• Title/Summary/Keyword: Methodological improvement

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What is the Role of Epidural Injections in the Treatment of Lumbar Discogenic Pain: A Systematic Review of Comparative Analysis with Fusion

  • Manchikanti, Laxmaiah;Staats, Peter S.;Nampiaparampil, Devi E.;Hirsch, Joshua A.
    • The Korean Journal of Pain
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    • v.28 no.2
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    • pp.75-87
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    • 2015
  • Background: Lumbar discogenic pain without pain mediated by a disc herniation, facet joints, or the sacroiliac joints, is common and often results in chronic, persistent pain and disability. After conservative treatment failure, injection therapy, such as an epidural injection, is frequently the next step considered in managing discogenic pain. The objective of this systematic review is to determine the efficacy of lumbar epidural injections in managing discogenic pain without radiculopathy, and compare this approach to lumbar fusion or disc arthroplasty surgery. Methods: A systematic review of randomized trials published from 1966 through October 2014 of all types of epidural injections and lumbar fusion or disc arthroplasty in managing lumbar discogenic pain was performed with methodological quality assessment and grading of evidence. The level of evidence was based on the grading of evidence criteria which, was conducted using 5 levels of evidence ranging from levels I to V. Results: Based on a qualitative assessment of the evidence for both approaches, there is Level II evidence for epidural injections, either caudal or lumbar interlaminar. Conclusions: The available evidence suggests fluoroscopically directed epidural injections provide long-term improvement in back and lower extremity pain for patients with lumbar discogenic pain. There is also limited evidence showing the potential effectiveness of surgical interventions compared to nonsurgical treatments.

Development of Key Indicators for Nurses Performance Evaluation and Estimation of Their Weights for Management by Objectives (목표관리를 적용한 간호사 성과평가 핵심 지표개발과 가중치 산정)

  • Lee, Eun-Hwa;Ahn, Sung-Hee
    • Journal of Korean Academy of Nursing
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    • v.40 no.1
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    • pp.69-77
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    • 2010
  • This methodological research was designed to develop performance evaluation key indicators (PEKIs) for management by objectives (MBO) and to estimate their weights for hospital nurses. Methods: The PEKIs were developed by selecting preliminary indicators from a literature review, examining content validity and identifying their level of importance. Data were collected from November 14, 2007 to February 18, 2008. Data set for importance of indicators was obtained from 464 nurses and weights of PEKIs domain was from 453 nurses, who worked for at least 2 yr in one of three hospitals. Data were analyzed using $X^2$-test, factor analysis, and the Analytical Hierarchy Process. Results: Based upon Content Validity Index of .8 or above, 61 indicators were selected from the 100 preliminary indicators. Finally, 40 PEKIs were developed from the 61 indicators, and categorized into 10 domains. The highest weight of the 10 domains was customer satisfaction, which was followed by patient education, direct nursing care, profit increase, safety management, improvement of nursing quality, completeness of nursing records, enhancing competence of nurses, indirect nursing care, and cost reduction, in that order. Conclusion: PEKIs and their weights can be utilized for impartial evaluation and MBO for hospital nurses. Further research to verify PEKIs would lead to successful implementation of MBO.

Clinical Application of Objective Structured Clinical Examination (OSCE) for Novice Nurses (신규간호사의 실무능력평가를 위한 OSCE(객관적구조적임상수기평가) 개발과 적용)

  • Cheung, Nam-Youn;Song, Young-Shin
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.13 no.3
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    • pp.334-342
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    • 2006
  • Purpose: The purpose of this study was to develop and examine the feasibility of OSCE for novice nurses. Method: The study was designed using a methodological design. Data were collected from January to February, 2005. Nine stations were developed for the examination. Five minutes was allowed for each station. The examination was administered to 2 groups of novice nurses. Results: OSCE for clinical performance improvement which consisted of nine 5-minute long stations, was developed. Those stations were tested by 79 beginning nurses who were divided into 2 groups. Reliability ranges for Cronbach's alpha were $0.399{\sim}0.811$ and the mean value was 0.797. Total mean score for the OSCE was 66.75. Total score for the 2nd group was significantly higher than the 1st group. The nurses were satisfied with the OSCE method and process. Conclusion: The OSCE can be an effective tool for evaluating clinical nursing skills in novice nurse. More reliable and valid stations need to be developed and then repeated evaluation of the nurses can be done.

