• 제목/요약/키워드: Clinical variables

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간호원의 근무성적 예측변인의 효율성에 관한 연구 (A Study on the Efficiency of Predicting Variables of Nurses ′ Clinical Performance flow College Achievements)

  • 정현숙
    • 대한간호학회지
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    • 제7권1호
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    • pp.112-120
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    • 1977
  • This study attempts to predict nurses'clinical performance from entrance examination of university and college achievements after graduation. This is based upon a survey study, 49 nurses in Yon Sei Medical Center after graduation of college of nursing. Correlation of college achievements, clinical performance and variables of nurses'clinical performance are produced using Pearson's Product moment correlation coefficient significance of correlation tested by T- test. The result of the study were as follows; 1. Clinical performance of the college achievements is the best efficient variables in predicting the nurses'clinical performance after graduation and next theory scholastic total achievements and entrance examination the last. 2. There are significant correlation among nurses'clinical performance rating variables as nursing ethics, nursing skills, achievements, attitude, the state of health.

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간호학생의 임상실습 환경에 관한 인식과 관련 변수의 관계 (The Relationship between Perceptions of Nursing College Students regarding Clinical Practice Environment and Related Variables)

  • 최귀윤
    • 성인간호학회지
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    • 제21권1호
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    • pp.129-139
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    • 2009
  • Purpose: This study was to identify the perceptions of nursing student on the clinical practice environment and related variables. Methods: The subjects of this study were 180 nursing students from a college participated in clinical practice at four regional hospitals. Data was collected with the questionnaire tool for the perceptions of clinical practice environment. Results: The students highly satisfied in the major had significantly high perception in innovation, personalization, student involvement, and clinical practice satisfaction. The students with a low level of stress and a clearly named guidance nurse were significantly high in the perceptions of task orientation, innovation, personalization, student involvement, and practice satisfaction. Clinical practice environment variables such as task orientation, innovation, individualization, personalization, student involvement, and practice satisfaction were significantly correlated with each other. In student characteristics, the main variables directly influencing the perceptions of clinical practice environment were religion, the level of stress, and the method of guidance. Conclusion: Understanding the students' perspective would be valuable for promoting a positive clinical practice environment. Developing a cooperative system between the college and educational hospitals is necessary for effective clinical practice education.

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Machine Learning-Based Prediction of COVID-19 Severity and Progression to Critical Illness Using CT Imaging and Clinical Data

  • Subhanik Purkayastha;Yanhe Xiao;Zhicheng Jiao;Rujapa Thepumnoeysuk;Kasey Halsey;Jing Wu;Thi My Linh Tran;Ben Hsieh;Ji Whae Choi;Dongcui Wang;Martin Vallieres;Robin Wang;Scott Collins;Xue Feng;Michael Feldman;Paul J. Zhang;Michael Atalay;Ronnie Sebro;Li Yang;Yong Fan;Wei-hua Liao;Harrison X. Bai
    • Korean Journal of Radiology
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    • 제22권7호
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    • pp.1213-1224
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    • 2021
  • Objective: To develop a machine learning (ML) pipeline based on radiomics to predict Coronavirus Disease 2019 (COVID-19) severity and the future deterioration to critical illness using CT and clinical variables. Materials and Methods: Clinical data were collected from 981 patients from a multi-institutional international cohort with real-time polymerase chain reaction-confirmed COVID-19. Radiomics features were extracted from chest CT of the patients. The data of the cohort were randomly divided into training, validation, and test sets using a 7:1:2 ratio. A ML pipeline consisting of a model to predict severity and time-to-event model to predict progression to critical illness were trained on radiomics features and clinical variables. The receiver operating characteristic area under the curve (ROC-AUC), concordance index (C-index), and time-dependent ROC-AUC were calculated to determine model performance, which was compared with consensus CT severity scores obtained by visual interpretation by radiologists. Results: Among 981 patients with confirmed COVID-19, 274 patients developed critical illness. Radiomics features and clinical variables resulted in the best performance for the prediction of disease severity with a highest test ROC-AUC of 0.76 compared with 0.70 (0.76 vs. 0.70, p = 0.023) for visual CT severity score and clinical variables. The progression prediction model achieved a test C-index of 0.868 when it was based on the combination of CT radiomics and clinical variables compared with 0.767 when based on CT radiomics features alone (p < 0.001), 0.847 when based on clinical variables alone (p = 0.110), and 0.860 when based on the combination of visual CT severity scores and clinical variables (p = 0.549). Furthermore, the model based on the combination of CT radiomics and clinical variables achieved time-dependent ROC-AUCs of 0.897, 0.933, and 0.927 for the prediction of progression risks at 3, 5 and 7 days, respectively. Conclusion: CT radiomics features combined with clinical variables were predictive of COVID-19 severity and progression to critical illness with fairly high accuracy.

