The Purpose of the study was to understand the experience of chronic renal failure patients for the qualified individual care for them. The purpose of this study was to explore the experience of patients living with chronic renal failure and to identify the meaning and structure of their experience. The subjects were four patients, two females and two males. The age range was from 21 to 54. Data was collected with a few in-depth interviews by the authors until the data was fully saturated. The framework and methodology of this study was based on Parse′s "Human Becoming methodology," an existential phenomenological research methodology. The findings of this study were as follows. Three experience structures of chronic renal failure patients were : 1. Sufferings and conflicts originated in the frustration caused by uncurable disease. 2. Dependence upon God and significant others with complex emotions. 3. Acceptance of sufferings, emerging hope for serving people, and gratitude for living. In conclusion the experience of chronic renal failure patients could be described from the findings (three structures) as "Experiencing the sufferings, conflicts originated in the frustration caused by uncurable disease, dependence upon God and significant others with complex emotion, acceptance of the suffering and hope for serving people, and gratitude for living." The three structures of the lived experience of patients with chronic renal failure, the findings of this study, could be explained by the three concepts of "Theory of Human Becoming," the first structure could be explained with values, the second with revealing-concealing, and the third with transforming.
Objective: To investigate correlations between adenosine triphosphate chemotherapy response assay (ATP-CRA) and clinical outcomes after ATP-CRA-based chemotherapy for drug selection in patients receiving intravesical chemotherapy to prevent recurrence of superficial bladder cancer after surgery. Methods: The chemosensitivities of 12 anticancer drugs were evaluated, including 5-Fu ADM, and EPI, using ATP-CRA and primary tumor cell culture in 54 patients. In addition, a further 58 patients were treated according to clinical experience. Differences in post-chemotherapeutical effects between drug sensitivity assay and experience groups were compared. Results: The evaluable rate of the test was 96.3%, the clinical effective rate was 80.8%, the sensitivity rate was 97.6% (41/42), the specificity was 20%, the total predicting accuracy was 74.3%, the positive predictive value was 83.7% (41/49), the negative predictive value was 66.7% (2/3); in the drug sensitivity test group, the clinical effective rate was 80.8%, the experience group response rate was 63.8%, with a significant difference in clinical effects between the ATP-based sensitivity and experience groups (${\chi}^2$=7.0153, P<0.01). Conclusion: ATP-CRA is a stable, accurate and potentially practical chemosensitivity test providing a predictor of chemotherapeutic response in patients with superficial bladder cancer.
This work was done for 9 patients having experience of a herb medical treatment after being diagnosed as CVA during a year from January, 1996 to December, 1996 by using an ethnographic research method. The summarized results of this research are following. Ⅰ. THE EXPERIENCE OF THE ILLNESS First, the falling-ill phase is the time that they have the first stroke of paralysis and the decision pattern of medical institution' comes out. The emotional experience in the period is something like 'flustration', 'anxiety', 'despair', and 'expectation'. Second, the active-treatment phase is the time that the patients as well as their family or care giver not only show the positive attitude and actively participate in the illness treatment but also show a lot of interest in medical institutions and activities of health recovery. There is a primary factor of the continuation of treatment as an experience of treatment and being crushed and sensitivity as an experience of the illness. Third, the rehabilitation phase is the time that the patients or their family become tired and insensitive to the treatment and recuperation, and then reduce the treatment activity. There is a primary influence factor of the discontinuance of treatment as an experience of treatment and physical experience and emotional experience as an experience of the illness. The physical experience is divided into 'personal-hygiene care', and 'the sphere of activity' The emotional experiences are 'blaming someone', 'contempt' and 'despair' as a negative experience and 'hope' as a positive experience. Ⅱ. COPING STRATEGY There are a physical coping, an emotional and mental coping, a social coping, and a spiritual coping as a coping strategy used for the patients to overcome their illness and adjust themselves to their altered life. First, the physical coping comes out as 8 categories, 'using an auxiliary tool', 'doing exercise', 'protecting', 'improving their diet', 'taking care of something', 'using subsidiary medicines', 'trying a folk remedy', and 'having interest in their health'. Second, for the emotional and mental coping, there are 'accepting' and 'trying' as a positive coping and a failure of control as a negative coping. Third, the social coping is appeared as 'being supported'. Fourth, the spiritual coping is recognized as' recourse to God' and 'preparation of death'. After all, the elderly CVA patients in an agricultural area choose the act of treatment based on the traditional belief and the relationship with a caretaker. A personal health can be maintained by taking care of themselves and controling their mind, and the overcome of the illness is decided on the basis of traditional concepts and cultural principles in which the patients as well as the family, neigbors and take carers should work out together and cooperate with each other in order to achieve that.
