• Title/Summary/Keyword: Collaborating care

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Antimicrobial photodynamic therapy as an adjunct to nonsurgical periodontal treatment - Systematic review and Meta-analysis (광역학요법을 이용한 치주염치료 - 체계적 문헌고찰 및 메타분석)

  • Mo, Jin-A
    • The Journal of the Korean dental association
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    • v.54 no.6
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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).

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Assessment of Nurses' Nutritional Knowledge and Educational Needs Regarding Stroke Specific Diet Regimens (간호사의 뇌졸중 관련 영양지식 및 영양교육 요구도 조사)

  • Song, Suk-Hee;Choi-Kwon, Smi;Baek, Ji Hyun;Song, Kuyng-Ja;Koh, Chi-Kang
    • Journal of Korean Biological Nursing Science
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    • v.17 no.3
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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.

Physical Discomforts and Sexual Life Pattern of Women with Hysterectomy (자궁절제술 후 신체적 불편감과 성생활 양상)

  • Ahn, Young-Lan;Park, Young-Sook
    • Women's Health Nursing
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    • v.6 no.2
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    • pp.218-233
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    • 2000
  • The purposes of this study were to investigate the physical discomforts and sexual life pattern and to identify the relation between the physical discomforts and the satisfaction of sexual life in women with hysterectomy. The subject were 301 women who lived with their spouses from 3 months to 2 years after hysterectomy in S. University Hospital. The data were collected using a self-reported questionnaire by mail, which composed of 25 items of physical discomforts, restarting time and frequency of sexual intercourse, and 10 items of sexual satisfaction, The results were as follows: 1) The mean score of physical discomforts was 13.22 and range of score was 0-45. 1.7% of 301 women had no physical discomforts and 12.0% of them complained of severe physical discomforts such as fatigue, lumbago and pain of extremities. 2) The women with hysterectomy complained of fatigue(76.1%), lumbago(68.8%), pain of extremities(63.5%), weight gain(55.5%), vaginal dryness(50.8%) and symptom of estrogen deficiency such as perspiration (47.5%), flush(41.2%) and palpitation (38.5%). As unusual symptom, numbness of thigh (20.3%) and acne(16.3%) were identified. 3) There was no significant difference between the degree of physical discomforts and the laps of time after hysterectomy. But the score of physical discomforts was lower in women with vaginal hysterectomy than in women with abdominal hysterectomy. 4) The mean score of sexual satisfaction was 33.11 and range of score was 10-50. There was no significant difference between the degree of sexual satisfaction and the lapse of time after hysterectomy. 83.8% of women had not change of sexual life satisfaction after hysterectomy. The women restarted sexual intercourse in average 2.57 months after hysterectomy. 5) There was a negative correlation between the physical discomforts and the sexual satisfaction. In conclusion, nurses should make the discharge educational program of the physical discomforts and the sexual pattern for women with hysterectomy in hospital.

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Inter-rater Reliability Study on Pattern Identification Using Nasal Endoscopy for Rhinitis (비내시경 활용 비염 변증 지표의 평가자 간 신뢰도 연구)

