• Korea Journal of Hospital Management
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• v.24 no.3
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• pp.61-71
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• 2019

Purposes: The purpose of this study is to analyze nurses' perception on the clinical career ladder system which was introduced to enhance the nursing capabilities in general hospital. Methods: Research data has been collected for approximately 30 days since March 28, 2017 from 171 nurses who had been involved in the clinical career ladder system, 177 nurses who had not participated, and a total of 348. Finding: The study results showed that nurses' perception on the cost effectiveness of clinical career ladder system is significantly different depending on the sex, age, program experience, personal stage in the clinical career ladder system and the individual's health condition. In addition, the nurses' willingness to pay for the clinical career ladder system was significantly associated with their department and the needs for the system. With adjusted age, gender, position, education and marital status, nursing competency was 8.71(95% Confidence Interval; 4.79 to 12.63) in the presence of system experience, but the perception on clinical career ladder system was 4.34(95% Confidence Interval; -6.84 to -1.84). Practical Implications: Based on the study results, we expect that more hospitals introduce the clinical career ladder system and also use these study results as basic data for securing excellent nurses.

• Korean Journal of Acupuncture
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• v.29 no.4
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• pp.519-536
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• 2012

Objectives : The purpose of this study is to figure out which acupoints are selected to treat low back pain and attempt to analyze the effectiveness of those acupoints in current clinical trials. Methods : We searched the three electronic databases(PUBMED, RISS, KISS) and manually checked related Korean journals and reference lists up to April 2012. We included randomized controlled trials, clinical controlled trials, and case reports/series using needle type acupuncture( manual acupuncture, electronic acupuncture) to treat low back pain in English and Korean. We investigated the frequency of selected acupoints, change of visual analogue scale of low back pain and statistical significance in each study among trials. Results : We included 37 articles(Domestic 17, International 20) 53 studies(Domestic 28, International 25) in this study. The most frequently adopted acupoints were BL23, BL24, BL25, GB30, BL26, BL60, BL32, BL40, KI3, GV3, ST36 in domestic studies and BL23, BL25, BL40, BL60, GB30, GB34, BL32, BL26 in international studies. There were differential effectiveness of acupoints between domestic and the international studies using statistical significance of visual analog scale for low back pain. Conclusions : These results suggest that both proximal and distal acupoints based on meridian theory were used in clinical trials to treat low back pain. It would be helpful to provide clinical guideline, evaluate the results of clinical trials appropriately, and reveal the effectiveness of acupoints.

• Journal of Acupuncture Research
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• v.32 no.4
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• pp.147-156
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• 2015

Objectives : This study aims to evaluate the effectiveness and safety of Korean medicine for a thoracolumbar compression fracture. Methods : We searched six Korean databases (DBPIA, Korean Studies Information Service System, Oriental Medicine Advanced Searching Integrated System, National Digital Science Library, Research Information Sharing Service, KoreaMed) (up to June 2015) and the Journal of Korean Acupuncture and Moxibustion Society. Unpublished studies were also searched. Clinical research, other than case reports involving less than 10 patients, were eligible. The effectiveness and safety of Korean Medicine was analyzed. The 'Risk of Bias' was assessed using the 'Risk of Bias' assessment tool for non-randomized studies as well as the Cochrane Collaboration's 'Risk of Bias' tool. Results : We found 12 before-after studies (374 patients). There was no randomized trial. All studies combined at least three different types of Korean medicine treatments. The period of treatment varied between less a week and 154 days. All the included studies reported improvements in pain, functional disability related to lower back pain, global assessment, and benefits in the compression ratio of a fractured vertebrae and skin temperature measured by digital infrared thermal imaging in comparison with the baseline. However, all studies had a high risk of bias and three studies reported mild adverse events. Conclusions : There is no randomized trial for the role of Korean medicine for patients with a thoracolumbar compression fracture. The effectiveness and safety of Korean medicine for this population remains unclear. Findings in this review are seriously biased due to observational design and a high risk of bias included in the studies. Future high-quality randomized trials are warranted.