Purpose: The aim of this study is to identify the legal concept of a license and a qualification for health care personnel. We analyze the appropriateness of the qualification for the first-class paramedics and the sufficiency of 3-year job experience in substitution for college level academic major. Method: We reviewed Laws on Healthcare which stipulate academic and career qualifications for healthcare personnel for whom college-level academic training and job experience to get a license. Results: There is no legal consideration which permits major and educational background substituted by job experience. Only third-class hygienist who graduated from a high school or the equivalent with 3 year job experience can apply for first-class hygienist' national license examination without educational requirements. However, it is nothing to compare with first-class paramedics because the work of hygienist is not directly related to patients care and there is no need of doctor's supervision for hygienist' job. Paramedics have a major role in saving emergency patients in making prompt decision, applying appropriate emergency treatment, securing intravenous route, managing intubation, applying defibrillator, and etc. Conclusion: Ministry of Health & Welfare should grant license to paramedics and annul replacement of academic major background. In addition, it is imperative to broaden the scope of paramedics' job so that they can guarantee patient's life saving in emergency situation with quality major curriculum of college level.
Immune thrombocytopenia (ITP) is a disease in which thrombocytopenia occurs because of immune-mediated platelet destruction and decreased platelet production. Although many pediatric patients with ITP experience spontaneous remission or reach remission within 12 months of first-line therapy, approximately 20% progress to chronic ITP. Patients who do not respond to first-line treatment or experience frequent relapses are of great concern to physicians. This review summarizes recent treatments for second-line treatment of pediatric chronic ITP.
Journal of the korean academy of Pediatric Dentistry
/
v.21
no.2
/
pp.469-485
/
1994
The present study was undertaken to examine the relationship between time required for each step in the treatment process for pedodontic patients. and age of the patients, and experience of special training for pedodontics and career of dental practitioners. Information of these matters was gained from 580 questionnaires collected from 69 practitioners (62 male and 7 female). The questionnaires included questions about the patients' sex(303 male and 207 female) and age. The patients were categorized into 5 different age groups : Group 1, age $1{\sim}3$-year ; Group 2, $4{\sim}6$-year ; Group 3, $7{\sim}9$-year ; Group 4, $10{\sim}12$-year ; Group 5, $13{\sim}15$-year. The questions about the dental practitioners were the years of experience in private dental practice(5 years or more than 5 years) and whether or not they took the special training for pedodontics in the authorized institutes. The practitioners were asked to answer the questions about Frankl scale of the patients' behavior during the treatment, and time spent for managing the patients to be subjected to local anesthetic injection (the first behavior control), time for the injection, and time for the subsequent treatment. The results obtained by analyzing the information collected from the questionnaires were as follows : 1. The younger the patients, the lower the Frankl scale was counted at the time of the first behavior control, injection, and the subsequent treatment(p<0.001). 2. The lowest Frankl scale was scored during the injection regardless of the age of the patients. 3. Time for management and treatment was decreased in the order of age Groups 1 and 2< Group 3 < Groups 4 and 5. 4. The patients showed a more positive frankl scale in response to the treatment performed by those who were more-experienced in dental practice as compared with those were less-experienced. 5. Pedodontic training experience of the practitioners did not appear to influence the patients with respect to the treatment time and Frankl scale.
