• Title/Summary/Keyword: Dependence of a patient

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Exploring Concurrent Validity and Item Level Analysis for Two Korean Versions of Health-Related Quality of Life Instrument: EQ-5D vs. WHOQOL-BREF

  • Choi, Bongsam
    • Physical Therapy Korea
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    • v.27 no.4
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    • pp.233-240
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    • 2020
  • Background: Cross-culturally adapted questionnaires may not be comparable to their original version. Objects: To examine concurrent validity of two health-related quality of life (HRQOL) instruments for the Korean versions of EuroQOL-5 Dimension (EQ-5D) and the abbreviated version of the World Health Organization Quality of Life (WHOQOL-BREF) instrument. Methods: A total of 139 cancer survivors from two rehabilitation institutes was recruited. All participants were registered for palliative rehabilitation care. Both instruments were concurrently administered by health care providers following the second bout of the rehabilitation cares. Rasch partial credit model and Spearman's correlation analysis were used to investigate: 1) dimensionality, 2) hierarchical item difficulty, and 3) concurrent validity using correlations between two instruments. Results: For the WHOQOL-BREF, all items except negative feeling, pain, dependence of medical aid, were found to be acceptable, while all items of EQ-5D were acceptable. There was an evidence of negative correlations between EQ-5D and 4 domains of WHOQOL-BREF. Two correlations were strong (EQ-5D vs. physical health domain, ρ = -0.610, 95% CI = -0.716 to -0.475) and moderate (EQ-5D vs. psychosocial domain, ρ = -0.402, 95% CI = -0.546 to -0.236). Other two correlations were weak (EQ-5D vs. social relationship and environmental domains, ρ = -0.242, 95% CI = -0.401 to -0.075 and ρ = -0.364, 95% CI = -0.514 to -0.207, respectively). Item difficulty calibrations of the two measurements were ranged from -0.84 to 0.86 for the EQ-5D and -1.07 to 1.06 for the WHOQOL-BREF. Conclusion: The study provides some supports for the concurrent validity of the two Korean versions of HRQOL instrument, with evidences of weak to strong correlations between the EQ-5D and four domains of the WHOQOL-BREF applied to various cancer survivors. Additionally, the cancer survivors appeared to have more of a tendency to view the EQ-5D items as being slightly more challenging than the WHOQOL-BREF items.

The Big Data Analysis and Medical Quality Management for Wellness (웰니스를 위한 빅데이터 분석과 의료 질 관리)

  • Cho, Young-Bok;Woo, Sung-Hee;Lee, Sang-Ho
    • Journal of the Korea Society of Computer and Information
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    • v.19 no.12
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    • pp.101-109
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    • 2014
  • Medical technology development and increase the income level of a "Long and healthy Life=Wellness," with the growing interest in actively promoting and maintaining health and wellness has become enlarged. In addition, the demand for personalized health care services is growing and extensive medical moves of big data, disease prevention, too. In this paper, the main interest in the market, highlighting wellness in order to support big data-driven healthcare quality through patient-centered medical services purposes. Patients with drug dependence treatment is not to diet but to improve disease prevention and treatment based on analysis of big data. Analysing your Tweets-daily information and wellness disease prevention and treatment, based on the purpose of the dictionary. Efficient big data analysis for node while increasing processing time experiment. Test result case of total access time efficient 26% of one node to three nodes and case of data storage is 63%, case of data aggregate is 18% efficient of one node to three nodes.

Genotype-phenotype correlations in pediatric patients with myotonic dystrophy type 1

  • Kim, Hyeong Jung;Na, Ji-Hoon;Lee, Young-Mock
    • Clinical and Experimental Pediatrics
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    • v.62 no.2
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    • pp.55-61
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    • 2019
  • Purpose: Myotonic dystrophy, also known as dystrophia myotonica (DM), is an autosomal dominant disorder with 2 genetically distinct forms. DM type 1 (DM1) is the more common form and is caused by abnormal expansion of cytosine/thymine/guanine (CTG) repeats in the DM protein kinase (DMPK ) gene. Our study aimed to determine whether the age of onset is correlated with CTG repeat length in a population of pediatric patients with DM1. Methods: We retrospectively identified 30 pediatric patients with DM1 that underwent DMPK testing, of which the clinical data of 17 was sufficient. The cohort was divided into 2 subgroups based on the clinical phenotype (congenital-onset vs. late-onset) and number of CTG repeats (<1,000 vs. ${\geq}1,000$). Results: We found no significant difference between the age of onset and CTG repeat length in our pediatric patient population. Based on clinical subgrouping, we found that the congenital-onset subgroup was statistically different with respect to several variables, including prematurity, rate of admission to neonatal intensive care unit, need for respiratory support at birth, hypotonia, dysphagia, ventilator dependence, and functional status on last visit, compared to the late-onset subgroup. Based on genetic subgrouping, we found a single variable (poor feeding in neonate) that was significantly different in the large CTG subgroup than that in the small CTG subgroup. Conclusion: Clinical variables exhibiting statistically significant differences between the subgroups should be focused on prognosis and designing tailored management approaches for the patients; our findings will contribute to achieve this important goal for treating patients with DM1.

