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Myths and truths about pediatric psychogenic nonepileptic seizures

  • Yeom, Jung Sook;Bernard, Heather;Koh, Sookyong
    • Clinical and Experimental Pediatrics
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    • v.64 no.6
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    • pp.251-259
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    • 2021
  • Psychogenic nonepileptic seizures (PNES) is a neuropsychiatric condition that causes a transient alteration of consciousness and loss of self-control. PNES, which occur in vulnerable individuals who often have experienced trauma and are precipitated by overwhelming circumstances, are a body's expression of a distressed mind, a cry for help. PNES are misunderstood, mistreated, under-recognized, and underdiagnosed. The mind-body dichotomy, an artificial divide between physical and mental health and brain disorders into neurology and psychiatry, contributes to undue delays in the diagnosis and treatment of PNES. One of the major barriers in the effective diagnosis and treatment of PNES is the dissonance caused by different illness perceptions between patients and providers. While patients are bewildered by their experiences of disabling attacks beyond their control or comprehension, providers consider PNES trivial because they are not epileptic seizures and are caused by psychological stress. The belief that patients with PNES are feigning or controlling their symptoms leads to negative attitudes of healthcare providers, which in turn lead to a failure to provide the support and respect that patients with PNES so desperately need and deserve. A biopsychosocial perspective and better understanding of the neurobiology of PNES may help bridge this great divide between brain and behavior and improve our interaction with patients, thereby improving prognosis. Knowledge of dysregulated stress hormones, autonomic nervous system dysfunction, and altered brain connectivity in PNES will better prepare providers to communicate with patients how intangible emotional stressors could cause tangible involuntary movements and altered awareness.

The Effects of a Mobile Computerized System for Individual Tailored Home Care Services in a City (일 지역 이동형 방문보건 전산시스템의 재구축과 활용의 효과)

  • Park, Nam-Hee;Jang, Rang;Kim, Jung-Young;Kim, Myoung-Soo
    • Research in Community and Public Health Nursing
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    • v.23 no.1
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    • pp.71-81
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    • 2012
  • Purpose: The aim of this study was to evaluate the process and outcome of a mobile computerized system for individual home visiting healthcare. Methods: A nonequivalent control group non-synchronized design was employed for this study. The newly constructed system was administered to 80 healthcare providers in the experimental group for 8 weeks. Data were analyzed using descriptive analysis, t-test, and ANCOVA with the SPSS 18.0 program. Results: In the process stage, the difference in the frequency of computerized information usage between the experimental and control groups was significant as $8.88{\pm}3.20$ and $7.08{\pm}2.92$, respectively (t=3.90, p<.001). In the outcome evaluation stage, all kinds of healthy lifestyle such as alcohol use, nutrition, weight management and mental health were not improved. Conclusion: The findings of this study showed that the revised mobile computerized system was an effective device for individual visiting healthcare providers. Further advanced strategies for using this system should be developed and applied in a broad range of community healthcare.

Role for Social Media in Pediatric Liver Disease: Caregiver and Provider Perspectives

  • Mogul, Douglas B.;Bowring, Mary Grace;Lau, Jennifer;Babin, Erin;Bridges, John F.P.;Harpavat, Sanjiv;Miloh, Tamir
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.6
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    • pp.548-557
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    • 2020
  • Purpose: To better understand the benefits and harms of engagement with online pediatric liver disease communities within social media. Methods: We conducted a survey of caregivers of children with liver disease participating in online pediatric liver disease communities within social media, as well as a survey of healthcare providers (e.g., physicians, surgeons, nurse coordinators) from this field to better understand the perceived benefits and harms of participation. Results: Among 138 caregivers of children with liver disease that completed the survey, 97.8% agreed social media was a good place to learn about patient experiences and 88% agreed it was a good source of general information. Among caregivers, 84.8% agreed social media helps them to better advocate for their child. While 18% agreed that the information over social media was equal to the information from their healthcare team and 19% neither agreed/disagreed, only 3% indicated they would use this information to change care without telling their provider; in contrast, among 217 healthcare providers, 55% believed social media may lead caregivers to change management without telling their team. Conclusion: Engagement with online disease-specific communities in social media yields several benefits for caregivers and, in contrast to healthcare providers' concerns, participation is unlikely to lead to problems including caregivers changing the treatment plan without first discussing these plans with their team. Openness between caregivers and medical teams about the role for social media can help to improve trust and maximize the potential benefits of engagement with these groups.

