• 제목/요약/키워드: Health care outcome assessment

검색결과 97건 처리시간 0.025초

Role of Bedside Ultrasonography in Assessment of Diaphragm Function as a Predictor of Success of Weaning in Mechanically Ventilated Patients

  • Elshazly, Mostafa Ibrahim;Kamel, Khaled Mahmoud;Elkorashy, Reem Ibrahim;Ismail, Mohamed Said;Ismail, Jumana Hesham;Assal, Hebatallah Hany
    • Tuberculosis and Respiratory Diseases
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    • 제83권4호
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    • pp.295-302
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    • 2020
  • Background: Weaning failure is common in mechanically ventilated patients, and if ultrasound can predict weaning outcome remains controversial. The purpose of this study was to evaluate the diaphragmatic function (thickness and excursion) measured by ultrasound as a predictor of the extubation outcome. Methods: We included 62 mechanically ventilated patients from the chest intensive care unit in this study. Sixty-two patients who successfully passed the spontaneous breathing trial (SBT) were enrolled. The transthoracic ultrasound of the diaphragm was performed during an SBT to the assess diaphragmatic function (excursion and thickness), and they were classified into the successful extubation group and the failed extubation group. Results: There was a statistically significant increase in the successful extubation group in the diaphragmatic excursion and thickness fraction (p<0.001), a statistically significant negative correlation between the diaphragmatic function and the duration of the mechanical ventilation, and a statistically significant negative correlation between the diaphragmatic excursion and the Acute Physiology and Chronic Health Evaluation II. The diaphragmatic excursion cut-off value predictive of weaning was 1.25 cm, with a specificity of 82.1% and a sensitivity of 97.1% respectively, and the diaphragmatic thickness cut-off value predictive of weaning was 21.5%, with a specificity of 60.7% and a sensitivity of 91.2%, respectively. Conclusion: The diaphragmatic ultrasonography was found to be a promising tool for predicting the extubation outcome for mechanically ventilated patients.

간호사의 환자참여 간호서비스 수행정도와 필요성 인식 (Nurses' Perception of the Performance and Necessity of Nursing Services for Patients Engagement)

  • 이태화;장연수;지윤정;도현옥;오경환;김창경;천자혜;신혜경;조미영;배정임
    • 임상간호연구
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    • 제25권2호
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    • pp.120-132
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    • 2019
  • Purpose: This study aimed to investigate the performance of patient engagement nursing services perceived by nurses and necessity in Korea. Methods: This study was a descriptive research. A total of 205 nurses participated in the study. The Smart Patient Engagement Assessment Checklist was developed by the investigators to assess patient engagement nursing services performance and necessity. The data were collected using online survey. Descriptive analysis and $x^2$ analysis were performed using SPSS 25.0 program. Results: The mean age of participants was $36.6{\pm}8.5years$ and the mean working experience was $12.92{\pm}9.23years$. Seventy eight percent of participants reported that patients and family participated in care as advisors through customer's suggestion or patient satisfaction assessment. The rate of patients' and family's engagement in care as advisors was significantly higher in tertiary hospitals ($x^2=28.54$, p<.001). About 89% of participants communicated with patients and family to make clinical decisions with a multidisciplinary approach. The rate of communication for multidisciplinary decision making was significantly higher in tertiary hospitals ($x^2=6.30$, p=.012). With regards to nurses' bedside patient handoff, 22.0% of participants reported that they were performing bedside patient handoff, and there was no significant difference between type of hospitals. About discharge planning, 72.2% of participants reported utilizing discharge checklist. Conclusion: Currently, patient engagement nursing services are applied partially in Korea. It seems that care protocols to be applied for patient engagement nursing services are insufficient. Therefore, patient engagement care protocols need to be developed to improve patient's health outcome and safety.

