• 제목/요약/키워드: Face-to-Face Clinical Practice

검색결과 65건 처리시간 0.023초

사상체질 전문가의 체질진단 일치도 및 타당도 평가 (The Concordance and Validity Assessment of Diagnosis for the Expert in Sasang Constitution)

  • 백영화;김호석;이시우;장은수
    • 사상체질의학회지
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    • 제26권3호
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    • pp.295-303
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    • 2014
  • Objectives It is very important to diagnose Sasang Constitution (SC) correctly. The aim of this study was to reveal the concordance and validity of the specialists in Sasang Constitutional Medicine (SCM). Methods Three experts who had more than 5 years of experience and used more than 90% of Sasang Constitutional prescription in clinical practice of SCM participated in this study. The data composed of body shape, face, voice, temperament and physio-pathological symptoms were collected in the Korea Constitutional Multicenter Bank and 81 subjects' data were extracted randomly. The experts reviewed all 81 subjects data independently. Kappa analysis was conducted. Results 1) The concordance is from 52.5% to 68.4% among three experts. 2) The validity between individual expert and gold standard is from 54.3% to 63% and Kappa's coefficients are from 0.283 to 0.421. 3) The validity is from 68.5% to 70.7% when two or three experts agree the Sasang constitution independently and 75.7% when all of experts agree it. Conclusions The concordance and validity of experts in SCM seems to be moderate. We think further study is needed.

Anatomical study of divergences in facial artery endings

  • Yasser Ayish Alharbi
    • Anatomy and Cell Biology
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    • 제56권2호
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    • pp.211-218
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    • 2023
  • Despite several studies focusing on the facial arteries variable courses, the findings have significantly differed. The divergent findings have made it increasingly challenging to establish consistent correlations. Thus, as a vital artery, the facial artery is prone to numerous variations, which makes the identification of the variations vital to clinical practice, particularly for the orofacial and rhinoplastic surgery, and the increasingly selective chemotherapy procedures. The present research uses angiography images for analysis in studying the bilateral facial artery variations noted in patients undergoing carotid angiography for the evaluation of congenital anomalies, cerebral vascular malformations, and intra-arterial procedures. Conventional angiography was used, as it is a vital assessment tool that helps in the assessment of variations in the facial arteries and is suitable in evaluating smaller vascular anatomy, due to the perfect spatial resolution and portrayal of vascular anatomy. Thus, rather than normal ending of the facial artery as an angular artery, the study disclosed that in certain instances, the artery termination took the form of a superior labial artery with a small lateral nasal artery branch located closer to the midline compared to the normal cases. Also, the study has disclosed a conspicuous pre-masseteric branch with small branches originating from the infraorbital artery and providing potential compensation for the facial artery's shortness. Regardless of the infrequency of such variations, it is vital that they are considered during the performance of any facial surgical procedure.

정신적 장애 환자의 임플란트를 이용한 보철 치료 (DENTAL IMPLANTS IN EDENTULOUS PATIENTS WITH COGNITIVE DISABILITIES: CASE REPORTS)

  • 유은규;최성철;김광철;박재홍
    • 대한장애인치과학회지
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    • 제7권1호
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    • pp.11-14
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    • 2011
  • 본 증례에서는 정신적 장애를 가진 환자들에게 임플란트를 이용한 보철 수복을 시행하였다. 이런 환자들에게 보철물의 형식은 고정성 보철물이나, 피개의치를 사용하였고, 임플란트의 실패나 보철물의 파절은 보이지 않았다. 이런 환자들에서 구강을 청결히 유지하기 힘들기 때문에 적극적인 정기검진 및 치태 조절이 필요할 것으로 사료된다.

항암화학요법 후 퇴원한 암 환자의 증상관리를 위한 전화상담 가이드라인 개발 (Developing Telephone Guidelines for Symptom Management of Cancer for Outpatients with Cancer after Chemotherapy)

  • 박인숙;김은미;오필주;김수진;김혜진;김보경;황은경;박세림;이미정
    • 임상간호연구
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    • 제18권2호
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    • pp.317-328
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    • 2012
  • Purpose: This study was done to provide oncology nurses systemic guidelines designed to perform telephone counseling in outpatient settings treating patients with chemotherapy. Methods: Symptoms which are frequently questioned were identified through case reports recorded by 4 clinical nurse specialists from January 4 to December 31. 2010. Fifteen clinical experts and two hemato-oncologists reviewed the developed draft. Their opinions were synthesized to arrive at consensus on the ideal guidelines. This process confirmed content validity. The two hemato-oncologists also verified the face validity. Results: The six symptoms which were most frequently asked about were identified through 4,644 case reports and concerned pain, fever, skin alteration, nausea/vomiting, stomatitis and diarrhea. Evidence-based telephone triage guidelines for the 6 major symptoms in patients receiving chemotherapy were developed. Conclusion: These guidelines will help oncology nurses from novice to expert incorporate evidence-based telenursing into their practice.

