• Title/Summary/Keyword: Patient's Severity

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A study of Priority-setting in Korean National Dental Health Insurance Scheme (치과 건강보험 우선순위 설정을 위한 고찰)

  • Han, Ji-Hyoung;Hwang, Yoon-Sook
    • Journal of Korean society of Dental Hygiene
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    • v.6 no.3
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    • pp.243-261
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    • 2006
  • Priority setting in national health insurances in major advanced countries and the nation was investigated to draw the criteria for priority setting and suggest the most rational criteria for dental insurance so as to help secure the efficiency of medicare financing and individual's health right and also elevate medical consumers' satisfaction with health insurance. 1. Priorities in national health insurance are different from country to country, depending on the medical security systems, priority introducing conditions, and social environment, but have many common factors. 2. The priority setting criteria for national health insurance in those countries include the following in common: the efficiency, equity, and cost effect of treatment, emergency of treatment, consumption of expense, efficacy of treatment, patient's receptiveness, patient's demand, severity of disease, and patient's responsibility for the disease. 3. In oral diseases, severe diseases including oral cavity cancer are low in rate, and in-hospital treatments are few. From the above findings, it is suggested that dental insurance should establish discriminative criteria for priority setting by reflecting the aspects of dental diseases and system difference between dental and other health insurances and taking account of efficiency of treatment through prevention, cost effect, prevalence and incidence of generalized diseases, and individual's financing burden.

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Frequency and Severity of the Nurses' Role Conflict in the Hospital Nurses (병원간호사 역할갈등의 빈도와 심각성)

  • Lee, Eun Hee;Cho, Kyung Sook;Son, Haeng Mi;Yi, Yeo Jin;Yoo, Cheong Suk
    • Journal of Korean Clinical Nursing Research
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    • v.19 no.1
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    • pp.81-95
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    • 2013
  • Purpose: The purpose of this study was to identify the frequency and severity of role conflict experienced by nurses in the hospital. Methods: For this survey a self-report questionnaire on nurses' role conflict was used for data collection. Participants were 472 nurses in hospitals with over 500 beds. The questionnaire had 82 items classified into five categories (role activity, relationships between: nurse-nurse, nurse-patient/caregiver, nurse-doctor, and nurse-other department staff). The questionnaire was developed through focus group interviews with nurses according on their work experiences and literature reviews that were validated by the researchers. Data were analyzed using descriptive statistics for frequency and severity of nurses' role conflict. Cronbach's ${\alpha}$ for the questionnaire was .95 (frequency), .97 (severity). Results: Mean score for nurses' role conflict was 1.64. The highest frequency for nurses' role conflict was in the category, relationship between nurse and patients or their families ($2.00{\pm}0.46$). The highest severity for nurses' role conflict was in the category; relationship between nurses and doctors ($1.96{\pm}0.56$). Conflict about nurses' role activity showed both high frequency ($1.99{\pm}0.39$) and severity ($1.95{\pm}0.43$). Conclusion: Results indicate a need to develop programs to improve interpersonal relationship so as to reduce role conflict and encourage nurses' professional satisfaction and achievement.

A Case Report of Chronic Prostatitis/Chronic Pelvic Pain Syndrome Treated with Hoeeum Bee-venom Therapy and Balio Acupuncture Treatment (회음혈 봉약침 치료와 팔료혈 자침을 통한 만성전립선염/만성골반통증 증후군 치험 1례)

  • Do-yeon Park;Hyang-ran Moon;Hui-jeong Noh;Sang-yoon Jeon
    • The Journal of Internal Korean Medicine
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    • v.44 no.3
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    • pp.536-543
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    • 2023
  • Objectives: The purpose of this study was to report the effectiveness of Hoeeum Bee-venom Therapy and Balio Acupuncture Treatment in the management of chronic prostatitis/chronic pelvic pain syndrome. Methods: A patient with chronic prostatitis/chronic pelvic pain syndrome underwent Korean medical treatment, including Hoeeum Bee-venom Therapy and Balio Acupuncture Treatment. The severity of symptoms was assessed with a daily visual analog scale (VAS) for orchialgia and lower abdominal pain. In addition, we measured the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) on the first and last days of visit. Results: The patient's symptoms were improved after treatment. The severity of orchialgia was reduced from VAS7 to VAS2, and lower abdominal pain was improved from VAS6 to VAS1. NIH-CPSI decreased from 21 to 5. Conclusion: Hoeeum Bee-venom Therapy and Balio Acupuncture Treatment are effective in treating chronic prostatitis/chronic pelvic pain syndrome.

