• 제목/요약/키워드: Evidence-based Practice

검색결과 566건 처리시간 0.024초

기관내관을 적용중인 국내 중환자실 성인 입원환자의 구강간호에 대한 주제범위 문헌고찰 (Oral Hygiene Care of Endotracheal Intubated Patients in Korean Intensive Care Units : A Scoping Review)

  • 임정은;정덕유;유리호
    • 중환자간호학회지
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    • 제17권1호
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    • pp.68-82
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    • 2024
  • Purpose : This scoping review was designed to identify gaps in knowledge and guide future directions for clinical nursing practices and research on oral hygiene care for endotracheally intubated patients in Korean intensive care units. Methods : We conducted a scoping review using the methodological framework proposed by Arksey and O'Malley. PubMed, CINAHL, RISS, Science On, and DBpia databases were searched. Two reviewers independently selected the studies and extracted data. A total of 445 studies were identified, of which 17 were included in the final analysis. Results : No research has been conducted from 2021 to the present. A total of 12 instruments were utilized in 13 studies to assess the effectiveness of oral hygiene care. All studies investigating the effectiveness of oral hygiene care have consistently documented that chlorhexidine has the most significant effect. The frequency and time of oral hygiene care were each examined in one study. Conclusion : A research study is necessary to develop a measurement tool for assessing the effectiveness of oral hygiene care suitable for endotracheal intubated patients in intensive care units. Interventional studies should be conducted to determine the effects of chlorhexidine and the appropriate frequency and time of oral hygiene care. Thereafter, revision of domestic evidence-based clinical practice guidelines by integrating these results will be necessary.

The new frontier: utilizing ChatGPT to expand craniofacial research

  • Andi Zhang;Ethan Dimock;Rohun Gupta;Kevin Chen
    • 대한두개안면성형외과학회지
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    • 제25권3호
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    • pp.116-122
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    • 2024
  • Background: Due to the importance of evidence-based research in plastic surgery, the authors of this study aimed to assess the accuracy of ChatGPT in generating novel systematic review ideas within the field of craniofacial surgery. Methods: ChatGPT was prompted to generate 20 novel systematic review ideas for 10 different subcategories within the field of craniofacial surgery. For each topic, the chatbot was told to give 10 "general" and 10 "specific" ideas that were related to the concept. In order to determine the accuracy of ChatGPT, a literature review was conducted using PubMed, CINAHL, Embase, and Cochrane. Results: In total, 200 total systematic review research ideas were generated by ChatGPT. We found that the algorithm had an overall 57.5% accuracy at identifying novel systematic review ideas. ChatGPT was found to be 39% accurate for general topics and 76% accurate for specific topics. Conclusion: Craniofacial surgeons should use ChatGPT as a tool. We found that ChatGPT provided more precise answers with specific research questions than with general questions and helped narrow down the search scope, leading to a more relevant and accurate response. Beyond research purposes, ChatGPT can augment patient consultations, improve healthcare equity, and assist in clinical decision-making. With rapid advancements in artificial intelligence (AI), it is important for plastic surgeons to consider using AI in their clinical practice to improve patient-centered outcomes.

Korean Society of Heart Failure Guidelines for the Management of Heart Failure: Definition and Diagnosis

  • Jae Yeong Cho ;Dong-Hyuk Cho;Jong-Chan Youn;Darae Kim;Sang Min Park;Mi-Hyang Jung;Junho Hyun;Jimi Choi;Hyun-Jai Cho;Seong-Mi Park;Jin-Oh Choi;Wook-Jin Chung;Byung-Su Yoo;Seok-Min Kang;Committee of Clinical Practice Guidelines, Korean Society of Heart Failure
    • Korean Circulation Journal
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    • 제53권4호
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    • pp.195-216
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    • 2023
  • The Korean Society of Heart Failure guidelines aim to provide physicians with evidence-based recommendations for diagnosing and managing patients with heart failure (HF). In Korea, the prevalence of HF has been rapidly increasing in the last 10 years. HF has recently been classified into HF with reduced ejection fraction (EF), HF with mildly reduced EF, and HF with preserved EF (HFpEF). Moreover, the availability of newer therapeutic agents has led to an increased emphasis on the appropriate diagnosis of HFpEF. Accordingly, this part of the guidelines will mainly cover the definition, epidemiology, and diagnosis of HF.

