• Title/Summary/Keyword: Evidence-Based practice

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A Geographical Study on the Behavior Changes of Telemedicine Participants in Terms of Time and Space (시공간 관점에서 본 원격진료 이용자 행태 변화에 관한 연구)

  • Park, Sookyung;Hanashima, Yuki
    • Journal of the Economic Geographical Society of Korea
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    • v.16 no.2
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    • pp.198-217
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    • 2013
  • This research aims to examine the behavior changes of telemedicine participants with regard to time-space reconfiguration and to address the implications of telemedicine in terms of extensibility and restrictions (ambilaterality). According to the results of this research, telemedicine can lead to behavior changes in telemedicine participants, particularly patients. However, it is difficult to anticipate the time-space reconfiguration of telemedicine participants drastically. In other words, although telemedicine minimizes patients' burden of accessibility to and utilization of medical institutions, it requires the patients to visit medical institutions at least once due to the restricted application of telemedicine related to technological problems, the characteristics of medical practice and mutual stakes among the medical institutions involved in telemedicine. And physicians (telemedicine providers as mediators between medical specialists and patients) and medical specialists (as the ultimate telemedicine providers) do not evidence considerable changes in their behaviors, except for offline meetings for information sharing and medical training. Because the present telemedicine system does not require simultaneity between physicians, patients and medical specialists. Furthermore, present telemedicine operation is absorbed into existing medical activities as a health care delivery method. These phenomena are due to 1) the interests among medical institutions and the limitation or generalization of telemedicine technologies to stimulate regional-based telemedicine operation and 2) the goal of face-to-face interactions between patients and doctors, which is to avoid misdiagnosis and side effects. Finally, medical activities related to telemedicine do not differ from general medical activities. The ambilaterality of telemedicine in terms of extensibility and the restriction of time-space reconfiguration is an unsettled problem in the ICT technologies of medical services.

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The NHS Over-the-Counter Drugs Policy in UK: Its Experiences and Implications (영국의 일반의약품(Over-the-counter drugs) 관리법의 의료정책적 함의)

  • Han, Dong-Woon
    • The Korean Society of Law and Medicine
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    • v.12 no.2
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    • pp.265-291
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    • 2011
  • Changes in a drug's availability from prescription only to over-the-counter (OTC) status is of concern to physicians from both public health and individual patient perspectives. Government has generally been supportive of changes in medications from prescription(Rx) to over-the-counter (OTC) status in Korea, however, recognizing that there are both benefits and risks to any health care intervention, health care professionals are conservative in implementing changes to either the process or structure of health care. Changes in status of a drug from Rx to OTC can represent a change in both structure and process. Cost and convenience seem to be major factors in determining whether, given the choice, patients purchase a medicine over the counter or obtain it on prescription. With current arrangements, exemption from prescription charges provides an incentive to continue to obtain products on NHS prescription even when they are available over the counter. There is therefore no simple relation between the availability of over the counter medicines and the level of prescribing of deregulated products. The appropriate use of over the counter medicines-particularly those that have only recently been deregulated-places a burden of care on community pharmacists and calls for closer working relationships with general practitioners. In particular, systems for referral and for recording details of both prescribed and over the counter medicines need to be developed, and a direct route needs to be established for community pharmacists to report adverse drug reactions to over the counter products. Reclassification of prescription medicines-by making them available through pharmacies without a prescription-provides the opportunity for consumers to purchase a wider range of medicinal products without making a demand on NHS resources. There is, however, no simple relation between availability of over the counter medicines and demand for NHS prescriptions. In the late 1980s the UK government fuelled the over the counter market by making it easier to reclassify certain medicines from prescription only status to allow over the counter sale in pharmacies. To explore the influence of deregulation of medicines on NHS prescribing, this article presents analyses of consumer behaviour in using medicines and prescribers' attitudes to over the counter medication and collates findings from research. Policy makers should be aware that patients' expectations in relation to OTC medicines may be in conflict with evidence-based practice.

