• Title/Summary/Keyword: Long-term Care Patient

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Case report: Laminate prosthesis with orthodontic treatment for achieve anterior esthetics and functional occlusion (심미와 기능 회복을 위한 교정- 라미네이트 수복 치료 증례)

  • Lee, Han Na
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.23 no.2
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    • pp.80-85
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    • 2014
  • Orthodontic treatment is obviously the first choice to get aligned teeth cause of conservative treatment. But it is impossible to get highly esthetic result only orthodontic treatment in case of peg lateralis, discrepancy tooth size, discolored teeth or fractured teeth. As all treatment does, especially in esthetic treatment it is always required interdisciplinary diagnosis and treatment plan; orthodontics, periodontology, prothetics, implant therapy. As also, the treatment should be maintained long-term treatment with stable and harmonious state by esthetic satisfaction and functional occlusion those who needs various dental care as interdisciplinary treatment. This case is the laminate treatment with the orthodontic treatment on 37 ages/ Female patient who has cross bite at anteriors and premolar area and abrasion on centralis at right maxilla. By orthodontic treatment aligned teeth positions, it makes functional occlusion. As laminate treatment with minimum teeth preparation is able to release anterior esthetics. Follow up check for 2 years has been performed since the final prosthetics delivery to the patient. No sign of relapse, fracture of laminate were detected.

Effect of Nursing Intervention of Mutual Goal Setting on Recovery of Mastectomy Patient (상호목표설정 간호중재가 유방절제술 환자의 수술 후 회복에 미치는 효과)

  • Jang Eun-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.8 no.2
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    • pp.172-188
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    • 2001
  • Purpose: The purpose of this research was to test the effectiveness of the nursing intervention, mutual goal setting, for patients who have had a mastectomy. Special reference was given to King's goal attainment theory and a theoretical framework for establishing an effective nursing strategy to enhance patient recovery is suggested. Method: This research employed a quasi-experimental design which consisted of pretest-posttest non-equivalent control and experimental groups. Data were collected from 37 patients who had a mastectomy and were hospitalized in the Department of Surgery of Y Medical Center from January 2001 to May 2001. The experimental group received the nursing intervention, mutual goal setting four times from the day before the operation to the fifth day after the operation while the control group received only routine nursing care. As postoperative recovery indicators, ROM of arm joints, arm circumference, pain, physical symptoms, oxygen saturation stress, anxiety and body image were measured. Result: The test results are as follows : 1) there were statistically significant differences between the experimental and control groups in extension and internal rotation of the shoulder Joint and flexion of the wrist joint. 2) there was no significant difference between the two groups in arm circumference. 3) there were no significant differences between the two groups in pain, physical symptoms, or oxygen saturation. 4) there were no significant differences between the two groups in stress, anxiety, or body Image. On the basis of research results, the following are recommended : 1) The effectiveness of nursing intervention in the acute recovery period as well as long term effects need to be investigated. 2) There is a need to develop an instrument to measure perception which facilitates goal attainment in the interactive setting between patients and nurses.

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Solid tumors in childhood: risk-based management (소아 고형종양 - 위험군에 따른 맞춤 치료 -)

  • Koo, Hong Hoe
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.606-612
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    • 2007
  • Since the introduction of chemotherapy for the treatment of childhood leukemia more than 50 years ago, the results of childhood cancer have improved dramatically. The 5-year survival rate of disease, many of which were uniformly fatal in the prechemotherapy era, reached to more than 75%. This remarkable improvement in survival is a direct result of the incorporation of chemotherapeutics into treatment regimens that previously relied only on surgery or radiotherapy for the primary tumor. The multimodality approach, which integrates surgery and radiotherapy to control local disease with chemotherapy to eradicate systemic or metastatic disease, has become the standard approach to treating most childhood cancers. The overall improvement in outcomes in childhood solid tumors has been related to the development of multidisplinary cooperative studies that has permitted the development of well-designed tumor treatment protocols characterized by uniform staging criteria, sharing informations in pathologic classification, uniform methods for tumor markers, oncogenes, and other biologic and genetic factors. Important advances in the biologic study of cancer and its genetic basis led to a number of observations that impact directly on the management of childhood solid tumors. Identification of specific genes, oncogenes, tumor markers, and other biologic and pathologic factors plays an important role in both staging and clarifying the risk categorization of individual patients. Treatment of the patient is influenced by the recognition of specific risk factors. This knowledge has resulted in a change in the approach to care based not only on staging criteria, but also on risk-based management. This concept uses various risk factors of outcomes. Risk-based management allows for each patient to maximize survival, minimize long-term morbidity and improve the quality of life, especially for children's growth and development.

