• 수면정신생리
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• 제26권2호
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• pp.86-103
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• 2019

목 적 : 본 연구는 대한수면의학회로부터 수면에 대한 전문가로 구성된 집단을 모집하여 델파이 기법을 통해 수면진정제의 안전사용지침을 개발하고자 한다. 방 법 : 대한수면의학회 소속 수면 전문가 15인을 모집하였으며, 전문가들을 대상으로 웹 기반의 3차 델파이 조사를 시행하였다. 첫 델파이 조사는 39개의 문항으로 구성되었으며 한국에서 수면진정제 사용의 문제점을 환기하고, 안전사용지침에 포함되어야 할 항목들에 대한 조사를 시행하였다. 두번째 델파이 조사는 21개의 문항으로 구성되었으며 수면진정제 처방에 있어서 임상적으로 중요한 문제들에 대한 구체적인 의견을 수집하였다. 세번째 델파이 조사는 Likert 척도를 이용하여 1, 2차 조사를 통해 도출한 수면진정제 안전사용지침에 대한 의견 동의율을 구하고 이를 바탕으로 수면진정제 안전사용지침을 개발하였다. 결 과 : 17개 항목에 대한 전문가들의 의견 동의율이 중앙값 4점 이상이었으며 평균 4.12, 표준편차 0.32를 보였다. 본 연구를 통해 개발된 수면진정제 안전사용지침은 수면진정제의 처방, 유지, 그리고 감량 및 중단에 대한 총 13개의 지침을 제안한다. 결 론 : 증가하는 불면증 환자와 수면진정제 처방에도 불구하고 한국 임상 현실에 맞는 안전사용지침이 부재하였는데, 본 연구를 통해 개발된 수면진정제 안전사용지침을 통해 한국 임상에서 수면 비전문가들이 수면진정제를 처방할 시에 안전하고 효과적인 처방을 위해 유용하게 사용될 수 있을 것이다.

• 대한한방부인과학회지
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• 제31권4호
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• pp.165-178
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• 2018

목 적: 한의사의 유방암 보완치료에 대한 실태를 조사하고 임상진료지침의 필요성을 알아보고자 본 연구를 시행하였습니다. 방 법: 본 연구는 e mail 설문지를 사용하였으며 유방암 환자 치료 여부, 내원환자들의 병기, 증상, 진단, 치료, 기타 의견 등을 설문하였습니다. 결 과: 322명이 응답하였으며 그 중 84명이 해당 기관에서 유방암 치료를 시행하고 있었습니다. 내원 환자들의 주된 호소는 피로 및 전신 소력감이었고 변증 및 맥진을 주된 진단법으로 한약 및 침뜸을 중심으로 치료하고 있다고 응답하였습니다. 유방암의 한의학적 보완치료로서 임상진료지침이 필요하다고 생각하며 개발된다면 적극적으로 사용하겠다고 응답하였습니다. 결 론: 유방암 보완치료 실태조사를 통해 임상진료지침에 대한 필요성을 알 수 있었으며 추가적인 연구가 필요합니다.

• Physical Therapy Rehabilitation Science
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• 제13권1호
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• pp.71-77
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• 2024

Objective: The purpose of this study is to present practice guidelines on what physical therapy students must learn during clinical training and how to evaluate them. Design: Design & development research Methods: A Delphi survey was conducted with 16 experts. Experts who participated in the study were asked to respond to 15 musculoskeletal system, 14 nervous system, and 12 physical factor therapy items through an online survey with a 5-point Likert score for each item regarding suitability and importance. Results: As a result of defining the core basic physical therapy skills that students in the Department of Physical Therapy must learn through clinical practice and in the process of evaluating them, there was a strong opinion that among the specific fields of physical therapy, evaluation items related to the musculoskeletal system, nervous system, and cardiorespiratory system were important. On the contrary, physical factor therapy showed poor results. Conclusions: In a previous study, opinions on the specialty of physical therapists were collected from current physical therapists, and the field of physical factor therapy was evaluated low. I think this reflects the perception that treatment using electricity has been commonly used in the field of physical therapy for a long time and does not require deep expertise among clinicians. Physical therapy clinical practice guidelines and efficient operation plans for clinical practice were presented. Through this, it can be usefully applied in hospitals where physical therapy students undergo clinical training in the future.

