• Title/Summary/Keyword: Hospital-based intervention

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A Survey on the Status of Hospital-Based Early Intensive Intervention for Autism Spectrum Disorder in South Korea (국내 자폐스펙트럼장애 아동의 병원 기반 조기 집중 중재 실태 조사)

  • Lee, Ju Young;Moon, Duk-Soo;Shin, Suk-Ho;Yoo, Hee-Jung;Byun, Hee-Jung;Suh, Dong-Soo
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.28 no.4
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    • pp.213-219
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    • 2017
  • Objectives: Early intensive interventions are very important for children with autism spectrum disorder. We examined the actual conditions of hospital-based early intensive interventions for autism spectrum disorder in Seoul, in order to help develop and implement an evidence-based early intensive intervention model for use in Korea. Methods: Nine hospital-based institutes running an early intensive intervention program for children with autism spectrum disorder responded to a questionnaire in September 2014. They provided a brief introduction to their program, explained its theoretical bases, and reported the number of children, their age, intervention time, duration and so on. Results: In the majority of the institutions, the intervention was provided for over 20 hours every week, and the theoretical bases included various applied behavioral analysis (ABA) methods and other therapies (language and occupational therapy). The therapist-child ratio ranged from 1:1 to 5:3. Various types of therapists were involved, including behavioral analysts, special education teachers and (or) language pathologists. There was only one clinic where the behavioral analyst was the main therapist. Usually, the intervention was terminated just before the child entered elementary school. The main merit of the hospital-based intervention in our survey was the effectiveness of the multi-disciplinary intervention plan and its other merits were the accuracy of the diagnosis, its ability to be combined with medicine, and so on. Conclusion: The current hospital-based early intensive intervention programs provide interventions for over 20 hours per week and employ multidisciplinary approaches. However, there are very few institutes for children with autism and very few intervention specialists and specialist education courses in the country. We need more educational programs for intervention therapists and have to try to develop policies which encourage the implementation of an evidence-based early intensive intervention program nationwide.

The effect of a hospital-based smoking cessation intervention on the continuous abstinence rate from smoking over 12 months in patients with cerebral infarction (병원기반 금연중재가 뇌경색 환자의 퇴원 후 12개월 지속 금연율에 미치는 효과)

  • Lee, Young-Hoon;Oh, Gyung-Jae;Han, Mi-Hee;Kim, Gue-Jin;Park, Hyun Young;Kim, Hee-Sook;Lee, Kun Sei
    • Korean Journal of Health Education and Promotion
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    • v.33 no.3
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    • pp.61-70
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    • 2016
  • Objectives: The aim of this study was to investigate the effectiveness of a hospital-based smoking cessation intervention for increasing continuous abstinence rate from smoking in patients with cerebral infarction. Methods: One-hundred and two smokers with cerebral infarction who decided to quit smoking were enrolled in the smoking cessation intervention from December 2012 to February 2015. The smokers underwent six consecutive times of individual intervention with nurse specialist on smoking cessation including education on behavioral modification, counseling for withdrawal symptoms, and anti-smoking advice over a 12-month period. Results: Among the total participants, the continuous abstinence rate from smoking changed from 79.4% at 1 month to 60.8% at 12 months after discharge. The continuous abstinence rate from smoking after 12 months was 88.5% in participants who completed the entire program (6 times), while 51.3% in participants who did not complete the entire program (${\leq}5$ times) (P=0.001). After adjustment for general and smoking-related characteristics, complete implementation of hospital-based smoking cessation intervention was significantly associated with continuous abstinence from smoking after 12 months (odds ratio: 5.93; 95% confidence interval: 1.45-24.22). Conclusions: The hospital-based smoking cessation intervention might be effective for smoking cessation in patients with cerebral infarction, especially when the intervention was implemented thoroughly.