A Comparative Study of Consumers and Providers on Nursing Service Quality, Satisfaction, and Hospital Revisiting Intent (간호서비스 질, 만족 및 병원 재이용 의도에 관한 소비자와 제공자간의 지각차이 비교)

  • Lee, Mi-Aie;Yom, Young-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.11 no.4
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    • pp.425-437
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    • 2005
  • Purpose: The purposes of this study were to compare the nursing service quality, gap, overall nursing service satisfaction, overall medical service satisfaction and intent to revisit the hospital perceived by consumers and providers. Methods: Data were collected with self-administered questionnaire and analyzed using frequency, %, mean, standard deviation, t-test, Pearson correlation coefficient, and multiple regression analysis. Result: Nursing service gap perceived by consumers was smaller than that of providers. Consumer's overall satisfaction with nursing and medical service was higher than that of nurses. In consumers, nursing service satisfaction alone accounted for 62.9% of the variance in their intent to revisit the hospital, while explained 3% of the variance in providers. Conclusion: There are definitely perception gap between consumers and providers. Therefore nursing and hospital managers must recognize it, and carry out the internal marketing strategies for nurses.

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A Study on the Consumer Disputes and Protection Measures of the Digital Healthcare Market and O2O Service (디지털헬스케어 시장과 O2O서비스 소비자분쟁 및 보호방안)

  • Byeon, Seung Hyeok
    • Journal of Arbitration Studies
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    • v.30 no.4
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    • pp.121-138
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    • 2020
  • The O2O services in the healthcare sector have only been in full swing for about three years, and unlike existing O2O consumer goods, the scale and scope of the dispute are more complicated due to restrictions on medical treatment. In this study, O2O service platform operators and medical institutions' roles and responsibilities were redefined as a countermeasure for resolving disputes in healthcare O2O services and the laws for changing the transaction environment. A change in institutional mechanisms was proposed. This study looked at the types of consumer disputes related to healthcare O2O services as insufficient information problems, problems in the course of medical service implementation, problems with immunity provisions for platform operators, cancellations, and non-compliance with refunds. All the information generated during transactions in the healthcare sector was extensive in scale and included the most sensitive information among personal information, stressing the importance of ensuring security. The area that started in the O2O range before the medical institution visit also proposed a plan to establish a system for the delivery of proven information as a pre-medical person. The scale and growth will grow faster, given that consumers can experience the information they want anytime, anywhere they want. However, the platform broker's role, a link player, will become more important because consumers who use the service will have their first meeting with non-face-to-face product providers. On the other hand, service providers may have side effects of misleading consumers by providing false information or misleading consumers through exaggerated advertisements. The O2O service market is expected to expand beyond distribution and dining out to the entire industry. However, since it is challenging to check accurate statistics on the detailed market, various disputes and consumer protection measures will be required for each detailed market, and comprehensive leading solutions will be essential in the future.

Automated external defibrillator electrode pad placement by the general public and health-care providers : A manikin study (일반인 및 의료종사자들의 자동제세동기를 이용한 제세동에서 전극부착 위치에 관한 연구: 마네킨을 이용한 연구)

  • Park, Si-Eun
    • The Korean Journal of Emergency Medical Services
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    • v.20 no.1
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    • pp.83-94
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    • 2016
  • Purpose: This study aimed to assess defibrillator pad positioning by the general public and healthcare providers during basic life support (BLS) renewal education (RE). Methods: A total 130 subjects performed defibrillation using an automated external defibrillator (AED) equipped with electrode pads developed by the researchers and male resuscitation manikins, in order to assess electrode pad placement (EPP) before BLS RE. Subjects included 54 Healthcare providers (HP) and 76 members of the general public (GP). Results: The apex EPP was positioned in the risk area (RA), more than 5 cm distant from the area recommended, by 63.2% of the GP (n = 48). The apex EPP was positioned in the RA by 44.4% of the HP (n = 23). The distance from the apex (GP $5.27{\pm}2.21cm$, HP $4.18{\pm}1.71cm$) was statistically significant, using Student's t-test. Conclusion: For both GP and HP, apex EPP was significantly in error. Thus, to prevent defibrillation failures, EPP education and practice for GP and HP in all BLS education programs should be improved, and incorrect Korean cardiopulmonary resuscitation guidelines and related literature should be revised and corrected.

