• Title/Summary/Keyword: Clinical nurses

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Inter-rater Reliability and Training Effect of the Differential Diagnosis of Speech and Language Disorder for Stroke Patients (뇌졸중 환자의 말, 언어장애 선별에 대한 검사자간 신뢰도 및 훈련효과)

  • Kim, Jung-Wan
    • The Journal of the Korea Contents Association
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    • v.11 no.9
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    • pp.407-413
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    • 2011
  • Distinguishing aphasia in stroke patients and observing the subtle linguistic characteristics associated with it primarily requires the use of instruments that provide reliable assessment results. Additionally, examiners should be fully aware of how to use those instruments. This study examined 46 stroke patients for aphasia and assessed the reliability of their diagnoses according to examiners whose medical fields were different from each other. Furthermore, a comparison was made between the reliability before training and that after training. To this end, 46 stroke patients were tested for aphasia and in terms of their speech disorder degree by 3 groups, each of which consisted of 12 professionals (3 SLP, 3 neurologist, and 3 nurse). In the result, a rating of 'acceptable' was given for speech intelligibility tasks and the voice quality of /ah-/ prolongation, and other sub-tests were marked as 'good-excellent' by the experts with different areas of medical expertise. For the tasks marked as 'acceptable', the subjects were video-trained for 3 weeks and the differences were compared before and after their training. Consequently, the differences in the examiners' ratings in the speech intelligibility tasks showed a significant decrease and the accuracy of their voice quality ratings showed a significant increase. In the result of research on the correlation between the accuracy of the sub-test ratings and the amount of clinic experience, speech therapists developed more accuracy in rating a picture description task and a speech intelligibility task as their experience accumulated. Meanwhile, doctors and nurses showed more accurate ratings in picture description tasks with greater clinical experience. The results of this study suggest that assessing the neurologic-communicative disorders of stroke patients requires ongoing training and experience, especially for speech disorders. It was also found that the rating reliability in this case could be improved by training.

Current Roles and Administrative Facts of the Korean Physician Assistant (전담간호사 운영현황과 역할 실태)

  • Kwak, Chan-Young;Park, Jin-Ah
    • The Journal of the Korea Contents Association
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    • v.14 no.10
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    • pp.583-595
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    • 2014
  • Hospitals in Korea have been increasingly using physician assistants (PA) as an alternative way of dealing with the shortage of residents. However, some incidents of a Physician's Assistant practicing beyond their legal scope require closer examination of the current PA's roles and functions. This study is a web-based survey designed towards targeting physician assistants in Korea (KPA) who practice delegated tasks under a physician's license. Currently, there are 2,125 KPAs working in 141 general hospitals and medical centers. Data from 704 nurses from who responded to the questionnaire were analyzed with descriptive statistics using the SPSS 12.0 program. Their mean age is 32.5 years with 8-10 years of clinical experiences, with males being more likely to be a PA. Despite of KPAs providing medical services and performing invasive procedures, only 13% of KPAs are licensed APNs (advanced practice nurse). KPAs have a low job satisfaction due to a lack of rewards and the necessity for providing illegal practices, and are experiencing identity confusion. The current KPA system is a transitional product of the change from the hierarchial structure to a more collaborative relationship between the medical and nursing departments. Providing adequate education and training, establishing protocols with legal protection, and developing professional independent scope of care are recommended to deliver safe and efficient medical services.

A Study on The Periodic Medical Examination, and Health Care Management Programs of Industries -Busan City Province- (산업장의 건강검진과 보건관리실태에 관한연구 -부산 지역을 중심으로-)

