• Title/Summary/Keyword: Evidence-based

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Applying Theory Informed Global Trends in a Collaborative Model for Organizational Evidence-based Healthcare

  • Lockwood, Craig
    • Journal of Korean Academy of Nursing Administration
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    • v.23 no.2
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    • pp.111-117
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    • 2017
  • Getting evidence in to practice tends to focus on strategies, theories and studies that aim to close the gap between research knowledge and clinical practice. The evidence to practice gap is more about systems than individual clinician decision making. The absence of evidence for administration and management in the organization of healthcare is persistent. Teaching nurses and providing evidence as the solution to evidence-based healthcare is no longer axiomatic. Previous studies have concluded that unit level strategies integrate multi-professional teams with organizational needs and priorities. This 'best fit' approach that characterizes how healthcare is structured and delivered. The published literature shows that increased readiness for change is aligned with integrated approaches informed by conceptual models. The Joanna Briggs Collaboration is the largest global collaboration to integrate evidence within a theory informed model that brings together academic centres, hospitals and health systems for evidence synthesis, transfer and implementation. The best approaches to implementation are tailored to local culture and context, benchmark against international evidence, combine a theory informed model and stakeholder perspectives to improve the structure and processes of health care policy and practice.

Overview of Methodological Quality of Systematic Reviews about Gastric Cancer Risk and Protective Factors

  • Li, Lun;Ying, Xiang-Ji;Sun, Tian-Tian;Yi, Kang;Tian, Hong-Liang;Sun, Rao;Tian, Jin-Hui;Yang, Ke-Hu
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.2069-2079
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    • 2012
  • Background and Objective: A comprehensive overall review of gastric cancer (GC) risk and protective factors is a high priority, so we conducted the present study. Methods: Systematic searches in common medical electronic databases along with reference tracking were conducted to include all kinds of systematic reviews (SRs) about GC risk and protective factors. Two authors independently selected studies, extracted data, and evaluated the methodological qualities and the quality of evidence using R-AMSTAR and GRADE approaches. Results: Beta-carotene below 20 mg/day, fruit, vegetables, non-fermented soy-foods, whole-grain, and dairy product were GC protective factors, while beta-carotene 20 mg/day or above, pickled vegetables, fermented soy-foods, processed meat 30g/d or above, or salty foods, exposure to alcohol or smoking, occupational exposure to Pb, overweight and obesity, helicobacter pylori infection were GC risk factors. So we suggested screening and treating H. pylori infection, limiting the amount of food containing risk factors (processed meat consumption, beta-carotene, pickled vegetables, fermented soy-foods, salty foods, alcohol), stopping smoking, avoiding excessive weight gain, avoidance of Pb, and increasing the quantity of food containing protective components (fresh fruit and vegetables, non-fermented soy-foods, whole-grain, dairy products). Conclusions: The conclusions and recommendations of our study were limited by including SRs with poor methodological bases and low quality of evidence, so that more research applying checklists about assessing the methodological qualities and reporting are needed for the future.

Implementing Evidence into Practice for Best Dementia Care

  • Park, Myonghwa
    • Journal of Korean Academy of Nursing
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    • v.45 no.4
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    • pp.495-500
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    • 2015
  • Purpose: The purpose of this paper was to discuss the need for translation studies in dementia care and current translational endeavors, and to provide recommendations for evolving evidence-based dementia care. Methods: A literature review yielded current evidence and translational efforts. Results: Dementia care interventions need to be implemented at various service levels. Barriers to translation include evidence gaps, lack of the use of a conceptual framework to explain the implementation process, and unsupportive funding mechanisms for applying innovations. Conclusion: There is clear evidence of the need for and benefits of evidence-based dementia care for patients with dementia, family caregivers, and care professionals. The urgent need now is finding ways to advance translational activities and facilitate future research into translation science.

The Application of Customized Evidence-based Counseling for Abused Preschool Children in Day Care Centers: Focusing on the Multidisciplinary Cooperative Linking System (보육현장 아동학대에 대한 근거기반 맞춤형 개입 모델 개발 및 적용: 다학제간 협력적 연계 시스템을 중심으로)

  • Lee, Kyung-Sook;Park, Jinah
    • Korean Journal of Childcare and Education
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    • v.16 no.1
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    • pp.1-20
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    • 2020
  • Objective: The purpose of this study was to explore the application of the multidisciplinary model, which is customized evidence-based counseling for abused preschool children done by a day care center teacher. Methods: The participants were 16 preschool children which were abused by a day care center teacher and their parents. The data were analyzed by using the Wilcoxon Signed-rank test. Results: The multidisciplinary cooperative service model based on customized evidence-based counseling for abused preschool children, their parents, and day care center teachers was developed. Based on this model, customized evidence-based Post-Traumatic Stress Disorder (PTSD) emergency intervention was provided to preschool children abused by a day care teacher in Incheon. The multidisciplinary cooperative emergency intervention service proved to be effective in reducing emotional and behavioral problems of abused preschool children and enhancing the mental health of parents. Conclusion/Implications: The results of this study indicated that the customized evidence-based counseling for abused preschool children done by a day care center teacher using the multidisciplinary cooperative linkage system would be effective, and that child abuse prevention by day care center teachers and intervention services should be provided systematically at the national level.

