• Clinics in Shoulder and Elbow
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• 제26권3호
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• pp.238-244
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• 2023

Background: Many patients use online resources to educate themselves on surgical procedures and make well-informed healthcare decisions. The aim of our study was to evaluate the quality and readability of online resources exploring shoulder arthroplasty. Methods: An internet search pertaining to shoulder arthroplasty (partial, anatomic, and reverse) was conducted using the three most popular online search engines. The top 25 results generated from each term in each search engine were included. Webpages were excluded if they were duplicates, advertised by search engines, subpages of other pages, required payments or subscription, or were irrelevant to our scope. Webpages were classified into different source categories. Quality of information was assessed by HONcode certification, Journal of the American Medical Association (JAMA) criteria, and DISCERN benchmark criteria. Webpage readability was assessed using the Flesch reading ease score (FRES). Results: Our final dataset included 125 web pages. Academic sources were the most common with 45 web pages (36.0%) followed by physician/private practice with 39 web pages (31.2%). The mean JAMA and DISCERN scores for all web pages were 1.96±1.31 and 51.4±10.7, respectively. The total mean FRES score was 44.0±11.0. Only nine web pages (7.2%) were HONcode certified. Websites specified for healthcare professionals had the highest JAMA and DISCERN scores with means of 2.92±0.90 and 57.96±8.91, respectively (P<0.001). HONcode-certified webpages had higher quality and readability scores than other web pages. Conclusions: Web-based patient resources for shoulder arthroplasty information did not show high-quality scores and easy readability. When presenting medical information, sources should maintain a balance between readability and quality and should seek HONcode certification as it helps establish the reliability and accessibility of the presented information. Level of evidence: IV.

• 대한영상의학회지
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• 제85권1호
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• pp.54-76
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• 2024

후관절병증은 퇴행성 추간판 질환 또는 척추관 협착증과 같은 척추 퇴행성 질환과 잘 동반되는 진행성 퇴행성 질환이다. 요추의 후관절병증은 근위부 하지의 통증을 유발할 수 있지만 그 증상과 영상 소견이 비특이적이기 때문에 추간판 탈출증이나 신경근 압박에 의한 통증과 감별이 어렵다. 또한 치료적 요추 후관절 내 스테로이드 주사는 현재까지 그 근거가 낮다고 분류되어 있으나, 다른 여러 연구들에서는 후관절 내 스테로이드 주사의 치료적 효과를 보고하고 있다. 실제 진료 현장에서는 치료적 후관절 내 스테로이드 주사 시술이 증가하고 있는 추세로, 본 종설에서는 후관절 내 주사에 대한 저자들의 경험을 바탕으로 요추 후관절 내 주사의 임상적 유용성 및 시술의 안전성에 대해서 소개하고자 한다.

• Korean Circulation Journal
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• 제54권1호
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• pp.1-12
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• 2024

Background and Objectives: The objective of this study was to estimate the supply and demand for cardiologists in Korea and provide evidence for healthcare policy to ensure a stable and adequate workforce for optimal cardiovascular disease management. Methods: Past trends of inflow and outflow of cardiologists were used to make crude projections, which were then adjusted based on demands of services to obtain final projections. Inflow of cardiologists was estimated using second-order polynomial regression and demand for cardiology care was estimated using linear regression. Results: There were 1,139 active cardiologists who were under the age of 65 in clinical practice in Korea. The estimated number of cardiologists from 2022 to 2040 showed that the number of cardiologists would peak at 1,344 in 2032 and gradually decrease thereafter. We also estimated an increase of 947,811 cases of heart-related procedures annually from 2023 to 2032. The number of heart-related procedures per cardiologist would increase 1.4 times from 12,964 in 2023 to 17,862 in 2032. The estimated number of emergency patients per cardiologist under 50 years old would almost double from 544 in 2022 to 987 in 2032. Conclusions: We expect significant shortage of cardiologists in Korea within the next 10 years. The number of emergency patients per cardiologist will increase by nearly 50%, leading to high individual workload for cardiologists. To prevent this imbalance between supply and demand, an organized and collective approach by the specialty of cardiology is imperative to produce a balanced workforce.

• Journal of Digestive Cancer Research
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• 제8권1호
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• pp.1-50
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• 2020

Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.

