• 제목/요약/키워드: Evidenced-based Practice

검색결과 12건 처리시간 0.02초

병원 간호사들의 근거활용 경험 및 장애요소와 촉진요소에 대한 탐색 (Hospital Nurses' Uses of Evidence, and Barriers to and Enablers of Evidenced-based Practice)

  • 황지인
    • 간호행정학회지
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    • 제19권2호
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    • pp.292-303
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    • 2013
  • Purpose: The purpose of this study was to explore nurses' experience of evidence-based nursing practice in general hospitals. Methods: Data were collected from 13 nurses through in-depth interviews about their experiences with evidence-based practice. The research questions were "What kind of evidence are you using in your practice?" and "What are the barriers to and enablers of evidence-based practice that you have experienced?" Qualitative data from field and transcribed notes were analyzed using qualitative content analysis methodology. Results: Major themes of using evidence were identified as 'research as primary valid evidence', 'information from local context and internet as realistic evidence', and 'clinical experience as pragmatic evidence'. Patient experience was not used as evidence in solving nursing problems. Barriers to and enablers of evidence-based practice were linked. They included both external, organizational factors and individual factors. Main issues were 'lack of evidence and poor work environment', and major facilitating factors were 'improving knowledge and skills related to evidence-based practice' and 'communicating and sharing evidence'. Conclusion: The study findings provide useful information for understanding nurses' experience of using external and internal evidence along with their meaning. A multidimensional approach is needed to overcome barriers to and implement evidence-based practice.

항암화학요법을 받는 암 환자의 오심, 구토관리를 위한 환자용 지침 개발 (Development of Cancer Patient Guide for Nausea & Vomiting Management in Chemotherapy)

  • 이지은;박명화
    • 성인간호학회지
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    • 제22권6호
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    • pp.570-581
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    • 2010
  • Purpose: This study was conducted to develop a Cancer Patient Guide with patients involvement using evidenced based practice research. The purpose of this patient guide was to help patients undergoing chemotherapy to manage their nausea and vomiting based on evidence. Methods: The design of the research was a methodological study. The participants consisted of seven cancer patients who were asked about their ' need for nausea and vomiting management, and secondly, 16 expert & 15 cancer patients to evaluate the Cancer Patient Guide using the DESCERN tool. Results: 1) Sixty-four relevant research evidences based articles were reviewed. 2) Patients were interviewed as to their needs in controlling nausea and vomiting. 3) The preliminary Cancer Patient Guide utilizing the research evidenced and the cancer patients interviews was then evaluated and revised by the experts and cancer patients. Lastly, the Cancer Patient which included an overview of chemotherapy, pathophysiology of nausea & vomiting, pharmacological and non-pharmacological interventions was finalized with each intervention supported by research evidence and patients' narratives of their experience. Conclusion: The Cancer Patient Guide was developed using evidenced based research and cancer patients in-put and be used to improve patients' self-management skill of nausea and vomiting in chemotherapy. The guide t also provides evidence based patient friendly information and contributes as a baseline data for developing and evaluating evidence-based guide for patients.

근거기반설계 연구의 근거 특성과 의료건축의 근거기반실무를 위한 시사점 - HERD의 연구경향 분석을 중심으로 (The Characteristics of Evidence in Evidence-based Design Research and Their Implications to the Evidence-based Practice of Healthcare Architecture - Focused on Health Environments Research & Design Journal)

  • 김덕수
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제28권4호
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    • pp.21-30
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    • 2022
  • Purpose: To prove the credibility of EBD, it is necessary to define concepts regarding the nature of credible knowledge and the hierarchy of evidence. In addition, the relationship between EBD and EBP needs to be addressed through a practical viewpoint. Methods: The systematic review is applied to define the nature of knowledge and the characteristics of research papers in architectural EBD while analyzing the field of study, knowledge focus and types of keywords of the first author. Results: As a whole, the types of research focus evaluated using the most frequent keywords include function(40.86%), specialized knowledge(30.52%), professional practice(21.37%), and health(5.78%). Empirical research(83.72%) is more likely to be found than theoretical research(13.95%). The EBD research papers ranked as top-tier are only 7(2.03%) among a total of 344, while the research papers ranked in the third to fourth tiers are 276(80.23%). Implications: There is a deficiency of reliable 1-2 tier research papers. From a practical viewpoint, it would be realistic to recommend that healthcare architects appropriately evaluate the quality of EBD research and apply it in practice, rather than to conduct EBD research themselves. This systematic review illustrates the nature of EBD research.

