• Title/Summary/Keyword: Clinical skills

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The Effect of Group Treatment Based on Occupational Therapy for Children : A Systematic Review (아동 그룹 작업치료의 효과 : 체계적 고찰)

  • Lee, Ga-Young;Lee, Ji-Ho;Kim, Bo-Ram;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.14 no.2
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    • pp.33-45
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    • 2016
  • Objective : The purpose of this article is to study the effectiveness of a group occupational therapy for children via systematic review, and to provide clinical evidences. Methods : The systematic review initially included articles in Pubmed, Ovid, RISS, KISS, and DBpia, published until 2014. Total 14 articles have been chosen, using different keyword of each domestic/foreign studies. Selected articles were divided depending on the level of evidence, and eventually been organized into group PICO (Patient, Intervention, Comparison, Outcome). Results : The results indicated that there are more diagnosed children than normal in participants and especially children with sensory integration disorder (28.6%) appeared to be the most common. In intervention, group sensory integrative intervention had the largest frequency, and instruments measuring social skills were used most for analyzing the intervention results. The effectiveness of interventions showing statistically significant results were 40.7% of Total. Conclusion : Group occupational therapy for children should be provided to various diagnosis with widely better quality of interventions providing the enough support for the evidence level.

Physical Therapist's Understanding and the Usage of Assessment Tools for Children With Delayed Development and Cerebral Palsy (발달지연 아동 및 뇌성마비 아동의 평가실태와 물리치료사들의 평가에 대한 인식도 조사)

  • Park, Hey-Jeong;Yi, Chung-Hwi;Cho, Sang-Hyun;Kwon, Hyuk-Cheol
    • Physical Therapy Korea
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    • v.7 no.1
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    • pp.1-21
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    • 2000
  • The purposes of this study were to research the current state of evaluation of children with delayed development and cerebral palsy and determine pediatric physical therapists' knowledge of assessment tools and their use. The subjects were 130 pediatric physical therapists (general hospitals, university-related hospitals, rehabilitation centers, etc.). Data was obtained from August 24, 1999 to October 18, 1999 by means of a survey questionnaire. The results were as follows: 1. The current state of pediatric physical therapist evaluation of children with delayed development and cerebral palsy. 1) Tools used to assess functional areas of children with cerebral palsy were: subjective description format-128 (47.1%); the GMFM-58 (21.3%); facility-generated tool-51 (18.8%); and DDST-15 (5.5%). 2) Tools used to assess developmentally delayed children were: subjective description format-121 (50.6%); the GMFM-43 (18.0%); facility-generated tool-41 (17.2%); and DDS T-14 (5.9%). 3) After their college or university study, therapists who had attended lectures on evaluation were 113 (86.9%); 13 (10.0%) therapists had not attended any lectures on evaluation 2. Test scores of physical therapists' professional knowledge of evaluation procedures: high (more than 36 points)-74 (56.9%); moderate (18~35 points)-39 (30.0%); and low (below 17 points)-none. 1) For therapists treating cerebral palsied children, 73 (65.2%) were in the high range, 39 (34.8%) were in the moderate range and none were in the low range. 2) For therapists treating children with delayed development, 71 (65.7%) were in the high range, 37 (34.3%) were in the moderate range and none were in the low range. Although the general degree of professional knowledge of evaluation was quite high, there was a lack of variety in the assessment tools used With a large number of therapists depending on subjective description. Possible reasons for the low rate of objective asses sment tool use: 1) Poor clinical environment: too many clients and lirnited treatment time. 2) Lack of any medical insurance fee category for specific assessment tools. 3) Lack of continuing education opportunities in pediatric evaluation skills during or after either college-based (3 year) or university-based (4 year) education programs. Based on the study results, provision of more extended educational opportunities would promote the use of a greater variety of objective assessment tools by pediatric physical therapists.

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Effect of Ethics Education on Nurse덕s Moral Judgement (윤리교육이 간호사의 도덕판단에 미치는 영향)