• Journal of Korean Academy of Nursing
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• v.29 no.4
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• pp.855-869
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• 1999

The purpose of this study was to test the effectiveness of self-management relaxation training through biofeedback and progressive muscle relaxation methods. The effectiveness of the experimental methods was tested by measuring the degree of symptoms of stress (SOS), the McNair's profile of Mood States (POMS), the levels of ephinephrine, norepinephrine, pulse rate, blood pressure and natural killer cells. The subjects of this study were sixty six nursing students divided into four groups : two groups were the biofeedback and progressive muscle relaxation groups, the other two groups served as control groups. One was a group of sophomores with no experience at all, the other a junior group without self -management or relaxation training. This study was conducted for eight weeks of clinical practice from April, 26th 1998 to June, 20th 1998. Biofeedback training was done with software developed by J&J company (1-410 form for abdominal respiration training). Progressive muscle relaxation training was done with u audiotape recorded according to Jacobson's Theory. The data were analyzed with frequencies, means, and analysis of covariance using the SPSS program and the significance level of statistics was 5%. The results of the study are : 1) The importance of clinical practice stress reduction is shown in that the level of symptoms of stress in the experimental groups in clinical practice was higher than in the group receiving only a lecture. 2) The relaxation training methods of biofeedback and progressive muscle relaxation were effective in reducing the symptoms of stress under the clinical practice stress conditions. 3) The effectiveness of the biofeedback training relaxation method to reduce symptoms of stress was higher than that of progressive muscle relaxation. 4) The relaxation training methods of biofeedback and progressive muscle relaxation were effective in reducing stressful mood states. 5) The relaxation training methods of biofeedback and progressive muscle relaxation were not effective in reducing epinephrine and norepinephrine levels. 6) The relaxation training methods of biofeedback and progressive muscle relaxation were effective in increaing the number of natural killer cells. 7) The relaxation training methods of biofeedback and progressive muscle relaxation were effective in decreasing high systolic and diastolic values of blood pressure and high pulse rates. In summary, the relaxation methods of biofeedback and progressive muscle relaxation in reducing clinical practice stress were effective in lowering the level of symptoms of stress and the profile of stressful mood states. They were also effective in lowering high blood pressure and pulse rates. The relaxation methods were effective in increasing the number of natural killer cells as part of the immune function. However, relaxation methods were not effective in reducing the catecholamine level. The biofeedback training method for reduction of symptoms of stress was more effective than the progressive muscle relaxation method.

• Korean Journal of Radiology
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• v.24 no.12
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• pp.1249-1259
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• 2023

Objective: This study aimed to evaluate the clinical outcomes and cost-effectiveness of dual-energy X-ray absorptiometry (DXA) for osteoporosis screening. Materials and Methods: Eligible patients who had and had not undergone DXA screening were identified from among those aged 50 years or older at Kaohsiung Veterans General Hospital, Taiwan. Age, sex, screening year (index year), and Charlson comorbidity index of the DXA and non-DXA groups were matched using inverse probability of treatment weighting (IPTW) for propensity score analysis. For cost-effectiveness analysis, a societal perspective, 1-year cycle length, 20-year time horizon, and discount rate of 2% per year for both effectiveness and costs were adopted in the incremental cost-effectiveness (ICER) model. Results: The outcome analysis included 10337 patients (female:male, 63.8%:36.2%) who were screened for osteoporosis in southern Taiwan between January 1, 2012, and December 31, 2021. The DXA group had significantly better outcomes than the non-DXA group in terms of fragility fractures (7.6% vs. 12.5%, P < 0.001) and mortality (0.6% vs. 4.3%, P < 0.001). The DXA screening strategy gained an ICER of US$ -2794 per quality-adjusted life year (QALY) relative to the non-DXA at the willingness-to-pay threshold of US$ 33004 (Taiwan's per capita gross domestic product). The ICER after stratifying by ages of 50-59, 60-69, 70-79, and ≥ 80 years were US$ -17815, US$ -26862, US$ -28981, and US$ -34816 per QALY, respectively. Conclusion: Using DXA to screen adults aged 50 years or older for osteoporosis resulted in a reduced incidence of fragility fractures, lower mortality rate, and reduced total costs. Screening for osteoporosis is a cost-saving strategy and its effectiveness increases with age. However, caution is needed when generalizing these cost-effectiveness results to all older populations because the study population consisted mainly of women.