직장 탈출증에 대한 보중익기탕과 수술 치료 병용요법의 임상 연구 고찰 - 무작위 대조군 연구를 중심으로 (A Review of Clinical Studies about Bojungikgi-tang Combined with Surgical Therapy on Rectal Prolapse - Focusing on Randomized Controlled Trial)

  • 공경환;김도현
    • 동의생리병리학회지
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    • 제38권2호
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    • pp.59-65
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    • 2024
  • Rectal prolapse is a condition where the rectal wall protrudes outside the anus. While it is a rare condition, it can cause discomfort for patients due to the protrusion of the rectal structure, discharge of mucus and blood, fecal incontinence, constipation, and other inconveniences. In this review, we analyzed a randomized controlled trial (RCT) study that used the herbal medicine Bojungikgi-tang(Buzhongyiqi-tang) as a complementary therapy to improve the weaknesses and side effects of the standard treatment, surgical therapy, for rectal prolapse. The analysis included 12 RCT studies, and in all studies, the prescription involved the use of Astragali Radix at the highest dosage. Among the 11 studies that evaluated efficacy, 7 studies showed a significant effect compared to the control group. In all 3 studies that evaluating recurrence rates and all 5 studies investigating complications after surgery, the experimental group showed significant effects. Based on these findings, this study could be considered as a foundational evidence for the application of bojungikgi-tang(Buzhongyiqi-tang) in clinical practice in Korean medicine for patients with rectal prolapse. It could also serve as foundational data for future research.

Online resources for information on shoulder arthroplasty: an assessment of quality and readability

  • Mohamad Y. Fares;Jaspal Singh;Amar S. Vadhera;Jonathan Koa;Peter Boufadel;Joseph A. Abboud
    • 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.

요추 후관절 주사: 임상적 유용성과 안전성에 대한 고찰 (Lumbar Facet Joint Injection: A Review of Efficacy and Safety)

  • 도윤아;이영준;지충근;이준우
    • 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.

Short-acting β2-agonist prescriptions in patients with asthma: findings from the South Korean cohort of SABINA III

  • Kwang-Ha Yoo;Sang-Ha Kim;Sang-Heon Kim;Ji-Yong Moon;Heung-Woo Park;Yoon-Seok Chang;Maarten J.H.I Beekman
    • The Korean journal of internal medicine
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    • 제39권1호
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    • pp.123-136
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    • 2024
  • Background/Aims: Despite short-acting β2-agonist (SABA) overuse being associated with poor asthma outcomes, data on SABA use in South Korea is scarce. Herein, we describe prescription patterns of SABA and other asthma medications in patients from the South Korean cohort of the SABA use IN Asthma (SABINA) III study. Methods: This study included patients with asthma aged ≥ 12 years, who had ≥ 3 consultations with the same healthcare provider, and medical records containing data for ≥ 12 months prior to the study visit. Patients were classified by investigator-defined asthma severity (per 2017 Global Initiative for Asthma recommendations) and practice type (primary or specialist care). Data on disease characteristics, asthma treatments, and clinical outcomes in the 12 months before the study visit were collected using electronic case report forms. Results: Data from 476 patients (mean age, 55.4 years; female, 63.0%) were analyzed. Most patients were treated by specialists (83.7%) and had moderate-to-severe asthma (91.0%). Overall, 7.6% of patients were prescribed ≥ 3 SABA canisters (defined as over-prescription). In patients prescribed SABA in addition to maintenance therapy, 47.4% were over-prescribed SABA. Most patients (95.4%) were prescribed a fixed-dose combination of an inhaled corticosteroid and a long-acting β2-agonist as maintenance therapy. Although asthma was well-controlled/partly-controlled in 91.6% of patients, 29.6% experienced ≥ 1 severe asthma exacerbation. Conclusions: SABA over-prescription was reported in nearly 50% of patients prescribed SABA in addition to maintenance therapy, underscoring the need to align clinical practices with the latest evidence-based recommendations and educate physicians and patients on appropriate SABA use.

