• Title/Summary/Keyword: Medical consultation

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Primary Study to Develop the Instrument of Pattern Identification for Common Cold (감모변증도구 개발에 관한 예비 연구)

  • Byun, Jun-Seop;Yang, Su-Young;Kang, Wee-Chang;Park, Yang-Chun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.6
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    • pp.1226-1233
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    • 2009
  • Common cold occurs frequently and occupies an important position in medical treatment however obvious treatment is not suggested. There has been no agreement of pattern identification for common cold in oriental medicine. The purpose of this study is to develop a standard instrument of pattern identification for common cold which will be applied to clinical research. The items and structure of the instrument were based on review of published literature. The advisor committee on this study was organized by 9 oriental respiratory internal medicine professors of 11 oriental medical colleges nationwide. The experts attended 3 consultation meetings and discussed developing the instrument, and we also took professional advices by e-mail. The results were as follows; First, we divided the pattern identification of common cold into nine pattern: Wind-cold type, Wind-heat type, Contain summerheat type, Contain dampness type, Qi deficiency type, Blood deficiency type, Yang deficiency type, Yin deficiency type, Influenza. Second, we got the mean weights to each symptom of nine pattern identification which had been scored on a 5-point scale - ranging from 0 to 4 by the 9 experts. Third, we made out the Korean instrument of the pattern identification for common cold. It was composed self reporting questionnaire and researcher reporting questionnaire. Though this study is not proved about validity, reliability, the instrument of pattern identification for common cold is meaningful and expected to be applied to the subsequent research. And also, we hope to improve the instrument and make up for this study through various research and discussion.

The Effect of Bojungikgi-tang on Stress Urinary Incontinence: A Systematic Review and Meta-Analysis (복압성 요실금에 대한 보중익기탕의 효과 : 체계적 문헌고찰과 메타분석)

  • Nam, Hyun-seo;Baek, Tae-hyun
    • The Journal of Internal Korean Medicine
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    • v.42 no.3
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    • pp.293-307
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    • 2021
  • Objectives: This study investigates the effects and safety of Bojungikgi-tang for stress urinary incontinence by systemic review and meta-analysis of randomized controlled trials (RCTs). Methods: RCTs were selected from articles published until December 2019 in seven domestic and foreign databases. The quality of the literature was evaluated using Cochrane's risk of bias (RoB) tool, and RevMan 5.3 was used to synthesize the results. Results: A total of 694 patients with stress urinary incontinence participated in eight RCTs. Meta-analysis showed that the total effective rate of treatment that combines pelvic floor muscle training (PFMT) and Bojungikgi-tang was significantly higher than that of PFMT alone. The volume of urine leakage per hour after the combined treatment was significantly lower than that of PFMT alone. The International Consultation on Insurance Questionnaire-Short Form (ICIQ-SF) scores from combining PFMT and Bojungikgi-tang were significantly lower than those for PFMT alone. Conclusion: This study suggests that Western medical treatment combined with Bojungikgi-tang for urinary incontinence from stress might be more effective in improving symptoms than conventional Western medical treatment alone. However, the number of studies included in the meta-analysis was insufficient, and the quality of the selected literature was generally low. Therefore, high-quality clinical studies on herbal medicine treatment for urinary incontinence would be required in the future.

An analysis of patients referred to the advanced general hospital pain clinic center: multicenter study in province of Jeollabuk-do, Korea (3차 병원 통증 클리닉에 의뢰되어 오는 환자들의 특성 분석: 전라북도 지역의 다기관 연구)

  • Kim, Yeon-dong;Lee, Cheolhyeong
    • Journal of the Korea Convergence Society
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    • v.12 no.2
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    • pp.311-316
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    • 2021
  • The number of patients referred to pain clinic is increasing. The purpose of this study was to describe and understand characteristic of patients referred to the tertiary pain clinic. This study was conducted on 587 patients who had been referred to pain clinics at three university hospitals in the Jeollabuk-do region from January 2011 to December 2015. The data was retrospectively collected on a record sheet prepared in the clinic. we analyzed these patients according to their age, sex, chief complaint, pain location, coexisting disease, referring department, referral causes. There were various medical problems addressed by a pain clinic consultation. It is reasonable to develop standardized guidelines for pain management. To do so, it is necessary to identify the characteristics of the patients. A study with more patients in another area will be helpful in characterizing the patients referred to the pain clinic in Korea.