• Child Health Nursing Research
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• 제8권4호
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• pp.449-457
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• 2002

The main purpose of this study is to examine the concepts appeared on researches and provide the future research directions in field of child health nursing. A descriptive study was conducted. 205 studies were included in an analysis the concepts in terms of the domain of client for a total 321 researches. All were originally published between 1990 and 2000 in Korea. An analysis of concepts for this study was used the metaparadigm framework for nursing proposed by H.S. Kim(2000). The concepts for this study were categorized by essentialistic concepts, problematic concepts, health-care experiential concepts with the following results. 1. Based on the four domains suggested Kim (2000), 205 studies(63.9％) belong to the domain of client ; 109 studies(34％) belong to the practice domain of nursing; 3 studies(0.9％) belong to the client-nurse domain; and 4 studies belong to the domain of environment, respectively. 2. In the domain of client, 117(57.1％) studies used concept of parent. Among them, mother was the prevailing research population(103 studies). 64 studies(31.2％) used child population and the developmental stage of children varied from preterm to puberty but school aged children was the most target population(28 studies). Family as a concept of client was used in 20 studies(9.8％) but most primary care provider was the mother. 3. In terms of research design, non-experimental design(83.5％) is the most and among them survey was 159 studies(77.6％). Qualitative research(23 studies) and experimental research(10 studies) methods were used relatively few. 4. In terms of the categories of concepts, 196 (61.4％) studies included the essentialistic concepts like stress and coping(20.4％), mothering role and child care(7.8％), health (5.6％), breast feeding(4.7％). 31 studies included problematic concepts like power-lessness, safety, obesity, pain, anxiety. And 65 studies included health-care experiential concepts like compliance, growth, hope, environment but relatively few. The findings of this study provide the evidence that research related problematic concept and health-care experiential concept should be conducted actively to improve the practice of child health nursing. Also to deeply understand the phenomena of client in field of child health nursing, interpretive research methods should be conducted actively, too.

• 대한간호
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• 제33권2호
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• pp.45-58
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• 1994

This study was conducted for the purpose of identifying the trends of nursing research and to suggest the direction of future research in the graduate levels of the study. The data was collected from 469 abstracts of master's and doctoral rapers from three graduate schools, one in Nursing, another in Education, and the other in Public Health Graduate College. The results of the study are as follows: The number of research was increased from 102 to 286 between the 1970 s and 1980's. The most frequently employed research design was descriptive studies in the master's level, but there was some balance between descriptive and experimental studies along with some qualitative approaches in the doctoral thesis. Patients were the most often studied sample group reaching 42% of the cases, though it Was noted that there was steady shift: toward the non-ratient population. With this shifting of the study sample, the places of the study also have showed some changes moving toward community. The most widely studied area was in clinical practice. Chronic illness, preventive, and health promoting areas of studies also increased in numbers. However, most of them were at the descriptive level of phenomena and only a few were concerned with cost/effective measures of nursing intervention. The number of variables studied repeatedly more than five times was 43. They were not only physical but also psychosocial aspects which imply the efforts to incorporate the whole person in nursing discipline. However, most researches with repeated studies showed little relation to previous studies, and thus little accumulation in knowledge. There was also little evidence of linkage to nursing theory in most studies of master's level. For the doctoral rapers, 17 out of 51 rapers showed specific theories related to the researches. Based on the above findings, the following suggestions were made. Various research design should be employed including case studies, historical studies, as well as qualitative approaches. There should be more effort to establish linkage between theory and research. The areas needing more attention are Korean Nursing History, Ethics in our Culture, Cost/Effective Measures of Nursing Intervention, Concept and Thory Development, and the Strategies for the Implication of the Research Results in clinical practice.

• 무역학회지
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• 제41권5호
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• pp.1-14
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• 2016

최근 소비자들은 제품을 구매할 때 제품의 본질적인 특성 뿐 아니라 기업의 투명성과 윤리성 특히 공정무역제품에 대한 관심이 높아지고 있다. 일반적으로 공정무역을 하는 기업의 제품이나 서비스에 대해 소비자들은 긍정적인 태도를 가지게 되어 제품을 구매하게 되는 윤리적인 마케팅으로 간주 되지만 이를 실증한 연구는 거의 없다. 본 연구는 공정무역과 관련된 소비자의 구매의도를 파악하여 실제로 공정무역의 행위가 기업의 경쟁우위가 될 수 있는지 수단적 이해관계자 이론과 신호이론에 근거하여 실증분석 하였다. 첫 번째 실험은 순수 실험 디자인 중 피실험자 내 디자인을 통해 소비자 구매의도의 공정무역 마케팅 효과를 조사하였다. 두 번째 실험은 소비자 구매의도의 공정무역인증의 효과를 테스트하기 위해 시행되었다. 연구결과 소비자들은 일반적인 제품보다 공정무역제품을 선호한다는 결과를 도출하였으며, 공정무역인증 제품인 경우 그렇지 않은 제품보다 프리미엄 가격을 지불하고서라도 소비하려는 성향을 파악하였다. 또한 공정무역인증 라벨을 부착한 제품이 판매되는 장소에 따라 다른 결과를 도출하였는데, 이는 향후 기업이 목표로 하는 소비자에 따라 차별화된 제품을 유통해야한다는 시사점을 제시할 수 있을 것으로 보인다. 본 연구 결과는 기업이 목표로 하는 기대성과를 위하여 보다 차별화되고 중점적으로 활동할 수 있는 기업의 사회적 책임활동 방향을 제시할 수 있을 것으로 보인다.