  • Huang, Bo-Sun;Shin, Yu-Sun;Yun, Suk-Ok;Lee, Ji-Hyun;Kim, Jung-Soon;Kim, Lee-Soon;Kim, Bok-Yong;Kang, Young-Mee
    • Research in Community and Public Health Nursing
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    • v.4 no.1
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    • pp.14-24
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    • 1993
  • The Purpose of this study was to explore the condition of periodic medical examination and the health care services of industries in order to offer some basic data on developing industrial nursing care. To achieve this goal a self - administered questionnaire (developed by the academic affairs of community health nursing) was provieded to the nurses in 56 industries from Dec. 10, 1992 to Jan. 20, 1993. The statistical computer package, SPSS, was used to manipulate the data along with T-test and ANOVA. The results were as follows : 1. General characteristics: The greater part of the industries were manufacturing company, and below 300 employees of industry were 55.4%. The shift system was mostly one shift(66.1%) and three shift(23.2%), and 50.0% them organized the Industrial Safety and Health Commitee. Average a number of employees was 631 person. 2. Periodic Medical Examination: Most of the workers were receiving periodic medical examination from the designated hospital (95.71%). From the about 12.89% were gone through a colse medical examination. In colse medical examination 58.41% were decided 'C' and 36.73% were decided 'D'. About 6.23% off those who had any clinical findings were work-time shortening(7.84%), work-transition(8.12%), recoverating at home. The majority of the workers receive the result of the periodic medical examination individually (78.5%). 3. Special medical examination: The rate of those who are receiving special medical examination were 76.82% and about 8.24% were decided 'C' and 1.23% were decided 'D' Those who had any health problems were receiving follow-up checking (9.10%) and medical treatment while working (15.04%). The health managers in the company can consult (85.7%) those who had any suspicious sign and symptoms of occupational disease. 4. Health care services: The average score of health care services were 17.57 point out of 28 point, and the score was lower in health assessment and environmental hygiene than medical diagnosis and health education. There were significant differences in environmental hygine (F=3.72, P=0.017), health care services(F=3.94, P=0.013) according to the size of the size of the industries The other's significancy is not shown by any type of industrial nurse. The level of health care services were higher in the wokers who had better health and showed no singificant differences(T=-0.73, P=0.470).

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Analyses of Studies on the Intervention programs for the Prevention of Falls in Elderly with Dementia (치매노인의 낙상예방을 위한 중재 프로그램에 대한 국내·외 논문 분석)

  • Cha, Hyun-Su;Hwang, Sung-Woo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.6
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    • pp.391-404
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    • 2018
  • The purpose of this study was to determine the status of interventional studies to prevent falling in elderly with dementia and to determine the contents and effectiveness of intervention programs to prevent falling. Existing reports published between January 1, 2000 and December 31, 2016 were searched electronically using the RISS, National Library, KISS, PubMed, and CINAHL database with the keywords dementia, Alzheimer's or Alzheimer's disease, falling, and prevention of falling. After checking the original sources of the articles, 13 articles were included in the review. Therapeutic interventions used in the articles included exercise therapy (8, 61.5%), physiotherapy and occupational therapy (2, 15.4%), complementary therapies (2, 15.4%), and music therapy (1, 7.7%). As a result of the qualitative evaluation of the papers using a checklist of the Scottish Intercollegiate Guideline Network, two studies scored 9 out of 10 points, five studies scored 8 out of 10, and six studies scored 7 out of 10. Intervention sessions were conducted for 55 minutes, on average, for a total of 37 sessions. This study found that exercise, music therapy, physical and occupational therapy, and rhythmic motion therapy were effective in preventing falling in the elderly with dementia. In the future, these findings are expected to be used as a basis for the development of a preventive intervention program for nurses in a clinical setting.

Selection and optimization of nutritional risk screening tools for esophageal cancer patients in China