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Assisted Outpatient Treatment and Crisis Intervention in USA and their Implications for Korea (미국의 외래치료명령제도 및 위기대응과 국내적 시사점)

  • Park, Inhwan;Han, Meekyung
    • The Korean Society of Law and Medicine
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    • v.19 no.1
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    • pp.23-80
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    • 2018
  • Since the 1960s, the United States' (U.S.) deinstitutionalization policy has reinstated people with mental illness into communities. Unfortunately, when untreated, some people with psychiatric disorders become homeless, and some commit serious crimes during a psychological crisis. Assisted Outpatient Treatment (AOT), also known as Kendra's Law in New York and Laura's Law in California, provides treatment, services and support to people with mental illness in the community. AOT has repeatedly been found effective and is recognized as an evidence-based practice. The response to the mental health crisis (crisis intervention) in the U.S. has also been successful in preventing worsening mental illness and related criminality and other issues. This paper provides an opportunity to create a platform from which to learn how to successfully apply the AOT and crisis intervention of the U.S. to South Korea within the cultural and societal context when establishing social services for people with mental illness in South Korea's communities.

Research Trend on Social Welfare Administration in Korea - Using both Network and Content Analysis for the Recent 10 years - ('한국사회복지행정'의 최근 10년간 연구경향 특성 - 네트워크분석과 내용분석의 활용-)

  • Choi, Jae-sung;Cheong, Sejeong;Cho, Jayoung
    • Korean Journal of Social Welfare
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    • v.68 no.1
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    • pp.73-94
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    • 2016
  • The purpose of this study is to examine the trend of the studies on Korean social welfare administration over a recent 10 year period. Employing both network analysis and content analysis, which are representative statistical strategies to identify research trends, we analyzed 221 articles published in the Journal of Korean Social Welfare Administration from 2005 to 2014. The major findings were as follows; First, we found two clusters -"social (welfare) service" and "social welfare organization"- in the studies of social welfare administration. In addition, more than 80% of articles are mainly related with human resource management, including job satisfaction, organizational commitment, and so forth. Second, the newly emerging academic subjects such as social enterprise and community network appeared to be done independently of traditional subjects. Third, the proportion of quantitative studies being focused on human resources was overwhelmingly high compared to the other types of studies; therefore, there are a few studies using qualitative or mixed method, evidence based practice, and discourse studies. In addition, the studies of the rural areas, which are a blind spot of the social service delivery system, and the studies about information management, financial management, marketing, organization innovation rarely appeared, despite their significance.

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Occupational Therapy Intervention for Improving Play of Children : A Systematic Review (아동의 놀이 향상을 위한 작업치료 중재에 관한 체계적 고찰)

  • Lee, Sun-Hee;Park, Hae Yean
    • The Journal of Korean Academy of Sensory Integration
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    • v.15 no.2
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    • pp.93-106
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    • 2017
  • Objective : The purpose of this study is to provide an evidence for clinical practice by systemic analysis on occupational therapy interventions for improvement of children's play. Methods : Articles used in this study were collected from database of Pubmed, ProQuest, EBSCOhost, Scopus, RISS, KISS, and National Library of Korea. The key words used in the search were "Play AND Occupational Therapy AND (Intervention OR Treatment)" and the publication period was limited from January 2007 to April 2017. 11 articles in total were selected for the systematic review analysis. Results : The results revealed that the majority of studies was one-group non-randomized study and the majority of intervention used was play-based intervention in case of that play itself was the intervention goal. The most frequently used environment for the intervention was parallel setting of home and treatment room. The majority of studies was for children with ADHD and the most commonly used assessment tool was Test of Playfulness (ToP). Dependent variables measured along with play were language skills, social interactive skills, communication and pragmatic skills, problem-solving skills, caregiver responsiveness, and parent-child interaction. Conclusion : This study help to understand the current state of occupational therapy intervention for improvement of children's play. Starting with the understanding, it is expected that various studies on play of children will be done in the future.