Acute Response to Co-60 Total Body Irradiation (TBI) With 600 cGy at 3 Different Does Rates in the Mice (코발트-60 원격치료기를 이용한 전신 방사선 조사에서 선량율의 차이에 따른 급성효과)

  • Kang Cheol Hoon;Kum Sung Kyu;Shin Sei One;Kim Myung Se
    • Radiation Oncology Journal
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    • v.8 no.2
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    • pp.151-154
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    • 1990
  • The acute effects of variable dos rates to total body irradiation (TBI) were investigaed with 600 cGy of single exposure in the mice as a preclinical model. Total 80 mice (ICR) were used. Twenty of which sewed as controls, receiving no irradiation. All irradiated mice showed a universal decline in their weight and white blood cell count. The degree of weight loss and leukopenia were similar at 3 different dos rate but slightly prominent with 15 cGy/minute group. The degree of recovery among the groups showed no dose rate dependence. Our results suggest that TBI with 15 cGy/mimute may be applicable for clinical therapy with careful evaluation of patient's condition.

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Content Analysis of the Nursing Interventions and Telephone Calls to the Pediatric Nursing Unit (외래 및 퇴원환아 부모의 전화상담과 간호중재의 내용분석)

  • 한경자;최명애;강화자;박승현;김영미;권원경;안혜영
    • Journal of Korean Academy of Nursing
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    • v.26 no.3
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    • pp.515-530
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    • 1996
  • A descriptive study was conducted to describe the content of nursing interventions and incoming telephone calls from the parents whose child was discharged to home or who has planned immunization during the period from March 15, 1995 to November 30, 1995. Detailed notes on 145 telephone calls and 243 nursing interventions were recorded by head nurses on pediatiric nursing units were entered to data collection and content analysis. The results of the study are as follows : 1. Six analysis categories for the records on incoming telephone calls were identified judgement-dependence, dependent -coping, self-initiated coping, support, adjustment and intermediation need. 2. Five analytic categories for the records on telephone interventions were identified : guidance, mediation, facilitating self -care abilities, support, instrumental use. 3. Problems related to physical signs and symptoms, medication, immunization, and vital signs were most often cited as concerns by parents and caregivers. 4. Instruction, suggestion, provision knowledge and information, reassurance related to physical problems, medication, immunization and clinic visits were most often used as an nursing interventions by head nurses on pediatric nursing units. In spite of the fact that the telephone calls were initiated by the parents, dependency of parents during the telephone calls was remarkable. The dependency of parents on judgement and decision making of the pediatric nurses should be understood in terms of the psychosocial content as well as cultural characteristics. Therefore, it is suppested that telephone interventions focus on facilitating the self-care ability of the parents whose children have chronic conditions. The results of this study will be useful as an essential reference in providing effective for children and their families after discharged from the hospital. The results can also be used as reliable data for extended pediatric nursing service in the health care delivery system as well as for the development of telephone intervention service program in responding to the current health care environment.

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A Study on the Directional Dependence of Scatter Ray in Radiography (X선 촬영시 산란선 방향 의존성에 관한 연구)