Retrospective study of single vitrified-warmed blastocyst transfer cycles according to the presence of morphokinetic variables

  • Hur, Yong Soo;Ryu, Eun Kyung;Hyun, Chang Seop;Yang, Seong Ho;Yoon, San Hyun;Lim, Kyung Sil;Lee, Won Don;Lim, Jin Ho
    • Clinical and Experimental Reproductive Medicine
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    • 제45권1호
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    • pp.52-55
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    • 2018
  • This study retrospectively assessed whether time-lapse data relating to developmental timing and morphology were associated with clinical outcomes, with the eventual goal of using morphokinetic variables to select embryos prospectively for cryopreservation. In this study, we examined the clinical outcomes of single vitrified-warmed blastocyst transfer cycles that were cultured in a time-lapse incubation system. The morphokinetic variables included uneven pronuclei, an uneven blastomere, multinucleation, and direct, rapid, and irregular division. A total of 164 single vitrified-warmed blastocyst transfer cycles were analyzed (102 cycles of regularly developed blastocysts and 62 cycles of blastocysts with morphokinetic variables). No significant differences in the age of females or the standard blastocyst morphology were found between these two groups. The regularly developed blastocysts showed significantly higher implantation and clinical pregnancy rates than the blastocysts exhibiting morphokinetic variables (30.4% vs. 9.7% and 37.3% vs. 14.5%, respectively; p< 0.01). The blastocysts that exhibited morphokinetic variables showed different mean development times compared with the regularly developed blastocysts. Although morphokinetic variables are known to have fatal impacts on embryonic development, a considerable number of embryos developed to the blastocyst stage. Morphokinetic variables had negative effects on the implantation and clinical pregnancy rates in vitrified-warmed blastocyst transfer cycles. These findings suggest that blastocysts cultured in a time-lapse incubation system should be considered for selective cryopreservation according to morphokinetic variables.

간호학 임상실습 교육에 대한 연구 논문 분석 (An Analysis of Research on Clinical Nursing Education)

  • 권인수
    • 대한간호학회지
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    • 제32권5호
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    • pp.706-715
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    • 2002
  • This literature review was designed to identify a trend of study in clinical nursing education, to propose the idea for further study on an improvement of teaching students in the clinical setting. Method: The researches reviewed were 36 (seven in Korea and twenty nine out of Korea) on clinical nursing education in baccalaurate program from 1996 to 2000 from Journal of Korean Academy of Nursing, Journal of Korean Education of Nursing, Journal of Nursing Education, and Nurse Educator. Result: The prevailing research design was the nonexperimental(N=21). Subjects were predominantly nursing students(N=24). Structured questionnaire(N=22) was used most often for data collection. Among clinical setting studied, specific area was none in Korea. Research variables in nonexperimental studies were 4 types of student, teacher and teaching method. Independent variables in experimental studies were 7 types of clinical teaching methods, and dependent variables were six types of competence and knowledge of student. Research theme of qualitative research was most in clinical experience of student. Conclusion: In Korean, there were the lack of researches in specific clinical area, clinical teacher and teaching method. Accordingly, future studies need to be focused on various clinical areas, clinical teacher, and teaching method to improve the clinical nursing education in Korea.

정신분열증환자의 연성 신경학적 증상과 임상변인과의 관련성 (Relationship Between Neurologic Soft Signs and Some Clinical Variables in Patients with Schizophrenia)

