• 제목/요약/키워드: Guidelines adherence

검색결과 104건 처리시간 0.033초

간호사 주도의 중재가 신장이식 수혜자의 삶의 질, 약물 순응도, 불안 및 우울에 미치는 효과: 체계적 문헌고찰 및 메타분석 (The effectiveness of nurse-led interventions on quality of life, medication adherence, anxiety, and depression in kidney transplant recipients: A systematic review and meta-analysis)

  • 박승연;곽이화
    • 한국간호교육학회지
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    • 제30권3호
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    • pp.263-279
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    • 2024
  • Purpose: This study was conducted to evaluate the effects of nurse-led interventions on quality of life, medication adherence, anxiety, and depression in kidney transplant recipients. Methods: A systematic literature review was conducted following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Two researchers independently selected the final literature, and the quality assessment was performed using Cochrane's Risk of Bias tool. Additionally, a meta-analysis was conducted using the statistical software RevMan 5.4 to estimate effect sizes. Results: Among the reviewed 2,264 papers, 8 final papers, including 6 from the literature search and 2 from manual searches, were included in the analysis. The total number of participants included in the analysis was 477. Nurse-led interventions were found to be effective in improving quality of life (d=1.05) and reducing anxiety (d=-0.98) and depression (d=-1.25). Due to the heterogeneity of the measurement tools, the effect size for medication adherence could not be calculated. Despite this, nurse-led interventions were shown to improve medication adherence. In the cases of anxiety and depression, longer intervention periods showed a more significant reduction trend. Conclusion: The results of this study suggest that nurse-led interventions positively impact quality of life, medication adherence, anxiety, and depression in kidney transplant recipients. Therefore, it is important to recognize the crucial role of nurses and explore ways to provide continuous nursing interventions for kidney transplant recipients.

Assessment of the Quality of Case Reports in the Journal of Acupuncture Research Using the CARE and STRICTA Guidelines

  • Nam, Eun-Young;Hwang, Ji Hye
    • Journal of Acupuncture Research
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    • 제37권4호
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    • pp.224-232
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    • 2020
  • The purpose of this study was to assess the quality of the case reports in the Journal of Acupuncture Research (JAR). All case reports were retrieved from November 2017 to June 2020. There were 19 case reports included in this assessment based on the case report (CARE) guidelines and case report and standards for reporting interventions in clinical trials of acupuncture (STRICTA) guidelines. The overall quality of reporting was relatively high (83.08% on Case Report guidelines and 77.78% on Standards for Reporting Interventions in Clinical Trials of Acupuncture guidelines), but several crucial items remained substantially underreported, such as identifying as a case report (keywords), patient information and perspective, clinical findings, diagnostic assessment, and intervention information. In 18 out of 19 included case reports of acupuncture-related interventions, several items remained considerably underreported such as acupuncture regimen variation, depth of needle insertion, response sought, and experience of acupuncturists. In the classification by disease, condition, or syndrome, 13 out of 19 included case reports were for musculoskeletal disorders (68.4%), which is the main clinical medical field of Korean medicine services. The results of this study may help develop more appropriate reporting guidelines for case reports published in JAR.

The Role of Pharmacists' Interventions in Increasing Medication Adherence of Patients With Epilepsy: A Scoping Review

  • Iin Ernawati;Nanang Munif Yasin;Ismail Setyopranoto;Zullies Ikawati
    • Journal of Preventive Medicine and Public Health
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    • 제57권3호
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    • pp.212-222
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    • 2024
  • Objectives: Epilepsy is a chronic disease that requires long-term treatment and intervention from health workers. Medication adherence is a factor that influences the success of therapy for patients with epilepsy. Therefore, this study aimed to analyze the role of pharmacists in improving the clinical outcomes of epilepsy patients, focusing on medication adherence. Methods: A scoping literature search was conducted through the ScienceDirect, PubMed, and Google Scholar databases. The literature search included all original articles published in English until August 2023 for which the full text was available. This scoping review was carried out by a team consisting of pharmacists and neurologists following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews and the Joanna Briggs Institute guidelines, including 5 steps: identifying research questions, finding relevant articles, selecting articles, presenting data, and compiling the results. Results: The literature search yielded 10 studies that discussed pharmacist interventions for patients with epilepsy. Five articles described educational interventions involving drug-related counseling with pharmacists. Two articles focused on similar pharmacist interventions through patient education, both verbal and written. Three articles discussed an epilepsy review service, a multidisciplinary intervention program involving pharmacists and other health workers, and a mixed intervention combining education and training with therapy-based behavioral interventions. Conclusions: Pharmacist interventions have been shown to be effective in improving medication adherence in patients with epilepsy. Furthermore, these interventions play a crucial role in improving other therapeutic outcomes, including patients' knowledge of self-management, perceptions of illness, the efficacy of antiepileptic drugs in controlling seizures, and overall quality of life.