  • Min, Kyung-Jin;Son, Mi-Ju;Kim, Young-Eun;Kim, Jeong-Hun;Lee, Dong-Hyo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.30 no.4
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    • pp.97-103
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    • 2017
  • Objectives : To identify whether pattern identification using nasal endoscopy for rhinitis can be applied as a tool for evaluating rhinitis in routine care setting, we performed a inter-rater reliability study on this pattern identification. Methods : Two Korean medicine doctors assessed 290 left/right nasal endoscopy photograph cases of rhinitis patients with pattern identification using nasal endoscopy. This pattern identification consist of four assessment items, nasal membrane color(pale/hyperemia), nasal membrane humidity(dryness/dampness), rhinorrhea(watery/yellow), and turbinate membrane edema(atrophic/edematous). Cohen's kappa statistic and Percentage agreement were used to evaluate the inter-rater reliability. Results : Inter-rater percentage agreement and Kappa coefficient for left nasal endoscopy photograph cases was from 'slight' to 'moderate'(% agreement: 40.00-67.59%/Kappa: 0.06-0.407). Only the agreement of 'rhinorrhea (watery/yellow)' item was moderate(% agreement: 67.59%/Kappa: 0.407). Inter-rater percentage agreement and Kappa coefficient for right nasal endoscopy photograph cases was also from 'slight' to 'moderate'(% agreement: 42.41-68.97%/Kappa: 0.109-0.465). Only the agreement of 'rhinorrhea(watery/yellow)' item was moderate(% agreement: 68.97%/Kappa: 0.465). Conclusions : It is necessary to resolve problems such as cut-off value setting, bipolar evaluation values(pale/hyperemia, dryness/dampness, watery/yellow, atrophic/edematous) and weighting items. Further rigorous studies that overcome the limitations of the current research are warranted.

Utilization of Hospitals Located Outside Patients' Residential Areas among Those with Acute Cerebral Infarction (급성뇌경색증 환자의 타지역 의료기관 이용현황 및 관련 특성 연구)

  • Lee, Sae Young;Kim, Stella Jung-Hyun;Park, Keun Young;Kim, Ji Man;Kim, Han-Joon;Lee, Changwoo;Shin, Euichul
    • Health Policy and Management
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    • v.28 no.1
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    • pp.48-52
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    • 2018
  • Background: The current study evaluated the hospital utilization and characteristics of patients who received health care services for acute cerebral infarction outside their own residential area. Methods: Using the 2014 national patient survey data, information on 2,982 patients diagnosed with acute cerebral infarction through emergency department were retrieved for the analyses. Multiple logistic regression was performed to investigate the characteristics associated with using hospitals outside residential area among patients diagnosed with acute cerebral infarction. Results: Fifteen point nine percent of patients admitted for acute cerebral infarction utilized hospitals outside their residential area. Patients residing in a province were 7.7 times more likely to utilize hospitals located outside their residential areas compared to those living in Seoul metropolitan city. Patients living in Gangwon and Jeolla were 0.26 times and 0.48 times more likely to go to hospitals in different geographical areas. Also, patients within the age group of 80 years and over were 0.65 times less likely to be admitted to hospitals outside their residential area compared to those in their 40s-50s. Conclusion: The use of hospitals outside patient's residential area is shown to be substantial, given that the acute cerebral infarction requires immediate recognition and treatment. The findings on the geographical differences in the hospital utilization suggest further investigation.

Impact of Anti-Tuberculosis Drug Use on Treatment Outcomes in Patients with Pulmonary Fluoroquinolone-Resistant Multidrug-Resistant Tuberculosis: A Nationwide Retrospective Cohort Study with Propensity Score Matching

  • Hongjo Choi;Dawoon Jeong;Young Ae Kang;Doosoo Jeon;Hee-Yeon Kang;Hee Jin Kim;Hee-Sun Kim;Jeongha Mok
    • Tuberculosis and Respiratory Diseases
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    • v.86 no.3
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    • pp.234-244
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    • 2023
  • Background: Effective treatment of fluoroquinolone-resistant multidrug-resistant tuberculosis (FQr-MDR-TB) is difficult because of the limited number of available core anti-TB drugs and high rates of resistance to anti-TB drugs other than FQs. However, few studies have examined anti-TB drugs that are effective in treating patients with FQr-MDR-TB in a real-world setting. Methods: The impact of anti-TB drug use on treatment outcomes in patients with pulmonary FQr-MDR-TB was retrospectively evaluated using a nationwide integrated TB database (Korean Tuberculosis and Post-Tuberculosis). Data from 2011 to 2017 were included. Results: The study population consisted of 1,082 patients with FQr-MDR-TB. The overall treatment outcomes were as follows: treatment success (69.7%), death (13.7%), lost to follow-up or not evaluated (12.8%), and treatment failure (3.9%). On a propensity-score-matched multivariate logistic regression analysis, the use of bedaquiline (BDQ), linezolid (LZD), levofloxacin (LFX), cycloserine (CS), ethambutol (EMB), pyrazinamide, kanamycin (KM), prothionamide (PTO), and para-aminosalicylic acid against susceptible strains increased the treatment success rate (vs. unfavorable outcomes). The use of LFX, CS, EMB, and PTO against susceptible strains decreased the mortality (vs. treatment success). Conclusion: A therapeutic regimen guided by drug-susceptibility testing can improve the treatment of patients with pulmonary FQr-MDR-TB. In addition to core anti-TB drugs, such as BDQ and LZD, treatment of susceptible strains with later-generation FQs and KM may be beneficial for FQr-MDR-TB patients with limited treatment options.