  • 김용순
    • Journal of Korean Academy of Nursing
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    • v.30 no.1
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    • pp.183-193
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    • 2000
  • This main purpose of this study was to assess the effects of two different types of ethics education on the moral judgement of clinical nurses. One type was free discussions among nurses with given specific moral issues and the other type was discussions guided by experts on specific moral issues. The study employed a quasi-experimental, nonequivalent pre test-post test design using two different control groups. The conceptual framework of the study was derived from the Kohlberg′s Moral Development Theory (1969) and the Greipp′s Ethical Decision-Making Model (1992). The data was collected during the period of October 14 through December 15, 1998. Sample consists of 32 nurses working in the ICU who met research criteria. 16 nurses were assigned to the free discussion group and 16 nurses to the group for the guided discussion with experts group. For the pre-test, the DIT which was developed by Rest (1984) and JAND by Ketefian (1998) were used with some modification by the author. After the education, only JAND was used to assess the changes in moral judgement. The collected data was analysed using SPSS PC program. The findings are as follows: 1. There was no significant difference between two groups in their general characteristics. Only difference which was statistically significant between two groups was that realistic score on Case 3/Medical Research and Autopsy was higher in the free discussion group. 2. Hypothesis 1: "There will be a difference on the moral judgement of nurses before and after they receive an ethics education". This hypothesis was supported partially. Those who had low scores on moral judgement before the education tended to have higher scores after the education on the same issues. And, after the education, the nurses tend to give lower scores on the dilemmas they had experienced frequently at work; while giving higher scores on those dilemmas they had no prior experience. 3. Hypothesis 2: "The effect of education may differ depended upon the moral development index [P(%)] score of nurses". The effect of education was different depend on moral development level. The group who′s P(%) scores was low at the pretest has higher scores in realistic moral judgement after the education, while the groups with middle or high P(%) scores went down after the education. These changes were statistically significant in some cases, thus, the Hypothesis 2 was partially supported 4. Hypothesis 3: "The method of ethics education will have different effects on the moral judgement of nurses". Even though several nurses attended the guided discussion stated that the education program broadend their perspectives the difference between two groups was not significant and this hypothesis was not supported. In conclusion, both types of ethics education had helped the nurses to acquire the skills to deal some nursing dilemmas. The effects of ethics education may differ according to the moral development index - P(%) score. However, because of some of the limitations of this study, mainly small sample size, short term education, unable to control other variables which may affect moral judgement of nurses, further research is warranted.er research is warranted.

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Adolescents Pregnancy and Stress (청소년 임신과 스트레스)

  • Kim, Man-Jee
    • 한국사회복지학회:학술대회논문집
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    • 2000.04a
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    • pp.615-628
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    • 2000
  • It is said that stress is the threat of peace and excess of resources which man has from special relationship between individual and environment. This study is for suggesting the method of intervention of the clinical social work service concerning stress for the adolescents who can conceive looking into the relationship between adolescent pregnancy and stress through the sundry records for them. When the change of making into parents from pregnancy overlapped with stress in the cycle of life as an adolescent period itself, the accumulated stress grows much bigger. The repeated change causes an obscurity of individual role and worsens stress and brings confusion on a priority ranking of developmental task. The pregnancy of adolescence has a demoralizing influence upon the adolescents themselves who are going to be adults, their children, and society. These negative effects won't be end in a short period so the effort of intervention in necessary to improve the coping skills and adaptability of pregnant adolescents. In case of pregnant adolescents, the approach of personal counsel is not just enough and effective prevention program can be better alternative and purpose at the same time. This intervention protects adolescents from the distress which can be easily disclosed after delivery and contribute to promote a good mental health of adolescents who will grow to be adults later. After all it implies the necessity of stress management program which can improve the coping ability against stress and develop positive recognition for the pregnant adolescents. Therefore much profounder study for practical intervention program, implementation, and evaluation is necessary with the conclusion which has the results of this literature study.

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Introduction of Medical Simulation and the Experience of Computerized Simulation Program Used by $MicroSim^{(R)}$

  • Lee, Sam-Beom;Bang, Jae-Beum;SaKong, Joon
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.148-153
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    • 2007
  • Background : Computer- and web-based simulation methods help students develop problem solving and decision making skills. In addition, they provide reality based learning to the student clinical experience with immediate medical feedback as well as repetitive training, on-site reviews and case closure. Materials and Methods : Seventy-five third-year medical students participated in a two-week simulation program. The students selected four modules from eight modules as follows: airway and breathing 1, cardiac arrest 1, cardiac arrhythmia 1, and chest pain 1, and then selected the first case within each of the modules. After 2 weeks, a pass score was obtained and the data analyzed. The average pass score of over 70% was considered a passing grade for each module. If the student did not pass each module, there was no score (i.e., pass score was zero). In addition, when at least one of the four modules was zero, the student was not included in this study. Results : Seventy-five students participated in the simulation program. Nineteen students were excluded based on their performance. The final number of students studied was 56 students (74.7%). The average scores for each module 1 to 4 were 86.7%, 85.3%, 84.0%, and 84.0%, and the average obtained pass score was 88.6 for the four modules in all 56 students. Conclusion : Medical simulation enabled students to experience realistic patient situations as part of medical learning. However, it has not been incorporated into traditional educational methodology. Here we describe the introduction and the development of various simulation modules and technologies for medical education.