Analyses of Studies on Swallowing Rehabilitation Program for Stroke patients in Korea (뇌졸중 환자 대상의 연하재활프로그램에 대한 국내 연구 논문 분석)

  • Kwak, Hye-Weon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.11
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    • pp.7394-7402
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    • 2015
  • The purpose of this study was to investigate the status of studies on swallowing rehabilitation interventions for stroke patients that had been conducted in the past 5 years (2010-2014) in Korea and to examine their findings. A literature search was conducted through RISS, National Assembly Library, and KISS, and 12 papers were analyzed. Four articles were from nursing science, and 8 from other disciplines. Qualitative evaluation of the articles was conducted by using an evaluation framework that was designed by the researcher, which took into account the checklist presented by the Scottish Intercollegiate Guideline Network (2013). In the results of the qualitative evaluation on the papers, 4 studies scored 7 out of 10 points, 6 studies scored between 5 and 6 points, and 2 studies scored 4 points. Intervention sessions were conducted for 25 minutes, on average, each at a frequency of 4.1 sessions per week, for a total of 33.7 sessions. This study found that direct swallowing training and comprehensive intervention of respiratory and oral, including pharyngeal were effective in relieving difficulties in swallowing. In the future, such findings are expected to be used in nursing interventions for establishment of the basis for evidence-based nursing practice.

Usual intake of dietary isoflavone and its major food sources in Koreans: Korea National Health and Nutrition Examination Survey 2016-2018 data

  • Kim, Yoona;Kim, Dong Woo;Kim, Kijoon;Choe, Jeong-Sook;Lee, Hae-Jeung
    • Nutrition Research and Practice
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    • v.16 no.sup1
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    • pp.134-146
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    • 2022
  • BACKGROUND/OBJECTIVES: Accumulating evidence has shown the beneficial effects of isoflavone on health. There is limited information on the usual isoflavone intake for Koreans. This study examined the usual intake of total isoflavone and its major food sources in Koreans according to age and gender. SUBJECTS/METHODS: The dietary intake data of 21,271 participants aged 1 yrs and older from the Korea National Health and Nutrition Examination Survey (KNHANES) VII 2016-2018 were analyzed. The average isoflavone intake was estimated based on the 24-h dietary recall data in KNHANES and the isoflavone database from the Korea Rural Development Administration (RDA) and literatures. The usual isoflavone intake was estimated by applying the ratio of within- and between-participant variance estimated from the 2009 KNHANES data to the 7th KNHANES (2016-2018) data. The variance of the isoflavone intake was calculated using MIXTRAN macro with intake data for two days in the 2009 KNHANES. Complex sample analysis with stratified variables and integrated weights was conducted. RESULTS: The mean total isoflavone intake in the Korean population aged 1 yrs and older (n = 21,271) was 139.27 mg/d, which was higher than the usual intake of 47.44mg/d. Legumes were a major contributing food group (91%), with arrowroot being a major individual contributor to the isoflavone intake (67.2%), followed by 21.3% of soybean, 5.4% of bean sprouts, and 2.1% of tofu. The usual isoflavone intake was highest in the participants aged 50 to 64 yrs old and increased with age until 50 to 64 yrs and then decreased with further increases in age. The usual isoflavone intake of participants aged 65 yrs and older was higher for men than for women, showing gender differences. CONCLUSIONS: The usual dietary intake of isoflavone varied according to age and gender in the Korean population. This study showed that the usual isoflavone intake was lower than the average isoflavone intake. The difference between percentiles of the usual isoflavone intake was similarly smaller than the average intake. An estimation of average intake can be hindered by the occasional consumption of foods high in isoflavones, suggesting that the usual intake estimation method can be more appropriate. Further research will be needed to establish isoflavone dietary guidelines regarding the effects of isoflavone intake on health outcomes.

A Systematic Review of Occupational Therapy Interventions for Children With Cerebral Palsy: Focus on Single-Subject Research Design (뇌성마비 아동을 위한 작업치료 중재에 대한 체계적 고찰: 국내 단일대상연구를 중심으로)

