• 제목/요약/키워드: Clinical Setting

검색결과 896건 처리시간 0.027초

노인에서 임상적 균형평가 지수들의 유용성 : 힘판을 이용한 균형평가와의 상관관계 (The Usefulness of Clinical Balance Tests in Elderly : Correlation of Balance Evaluation using by Forceplate)

  • 우영근;황수진;이우형
    • PNF and Movement
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    • 제8권1호
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    • pp.67-77
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    • 2010
  • Purpose : The purpose of this study was to investigate the usefulness of clinical balance tests through the correlation of balance evaluation using by forceplate in elderly. Methods : Thirty nine healthy elderly subjects (14 males, 25 females) participated in the study. The subjects were evaluated with clinical balance tests [(Berg balance scale (BBS), Functional reach test (FRT), Tinetti's performance oriented mobility assessment (POMA), and one leg standing (OLS)]. Static balance evaluation was assessed by using forceplate. Center of pressure (COP) parameters were obtained using it as total path distance, total sway area, X mean frequency and Y mean frequency for 20 seconds in the following conditions: (1) comfortable standing with eyes opened and closed, (2) uncomfortable standing with eyes opened and closed. After static balance evaluation tested, dynamic balance evaluation was assessed. COP parameters were error distance and area during sine curve trace. COP parameters were movement time, error distance, and maintained time in the circle during COP movement task. Results : Clinical balance tests showed statistically significant correlation between static and dynamic balance evaluations. Among the clinical balance tests, the BBS, POMA, and OLS showed significant correlation with to assess the balance ability of elderly in clinical setting both evaluations. Conclusion : Clinical balance tests can be recommended in clinical setting because of low costs and simplicity.

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초기사정을 위한 간호정보조사지의 임상내용 모델 개발 (Development of Detailed Clinical Models of Nursing Information for Initial Assessment)

  • 김영란;박현애;민열하;이명경;이영지
    • 임상간호연구
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    • 제17권1호
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    • pp.101-112
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    • 2011
  • Purpose: The purpose of this study is to develop a detailed clinical model for recording initial nursing assessment items, and to test the applicability of the model to facilitate semantic interoperability for sharing and exchanging nursing information. Methods: First, the researchers extracted items by analyzing initial nursing assessment records. Second, defining characteristics were identified by analyzing nursing records and reviewing the literature. Third, value sets for defining characteristics were identified and types and cardinalities of defining characteristics were defined based on the value sets. Finally, the detailed clinical model was tested through evaluation by experts and comparison with the initial nursing assessment in a clinical setting. Results: Sixty-one detailed clinical models were developed with 178 defining characteristics and value sets. The experts evaluation and comparison with the initial nursing assessment in a clinical setting showed that the detailed clinical model developed in this study was valid. Conclusion: Use of this detailed clinical model can ensure that the Electronic Health Record contains meaningful and valid information and supports semantic interoperability of nursing information. This use will promote quality in the nursing records and eventually quality of nursing care.

아동간호학 임상실습 교육의 방향

  • 박문희
    • 대한간호
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    • 제35권4호
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    • pp.51-56
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    • 1996
  • This research was an attempt to restructure the curriculum of pediatric clinical education on the base of the analysis of the pediatric clnical experience of nursing students acquired according to the traditional hospital-based pediatric clinical education and the evaluation of its results. As the focus of health care changes, pediatric clinical education the future necessitates changes in the traditional clinical experince at all levels. The traditional concentration of clinical experience within an acute care setting must be restructured to include the expanding future roles of the nurse and the changes in the health care structure. In order to meet the need for restructuring, it is inevitably necessary to adopt an organizational design for pediatric clinical experience that is not all traditional. The additional experiences and variety of settings will enhance the quality of pediatric clinical experience. And as a matter of course this organizational change will enhance the student learning experience by giving them the opportunity to observe normal growth and development, preventive health care measures, and the role of the nurse outside the acute care setting. As the nursing's focus changes to meet the challenges of the future the faculty must apply themselves to these changes to prepare students for the future. Students must be ready to fill the many roles that nurses will hold in the future.