의료용 마약류 진통제 처방자와 조제자의 마약류통합관리시스템 사용경험에 관한 질적 연구 (Qualitative Study on the Narcotics Information Management System (NIMS) Experience of Doctors and Pharmacists Using Narcotic Analgesics)

  • 김진이;신영전
    • 한국임상약학회지
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    • 제33권1호
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    • pp.22-34
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    • 2023
  • Background: With the increasing use of narcotic analgesics, the Ministry of Food and Drug Safety has been operating the National Narcotics Information Management System (NIMS) since 2018 in Korea. Some studies are related to the narcotic analgesics use, but the evaluation studies of system, including NIMS users are insufficient. Objective: This study evaluated the NIMS enforcement process through in-depth interviews on the experience of using NIMS of doctors and pharmacists who prescribe or dispense opioid analgesics. Methods: Participants in this study were selected through purposeful sampling as three doctors and two pharmacists in the metropolitan area. The interviews were conducted from August 27 to October 19, 2022. Each interview was analyzed using a phenomenological method. Results: Six components of this study included "Doctors and pharmacists come across drug abusers", "They respond individually to drug abusers", "They use NIMS tailored to the needs of system managers", "They are concerned about the role of NIMS in practice settings", "They face challenges against drug abusers" and "They find a way to utilize the system to deal with drug abusers." The interviews confirmed that doctors and pharmacists used NIMS little in their work, and they only reported data. Therefore, it might be difficult for doctors and pharmacists to take measures for the safe use of narcotic analgesics. Conclusion: It is likely that adding data-feedback and medication-check function can reduce the abuse of narcotic analgesics. In the future, further studies on the evaluation of the empirical results of NIMS and review of systems in other countries will be required.

비만대사수술을 받은 고도비만 청년들의 체중감량 경험 (Weight Loss Experience of Highly Obese Young Adult Who Underwent Bariatric Surgery)

  • 이호임;정효주;권수혜
    • 대한간호학회지
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    • 제53권2호
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    • pp.260-273
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    • 2023
  • Purpose: This study aimed to explore the weight loss experience of highly obese young people who underwent bariatric surgery. Methods: Data were collected, from October 2021 to April 2022, through individual in-depth interviews with eight highly obese young adults who underwent bariatric surgery and analyzed using Colaizzi's phenomenological method. Results: The following four theme clusters were extracted. First, 'The unbearable sorrow of obese people' explains the process of choosing bariatric surgery after fluctuations and frustration despite countless repeated weight loss attempts. Second, 'The impact aftermath of bariatric surgery' revealed participants struggling in the face of unexpected changes due to bariatric surgery. Third, 'Efforts to rebuild a healthy myself' demonstrated the struggle to regain health by using the surrounding support system to overcome the difficulties of this surgical procedure. Lastly, 'Facing life by getting rid of the yoke of obesity' displayed the experiences of the participants who felt ambivalent about their changed appearance, but coping positively with the new life. Conclusion: This study provides an in-depth understanding of the weight loss experiences of highly obese adolescents who underwent bariatric surgery and presents a new perspective on clinical practice. The results of this study are expected to be useful in developing and applying systematic and customized nursing interventions before and after bariatric surgery.

Classification of Nasal Index in Koreans According to Sex

  • Sung-Suk Bae;Hee-Jeung Jee;Min-Gyu Park;Jeong-Hyun Lee
    • 치위생과학회지
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    • 제23권3호
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    • pp.193-198
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    • 2023
  • Background: The nose is located at the center of the face, and it is possible to determine race, sex, and the like. Research using the nasal index (NI) classification method to classify the shape of the nose is currently in progress. However, domestic research is required as most research is being conducted abroad. In this study, we used a 3D program to confirm the ratio of the nose shape of Koreans. Methods: One hundred patients (50 males and 50 females) in their 20s were evaluated (IRB approval no. DKUDH IRB 2020-01-007). Cone beam computed tomography was performed using the Mimics ver.22 (Materialise Co., Leuven, Belgium) 3D program to model the patient's skull and soft tissues into three views: coronal, sagittal, and frontal. To confirm the ratio of measurement metrics, analysis was performed using the SPSS ver. 23.0 (IBM Co., Armonk, NY, USA) program. Results: Ten leptorrhine (long and narrow) type, 76 mesorrhine (moderate shape) type, and 14 platyrrhine (broad and short) type noses were observed. In addition, as a result of sex comparison, five males had the leptorrhine (long and narrow) type, 40 mesorrhine (moderate shape), and five platyrrhine (broad and short) types. For females, five patients had the leptorrhine (long and narrow) type, 36 patients had the mesorrhine (moderate shape) type, and nine patients had the platyrrhine (broad and short) type. Conclusion: This study will be helpful when performing nose-related surgeries and procedures in clinical practice and for similar studies in the future.