패혈증과 패혈쇼크의 치료 지침 (Treatment Guidelines of Sepsis and Septic Shock)

  • 이흥범;문희
    • Tuberculosis and Respiratory Diseases
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    • 제67권6호
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    • pp.491-498
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    • 2009
  • Severe sepsis and septic shock are major healthcare problems with high mortality, ranging from 20% to 60%, affecting millions of individuals around the world each year. The speed and appropriateness of therapy administered in the initial hours after severe sepsis develops have an important impact on the outcome. In 2004, an international guideline that the bedside clinician could use to improve the outcomes in severe cases of sepsis and septic shock was published. Several landmark studies recently demonstrated that therapeutic strategies may reduce mortality substantially. The "Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock: 2008", using a new evidence-based methodology system for assessing the quality of evidence and the strength of the recommendations, was updated. The revised version is based on an updated search into 2007. Evidenced-based recommendations regarding the acute management of sepsis and septic shock are the first step toward improving the outcomes of critically ill patients. We review the treatment guidelines of sepsis and septic shock.

정례적 결혼검진의 가족센터 적용에 관한 효과성 연구 (Effectiveness of Repeated Marriage Checkups in a Family Center)

  • 박우철
    • Human Ecology Research
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    • 제60권1호
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    • pp.69-86
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    • 2022
  • The present study examined the effectiveness of repeated marriage checkups at intervals of six months in a Family Center in Seoul. To achieve this, the pilot study protocol (Park, 2019) was adapted, emphasizing strength-based, counseling-oriented approaches. Two couples and family therapists with master's degrees were trained and their practice was monitored to ensure program fidelity. The methods employed for the assessment of marriage checkup were an online survey, a video recording of couple problem-solving, and a clinical interview. A total of 14 couples participated in the 1st checkup, 10 of whom also completed the 2nd checkup. Couples with varying levels of marital satisfaction participated in the program. Descriptive statistics indicated gradual increases over 8-9 months in diverse indices such as marital satisfaction and relationship strength, while other indices fluctuated slightly but converged to higher levels over time. A non-parametric analysis appropriate for small samples demonstrated statistically significant increases over the 8-9 months in marital satisfaction among couples. The current study evidenced the effectiveness of repeated marriage checkups in the Family Center, which is the primary public institution for family policy and services in Korea. Repeated marriage checkups are therefore a promising way to enhance couples' relationship health and improve the family management system of the Family Center.

미국 전문간호사(NP)의 역할과 교육과정에 관한 고찰 (Nurse Practitioner Roles and Curriculums in the United States)

  • 이선옥
    • 한국간호교육학회지
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    • 제5권1호
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    • pp.97-105
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    • 1999
  • Based on literature, status and role of the NP in America was reviewed. The process of developing NP program in America suggests us many things. In America, nurse practitioners have sustained a mutually beneficial status with their patients for over thirty years. Excel fence in academic education and clinical training will enable nurse practitioners to continue to provide quality health care. The magnitude changes in the health care system of the United States, the challange of providing real access of health care continues. Lack of access to adequate primary care was the driving force in the initial 1965 Federal Involvement in developing the NP role. In 1993 President Bill Clinton's health care reform initiative provided policy support for NPs as primary care providers. The Institute of Medicine explicitly recognized NPs as an integral part of the primary care team. In addition, several national reports recognized NPs as affordable, accessible, high-quality care providers. The recent passage of direct Medicare reimbursement for NPs reflected public policy statements coincided with and likely contributed to a growth spurt in the NP workforce. From 1965 to 1977 NP programs offered traditional primary care clinical tracks(adult, family, woman's health, and pediatrics) for relatively small clusters of students in a variety of institutional settings. From 1978 to 1990 these educational programs were incorporated into graduate schools of nursing. By 1990 the majority of NPs received educational preparation in master's-level nursing programs. A new emphases was placed on postmaster's NP programs designed for master's prepared clinical nurse specialists and nurse managers. he the health care system shifted hospital nursing resources toward community-based care, these master's -level nurses sought additional NP preparation. NP educational programs are defined as the educational structure in which one or more NP clinical tracks are offered. NP clinical tracks, in turn, offer curriculum and supervised clinical experiences that match standards in specific practice areas such as family(FNP), adult(AUP), geriatrics(GNP), pediatrics(PNP), women's health (WHNP), neonatal (NNP), and acute care(ACNP). There were indications that NP practice was expanding into new clinical areas as evidenced by new types of tracks, particularly in acute care and psychiatry. The increase in acute care NP students likely reflects the increased demand from hospitals and other acute care settings. In Korea, change of nurse's role into nurse practitioner's role may have many difficulties. The need of health consumer, policy support of government, approval of medical care team are all essential component. Every nursing personnel make effort to planning the new health care delivery system.

