• The Journal of Korean Medicine
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• v.45 no.1
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• pp.182-201
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• 2024

Objectives: This study was conducted to develop a standard acupotomy consent form that takes into account the unique characteristics of Korean Medicine. The study was motivated by the increasing importance of patient autonomy and the growing number of legal disputes related to medical malpractice in the clinical field of Korean Medicine. Methods: The analysis phase of the study involved a survey of the current status of acupotomy consent forms in Korean Medicine hospitals nationwide. The items of each form were analyzed based on the contents of the Medical law and the standard contract for medical procedures of the Fair Trade Commission (FTC). In the development and evaluation phase, the items and contents of the acupotomy consent form were evaluated using a 5-point Likert scale and content validity was assessed through two rounds of Delphi surveys. In the improvement phase, the contents of the consent form were revised based on the results of a survey of inpatient and outpatient patients in the Department of Acupuncture and Moxibustion at Pusan National University Korean Medicine Hospital, and real-time online meeting. The final version of the standard acupotomy consent form was completed after undergoing proofreading and corrections by a linguistics expert. Results: Only 30% of Korean Medicine hospitals have implemented acupotomy consent forms. The items of the consent forms did not fully include the items presented in the Medical act and the standard contract for medical procedures of the FTC. To address this issue, two rounds of Delphi surveys and a real-time discussion were conducted with a panel of 12 experts on 27 preliminary items of consent forms. The items and contents that met the criteria for content validity ratio, convergence, and consensus were derived. Based on the derived items and content, a standard acupotomy consent form was developed. Conclusions: The standard consent form for acupotomy is anticipated to ensure patient autonomy and enhance transparency and liability in acupotomy. Furthermore, it is expected to serve as evidence in case of medical disputes related to acupotomy and contribute as a reference document for the development of standard consents forms for various procedures of Korean Medicine. However, the limitations of the study include that the survey of consent forms was limited to only training hospitals of Korean Medicine, and the standard consent form is only applicable to adults in Korea. Future studies are needed to address these limitations.

• Child Health Nursing Research
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• v.2 no.1
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• pp.112-126
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• 1996

The purpose of this study was to investigate the current status of the need of telephone call and to identify the status of nursing intervention through telephone. Head nurses of the pediatric nursing unit and a nurse of pediatric outpatient clinic wrote down the telephone record of calls by parents of children discharged from hospital from 7 am to 3 pm during the period of March to June, 1995. Content of 120 telephone calls but for 26 calls with incomplete record among 146 calls were analyzed into frequency of general characteristics, needs and nursing intervention. The needs of telephone call were identified and classified into 11 areas and analyzed into frequency of detailed content by 11 areas. Nursing intervention was identified and classified into 10 categories, and analyzed into frequency of detailed content by 10 categories. The findings of this study were as follows ; The need of telephone call was identified with nutritional state, medication, vital signs, language retardation, personal hygiene, vaccination, administration procedure, physical symptoms, follow up care management and others. The most frequent needs were physical symptoms and vaccination. A kind of food among nutrition dose of drugs among medication, fever among vital signs, cough among physical symptoms, and content of vaccination among vaccination was the most frequent needs. Nursing intervention through telephone was identified with instruction, knowledge offer, information offer, judgement, solicitation, referral and instruction, referral, connection, reassurance, reservation, and regulation. Instruction, knowledge offer and information offer was the most frequent nursing intervention by telephone call. Instruction was about a visit to hospital, a visit to nearby clinic, instruction about symptoms,, instruction about nursing care procedure, retelephoning and vaccination. Knowledge offer was about vaccination, knowledge related to medication, and dental care. Information offer and judgement was about vaccination and medication. Referral and instruction delivery was about instruction delivery following consultation to doctor, visit to emergency room and a visit to hospital following consultation to doctor. These results suggest that telephone call intervention program should be established as a field of extended pediatric nursing role in health care delivery system for the children.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.13 no.1
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• pp.93-103
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• 2002

The aim of this study is to examine the diagnostic profiles and related clinical variables of children with attention and hyperactivity in psychiatric outpatient clinic. Seventy one children with age range of 5 to 14 were diagnosed by DSM-IV, and assessment battery including KEDI-WISC, KPI-C, ADS(ADHD Diagnostic System) were completed. The subjects were divided into 3 diagnostic groups：ADHD only(n=17), ADHD comorbid(n=27), Other diagnosis(n=27). The results were as follows：In ADHD comorbid group, tic disorder, developmental language disorder, borderline intellectual function, oppositional defiant/conduct disorder, and learning disorder were combined in descending order. Other diagnosis group consisted of tic disorder, borderline intellectual function, depression/anxiety, oppositional defiant/conduct disorder, and others. There were significant differences in IQ, PIQ, and VIQ among the three groups, and ADHD only group showed higher scores of IQ and VIQ than ADHD comorbid group. On the KPI-C, there were no significant differences in all subscales among the three groups. On the visual ADS, omission error and sensitivity showed significant differences among the three groups, and ADHD comorbid group represented higher omission error and lower sensitivity than other diagnostic group. The findings indicated that the inattention and hyperactivity symptoms could be diagnosed into diverse psychiatric disorders in child psychiatry, and ADHD children with comorbidity will show more problems in academic performance and school adjustment.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.18 no.2
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• pp.138-144
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• 2007