COVID-19시기의 예비간호사 training을 위한 학생주도 팀기반 문제중심학습 시뮬레이션 수업 효과검증 (Verification of the Effects of Student-led Simulation with Team and Problem-Based Learning Class Training during COVID-19)

  • 김하나;심미옥;이지산
    • 한국시뮬레이션학회논문지
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    • 제32권4호
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    • pp.27-39
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    • 2023
  • 본 연구는 간호대학생을 대상으로 학생주도 팀기반 문제중심학습 시뮬레이션 (SSTPBL) 수업을 개발하고 그 효과를 검증하기 위한 혼합연구이다. 자료수집은 2022년 9월 15일부터 2022년 10월 20일까지 A시 소재 일개 대학 간호학과 4학년 학생 51명에게 설문조사 및 4명을 대상으로 포커스 그룹 인터뷰를 진행하였다. 수집된 자료는 SPSS version 25.0과 주제분석을 활용하여 분석하였다. 양적연구 결과, 시뮬레이션 경험 만족도(t = 3.51, p < .01), vSim 경험 만족도(t = 3.50, p < .01), 예비 간호사로서의 준비 정도(t = 3.73, p < .01), 학습 자기효능감(t = 3.87, p < .01), 협력적 자기효능감(t = 4.30, p < .01), 문제해결 능력(t = 5.26, p < .01), 교육 만족도(t = 3.54, p < .01), 디지털 헬스 형평성(t = 2.18, p < .05)을 향상시키는 데 효과가 있었다. 질적연구에서 도출된 6개 주제는 '임상실습과 유사함', '몰입에 어려움', '타인을 통해 배워감', '자기반성을 통한 배움', '새로운 경험을 통한 자신감 향상', '새로운 수업방식'이었다. 본 연구결과를 바탕으로 팬데믹 이후 임상실습 제한이 커지고 있는 상황에서 학생주도 팀기반 문제중심학습 시뮬레이션 (SSTPBL) 수업이 예비간호사들의 새로운 훈련 방법으로 다양하게 활용될 수 있을 것으로 기대한다.

Institutional Review Board 심의에 대한 연구자 만족도 및 임상연구보호프로그램 개선 요구도에 대한 설문조사 연구 (A Survey Study on Researchers' Satisfaction with Institutional Review Board Reviews and Demands for Enhancing Human Research Protection Programs)

  • 박신영;안초롱;노양희;김세주;라선영
    • 대한기관윤리심의기구협의회지
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    • 제5권2호
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    • pp.43-50
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    • 2023
  • Purpose: Due to the stringency of regulations related to clinical research, researchers face various requirements in the Institutional Review Board (IRB) review process. Specifically, they encounter time constraints and administrative burdens. In order to cultivate a more favorable review culture and establish a robust research environment, it is necessary to analyze researchers' perceptions of the IRB review. Therefore, this study aims to assess researchers' overall experiences with the IRB and identify researchers' educational needs and demands for research-related policies. Methods: A semistructured questionnaire with 34 items was developed and refined in consultation with advisors from IRB and Human Research Protection Program (HRPP). The questionnaire was distributed via an online survey to researchers with experience in IRB review. The survey covered general characteristics, satisfaction with the IRB review process (rated on a 10-point scale), experiences with IRB review, HRPP policy demands. Results: The study's descriptive statistics revealed a moderate satisfaction level (average rating, 6.75 out of 10) with the IRB review. Researchers from clinical medicine and other disciplines showed similar satisfaction scores of 6.65 and 6.87, respectively. However, respondents with over 5 years of research experience expressed higher satisfaction (mean score, 7.03) compared to those with less experience (mean score, 6.57). Institutional support was emphasized for improving the IRB review process. Certain training topics generated higher demands for addressing frequently raised IRB issues among minor discipline researchers compared to clinical medicine (p=0.017). Conclusion: We conducted an analysis of researchers' perceptions regarding the IRB as well as their demands concerning educational and HRPP policies. It is imperative to address the pinpointed areas for enhancement and integrate a range of perspectives in order to effectively cultivate a robust research ethics culture and ensure comprehensive participant protection.

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원발성 간세포암의 비특이적 영상 소견 및 간암으로 오인될 수 있는 병변에 대한 영상의학적 고찰 (Atypical Manifestation of Primary Hepatocellular Carcinoma and Hepatic Malignancy Mimicking Lesions)

  • 윤지영;박소현;안수좌;심영섭
    • 대한영상의학회지
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    • 제83권4호
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    • pp.808-829
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    • 2022
  • 간세포암종은 역동적 조영증강 컴퓨터단층촬영이나 자기공명영상에서의 동맥기 조영증강 및 문맥기 또는 지연기 씻김현상과 같은 전형적 영상 소견을 기반으로 비침습적으로 진단할 수 있다. 그러나 일부 간세포암종은 비전형적인 영상 소견을 나타내기 때문에 영상의학과 의사는 진단에 있어 어려움에 직면하게 된다. 더욱이 동맥 문맥 단락, 혼합 간세포-담관암, 간내 담관암, 혈관종과 같이 많은 간세포암 유사 병변들이 다수 존재하여 영상을 통한 감별 진단에 난항을 겪는다. 초기 영상 검사에서 간세포암종과 이러한 유사 종양을 구별하는 능력은 적절한 관리 및 치료 결정에 중요하다. 따라서 본 임상화보에서는 간세포암종의 비전형적 영상 소견과 간세포암종을 모방하는 악성 및 양성 병변들의 영상 소견을 제시하고 감별 진단을 좁히는 데 도움이 될 수 있는 중요한 단서들에 대해 알아보고자 한다.