• Korean Journal of Clinical Pharmacy
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• v.25 no.3
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• pp.151-158
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• 2015

Objective: This study was designed to compare pegfilgrastim and filgrastim in diffuse large B-cell lymphoma (DLBCL) patients treated with a rituximab with cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisone (R-CHOP) regimen in terms of clinical efficacy and cost-effectiveness. Method: Clinical efficacy was measured by trough level of absolute neutrophil count (ANC), days of ANC under 50% of baseline value, days of ANC under 90% of baseline value, duration of ANC recovery to baseline value, days of ANC less than $0.5{\times}10^9cells/L$, and difference of peak and trough level of ANC during 1 cycle of R-CHOP regimen. To evaluate cost-effectiveness, total prices of used filgrastim and pegfilgrastim within 1 cycle of R-CHOP were analyzed. Results: In terms of clinical efficacy, trough level of ANC and days to ANC recovery showed statistical significance. The median trough levels of ANC with administration of filgrastim and pegfilgrastim were 0.18 and 1.94 (p = 0.021), respectively, and the median durations of ANC recovery to baseline value were 5.5 days and 2 days (p = 0.023), respectively. For the median days of ANC under 50% of baseline value, days of ANC under 90% of baseline value, days of ANC less than $0.5{\times}10^9cells/L$, and difference of peak and trough level of ANC during 1 cycle of R-CHOP, the pegfilgrastim group performed better than the filgrastim group. However the difference was not statistically significant. In terms of overall expense during 1 cycle of R-CHOP, pegfilgrastim is about 3.43 times more expensive than filgrastim. Conclusion: Pegfilgrastim is more efficient than filgrastim in terms of clinical efficacy. In terms of prices, pegfilgrastim is more expensive than filgrastim for patients, but it is more convenient in clinical use. Therefore, pegfilgrastim should be the preferred choice of G-CSF for neutropenic patients. Further comparative study of pegfilgrastim and filgrastim is needed.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.7 no.1
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• pp.109-121
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• 2000

Increasingly nursing science is embracing the concepts and methodology derived from psycho-neuroimmunology. It has been previously shown that stress increases and immune function declines in students undergoing examinations. To date, however, no many studies have been reported on stress levels, immune function and interventions in Korean students undergoing their first clinical nursing rotation. It was proposed that nursing students during their first clinical rotation experience increase in stress because of the novelty of the situation and their lack of clinical knowledge. It was also hypothesized that biofeedback and progressive relaxation, methods of self-regulation of involuntary autonomic nervous system responses, would reduce the stress response. The purpose of this study is to test the effectiveness of progressive muscle laxation using biofeedback The effectiveness of the experimental methods was tested by measuring the degree of symptoms of stress (SOS) and the values of ephinephrine, pulse rate, blood pressure and natural killer cells. The subjects of this study were thirty nursing students divided into two groups: experimental group was progressive muscle relaxation group using biofeedback and control group. This study was conducted for 8 weeks of clinical practice. Biofeedback training was done by software developed by J&J company (1-410 form for progressive muscle training). Progressive muscle relaxation training according to Jacobson's Theory was done by messaged word from biofeedback. The data was analyzed using Chronbach' ${\alpha}$ and t-test of the SPSS program and the significance level of statistics was 5%. The results of the study were : 1) The progressive muscle relaxation training using biofeedback was effective for the reduction of symptoms of stress(t=-4.248, p<.001) under clinical practice stress conditions. 2) The progressive muscle relaxation training using biofeedback was not effective for the values of epinephrine(t=-1.294, p=.206). 3) The progressive muscle relaxation training using biofeedback was effective for the reduction of systolic blood pressure (t=-2.757, p=.01). 4) The progressive muscle relaxation training using biofeedback was effective for the reduction of diastolic blood pressure (p=-2.032, 0=.05). 5) The progressive muscle relaxation training using biofeedback was not effective for the reduction of pulse rate(t=-15, p=.988). 6) The progressive muscle relaxation training using biofeedback was effective for the maintenance of natural killer cells (t=2.381, p=02). The first clinical rotation for student nurses is a stressful experience as seen by the rise in the SOS in the control group. Biofeedback using progressive muscle relaxation were effective in preventing the rise of symptoms of stress and the blood pressure means when comparing the pre to post clinical experience, The mean natural killer cell count was depressed in the control group but not significantly different in the experimental groups, It is proposed here that stress via the hypothalamic - pituitary - adrenal axis suppressed the NK cell count whereas the relaxation methods prevented the rise in stress and the resulting immune depression. We recommend relaxation techniques using biofeedback as a health promotion technique to reduce psychological stress. In summary. the progressive muscle relaxation training using biofeedback was effective for the reduction of symptoms of stress under clinical practice stress conditions.

