (OLT). Based on the Korean Foot and Ankle Society (KFAS) member survey, this study aimed to report the current trends in the management of OLT. Materials and Methods: A web-based questionnaire containing 30 questions was sent to all KFAS members in September 2021. The questions were mainly related to clinical experience and preferences in diagnosis, conservative, and surgical treatments for patients with OLT. Answers with a prevalence of ≥50% of respondents were considered a tendency. Results: Sixty-two (11.3%) of the 550 surgeons queried responded to the survey. The responses to 9 (30.0%) of the total of 30 questions established a tendency. Answers exhibiting a tendency were as follows; additional diagnostic tools except for plain radiograph (magnetic resonance imaging), most common conservative treatment method (oral medication, rest), most important radiological factor in decision making for surgical treatment and method (size of the lesion, ankle instability, loose bodies), most important patient factors in decision making for surgical treatment and method (age, activity or occupation), infrequently requiring posterior arthroscopy (less than 3%), most common revision surgery for failed bone marrow stimulation procedure (osteochondral autograft transplantation [OAT]), not requiring additional procedure for donor site in OAT, the main reason for unsatisfactory result after OAT (persistent pain without radiological abnormality), no generalization of autologous chondrocyte implantation or chondrogenesis using stem cells. Conclusion: This study presents updated information on current trends in the management of OLT in Korea. Both consensus and variations in the approach to patients with OLT were revealed through this survey. Since recent biologic efforts to regenerate cartilage have been unsuccessful, further studies to identify clinical evidence would be needed.

• Journal of Acupuncture Research
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• 제40권3호
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• pp.245-251
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• 2023

Background: The incidence of facial palsy has been increasing. Many patients consult both Korean and Western physicians; however, no critical pathway (CP) for facial palsy has been established based on integrated medicine including Korean medicine, Western medicine, and complementary and alternative medicine. Thus, we developed and implemented an integrated CP for patients with acute facial palsy and investigated the satisfaction with CP. Methods: Overall, 20 patients who received treatment following the CP and 20 medical staff members involved in their care responded to a questionnaire survey. The questionnaire was developed based on a review of previous studies and focused on the satisfaction with the CP. Results: Patients' satisfaction score with the integrated CP was ≥ 4.4 for all items using a 5-point Likert-type scale. Smooth and cooperative treatment procedures, time-saving practices, and a clear explanation of the integrated treatment plan were satisfactory factors. Additionally, they preferred incorporating specialized facial massage and receiving education on self-exercise or massage techniques as complementary therapies. The medical staff members expressed a high level of satisfaction with the CP; however, the work division and treatment guidelines must be improved. Conclusion: An integrated CP program for acute facial palsy was implemented, and the satisfaction levels of patients and medical staff members were assessed. The results revealed high levels of satisfaction, and several improvements identified will be incorporated into clinical practice going forward.

• 한국간호교육학회지
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• 제4권2호
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• pp.249-263
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• 1998

The competence of newly graduated nurses is based on various clinical expriences gained when they were students. Therefore, instructors of nursing students, professors in nursing schools or directors in hospitals must play a critical role in assisting them to obtain various knowledge and experienced nursing skills. The purpose of this study was to investigate nursing care activities and nursing care hours practiced by nursing students in a general hospital. The subject students were total 214 nursing students, 2nd graders(sophomores) and 3rd graders(juniors) from 5 Junior Nursing Colleges in Seoul and they practiced at S general hospital to gain clinical experience. The data were collected for 4 days. The tools for this study were the direct nursing care activity list consisted of 15 nursing areas and the indirect nursing care activity list consisted of 9 nursing areas. The subject students were supposed to record their own score. The results of this study are ; 1. The nursing care hours per nursing student 1) The average total nursing care hours a day per each nursing student are 362.65 mins(6.04hr), the direct nursing care hours per each nursing stuent are 202.09 mins(direct nursing care rate 56.0%) and it is higher than the indirect nursing care hours, 159.75mins(indirect nursing care rate 44.0%). The direct nursing care rate of each student by a team approach in the evening shift(56.3%) is higher than that in the day shift(55.8%). 2) The hours of checking vital signs are the longest(47.35mins) among the direct nursing care activites and next is in order of counseling 8l emotional support, nurse rounds, and accompaning a patient during examination. The hours of reporting are the longest(32.39mins) among the indirect nursing care activites, and next is the activities related to education such as reviewing chart, looking up references, etc. 3) The freqency of checking vital signs practiced by nursing student is the highest(the average of 55.7 times) among the direct nursing care activities and next is in order of nurse rounds, assistance of feeding, and counseling & emotional support. The required time for nursing students to accompany their patient during examination is the longest(20.7mins) and next are in order of restriction on patient' activity, orientated by a head nurse, skin care, sitz bath, bathing & hair shampoo, and assisting with patients' exercise. 2. The nursing care hours per grader 1) The average hours of total nursing care per a nursing student are 369.2mins(6.2hrs) to 2nd graders, 355.9mins(5.9 hrs) to third graders. The direct nursing care rate per each nursing student to 3rd graders(59.3%) was higher than that to End graders(52.8%). 2) For 2nd graders, the highly marked nursing activities are teaching associated with direct nursing care activities such as drawing up papers, looking up references, reviewing charts, and being orientated by staff nurses. For 3rd graders, measurments, observations, and nurse rounds in indirect nursing care activities are taken highly 3) The most frequent practice of the nursing care activites is checking vital signs : 65 times to 3rd graders and 46.5 times to 2nd graders. Our suggestions based on the results of this study are : 1. It is recommanded to repeat the same designed study in a variety of clinical fields for further study. 2. It is recommanded to collect data not by self-record method but by observated method. 3. It is needed for nursing instructors in Nursing Schools and in hospitals to develop the guidelines and check-list of clinical practice courses.