Effects of Group Comprehensive Behavioral Intervention for Tics in Children With Tourette's Disorder and Chronic Tic Disorder

  • Kang, Na Ri;Kim, Hui-Jeong;Moon, Duk Soo;Kwack, Young Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.33 no.4
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    • pp.91-98
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    • 2022
  • Objectives: Comprehensive behavioral intervention for tics (CBIT) is effective in children with chronic tic disorders. This study aimed to assess the effect of group-based CBIT (group-CBIT) on tic severity and comorbid symptoms. We compared the efficacy of group CBIT with that of a control. Methods: Thirty children with chronic tic disorder or Tourette's disorder were enrolled in this study. Eighteen were assigned to the group-CBIT for eight sessions, and 12 were assigned to the control group. Tics and comorbid symptoms were assessed pre- and post-intervention using the Yale Global Tic Severity Scale (YGTSS), Premonitory Urge for Tics Scale, attention-deficit hyperactivity disorder Rating Scale-IV, Children's Yale-Brown Obsessive-Compulsive Scale, and the Korean-Children Behavioral Checklist. We compared the pre- and post-intervention results of each group and determined the difference in the pre- and post-intervention results between intervention and the control group. Results: The YGTSS motor and vocal tic interference, global impairment, and global severity scores decreased in the intervention group only. Group CBIT was superior in reducing the motor tic interference, impairment score, and global severity score to the control group. Conclusion: The group-CBIT showed an improvement in tic symptoms, especially in reducing the level of interference and impairment of tics.

Effects of Nutritional Interventions based on Enteral Nutrition Guidelines for Neurosurgical Intensive Care Unit Patients (신경외과 중환자실 환자의 경장영양 지침서 적용에 따른 영양적 중재 효과)

  • Han, Jung-Hee;Kim, Young Ran;Lee, Young Min;Kim, Ae Lee;Kim, Ho Jin;Jeong, Young-Gyun;Ryu, Jeong Ha
    • Quality Improvement in Health Care
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    • v.17 no.1
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    • pp.79-88
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    • 2011
  • Background : Evidence-based guidelines are now used for enteral nutrition(EN) in neurosurgical intensive care unit patients who mostly depend on EN. This study compared and analyzed the nutritive conditions of patients before and after they underwent guideline based nutritional interventions in order to determine whether using these guidelines improved their calorie supply. Methods : Data on the patients' nutritional requirements, maximum calorie supply through EN, serum albumin level, and total lymphocyte count were collected and analyzed using SAS version 9.1.3. All the statistical analyses were performed at a significance level of P<0.05. Result : The maximum calorie supply through EN was $923.1{\pm}359.7$ kcal before the intervention and $1254.4{\pm}196.3$ kcal after the intervention; this difference was statistically significant(P<0.05). The ratio of nutritional requirements to maximum calorie supply through EN was $55.5{\pm}22.4%$ and $74.2{\pm}13.9%$ before and after the intervention, respectively; this difference was statistically significant(P<0.05). This indicates a 19% increase in the ratio after the nutritional intervention. The serum albumin level also significantly increased from $2.7{\pm}0.6g/dL$ before the intervention to $3.2{\pm}0.4g/dL$ after the intervention(P<0.05). The total lymphocyte count slightly increased from $1267.7{\pm}728.2cells/mm^3$ before the intervention to $1801.9{\pm}1211.5cells/mm^3$ after the intervention; this difference was not statistically significant. Conclusion : The results showed that using the evidence-based feeding guidelines for interventions increased the calorie supply and improved the patients' nutritive conditions from moderate malnutrition to mild malnutrition.

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Adaptation and Effects of the Evidence-based IPC Nursing Protocol on Prevention of Postoperative Venous Thromboembolism (외과적 수술 후 정맥혈전색전증 예방을 위한 근거기반 IPC(Intermittent Pneumatic Compression) 간호프로토콜의 수용개작 및 효과)

  • Kim, Nam Yong;Kim, Eun A;Sim, Jae Yeun;Jung, Soon Hee;Kim, Hye Young;Jang, Eun Hee;Shin, Jee Hye
    • Journal of Korean Academy of Nursing Administration
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    • v.23 no.1
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    • pp.63-75
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    • 2017
  • Purpose: This study was conducted to adapt the standardized evidence-based nursing protocol using the IPC (intermittent pneumatic compression) intervention to prevent venous thromboembolism in surgical patients. Further, an investigation was done to measure knowledge on prevention of venous thromboembolism, surrogate incidence of venous thromboembolism and to assess IPC compliance in the study patients compared with those in surgical patients who underwent IPC intervention due to previous clinical experience. Methods: An analysis was done of the nine modules suggested by National Evidence-based Healthcare Collaborating Agency (NECA) in the adaptation manual of the clinical practice guideline for protocol adaptation. A nonequivalent control group post test design as a quasi-experiment was used to verify the effect of the IPC protocol. Results: There was a significant difference in knowledge of prevention of venous thromboembolism, IPC application time after intervention and the number of IPC applications between the experimental group (n=50) using the IPC nursing protocol and the control group (n=49). However, the symptoms of deep vein thrombosis and pulmonary thromboembolism were not observed in either the experimental group or the control group after the intervention. Conclusion: Results confirm that the standardized IPC nursing protocol provides effective intervention to prevent venous thromboembolism in surgical patients.