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소아 자폐스펙트럼 장애의 추나 치료에 대한 중의학 임상 연구 고찰 (Review of Traditional Chinese Medicine Clinical Studies on Tuina Treatment of Children's Autism Spectrum Disorder)

  • 박젬마
    • 대한한방소아과학회지
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    • 제35권3호
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    • pp.28-42
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    • 2021
  • Objectives The purpose of this study is to investigate the effect of Tuina treatment for children with Autism Spectrum Disorder (ASD), and to propose guidance to future studies or application in clinical setting. Methods The articles published from year 2000 to May 2021 by China National Knowledge Infrastructure (CNKI) were searched by setting up field as '中醫學', '中藥', '中西醫結合' and by setting up keyword as '小儿自閉症', '儿童自閉症', '自閉症譜系障碍', 'Autism', 'Autism spectrum disorder' that corresponds to participant and '推拿', '導引', '按摩', 'Tuina', 'massage'. Results Nine selected articles were analyzed and summarized by authors and year published, characteristics, diagnostic criteria, treatment methods and contents, treatment duration, evaluation criteria and results of the study. The articles were also reviewed by reported side effects, and evaluated the quality of the study according to Cochrane Handbook's Risk of Bias 2 (RoB 2) assessment of the Randomized Control Trial (RCT) articles. All studies used Tuina treatment to achieve effective results for pediatric autism spectrum disorder. Conclusion Pediatric Tuina treatment (TM) is a non-invasive treatment that does not stimulate patients with unstable ASD but increase patient adherence, and can be safely and simply operated. Therefore, pediatric Tuina treatment is worth utilizing as a clinical basis for further development of ASD treatment.

Capecitabine Pattern of Usage, Rate of Febrile Neutropaenia and Treatment Related Death in Asian Cancer Patients in Clinical Practice

  • Phua, Vincent Chee Ee;Wong, Wei Quan;Tan, Pei Lin;Bustam, Anita Zarina;Saad, Marniza;Alip, Adlinda;Ishak, Wan Zamaniah Wan
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권4호
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    • pp.1449-1453
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    • 2015
  • Background: Oral capecitabine is increasingly replacing intravenous 5-fluorouracil in many chemotherapy regimens. However, data on the risk of febrile neutropaenia (FN) and treatment related death (TRD) with the drug remain sparse outside of clinical trial settings despite its widespread usage. This study aimed to determine these rates in a large cohort of patients treated in the University of Malaya Medical Centre (UMMC). Materials and Methods: We reviewed the clinical notes of all patients prescribed with oral capecitabine chemotherapy for any tumour sites in University Malaya Medical Centre (UMMC) from $1^{st}$ January 2009 till $31^{st}$ June 2010. Information collected included patient demographics, histopathological features, treatment received including the different chemotherapy regimens and intent of treatment whether the chemotherapy was given for neoadjuvant, concurrent with radiation, adjuvant or palliative intent. The aim of this study is to establish the pattern of usage, FN and TRD rates with capecitabine in clinical practice outside of clinical trial setting. FN is defined as an oral temperature > $38.5^{\circ}C$ or two consecutive readings of > $38.0^{\circ}C$ for 2 hours and an absolute neutrophil count < $0.5{\times}10^9/L$, or expected to fall below $0.5{\times}10^9/L$ (de Naurois et al., 2010). Treatment related death was defined as death occurring during or within 30 days of last chemotherapy treatment. Results: Between $1^{st}$ January 2009 and $30^{th}$ June 2010, 274 patients were treated with capecitabine chemotherapy in UMMC. The mean age was 58 years (range 22 to 82 years). Capecitabine was used in 14 different tumour sites with the colorectal site predominating with a total of 128 cases (46.7%), followed by breast cancer (35.8%). Capecitabine was most commonly used in the palliative setting accounting for 63.9% of the cases, followed by the adjuvant setting (19.7%). The most common regimen was single agent capecitabine with 129 cases (47.1%). The other common regimens were XELOX (21.5%) and ECX (10.2%). The main result of this study showed an overall FN rate of 2.2% (6/274). The overall TRD rate was 5.1% (14/274). The FN rate for the single agent capecitabine regimen was 1.6% (2/129) and the TRD rate was 5.4% (7/129). All the TRDs were with single agent capecitabine regimen were used for palliative intent. Conclusions: Oral capecitabine is used widely in clinical practice in a myriad of tumour sites and bears a low risk of febrile neutropaenia. However, capecitabine like any other intravenous chemotherapeutic agent carries a significant risk of treatment related death.