• 동의신경정신과학회지
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• 제27권4호
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• pp.235-248
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• 2016

Objectives: The aim of this review was to investigate whether evidence of complementary and alternative medicine (CAM) was reflected in clinical practice guidelines (CPGs) for insomnia based on relevant clinical trials. Methods: We conducted a systematic search on domestic and international CPG databases and medical databases. In addition, we conducted manual searches of relevant articles. Three authors independently searched and selected relevant studies; any disagreement was resolved by discussion. We extracted and analyzed the following data: published language, country, development group, participants, interventions, presence or absence of recommendations for CAM, level of evidence, grade of recommendation for CAM, and methods of development. Results: We identified 8,241 records from domestic and international databases, and 22 CPGs were included. Eleven of the 22 CPGs mentioned CAM interventions including herbal medicine, relaxation, acupuncture moxibustion, Tai Chi, meditation, hypnosis, biofeedback, Tuina, and external herbal medicine. However, most of the CPGs indicated 'no recommendation' or 'weak recommendation' for CAM interventions. Only Valeriana dageletiana Nakai and relaxation were considered to have experimental evidence. Valeriana dageletiana Nakai was recommended for improvement of sleep latency, sleep maintenance, total sleeping time, and sleep cycle. Relaxation was recommended as effective intervention for relieving physical and psychological arousal. Conclusions: Despite systematic reviews and randomized controlled trials on CAM for insomnia, most of the CPGs for insomnia did not reflect the evidence obtained. Further CPGs for insomnia should be developed by considering the current advanced studies in the field of CAM.

• 대한한방부인과학회지
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• 제29권1호
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• pp.78-91
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• 2016

Objectives: Breast cancer patients in Korea need to care about symptoms with complementary medicine including acupuncture. We reviewed the randomized controlled studies using acupuncture in breast cancer patients to establish a basic knowledge of clinical practice guidelines. Methods: We searched the following databases through July 2015: the Cochrane Central Register of Controlled Trials, Ovid-Medline, Ovid-EMBASE, the Allied and Complementary Medicine Databases and OASIS. The articles of RCTs using acupuncture in breast cancer for all symptoms were selected and analyzed. The acupoints, treatment period, inclusion criteria of participants, follow-up period and effectiveness were extracted. Results: Three hundred fifty five records after duplicate were screened, and 14 RCTs were selected. RCTs of Hot flush, pain, fatigue were reviewed. The adverse symptoms using medical treatment in breast cancer patients were targets of acupuncture in RCTs. The acupuncture treatment was decreased the hot flush, pain and fatigue. However, the effect was not confirmed due to various study design. Conclusions: The analysis of the research would be conjugated to establish a basic knowledge of clinical practice guidelines. Well designed studies in Korea are needed to confirm the efficacy and safety of acupuncture in patients with breast cancer.

• Neonatal Medicine
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• 제15권2호
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• pp.119-122
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• 2008

Clinical research is a necessity, not an option, for developing better and new medicines and therapeutic modalities. But in the course of clinical research, there are rules and guidelines that should be followed to ensure the due respect for persons, beneficence, and justice for persons who voluntarily participate in the research as described in the Belmont Report. Good Clinical Practice (GCP) is an "international scientific and ethical quality standard for designing, conducting, recording, and reporting" clinical trials. The main purposes of GCP would be to protect rights, safety, and well-being of trial subjects, in compliance with the principles of Declaration of Helsinki, and to assure that the data obtained from clinical trials are credible. In order to achieve these, investigators must be fully aware of the meanings as well as actual procedures involved in the research and should make the best effort to comply with GCP. For those individuals who belong to vulnerable populations, such as neonates, in addition to the general principles of GCP, further measures to ensure added protection should be implemented. It is our duty to develop and provide better care through clinical research even for neonates. But in doing so, we have to make sure that the importance of protecting the rights, safety, and well-being of the subjects supersede the interests of science and society.

