• 대한간호학회지
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• 제46권1호
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• pp.1-18
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• 2016

Purpose: This study was conducted to synthesis the results of research on relationships of cognitive impairment with multi-dimensional correlates of rheumatic disease through a systematic literature review and meta-analysis. Methods: For the study purpose, 23 studies were selected through a systematic process of searching the literature. Results: The study results showed that among general characteristics, age and education were the variables having a significant relationship with cognitive impairment. Among health risk factors, obesity appeared to have a significant positive relationship with cognitive impairment. For past history, diabetes and hypertension were shown to have a significant positive relationship with cognitive impairment. It was noted also that aPL, one of the physiological factor, had significant association with cognitive impairment. None of the medication related factors had a significant relationship with cognitive impairment. Results showed that among disease related factors, disease activity had the highest relationship with cognitive impairment. Depression, among psychological factors, was the only variable having a significant relationship with cognitive impairment. Conclusion: The findings indicate that the variables strongly impacting on cognitive impairment in rheumatic disease are depression and disease activity.

• 보건교육건강증진학회지
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• 제31권4호
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• pp.63-72
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• 2014

Objectives: The current study reviews the implementation and evaluation of the Chronic Disease Self-Management Program (CDSMP) in the United States (U.S.) to illustrate the program's potential contribution to improving health among Korean adults with chronic conditions while saving healthcare costs. Methods: This study examines existing literature on the history, theoretical background, essential elements, and delivery outcomes of CDSMP with special focus on the successes and challenges to be faced in the implementation of CDSMP to Koreans with chronic conditions. Results: CDSMP is designed to empower people with chronic conditions to develop skills necessary for medical, social role, and emotional management of chronic conditions. Recent studies show the utility of CDSMP in achieving the Triple Aim health reform goals (i.e., better care, better health, better value). Lessons learned from the U.S. experience emphasize the importance of establishing evidence-based studies, collaborating with community partners, and diversifying funding sources to make CDSMP more sustainable. Conclusion: The current study demonstrates the replicability of CDSMP and potential for expansion in Korea. More concerted efforts among academia, government, and communities are needed to deliver CDSMP to Korean adults and identify its effectiveness within the Korean context in terms of meeting the Triple Aim goals of better care, better health, and better value.

• 한국의료질향상학회지
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• 제24권2호
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• pp.41-61
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• 2018

Purpose: Falls are one of the most frequent health events in medical institutions, however, they can be predicted and prevented. The Quality Improvement Nurse Society clinical practice guideline Steering Committee developed the Clinical Practice Guideline for the assessment and prevention of falls in adult people. The purpose of this study was to assess the risk factors for falls in adults aged 19 years and older, to present an evidence for preventing falls, formulate a recommendations, and indicators for applying the recommendations. Methods: This clinical practice guideline was developed using a 23-step adaptation method according to the Handbook for clinical practice guideline developer (version 1.0) by National Evidence-based Healthcare Collaborating Agency. Evidence levels and recommendation ratings were established in accordance to SIGN 2011 (The Scottish Intercollegiate Guidelines Network). Results: The final 15 recommendations from four domains were derived from experts' advice; 1) assessment of risk factor for falls in adult 2) preventing falls and reducing the risks of falls or falls-related injury 3) management and reassessment after a person falls 4) leadership and culture. Conclusion: This clinical practice guideline can be used as a basis for evaluation and prevention of fall risk factors for adults, to formulate recommendations for fall risk assessment and fall prevention, and to present monitoring indicators for applying the recommendations.

• Tuberculosis and Respiratory Diseases
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• 제79권1호
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• pp.14-21
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• 2016

Cough is one of the most common symptom of many respiratory diseases. The Korean Academy of Tuberculosis and Respiratory Diseases organized cough guideline committee and cough guideline was developed by this committee. The purpose of this guideline is to help clinicians to diagnose correctly and treat efficiently patients with cough. In this article, we have stated recommendation and summary of Korean cough guideline. We also provided algorithm for acute, subacute, and chronic cough. For chronic cough, upper airway cough syndrome (UACS), cough variant asthma (CVA), and gastroesophageal reflux disease (GERD) should be considered. If UACS is suspicious, first generation anti-histamine and nasal decongestant can be used empirically. In CVA, inhaled corticosteroid is recommended in order to improve cough. In GERD, proton pump inhibitor is recommended in order to improve cough. Chronic bronchitis, bronchiectasis, bronchiolitis, lung cancer, aspiration, angiotensin converting enzyme inhibitor, habit, psychogenic cough, interstitial lung disease, environmental and occupational factor, tuberculosis, obstructive sleep apnea, peritoneal dialysis, and idiopathic cough can be also considered as cause of chronic cough. Level of evidence for treatment is mostly low. Thus, in this guideline, many recommendations are based on expert opinion. Further study regarding treatment for cough is mandatory.