  • Dong, Wen;Liu, Xiguang;Zhu, Shunfang;Lu, Di;Cai, Kaican;Cai, Ruijun;Li, Qing;Zeng, Jingjing;Li, Mei
    • Nutrition Research and Practice
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    • v.14 no.1
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    • pp.20-24
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    • 2020
  • BACKGROUND/OBJECTIVES: Malnutrition has multiple impacts on surgical success, postoperative complications, duration of hospital stay, and costs, particularly for cancer patients. There are various nutrition risk screening tools available for clinical use. Herein, we aim to determine the most appropriate nutritional risk screening system for esophageal cancer (EC) patients in China. SUBJECTS/METHODS: In total, 138 EC patients were enrolled in this study and evaluated by experienced nurses using three different nutritional screening tools, the Nutrition Risk Screening 2002 tool (NRS2002), the Patient-generated Subjective Globe Assessment (PG-SGA), and the Nutrition Risk Index (NRI).We compared sensitivity, specificity, positive and negative likelihood ratios, and Youden index generated by each of the three screening tools. Finally, cut-off points for all three tools were re-defined to optimize and validate the best nutritional risk screening tool for assessing EC patients. RESULTS: Our data suggested that all three screening tools were 100% sensitive for EC patients, while the specificities were 44.4%, 2.96%, and 59.26% for NRS 2002, PG-SGA, and NRI, respectively. NRI had a higher positive likelihood ratio as well as a higher area under the receiver operating characteristic curve compared to those of NRS 2002 and PG-SGA; although, all three tools had null negative likelihood ratios. After adjusting the cut-off points, the specificity and accuracy for all tools were significantly improved, however, the NRI remained the most appropriate nutritional risk screening system for EC patients. CONCLUSIONS: The NRI is the most suitable (highest sensitivity and accuracy) nutritional risk screening tool for EC patients. The performance of the NRI can be significantly improved if the cut-off point is modified according to the results obtained using MedCalc software.

Development of a Smartphone Application for Clinical Decision Making of Medication Administration (투약적용의 임상적 의사결정을 위한 스마트폰 어플리케이션의 개발)

  • Kim, Myoung-Soo;Park, Jung-Ha;Kim, Sungmin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.3
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    • pp.1650-1662
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    • 2014
  • This study aimed to develop smartphone application contents for the medication reconciliation of high-alert medications and to evaluate the satisfaction for this application. The xcode 4.5 and ios 6.1 SDK(software development kit) were used for constructing screen of the system. After implementation during 4 weeks, thirty five ICU(Intensive Care Unit) nurses were asked function related, contents related, and usage related satisfaction using 12 items. And differences of satisfaction according to the number of daily use and the frequency of use were evaluated. Data were analyzed using descriptive analysis, ANOVA with the SPSS 18.0. We developed the formula for drug dosage calculation, the alarming procedure, and the information of the high alert medication. In the satisfaction items, the mean score of 'This application is helpful to perform drug dosage calculation' was 3.14. However, 'I satisfy this application' was relatively low as 2.94. There were no differences in satisfaction according to the daily use and frequency of use. Based on the results of this study, more advanced smartphone application for medication reconciliation of high-alert medications will provide an important platform for patient safety.

Effects of Laughter Therapy on Joint Pain, Functional Status of Knee Joint and Depression in Elderly with Degenerative Knee Arthritis (웃음요법이 퇴행성 슬관절염 노인의 관절통증, 관절기능상태, 우울에 미치는 효과)

  • Lee, Yim Sun;Park, Hyo Jung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.9
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    • pp.440-449
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    • 2020
  • This study examined the effects of laughter therapy in the elderly with degenerative arthritis who had joint pain, joint dysfunction, and depression. Through a single-blind, randomized assignment, an experimental group of 26 subjects and a control group of 26 subjects were recruited among the elderly with degenerative knee arthritis, who were over 65 years of age. From January 8 to March 11 of 2019, a total of 16 laughter therapies were administered two times a week, 60 minutes per session, in eight weeks. The pain threshold (p=.012) and joint function status (p<.001), which represents the pain, joint stiffness, and physical function, and depression (p<.001), in the experimental group improved after the eight weeks laughter therapy compared to the control group. Laughter therapy is a therapeutic intervention that can be delivered through physical or intellectual activities. This therapy is a non-invasive procedure and has the advantage that nurses can practice easily with a little training. It can be used as an intervention within community and clinical settings to relieve pain and improve depression in the elderly with arthritis.