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Evaluation of Job Performance of Radiology Students by using Field-based Radiography Course (현장중심 교육과정을 적용한 방사선과 재학생의 직무수행도 평가 -일반촬영)

  • Kwon, Soonmu;Kim, Kyoungah;Park, Changhee
    • Journal of the Korean Society of Radiology
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    • v.10 no.7
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    • pp.551-557
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    • 2016
  • National competency standards, which are the contents of the knowledge, skills and attitudes required to perform a job in industry, is organized by the country. the job performance was evaluated based on the National competency standards from the third-year grade of radiology students by using field-based training courses. according to the evaluation results, students showed over 93% satisfactory ratio of job performance in all radiography projection methods. Therefore, it can be predicted that field-based training courses for students made a positive effect on improving their job performance. Exposure methods with CR equipment were evaluated the best rating, yet it has various problems. The standard deviation between students was very high, and the CR operation skill of students was insufficient. Film methods was evaluated also showed problems, due to the exposure condition setting and developing operation. although DR method was rated good to the students, it was evaluated that the operation skill of DR and the ancillary equipment operation skill was shortage. By supplementing the evaluation factors below proficiency levels to a course management in each exposure method, it could help students course achievement. Also, it could help students to improve job performance of clinical areas after graduation.

Discriminant and predictive validity of TUG, F8WT, FSST, ST for community walking levels in chronic stroke survivors (만성 뇌졸중 환자들의 지역사회 보행 수준 구별을 위한 일어나 걸어가기 검사, 8자 모양 경로 보행 검사, 네 막대 스텝 검사, 스텝 검사의 변별력과 예측 타당도)

  • Lee, DongGeon;An, SeungHeon;Lee, GyuChang
    • Journal of Korean Physical Therapy Science
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    • v.27 no.2
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    • pp.25-35
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    • 2020
  • Background: There are many situations where walking in an actual community needs to change direction along with walking on a straight path, and this situation needs to be reflected in assessing walking ability of the community. Therefore, in this study, we tried to determine whether the assessments can distinguish the level of walking in the community. Design: Retrospective cohort study. Methods: Fifty-two survivors with chronic stroke have participated in the study. According to the evaluation result of 10mWT, the subjects of 0.8m/s and above were classified as the group who could walk in the community (n=22), and the subjects of 0.4m/s~0.8m/s were classified into the group who could not walk in the community (n=30). Modified Rivermead Mobility Index, Postural Assessment Scale for Stroke, Fugl-Meyer Assessment, Berg Balance Scale, 10-meter Walk Test (10mWT) were used to evaluate the motor skills. Furthermore, Activities-specific Balance Confidence Scale was used to evaluate psychological factors, and Timed Up & Go Test (TUG), Figure-of-Eight Walk Test (F8WT), Four Square Step Test (FSST), Step Test (ST) were applied to evaluate dynamic balance and mobility. Results: As a result for distinguishing walking levels in the community, TUG was 14.25 seconds, F8WT was 13.34 seconds, FST was 19.43 seconds, and ST of affected side and non-affected side were 6.5 points and 7.5 points, respectively. TUG (AUC=0.923), F8WT (AUC=0.905), and FST (AUC=0.941) were highly accurate, but the ST of affected side and non-affected side (AUC=0.806, 0.705) showed the accuracy of the median degree, respectively. Conclusion: To distinguish walking levels in the community of survivors with chronic stroke, TUG and FSST have been found to be the best assessment tool, and in particular, FSST could be very valuable in clinical use as the most important assessment tool to distinguish walking levels in the community.

20 Years-experience of 1000 Consecutive Vasovasostomy (20년간 정관정관문합술 1000례의 임상적 경험)

  • Seo, Ho-Kyung;Park, Nam-Cheol
    • Clinical and Experimental Reproductive Medicine
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    • v.25 no.2
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    • pp.189-198
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    • 1998
  • Since the male sterilization (vasectomy) has been performed on a large scale as an accepted family planning in Korea on 1980s and this, in turn, has been followed by an increase in the number of patients requesting vasovasostomy. We studies 1000 consecutive cases of vasovasostomy performed from January 1975 to July 1995 in Pusan National University Hospital. In this report, we are going to present serial studies of vasovasostomy through which we attempted to find out what factors are of impotence in influencing the successful outcome of vasovasostomy operation. We inquired the operative results data through the questionnaire and telephone interview with survey of medical records. A total of 259 cases was excluded due to the loss of follow-up. The overall patency and pregnancy rates of 741 cases were 86.9% and 51.1%, respectively. The age of man at the time of anastomosis ranged from 23 to 57 years old with an average of 34.9. The most frequent reason for requesting vasovasostomy was the desire to have more children (43.4%). The average obstructive interval was 60.6 months with range from 1 to 264 months. If the obstructive interval had been less than 5 years patency rate was 92.4% and pregnancy rate 64.8%, but 6 years or more 84.1% and 48.5% (p<0.01, p<0.01). Patency and pegnancy rates according to intraoperative vas fluid were 93.1% and 62.8% for presence and 83.7% and 53.1% for absence (p<0.01, p<0.05). Patency and pregnancy rates according to histologically proven sperm granuloma at vasectomy site were 87.7% and 49.2% for presence and 86.9% and 50.6% for absence (p>0.05, p<0.05). Patency and pregnancy rates were not significantly different between microscopic standard vasovasostomy (88.4%, 64.3%) and modified vasovasostomy (89.5%, 56.3%)(p>0.05, p>0.05). Both patency and pregnancy rates according to level of anastomosis were 89.8% and 59.8% in cases of straight vas and 91.5%, 60.1% in cases of convoluted vas (p>0.05, p>0.05). Patency and pregnancy rates according to the kind of suture materials were 91.5% and 56.2% for absorbable, 91.0% and 64.2% for non-absorbable and 93.3% and 53.3% for absorbable plus non-absorbable, respectively (p>0.05, p<0.05). Thus it is suggested that the important factor influencing the success rate of vasovasostomy is the interval of obstruction and vasal ooze with surgical skills.