• 가정간호학회지
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• 제10권1호
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• pp.58-72
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• 2003

The purpose of this study was to describe the perceived burden of the terminally III patients's caregiver and to analyze relationship between the perceived burden and the various demographics, illness characteristics, family relationships, and economic factor of the family & patients. The sample of 132 caregivers who care for the terminally III patients Kyung-Gi province, Seoul, Korea. The period of this study was from August to September, 2002. The perceived burden of the family caregiver was measured by the burden scale(20 items, 4 point scale) developed by Montgomery et al. (1985). The Data was analyzed using SAS-program by t-test and ANOVA. The results were as follows; 1. The mean of the family caregiver's burden score was 3.02. The score showed that caregivers perceive severe the level of burden. The hight items of the family caregiver's burden were' I feel it is painful to watch patient's diseases'(3.77). 'I feel afraid for what the future holds for my patients'(3.66), 'I feel it reduced to amount of privacy time'(3.64). 2. The caregiver's burden was significantly related to patient's gender(F=3.17, p= 0.0020), patient's job(F=2.49, p=0.0476), caregiver's age(F=4.29, p=0.0030), and caregiver's job(F=2.49, p=0.0476). 3. The caregiver's burden according to illness characteristics showed no significant difference. 4. The caregiver's burden was significantly associated with patient's family relationship (F=4.05, p=0.0041), patient's care mean period in a day(F=47.18,

• 한방안이비인후피부과학회지
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• 제34권2호
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• pp.38-52
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• 2021

Objectives : The purpose of this study is to analyze the use of insured herbal extracts and Korean medicinal treatments, which are mainly used to treat allergic rhinitis in Korean medicine. Methods : Among all HIRA(Health Insurance Review and Assessment Service) claims data in 2016, we included all statements that included J30(vasomotor and allergic rhinitis) or a subcategory of J30(J30.0, J30.1, J30.2, J30.3, or J30.4) as the main disease, using the Korean Standard Classification of Diseases(KCD-7). This study analyzed the most frequently used insured herbal extracts and Korean medicinal treatments for allergic rhinitis in Korean medicine. We performed a frequency analysis on subgroups based on treatment type(inpatient or outpatient), sex, age, insurance type, and medical institution type. Results : The result shows the 10 most frequently used insured herbal extracts and Korean medicinal treatments for allergic rhinitis. The total number of insured herbal extracts prescriptions was 82,533, and the most commonly prescribed insured herbal extracts was socheongryong-tang(35,131 prescriptions), followed by hyeonggaeyeongyo-tang(18,157 prescriptions), samsoeum(6,257 prescriptions), and galgeun-tang(4,465 prescriptions). The total number of Korean medicinal treatments prescriptions was 1,878,541, of which the most common Korean medicinal treatments was acupuncture(922,977 prescriptions), followed by moxibustion(372,120 prescriptions), cupping(242,094 prescriptions), and segmental acupuncture(161,553 prescriptions). Conclusions : It is expected that the results of this study can be used as a basis for establishing the priorities of evidence-based clinical research topics in the field of Korean medicine and making health care policy decisions to strengthen coverage in the future.

• 한국산학기술학회논문지
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• 제15권1호
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• pp.331-343
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• 2014

본 연구의 목적은 National Collaborating Centre for Nursing and Supportive Care (NCC-NSC)에서 개발한 수술 환자의 체온 관리 근거중심 가이드라인의 국내 타당성을 검증하기 위한 것이다. 수술 환자 관리 경험 및 지식이 풍부한 의사와 간호사 총 180명으로 구성된 전문가 집단을 대상으로 가이드라인 각각의 권고사항에 대한 적절성과 적용가능성을 평가하였다. 수집한 자료는 SPSS/WIN 18.0을 이용하여 평균, 표준편차, paired t-test 이용하여 분석하였다. 가이드라인의 적절성과 적용가능성은 9점 척도로 각각 평균 8.11점과 7.28점으로 높게 나타났으며, 대부분의 권고사항의 적절성과 적용가능성도 평균 6-8점 이상으로 비교적 높게 평가되었다. 그러나 대부분의 가이드라인 권고사항에서 적절성이 적용가능성 보다 유의하게 높게 나타나, 실제 임상환경에서 가이드라인의 권고사항을 직접 적용하는 데는 장애가 있는 것으로 나타났다. 따라서 가이드라인의 권고사항을 임상환경에 적용하는 데 장애가 되는 요인을 확인하고 이를 적절히 해결하는 방안이 모색되어야 할 것이다.