우리나라 3차진료기관의 구조적인 특성과 병원사망률의 관계 (Relationship between structural characteristics and hospital mortality rates on tertiary referral hospitals in Korea)

  • 손태용;유승흠
    • Journal of Preventive Medicine and Public Health
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    • 제29권2호
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    • pp.279-294
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    • 1996
  • This study was to evaluate hospital characteristics as composition of manpower and facilities to the death rate of patient; and to earmark the factors affecting the overall hospital mortality rates. The data utilized were derived from survey material conducted by the Korean Hospital Association on 32 tertiary referral hospitals in Korea between 1986 and 1994. The findings are : 1. Those hospitals having the most capacity per bed had little difference to the mortality rates than the others. 2. Those hospitals having the most daily patients per specialist had significantly higher mortality rates than the others, but the number of daily patients per nurse had little effect on the mortality rates. 3. Those hospitals which had a relatively sufficient number of quality assurance activities revealed a lower mortality, and particularly in case where such effort was directed to the clinicians, the outcome was remarkable. We concluded that the major factor affecting the hospital mortality rates seems to be the number of specialists per number of beds, the degree of quality assurance assessment of the clinicians, the quality assurance activities of each hospital as a whole, and the number of daily patient per specialist. According to the findings of this study, the composition and quality of specialist and adequate quality assurance activities seemed to be the essential for the improvement of hospital care. Therefore, in this regard e proper implementation of policy and support is highly recommended. Due to lack of available research material, the personal characteristics of specialists haven't been considered in this study. However, this longitudinal observation of 32 tertiary referral hospitals over a nine year period has significant merit alone.

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아로마테라피가 산전 및 산후 피로에 미치는 영향: 체계적 문헌고찰 및 메타분석 (Fatigue relief by aromatherapy use in prenatal and postnatal women: a systematic review and meta-analysis)

  • 송지아;양혜진
    • 여성건강간호학회지
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    • 제28권2호
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    • pp.87-99
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    • 2022
  • Purpose: The purpose of this systematic review was to examine aromatherapy interventions for prenatal and postnatal women, and to determine the effectiveness of these interventions on fatigue. Methods: Six national and international databases were reviewed to retrieve and collect studies published up to September 7, 2021, describing randomized controlled trials and controlled clinical trials of aromatherapy interventions for prenatal and postnatal women's fatigue. Of the 323 articles initially identified, 64 duplicates were excluded and 259 were screened. After further excluding 216 articles not related to PICO framework, 10 were selected for review. Two reviewers independently selected studies and conducted data extraction and quality appraisal using Cochran's Risk of Bias and Risk of Bias Assessment Tool for Non-randomized Studies. Results: The quality of the 10 selected studies was overall satisfactory. A meta-analysis of three studies showed that aromatherapy with lavender oil produced a 0.75-point reduction in postnatal mothers' fatigue when compared to control groups. Sleep quality was also analyzed as a secondary outcome of fatigue. A meta-analysis of four studies using lavender and/or orange peel oil found that aromatherapy produced a 0.98-point improvement in postnatal mothers' quality of sleep. Although a meta-analysis could not be conducted to synthesize the findings for fatigue in pregnant women, inhalation and massage therapy using lavender oil showed positive effects on prenatal fatigue and sleep quality. Conclusion: Aromatherapy using lavender oil and orange peel oil is effective in improving prenatal and postnatal fatigue and sleep quality.

직장인들의 건강수준 평가를 위한 측정도구의 신뢰도와 타당도 분석 (Reliability and Validity on Measurement Instrument for Health Status Assessment in Occupational Workers)

  • 고상백;장세진;강명근;차봉석;박종구
    • Journal of Preventive Medicine and Public Health
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    • 제30권2호
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    • pp.251-266
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    • 1997
  • In order to test scaling assumption, and to assess the validity, reliability, and acceptability of the Short form 36(SF-36) health survey questionnaire, we conducted a survey. Samples were 296 workers who had been employed in small sized companies. All scale passed for item internal consistency(100% sucess rate) and item discriminant validity(100% success .ate). Reliability coefficients were ranged from the lowest 0.51 to the highest of 0.85. For 87.5% of the total workers, inconsistent responses were not observed. Only 3.0% of the total workers failed two or more checks. Factor analysis was performed using principal axis factor method and quartimax rotation. In this survey, the SF-36 retained available psychometric properties even when used in a generally healthy worker group. But further study with some consideration to develope health status measurement is expected : first, the definition of health status should be rationalized. Second, the measurement of outcome is an important consideration in evaluations of quality of care. But ambiguities hinder understanding of this important topic. Third, internal consistency should be interpreted with caution as an indication reliability because it ignores potentially important sources of variation that can occur over time.