  • Shin, Chae-Eun;Choi, Yoo-Im
    • Therapeutic Science for Rehabilitation
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    • v.12 no.2
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    • pp.25-42
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    • 2023
  • Objective : The purpose of this study was to identify the characteristics of a single-subject research study and qualitative levels in which occupational therapy interventions were performed on children with cerebral palsy. Methods : This study targeted papers, published in Research Information Sharing Service (RISS), National Digital Science Library (NDSL), Koreanstudies Information Service System (KISS), and E-article from May 20 to 29, 2022. The search terms were 'cerebral palsy' AND 'single subject research design' OR 'individual subject study'. Eleven papers, were finally selected and analyzed. Results : Most of the studies were medium in methodological quality, and the subjects were pre-school age and spastic hemiplegia. Among the single-subject designs, intervention-removal designs were the most common, and among them, ABA designs were the most common. Interventions included assistive devices, constraint-induced therapy, neurodevelopmental therapy, and sensory integration therapy were 2, and upper extremity exercise, interactive metronome, and CO-OP were 1. Dependent variables were measured with 2 to 4 measurement tools, Significant improvements were found in postural control ability, gait and balance, hand function, and upper extremity function. Conclusion : This study confirmed that it is helpful to apply cerebral palsy occupational therapy by presenting the characteristics of cerebral palsy, intervention sessions and effects, measurement tools and methodological quality levels.

A Study of factors influencing on Children's Social Distance towards Children from Multicultural families (다문화가정자녀에 대한 일반아동의 사회적 거리감에 영향을 미치는 요인 연구)

  • Youn, In-Sung;Park, Sun-Young
    • Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
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    • v.6 no.3
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    • pp.191-202
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    • 2016
  • Social distance can indicate cognitive and behavioral attitudes toward a social group, and is useful for investigating people situated in a socially vulnerable position. When the children from multicultural family aware negative attitudes from peer Korean children, self-confidence and social competence can be disturbed. This study intended to examine influential factors on children's social distance towards children from multicultural families including multicultural contact experience, stereotype, ethnically homogeneous nationalism, thereby providing empirical evidence on social distance regarding multicultural families and their children. The results of this study are as follows. First, when the Korean children felt closeness with a multicultural child, when the ethnicity of the foreigner resided in the neighbor is White or Black, when they contact multicultural children through the media and a multicultural education, the level of social distance was higher, while the neighbor's ethnicity is Abrab, social distance was lower. Second, there was a significant association between the higher level of Korean children's positive cognition and emotion and the lower level of social distance. Third, hierarchial regression analyses demonstrated that positive emotion and cognition decreased the level of social distance, while both closeness with a multicultural child and taking the multicultural education increased the level of social distance. Finally, based on these results, this study suggested implications for social work practice and research to better understand and reduce children's social distance towards children from multicultural families.

Research for the Development of an Integrated Medical System for Idiopathic Pulmonary Fibrosis: Based on an Analysis of Questionnaire Survey in Doctor and Patient Groups (특발성 폐섬유증의 통합의료 협진 모델 개발을 위한 의료진 및 환자 대상 설문조사 연구)

  • Jiwon Park;Beom-Joon Lee;Jeong-Won Shin;Su-Hyun Chin;Jung-Min Yang;Sooduk Kim;Kwan-Il Kim;Hye Sook Choi;Hee-Jae Jung
    • The Journal of Internal Korean Medicine
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    • v.44 no.3
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    • pp.366-386
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    • 2023
  • Objective: In this study, a questionnaire survey was conducted for doctors and patients to obtain basic data necessary for the development of an integrated medical system for idiopathic pulmonary fibrosis (IPF). Methods: Questionnaires were developed separately for doctors and patients through an expert group meeting. The survey subjects were recruited online and offline, and finally, responses from 231 doctors and 59 patients were used for statistical analysis. Results: The most important parts in the treatment of IPF for both doctors and patients were the "improvement of respiratory symptoms," "improvement of quality of life," and "prevention of disease progression." Antifibrotic agents were prescribed at a high rate, and 100% of the specialists in Western medicine (WM) and 45.8% of patients reported experiencing side effects. As for the additional payment costs that patients considered as affordable for an integrated medical system, "under 50,000 won (about 38$)" was reported the most in both doctor and patient groups. With regard to the reasons for their reluctance to recommend an integrated medical system for IPF, specialists in WM responded highly to "uncertain evidence for treatment effectiveness." Regarding complementary and alternative medicine therapies that can be beneficial in patients with IPF, "lifestyle management," "diet management," "herb," "relaxation therapy," and "psychotherapy" were ranked high in both doctor and patient groups. Conclusions: In this study, a questionnaire survey on IPF was conducted to review actual treatment status, analyze shortcomings, and identify considerations for the development of an integrated medical system for IPF in the future.