• 대한예방한의학회지
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• 제21권3호
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• pp.1-10
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• 2017

Objectives : The purpose of this study is to investigate the practice patterns of traditional Korean medicine (TKM) doctors and the acceptance of payment model in order to develop a new TKM health insurance payment model linked with TKM clinical practice guidelines (CPGs). Methods : Lumbar herniated intervertebral disc (HIVD) and idiopathic facial palsy (IFP) were selected as a test diseases to develop a new TKM payment model. The level of benefit coverage in the National Health Insurance (NHI) was designed. The survey asked 228 TKM doctors about their practice patterns in HIVD and IFP patients and acceptance of new payment model. Results : Mean of medical cost for treatment of HIVD was 441,000 KW, mean of treatment period ranged from 4.9 to 17.5 weeks, and mean of number of treatment ranged from 14.6 to 50.4 HIVD patients. In the case of IFP, mean of medical cost for treatment of IFP was 468,000 KW, mean of treatment period was at least 4.2 and up to 15.9 weeks and mean of number of treatment ranged from 14.2 to 52 IFP patients. Conclusions : Current study suggests that mixed payment model of per-visit and episode-based model seem to be proper. The model 1 bundles both items which were covered and not covered by NHI in a rational way. The model 2 is based on the development and application of critical pathway. Lastly, model 3 suggests bundling of items covered by current NHI. Acceptance of TKM doctors is expected to be highest in the model 3.

• 동의생리병리학회지
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• 제30권4호
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• pp.209-218
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• 2016

The objective of this study was to investigate the diagnosis and treatment of Retinal vein occlusion such as syndrome differentiation and herbal medicine by reviewing Chinese traditional medicine`s journals. The journal search was carried out using China National Knowledge Infrastructure and Pubmed from January 2000 to December 2014. Searching key words were the various combination of "Retinal vein occlusion", "traditional chinese medicine", "syndrome differentiation". The final selection of 11 studies were selected and summarized by researchers. The effective rate was significantly higher than control but, methodological quality of the trials was generally low questioning their liability. The syndrome differentiation was classified as hyperactivity of liver yang and blood stasis. The most frequently prescribed herbal medication was Hyulbuchookeotang, Boyanghwanotang and Cheomagudeungum. This finding could be widely utilized in future clinical practice and form the basis for the development of clinical practice guidelines in advance.

• 대한한방소아과학회지
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• 제38권2호
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• pp.21-31
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• 2024

Objectives This study aimed to develop consensus-based recommendations for establishing standard clinical practice guidelines for pediatric anorexia through the utilization of a Delphi study. Methods We analyzed existing randomized controlled trials for pediatric anorexia treatment using the Delphi method-a structured process for achieving consensus among a panel of experts. A questionnaire was distributed among a select panel of nine specialists in the field. Results The initial Delphi round led to consensus on 30 distinct recommendations; however, consensus was not reached for 19 other recommendations, prompting a second Delphi round. In the subsequent round, adjustments were made based on feedback from the initial round, and deliberations were held on recommendations that previously lacked consensus. Following these adjustments, consensus was achieved on all recommendations. Additionally, a third Delphi iteration was conducted to address three specific queries that required amendment due to a reevaluation of the evidence levels of certain recommendations. In total, three Delphi rounds were carried out to produce informed recommendations related to the diagnosis, treatment, and general management of anorexia. Conclusions This investigation successfully generated evidence-based recommendations for the diagnosis and treatment of pediatric anorexia. The recommendations encompassed various practices, including herbal medicine, acupuncture, moxibustion, cupping, and Chuna manual therapy, which can be integrated into clinical settings.

• 성인간호학회지
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• 제27권5호
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• pp.481-492
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• 2015

Purpose: The purpose of this study was to examine the effects of the evidence-based clinical practice guidelines on Postoperative Nausea and Vomiting (PONV). Methods: The research design was a non-equivalent control group with a non-synchronized design. The participants were the patients undergoing gynecologic laparoscopy. Data were collected from July, 2014 through January, 2015. The participants in the experimental group (n=35) received an assessment of risk factors of PONV, aroma therapy, and P6 acupressure method as recommended in the guidelines. Those in the control group (n=35) received usual nursing care. Data were analyzed by mean, standard deviation, t-test, ${\chi}^2$-test using SPSS/WIN 19.0 program. Results: The occurrence of nausea and vomiting, the level of nausea and vomiting, and the need for antiemetic medicine in the experimental group were significantly less than those in the control group after surgery. The levels of postoperative pain and the amounts of time for nursing activities in the experimental group were significantly reduced than those in the control group after surgery. The levels of satisfaction were significantly higher in the experiment group than that of the control group. Conclusion: The evidence-based guidelines is recommended for nursing practice as a guidance for managing PONV and helping the recovery of patients after laparoscopic surgery.