• 제목/요약/키워드: Clinical field

검색결과 2,055건 처리시간 0.029초

동측 반맹과 안면실인증을 호소하는 뇌경색 환자 한방복합치료 1례 (A Case of Combined Korean Medicine Treatment for Homonymous Hemianopia and Prosopagnosia after Ischemic Stroke)

  • 김근영;박호정;이유진;조기호;문상관;정우상;권승원;진철
    • 대한중풍순환신경학회지
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    • 제22권1호
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    • pp.21-30
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    • 2021
  • ■ Background Patients with posterior cerebral artery infarction could complain of visual field defects or prosopagnosia that does not recognize a person's face. However, there has been no standardized treatment for these symptoms. ■ Case report A 57-year-old male patient complained homonymous hemianopia and prosopagnosia after posterior cerebral artery infarction. After combined Korean medicine treatment for 49 days, subjective visual field was improved and the discomfort associated with visual field defect and the disability of recognizing people was decreased. Evaluations were took place by assessing visual field using Automated Perimetry and Confrontation visual field exam. Discomfort caused by visual field defects or prosopagnosia was evaluated by visual analog scale. The patient was treated with acupuncture, moxibustion, and herbal medications. ■ Conclusion The present case report suggests that combined Korean medicine treatment might be effective to resolution of homonymous hemianopia and prosopagnosia after stroke.

우리나라 전문간호사제도 개선방안에 관한 연구 (A Study on the Establishment of Clinical Nurse Specialist)

  • 변영순;김영임;송미숙
    • 지역사회간호학회지
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    • 제5권2호
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    • pp.130-146
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    • 1994
  • Our medical care system is trying to diversify in order to meet the client's needs, and to adjust to a medical environment which is changing very rapidly. Because current nursing theory and practice focus on holistic care, health care management, education, and research, contrary to the traditional emphasis on only assisting a physician, more autonomy and specialization for the implementation of nursing are required. Considering these trends and actual needs, the category of clinical nurse specialist should be established as soon as possible. In order to develop strategies for implementing this new professional specialty, the authors conducted a field survey and literature review of the current system in Korea. As a result, various obstacles and constraints were discovered as follows : 1) There are few accredited educational programs for the training of CNS's. 2) Several hospitals already have staff designated as clinical nurse specialist (CNS) even though the term CNS is not yet standardized or adopted in nationwide. 3) The role of the CNS is not clearly understood by the medical societies, or even nursing societies. A nurse who works in specific nursing areas such as central supply, kidney dialysis, intensive care, coronary care, etc. for a long time, considers herself /himself a CNS. Based upon the above findings, the following alternatives are recommended. 1) The role of the CNS should be defined according to specified functions and authority : professional autonomy ; counselling and educating patients and their familes, nurses, and even other medical personnel ; research on improvement of nursing ; and management of the nursing environment including medical resources, information, and cases. 2) the qualification of CNS should be attained only by a nurse who has an RN license and clinical experience of more than 3 years in a specific nursing field: passes a qualifying examination; and contributes to the professional development of peers, colleagues, and others. A master's degree should only be optional, because of the insufficient of graduate programs which are well designed for the CNS. 3) The CNS should initially be a head nurse rather than line staff in order to deal with as wide an experience base as possible. 4) The nursing specialty could be divided into two areas such as a clinical field and a community field. The clinical field could then be categorized by the Styles' classification such as diseases and pathogenics, systems, ages, acuity, skills/techniques, and function/role ; the community field could be classified according to work site.

