• Title/Summary/Keyword: Hospital-based intervention

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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.

A Therapeutic Approach Based on Motor Development in Congenital Muscular Torticollis: A Case Report (선천성 근육 사경 환아에 대한 운동 발달적 치료 접근: 증례보고)

  • Ryu, Je-Yong;Kim, Yu-Jin;Sung, Ju-Yeon;Shim, Jae-Hun;Lee, Gyu-Wan;Oh, Duck-Won
    • Physical Therapy Korea
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    • v.13 no.2
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    • pp.77-84
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    • 2006
  • Although conservative management of congenital muscular torticollis (CMT) has been well documented, relatively little is known about the response to the treatment. The purposes of this case report were to describe the use of a therapeutic approach based on motor development in physical therapy intervention for an infant with CMT and to report the result of the treatment. The patient was a 20-day-old baby boy with left CMT presenting muscular mass in the left sternocleidomastoid muscle. The angle of the lateral head tilt was 20 degrees. The size of muscular mass was 5.3 mm in ultrasonography. Intervention included ultrasonic therapy, soft tissue massage, passive and active range of motion exercises, motor developmental therapy, and parent instruction. The procedures of motor developmental therapy and changes in the amount of lateral head tilt were documented using photography. The size of the mass was decreased to .3 mm before the 5-month follow-up. The patient also maintained a midline head position in the supine position and a midline head alignment during all functional activities. A therapeutic approach based on motor development is a beneficial method for reducing an asymmetrical head and neck position, and facilitating normal development as a component of physical therapy intervention.

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Effects of Time-Use Intervention on Life Satisfaction and Self-Esteem in Stroke Patients (시간사용중재가 뇌졸중 환자의 생활만족도 및 자아존중감에 미치는 영향)

  • Ryu, Sung-Hyun;Park, Su-Jin;Kim, Min-Huck;Hwang, Do-Yeon
    • Therapeutic Science for Rehabilitation
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    • v.9 no.3
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    • pp.91-102
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    • 2020
  • Objective : This study investigated the effects of time-use intervention, conducted during 8 weeks, on the life satisfaction and self-esteem of stroke patients. Methods : Twenty-one stroke patients who were divided into an experimental group (n=10) and a control group (n=11), participated in this study from July 2019 to October 2019. Life satisfaction changes were measured using the Life satisfaction scale. Self-esteem changes were measured using the Self-esteem scale. Results : First, comparison between pre and post intervention showed a statistically significant difference in life satisfaction and self-esteem (p<.05). Second, comparison between post intervention groups showed a statistically significant difference in life satisfaction and self-esteem (p<.05). Conclusion : Based on the results from this study, we found that time-use intervention has a positive impact on life satisfaction and self-esteem. Therefore, participating in meaningful occupation performance will improve the mental health and quality of life of stroke patients.

The Effects of a Home-Visiting Discharge Education on Maternal Self-esteem, Maternal Attachment, Postpartum Depression and Family Function in the Mothers of NICU Infants

  • Ahn Young-Mee;Kim Mi-Ran
    • Journal of Korean Academy of Nursing
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    • v.34 no.8
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    • pp.1468-1476
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    • 2004
  • Purpose: A quasi-experimental study was performed to investigate the effects of a home visiting discharge education program on the maternal self-esteem, attachment, postpartum depression and family function in 35 mothers of neonatal intensive care unit (NICU) infants. Methods: Twenty-three mothers in the intervention group received the home visiting discharge education while 12 mothers in the control group received the routine, hospital discharge education. Baseline data was collected in both groups one day after delivery. The intervention group received the home visiting discharge education while the control group did the routine hospital-based discharge education. The questionnaire including the data on maternal self-esteem, attachment, postpartum depression and family function were collected within 1 week after the discharge by mail. Results: The scores of maternal self-esteem, and attachment were significantly increased, and the postpartum depression and the family function score were decreased after the home visiting discharge education in intervention group. There were no changes in these variables before and after the routine hospital-based discharge education in control group. Conclusion: These results support the beneficial effects of home visiting discharge education on the maternal role adaptation and family function of the mothers of NICU infants.