Factors Associated with Vancomycin-Resistant Enterococcus Colonization in Patients Transferred to Emergency Departments in Korea

  • Kim, Hyun Soon;Kim, Dae Hee;Yoon, Hai-jeon;Lee, Woon Jeong;Woo, Seon Hee;Choi, Seung Pill
    • Journal of Korean Medical Science
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    • v.33 no.48
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    • pp.295.1-295.7
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    • 2018
  • Background: Vancomycin-resistant enterococci (VRE) infections have become a major healthcare-associated pathogen problem worldwide. Nosocomial VRE infections could be effectively controlled by screening patients at high risk of harboring VRE and thereby lowering the influx of VRE into healthcare centers. In this study, we evaluated factors associated with VRE colonization in patients transferred to emergency departments, to detect patients at risk for VRE carriage. Methods: This study was conducted in the emergency department of a medical college-affiliated hospital in Korea. Every patient transferred to the emergency department and admitted to the hospital from January to December 2016 was screened for VRE using rectal cultures. In this cross-sectional study, the dependent variable was VRE colonization and the independent variables were demographic and clinical factors of the patients and factors related to the transferring hospital. Patients were divided into two groups, VRE and non-VRE, and previously collected patient data were analyzed. Then we performed logistic regression analyses of characteristics that differed significantly between groups. Results: Out of 650 patients, 106 (16.3%) had positive VRE culture results. Significant variables in the logistic analysis were transfer from geriatric long-term care hospital (adjusted odds ration [aOR]: 8.017; 95% confidence interval [CI]: 1.378-46.651), hospital days (4-7 days; aOR: 7.246; 95% CI: 3.229-16.261), duration of antimicrobial exposure (1-3 days; aOR: 1.976; 95% CI: 1.137-3.436), and age (aOR: 1.025; 95% CI: 1.007-1.043). Conclusion: VRE colonization in patients transferred to the emergency department is associated primarily with factors related to the transferred hospitals rather than demographic and clinical characteristics.

A LONG-TERM NEGLECTED BED PATIENT WITH CEREBRAL PALSY : A CASE REPORT (병상에서 장기간 방치 된 뇌성마비 환자 : 증례보고)

  • Kim, Do-young;Yang, Yeon-mi;Kim, Jae-gon;Lee, Dae-woo
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.13 no.1
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    • pp.33-36
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    • 2017
  • Cerebral palsy(CP) is a motor disorder of the central nervous system resulting from irreversible brain injury due to congenital or acquired causes. Health-related quality of their life is associated with severity of impairment and socioeconomic factors. These patients are particularly easy to be neglected because they lack capacity to care themselves unless they have the help of caregiver from high socioeconomic status. A 11-year-old girl with severe motor impairment came with the chief complaint of severe calculus deposition on whole dentition. She was taken with bed-ridden state with pediatrician not her parents. Since brain was damaged at the age of two, she has been left alone in the city care hospitals without parental care. Main caregiver is her father with not high educational level. Oral hygiene was not performed at all. Severe calculus deposition, gingival swelling, and gingival redness around the whole dentition were observed. During the 1st and 2nd visit, scaling and extraction was performed. CP patients with low socioeconomic status and severe motor impairment tend to be neglected from dental treatment. Dental care, along with medical care, is crucial to the quality of CP patients' lives. Therefore it is important that they visit for regular dental check ups and receive preventative care.