A retrospective analysis of outpatient anesthesia management for dental treatment of patients with severe Alzheimer's disease

  • So, Eunsun;Kim, Hyun Jeong;Karm, Myong-Hwan;Seo, Kwang-Suk;Chang, Juhea;Lee, Joo Hyung
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.4
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    • pp.271-280
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    • 2017
  • Background: The number of patients with Alzheimer's disease is growing worldwide, and the proportion of patients requiring dental treatment under general anesthesia increases with increasing severity of the disease. However, outpatient anesthesia management for these patients involves great risks, as most patients with Alzheimer's disease are old and may show reduced cardiopulmonary functions and have cognitive disorders. Methods: This study retrospectively investigated 43 patients with Alzheimer's disease who received outpatient anesthesia for dental treatment between 2012-2017. Pre-anesthesia patient evaluation, dental treatment details, anesthetics dose, blood pressure, duration and procedure of anesthesia, and post-recovery management were analyzed and compared between patients who underwent general anesthesia or intravenous sedation. Results: Mean age of patients was about 70 years; mean duration of Alzheimer's disease since diagnosis was 6.3 years. Severity was assessed using the global deterioration scale; 62.8% of patients were in level ${\geq}6$. Mean duration of anesthesia was 178 minutes for general anesthesia and 85 minutes for intravenous sedation. Mean recovery time was 65 minutes. Eleven patients underwent intravenous sedation using propofol, and 22/32 cases involved total intravenous anesthesia using propofol and remifentanil. Anesthesia was maintained with desflurane for other patients. While maintaining anesthesia, inotropic and atropine were used for eight and four patients, respectively. No patient developed postoperative delirium. All patients were discharged without complications. Conclusion: With appropriate anesthetic management, outpatient anesthesia was successfully performed without complications for dental treatment for patients with severe Alzheimer's disease.

A Case Report of VulvoVaginal Candidiasis treated by Dahuanghuanglianxiexin-tang based on Shanghanlun provisions (『상한론(傷寒論)』 변병진단체계(辨病診斷體系)에 근거하여 대황황련사심탕(大黃黃蓮瀉心湯)을 투여한 칸디다성 질염 치험 1례)

  • Choi, Ju-Young
    • 대한상한금궤의학회지
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    • v.7 no.1
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    • pp.53-63
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    • 2015
  • Objective : This case report show the effect of Dahuanghuanglianxiexin-tang on VulvoVaginal Candidiasis. Methods : According to disease pattern identification diagnostic system based on shanghanlun provisions, The author diagnosed Taeyang-byung kyeolhyung. The symptoms of VulvoVaginal Candidiasis were worsen when the patient had long sitting position and digestive problems. Therefore the patient treated with Dahuanghuanglianxiexin-tang for 3 months. The severity of Candida Vaginitis was evaluated by patient's subjective statements(Vaginal pruritus, Vaginal secretion, Burning sensation). Results : After the treatment, Level of syptoms decreased from Severe to Trace and Eliminated. Conclusions : Dahuanghuanglianxiexin-tang improved the symptoms of VulvoVaginal Candidiasis on this study. Although Dahuanghuanglianxiexin-tang is not an usual treatment for VulvoVaginal Candidiasis, the author could prescribe the medicine due to shanghanlun six meridian patterns diagnostic system.

A Case Report of Dyshidrotic Eczema treated by Socheongryong-tang based on shanghanlun Provisions (『상한론(傷寒論)』 변병진단체계(辨病診斷體系)에 근거하여 소청용탕(小靑龍湯) 투여 후 호전된 한포진 1례)

  • Lee, Sung-Jun;Kim, Nam-Gon
    • 대한상한금궤의학회지
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    • v.8 no.1
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    • pp.41-51
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    • 2016
  • Objective : This study reports the effect of Socheongryong-tang on Dyshidrotic Eczema. Methods : This is a case report on a patient who has been suffering from Dyshidrotic Eczema. According to Diagnostic system based on Shanghanlun provisions, Socheongryong-tang was provided for 30 days. The severity of Dyshidrotic Eczema was evaluated by VAS and pictures. Results : When analyzing the patient's history and symptoms, it can be found in article No. 40 in Shanghanlun. The area and intensity of Dyshidrotic Eczema were reduced when viewed photos findings, so diagnosis and therapies showed valid results in Dyshidrotic Eczema. Conclusions : Socheongryong-tang is efficient to patient of this case report as a treatment.

A Case Report of Atopic dermatitis treated by Kyejiinsam-tang based on shanghanlun provisions (『상한론(傷寒論)』변병진단체계(辨病診斷體系)에 근거하여 계지인삼탕(桂枝人參湯)을 투여한 아토피 피부염 치험 1례)

  • Kim, Nam-Gon
    • 대한상한금궤의학회지
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    • v.9 no.1
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    • pp.75-83
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    • 2017
  • Objective : This study reports the effect of Kyejiinsam-tang on Atopic Dermatitis. Methods : This is a case report on a patient who has been suffering from Atopic Dermatitis. According to Diagnostic system based on Shanghanlun provisions, Kyejiinsam-tang was provided for 250 days. The severity of Atopic Dermatitis was evaluated by SCORAD index and pictures. Results : When analyzing the patient's history and symptoms, it can be found in article No. 163 in Shanghanlun. The area and intensity of Atopic Dermatitis were reduced when viewed photos findings, and SCORAD index decreased 58.1 to 7.1. So diagnosis and therapies showed valid results in Atopic Dermatitis. Conclusions : Kyejiinsam-tang is efficient to patient of this case report as a treatment.