The Status of Home-Based Hospice Care in Korea (국내 가정 호스피스 운영 실태)

  • Park, Chai-Soon;Yoon, Soojin;Jung, Yun
    • Journal of Hospice and Palliative Care
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    • v.16 no.2
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    • pp.98-107
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    • 2013
  • Purpose: This study was conducted to investigate how home-based hospice care is provided in Korea. Methods: From July 2011 through August 2011, 29 hospice facilities that provide home-based hospice care were surveyed using a questionnaire. Items included in the questionnaire were general characteristics of the organization, staff members, service programs, difficulties. Results: Among the surveyed, hospice care was hospital-based for 11 (37.9%) facilities, hospital-independent center-based care for four (13.8%) and home-based care only for 10 (34.5%). Near half the participants were located in Seoul and Gyeonggi-do. Caregivers included nurses for 62.1% of the participants, volunteers 62.0%, pastors 44.8%, social workers 37.9%, coordinators 31.0% and doctors 31.0%. The facilities offered service programs such as family counseling (96.6%), transfer to other facilities (93.1%), psychological support (89.7%), bereavement support (86.2%), dying care (79.3%), clinical care (75.9%) and spiritual support (75.9%). The major obstacles were financial issues (24.1%), lack of trained staff (20.7%) and staff members' lack of awareness of home-based hospice care (13.8%). Conclusion: In Korea, home-based hospice care is provided by an insufficient number of facilities. Moreover, the service providers are experiencing difficulties such as lack of trained staff, insufficient financial resource and staff's lack of awareness of home-based hospice care. It is necessary to increase the number of home-based hospice care facilities with consideration of even distribution across regions and standard staffing and service programs and develop related insurance policies.

Using the X-ray Image, Augmented Reality based electrocardiogram measurement system Development (X-ray 이미지를 활용한 증강현실 기반 심전도 측정시스템 개발)

  • Lee, Kwang-In;Jang, Jin-Soo;Lee, Tae-Ro
    • Journal of Digital Convergence
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    • v.14 no.9
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    • pp.331-339
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    • 2016
  • Chronic diseases are increasing nowadays as daily habits changed due to economic growth. Among chronic diseases, heart cerebrovascular disease is one of the major causes of death in South Korea that accounts for approximately 20% of mortality. Tests to measure anomaly of the heart is ECG tests, which measures and analyzes the electrical heart activity. Any mistakes in lead attachment location critically affects ECG testings, and statistical facts showed that only 2.8% of the nurses properly located leads to patients. As a solution, this paper proposes a system based on a projection-based augmented reality technology to generate X-ray images to the patient's chest to point out exact attachment locations of ECG leads. Evaluation comparison results showed a 2.6 cm difference between the conventional system and the proposed system. ECG test results also showed significant signal differences between the systems in leads V1, V2, and V3. The ECG measured accurately by the proposed system would help greatly in patient management and clinical decisions of clinicians.

The Clinical Review of Samgi-Halleak Pharmacopuncture Effects for Insomnia & Fatigue (삼기활력약침이 불면, 피로에 미치는 효과)

  • Lee, Yoo-Hwan;Kwon, Gi-Sun;Lee, Seung-Hwon;Lee, Eun-Sol;Kim, Cheol-Hong;Jang, Kyung-Jun;Song, Choon-Ho;Kim, Young-Gyun;Kim, Won-Il;Yoon, Hyun-Min
    • Journal of Acupuncture Research
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    • v.29 no.3
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    • pp.101-113
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    • 2012
  • Objectives : The purpose of this study is to investigate the effects of Samgi-Halleak pharmacopuncture treatment on insomnia and fatigue. Methods : This study was done with 47 nurses under shiftwork schedule. Subjects were divided into two groups ; Samgi-Halleak pharmacopuncture treated group(experimental group, N=24), normal saline treated group(control group, N=23). The procedures had been conducted to the subjects injecting 0.1~0.2mL total 1mL, 0.5~1cm deep on each acupoint 2 times per week. The acupoints were Pungji($GB_{20}$), Gyeonjeong($GB_{21}$), Sinsu($BL_{23}$). Both of groups were treated total 8 times, but control group was treated additional pharmacopuncture the same way as experimental group after 8 times normal saline treatment. The collected data were analyzed with insomnia and fatigue at baseline and post pharmacopuncture using independent samples t-test, Paired t-test, ${\chi}^2$-test by SPSS 18.0 Windows program. Results : After 8 times treatment, the scores of both groups showed significant improvement in insomnia and fatigue. Comparing the experimental and control group, there were more significant improvement in experimental group than control group in the scores of insomnia and fatigue. Conclusions : Samgi-Halleak pharmacopuncture can be used for effective treatment in patients with insomnia and fatigue.