• 한국융합학회논문지
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• 제8권2호
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• pp.63-72
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• 2017

본 연구는 간호대학생의 DNR에 대한 융합적 인식 및 윤리적 태도를 파악하여 DNR 환자간호에 도움이 되는 기초자료로 활용하고자 시도하였다. G광역시 4년제 간호대학생 306명을 대상으로 2016년 6월 1일부터 2016년 7월 10일까지 설문조사하였고, SPSS 23.0 Program을 이용하여 최종 분석하였다. 분석결과 DNR에 대한 인식은 DNR의 필요성, 환자와 가족의 의지에 의한 DNR 결정, 문서화된 지침서의 필요성에 찬성하였다. 윤리적 태도는 환자의 의지에 의한 결정, 치료범위, 설명 여부, 지침에 따른 결정에 찬성하였고, 주치의에 의한 결정, 기본간호 제공 감소에는 반대하였다. 일반적 특성에 따른 윤리적 태도는 학년, 임상실습경험, 윤리가치관에 대한 교육경험, DNR에 대한 교육경험, 삶에 대한 만족도, 죽음에 대한 가치관에 따라 유의한 차이가 있었다. 본 연구결과를 토대로 DNR 결정에 관한 기준 및 지침을 마련하기 위한 지속적인 후속연구가 필요하다고 사료된다.

• 간호행정학회지
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• 제22권5호
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• pp.496-506
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• 2016

Purpose: This study was conducted to examine the adaptation experience of male nurses working in general wards. Methods: Experiential data was collected from 16 general ward nurses through in-depth interviews. Participants were selected from male nurses working in the general wards with over one year of clinical experience at a tertiary university hospital. The main question was "Can you describe your adaptation experience in the general ward as a nurse?" All interviews were recorded and transcribed, then analyzed using Colaizzi's method. Results: Four categories were derived from the analysis: 'difficulties from task adaptation by characteristics', 'limited nursing situation and circumstance as a male nurse', 'efforts to adapt at general nursing unit', and 'self-worth, and worry about something as a male nurse'. Conclusion: Male nurses had a difficulty adapting to work in wards due to lack of multi-tasking skills, as well as some social prejudice or negative views on male nurses. Establishing reasonable guidelines for male nurses in practice, promoting their responsibilities to patients, developing mentoring programs, and reassessing the policy of assigning male nurses to general wards are recommended to help in better adaptation.

• The Korean Journal of Pain
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• 제31권4호
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• pp.253-260
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• 2018

Background: One of the most frequent problems caused by diabetes is the so called painful diabetic neuropathy. This condition can be treated through numerous types of therapy. The purpose of this study was to analyze, as a meta-analysis, different treatments used to alleviate painful diabetic neuropathy, with the aim of generating results that help making decisions when applying such treatments to tackle this pathology. Methods: A search was conducted in the main databases for Health Sciences, such as PUBMED, Web of Science (WOS), and IME biomedicina (Spanish Medical Reports in Biomedicine), to gather randomized controlled trials about treatments used for painful diabetic neuropathy. The analyzed studies were required to meet the inclusion criteria selected, especially those results related to pain intensity. Results: Nine randomized controlled trials were chosen. The meta-analysis shows significant positive effects for those treatments based on tapentadol [g: -1.333, 95% CI (-1.594; -1.072), P < 0.05], duloxetine [g: -1.622, 95 % CI (-1.650; -1.594), P < 0.05], pregabalin [g: -0.607, 95% CI (-0.980; -0.325), P < 0.05], and clonidine [g: -0.242, 95 % CI (-0.543; -0.058), P < 0.05]. Conclusions: This meta-analysis indicates the effectiveness of the treatments based on duloxetine, gabapentin and pregabalin, as well as other drugs, such as tapentadol and topic clonidine, whose use is better prescribed in more specific situations. The results provided can help increase the knowledge about the treatment of painful diabetic neuropathy and also in the making of clinical practice guidelines for healthcare professionals.