The Trends and Prospects of Health Information Standards : Standardization Analysis and Suggestions (의료정보 표준에 관한 연구 : 표준화 분석 및 전망)

  • Kim, Chang-Soo
    • Journal of radiological science and technology
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    • v.31 no.1
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    • pp.1-10
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    • 2008
  • Ubiquitous health care system, which is one of the developing solution technologies of IT, BT and NT, could give us new medical environments in future. Implementing health information systems can be complex, expensive and frustrating. Healthcare professionals seeking to acquire or upgrade systems do not have a convenient, reliable way of specifying a level of adherence to communication standards sufficient to achieve truly efficient interoperability. Great progress has been made in establishing such standards-DICOM, IHE and HL7, notably, are now highly advanced. IHE has defined a common framework to deliver the basic interoperability needed for local and regional health information networks. It has developed a foundational set of standards-based integration profiles for information exchange with three interrelated efforts. HL7 is one of several ANSI-accredited Standards Developing Organizations operating in the healthcare arena. Most SDOs produce standards (protocols) for a particular healthcare domain such as pharmacy, medical devices, imaging or insurance transactions. HL7's domain is clinical and administrative data. HL7 is an international community of healthcare subject matter experts and information scientists collaborating to create standards for the exchange, management and integration of electronic healthcare information. The ASTM specification for Continuity of Care Record was developed by subcommittee E31.28 on electronic health records, which includes clinicians, provider institutions, administrators, patient advocates, vendors, and health industry. In this paper, there are suggestions that provide a test bed, demonstration and specification of how standards such a IHE, HL7, ASTM can be used to provide an integrated environment.

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Application of Sociodrama for Reducing Burnout of Nurses in General Hospital (종합병원 간호사의 소진개선을 위한 소시오드라마의 활용)

  • Shin, Eun-Hee;Jung, Hyun-Gang;Eun, Hong-Bae;Jung, Kyung-Hee;Lim, Se-Won
    • Korean Journal of Psychosomatic Medicine
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    • v.17 no.2
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    • pp.62-67
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    • 2009
  • Objectives : The aim of this study was to evaluate the effect of sociodrama for reducing burnout among health care workers and to investigate relationship between the job satisfaction, conflict with other professions, and burnout. Methods:15 nurses in general hospital participated in sociodrama directed by psychiatrist. One week after acting sociodrama, they were requested to complete ward organizational feature scale(WOFS) and maslach burnout inventory(MBI). The other twenty nurses in same ward requested to complete questionnaire without participating in sociodrama at the same time. Results : Sociodrama group(N=15) showed significantly lower score in burnout when compared to control group(N=17). Nurse/physician relationship was significantly correlated with job satisfaction and burnout. After controlling for interaction between variables by multivariate regression analysis, only job satisfaction was significant predictive factor to burnout. Conclusion : Our result suggests that the sociodrama can be effective in reducing burnout of health care workers in general hospital. These finding also underline the importance of relationship with physicians in job satisfaction and burnout of healthcare workers in general hospital.