  • Oh, Hyun-Joo;Kim, Sung-Soo;Kim, Young-Il;Lim, Han-Young;Kim, Heung-Tae;Lee, Who-Min;Kim, Hak-Sung;Lee, Sang-Suk
    • Journal of radiological science and technology
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    • v.18 no.1
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    • pp.63-70
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    • 1995
  • In this pauper, the back, forward, side and $45^{\circ}$ oblique scatter dose were measured the X-ray exposure conditions 60, 80, 100, 120kV, FFD 100cm, FS $20\times20cm$, toward the $25\times25cm\times10\sim20cm$ of solid water, paraffin and MiX-DP phantom, and Pb, Cu, Al, and styrofoam meterials, by the electrometer and 5.3 cc ionization chamber. The obtained results are summarized as following. 1. The percentage depth dose(PDD) at the range of the diagnostic x-ray energy were appeared 50 % depth dose at the 2 cm depth with 60 kV, and 5 cm depth with 120 kV X-ray, 10 % depth dose at the 10 cm depth with 60 kV and 14 cm depth with 120 kV X-ray, 5 % below depth dose at the 20 cm depth. 2. The back scatter dose which were generated the surface of Pb, Cu and Al metal plates were 10 % below, and than the back scatter dose at the Pb plate were a most amount of these which were about 10 %, and were appeared the order of Cu and Al. 3. The percentage forward scatter were appeared from 50 % to 65 %, and the more phantom thicknees become, the more forward scatter were increased with the ratio of 5 % per 5 cm thickness. 4. The percentage back scatter which were generated the tissue equivalence meterials solid water, paraffin and MiX-DP were from 20 % to 40 %, and than the back scatter dose at the solid water were a mest amount of those, and paraffin and MiX-DP were appeared with the next values. 5. The percentage $90^{\circ}$ lateral and $45^{\circ}$ oblique side scatter dose were measured from 4 % to 12 %. a most amount of scatter dose which were generated from the patient in radiography were the forward scatter, the next values were the back scatter, the third values were the $90^{\circ}$ lateral scatter.

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Validation of Nursing-sensitive Patient Outcomes;Focused on Knowledge outcomes (지식결과에 대한 타당성 검증;간호결과분류(NOC)에 기초하여)

  • Yom, Young-Hee;Lee, Kyu-Eun
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.3
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    • pp.357-374
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    • 2000
  • The purpose of this study was to validate knowledge outcomes included Nursing Outcomes Classification(NOC) developed by Johnson and Maas at the University of Iowa. A sample of 71 nurse experts working in university affiliated hospitals participated in this study. They were asked to rate indicators that examplified the outcomes on a scale of 1(indicator is not all characteristic) to 5(indicator is very characteristic). A questionnaire with an adaptation of Fehring's methodology was used to establish the content validity of outcomes. The results were as follow: 1. All indicators were considered to be 'supporting' and no indicators were considered to be 'nonsupporting'. 2. 'Knowledge: Treatment Regimen' attained and OCV score of 0.816 and was the highest OCV score among outcomes. 3. 'Knowledge: Energy Conservation' attained an OCV score of 0.748 and was the lowest OCV score among abuse outcomes. 4. 'Knowledge: Breastfeeding' attained an OCV score of 0.790 and was the highest indicator was 'description of benefits of breastfeeding'. 5. 'Knowledge: Child Safety' attained an OCV score of 0.778 and was the highest indicator was 'demonstration of first aids techniques'. 6. 'Knowledge: Diet' attained an OCV score of 0.779 and was the highest indicator was 'performance of self-monitoring activities'. 7. 'Knowledge: Disease Process' attained an OCV score of 0.815 and was the highest indicator was 'description of signs and symptoms'. 8. 'Knowledge: Health Behaviors' attained an OCV score of 0.800 and was the highest indicator was 'description of safe use of prescription drugs'. 9. 'Knowledge: Health Resources' attained an OCV score of 0.794 and was the highest indicator was 'description of need for follow-up care'. 10. 'Knowledge: Infection Control' attained an OCV score of 0.793 and was the highest indicator was 'description of signs and symptoms'. 11. 'Knowledge: Medication' attained an OCV score of 0.789 and was the highest indicator was 'description of correct administration of medication'. 12. 'Knowledge: Personal Safety' attained an OCV score of 0.804 and was the highest indicator was 'description of measures to reduce risk of accidental injury'. 13. 'Knowledge: Prescribed Activity' attained an OCV score of 0.810 and was the highest indicator was 'proper performance of exercise'. 14. 'Knowledge: Substance Use Control' attained an OCV score of 0.809 and was the highest indicator was 'description of signs of dependence during substance withdrawl'. 15. 'Knowledge: Treatment Procedure(s)' attained an OCV score of 0.795 and was the highest indicator was 'description of appropriate action for complications'. 16. 'Knowledge: Treatment Regimen' attained an OCV score of 0.816 and was the highest indicator was 'description of self-care responsibilities for emergency situations'. More outcomes need to be validated and outcomes sensitive to Korean culture need to be developed.