• International Journal of Industrial Entomology and Biomaterials
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• 제32권1호
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• pp.12-25
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• 2016

Recently, research investment in the improvement of food safety as a food source and specializing of nutritional source of edible insects is being actively conducted. Cricket especially has been attracting considerable interest in entomophagy; however, research on the safety assessment of cricket is limited. This study investigated the effects of cricket ethanol extract when orally administrated in Sprague-Dawley rats. Here, we performed a 4 wk repeated oral dose toxicity test in Sprague-Dawley rats following the Organization for Economic Cooperation and Development test guidelines 407 under Good Laboratory Practice regulation. Rats were randomly allocated 4 groups: vehicle control, 250, 500, 1,000 mg/kg test groups and administrated based on body weight for 28 d. The animals were observed for mortalities and clinical signs, body weight changes, food and water consumption. At the end of treatment period, blood and urine were collected and analyzed. Subsequently, the animals were sacrificed and subjected to gross pathological examination and organ weight measurement. The organs were preserved for histopathological examination. The results showed that there were no systemic toxicological effects related with the cricket ethanol extract in the 4 wk oral repeated dose toxicity study. It is considered that NOAEL of cricket ethanol extract is greater than 1,000 mg/kg/d and there was no target organ detected.

• 한국전문물리치료학회지
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• 제24권4호
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• pp.54-59
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• 2017

Background: Light touch cue is a sensory input that could potentially help in the control of posture. The immediate stimulatory effect of light touch cues using a cane during gait is associated with postural stability. This strategy can help post-stroke individuals regain their ability to perform the sit-to-stand (STS) transfer safely. Objects: The effects of light grip on postural control during the STS transfer in post-stroke subjects were investigated. Methods: Eleven participants (6 men, 5 women) with hemiplegia due to stroke were recruited in the study. The subjects with hemiparesis performed STS transfer in three randomly assigned conditions (1) without a cane (2) light grip with a cane (3) strong grip with a cane. Results: The difference in weight-bearing distribution between the left and right feet, when the subjects were instructed to stand up, was $52.73{\pm}2.13%$ without a cane, $42.75{\pm}3.26%$ with a strong grip, and $43.00{\pm}2.55%$ with a light grip (p<.05). The rate of rise in force indicates the peak power provided by subjects during their STS transfers. The rate of rise in force was statistically significantly lower without a cane than that with a light grip or a strong grip (p<.05). The subjects' centers of pressure sway on the mediolateral side during STS transfers statistically significantly declined with a light grip or a strong grip when compared to those without a cane (p<.05). Conclusion: When the subjects with hemiparesis used a cane during STS transfers, their duration, center of pressure sway, and difference in weight-bearing distribution were all reduced. The subjects also exhibited similar results during STS transfers with a cane gripped lightly. This result may provide guidelines for the use of assistive devices when patients with hemiparesis practice STS transfers in clinical settings.

• 동의신경정신과학회지
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• 제29권3호
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• pp.135-144
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• 2018

Objectives: The purpose of this study was to analyze the medical cost for patients with vertigo and to examine associations between chronic vertigo and mental disorder using 2014 Health Insurance Review & Assessment Service-National Patients Sample (HIRA-NPS). Methods: We analyzed sociodemographic characteristics, medical cost and medical care use pattern for vertigo patients. We used hierarchical multiple logistic regression analysis to examine odds ratio between chronic vertigo and mental disorder. Results: A total of 46,502 people and 118,504 claims data were identified for vertigo cases. Characteristics of vertigo patients have significant differences on proportion of female patients (68.36%), patients' average age (54.98) and proportion of medical assistance (5.76%) compared with non-vertigo patients. Results revealed that Korean medicine are one of frequent methods among total treatments for vertigo patients. Total days of medical care and total costs are 2.78 days and 111,362 won, respectively, and days for outpatients in Korean medical care (mean: 2.26 days) are more than those (mean: 5.05 days) in Western medical care. There is significant difference relative to sex between acute vertigo and chronic vertigo. The odds ratio between chronic vertigo and mental disorder is estimated as 1.34, that means risk of becoming chronic is 34% higher for vertigo patients with mental disorder. Conclusions: This study assessed socio-demographic characteristics, medical care use and expenses related to vertigo, and estimated associations between chronic vertigo and mental disorder. Findings provide a basis for economic evaluation studies on vertigo patients and development of clinical practice guidelines for vertigo patients with mental disorder.