Effects of a Class-Based School Violence Prevention Program for Elementary School Students

  • Lim, Soo Youn;Kang, Na Ri;Kwack, Young Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.29 no.2
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    • pp.54-61
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    • 2018
  • Objectives: This study was conducted to investigate the effectiveness of a class-based school violence prevention program for elementary school student. Methods: 29 students were assigned to the school violence prevention program of 8 sessions, 28 students have been assigned to the control group. We assessed participants at baseline and post-intervention, through their self-report questionnaires such as Children's Depression Inventory (CDI), Strengths and Difficulties Questionnaire and school violence experience, awareness about school violence, and coping ability to school violence. We compared the baseline and post-intervention result of each group and compared the post-test scores between the intervention group and the control group. Results: Comparing the intervention group and the control group, the post-intervention CDI total score and the awareness about school violence showed significant improvement in the intervention group. When compared according to gender, male students' perception of school violence was improved, and female students showed significant differences in CDI scores. Conclusion: The CDI total scores and the perception of school violence were improved in the intervention group compared to the control group. And there are differential pattern of intervention effects according to gender. These findings have important implications to develop effective violence prevention programs.

The Effect of TENS by Physiotherapist versus Home based TENS Intervention to reduce Pain and Improve Disability in Patients with Mechanical Neck Disorder (치료사에 의해 적용된 경피신경전기자극과 가정에서 시행된 경피신경전기자극이 경부통 환자의 통증과 장애에 미치는 영향)

  • Park, Jae-Myoung;Yang, Sung-Hwa;Lee, Jun-Yong;Lee, Jae-Min;Jung, Min-Keun
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.16 no.2
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    • pp.61-66
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    • 2010
  • Purpose: The purpose of this study was to determine the effect of TENS by physiotherapist versus home based TENS intervention to reduce pain and improve disability in patients with mechanical neck disorder. Methods: The subjects of the study were 30 selected patients who had been diagnosed with subacute or chronic neck disorders without neurological damage, during the period of four weeks, three times a week, and thirty minutes for one session, 15 patients received TENS by physiotherapist. 15 patients received home based TENS intervention. The primary outcome was pain intensity measured in using the Visual Analog Scale(VAS). The second outcome was Neck Disability Index to patient's disability. Results: The change in the pain perception degree were statistically significant in both group(p<0.05). TENS by physiotherapist group showed significantly improvement in disability, but, Home based TENS intervention group is not. TENS by physiotherapist group showed significantly greater improvement in pain intensity and patient's disability than the home based TENS intervention group. Conclusion: This study shows that received TENS by physiotherapist was effective in reducing pain, improving disability for mechanical neck disorder patient, physiotherapist' knowledge need to improve patient's pain and disability.

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The Effect of PNF-Based Weight Support Exercise on Weight-Supporting Ability, Fear of Falling, and Stair-Walking Ability of Subacute Stroke Patients (PNF를 이용한 체중지지훈련이 아급성 뇌졸중 환자의 체중지지, 낙상에 대한 두려움 및 계단보행 기능에 미치는 영향 -증례보고-)

  • Kim, Chang-Beom
    • PNF and Movement
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    • v.15 no.1
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    • pp.105-113
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    • 2017
  • Purpose: The purpose of this case study was to examine the effects of an intervention based on the concept of proprioceptive neuromuscular facilitation (PNF) on the weight-supporting ability, fear of falling, and stair-walking ability of stroke patients. Methods: One pretest, three intervention sessions, and one posttest were conducted. In the tests, weight-supporting ability, manual muscle strength, the fear of falling, and the time to go up and down a 'ㄱ'-shaped stair-walking machine were measured and compared. The intervention was implemented for 30 minutes per day for three days in combination with general rehabilitation. The intervention was planned and implemented based on the concept of PNF, and the goal was for the subjects, after their consent, to walk backward down the stairs. Results: After the intervention, functional improvement was seen in weight-supporting ability and the fear of falling felt when walking down the stairs. Whereas the subjects could not perform the task of walking down the stairs on the 'ㄱ'-shaped stair-walking machine in the pretest, they could perform the task in the posttest, and their stair-climbing speed was greater than before the intervention. Conclusion: This study verified that a PNF-based intervention can improve stroke patients' weight-supporting ability and stair-walking ability. Therefore, this intervention can be clinically applied to stroke patients.