A Case Study on Tic-disorder Child treated by Oriental Medicine and Play Therapy (놀이치료를 병행한 틱장애 환아 치험 1례)

  • Han, Jae-Kyung;Kim, Yun-Hee;Song, Hyun-Jee
    • The Journal of Pediatrics of Korean Medicine
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    • v.20 no.2
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    • pp.115-128
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    • 2006
  • Objective : The purpose of this study is to report a case of tic-disorder child treated by Oriental medicine and Play therapy. Methods : We treated the Tic-disorder child with herbal medicine (Yangsintangkamibang), acupuncture and Play therapy. Then we evaluated tic disorder by Yale Global Tic Severity Scale(YGTSS) and observed the progress of tic disorder with the play therapy. Results : We treated a tic-disorder patient with oriental medicine, play therapy and had a good effect on a patient who had facial motor tic disorder. The patient's symptoms were improved and the YGTSS also decreased. Conclusions : This study shows that co-treatment of oriental medicine and play therapy can be an effective treatment for tic disorder. And the further study is needed with more cases and longer duration.

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Severity of Emergency Patient classified by Triage System (중증도 분류체계를 이용한 중증도분류(Triage))

  • Bae, Jung-Hee;Sohn, Sue-Kyung
    • The Journal of Korean Academic Society of Nursing Education
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    • v.7 no.2
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    • pp.264-274
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    • 2001
  • About the patients who visited the emergency department of a hospital, investigative study was performed to assess and to classify them with triage tool, and to estimate the characteristics of them. 210 patients older than 15 years were investigated. Among them 11 patients who had responded inappropriately were excluded and remaining 210 patients were chosen as study subjects. Investigation had been performed for 30 days from Jan. 10, 2001 to Feb. 9, 2001. The triage tool was designed through the modification of triage tools developed by Kim and Choi. The data were analyzed with the SPSS program using mean, standard deviation, frequency, percentage, ANOVA and Scheffe's test. The results were as follows: 1. Of the characteristics of the study subjects, mean age of patients were 55.76 years and 70-79 years group which included 41 patients(20.6%) were most numerous. 101 (51.8%) patients visited emergency room by 119 emergency service and 91(45.7%) patients walked with assistance. 127 patients were cared in internal medicine department. 2. The distribution of triage scores were from minimum 6 points to maximum 18 points with mean $13.76{\pm}2.58$ points. 3. Triage scores had significant relationship with age(F=13.349,P=0.000), visiting method (F=8.832, P=0.000), walking status(F=28.185, p=0.000), care department(F=2.596, P=0.019), and preexisting disease(F=12.012, P=0.000). 4. After trage there were no urgent patient, 35 emergent patients(17.6%),109 subemergent patients(54.8%), and 55 nonemergent patients (27.6%). The result of emergency care were 80 admission(40.2%), 59 discharge (29.6%), 34 ICU admission(17.1%), 14 transfer to other hospital(7%), 10 operation (5%), and 2 death (2%). 5. About the time required for triage, mean duration to triage were $7.54{\pm}2.28$ mins in emergent patients, mean $7.23{\pm}2.50$ mins in subemergent patients and mean $6.49{\pm}2.19$ mins in nonemergent patients. There were no differences in duration to triage according to the severity of triage. 6. Time required in emergency treatment were mean $116.23{\pm}88.10$ in emergent patients mean $101.61{\pm}73.27$ in subemergent patients and mean $81.56{\pm}61.01$ in nonemergent patients. There were no significant difference among groups. This study depicted that triage scores were below the middle level and there were many geriatric patients in this hospital. Among the characteristics of patients, age, visiting method, walking status, care department, and accompanying disease could be data for triage of emergency patients. With triage score of a patient, the outcome of emergency care of a patient could be anticipated and this could be basal data in determining the priority of emergency nursing.

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Completeness of Patient Care Report (PCR) by Paramedics

  • Lee, HyoJu;Kim, JongHo;Yun, Seong Woo
    • Journal of information and communication convergence engineering
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    • v.20 no.3
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    • pp.204-211
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    • 2022
  • This study evaluated the completeness of patient care report (PCR). A retrospective quality analysis was conducted using raw data of 122,140 EMS activity reports prepared by paramedics in Gyeonggi-do from April 1 to May 31, 2021. In all, 67,830 cases of normal transfers were statistically analyzed using IBM SPSS Statistics version 22, and statistical significance was set at p<0.5. The 119EMT_2 certificate was omitted in 50,037 (73.8%) cases, followed by time-related items in 1,227 (1.8%) cases. In the primary assessment of vital signs, systolic blood pressure was omitted and erroneous in 1,218 (1.9%) and 1,129 (1.8%) cases, respectively. In the secondary assessment, the completeness of all vital sign items was approximately 70%. Advanced emergency care and online medical control (OLMC) reporting showed discrepancies in all items. As the severity of the patient's condition increased, the errors in the Patient care report (PCR) also increased, at a significant level (p= .00). Paramedics must be aware of the importance of completing the activity report.