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119구급대원의 병원 임상수련 운영 실태 및 만족도 (Operating conditions and satisfaction in a clinical training program for 119 emergency medical technicians)

  • 오현환;최은숙
    • 한국응급구조학회지
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    • 제19권2호
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    • pp.99-115
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    • 2015
  • Purpose: This study aimed to provide basic data for clinical training program development by analyzing the operating conditions and satisfaction in a clinical training program for 119 emergency medical technicians (EMTs) in South Korea. Methods: Data from 84 EMTs were collected on June 19, 2014. We administered a 64-item questionnaire about operating conditions and satisfaction in the clinical training program, and analyzed data (SPSS v 21.0). Results: The degree of performance in the field, importance of the item in the field, and level of difficulty were 3.36, 4.23, and 3.21, respectively. In the number of times that an item was directly performed according to the subjects' general characteristics a statistically difference in sex (p = .000), duty (p =.021), and total working time of trainees (p = .002). The subjects' total satisfaction score was 3.77. The difference in satisfaction according to the subjects' characteristics was a statistically significant in terms of sex (p = .016) and clinical training area (p = .005). Conclusion: A more efficient training system for hospital clinical training courses should be developed. The operation condition analyzed in this research may contribute to the improvement of the performance of EMTs.

Lymph Node Status after Neoadjuvant Chemoradiation Therapy for Esophageal Cancer according to Radiation Field Coverage

  • Kim, Sang Yoon;Park, Samina;Park, In Kyu;Kim, Young Tae;Kang, Chang Hyun
    • Journal of Chest Surgery
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    • 제52권5호
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    • pp.353-359
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    • 2019
  • Background: To explore the effect of radiation on metastatic lymph nodes (LNs) after neoadjuvant chemoradiation therapy (nCRT), we examined the metastatic features of LNs according to their inclusion in the radiation field. Methods: The patient group included 88 men and 2 women, with a mean age of $61.1{\pm}8.1$ years, who underwent esophagectomy and lymphadenectomy after nCRT. Dissected LNs were compared in terms of clinical suspicion of metastasis, nodal station, and inclusion in the radiation field. Results: LN positivity did not differ between LNs that were inside (in-field [IF]) and outside (out-field [OF]) of the radiation field (IF: 40 of 465 [9%], OF: 40 of 420 [10%]; p=0.313). In clinical N+ nodal stations, IF stations had a lower incidence of metastasis than OF stations (IF/cN+: 16 of 142 [11%], OF/cN+: 9/30 [30%]; p=0.010). However, in clinical N- nodal stations, pathological positivity was not affected by whether the nodal stations were included in the radiation field (IF/cN-: 24 of 323 [7%], OF/cN-: 31 of 390 [8%]; p=0.447). Conclusion: Radiation therapy for nCRT could downstage clinically suspected nodal metastasis. However, such therapy was ineffective when used to treat nodes that were not suspicious for metastasis. Because significant numbers of residual metastases were identified irrespective of coverage by the radiation field, lymphadenectomy should be performed to ensure complete removal of residual nodal metastases after nCRT.

동측 반맹 및 시력저하를 호소하는 후두엽 및 측두엽 뇌출혈 환자 한의복합치료 1례 (A Case of Combined Korean Medicine Treatment for Homonymous Hemianopia and Loss of Visual Acuity after hemorrhagic Stroke)

  • 성시윤;이다빈;이영선;조기호;문상관;정우상;권승원;이한결
    • 대한중풍순환신경학회지
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    • 제24권1호
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    • pp.25-40
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    • 2023
  • Background: Although not clarified, the overall prevalence of visual field loss after stroke was estimated at 52% of stroke survivors and for visual acuity loss, at 70% of them. Among visual field loss patients after stroke, homonymous hemianopia is the most common symptom. Visual defect degrades the quality of life by disrupting independent life and affecting the survival of the patients, but highly-evidenced treatment has not been found until now. ■Case report A 51-year-old female with left-side homonymous hemianopia and central vision loss by a right occipital-temporal hemorrhage was treated with Hyeolbuchukeo-tang, Ikgibohyeol-tang, acupuncture, electroacupuncture, and moxibustion. We used a confrontation visual field exam, automated perimetry and visual analog scale, and visual acuity test to observe changes in the patient's symptoms and evaluate the efficacy of the treatment. After 61 days of such interventions, the patient's subjective discomfort lessened, followed by positive changes in the scales of tests mentioned above. ■Conclusion This case suggests that combined Korean medicine treatment might be an effective tool for treating post-stroke homonymous hemianopia and central vision loss. More studies should be conducted to support the effectiveness of the treatment.