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Effects of Lumbar Mobilization for Lower Limb Strength in Healthy Individuals: A Protocol for Systematic Review and Meta-Analysis

  • Choi, Wansuk;Choi, Taeseok;An, Hojung;Kim, Jisung;Heo, Seoyoon
    • 국제물리치료학회지
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    • 제11권2호
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    • pp.2096-2101
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    • 2020
  • Background: The effect of mobilization on lumbar back pain has been fully described in several clinical aspects, but evidence for muscle strength would be still less clear. Objective: To assess the effect of lumbar mobilization on lower limb strength in healthy individuals. Methods and Analysis: Healthy people aged 18-65 will be included regardless of race or sex. Original peer-reviewed primary reporting randomized controlled trials (RCTs) will be included. Electronic databases, such as MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, Pedro, CINAHL, ClinicalTrials.gov will be searched from inception until July 30. Only studies published in English will be included in this review. Two reviewers will complete the screening for eligibility independently, and the other two reviewers will also complete the risks of data extraction and bias assessment independently. Lower Limb strength will be assessed as primary outcome, and particular intervention or participant characteristics will be assessed as the secondary outcomes. Meta-analysis will be conducted using Review Manager 5.3.3, and evidence level will be assessed using the method for Grading of Recommendations Assessment, Development and Evaluation. Outcomes will be presented as the weighted mean difference or standardized mean difference with 95% CI. If I2 ≤ 50%, P>.1, the fixed effect model will be used, otherwise, random-effects model will be used. Ethics and dissemination: This review might not be necessary ethical approval because it does not require individual patient's data; these findings will be published in conference presentations or peer-reviewed journal articles. PROSPERO registration number: CRD42020150144.

백내장 수술환자 진료결과들간의 관계 - 사전 연구를 중심으로 - (Relationship among Patient Outcomes in Cataract Surgical Patient - Pilot study -)

  • 박은철;김한중;홍영재;조우현;손명세;임승정;강형곤;최윤정
    • 한국의료질향상학회지
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    • 제5권1호
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    • pp.106-118
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    • 1998
  • Background : This study was done to assess the relationship among multiple patient outcomes of cataract surgery perioperatively, 3-4 months and 12 months after surgery. The patient outcomes include changes in visual acuity(operated eye, better eye), visual function(VF-14), patient satisfaction, subjective satisfaction with vision, and subjective overall health status. Methods : For the assessment of relationship, prospective study was performed with 92 patients who had undergone either one or both eye cataract surgery by 3 ophthalmologists practicing at a university hospital. Patients were interviewed. and clinical data were obtained. Doctors were questioned with self-entered questionnaire forms. Medical record was examined to understand surgery process. The survey was conducted at 4 stages : preoperatively, perioperatively, postoperative 3-4 months, and postoperative 12 months. Results : The correlations within patient outcomes at 4 stages - the visual acuity of operated eye and that of better eye, patient satisfaction and VF-14, subjective overall health status and relative health status as against others - were found to be positively correlated. The change in the visual acuity of operated eye and better eye was correlated with VF-14 as well as with patient satisfaction. The change was also correlated with overall health status. However, the correlations between variables were decreased as the postoperative period got longer. Conclusion : As for the postoperative clinical patient outcomes, VF-14 is acted to linker between visual acuity - clinical outcomes and overall health status - endpoint outcomes. Therefore. VF-14 is the index of patient-sided and disease-specific outcome for cataract surgery.