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ICU Nurses' Perceptions of Communication Difficulties, Importance, Satisfaction and Communication Barrier with Patient Families (중환자실 간호사의 의사소통 난이도, 중요도 및 만족도에 관한 인식과 환자 가족과의 의사소통 장애에 대한 조사연구)

  • Ahn, Jung Won;Kim, Keum Soon
    • Perspectives in Nursing Science
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    • v.10 no.1
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    • pp.12-23
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    • 2013
  • Purpose: This study was conducted to investigate ICU nurses' perceptions of communication difficulties, the importance of and satisfaction with communication with doctors, other nurses, patients, and family, as well as to explore communication barrier with patient families. Methods: Investigators developed a 15-item communication perception questionnaire and 58-item communication barrier questionnaire. Communication barrier included 4 domains: nurses, family, environment, and patient condition. A total of 151 ICU nurses with a minimum of one year of ICU experience participated. Results: ICU patients ($3.38{\pm}0.73$) were the most difficult group to communicate with, followed by family ($3.32{\pm}0.72$), senior nurses ($3.25{\pm}0.74$), doctors ($3.21{\pm}0.68$), and nurse colleagues ($2.64{\pm}0.73$). Doctors ($4.61{\pm}0.53$) were the most important group to communicate with, followed by nurse colleagues ($4.52{\pm}0.54$), patients ($4.49{\pm}0.58$), senior nurses ($4.44{\pm}0.55$), and family ($4.43{\pm}0.61$). Satisfaction with communication was the highest with colleague nurses ($3.60{\pm}0.68$), then senior nurses ($3.37{\pm}0.74$), family ($3.18{\pm}0.71$), patients ($3.09{\pm}0.75$), and doctors ($3.06{\pm}0.83$).The total score of the communication barrier was $2.83{\pm}0.52$, where each domain was scored as follows: patient condition $3.13{\pm}0.74$, nurses $2.83{\pm}0.60$, environment $2.81{\pm}0.66$, and family $2.76{\pm}0.57$. The ICU nurses reported that communication was difficult due to 'sudden deterioration in the patient's condition', 'being too busy', 'a noisy environment', and 'information not being shared between family members.' Significant differences were noted by age, clinical experience, and marital status of nurse respondents. Conclusion: The findings indicated that development of a protocol on communication between nurses and doctors as well as development of an educational program on communication skills are necessary.

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Development and Evaluation of a Scenario for Simulation Learning of Care for Children with Respiratory Distress Syndrome in Neonatal Intensive Care Units (시뮬레이션 학습을 위한 호흡곤란증후군 환아 시나리오 개발 및 학습 수행 평가)

  • Lee, Myung-Nam;Kim, Hee-Soon;Jung, Hyun-Chul;Kim, Young-Hee;Kang, Kyung-Ah
    • Child Health Nursing Research
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    • v.19 no.1
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    • pp.1-11
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    • 2013
  • Purpose: This study was done to develop a scenario and evaluate student performance in simulation learning of care for children with respiratory distress syndrome in neonatal intensive care units. Methods: To test the application effect, a one group pre-test design was applied. The scenario based on actual patients and textbook material was developed through several meetings of experts. The scenario was used with 17 groups of 55 senior nursing students who participated voluntarily. Results: Contents were organized focusing on the nursing process for simulation learning. In the application of knowledge and skills, nursing students had high scores in the contents of observation of oxygen saturation, and care to relieve dyspnea. Participants' ability, especially in suction and oxygen supply in the evaluation of objective structured clinical examination was not adequate. There was a significant positive correlation between problem-solving ability and satisfaction in learning. Conclusion: The respiratory distress syndrome simulation scenario developed in this study was an effective tool to give students experience in problem solving and critical thinking ability under conditions similar to reality. The development of various scenarios for child nursing care is needed.