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Community Health Promotion Program for Vulnerable Women (취약계층 여성의 건강증진 방안)

  • Jeon, Gyeong-Suk;Lee, Seon-Ja;Lee, Hyo-Young;Hong, Bo-Kyung;Kim, Bo-Ram;Jang, Soong-Nang
    • Korean Journal of Health Education and Promotion
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    • v.24 no.3
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    • pp.99-118
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    • 2007
  • There are little program and services that have been developed to address the health and health care needs of vulnerable women. The access for their timely and appropriate health care and health promotion services have been a increasing concern. The purpose of this study was to suggest health promotion program for vulnerable women with collaboration of women's NGOs. At the first part of this study, we reviewed a conceptual framework for identifying vulnerable population, and issues regarding health problems, unmet needs, policies and programs that have been developed to address their need. In second part, we focused on investigating the role, subjects and activities of women's NGOs and their capacity for health promotion program. The last part of this study proposed health promotion programme with integrating above two parts of study. In describing what type of health promotion program available in women's NCOs, eight major programs and services were summarized. 1. Direct health promotion program and collaborating program with other services. 2. Education and training for empowerment of vulnerable women 3. Organizing mutual support system such as self-help group 4. Community supports. Vulnerable women living at home may benefit from linkage to community services as much as women living in facility 5. Organizing collaboration system with program for economic support and job training, social rehabilitation 6. Trainer's training for practitioners in NGOs 7. Technical, informational support from professional groups 8. A national coordinating policies for vulnerable population should be established at the central level. National support for NGOs' health promotion program are needed hi solving unmet needs of vulnerable women.

Special Issue for the 30th Anniversary of the Korean Academy of Health Policy and Management (한국보건행정학회 30주년 기념 특별호)

  • Park, Eun-Cheol
    • Health Policy and Management
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    • v.28 no.3
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    • pp.195-196
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    • 2018
  • The Korean Academy of Health Policy and Management (KAHPM) has shown remarkable achievements in the field of health policy and management in Korea for the last 30 years. The KAHPM consists of experts in various fields of health policy and management, and has been the leading academic discussion forum for health policy agendas of interest to the public. Health Policy and Management (HPM), the official journal of the KAHPM, published the first issue of volume 1 in October, 1991 and is publishing the second issue of volume 28 as of 2018. Currently, it is one of Korea' main journals in the field of health policy and management. HPM has published a special issue in commemoration of the 30th anniversary of the KAHPM. The HPM invited authors, including former presidents of the KAHPM and current board members, to write about main issues in health policy and management. Although the HPM tried to set up an invited author on all subjects in the health policy and management field, 19 papers are published, that completed the peer review process by August, 2018. The authors of the special issue of the 30th anniversary of the KAHPM include six former presidents, a senior professor, and 12 board members. The subjects of this issue are reform of the healthcare delivery system, health insurance and medical policy, reform of health system governance, the role of National Health Insurance Service (NHIS), the Korea Institute for Health and Social Affairs (KIHASA) and the National Evidence-based healthcare Collaborating Agency (NECA), ethical aspects of health policy change, regional disparities of healthcare, healthcare accreditation, new healthcare technology evaluation system, globalization of the healthcare industry, the epidemiological investigator system, the quarantine system, safety and disaster, and official development assistance. There are some remaining topics to deal with for the KAHPM: aged society, anti-smoking, non-infectious disease, suicide, healthcare resources, emergency medical care, out-of-pocket money, medical fee payment system, medical aid system, long-term care insurance, industrial accident compensation insurance, community-centered health welfare system, and central government and local government of health. The HPM will continue to publish review articles on the main topics in health policy and management. This is because the KAHPM, which has been the leading academic society of Korea's health policy and management for the last 30 years, feels responsible for continuing its mission for the next 30 years.