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Factors Affecting Parents' Intention to Choose English Centers: The Role of STEM Education

  • Tran, Do-Van-Anh;Nguyen, Ngoc-Duyen;Tang, Thai-Ngoc;Le, Dinh-Bao-Nhi;Vo, Huyen-Yen-Nhi;Le, Hoanh-Su
    • Journal of Multimedia Information System
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    • 제7권1호
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    • pp.87-96
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    • 2020
  • Parents' desire for daily English practice for students and the urge for a etter English education has led to a demand for a highly qualified educational curriculum. In addition to getting deep-dive insights into parents' decision-making process, the increasingly important role of STEM education method has been proved in accordance with plenty of evidenced-based many of previous research. This study was conducted to examine the five independent factors affecting parents' intentions when designating English centers for their children, respectively named: Facility, Teachers, Brands, Social factors and Tuition. Through a preliminary approach, 235 samples were analyzed. Analysis of the sample responses reveals the importance level of five independent factors affecting Parents' intention to choose English centers in descending order: Facilities, Teachers, Brands, Tuition and Social factors. Furthermore, a positive correlation was found between STEM and Intention to choose English centers, indicating that whether the center applies STEM-related curriculum in English courses or not, in fact, has a significant impact on parents' decision. In terms of attitude towards STEM, further statistical tests revealed an interesting finding, which is the fact that how STEM affects Intention of parents is directly proportional to the Attitude towards STEM. With the help of SPSS 20 and AMOS 20, the SEM analysis was processed in order to draw conclusions about factors impacting Intentions to choose English centers. Combining with Multi-group analysis, the major role of STEM education has been assessed in relation to plenty of correlations. In light of recent major and massive growth of English teaching market in Vietnam, several suggestions and recommendations in terms of sustainable developments have been displayed in this research.

Effects of adlay, buckwheat, and barley on transit time and the antioxidative system in obesity induced rats

  • Kim, Jung-Yun;Son, Bo-Kyung;Lee, Sang-Sun
    • Nutrition Research and Practice
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    • 제6권3호
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    • pp.208-212
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    • 2012
  • In the present study, we examined whether four grains including adlay (AD), buckwheat (BW), glutinous barley (GB), and white rice (WR) affect the duration of food residence in the gastrointestinal tract and hepatic enzyme activities in rats fed different combinations of the grains. The rats were raised for 4 weeks on a high fat diet based on the American Institute of Nutrition-93 (AIN-93G) diets containing 1% cholesterol and 20% dietary lipids. Forty male rats were divided into four groups and raised for 4 weeks with a diet containing one of the grains. Corresponding to the dietary fiber contents of the experimental grains, gut transit time was shortest in the rats fed GB and increased in the order of BW, AD, and WR. In addition, the accumulated shortest transit time occurred in the GB group. Gut transit time affected weight gain and major organ weight, as it was closely related to the absorption of nutrients. The level of thiobarbituric acid reactive substance (TBARS) in liver was higher in rats fed WR, AD, BW, and GB, indicating that the other grains decreased oxidative stress in vivo more than WR. Glutathione, glutathione peroxidase, and glutathione S-transferase levels in the AD, BW, and GB groups were significantly higher than those in the WR group. In conclusion, reduced colonic transit time has been implicated in reducing the incidence of colon cancer, as evidenced by populations consuming diets rich in fiber. Whole grains such as AD, BW, and GB may contribute to a significant supply of antioxidants to prevent oxidative stress if they are consumed in large amounts.