Breaking the Code of Silence: A Qualitative Exploration of Cyberbullying Through the Lens of Habermas's Theory of Communicative Action

  • January Febro, Naga;Joshua Isaguirre;Elanie Vizconde;Raymund Sison
    • Journal of Information Science Theory and Practice
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    • 제12권3호
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    • pp.14-35
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    • 2024
  • This qualitative study explores cyberbullying among college students through Habermas's Theory of Communicative Action to examine the dissonance between online interactions and principles of rational discourse. Cyberbullying is a pervasive issue in digital communication that undermines logical, evidence-based conversation, fostering environments where misinformation, manipulation, and harm thrive. By analyzing case studies from three universities, the research identifies the characteristics, dynamics, and emotional impacts of cyberbullying on victims, highlighting the role of social media platforms in facilitating these negative interactions. The findings reveal significant challenges to authentic and equal online conversations, driven by power imbalances and a lack of genuine communication, leading to psychological distress, erosion of self-esteem, and changes in behavior among victims. The study underscores the potential of social media design and policy interventions to mitigate cyberbullying, emphasizing the need for educational programs, technological solutions, and community support to promote a safer, more respectful digital environment. Key themes include the dynamics of cyberbullying, the suppression of rational discourse, the psychological and emotional consequences of inauthentic communication, and strategies for resilience and recovery. The research contributes to understanding cyberbullying's complexities and suggests a multifaceted approach to addressing it, aligning with Habermas's ideal of communicative rationality to foster healthier online communities. Future research should further explore the intersection of technology design, user behavior, and regulatory policies to combat cyberbullying effectively.

Estimation of Supply and Demand for Cardiologists in Korea

  • Mira Kim;Kyunghee Chae;Ju Mee Wang;Arum Choi;Jang-Whan Bae;Keon-Woong Moon;Sukil Kim
    • 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.

Comparison of food and nutrient intake according to the presence of glaucoma among Korean older adults

  • Jungwon Kim;Seyeon Park;Yoon Jung Yang
    • Nutrition Research and Practice
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    • 제18권5호
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    • pp.701-710
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    • 2024
  • BACKGROUND/OBJECTIVES: The purpose of this study was to compare nutrient intake according to the presence of glaucoma among Korean individuals aged 60 yrs or older and to establish evidence for the necessity of dietary habits and nutritional management in the prevention and management of glaucoma. SUBJECTS/METHODS: The study was conducted on 4,195 older adults aged 60 or older who participated in the Korea National Health and Nutrition Examination Survey in 2017 and 2018. The subjects were classified into glaucoma (n = 186) and non-glaucoma (n = 4,009) groups based on the doctor's diagnosis of glaucoma. Nutrient intake was estimated using a 24-h recall method, and the intake of nutrients between the 2 groups was compared. RESULTS: The comparison of food group and nutrient intake according to the subjects' prevalence of glaucoma showed that the average intake of potatoes and starches was higher in the glaucoma group than in the non-glaucoma group (P = 0.049), whereas the average intake of meat, fish, and shellfish was higher in the non-glaucoma group than in the glaucoma group (P = 0.045, P = 0.018). Additionally, the average intake of omega-3 and vitamin C was higher in the non-glaucoma group than in the glaucoma group (P = 0.022, P = 0.045), while the average intake of niacin was higher in the glaucoma group than in the non-glaucoma group (P = 0.046). CONCLUSION: The intake of meats, fish, and shellfish, omega-3, and vitamin C was higher in the non-glaucoma group than in the glaucoma group. These results suggest that a healthy diet might be necessary for the prevention and management of glaucoma.