20세 이상 저소득층 여성의 연령에 따른 비만 및 영양상태 평가 - 제4기(2007~2009) 국민건강영양조사 자료를 이용하여 - (Evaluation of Obesity and Nutritional Status by Age among Low-income Women aged over 20 - Using Data from the Fourth Korea National Health and Nutrition Examination Survey -)

  • 장희경
    • 동아시아식생활학회지
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    • 제25권2호
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    • pp.246-260
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    • 2015
  • The purpose of this study was to evaluate the prevalence of obesity, dietary habits, and nutritional status by age among low-income women, using data from the fourth Korea National Health and Nutrition Examination Survey (2007~2009). Subjects were 8,356 women aged 20 and over. The subjects were classified into four groups by age. Dietary data from 24-hr recall methods were used to analyze nutritional status. The prevalence of obesity in the 50~64 years age group was significantly higher than those of the other age groups. Among age groups, malnutrition was the highest in the 65-and-over age group. It appears that women in the 20~29 and 65-and-over age groups were the highest nutritional risk. The percentage of carbohydrates in total energy intake was higher and the percentages of protein and fat were lower in the 65-and-over age group than other groups. Frequency of skipping breakfast was lower in women aged 65-and-over, and moderate physical activity significantly decreased with increasing age. Awareness of dietary guidelines was higher in women aged 30~49 years than other groups, whereas it was lower in those aged 65-and-over years. Adherence to dietary guidelines of 'eating a variety of foods from each food group' was significantly lower in women aged 65-and-over years than those of other groups. However adherence to dietary guidelines of 'eating breakfast everyday with a pleasant mind' was significantly lower in women aged 20~29 years than those of other groups. Therefore, this study shows that low income women have various nutritional problems by age group, and we should support a tailored approach to improve their nutritional status.

노인의 식생활지침 실천 평가도구 개발 (Development of an evaluation tool for dietary guideline adherence in the elderly)

  • 임영숙;오지수;김혜영
    • Journal of Nutrition and Health
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    • 제57권1호
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    • pp.1-15
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    • 2024
  • 한국인을 위한 식생활지침은 건강한 식생활을 위한 가이드로 활용되는데, 식생활지침에 대한 세부 항목이 제시되지 않아서 지침에 대한 실천도를 자세히 평가하기는 어렵다. 따라서 본 연구는 식생활지침 실천도를 평가할 수 있는 세부 항목들을 선별하여 지침 실천도를 평가하는 평가도구를 만들고자 수행되었다. 노인의 식생활지침 실천 평가도구 개발을 위하여 문헌검토와 전문가 자문을 거쳐 총 35개의 평가 후보 항목을 추출하고, 전국단위 5개 지역의 남녀 노인 800명 (남 400명, 여 400명)을 대상으로 설문조사를 수행하였다. 식생활지침의 세 가지 영역별로 후보 항목에 대한 탐색적 요인분석으로 평가도구에 사용될 항목을 선별하고, 확인적 요인분석을 수행하여 구성타당도를 검증하였다. 구조방정식 모형의 경로계수를 활용하여 항목별 가중치를 부여하여 식생활지침 실천 점수를 계산하고, 전국조사 결과를 바탕으로 평가도구의 등급 체계를 마련하였다. 본 연구에서 개발된 노인 식생활지침 실천 평가도구는 총 28개 항목으로 식품섭취 영역 13항목, 식생활습관 영역 7항목, 환경을 생각하는 식생활 문화 영역 8항목으로 구성되었다. 식품섭취 영역에는 신선 생채소, 황색채소, 생과일, 콩·견과류, 생선·해산물, 고기·달걀 섭취, 우유·유제품, 잡곡 섭취, 물, 다양한 식품군 섭취, 육류 가시지방 제거, 단 음료, 염장 식품 섭취 항목이 포함되었고, 식생활습관 영역에는 건강체중 유지, 활동량 증가 노력, 운동, 과식정도, 과음빈도, 아침식사 빈도, 식사의 규칙성 항목이 포함되었다. 환경을 생각하는 식생활문화 영역에는 조리 및 음식 먹기 전 손 씻기, 유통기한 (소비기한) 확인, 개인 접시에 덜어 먹기 실천, 냉장고에 보관한 음식 덜어 먹기, 제철음식 섭취, 지역 농산물 이용, 식품 원산지 확인, 음식물 쓰레기 줄이기가 포함되었다. 전국설문조사 노인 (n = 800)의 식생활지침 실천 평균 점수는 56.9점이었고, 식품섭취 영역 49.8점, 식생활습관 영역 63.2점 그리고 식생활문화 영역은 58.6점이었다. 식생활지침 실천 점수는 기 개발된 노인 영양지수 및 식품정보이해력 점수와도 유의한 상관성을 보여서 식생활지침 실천 평가 도구가 식품섭취와 식행동 뿐만 아니라 지속가능한 식생활 실천 부분도 잘 반영한다는 것을 확인할 수 있었다. 앞으로 노인 맞춤형 식생활지침 실천 평가 도구가 노인들의 식품섭취, 식생활습관 및 식생활문화 영역를 종합적으로 평가하는 쉽고 간편한 검색 평가 도구로 활발하게 활용될 것으로 기대된다.