• 재활치료과학
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• 제8권3호
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• pp.31-41
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• 2019

목적: 본 연구는 섭식 장애가 있는 뇌성마비 아동에게 시행한 구강감각운동치료에 대한 중재 방법, 중재 기간, 중지 시간, 평가 방법 등에 대한 국내외 문헌을 종합적으로 분석하고자 하였다. 연구방법: 본 연구는 2009년 1월부터 2018년 12월까지 국내외 논문을 검색하여 176편의 논문이 검색되었다. 1차 초록 및 제목 중심으로 47편의 논문이 선정되었고, 2차 원문 검색을 통해 5편의 논문이 선정되었다. 결과: 선정된 논문의 PEDro scale은 평균 7점으로 높은 편이었으며, 치료의 중재 기간은 8주에서 24주 사이로 나타났으며, 중재 시간은 일주일에 1회에서 5회, 하루에 최소 15분에서 1시간씩 제공되었다. 구강감각운동치료의 접근 방법은 손상 기반 치료적 접근과 적응 기반 치료적 접근이 사용되었으며, 평가 방법은 임상적 평가와 비 도구적 평가로 나누어 사용되었다. 결론: 본 연구는 섭식 장애를 가진 뇌성마비 아동에게 실시한 구강감각운동에 대해 분석하였고, 이러한 자료를 통해 뇌성마비 아동들의 구강운동치료 프로그램 계획 시 적절한 치료적 중재 적용방법을 선택하는 데 도움이 될 수 있는 정보 제공 및 근거를 마련하였다.

• 대한지역사회작업치료학회지
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• 제9권2호
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• pp.33-42
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• 2019

목적 : 이 연구는 국내 소아재활 분야에 종사하는 재활의학과의사 및 치료사를 대상으로 강제유도운동치료(constraint-induced movement therapy, CIMT)에 대한 지식과 임상적용 현황에 대해 조사하고자 하였다. 연구방법 : 대한소아재활발달의학회에 등록된 510명 (재활의학과의사 204명, 치료사 306명)을 대상으로 전자우편을 이용한 설문조사를 시행하였다. 결과 : 총 510명 중 179명이 설문에 응답하여 응답률은 35.1%였다. 응답한 179명 중 재활의학과 의사 39명, 물리치료사 89명, 작업치료사 48명, 언어치료사 3명이었다. 응답자 중 45.9%(82명)는 소아재활분야의 경험이 6년 이상인 전문가로 구성되어 있었고, 58.1%(104명)가 강제유도운동치료에 대한 경험이 있었다. 임상 진료에서 강제유도운동치료를 적용하는 경우는 환자의 순응도가 좋을 때 73.1%(76명), 보호자의 순응도가 좋을 때 48.1%(50명), 양손훈련(bimanual training)의 효과가 제한적이라고 판단될 때 39.4%(41명) 순으로 조사되었다. 임상적용에서 제한점으로 작용하는 요인은 치료인력 부족이나 가정내 환경 부적합 등과 같은 환경제한 35.1%(61명), 인식부족 19.5%(34명), 건측 제한으로 인한 건측 기능발달 저해에 대한 우려 13.8%(24명)으로 조사되었다. 강제유도운동치료를 중단한 이유로는 환자의 비협조 77.6%(76명), 인지/행동요인 42.9%(42명), 보호자의 비협조 25.5%(25명), 효과가 없다고 판단될 때(non-effectiveness) 11.2%(11명) 순으로 조사되었다. 결론 : 강제유도운동치료의 의학적 근거가 높게 보고되고 있지만 이 연구에서는 많은 수의 재활의학과 의사와 치료가사 실제 임상치료에서 적용하지 못하고 있음을 확인하였다. 국내 현황에서 제한점을 개선하여 향후 임상적용 확대를 위한 노력이 필요하겠다.

• Journal of Chest Surgery
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• 제52권4호
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• pp.248-329
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• 2019

Background: Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. Methods: This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors-primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. Results: CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Conclusion: Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.