  • 채정호;함웅;이정균
    • 생물정신의학
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    • 제2권1호
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    • pp.115-122
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    • 1995
  • This study was performed to know the relationship between neurologic soft signs (NSS) and clinical variables such as psychopathology. history of illness, and premorbid social adjustment in patients with schizophrenia. The authors evaluated NSS in 31 patients with schizophrenia using the structured tool for measuring neurologic abnormalities, Neurological Evaluation Scale- Korean Version(NES-K). Relationships between NSS and clinical variables such as duration of illness, intensity of precipitating stressors, duration of outpatient treatment, schooling, peer relationship, total duration of unemployment, total days of psychiatric admission, age, total days of being medicated, age at the first psychiatric admission, frequency of admissions, content of treatment, social adjustment, and severity of symptoms were analyzed. Differences between paranoid and non-paranoid schizophrenics were examined. In addition, Differences between patients with schizophrenia who have predominant positive symptoms and who have predominant negative symptoms were examined too. Total scores of NES-K were correlated with lower schooling (${\gamma}$=0.44, p<0.01). Scores of motor coordination subcategory were correlated with poor peer relationship(${\gamma}$=0.67, p<0.001). Other clinical variables were not correlated with any scores of NES-K. Paranoid and non-paranoid schizophrenics were not different in scores of NES-K. Also positive and negative schizophrenics were not different in scores of NES-K. Most clinical variables except schooling and peer relationship were not related with NSS. This results indicated that the meaning of these signs was not fully be understood. Introduction of the new classification concepts such as deficit or non-deficit syndrome will be helpful to elucidate the meaning of NSS in patients with schizophrenia.

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간호학생의 비판적 사고성향과 임상실습 스트레스 및 임상실습수행능력 (Critical thinking disposition, stress of clinical practice and clinical competence of nursing students)

  • 김인숙;장윤경;박수호;송소현
    • 한국간호교육학회지
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    • 제17권3호
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    • pp.337-345
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    • 2011
  • Purpose: This study was done to identify the relationship among Critical Thinking Disposition (CTD), stress of clinical practice and clinical competence in Korean nursing students. Methods: Participants were 407 baccalaureate nursing students (3rd and 4th grades) in Korea. Variables included CTD, stress of clinical practice, clinical competence, and demographic variables. Data was analyzed by frequencies, t-test, ANOVA, Pearson's correlation and multiple regression. Results: Clinical competence positively correlated with CTD, but negatively correlated with stress of clinical practice. The regression model explained 25.6% of clinical competence. The significant predictors of clinical competence were intellectual eagerness, intellectual fairness in CTD, conflict with patients, and clinical environment in stress of clinical practice. Conclusions: CTD and stress of clinical practice contribute to nursing student's clinical competence. Therefore, efforts to encourage nursing student's CTD, increase stress management skills, especially in conflict with patients, and build a supportive clinical environment should be made to strengthen clinical competence.

중환자실 섬망 환자와 비섬망 환자 구분에 기여하는 임상 지표에 관한 연구 (A Study on Clinical Variables Contributing to Differentiation of Delirium and Non-Delirium Patients in the ICU)

  • 고찬영;김재진;조동래;오주영;박진영
    • 정신신체의학
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    • 제27권2호
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    • pp.101-110
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    • 2019
  • 연구목적 중환자실 환자들의 섬망 발생 유무와 관련이 되어 있는 것으로 알려진 많은 임상 지표들이 있지만, 이 중 실제 섬망군과 비섬망군을 분류하는 데 있어서 어떠한 지표가 보다 중요한 역할을 하는지에 대한 연구는 충분히 이루어지지 않았다. 본 연구는 중환자실 내에서 섬망이 발생한 군과 발생하지 않은 군 사이의 재실 기간 내 특징을 비교하고, 두 군을 효과적으로 구분할 수 있는 임상 지표들을 확인하고자 하였다. 방 법 2013년 3월 1일부터 2017년 5월 31일까지 강남세브란스병원 중환자실에 있던 6386명의 환자들 중, 섬망과 연관성을 보일 것으로 예상되는 40개의 임상 지표에 대한 데이터가 재실 기간 중 적어도 한 번 이상 측정되거나, 확인이 가능한 환자 1559명을 대상으로 하였다. 무작위 부분집합 특징 선택 방법 및 주성분분석을 사용하여 섬망과 비섬망을 구분하는 데에 기여도가 높은 특징들의 순위를 구하고, 몇 개의 상위 지표가 동시에 사용되었을 때에 섬망과 비섬망을 가장 효율적으로 판별할 수 있는지를 확인하였다. 확인된 상위 지표만을 이용한 것과 전체 임상 지표를 모두 사용하였을 때의 섬망과 비섬망을 구분할 수 있는 정확도에 대해서 비교 분석하였다. 결 과 총 40개 변수 중 32개의 변수에서 섬망과 비섬망군 간 유의미한 차이를 보였다. 주성분 분석(Principal Component Analysis, PCA)상, 상위 6개 변수인 리치몬드 흥분 진정 척도(Richmond Agitation Sedation Scale, RASS), 도뇨관 사용 유무, 혈관 카테터 사용 유무, 해밀턴 불안 척도(Hamilton Anxiety Rating Scale, HAM-A), 혈액 요소 질소(Blood Urea Nitrogen, BUN), 급성 생리학 및 만성 건강 평가-II (Acute Physiology and Chronic Health Examination II, APACHE II)를 사용했을 때에 섬망과 비섬망군이 가장 잘 구분되었다. 이들 상위 6개 변수에 대해 단일 변수 로지스틱 회귀분석 시행 시 모두 섬망 여부 결정에 대한 유의성을 보였다. 다중 변수 회귀분석 시행 시, 혈관 카테터 사용 유무 를 제외하고 나머지 5개 변수에서 모두 섬망 여부 결정에 대한 유의성을 보였다. 수신자판단특성곡선 분석 결과 신뢰구간 95%에서 곡선하면적 0.818로 높은 판별력을 보였다. 전체 임상 변수를 모두 사용한 수신자판단특성곡선 분석 결과에서는 곡선하면적 0.881로 매우 높은 판별력을 보였다. 결 론 본 연구 결과, 리치몬드 흥분 진정 척도, 도뇨관 사용 유무, 혈관 카테터 사용 유무, 해밀턴 불안 척도, 혈액 요소 질소, 급성 생리학 및 만성 건강 평가-II가 섬망이 발생한 군과 섬망이 발생하지 않은 군을 구분하는데 가장 유용하였다. 중환자실 환자 중 리치몬드 흥분 진정 척도 및 해밀턴 불안 척도 점수가 과도하게 낮거나, 도뇨관 및 혈관 카테터 등의 침습적인 시술을 사용하였을 경우 좀 더 집중적인 모니터링을 통해 섬망의 가능성을 살펴보아야 할 것이다.