Psychosocial Interventions for Children and Adolescents after a Disaster: A Systematic Literature Review (1991-2015) (재난 후 소아청소년의 정신사회적 개입: 체계적 문헌고찰(1991~2015))

  • Lee, Mi-Sun;Hwang, Jun-Won;Lee, Cheol-Soon;Kim, Ji-Youn;Lee, Ju-Hyun;Kim, Eunji;Chang, Hyoung Yoon;Bae, Seung-Min;Park, Jang-Ho;Bhang, Soo-Young
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.27 no.4
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    • pp.278-305
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    • 2016
  • Objective: The aim of this systematic literature review is to analyze the psychosocial interventions for children and adolescents after disasters. Methods: We conducted a review of the extant research literature from 1991 to 2015 via a comprehensive search of the MEDLINE, EMBASE, Cochrane CENTRAL, PubMed and PsyclNFO databases. The keywords employed in this research included: 'child', 'adolescent', 'youth', 'disaster', 'posttraumatic', 'psychosocial', 'therapy' and 'intervention'. The researchers followed the PRISMA guidelines. A total of 850 articles were screened for their eligibility and fifty-nine were found to meet the study criteria. The final data analysis was performed based on the disaster type, study design, type of intervention, sample size, age, school grade, number of sessions, setting of intervention delivery, providers, approach and parent involvement. Results: Countries worldwide have experienced various kinds of disasters, including earthquakes, hurricanes, vessel accidents, tornados, tsunamis, volcanic eruptions, war, fire, terrorism, and traffic accidents. The types of psychosocial intervention that were conducted after these disasters included: psychological first aid, psychological debriefing, psychoeducation, trauma focused cognitive behavior therapy, eye movement desensitization reprocessing, prolonged exposure therapy, group play therapy and arts therapy, project interventions, school-based interventions and web-based interventions. Conclusion: The findings of the systematic literature review suggest that an appropriate psychosocial intervention could be utilized as evidence-based mental health treatment for children and adolescents after disasters.

Is Routine Repeated Head CT Necessary for All Pediatric Traumatic Brain Injury?

  • Kim, Won-Hyung;Lim, Dong-Jun;Kim, Se-Hoon;Ha, Sung-Kon;Choi, Jong-Il;Kim, Sang-Dae
    • Journal of Korean Neurosurgical Society
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    • v.58 no.2
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    • pp.125-130
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    • 2015
  • Objective : Repeated computed tomography (CT) follow up for traumatic brain injury (TBI) patients is often performed. But there is debate the indication for repeated CT scans, especially in pediatric patients. Purpose of our study is to find risk factors of progression on repeated CT and delayed surgical intervention based on the repeated head CT. Methods : Between March, 2007 and December, 2013, 269 pediatric patients (age 0-18 years) had admitted to our hospital for head trauma. Patients were classified into 8 subgroups according to mechanisms of injury. Types, amount of hemorrhage and amount changes on repeated CT were analyzed as well as initial Glasgow Coma Scale (GCS) scores. Results : Within our cohort of 269 patients, 174 patients received repeat CT. There were progression in the amount of hemorrhage in 48 (27.6%) patients. Among various hemorrhage types, epidural hemorrhage (EDH) more than 10 cc measured in initial CT was found to be at risk of delayed surgical intervention significantly after routine repeated CT with or without neurological deterioration than other types of hemorrhage. Based on initial GCS, severe head trauma group (GCS 3-8) was at risk of delayed surgical intervention after routine repeated CT without change of clinical neurologic status. Conclusion : We suggest that the patients with EDH more than 10 cc or GCS below 9 should receive repeated head CT even though absence of significant clinical deterioration.

ICF Tool applied Intervention Strategy and Charting on Upper Extremity Functional Recovery of the Frozen Shoulder Patient - Case Study (동결견 환자의 상지 기능 회복에 대한 ICF Tool을 적용한 중재 전략과 문서 기록-사례연구)

  • Kong, Sun-Woong;Lim, Hyoun-Chyoul;Jung, Yeon-Woo
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.17 no.1
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    • pp.35-44
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    • 2011
  • Background: This study was to suggest the process of making strategy for effective intervention and evaluation on functional problems of the frozen shoulder patient applied International Classification of Functioning Disability and Health (ICF) Tools. Methods: The patient was 48years old woman with right shoulder adhesive capsulitis and calcific tendinitis. In first phase, therapists could list the information relating to functional problems used by the ICF Core set and then could confirm the interaction among the problems using the ICF assessment sheet. In second phase, therapist is needed to make the hypothesis and hypothesis testing and then set a primary functional goals and therapeutic goals in detail after prioritizing the problems to be managed based on the problem list. Lastly, after setting the confirmed problems as the purpose of intervention through the hypothesis testing, therapist could do some intervention after making a plan to solve these problems. Results: This report illustrates how to apply the process based on ICF concept into physical therapy practice. The decided hypothesis and goal that are to solve the problems the client faced were remarkably meaningful. Conclusions: Clinical decision making for the most effective intervention requires that therapists use the clinical reasoning process based on ICF concept.