Use of Web-Based Evidence-based Clinical Practice Guidelines for Patients following Gastrectomy: Effects on Body Temperature, Shivering, Perceived Thermal Comfort, and Satisfaction with Temperature Management (웹기반 체온 관리 근거중심 간호실무 가이드라인이 위절제술 환자의 체온, 전율, 체온 불편감, 체온 관리 만족도에 미치는 효과)

  • Hong, Sung-Jung;Lee, Eunjoo
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.21 no.2
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    • pp.112-122
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    • 2014
  • Purpose: The purpose of this study was to examine the effects on body temperature, shivering, and perceived thermal comfort of web-based evidence-based practice guideline for patients undergoing gastrectomy. Methods: Eighty patients scheduled for gastrectomy were recruited and assigned to the control or experimental group by sequential order. Before collecting data from the experimental group, a systematic educational program on evidence-based guidelines was provided to the nurses as well anesthesiologists. Data were analyzed using t-test and repeated measured ANOVA. Results: The experimental group showed higher body temperature from the induction of anesthesia until four hours after surgery compared to the control group. In addition, the levels of thermal comfort as well as satisfaction with thermal management were significantly higher in the experiment group. Conclusion: Use of evidence-based guidelines was effective in maintaining body temperature, lowering sensitivity to shivering, and promoting perceived thermal comfort. Therefore, adoption of evidence-based interventions in nursing practice is recommended.

A Survey of Evidence-Based Practice of Physical Therapist (물리치료사의 증거에 근거한 물리치료 실태조사)

  • Kwon, Mi-Ji
    • The Journal of Korean Physical Therapy
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    • v.18 no.3
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    • pp.23-36
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    • 2006
  • Purpose: The purpose of this study was to describe physical therapists' self-reported: (1) attitudes and beliefs about evidence~based practice(EBP), (2) education, knowledge, and skills related to obtaining and evaluating evidence, (3) attention to the literature relevant to practice, (4) access to and availability of information and (5) perceptions of the barriers to evidence-based practice. Methods: Our study sample consisted of a random sample of 90 physical therapists in gwang-ju and junnam. Participants completed a questionnaire. Responses were summarized for each item, and logistic regression analyses were used to examine relationships among variables. Results: According to the respondents, the primary barrier to implementing EBP was lack of time. The results suggest they believe that the use of evidence in practice was necessary, that the literature is helpful to them in their practice and decision making, and that quality of patient care is better when evidence is used. Many of the beliefs, skills and behaviors we examined were related to the education courses and sex. The majority of the respondents had access to online information at home. Conclusion: They noted that they needed to increase the use of evidence in their daily practice.

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Young Children's Abilities to Differentiate Hypothesis from Evidence (초등학교 저학년 아동들의 증거로부터 가설을 분화하는 능력)

  • Lee, Moon Nam;Chu, Hye Eun
    • Korean Journal of Child Studies
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    • v.22 no.4
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    • pp.331-341
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    • 2001
  • This study is to investigate whether young Korean children have understanding for testing hypothesis. Questions explored are; First, do children have notions of testing hypothesis? Or, do they just produce an effect? Second, choosing between conflicting hypotheses, can children distinguish between experiments that would produce conclusive and inconclusive evidence? For this study, 15 first grade and 15 second grade children in elementary school located in Kyunggi area near Seoul participated. Data collection and analysis were based on interviews with children for two weeks. Children were presented two conflicted hypotheses to decide which one is correct through conclusive evidence and inconclusive evidence in the interview. The results showed that children(1st: 93.3%, 2nd: 81.3%) of each grade can distinguish between hypothesis and evidence to do testing hypothesis, and distinguish between conclusive and inconclusive evidence. In conclusion, most young children have understanding of testing hypothesis based on their familiar experiences, so it was possible for them to differentiate hypothesis from evidence in certain situations.