파킨슨증으로 인한 마비말장애의 청지각적 평가에 대한 신뢰도 연구 (A Reliability Study on the Auditory-perceptual Evaluation of Parkinsonian Dysarthria)

  • 김향희;이미숙;김선우;이원용
    • 음성과학
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    • 제11권4호
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    • pp.129-141
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    • 2004
  • An auditory-perceptual evaluation has long been utilized in assessing dysarthric speech. The process involves subjective judgement and the results might vary depending on clinical experiences or training of listeners. This study aimed to investigate reliability of the auditory-perceptual evaluation of 22 multi -dimensional variables on 6 patients with Parkinsonian speech disorders. Listeners were divided into two groups: one consisted of 6 speech therapists with clinical experiences for three years or more, and the other 6 graduate students without any previous clinical background. The results showed that the former evaluated dysarthric speech with higher inter-rater and intra-rater reliabilities than the latter. Furthermore, such speech variables as 'precise consonant: 'speech intelligibility: and 'SMR regularity' were more influenced than others by clinical experiences. We, therefore, postulated that a reliable auditory-perceptual evaluation of dysarthric speech may require adequate amount of clinical training of listeners.

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Differences in the relationship, learning perception and satisfaction of nursing students before and after clinical practice

  • Lee, Mi-Ok
    • 한국컴퓨터정보학회논문지
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    • 제24권4호
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    • pp.145-151
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    • 2019
  • The purpose of this study was to find out whether there was a meaningful change in the learning perception and interpersonal relations of nursing students after completing clinical practice. Participants were 32 nursing students in the third grade. The research data were collected by questionnaire consisting of interpersonal relations and learning perception. The analysis of data was analyzed by SPSS 21 Version. General characteristics were analyzed by descriptive statistics, correlation between variables was analyzed by Pearson's relation, and differences of variables before and after clinical practice were analyzed by paired t-test. The results of the study are as follows. In clinical practice, interpersonal abilities showed a significant correlation with learning outcomes (R =.351, p =.049). The interpersonal abilities of nursing students improved significantly(t =2.264, p =.13) after completion of clinical practice. Nursing college students recognized that their interpersonal abilities had improved after completion of clinical practice, and the improvement of interpersonal abilities was statistically supported. Considering that the interpersonal relationship was an important factor in the clinical practice related stress of the nursing college students, it was meaningful that the interpersonal ability improved after the clinical practice. The positive correlation between interpersonal abilities and learning perceptions in clinical practice of nursing college students suggests future directions for future research. The results of this study will provide basic data on education that will enhance the satisfaction of students' clinical practice and improve their learning outcomes.