Case study on Dental Hygiene Care Program with the Focus on Non-surgical Periodontal Treatments with the Maternal and Child Health Center (일부 보건소 모자보건실 연계 비외과적 치주처치 중심의 치위생관리 프로그램 운영 사례연구)

  • Son, Jung-Hui;Kim, Sang-hee;Bae, Soo-Myoung
    • The Journal of the Korea Contents Association
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    • v.19 no.2
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    • pp.269-276
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    • 2019
  • This research was conducted by targeting pregnant women in the trial operation of dental hygiene care program with the focus on non-surgical periodontal treatments at the Maternal and Child Health center in the public health center. This study was conducted to provide basic data to dental hygienists who operate oral health promotion programs by targeting pregnant women of the local community through the evaluation on structure, the assessment process and results from the pilot program at the public health center. The targets are nine pregnant women who have been involved in the Dental hygiene care program three times. An evaluation on the structure, process and results according to the Indicators of each program were conducted. The results of dental hygiene care program found that the retention rate decreased. The retention of the probing pocket depth larger than 4mm was 40.4% to 14.0%(p<0.05). The retention rate of the gingival bleeding teeth was 4.6% to 2.7% (p=0.180). PHP Index improved. 1.7 points in the 1st to 1.4 points in the 3rd in the case of the second pregnant woman and 2.4 points in the 1st to 1.3 points (p<0.05) in the 3rd in the case of the third pregnant woman. The applicable and expandable possibility of the dental hygiene care program with the focus on non-surgical periodontal treatments at the Community Health Center is significant in the result of this study. In the future, long-term operation and ongoing monitoring of this program is needed.

Effect of trauma center operation on emergency care and clinical outcomes in patients with traumatic brain injury

  • Han Kyeol Kim;Yoon Suk Lee;Woo Jin Jung;Yong Sung Cha;Kyoung-Chul Cha;Hyun Kim;Kang Hyun Lee;Sung Oh Hwang;Oh Hyun Kim
    • Journal of Trauma and Injury
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    • v.36 no.1
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    • pp.22-31
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    • 2023
  • Purpose: Traumatic brain injury (TBI) directly affects the survival of patients and can cause long-term sequelae. The purpose of our study was to investigate whether the operation of a trauma center in a single tertiary general hospital has improved emergency care and clinical outcomes for patients with TBI. Methods: The participants of this study were all TBI patients, patients with isolated TBI, and patients with TBI who underwent surgery within 24 hours, who visited our level 1 trauma center from March 1, 2012 to February 28, 2020. Patients were divided into two groups: patients who visited before and after the operation of the trauma center. A comparative analysis was conducted. Differences in detailed emergency care time, hospital stay, and clinical outcomes were investigated in this study. Results: On comparing the entire TBI patient population via dividing them into the aforementioned two groups, the following results were found in the group of patients who visited the hospital after the operation of the trauma center: an increased number of patients with a good functional prognosis (P<0.001 and P=0.002, respectively), an increased number of surviving discharges (P<0.001 and P<0.001, respectively), and a reduction in overall emergency care time (P<0.05, for all item values). However, no significant differences existed in the length of intensive care unit stay, ventilator days, and total length of stay for TBI patients who visited the hospital before and after the operation of the trauma center. Conclusions: The findings confirmed that overall TBI patients and patients with isolated brain injury had improved treatment results and emergency care through the operation of a trauma center in a tertiary general hospital.

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

  • Kim, Seon-Ho;Song, Mi-Soon;Park, Yeon-Hwan;Song, Wook;Cho, Be-Long;Lim, Jae-Young;So, Wi-Young
    • Journal of muscle and joint health
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    • v.18 no.2
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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.