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어린이병원 신규간호사를 위한 간호역량 향상 교육프로그램 개발 및 효과검증 (The development and evaluation of a pediatric nurse education program to improve nursing competency for newly graduated nurses in a children's hospital)

  • 신혜경;김효영;김현정;김민경;신현주;이후연;한지희;이혜정
    • 한국간호교육학회지
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    • 제28권2호
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    • pp.179-192
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    • 2022
  • Purpose: The purpose of this study is to identify the effects of a standardized educational program to improve nursing competency on newly graduated nurses in a children's hospital after developing and applying a pediatric nurse education program. The effectiveness of the program was confirmed by evaluating the clinical competency and field adaptation. Methods: In the first step, an education program was developed using the analysis, design, development, implementation and evaluation (ADDIE) model. As a second step, a similar experimental study of a single group repeat measures design was conducted to evaluate the clinical competency and field adaptation over time after application of the program. Additionally, a focus group interviews were conducted to collect subjective data on the effects and improvement points of the program. Results: As a result of applying the program, there was a significant change in the clinical competence and the field adaptation of newly graduated nurses in a children's hospital. The categories derived from the focus group interviews were "getting special guidance," "better care," "becoming a nurse at a children's hospital" and "winning together." Conclusion: It was confirmed that the education program enhances the clinical competency of new nurses in children's hospitals. In addition, it provided the necessary data to understand the experiences of new nurses, help them adapt effectively, and establish appropriate interventions.

Assessment of the pigeon (Columba livia) retina with spectral domain optical coherence tomography

  • Kim, Sunhyo;Kang, Seonmi;Susanti, Lina;Seo, Kangmoon
    • Journal of Veterinary Science
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    • 제22권5호
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    • pp.65.1-65.12
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    • 2021
  • Background: To assess the normal retina of the pigeon eye using spectral domain optical coherence tomography (SD-OCT) and establish a normative reference. Methods: Twelve eyes of six ophthalmologically normal pigeons (Columba livia) were included. SD-OCT images were taken with dilated pupils under sedation. Four meridians, including the fovea, optic disc, red field, and yellow field, were obtained in each eye. The layers, including full thickness (FT), ganglion cell complex (GCC), thickness from the retinal pigmented epithelium to the outer nuclear layer (RPE-ONL), and from the retinal pigmented epithelium to the inner nuclear layer (RPE-INL), were manually measured. Results: The average FT values were significantly different among the four meridians (p < 0.05), with the optic disc meridian being the thickest (294.0 ± 13.9 ㎛). The average GCC was thickest in the optic disc (105.3 ± 27.1 ㎛) and thinnest in the fovea meridian (42.8 ± 15.3 ㎛). The average RPE-INL of the fovea meridian (165.5 ± 18.3 ㎛) was significantly thicker than that of the other meridians (p < 0.05). The average RPE-ONL of the fovea, optic disc, yellow field, and red field were 91.2 ± 5.2 ㎛, 87.7 ± 5.3 ㎛, 87.6 ± 6.5 ㎛, and 91.4 ± 3.9 ㎛, respectively. RPE-INL and RPE-ONL thickness of the red field meridian did not change significantly with measurement location (p > 0.05). Conclusions: Measured data could be used as normative references for diagnosing pigeon retinopathies and further research on avian fundus structure.

일부 치위생(학)과 학생들의 현장임상실습 만족도의 영향을 미치는 요인 (The factors to impact on the satisfaction of field practice among dental hygiene students)