Development of Korean Nurse Residency Program for Tertiary Hospitals (국내 상급종합병원 신규간호사의 실무적응지원 프로그램 개발)

  • Kwon, In Gak;Cho, Yong Ae;Kim, Kyeong Sug;Kim, Mi Soon;Cho, Myung Sook
    • Journal of Korean Clinical Nursing Research
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    • v.27 no.2
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    • pp.149-164
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    • 2021
  • Purpose: The purpose of this study was to develop a Korean Nurse Residency Program (KNRP) in order to facilitate new nurses' transition to clinical practice working at tertiary hospitals in Korea. Methods: The KNRP was developed through a literature review, investigation of NRP cases in United States, two rounds of expert consultation, and appropriateness survey. For appropriateness survey of the program, a questionnaire with 118 items and 14 subcategories including overview and operation of KNRP, education programs, staffing criteria for new nurses' education, preceptor supporting strategies, evaluation standards for new nurse's education, infrastructure, and KNRP benefits was used. Data were collected from 369 nurses including nurse educators, nurse managers, preceptors, and new nurses working at 43 tertiary hospitals in Korea from February 16, 2021 to March 22, 2021. Data were analyzed with descriptive statistics. Results: Appropriateness score of KNRP was 3.42±0.31 (out of 4) and those of 14 subcategories ranged from 3.18±0.47 to 3.58±0.46. The final version of the KNRP postulated is a one-year program, which is composed of off-job training and on-site training including preceptorship over 3 months, and competency reinforcement and adaptation supporting programs. Conclusion: The application of the one-year KNRP will facilitate new graduate nurses' transition to clinical practice. In order for effective application of the KNRP, cooperative efforts of the government, professional associations, and hospitals are needed.

Reviews Analysis of Korean Clinics Using LDA Topic Modeling (토픽 모델링을 활용한 한의원 리뷰 분석과 마케팅 제언)

  • Kim, Cho-Myong;Jo, A-Ram;Kim, Yang-Kyun
    • The Journal of Korean Medicine
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    • v.43 no.1
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    • pp.73-86
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    • 2022
  • Objectives: In the health care industry, the influence of online reviews is growing. As medical services are provided mainly by providers, those services have been managed by hospitals and clinics. However, direct promotions of medical services by providers are legally forbidden. Due to this reason, consumers, like patients and clients, search a lot of reviews on the Internet to get any information about hospitals, treatments, prices, etc. It can be determined that online reviews indicate the quality of hospitals, and that analysis should be done for sustainable hospital marketing. Method: Using a Python-based crawler, we collected reviews, written by real patients, who had experienced Korean medicine, about more than 14,000 reviews. To extract the most representative words, reviews were divided by positive and negative; after that reviews were pre-processed to get only nouns and adjectives to get TF(Term Frequency), DF(Document Frequency), and TF-IDF(Term Frequency - Inverse Document Frequency). Finally, to get some topics about reviews, aggregations of extracted words were analyzed by using LDA(Latent Dirichlet Allocation) methods. To avoid overlap, the number of topics is set by Davis visualization. Results and Conclusions: 6 and 3 topics extracted in each positive/negative review, analyzed by LDA Topic Model. The main factors, consisting of topics were 1) Response to patients and customers. 2) Customized treatment (consultation) and management. 3) Hospital/Clinic's environments.

One year of treating patients with open fractures of the lower extremity in a new military trauma center in Korea: a case series

  • Ji Wool Ko;Giho Moon;Jin Geun Kwon;Kyoung Eun Kim;Hankaram Jeon;Kyungwon Lee
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.376-384
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    • 2023
  • Purpose: The Armed Forces Trauma Center of Korea was established in April 2022. This study was conducted to report our 1-year experience of treating soldiers with open fractures of the lower extremity. Methods: In this case series, we reviewed the medical records of 51 Korean soldiers with open fractures of the lower extremity between April 2022 and March 2023 at a trauma center. We analyzed patients with Gustilo-Anderson type II and III fractures and reported the duration of transportation, injury mechanisms, injured sites, and associated injuries. We also presented laboratory findings, surgery types, intensive care unit stays, hospital stays, rehabilitation results, and reasons for psychiatric consultation. Additionally, we described patients' mode of transport. Results: This study enrolled nine male patients who were between 21 and 26 years old. Six patients had type II and three had type III fractures. Transport from the accident scene to the emergency room ranged from 75 to 455 minutes, and from the emergency room to the operating room ranged from 35 to 200 minutes. Injury mechanisms included gunshot wounds, landmine explosions, grenade explosions, and entrapment by ship mooring ropes. One case had serious associated injuries (inhalation burn, open facial bone fractures, and hemopneumothorax). No cases with serious blood loss or coagulopathies were found, but most cases had a significant elevation of creatinine kinase. Two patients underwent vascular reconstruction, whereas four patients received flap surgery. After rehabilitation, six patients could walk, one patient could move their joints actively, and two patients performed active assistive movement. Eight patients were referred to the psychiatry department due to suicidal attempts and posttraumatic stress disorder. Conclusions: This study provides insights into how to improve treatment for patients with military trauma, as well as medical services such as the transport system, by revising treatment protocols and systematizing treatment.