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Effects of an Individualized Cardiac Rehabilitation Education Program on Knowledge about Coronary Artery Disease, Compliance of Sick Role, and Vascular Health Status in Patients of Percutaneous Coronary Intervention (개별 심장재활 교육프로그램이 관상동맥중재술을 받은 환자의 질병관련지식, 환자역할이행과 혈관 건강상태에 미치는 효과)

  • Lee, Kyung Sim;Sung, Kyung Mi
    • The Korean Journal of Rehabilitation Nursing
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    • v.18 no.2
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    • pp.135-144
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    • 2015
  • Purpose: This study was conducted to examine the effects of an individualized cardiac rehabilitation education program on knowledge about coronary artery disease (CAD), compliance of sick role and vascular health status in patients with percutaneous coronary intervention (PCI). Methods: Quasi-experimental design-based nonequivalent control group pretest-posttest design was employed. Using convenience sampling, data were collected from 60 patients who underwent PCI at S Hospital in S City from September 2014 to February 2015. For examining the effects of an individualized cardiac rehabilitation education program, knowledge about CAD, compliance of sick role and vascular health status were measured. Results: The experimental group showed statistically significant differences in knowledge about CAD (t=24.21, p<.001), compliance with sick role (t=20.81, p<.001) and vascular health status (t=15.07, p<.001) compared to the control group. Conclusion: The individualized cardiac rehabilitation education program is effective in improving knowledge about CAD, compliance of sick role and vascular health status in patients who underwent PCI. Based on the findings of this study, nursing intervention programs focusing on individualized approach will be useful for patients undergoing PCI.

Effect of nutrition care process-based nutrition intervention on improvement of intake in the elderly in-patients with malnutrition (영양관리과정에 근거한 영양중재가 노인 영양불량 입원환자의 식사섭취량 증진에 미치는 효과)

  • Park, Ji-Hyun;Kang, Min-Ji;Seo, Jung-Sook
    • Journal of Nutrition and Health
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    • v.51 no.4
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    • pp.307-315
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    • 2018
  • Purpose: This study evaluated the effects of personalized nutrition intervention for increasing hospital meal intake by elderly patients with malnutrition. Methods: The subjects were 30 elderly patients with malnutrition who visited a general hospital located in Daegu. An individual nutrition intervention such as change of meal types or special meal service was given to the patients according to nutrition diagnosis related to inadequate intake of hospital meals. Nutritional intake status of the subjects was assessed by analyzing energy intake, protein intake, index of nutritional quality (INQ), nutrient adequacy ratio (NAR) and mean adequacy ratio (MAR). Results: The causes of inadequate intake in the subjects were poor appetite or preference problems (46.7%), symptom-related problems (30.0%) and mastication problems (23.3%). The INQ of protein in the subjects was significantly increased from $0.81{\pm}0.17$ to $1.41{\pm}0.25$ after the nutrition intervention (p < 0.05). The NAR of protein (before $0.50{\pm}0.21$, after $0.58{\pm}0.17$), iron (before $0.72{\pm}0.30$, after $0.84{\pm}0.29$) and vitamin $B_2$ (before $0.31{\pm}0.16$, after $0.37{\pm}0.14$) was also increased after the nutrition intervention (p < 0.05). The MAR of five nutrients, protein, calcium, iron, vitamin A and vitamin $B_2$, was significantly increased by the nutrition intervention (p < 0.05). Conclusion: Personalized nutrition intervention according to nutrition diagnosis related to inadequate intake of hospital meals may improve the intake amount of elderly patients with malnutrition.

Starting Construction of Frailty Cohort for Elderly and Intervention Study

  • Won, Chang Won;Lee, Yunhwan;Choi, Jaekyung;Kim, Ki Woong;Park, Yongsoon;Park, Hyuntae;Oh, In-Hwan;Ga, Hyuk;Kim, Young Sun;Jang, Hak Chul;Korean Frailty Cohort and Intervention Study Group
    • Annals of Geriatric Medicine and Research
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    • v.20 no.3
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    • pp.114-117
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    • 2016
  • A research project, the "Construction of Frailty Cohort for Elderly and Intervention Study," funded by the Ministry of Health and Welfare, has been ongoing since December 2015. The Korean Frailty and Aging Cohort Study (KFACS) aims to identify risk factors for adverse outcomes associated with frailty in community-dwelling older adults, as well as means of prevention. KFACS is a multicenter, longitudinal study, with the baseline survey being conducted in 2016-2017. The sample (n=3,000) consists of those aged 70-84 years, stratified by age and gender, recruited from urban and rural regions nationwide. An in-person interview and health examination are performed every 2 years. This project is also conducting many intervention studies. Project interventions focus on nutrition and exercise. The nutritional intervention study compares the effects of 1.2 g/kg versus 1.5 g/kg daily protein intake on sarcopenia and frailty in older Koreans. The exercise trial examines the effectiveness of an information and communication technology-based program in preventing or reducing frailty.