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A Study on Evaluation System for Nursing Bachelor Degree Program Outcomes: Focus on Improvement in Nursing Leadership Ability (간호학 학사학위 프로그램 학습성과 평가체계 개발 사례: 간호리더십 능력 향상을 중심으로)

  • Jang, Keum Seong;Kim, Bok Nam;Jeong, Seok Hee;Kim, Yun Min;Kim, Jung Sook
    • Journal of Korean Academy of Nursing Administration
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    • v.22 no.5
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    • pp.540-552
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    • 2016
  • Purpose: This study was conducted to develop a nursing leadership program outcome evaluation system, required for accreditation of nursing education. Methods: A methodological design was used. To ensure the theoretical validity of the evaluation system, learning objectives for nursing education programs and job descriptions for nurses in Korea were verified by analyzing the relationships in the five attributes of the nursing leadership concept. The nursing leadership program outcome evaluation system was developed based on the Kim & Park's developmental model (2008). Results: The nursing leadership program outcome evaluation system was established, including implementation level, education curriculum, level of performance, evaluation method, rubrics, and Close-the-Loop. Conclusion: The developed evaluation system can be actively used in nursing education, and contribute to enhancing the leadership competencies of nursing students and graduate nurses.

A Keyword-Based Big Data Analysis for Individualized Health Activity: Focusing on Methodological Approach

  • Kim, Han-Byul;Bae, Geun-Pyo;Huh, Jun-Ho
    • Proceedings of the Korea Information Processing Society Conference
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    • 2017.04a
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    • pp.540-543
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    • 2017
  • It will be possible to solve some of the major issues in our society and economy with the emerging Big Data used across 21st century global digital economy. One of the main areas where big data can be quite useful is the medical and health area. IT technology is being used extensively in this area and expected to expand its application field further. However, there is still room for improvement in the usage of Big Data as it is difficult to search unstructured data contained in Big Data and collect statistics for them. This limits wider application of Big Data. Depending on data collection and analysis method, the results from a Big Data can be varied. Some of them could be positive or negative so that it is essential that Big Data should be handled adequately and appropriately adapting to a purpose. Therefore, a Big Data has been constructed in this study to applying Crawling technique for data mining and analyzed with R. Also, the data were visualized for easier recognition and this was effective in developing an individualized health plan from different angles.

Development of an Algorithm for Emergency Nursing Care of Dyspneic Patients (호흡곤란 환자 응급간호 관리를 위한 알고리즘 개발 연구)

  • Yang, Jin-Ju;Jang, Keum-Seong
    • Journal of Korean Academy of Nursing Administration
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    • v.15 no.4
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    • pp.491-505
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    • 2009
  • Purpose: This study was to develop an algorithm for emergency nursing care of dyspneic patients. Methods: This methodological study was done through reviews of medical records and literatures, checklists of emergency nursing care for dyspneic patients, interviews with nurses, and experts' validity. Results: Firstly, the initial assessment confirmed the identification of airway patency, accessory muscle usage, RR, $SpO_2$, v/s, skin color, and mental status. Immediate emergency care provided oxygen, checked ABG, EKG, and chest X-ray, established a semi-fowler position, maintained IV routes, administered medication orders, and conducted careful monitoring. Secondly, if the patient exhibited $SpO_2$ of less than 90%, the nurse considered the patient's condition to be aggravated. Thirdly, if the patient showed improvement of more than 90% $SpO_2$, the nurse administered secondary assessment and carried out specific nursing care. However, if the patient continuously showed $SpO_2$ of less than 80%, the nurse assisted the intubation and then executed ventilator therapy. Conclusions: This study suggests that the algorithm is an effective decision tool and utilizing the algorithm is expected to improve the emergency nursing care for dyspneic patients.