Nurses' Perception on Clinical Nutrition Services by Types of Medical Institution and Area (병원 유형 및 지역에 따른 임상영양서비스에 대한 간호사의 인식)

  • Lee, Han Na;Lee, Song Mi;Park, Yoo Kyung;Lee, Seung Min;Lee, Eun;Cha, Jin A;Park, Mi Sun;Lee, Ho Sun;Rha, Mi Yong;Lyu, Eun Soon
    • Journal of the Korean Dietetic Association
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    • v.20 no.4
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    • pp.235-246
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    • 2014
  • The purpose of this study was to evaluate nurses' perception of clinical nutrition services. A cross-sectional survey design was performed. The research was accomplished by using questionnaires developed for this study and administered from September 12 to December 31, 2013 to 343 nurses at 43 tertiary hospitals and 20 general hospitals. The percentage of nurses who recognized clinical nutrition certificate as issued from nation was 27.8%. The mean scores of perceived usefulness on clinical nutrition services was 4.23/5.00, whereas that of perceived implementation was 3.76/5.00. The mean scores of necessity of disease-specialized clinical dietitian at capital hospitals were significantly higher for obesity (P<0.01), cancer (P<0.05), and infant & childhood disease (P<0.01) than at local hospitals. The rates of nurses' experience in group education on cancer at capital hospitals (21.7%) was significantly higher than that at local hospitals (10.3%) (P<0.05). The mean scores of perceived importance of clinical nutrition services were 4.46/5.00 for 'group nutrition education', 4.46/5.00 for 'individual consultation', and 4.40/5.00 for 'nutrition management for enteral nutrition (EN) patients'. The most common reason why clinical nutrition services are important was 'improving malnutritional status'. To activate clinical nutrition services especially at local hospitals, clinical dietitians should give systematic assistance to patients and also institutional supports are needed.

Analysis on the utilization Pattern of a General Hospital - With Cases of General Hospital Inpatients in the Provincial Area - (종합병원 이용형태에 관한 분석 - 지방소재 종합병원 입원환자 중심 -)

  • Jung, Yong-Mo;Jun, Sun-Kyong;Lee, Yong-Chul
    • The Korean Journal of Health Service Management
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    • v.3 no.1
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    • pp.14-24
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    • 2009
  • This study aims at deriving any useful information necessary to strengthen the competitiveness for growth through empirical analyses on general hospital located in a province in order to countermeasure the opening and competition of medical markets. The characteristics of user were identified on the basis of disease groups under KCD in the research method. In addition, the analysis on the expenses of diagnosis and treatment was divided into the treatment progress and degree of hospital resource utilization And the regression was carried out to identify the impacts of characteristics of inpatient users on the degree of hospital resource utilization. As a result of major research, the inpatient users of the general hospital located in the provincial area in consideration of inpatient users were formed around the inpatient disease groups representative for Korea(diseases of the respiratory system, injury and poisoning & certain other consequences of external causes). And it was understood that most of residents within a distance of 40 minute by the public transportation were using. And mostly were under the age of 9 or over 60, and the provision of medical features such as the degree of consultation and operational functions were inadequate. When we classify inpatient treatment cost for each resource application as the medical cost being the center of patient care function, the equipment and human resource application sector are constituted over half. Accordingly, the following suggestions are made as plans to strengthen the competitiveness for the growth of general hospitals located in the provincial areas on the basis of analytical results. First, it is necessary to have the characterization matching to the age and disease groups with a high frequency. Second, it is necessary to increase the degree of hospital resource utilization according to the characterization. Third, it is necessary to concentrate on public relations. The above suggestion, as a method for securing image improvement and competitive power as a general hospital, and through expansion of social function that a regional general hospital needs to secure not only as an individual institution but also as a general hospital, it can be seen that a general improvement of image as a regional general hospital is possible.