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A CLINICAL STUDY ON SKELETAL ANCHORAGE SYSTEM USING MINISCREW (구내고정원을 이용한 교정 치료중 miniscrew 탈락에 관한 연구)

  • Woo, Soon-Seop;Jeong, Soon-Tai;Huh, Young-Sung;Hwang, Kyung-Gyun;Yoo, Im-Hag;Shim, Kwang-Sup
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.2
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    • pp.102-107
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    • 2003
  • At orthodontic treatment, we have made every effort to get rigid anchorage which is not stirred when teeth move. As a result, the miniscrew that is rigid anchorage was invented recently, and now it is used widely. Concerning the advantage of miniscrew, it is reduced dependence of extraoral anchorage and it shortens treatment time for rapid tooth movement. In contrast, the defect of miniscrew is falling off it resulted from increasing of the mobility. So the purpose of this research is to be of help to prognose clinical use of miniscrew, which is inserted for intraoral anchorage, by investigating and comparing the failure rate of miniscrew for loading time. This study researches the failure rate of miniscrew for teeth movement at the orthodontic treatment. The failure rate of miniscrew in mid course, after inserting 147 miniscrews in 51 patients, is 13%(20/147). It showed no statistically significant differences as compared man with woman, maxilla with mandible, double-head with uni-head miniscrew, and drilling and non-drilling before inserting the miniscrew. In comparison below twenties with over twenties and the times that we give load to miniscrew, it produced that the failure rate of miniscrew is 9.7% higher in the case of below the twenties than over the twenties. Also, the failure rate of loading immediately is 10.8% higher than loading after 7 days. According to using driver for the insertion of miniscrew, the failure rate of miniscrew is higher in the case of using machined driver than in the case of using hand driver when the level of significance is 95%. According to the research, we can suppose that the failure rate has no concern with using miniscrew on man or woman, maxilla or mandible, the shape of head, and drilling or non-drilling before insertion of miniscrew. Therefore, we can choose eclectic miniscrew as demands. In addition, we must notify the patient, below twenties, to be possibility of high failure rate. And It is strongly recommended to give load after $1{\sim}2$ weeks for healing of the insertion area.

The Alignment Evaluation for Patient Positioning System(PPS) of Gamma Knife PerfexionTM (감마나이프 퍼펙션의 자동환자이송장치에 대한 정렬됨 평가)

  • Jin, Seong Jin;Kim, Gyeong Rip;Hur, Beong Ik
    • Journal of the Korean Society of Radiology
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    • v.14 no.3
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    • pp.203-209
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    • 2020
  • The purpose of this study is to assess the mechanical stability and alignment of the patient positioning system (PPS) of Leksell Gamma Knife Perfexion(LGK PFX). The alignment of the PPS of the LGK PFX was evaluated through measurements of the deviation of the coincidence of the Radiological Focus Point(RFP) and the PPS Calibration Center Point(CCP) applying different weights on the couch(0, 50, 60, 70, 80, and 90 kg). In measurements, a service diode test tool with three diode detectors being used biannually at the time of the routine preventive maintenance was used. The test conducted with varying weights on the PPS using the service diode test tool measured the radial deviations for all three collimators 4, 8, and 16 mm and also for three different positions of the PPS. In order to evaluate the alignment of the PPS, the radial deviations of the correspondence of the radiation focus and the LGK calibration center point of multiple beams were averaged using the calibrated service diode test tool at three university hospitals in Busan and Gyeongnam. Looking at the center diode for all collimators 4, 8, and 16 mm without weight on the PPS, and examining the short and long diodes for the 4 mm collimator, the means of the validation difference, i.e., the radial deviation for the setting of 4, 8, and 16 mm collimators for the center diode were respectively measured to 0.058 ± 0.023, 0.079 ± 0.023, and 0.097 ± 0.049 mm, and when the 4 mm collimator was applied to the center diode, the short diode, and the long diode, the average of the radial deviation was respectively 0.058 ± 0.023, 0.078 ± 0.01 and 0.070 ± 0.023 mm. The average of the radial deviations when irradiating 8 and 16 mm collimators on short and long diodes without weight are measured to 0.07 ± 0.003(8 mm sd), 0.153 ± 0.002 mm(16 mm sd) and 0.031 ± 0.014(8 mm ld), 0.175 ± 0.01 mm(16 mm ld) respectively. When various weights of 50 to 90 kg are placed on the PPS, the average of radial deviation when irradiated to the center diode for 4, 8, and 16 mm is 0.061 ± 0.041 to 0.075 ± 0.015, 0.023 ± 0.004 to 0.034 ± 0.003, and 0.158 ± 0.08 to 0.17 ± 0.043 mm, respectively. In addition, in the same situation, when the short diode for 4, 8, and 16 mm was irradiated, the averages of radial deviations were 0.063 ± 0.024 to 0.07 ± 0.017, 0.037 ± 0.006 to 0.059 ± 0.001, and 0.154 ± 0.03 to 0.165 ± 0.07 mm, respectively. In addition, when irradiated on long diode for 4, 8, and 16 mm, the averages of radial deviations were measured to be 0.102 ± 0.029 to 0.124 ± 0.036, 0.035 ± 0.004 to 0.054 ± 0.02, and 0.183 ± 0.092 to 0.202 ± 0.012 mm, respectively. It was confirmed that all the verification results performed were in accordance with the manufacturer's allowable deviation criteria. It was found that weight dependence was negligible as a result of measuring the alignment according to various weights placed on the PPS that mimics the actual treatment environment. In particular, no further adjustment or recalibration of the PPS was required during the verification. It has been confirmed that the verification test of the PPS according to various weights is suitable for normal Quality Assurance of LGK PFX.