의료현장에서의 설명동의에 대한 윤리적 고찰 (An Ethical Appraisal of Informed Consent in the Clinical Setting)

  • 공병혜;이원희;김인숙;김수;이선희
    • 성인간호학회지
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    • 제19권4호
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    • pp.556-566
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    • 2007
  • Purpose: This study attempted to analyze problems of informed consent in the clinical setting and appraise ethical aspects inherent in such issues in order to boost awareness of informed consent and its implementation among healthcare professionals. Methods: Study methods included identifying ethical meanings of informed consent in the clinical setting based on the principal ethics, and exploring the process of informed consent utilizing communicative ethics and feminine care ethics Results: The ethical basis of informed consent encompasses not only respect for autonomy but also prohibiting malice, practicing beneficience, and establishing justice. These principles, however, are limited in illustrating the ethical aspects of communicative ethics and care ethics that are entailed in informed consent within clinical settings. The ethical meaning of informed consent involves a communicative and caring process between healthcare professionals, patients, and family built on mutual respect. Conclusion: Healthcare professionals must fully understand the ethical meanings of informed consent and in turn respect and protect the clients' right to know and making decisions. Nurses especially, must take on the role of mediator and advocate throughout the process of obtaining informed consent, and practice ethical caring by facilitating communication grounded in mutual understanding among the physician, patient, and family members.

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Adiponectin Reference Range설정과 임상적 의의 고찰 (Setting of Adiponectin Reference Range and Clinical Significance of investigation)

  • 김용하;오춘순;이안나
    • 핵의학기술
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    • 제12권1호
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    • pp.82-87
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    • 2008
  • Purpose: The Bio-energy metabolism control hormone by Adipocytokine is composed with Leptin, Adiponectin, resistin, TNF-a, IL-6. Adiponectin become known to participating in Insulin sensitivity exasperation, Fat metabolism accomodation and inducing metabolic disease such as diabetes mellitus, arteriosclerosis, hyperlipemia. When we accomplished the test with purpose of Research, we observed significance with a result of test related to diabetes mellitus with reference setting by way of suggestion. Methods: Result of normal group (n=100) which is committed in the SCL from September 2006 to December 2006 and result of control group (n=50) relationship examination item that is decided diabetes measures themselves against each other. Also, we measured the normal group against the control group for the reference range of adiponectin. Results: Result in normal group (n=100) appeared by Glucose (reference 70~120 mg/dl) Mean and the SD 96.99 (${\pm}24.35$), HbA1c (reference 4.0~6.0%) Mean and the SD 5.64 (${\pm}0.90$), Insulin (reference 2.0~25.0 uIU/ml) Mean and the SD 7.80 (${\pm}4.42$), the Adiponectin the Mean and the SD 9,861.23 (${\pm}4,977.0$). Result in control group(n=50) appeared by Glucose (reference 70-120 mg/dl) Mean and the SD 224.95 (5.30), the HbA1c (reference 4.0~6.0%) Mean and the SD 8.22 (1.63), Insulin (reference 2.0~25.0 uIU/ml) Mean and the SD 17.02 (3.01), C-peptide (reference 0.48~3.30 ng/ml) Mean and the SD 7.92 (${\pm}7.40$), the Adiponectin Mean and the SD 18,110.03 (${\pm}12,843.29$). Conclusions: Therefore, it seems that test results are significant and we consider that it can be apply to useful diagnosis of diabetes mellitus, arteriosclerosis, hyperlipemia patients throughout the reference range setting of Adiponectin, Leptin is one of the Bio-energy metabolism control hormone.