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물리치료 연구동향과 미래연구 (Trend of Physical Therapy Research and Future Study)

  • 김용천;오경환;황성수;오경아;권혜정
    • 대한물리치료과학회지
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    • 제1권2호
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    • pp.251-263
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    • 1994
  • This article considers the trend of Korea physical therapy reaearch. Because physical therapy research is important for the continued growth of the physical therapy profesion. Such research results in improved patient care and heightens the professional standing of the physical therapy field. The purpose of this article is to discuss a current research trend and to suggest a direction for developing a physical therapy research. We discussed a research design, purposes, and methods. Measurement are fundamental to the practice of physical therapy. The physical therapy evaluation is the foundation for the measurement of the outcome of our therapertic intervention. And we must measure thess outcomes. Achieving a high quality of physical therapy practice requires us to evaluate the client, selecting and adminstering a variety of tests and measurent. For the future study, physical therapist has a good treatment model and research program for evaluating and assessment.

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혈액투석환자의 이행과 건강관련 삶의 질 간의 관계 (Relationships between compliance and health-related quality of life in patients with hemodialysis)

  • 차지은
    • 한국산학기술학회논문지
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    • 제16권10호
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    • pp.6495-6503
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    • 2015
  • 본 연구는 혈액투석환자의 이행 수준을 파악하고 이행과 생리적 지표, 건강관련 삶의 질 간의 관계를 조사하였다. 지역 투석의원 27곳에서 220명의 혈액투석환자로부터 자료를 수집하였다. 이행은 투석 간 체중증가, 혈중 칼륨과 인과 함께 환자역할행위이행 도구로 측정하였고 건강관련 삶의 질은 MOS-SF 12로 측정하였다. 자료는 서술통계, t-test, ANOVA, 피어슨 상관계수로 분석하였다. 이행의 평균 점수는 4점을 기준으로 2.92점이었고, 전체 15개 이행 항목 중 투석스케줄 지키기에서 가장 높은 점수를 보였다. 이행 수준은 연령, 결혼상태, 투석기간에 따라 유의한 차이가 있었으며, 이행 항목 중에서 복약, 감염관리, 수면, 야채와 과일섭취가 건강관련 삶의 질과 유의한 상관관계를 보였다. 본 연구결과는 혈액투석환자의 삶의 질을 향상시키기 위해 환자중심 접근이 도움이 될 것임을 시사한다. 건강돌봄제공자들은 환자에게 중요한 이행을 확인하고 환자의 가치와 우선순위를 고려함으로써 환자들의 입장을 이해할 필요가 있다.

만성질환 노인을 위한 운동교실 통합 자기관리교육 프로그램(하하프로그램)의 개발과정과 내용 (The Development Process and the Contents of the Self-management Education Program Integrated with Exercise Training (HAHA program) for Older Adults with Chronic Diseases)

  • 김선호;송미순;박연환;송욱;조비룡;임재영;소위영
    • 근관절건강학회지
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    • 제18권2호
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    • pp.169-181
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    • 2011
  • Purpose: This paper presents the development process and the final contents of the sellf- management education program integrated with exercise training (Healthy Aging Happy Aging, HAHA program) for community residing older adults with chronic diseases. Methods: The program evaluation methodology was applied which is an interactive program development process based on needs assessment, formative evaluation, process evaluation and outcome evaluation. The program was developed and revised while the program was implementing to 22 hypertension (HT) and 32 diabetic (DM) participants. Results: The final program has two sub-programs for HT and DM participants utilizing self-efficacy resources. They share four common components; 1) health screening of exercise risks, 2) weekly 1-hour group self-management education classes, 3) biweekly 1-hour group exercise training and 4) a mid-term individual counseling. Both sub-programs were 12-weeks long but have different education and exercise contents. Participants-rated mean satisfaction scores were 3.47/4 and 3.61/4 for HT and DM program respectively. Attendance rate were 83.1% ~ 92.3% for the classes. Conclusion: The HAHA program developed by multidisciplinary team which reflected participants needs was accepted well by participants evidenced by high attendance rate and perceived satisfaction level.