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Telemedicine Protocols for the Management of Patients with Acute Spontaneous Intracerebral Hemorrhage in Rural and Medically Underserved Areas in Gangwon State : Recommendations for Doctors with Less Expertise at Local Emergency Rooms

  • Hyo Sub Jun;Kuhyun Yang;Jongyeon Kim;Jin Pyeong Jeon;Sun Jeong Kim;Jun Hyong Ahn;Seung Jin Lee;Hyuk Jai Choi;In Bok Chang;Jeong Jin Park;Jong-Kook Rhim;Sung-Chul Jin;Sung Min Cho;Sung-Pil Joo;Seung Hun Sheen;Sang Hyung Lee
    • Journal of Korean Neurosurgical Society
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    • v.67 no.4
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    • pp.385-396
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    • 2024
  • Previously, we reported the concept of a cloud-based telemedicine platform for patients with intracerebral hemorrhage (ICH) at local emergency rooms in rural and medically underserved areas in Gangwon state by combining artificial intelligence and remote consultation with a neurosurgeon. Developing a telemedicine ICH treatment protocol exclusively for doctors with less ICH expertise working in emergency rooms should be part of establishing this system. Difficulties arise in providing appropriate early treatment for ICH in rural and underserved areas before the patient is transferred to a nearby hub hospital with stroke specialists. This has been an unmet medical need for decades. The available reporting ICH guidelines are realistically applicable in university hospitals with a well-equipped infrastructure. However, it is very difficult for doctors inexperienced with ICH treatment to appropriately select and deliver ICH treatment based on the guidelines. To address these issues, we developed an ICH telemedicine protocol. Neurosurgeons from four university hospitals in Gangwon state first wrote the guidelines, and professors with extensive ICH expertise across the country revised them. Guidelines and recommendations for ICH management were described as simply as possible to allow more doctors to use them easily. We hope that our effort in developing the telemedicine protocols will ultimately improve the quality of ICH treatment in local emergency rooms in rural and underserved areas in Gangwon state.

Association between job types of economically active population and sleep appropriateness among South Koreans (국내 경제활동 인구의 직업유형별 적정수면과의 연관성)

  • Kim, Sun Jung;Kim, Dong Jun;Gim, Eun Na;Yu, Tae Gyu
    • Korea Journal of Hospital Management
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    • v.25 no.3
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    • pp.67-77
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    • 2020
  • Background: As of 2016, average Koreans sleep 7 hours and 42 minutes, the lowest figure among Organization for Economic Cooperation and Development(OECD) countries, and the number of people with sleep disorders reached 561,000. Accordingly, the government has promoted the provision of 'Multiple Sleep Test' to strengthen the diagnosis service for patients with 'sleep disorder' in july 2018. As a result, healthcare costs for patients with sleep disorder is on the rise every year. In this study, we utilized 'Appropriate Sleep' criteria of United States's National Sleep Foundation(NSF) then investigated Korean's sleep pertinence using 「7th National Health and Nutrition Survey for 2016-2018」 by different occupational type, demographic characteristics, socio-economic characteristics, and health behaviors. Methods: We performed descriptive analysis to examine differences of sleep appropriateness by various sample characteristics. Multivariate logistic regression models were used to examine sleep appropriateness by occupational type and other variables. We also analyzed subgroup models to investigate. Results: As a result, a total of 1,948 (18.37%) study subjects experienced in-appropriate sleep. Results of the Multivariate logistic regression analysis revealed that blue color group had a higher odds ratio (OR) for experiencing in-appropriate sleep (OR=1.179). In addition, the odds ratio of experienced in-appropriate sleep among the elderly aged 70 and over was 2.698, and the odds ratio of the overstressed group was 1.299. Furthermore, sub-group analysis showed that blue color job of female(Or=1.334), high school or below(OR=1.404), divorce/death/separation(OR=2.039), 25%ile-50%lie income group(OR=1.411) more likely experienced in-appropriate sleep. Conclusion: Growing sleep disorder patients and related health care costs are expected. Government should apply detailed 'total periodic sleep disorder management policy' including pre-consultation, examination, diagnosis, treatment, post-consultation, self-management especially to vulnerable population that this study found.