장단기 고용량 카페인 투여가 청소년기 동물모델의 행동에 미치는 영향 (Influence of Short- and Long-term High-dose Caffeine Administration on Behavior in an Animal Model of Adolescence)

  • 박종민;김윤주;김하은;김연정
    • Journal of Korean Biological Nursing Science
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    • 제21권3호
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    • pp.217-223
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    • 2019
  • Purpose: Caffeine is the most widely consumed psychostimulant of the methylxanthine class. Among adolescents, high-dose of caffeine consumption has increased rapidly over the last few decades due to the introduction of energy drinks. However, little is known about the time-dependent effect of high doses of caffeine consumption in adolescents. The present study aims to examine the short- and long-term influence of high-dose caffeine on behavior of adolescence. Methods: The animals were divided into three groups: a "vehicle" group, which was injected with 1 ml of phosphate-buffered saline for 14 days; a "Day 1" group, which was injected with caffeine (30 mg/kg), 2 h before the behavioral tests; and a "Day 14" group, which was infused with caffeine for 14 days. An open-field test, a Y-maze test, and a passive avoidance test were conducted to assess the rats'activity levels, anxiety, and cognitive function. Results: High-dose caffeine had similar effects in short-and long-term treatment groups. It increased the level of locomotor activity and anxiety-like behavior, as evidenced by the increase in the number of movements and incidences of rearing and grooming in the caffeine-treated groups. No significant differences were observed between the groups in the Y-maze test. However, in the passive avoidance test, the escape latency in the caffeine-treated group was decreased significantly, indicating impaired memory acquisition. Conclusion: These results indicate that high-dose caffeine in adolescents may increase locomotor activity and anxiety-like behavior and impair learning and memory, irrespective of the duration of administration. The findings will be valuable for both evidence-based education and clinical practice.

통합적 환경설계 이론 기초 연구 (Exploring the Theoretical Trends of an Integrated Environmental Design)

  • 안명준;배정한
    • 한국조경학회지
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    • 제37권2호
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    • pp.14-25
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    • 2009
  • 지식 패러다임의 변화와 함께 우리는 혼합의 시대에 살고 있다. 현대 조경에서 다루는 새로운 대상지들은 혼합의 양상을 실천하는 장이 되고 있으며, 조경 영역의 변화를 이끄는 주요 동인이 되고 있기도 하다. 이러한 배경 아래 본 연구는 환경설계에 있어 관련 분야 통합의 양상이 어떻게 나타나는지를 살펴보았다. 이를 위해 먼저 조경 인접 분야에서의 통합 논의의 경향을 계획 이론, 도시 이론, 건축 분야, 공공 환경 분야, 엔지니어링 분야 그리고 조경 이론으로 나누어 살펴보았다. 실천으로 나타나고 있는 분야별 통합의 논의 경향은 아직까지 각 분야를 중심으로 인접 분야의 장점을 효과적으로 활용하고자 하는 방향에서 진행되고 있다. 실천 사례로 볼 때, 통합적 설계의 접근 경향은 크게 설계 대상, 개별 전문 분야, 접근 방식 및 설계 방법론의 세가지 차원에서 발견할 수 있다. 설계의 대상 측면에서는 주로 설계를 통해 형성되는 각 물리적 대상간의 통합 또는 결합의 모습을 주로 볼 수 있다. 대부분의 통합 사례가 여기에서 발견되며, 거의 모두 소재나 표현의 대상이 몇 가지의 방법으로 통합되는 모습이다. 전문 분야의 측면에서는 각 개별 주체들이 설계 시 어떻게 활동하는지가 주로 나타난다. 여기에서는 개별 분야의 장점이 시너지를 이루면서 최적의 결과를 향해 통합되는 양상을 보인다. 접근 방식 및 설계 방법론의 측면에서는 효과적인 의사결정의 방법으로서 통합적 접근이 시도되고 있는데, 이때에는 개별 이해 당사자들의 통합이 주가 된다. 통합 설계는 아직까지 실천적 사례를 통해 구체적인 디자인 방법론으로 강조되는 경우는 많지 않았다. 그러나 통합설계의 필요성과 이론적 접근이 다방면에서 확인되었고, 랜드스케이프 어바니즘과 같은 실천적 움직임이 태동하여 활동하고 있다는 점은 고무적이라고 하겠다. 이러한 종합적 접근을 바탕으로 통합의 실천이 환경설계의 측면에서 논의되어야 할 시점이다.