• 한국임상약학회지
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• 제25권4호
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• pp.280-285
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• 2015

Objectives: To suggest direction for improving policies by understanding current management of narcotics or psychotropic drugs and analyzing their distributions and usage. Method: We conducted a comparison analysis between health insurance claims and the amount supplied to health care institutions for narcotics or psychotropic drugs through health insurance claims data and drug distribution supply data from 2010 to 2012 collected from Korea Pharmaceutical Information Service Center (KPIS). Furthermore, we carried out literature investigation and online search to comprehend the current management of narcotics drugs in Korea. Results: The amount supplied to medical institutions for all drugs in 2012 was 19.4 trillion won, which increased from 19.5 trillion in 2011 by 0.54%. For narcotic drugs, the amount supplied was 318.4 billion won in 2011 and increased to 335.1 billion won by 5.3% in 2012, which exceeded the rate of increase for the amount supplied for all drugs. The proportion of amount claimed in the total amount supplied to medical institutions for all drugs was 60.5% in 2012, whereas the proportion of amount claimed for narcotic drugs was 55.6%, which showed that narcotic drugs were used relatively less within health insurance. Furthermore, management of the current domestic distribution supply data focuses on manufacturing and medical institution supply stages. Conclusion: Hereafter, the management of narcotics or psychotropic drugs needs to be improved by reinforcing active monitoring in optimal prescription and usage in patients by collecting and analyzing information on drug usage of patients.

• 대한치과의사협회지
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• 제54권6호
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• pp.429-437
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• 2016

Objectives: Photodynamic therapy has been proven to promote additional clinical and microbiological benefits in the treatment of chronic periodontitis and aggressive periodontitis. The purpose of this study is to assess the effectiveness of the photodynamic therapy for patient with periodontitis. Methods: We searched the eight Korean databases and Ovid-MEDLINE, Ovid-EMBASE, Cochrane Library. Total 300 studies were searched and 13 studies were included in the final assessment. Each of the stages from literature search and extraction of data were carried out independently by 2 researchers. We used tools of Scottish Intercollegiate Guidelines Networks for assessment of the quality of studies. Results: The safety of the photodynamic therapy was assessed by bleeding. The effectiveness of the photodynamic therapy was assessed by the reduction of Probing pocket depth (PPD) and the gain of Clinical attachment level (CAL). The mean difference of PPD was 0.46(95% CI 0.09~0.82), (p=.01).). The mean difference of CAL was ?0.49(95% CI ?1.12~0.14), (p=.13). Conclusion: The additional use of $^{\circ}{\infty}$Antimicrobial Photodynamic Therapy for Periodontitis$^{\circ}{\pm}$ caused hemorrhage to similar extents to conventional treatment modalities, where scaling and root planing are solely performed, in patients with periodontitis who are expected to have a lower degree of treatment response to non-surgical or surgical periodontal therapies (implant or refractory periodontitis) and those where there is a concern for the possible occurrence of antimicrobial side effects or resistance. This indicates that there are no problems with its safety. But there were no consistent reports about the effects of the additional use of photodynamic therapy. This led to a decision that the safety and efficacy of the current technology deserve further studies (Recommendation rating of A, Classification of technology II-a).

• Journal of Korean Biological Nursing Science
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• 제17권3호
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• pp.228-235
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• 2015

Purpose: Although the prevalence rate of chronic diseases is rapidly increasing due to an unhealthy diet in Korea, nurses may not have enough nutritional knowledge to educate their patients. This study investigated the level of nurses' nutritional knowledge for chronic diseases as well as for strokes, and the needs for nurses' nutritional education. Methods: This research is a descriptive research conducted from April to August of 2014, on 242 nurses who work with stroke patients, in two tertiary general hospitals in the city of Seoul, South Korea. Results: The average nutritional knowledge score of our subjects was $19.9{\pm}2.51$ (range 12-24). The correct response rate was 83% which was higher than expected. However, many nurses (31-66%) answered incorrectly on items such as 'Drinking low-fat milk is better than whole milk', and 'Seasoning with a large amount of soy sauce instead of salt can reduce sodium consumption'. We also found that nurses who received continuing education regarding nutrition scored higher than those who did not (p=.020). There was no correlation between nutritional knowledge and the need for nutritional education (r=.034, p=.601). Conclusion: The level of nutritional knowledge of the nurses was relatively low and irrelevant to the completion of nutrition courses during university or duration of experience. Rather, the relevance was higher when the nurse received nutrition-related training after graduating from university. Our results imply that continuous nutritional education is necessary for hospital nurses.