  • 심선주;백하영;엄정선;정하얀;지혜미;황시내;한지혜
    • 대한치과의료관리학회지
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    • 제5권1호
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    • pp.22-30
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    • 2017
  • 연구목적: 본 연구는 치위생(학)과 학생들의 현장임상실습 만족도에 영향을 미치는 요인을 파악하여 학생들의 현장임상실습 만족도 증진을 위한 기초자료로 제공하고자 실시하였다. 연구방법: 본 연구의 연구대상으로는 본 연구의 목적과 내용 및 취지를 밝히고 설문내용을 설명한 후 연구 참여에 동의한 치위생(학)과 학생 중 임상실습을 경험한 3학년, 4학년 학생 108명을 대상으로 2016년 4월 1일부터 2016년 4월 7일까지 실시하였다. 연구 방법으로는 일반적인 특성 5문항, 실습병원의 특성 4문항, 전공만족도는 7문항, 병원특성 및 전공만족도는 12문항 총 26문항으로 구성하였으며 5점 리커트 척도를 사용하였다. 연구결과: 본 연구는 치위생(학)과 학생들의 전공만족도와 현장임상실습 만족도의 관련성을 파악하고 학생들의 전공만족도를 높이기 위한 교육방법을 계획함에 있어 기초자료를 제공하고자 실시하여 다음과 같은 결론을 얻었다. 1. 연구대상자의 일반적인 특성과 현장임상실습 만족 여부는 학과 내 교수님들과의 소통 정도가 높을수록, 선후배 간의 소통 정도가 높을수록, 그리고 학교에 대한 적응 정도가 높을수록 현장임상실습만족도가 높게 나타났다(p<0.05). 2. 실습병원 특성과 현장임상실습 만족도는 현장 임상실습의 주 당 실습시간이 적절했다고 대답할수록, 실습생들과 직원들과의 친밀도가 높을수록, 그리고 현장임상실습의 총 실습 시간에 대한 만족도가 높을수록 현장임상실습 만족도가 높게 나타났다(p<0.05). 3. 전공과목에 대한 관심이 높을수록, 학과 실습실에 대한 만족도가 높을수록, 그리고 교과목 편성에 대한 만족도가 높을수록 현장임상실습에 대한 만족도가 높게 나타났다(p<0.01). 결론: 치위생(학)과에서의 교육을 통해 학생들의 전공지식 습득의 효율성을 높이고 다양한 현장임상실습 환경에 적용할 수 있도록 하여 전공만족도와 현장임상실습 만족도를 모두 높일 수 있는 체계적인 전공교과목 편성과 교육방법에 대한 방안을 모색하여야 한다.

한국과 미국의 치위생학과 교육과정 운영실태 (The actual condition of operating dental hygiene curriculum between Korea and America)

  • 원복연;황미영;천석연
    • 한국치위생학회지
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    • 제10권6호
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    • pp.1061-1071
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    • 2010
  • Objectives : The purpose of this study is to train talents with high quality in dental hygienists by suggesting problems and proposing basic data available for applying to development in dental hygiene curriculum, through analyzing contents of dental hygiene curriculum. Methods : To analyze curriculum of educational institutions for dental hygienists between America and Korea, it utilized materials that were notified on each university homepage, analyzed documents, analyzed curricular content analysis, comparatively analyzed America's ASDHEP field, and comparatively analyzed Biomedical Science field, dentistry field, prevention and public field, clinical dental hygiene field, integrated curriculum, and teaching course between domestic university and American university. Results : 1. The basic field of ASDHEP was indicated the average credit in 28.6 for 4-year university with establishment and the average credit in 26.9 for 3-year university with establishment. The curricular subject field of ASDHEP except the basic field was indicated the average credit in 29.45 for 4-year university with establishment and the average credit in 30.68 for 3-year university with establishment. The prevention and public field by university was indicated the totally average credit in 27.5 for 4-year university and in 26.2 for 3-year university. The clinical dental hygiene field by university was indicated the totally average credit in 27.5 for 4-year university and in 35.0 for 3-year university. The integrated curriculum was indicated to be established dental hygiene practice(3 universities), dental clinics practice for Dept. of clinical dental hygiene(2 universities), and comprehensive dental hygiene practice(1 university) for 4-year university, and to be established clinical dental hygiene(2 universities), comprehensive dental hygiene practice, dental hygiene practice, and dental clinics practice(1 university, respectively) for 3-year university. Comparing the teaching courses by university, they were established diversely from 8 credits to 2 credits. Conclusions : Seeing the above findings, a plan for dental hygiene curriculum needs to be continuously developed so that dental hygienists can enter upon a professional career. Development in the international standard curriculum proper for global era is considered to be desperately needed.