Objectives: The aim of this study was to evaluate the reliability and validity of the Korean Version of the Diagnostic Interview Schedule for Children Version IV(DISC-IV), a highly structured diagnostic interview used to assess more than 30 psychiatric disorders in children and adolescents. Methods: A total of 91 study subjects, including 67 subjects who visited the child and adolescent psychiatry outpatient clinic at our institution and 24 community-based subjects, were assessed using the Korean Version of the DISC-IV. Clinical diagnosis was used as a gold standard for the examination of the validity of the DISC-IV. Forty-four of the study subjects were randomly selected for test-retest reliability measurement. Results: The validity of the Korean Version of the DISC-IV showed kappa values ranging from 0.25 to 0.40 in the clinical sample and 0.65 to 1.00 in the community sample. The sensitivities varied according to the diagnostic categories, but the specificities were excellent for all diagnostic entities. Conclusion: The Korean Version of the DISC-IV showed good reliability and validity in Korean children and adolescents. The Korean Version of the DISC-IV might be a useful tool for assessing psychiatric disorders in children and adolescents.

• Tuberculosis and Respiratory Diseases
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• v.81 no.4
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• pp.289-298
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• 2018

Background: Obstructive airway disease patients with increased variability of airflow and incompletely reversible airflow obstruction are often categorized as having asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS). ACOS is heterogeneous with two sub-phenotypes: asthma-ACOS and COPD-ACOS. The objective of this study was to determine the difference in risk of exacerbation between the two sub-phenotypes of ACOS. Methods: A total of 223 patients exhibiting incompletely reversible airflow obstruction with increased variability (spirometrically defined ACOS) were enrolled. These patients were divided into asthma-ACOS and COPD-ACOS according to their physician's diagnosis and smoking history of 10 pack-years. Within-group comparisons were made for asthma-ACOS versus COPD-ACOS and light smokers versus heavy smokers. Results: Compared to patients with COPD-ACOS, patients with asthma-ACOS experienced exacerbation more often despite their younger age, history of light smoking, and better lung function. While the light-smoking group showed better lung function, they made unscheduled outpatient clinic visits more frequently. On multivariate analysis, asthma-ACOS and poor inhaler compliance were significantly associated with more than two unscheduled clinic visits during the previous year. Conclusion: Spirometrically defined ACOS includes heterogeneous subgroups with different clinical features. Phenotyping of ACOS by physician's diagnosis could be significant in predicting future risk of exacerbation.

• The Journal of Internal Korean Medicine
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• v.39 no.2
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• pp.247-252
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• 2018

A 58-year-old woman came into our clinic with headache, dizziness, and malaise after an electrical injury. Even though she received conventional treatment about five weeks after the injury, the symptoms did not improve, and she decided to undergo traditional Korean medicine treatment. During a 20-day hospital stay with acupuncture and herbal medicine, the symptoms were reduced to about half, and after six months of further treatment in the outpatient clinic, there was no pain during the day and only moderate headaches occurred intermittently after intense physical activity. As far as we know, this is the first report to treat the aftereffects of electrical injury with traditional Korean medicine treatment. Hence, here we tried to fully describe and announce the detailed progress of the patient through this report.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.1
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• pp.275-282
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• 2015

Background: Breast cancer (BC) is the most-common malignancy of women worldwide. Though there are differences among developed and developing countries, BC remains the most common cancer type of women in Turkey. Objective: This study aimed to identify the level of knowledge, awareness, and their potential predictors towards BC in Ankara, Turkey. Materials and Methods: The present descriptive study was conducted on 376 females attending a breast health outpatient clinic. A self-administered questionnaire was designed to evaluate knowledge level about BC and predictors effecting its level. Data analysis was performed using the chi-square test. A value of p<0.05 was considered statistically significant. Results: Mean age of the participants was $46.2{\pm}9.93$ (22-75). The majority (92.6 %) were married; 41.5% were educated less than nine years. Most of the women were housewives (82.7%) and, were living in an urban region (86.4%). Predictors of effecting responses to seven knowledge and awareness questions about BC varied from demographic features including older age groups, higher educational levels, being married, living in an urban area, being employee, smoking, having greater BMI to additional attributes associated breast health such as the increased number of births, applying for the purpose of control, positive family history of breast diseases, any diagnoses of breast diseases and performing BSE practice. Conclusions: It was determined that females in Turkey have better knowledge of BC than other developing countries even though it is not at the desired level. These findings revealed that females should be more informed about BC risk factors, prognosis and treatments by primary health-care providers to counteract the ascending burden of this disease.