Kim, Heenyun;Choi, Yongseok;Moon, Seokjun;Shin, Jeongwoo
Health Policy and Management
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v.32
no.1
/
pp.94-106
/
2022
Background: The efforts to build more "people centered," "patient centered" health system has been emerging all over the world. Aligning with it, the Korean government is conducing the survey called "Medical Service Experience Survey (MSES)." There are critics, however, that MSES is not scrutinizing the medical experiences of patients in various healthcare settings. For this reason, this study aims to perform an empirical analysis of the differences in answers of patients responding to various healthcare settings. Methods: There are two steps in this study. First, explanatory analysis is conducted to compare the tendency of statistical concentration on questionnaires by divided healthcare settings. Second, confirmative analysis is carried out to evaluate the construct validity, reliability, and discriminant validity of the questionnaire in each healthcare setting. The raw data of MSES, which was conducted in 2020 by the Ministry of Health and Welfare in Korea and the Korean Institute for Health and Social Affairs is used. Results: As a result of exploratory factor analysis for all outpatients, the items were classified into four factors statistically: "doctor experience," "nurse experience," "outpatient service experience," and "patient satisfaction." It was confirmed that the reliability of all factors extracted was secured. However, for patients who visited hospitals, questionnaires related to personal privacy, such as "experiences on medical staffs considering physical exposure" or "experiences related to personal information exposure," were answered in conjunction with items of "nurse experience." Besides, patients responded that administrative elements of medical services, such as "experiences of comfort in medical institutions" and "experiences of satisfactory administrative services," were related to the items of "nurse experience." The answers of patients who visited traditional medical hospitals and clinics about "doctor experience" and "nurse experience" were not discerned statistically, and the answers to "doctor experience," "nurse experience," and "medical institution experience" were entangled with the responses of patients who visited dental hospitals and clinics. On the other hand, as a result of the confirmatory factor analysis, it was found that the inquiries of MSES generally had intensive validity. Conclusion: The collection of objective and scientific data is the prominent component to enlighten the patient-centered healthcare system alongside with change of the worldwide paradigm of measuring the healthcare system performance as follows the transition of perspective of health care from provider-centered to patient-centered. This study empirically shows that the patient experience can vary as the healthcare settings. Furthermore, to make an advance in measuring the experience of patients with medical services, this article proposes the deliberate consideration of the different kinds of healthcare settings and articulate design of the survey.
Purpose: The purpose of this study was to understand nurses' experience of managing diet and fluid in hemodialysis patients and to provide helpful information in improving care of hemodialysis patients. Methods: Data were collected through in-depth interviews with ten nurses who had experience of providing care to hemodialysis patients. Colazzi's phenomenological method was used to analyze data. Results: Twenty themes were identified in the first stage of data analysis and were later categorized into ten theme clusters, of which four categories were derived. The four categories were 'developing a strong feeling of responsibility for management', 'acknowledging limits in performing duties', 'providing patient-centered education' and 'becoming a guide for the long treatment process'. Conclusion: The study results will be useful for improving nursing curriculum to ensure more effective and successful diet and fluid management in hemodialysis patients.
Purpose: The purpose of this study was to identify sleep disorder experience in older patients living in the community and acknowledging being depressed. Methods: For this study, 11 older patients with depression were purposively chosen. Data were collected through indepth individual interviews from July 2013 to January 2014 and analyzed in terms of by Giorgi's phenomenological methodology. Results: The study results showed that sleep disorder experience in older patients with depression consisted of sixteen themes and five themes-clusters: 1) exposure of the causes of sleep disorders; 2) life is painful; 3) harassing themselves and their family; 4) difficulty in controlling themselves; 5) trying to deal with the sleep disorder to overcome the situation. Conclusion: It is necessary to develop educational guidelines for patients with sleep disorders or nursing interventions that anyone can easily provide for elders in the communities. The first priority should be given to efforts to apply diverse methods to improve sleep hygiene and minimize the period of exposure to medication before starting medication for patients with sleep disorders.
Most of cancer therapy consists of surgery, chemotherapy and radiotherapy developed by modern western medicine. Often Korean patients use both modem western and oriental medicine through their cancer life. This study tried out to answer the the question : "What are the experience of a Korean cancer patients who follow oriental medicine after cancer diagnosis?" To answer to that, a micro-ethnographic research method was used. Total 6 patients were observed from March, 1996 to February, 1997. Data were obtained through interview, participant observation, audio-tape recording, field recoding, field note-taking, and ralated documents Using an analytical tool known as "pencil and scissors", the data were analyzed. First, I learned patietnts' accounts for cancer experience following oriental medicine, and I could found that they expereinced "feeling of uncertainty" through cancer life. Second, major argument was searched. : Feeling of uncertainty of cancer patients was extremely increased after cancer diagnosis. Oriental Medicine made cancer patients not only expect to improve general physical condition, but also gave them significnat emotional support to overcome their feeling of uncertanty. Third, I examined how did this argument form meanings in the context of individual life. Modem western mediacal service system could not satisfy cancer patients' informational and emotional need. But oriental medicine contribute to relieve the degree of their feeling of uncertainty. As a result of these understandings, I suggest that modern wetern medicine need to be concerned to feeling of uncertainty of cancer patietns and infomational service, and oriental medicine counsel with cancer patients much more systemically. Also nurses must improve cancer education with more accurate and practical information based on empirical data.
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