A study on the Improvement of Welfare System for Care Worker in Seoul (서울시 요양보호사 처우개선을 위한 지원방안 연구)

  • Kim, Jihye;Kim, Seokjoon;Lee, Junyoung;Lee, Okjin;Oh, Gayoung
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.17 no.4
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    • pp.15-23
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    • 2011
  • Long-term care Insurance system for the Elderly was started to respond to the aged society on July 2008 in Korea. So responsibility of the care for the old is being changed from the family to the society. The introduction of that insurance system has brought the growth of demand for care service. To improve the level of quality for care service providers in long-term care, the role of care worker in providers is recognized as important. But welfare system for the care worker seems to be poor. So the Seoul Metropolitan Council is preparing an ordinance for the care worker and the purpose of this study is for the ordinance as well. Questionnaires, interviews, documentary surveys were used to carry out this study. The results of this study are summarized as follows. The job stability is the most important thing for the care worker, so local government has to make efforts to promote the job stability of care worker. A welfare center for care workers is needed for the health for care workers in the local government. And the local government has to supervise service providers more strictly and evaluate them in treatments of care worker.

Development of ML and IoT Enabled Disease Diagnosis Model for a Smart Healthcare System

  • Mehra, Navita;Mittal, Pooja
    • International Journal of Computer Science & Network Security
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    • v.22 no.7
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    • pp.1-12
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    • 2022
  • The current progression in the Internet of Things (IoT) and Machine Learning (ML) based technologies converted the traditional healthcare system into a smart healthcare system. The incorporation of IoT and ML has changed the way of treating patients and offers lots of opportunities in the healthcare domain. In this view, this research article presents a new IoT and ML-based disease diagnosis model for the diagnosis of different diseases. In the proposed model, vital signs are collected via IoT-based smart medical devices, and the analysis is done by using different data mining techniques for detecting the possibility of risk in people's health status. Recommendations are made based on the results generated by different data mining techniques, for high-risk patients, an emergency alert will be generated to healthcare service providers and family members. Implementation of this model is done on Anaconda Jupyter notebook by using different Python libraries in it. The result states that among all data mining techniques, SVM achieved the highest accuracy of 0.897 on the same dataset for classification of Parkinson's disease.

A Phased Plan for the Expansion of Hospice and Palliative Care

  • So Young Park
    • Journal of Hospice and Palliative Care
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    • v.27 no.3
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    • pp.103-106
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    • 2024
  • Palliative care is a comprehensive approach aimed at improving the quality of life for patients and their families. The symptom burden and care needs of patients with end-stage, non-malignant diseases are similar to those experienced by patients with advanced cancer. Therefore, the World Health Organization (WHO) has recommended the expansion of palliative care to encompass a broad spectrum of diseases. However, in Korea, the adoption of palliative care for non-malignant conditions remains markedly low, presenting numerous challenges that differ from those associated with cancer. Key barriers to implementing hospice care for non-malignant diseases include the difficulty in predicting end-of-life and a general lack of awareness about hospice palliative care among healthcare providers, patients, and their families. Additionally, there is a risk that suggesting palliative care to patients with non-malignant diseases might be misinterpreted as an endorsement by healthcare providers to cease treatment or abandon the patient. This article explores strategies to broaden the scope of hospice and palliative care for patients with non-malignant diseases.

Education Topics for the Development of Doctors' Public Healthcare Competencies (의사의 공중보건 역량 개발을 위한 교육주제)

  • Ahn, Ducksun
    • Korean Medical Education Review
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    • v.24 no.1
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    • pp.35-45
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    • 2022
  • Needs for public healthcare have recently increased. This paper proposes education topics for competency development in public healthcare in line with the needs of the times. In Korea, various lifelong education providers have already provided public health-related education. For example, the Research Institute for Health Policy (RIHP) under the Korean Medical Association provided an "executive course for physicians' public health care competencies" in 2019 and 2020. At the end of the course, the RIHP published a comprehensive report, entitled "Curricular development and evaluation for doctors' public healthcare competencies." This article is based on a summary of that report. To develop a curriculum for public healthcare, the RIHP adopted the following methodologies for a needs analysis; reviewing already-existing education subjects, evaluating end-of-course reports, and conducting in-depth focused group interviews and questionnaire surveys with doctors at public healthcare-related institutions. The results from the needs analysis can be categorized into two domains of education topics for public healthcare. The first domain includes education subjects related to the theory and practice of public healthcare, as follows: a general overview, community or population health, organizational administration, planning and evaluation, budget and finance, responses to disasters such as infectious diseases, health policy, and the legal system. The second domain contained education topics related to general professional competencies: leadership, communication, cooperation, teamwork, and professionalism. In conclusion, the curricular content for public healthcare will be an appropriate combination of competencies specific to public healthcare and core competencies for health professionals.