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Evidence-based approach for herbal medicine-safety classification : Human equivalent dose-based the margin of safety (한약의 안전성 등급화를 위한 evidence-based approach : Human equivalent dose-based the margin of safety)

  • Park, Yeong-Chul;Lee, Sundong
    • Journal of Society of Preventive Korean Medicine
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    • v.17 no.3
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    • pp.19-30
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    • 2013
  • This study was aimed to develop a new formula for herbal medicine-safety classification in terms of evidence-based medicine. Recently, human equivalent dose(HED)-based therapeutic index was developed for herbal medicine-safety classification by transforming $LD_{50}$ to HED. However, the use of the $ED_{50}$ and $LD_{50}$ to derive the therapeutic index may be misleading as to safety, depending on the slope of the dose-response curves for therapeutic and lethal effects. To overcome this deficiency, HED-based MOS(Margin of Safety)was developed and suggested in this study. The HED-based MOS developed by using $LD_1$, changing to ALD(approximate lethal dose), and $ED_{99}$. The HED-based MOS seems to be more useful and safer than HED-based therapeutic index since its values for several herbal medicines are basically two times less than the values from HED-based therapeutic index. Thus, HED-based MOS can be a good example of Evidence-based approach for herbal medicine-safety classification.

Anti-inflammatory Effects of Sam-chul-kun-bi-tang

  • Lee, Jin-Ah;Ha, Hye-Kyung;Jung, Da-Young;Lee, Ho-Young;Lee, Nam-Hun;Lee, Jun-Kyoung;Huang, Dae-Sun;Shin, Hyeun-Kyoo
    • The Journal of Korean Medicine
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    • v.31 no.3
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    • pp.47-54
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    • 2010
  • Objective: To derive information on the efficacy of Sam-chul-kun-bi-tang (SKT), by evaluating its anti-inflammatory effect. SKT is a widely-used herbal formula in traditional Korean medicine. In man y studies, plant-derived anti-inflammatory efficacies have been investigated for their potential inhibitory effects on lipopolysaccharide (LPS)-stimulated macrophages. This study was performed to examine the anti-inflammatory effects of SKT extract on LPS-stimulated RAW 264.7 cells. Methods: The production of nitric oxide (NO), prostaglandin $(PG)E_2$, tumor necrosis factor (TNF)-$\alpha$ and interleukin (IL)-6 were examined in a macrophage cell line, RAW 264.7 cells, in the presence of SKT. RAW 264.7 cells were incubated with LPS 1 ${\mu}g/mL$ and SKT for 18 hrs. The anti-inflammatory activity of SKT was investigated by carrageenan-induced paw edema in rats. The paw volume was measured at 2 and 4 hrs following carrageenan-induced paw edema in rats. Results: SKT showed inhibitory effect on $PGE_2$, TNF-$\alpha$ and IL-6 in LPS-stimulated RAW 264.7 cells. But SKT was not inhibitory effect on NO by LPS-stimulated RAW 264.7 cells. Administration of SKT (1 g/kg) also showed a reduction in carrageenan-induced paw edema on rats. Conclusion: These results suggest that SKT has anti-inflammatory activities in both in vitro and in vivo models.

Economic Evaluation of Prostate Cancer Screening Test as a National Cancer Screening Program in South Korea

  • Shin, Sangjin;Kim, Youn Hee;Hwang, Jin Sub;Lee, Yoon Jae;Lee, Sang Moo;Ahn, Jeonghoon
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.8
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    • pp.3383-3389
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    • 2014
  • Background: Prostate cancer is rapidly increasing in Korea and professional societies have requested adding prostate specific antigen (PSA) testing to the National Cancer Screening Program (NCSP), but this started a controversy in Korea and neutral evidence on this issue is required more than ever. The purpose of this study was to provide economic evidence to the decision makers of the NCSP. Materials and Methods: A cost-utility analysis was performed on the adoption of PSA screening program among men aged 50-74-years in Korea from the healthcare system perspective. Several data sources were used for the cost-utility analysis, including general health screening data, the Korea Central Cancer Registry, national insurance claims data, and cause of mortality from the National Statistical Office. To solicit the utility index of prostate cancer, a face-to-face interview for typical men aged 40 to 69 was conducted using a Time-Trade Off method. Results: As a result, the increase of effectiveness was estimated to be very low, when adopting PSA screening, and the incremental cost effectiveness ratio (ICER) was analyzed as about 94 million KRW. Sensitivity analyses were performed on the incidence rate, screening rate, cancer stage distribution, utility index, and treatment costs but the results were consistent with the base analysis. Conclusions: Under Korean circumstances with a relatively low incidence rate of prostate cancer, PSA screening is not cost-effective. Therefore, we conclude that adopting national prostate cancer screening would not be beneficial until further evidence is provided in the future.