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Husserlian Phenomenology in Korean Nursing Research: Analysis, Problems, and Suggestions

  • Kim, Hye-Kyung;Jun, Myunghee;Rhee, Stephanie;Wreen, Michael
    • The Journal of Korean Academic Society of Nursing Education
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    • v.26 no.1
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    • pp.5-15
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    • 2020
  • Purpose: This paper is a critical review of descriptive phenomenological methodology in Korean nursing research. We propose constructive suggestions for the improvement of descriptive phenomenological methodology in light of Husserl's phenomenological approaches. Methods: Using the key words of 'phenomenology,' 'experience,' and 'nursing,' we identify and analyze 64 Korean empirical phenomenological studies (selected from 282 studies) published in 14 Korean nursing journals from 2005 to 2018. The PubMed and the Korea Citation Index were used to identify the studies. Results: Our analysis shows that all the reviewed articles used Giorgi's or Colaizzi's scientific phenomenological methodology, without critical attention to Husserl's philosophical phenomenological principles. Conclusions: The use of scientific phenomenology in nursing research, which originated in North America, has become a global phenomenon, and Korean phenomenological nursing research has faithfully followed this scholarly trend. This paper argues that greater integration of Husserlian phenomenological principles into scientific phenomenological methodology in nursing research, such as participant-centered bracketing and eidetic reduction, is needed to ensure that scientific phenomenology lives up to its promise as a research methodology.

A Novel Aromatic Fluorine-18 Labeling Method Using Iodonium Salts Precursor (이오도늄 솔트 전구체를 이용한 새로운 방향족 화합물 플루오린-18 표지 기술)

  • Moon, Byung-Seok;Lee, Byung-Chul;Kim, Sang-Eun
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.1
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    • pp.1-9
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    • 2009
  • As many new drug substances contained various aromatic rings and fluorine attached to an electron rich aromatic ring or on the meta-position, a strategy towards improvement in aromatic fluorination of these compounds is highly desirable. The introduction of fluorine-18 onto aromatic rings showed in the limited condition containing electron withdrawing group (EWG) on the para- or ortho-position to get reasonable radiochemical yield so far. No-carrier added (NCA) [$^{18}F$]fluoroarene syntheses by iodonium salts recently reported that has the potential to greatly increase the yield in systems or positions that normally not reactive enough to give sufficient yields in simple model reaction. This review describes the methodological approach towards effective aromatic fluorination by diaryliodonium salts and future prospects in an application of novel PET radiotracer.

Development of a resilience scale for paramedics (응급구조사의 극복력 측정도구 개발)

  • Cho, Hye-Young;Park, Sung-Hee
    • The Korean Journal of Emergency Medical Services
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    • v.22 no.2
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    • pp.35-49
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    • 2018
  • Purpose: This study aimed to develop a resilience measurement scale and verify its validity and reliability. Methods: This was a methodological study. The preliminary items of the scale were derived from literature reviews and in-depth interviews. The data were collected from October 30, 2017 to January 20, 2018, and paramedics working in hospitals or fire departments were selected using convenience sampling. A self-reported questionnaire was completed by 213 paramedics in Korea. Results: Through content validity, item analysis and exploratory factor analysis, a total of 6 factors and 26 items were extracted, and the total variance was 67.12%. Factor 1 was "self-efficacy" (11 items), factor 2 was "internal control" (5 items), factor 3 was "empowerment" (2 items), factor 4 was "interpersonal capability", (3 items), factor 5 was "social support" (2 items), and factor 6 was "adaptation and coping" (3 items). Conclusion: This is the first scale developed in Korea to measure the resilience of paramedics. In future, this scale of this study will contribute to developing a resilience improvement program based on understanding the resilience level of paramedics.

A case report of Benign Paroxysmal Positional Vertigo Patient Treated with Dong-Shi(董氏) Acupuncture Therapy (동씨침을 이용한 양성 발작성 체위성 현훈환자 치험 1례)

  • Park, Min-je;Kim, Jung-uk;Kim, Eun-geol;Lee, Won-hui;Hwang, Min-seop;Yoon, Jong-hwa
    • Journal of Korean Medical Ki-Gong Academy
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    • v.10 no.1
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    • pp.37-45
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    • 2007
  • Benign Paroxysmal Positional Vertigo(BPPV) is a common disorder that peripheral vertigo in clinic, it is provoked Paroxysmal vertigo according to positional change. A man, aged 75, suffered from attacks of vertigo when get out of bed, He complained vertigo, nausea and walking trouble So he visited our clinic Based upon the case history and position-provoked vertigo with characteristic findings on the Dix-Hallpike maneuver, we diagnosed as BPPV. Through only Shang-San-Huang(上三黃) of Dong Shi Xue(董氏穴) acupuncture therapy symptoms were vanished completely. This study was showed effect that operating only Dong-Shi acupuncture therapy without maneuver therapy and the other therapies to patient can not tolerate the Dix-Hallpike Maneuver. We need additional researches with methodological improvement and many clinical cases.