• Anxiety and mood
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• v.10 no.1
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• pp.11-16
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• 2014

Objective : Despite the high prevalence and clinical importance of panic disorder, studies on the clinical characteristics and course of panic disorder are relatively rare. This study is a multi-center, and retrospective study to examine the clinical characteristics and course of Korean panic disorder patients who visit university hospital. Methods : The study subjects were panic disorder patients who had visited the psychiatric outpatient clinics of 8 university hospitals in South Korea from January to December in 2008. Finally, 238 panic patients were included in this study. Their medical charts were retrospectively reviewed and reassessed by experienced psychiatrists to examine their clinical characteristics, demographic data and clinical course in repose to pharmacotherapy. Results : Among the 238 patients (121 males vs. 117 females), the mean age of disease onset was $41.3{\pm}12.7$ years and female patients showed 5 years older age of disease onset, compared with male patients. The mean score of PSR scale was $4.5{\pm}1.0$ at the first visit, reflecting a 'marked' level of severity of illness and impairment in functioning. Only 110 patients (46.4%) completed the whole follow up visits, whereas 128 patients (53.6%) dropped out during the treatment. After $17.7{\pm}0.5$ months of mean follow up period, the mean score of PSR scale at the last visit was reduced into $2.1{\pm}0.9$, reflecting a 'residual' severity of illness and impairment in functioning. The cumulative recovery rate was 62.1% in the completer group, whereas that of the drop-out group was 47.7%. Conclusions : The mean age of disease onset in Korean panic disorder patients who had visited university hospital was about 10 years older than that of Western panic disorder patients in previous studies, and the Korean panic disorder patients who had visited university hospital showed a relatively higher cumulative recovery rate. These differences might result from an ethnic difference in clinical characteristics and course in response to pharmacotherapy of panic disorder.

• Journal of The Korean Dental Society of Anesthesiology
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• v.8 no.1
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• pp.22-28
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• 2008

Background: Cerebral palsy (CP) is non-progressive disorder of motion and posture. In CP patient, there are difficulties in dental treatment because of uncontrolled movement of limb and head, and conjoined disabilities such as cognitive impairment, sensory loss, seizures, communication and behavioral disturbances. It is reported that CP patients have high incidence in caries and a higher prevalence of periodontal disease. But, despite the need for oro-dental care, these patients often are unlikely to receive adequate treatment without sedation or general anesthesia because of uncontrolled movements of the trunk or head. Methods: We reviewed the 58 cases of 56 patients with CP who underwent outpatient general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital. Results: The mean age was 19 (2-54) years. The number of male patient was 40 and that of female was 18. They all had severe spastic cerebral palsy and 22 had sever mental retardation, 15 epilepsy, 8 organic brain disorder, 1 blindness, 2 deafness and cleft palate. For anesthesia induction, 14 cases was needed physical restriction who had sever mental retardation and cooperation difficulty, but 44 cases showed good or moderate cooperation. Drugs used for anesthesia induction were thiopental (37 cases), sevoflurane (14 cases), ketamine (3 cases ) and propofol (4 cases). All patients except one were done nasotracheal intubation for airway management and 4 cases were needed difficult airway management and 1 patient already had tracheostomy tube. Mean total anesthetic time was $174{\pm}56$ min and staying time at PACU was $88{\pm}39$ min. There was no death or long term hospitalization because of severe complications. Conclusion: If general anesthesia is needed, pertinent diagnostic tests and workup about anomaly, and appropriate anesthetic planning are essential for safety.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.9
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• pp.464-471
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• 2016

To investigate the effects of cardiac rehabilitation (CR) on cardiopulmonary exercise capacity in both elderly and younger patients with myocardial infarction (MI). Of the MI patients who received hospital-based CR between February 2012 and December 2015, we retrospectively reviewed the medical records of patients who continued a follow-up through the outpatient clinic. A total of 46 patients (18 elderly patients (${\geq}60years$) and 28 younger patient (< 60)) were included in this study. The subjects visited the clinic to perform aerobic exercises with ECG monitoring based on their initial exercise tolerance test outcome. The exercise capacity was measured by symptom-limited exercise tests before and after hospital-based CR. Before CR, the elderly group had a significantly lower exercise capacity in peak VO2, METs, anaerobic threshold, exercise time, respiratory exchange ratio (RER) than the younger group. After CR, elderly groups showed a significantly improved exercise capacity in exercise time, HRmax, HRrest, peak VO2, METs, anaerobic threshold, and RER. Both elderly and younger groups showed similar improvement of cardiopulmonary exercise capacity after hospital-based CR. There is a very low cardiac rehabilitation participation and referral rates with MI patients in Korea. It is considered necessary to further expand the participation of cardiac rehabilitation in elderly MI patients.