Bayesian Network Model to Evaluate the Effectiveness of Continuous Positive Airway Pressure Treatment of Sleep Apnea

  • Ryynanen, Olli-Pekka;Leppanen, Timo;Kekolahti, Pekka;Mervaala, Esa;Toyras, Juha
    • Healthcare Informatics Research
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    • v.24 no.4
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    • pp.346-358
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    • 2018
  • Objectives: The association between obstructive sleep apnea (OSA) and mortality or serious cardiovascular events over a long period of time is not clearly understood. The aim of this observational study was to estimate the clinical effectiveness of continuous positive airway pressure (CPAP) treatment on an outcome variable combining mortality, acute myocardial infarction (AMI), and cerebrovascular insult (CVI) during a follow-up period of 15.5 years ($186{\pm}58$ months). Methods: The data set consisted of 978 patients with an apnea-hypopnea index (AHI) ${\geq}5.0$. One-third had used CPAP treatment. For the first time, a data-driven causal Bayesian network (DDBN) and a hypothesis-driven causal Bayesian network (HDBN) were used to investigate the effectiveness of CPAP. Results: In the DDBN, coronary heart disease (CHD), congestive heart failure (CHF), and diuretic use were directly associated with the outcome variable. Sleep apnea parameters and CPAP treatment had no direct association with the outcome variable. In the HDBN, CPAP treatment showed an average improvement of 5.3 percentage points in the outcome. The greatest improvement was seen in patients aged ${\leq}55$ years. The effect of CPAP treatment was weaker in older patients (>55 years) and in patients with CHD. In CHF patients, CPAP treatment was associated with an increased risk of mortality, AMI, or CVI. Conclusions: The effectiveness of CPAP is modest in younger patients. Long-term effectiveness is limited in older patients and in patients with heart disease (CHD or CHF).

The Study on Identifying the Components of Community Pharmacy Externship Based on Korean Community Pharmacists' Consensus (약학교과과정의 개국약국실습 방향에 관한 연구)

  • Kim, Sung Hyun;Oh, Jung Mi
    • Korean Journal of Clinical Pharmacy
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    • v.9 no.2
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    • pp.109-118
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    • 1999
  • The need for and components of a contemporary community pharmacy externship for pharmacy students have not been clearly identified in Korea. Mail survey was performed among 20 college of pharmacy deans and 800 community pharmacists to analyze the current status and develop a consensus regarding major focus area and criteria of community pharmacy externship to be implemented under the separation of dispensary from medical practice in year 2000. Mail survey yielded $80\%\;and\;23.5\%$ response rate for pharmacy school deans and community pharmacists, respectively. Of the 16 pharmacy schools that responded 14 said they have externship program in hospital pharmacy, and only 8 pharmacy schools responded of having externship program for community pharmacy. However, these community pharmacy programs lacked criteria and standard guideline for the externship. The results of survey revealed that community pharmacy externship program for students should be organized and directed toward developing expert knowledge and skills in pharmacy practice activities, clinical services, communications, pharmacy management, and professionalism. Pharmacy practice components should include competencies and skills in computer application, prescription processing, dispensing, pharmaceutical compounding, Narcotics Control Law application, maintenance and provision of drug information, and laws and regulations. Clinical service components should include the ability to identify patient's drug-related problems, provide long-term patient care and appreciate drug therapy services. Communication skills should be taught to effectively express his/her professional opinion, deduce the needs of others, utilize appropriate techniques and media to communicate ideas and conduct a patient interview and to obtain patient drug history. Pharmacy management skills should be taught to be efficient in medical insurance and drug control process. It was found that professionalism, morality, pharmacy practice experience, ability to provide clinical services, collect and provide drug information and regality are important criteria of preceptors. Externship sites should possess the ability to stock various drugs, access and provide diverse pharmacy services and should have private patient counseling area. Most pharmacists agreed that top 200 drugs' generic and brand name, indications, dosage, side effects, and contraindication should be instructed during the externship. It was also found that student and preceptor should be evaluated for their performances during the externship. This information will be incorporated into teaming objectives for students and to develop Academic Extemship Program Guidelines.

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