A Literature Review for Approach of Oriental Nursing (한방간호접근을 위한 이론적 고찰)

  • 강현숙
    • Journal of Korean Academy of Nursing
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    • v.23 no.1
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    • pp.118-129
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    • 1993
  • In order to approach the nursing care of clients who are using oriental medicine and to understand the perception of the client who uses oriental medicine practices and the need to develop a model of nursing related to oriental medicine it is important to examine the major nursing concepts as they are found in oriental medicine and as they are differently defined according to the basic thought, theory and philosophical perspectives between East and West. Oriental medicine developed based on Sung Confucianism the teachings of Chut-zu, especially Tai-Chi-Tu Shuo and energy thought which are similar to traditional Korean Sasang Constitutional medicine. The basic theory on which oriental medicine is build is the theory of the five elements of Yin / Eum-Yang Theory(cosmic dual forces) and Meridian Theory. The most important attribute of Yin Yang is the concept of duality, confrontation and dependence, within Yin Yang but which do not exist separately. That is, the universe is a vast, indivisible entity within which all things exist in harmonious interdependence and balance. Harmony is achieved only when the two primorial forces, Yin and Yang, are brought into perfect balance. Each is contained within the other and there is a continuing interchange between the two. This also applies to the human body including human health which is defined as balanced harmony. The most universal connection of Yin and Yang is found in the universe where the five elements of life, fire, water, earth, wood and metal can be explained as having either Yin or Yang and therefore being in a state of connectedness but systematically circulating between the two, that is essentalilly one (the control of the unified ) or as coexistant poles of individual wholes (the pluralism of Yin Yang Theory) so that it is all unified(balanced) in the Great Absoulte. Human beings also maintain a balance of Yin and Yang in the five elements and this relationship is very important in approaching ·oriental medicine, The meridians are the channels in the body through which the life force flow throughout the body. In oriental medicine the meridians are seen as the railroad, the acupuncture points on the meridians as the stations and energy as the train. In the normal healthy organism, all are maintained in balance and in a contiuous circulation of energy. illness is the result of the energy flow becoming disarranged. Although practitioners of oriental medicine approach the client differently than do practitioners of Western medicine and their method of examining the patient is different, the basic objectives of the examination are the same for practitioners of both types of medicine. Therefore if each could be used to supplement the defiencies in the other and achieve a harmonious cooperation between the two, a higher level of care which is culturally appropriate to korean culture could be achieved. The traditional korean concept of health is a naturalistic view which emphasizes being in harmony with nature. Any manifestation of disease is considered a sign that the body is in a state of disequilibrium and is thus no longer in harmony with the universe. The wholistic view of the world held by practitioners of oriental medicine can be used by nursing in the development of a world view of nursing in which the human being is seen within the macrocosm as part of the natural phenomenon of the universe and but also as a microcosm of the universe, a universe which is a vast and indivisible entity within which all things exist in harmonious interdependence and balance. Interaction between human beings and their environment and the relationship of this interaction to health are concepts that are also found in nursing. Nursing views human brings, not as an accumulation of separate cells and organs but, as unified wholes interacted in very close relationship nth their environment. Nursing also maintains a view of human beings in which emphasis is placed on the role of the mind in explaining the concepts of harmony and balance in health. Although there are differences between oriental medicine and nursing in approaches to clients, the basic point of view and philosophy have many fundamental similarites. An understanding of the basic thought and philosophy of oriental medicine if applied to nursing, would allow for the development, not only of nursing related to oriental medicine, but of a nursing theory appropriate to the korean context.

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