The Effect of a Computerized Pharmacist Communication Application-based SBAR Tool

  • Young Ju Cheon;Kyong Nam Ye;Jung Bo Kim;Jung Tae Kim;Sook Hee An
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.2
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    • pp.135-142
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    • 2023
  • Background: Pharmacists communicate with a variety of healthcare experts to prevent medication errors. Situation-Background-Assessment-Recommendation (SBAR) is a tool used for concise and accurate communication. In 2018, we developed the pharmacy-SBAR (P-SBAR) to deliver pharmacists intervention more quickly and effectively through quality improvement activities. Objectives: This study evaluates the efficacy of P-SBAR on pharmacists' intervention activities before and after the implementation of P-SBAR applications. We assessed the impact of P-SBAR on reducing the burden of intervention work, promoting pharmacists' participation, and enhancing the acceptance rate. Methods: This is a retrospective study of the two groups before and after P-SBAR implementation. All pharmacists' intervention records during two periods (2016-2017 and 2019-2020) were extracted from the data warehouse system at Kyunghee University Hospital at Gangdong, Seoul. The outcome was the number of inpatients and pharmacists who participated in the prescription monitoring activity, the number of interventions, and the physicians' acceptance rate. Results: Although the total number of inpatients decreased (364,753 vs. 348,229), the number of pharmacists who participated in intervention activity increased (monthly mean: 15.8 vs. 18.0, p=0.001). The total number of interventions (2,767 vs. 4,389), the frequency of full acceptance (2,018 vs. 3,710), and the monthly acceptance rate increased significantly (73.8% vs. 83.8%, p<0.001). Conclusion: P-SBAR improved accessibility and convenience by digitalizing the intervention activities performed in an offline environment. Improvement in work burden and acceptance rate using P-SBAR is expected to contribute toward reducing medication errors.

Effect of National Implementation of Telephone CPR Program to Improve Outcomes from Out-of-Hospital Cardiac Arrest: an Interrupted Time-Series Analysis

  • Lee, Yu Jin;Hwang, Seung-sik;Shin, Sang Do;Lee, Seung Chul;Song, Kyoung Jun
    • Journal of Korean Medical Science
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    • v.33 no.51
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    • pp.328.1-328.12
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    • 2018
  • Background: In cardiac arrest, the survival rate increases with the provision of bystander cardiopulmonary resuscitation (CPR), of which the initial response and treatment are critical. Telephone CPR is among the effective methods that might increase the provision of bystander CPR. This study aimed to describe and examine the improvement of neurological outcomes in individuals with out-of-hospital acute cardiac arrest by implementing the nationwide, standardized telephone CPR program. Methods: Data from the emergency medical service-based cardiac arrest registry that were collected between 2009 and 2014 were used. The effectiveness of the intervention in the interrupted time-series study was determined via a segmented regression analysis, which showed the risk ratio and risk difference in good neurological outcomes before and after the intervention. Results: Of 164,221 patients, 148,403 were analyzed. However, patients with unknown sex and limited data on treatment outcomes were excluded. Approximately 64.3% patients were men, with an average age of 63.7 years. The number of bystander CPR increased by 3.3 times (95% confidence interval [CI], 3.1-3.5) after the intervention, whereas the rate of good neurological outcomes increased by 2.6 times (95% CI, 2.3-2.9 [1.6%]; 1.4-1.7). The excess number was identified based on the differences between the observed and predicted trends. In total, 2,127 cases of out-of-hospital cardiac arrest (OHCA) after the intervention period received additional bystander CPR, and 339 cases of OHCA had good neurological outcomes. Conclusion: The nationwide implementation of the standardized telephone CPR program increased the number of bystander CPR and improved good neurological outcomes.