Quality indicators for cervical cancer care in Japan

  • Watanabe, Tomone;Mikami, Mikio;Katabuchi, Hidetaka;Kato, Shingo;Kaneuchi, Masanori;Takahashi, Masahiro;Nakai, Hidekatsu;Nagase, Satoru;Niikura, Hitoshi;Mandai, Masaki;Hirashima, Yasuyuki;Yanai, Hiroyuki;Yamagami, Wataru;Kamitani, Satoru;Higashi, Takahiro
    • Journal of Gynecologic Oncology
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    • 제29권6호
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    • pp.83.1-83.10
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    • 2018
  • Objective: We aimed to propose a set of quality indicators (QIs) based on the clinical guidelines for cervical cancer treatment published by The Japan Society of Gynecologic Oncology, and to assess adherence to standard-of-care as an index of the quality of care for cervical cancer in Japan. Methods: A panel of clinical experts devised the QIs using a modified Delphi method. Adherence to each QI was evaluated using data from a hospital-based cancer registry of patients diagnosed in 2013, and linked with insurance claims data, between October 1, 2012, and December 31, 2014. All patients who received first-line treatment at the participating facility were included. The QI scores were communicated to participating hospitals, and additional data about the reasons for non-adherence were collected. Results: In total, 297 hospitals participated, and the care provided to 15,163 cervical cancer patients was examined using 10 measurable QIs. The adherence rate ranged from 50.0% for 'cystoscope or proctoscope for stage IVA' to 98.8% for 'chemotherapy using platinum for stage IVB'. Despite the variation in care, hospitals reported clinically valid reasons for more than half of the non-adherent cases. Clinically valid reasons accounted for 75%, 90.9%, 73.4%, 44.5%, and 88.1% of presented non-adherent cases respectively. Conclusion: Our study revealed variations in pattern of care as well as an adherence to standards-of-care across Japan. Further assessment of the causes of variation and non-adherence can help identify areas where improvements are needed in patient care.

Large Variation in Clinical Practice amongst Pediatricians in Treating Children with Recurrent Abdominal Pain

  • van Kalleveen, Michael W.;Noordhuis, Elise J.;Lasham, Carole;Plotz, Frans B.
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제22권3호
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    • pp.225-232
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    • 2019
  • Purpose: To evaluate intra- and inter-observer variability and guideline adherence amongst pediatricians in treating children aged between 4 and 18 years referred with recurrent abdominal pain (RAP) without red flags. Methods: The first part of the study is a retrospective single-center cohort study. The diagnostic work-ups of eight pediatricians were compared to the national guidelines. Intra- and inter-observer variability were examined by Cramer's V test. Intra-observer variability was defined as the amount of variation within a pediatrician and inter-observer variability as the amount of variation between pediatricians in the application of diagnostic work-up in children with RAP. Prospectively, the same pediatricians were requested to provide a report on their management strategy with a fictitious case to prove similarities in retrospective diagnostic work-up. Results: A total of 10 patients per pediatrician were analyzed. Retrospectively, a (very) weak association between pediatricians' diagnostic work-ups was found (0.22), which implies high inter-observer variability. The association between intra-observer diagnostic was moderate (range, 0.35-0.46). The Cramer's V of 0.60 in diagnostic work-up between pediatricians in the fictitious case implied the presence of a moderately strong association and lower inter-observer variability than in the retrospective study. Adherence to the guideline was 66.8%. Conclusion: We found a high intra- and inter-observer variability and moderate guideline adherence in daily clinical practice amongst pediatricians in treating children with RAP in a teaching hospital.