• Korean Journal of Acupuncture
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• v.30 no.3
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• pp.151-160
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• 2013

Objectives : The purpose of this study is to review the thread embedding treatment studies of obesity in Traditional Chinese Medicine. Methods : We reviewed 59 studies on cat-gut-embedding treatment of obesity which were published from 2005 to 2012. The studies were searched using the data base-CAJ(China Academic Journals; 中國期刊全文數據庫)(2005~2012). Results : Selected 59 studies were divided into 27 case series and 32 control studies. The number of studies has increased since 2005, more rapidly in 2011~2012. Most case series reported were about effectiveness of thread embedding monotherapy treating obesity. Control studies reported were about effectiveness of thread embedding treatment compared with acupuncture, electroacupuncture, and medicine. Most studies on thread embedding treatment of obesity showed that its effectiveness was very good. Conclusions : There have been many reports of thread embedding treatment studies of obesity in Traditional Chinese Medicine. We believed that these studies could be applied to the clinical practice and basic research in Korea.

• Journal of Acupuncture Research
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• v.17 no.3
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• pp.99-105
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• 2000

Objectives : 19 patients diagnosed with chronic paranasal sinitis among the patients who visited to Kyunghee University Oriental Medical Center Department of Acupuncture and moxibustion from July, 1999 through July, 2000. Methods : The needle used in the treatment was 16cm in length and 0.375mm in radius. Using the straight needling method the choana was acupunctured straightly, and the opening of maxcillary sinus was acupunctured obliquely with the oblique needling method. Resuits : Looking at the effectiveness of this nasal acupuncture treatment, excellent was found in 4 cases(21%), good in 13 cases(68.4%), and unchanged in 2 cases(10.5%). The effectiveness totals up to 17 cases (89.4%) which is considerably high. Conclusions : Nasal acupuncture treatment can be used with high effectiveness in treatment of the chronic paranasal sinitis.

• The Journal of Korean Academic Society of Nursing Education
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• v.7 no.1
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• pp.54-67
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• 2001

This study was tried to investigate the effectiveness of assertive training on the state anxiety and assertive behavior which nursing students had experienced during clinical practice training from April 29, to June 5, 2000. Subjects for this study were thirty-six nursing students of practicing in a general hospital. Eighteen nursing students were assigned for the experimental group and trained by assertive training program during 4 weeks and eighteen nursing students were assigned for the control group. The assertive training program was composed of cognitive, behavioral and emotional assertive training. Post- test assessment was administrated to all subjects on a week later after the last session. The data were analyzed with SPSS PC programs. The results of this study were summarized as follows: 1) There were no significant differences between the experimental group and the control group on post- intervention comparisons of the state anxiety score (p=0.230), but in the experimental group, the anxiety score more decreased after the assertive training than that in the control group with significant differences(p=0.019). 2) There were no significant differences between the experimental group and the control group on post- intervention comparisons of assertive behavior (p=0.530). However, after the assertive training, the experimental group became more assertive than the control group with no significant differences(p=0.721). 3) The hypothesis that the more the assertive behavior, the less the state anxiety experienced by nursing students of clinical practice training was supported(r=-0.397, p=0.017). On the basis of this study results, the assertive training is effective for the reduction of the state anxiety experienced by nursing students of clinical practice training.