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환자중심 목표설정이 아급성기 뇌졸중 환자의 재활치료 성과에 미치는 영향 (The Effect of Patient-Centered Goal Setting on Rehabilitation Outcomes in Patients With Subacute Stroke)

  • 원종임;안창만;박민희
    • 한국전문물리치료학회지
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    • 제25권1호
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    • pp.31-38
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    • 2018
  • Background: Patient-centered care has recently become highly recommended, because it can improve health outcomes more effectively than problem-oriented care. The goal attainment scale (GAS) is one of the methods used for patient-centered care. It was originally developed as an outcome measurement tool, but it can also be used as a therapeutic intervention when setting quantifiable patient-centered goals. Objects: We sought to identify the effect of setting patient-centered goals on rehabilitation outcomes in patients with subacute stoke using GAS. Methods: Overall, 46 subjects with subacute stroke were divided into experimental ($n_1=23$) and control ($n_2=23$) groups. Subjects in both groups attended physical therapy sessions five times a week for four weeks. Those in the experimental group set goals using goal-attainment scaling. The mobility of each subject was evaluated using the Rivermead mobility index (RMI); daily-living activities, using the K-modified Barthel index (K-MBI); participation, using the Hopkins rehabilitation-engagement rating scale (HRERS); satisfaction, using the patient-satisfaction scale (PSS). Results: Subjects in the experimental group experienced more significant increases in RMI, HRERS, and PSS than those in the control group (p<.05, p<.05 and p<.01, respectively). After four weeks, GAS scores of the experimental group had increased more significantly than those of baseline (p<.01). Conclusion: Setting patient-centered goals is effective in improving the mobility and satisfaction of patients with subacute stoke. Setting patient-centered goals needs to be performed more frequently in clinical settings.

방사선(학)과 재학생의 임상적응 향상을 위한 개방형 임상실습 프로그램의 제안 (Development of Open Clinical Training Program to Improve Radiology-Major Students' Clinical Competency)

  • 김선칠
    • 대한방사선기술학회지:방사선기술과학
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    • 제33권3호
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    • pp.193-201
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    • 2010
  • 본 연구는 환자 중심의 의료서비스를 강화하고 있는 현 병원 이미지에 부합하는 개방형 임상실습 프로그램을 개발하여 방사선(학)과 졸업생의 임상 적응력과 전문성을 높이는데 목적을 두고 있다. 개방형 임상실습 프로그램은 학습모형 개발과정과 유사하여 ADDIE학습모형을 근간으로 각 단계별 요소를 구성하여 개발하였다. 문헌고찰과 임상의 요구사항을 수렴하여 일부 학생을 대상으로 1차 시안을 통해 예비수업을 시행하였으며, 관련 전문가의 자문과 수정을 거쳐 프로그램을 개발하였다. 개발된 프로그램은 전문가 그룹을 통해 내용 타당도의 검증을 받고자 하였다. 분석, 설계, 개발, 실행, 평가의 다섯 단계가 순환적으로 구성되어 있는 프로그램은 임상의 변화와 요구사항에 적절한 학습과제에 대해 적용할 수 있는 단계별 과정으로 구현되었다. 프로그램의 유용성과 단계별 내용 타당도는 유의 수준에서 만족한 결과를 도출하였다. 개방형 임상실습 프로그램은 의료계의 요구사항과 효과적인 학습 프로그램 적용을 통해 임상에 있는 방사선사가 환자 중심의 의료서비스에 좀 더 적극적으로 임상에 적응하고 이를 통해 전문적인 전공기술을 활용하는데 도움을 주고자 제안되었다.