성인의 외식 빈도와 관련된 식습관 및 생활습관 요인 분석 (Dietary Behaviors and Lifestyle Characteristics Related to Frequent Eating Out Among Korean Adults)

  • 구슬;박경
    • 한국식품영양과학회지
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    • 제42권5호
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    • pp.705-712
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    • 2013
  • 본 연구에서는 제4기 국민건강영양조사 중 성인 남녀를 대상으로 외식 현황과 이와 관련된 인구사회학적 특성, 영양섭취 수준, 식습관 등을 분석하였다. 본 연구의 결과를 요약하면 첫째, 남성이 여성과 비교하여 외식을 자주하는 경향을 보였고, 도시에 거주하는 젊은 성인일수록, 가구소득 및 교육 수준이 높을수록 더 자주 외식을 하는 것으로 보였다. 둘째, 외식 빈도에 따라 영양 섭취 기준 대비 영양소 섭취비율을 분석한 결과 남녀의 패턴이 유사한 경향을 보였는데, 외식을 자주 하는 사람에게서 대부분의 영양소 섭취가 더 높은 반면 탄수화물 및 조섬유의 섭취는 더 낮은 수준을 보였다. 또한 외식 빈도가 높은 그룹에서 낮은 그룹에 비해 에너지/지방 과잉 섭취자의 비율이 더 높은 경향을 보였다. 셋째, 외식 빈도에 따른 아침 결식률을 분석한 결과, 남녀 모두 외식을 자주 하는 사람일수록 아침결식률이 더 높았고, 특히 이는 여성에게서 두드러졌다. 넷째, 대상자의 한국인 식생활 지침 실천도를 분석한 결과, 나이가 많은 여성일수록 식생활 지침 실천도가 더 높은 것으로 보였고, 남녀 모두 외식을 자주 하는 사람일수록 식생활 지침 실천 점수가 더 낮은 경향을 보였다. 이를 바탕으로 구체적인 문항에 대한 실천도를 비교한 결과, 성별, 연령별로 상이한 식생활 문제점이 파악되었다. 따라서 한국인 식생활 중 외식의 비중이 꾸준히 높아지고 있는 가운데, 성인의 건강한 외식 관련 식생활 문화에 기여하기 위한 공중보건안이 마련되어야 하며, 이러한 영양교육 및 정책 마련 시 본 연구 결과에 근거하여 집단의 특성에 따라 외식 관련 식습관문제점이 차이가 있음을 고려하여야 한다.

Quality of Radiomics Research on Brain Metastasis: A Roadmap to Promote Clinical Translation

  • Chae Jung Park;Yae Won Park;Sung Soo Ahn;Dain Kim;Eui Hyun Kim;Seok-Gu Kang;Jong Hee Chang;Se Hoon Kim;Seung-Koo Lee
    • Korean Journal of Radiology
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    • 제23권1호
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    • pp.77-88
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    • 2022
  • Objective: Our study aimed to evaluate the quality of radiomics studies on brain metastases based on the radiomics quality score (RQS), Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) checklist, and the Image Biomarker Standardization Initiative (IBSI) guidelines. Materials and Methods: PubMed MEDLINE, and EMBASE were searched for articles on radiomics for evaluating brain metastases, published until February 2021. Of the 572 articles, 29 relevant original research articles were included and evaluated according to the RQS, TRIPOD checklist, and IBSI guidelines. Results: External validation was performed in only three studies (10.3%). The median RQS was 3.0 (range, -6 to 12), with a low basic adherence rate of 50.0%. The adherence rate was low in comparison to the "gold standard" (10.3%), stating the potential clinical utility (10.3%), performing the cut-off analysis (3.4%), reporting calibration statistics (6.9%), and providing open science and data (3.4%). None of the studies involved test-retest or phantom studies, prospective studies, or cost-effectiveness analyses. The overall rate of adherence to the TRIPOD checklist was 60.3% and low for reporting title (3.4%), blind assessment of outcome (0%), description of the handling of missing data (0%), and presentation of the full prediction model (0%). The majority of studies lacked pre-processing steps, with bias-field correction, isovoxel resampling, skull stripping, and gray-level discretization performed in only six (20.7%), nine (31.0%), four (3.8%), and four (13.8%) studies, respectively. Conclusion: The overall scientific and reporting quality of radiomics studies on brain metastases published during the study period was insufficient. Radiomics studies should adhere to the RQS, TRIPOD, and IBSI guidelines to facilitate the translation of radiomics into the clinical field.