• Title/Summary/Keyword: Patient's satisfaction

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Three-dimensional computed tomography evaluation of craniofacial characteristics according to lateral deviation of chin

  • CHOI, Hyo-Won;KIM, Bola;KIM, Jae-Young;HUH, Jong-Ki;PARK, Kwang-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.57.1-57.8
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    • 2019
  • Background: The relationship between the lateral deviation of chin and the upper and middle facial third asymmetry is still controversial. The purpose of this study is to evaluate the correlation of upper and middle facial third asymmetry with lateral deviation of chin using 3-dimensional computed tomography. The study was conducted on patients who underwent orthognathic surgery from January 2016 to August 2017. A total of 40 patients were included in this retrospective study. A spiral scanner was used to obtain the 3-dimensional computed tomography scans. The landmarks were assigned on the reconstructed 3-dimensional images, and their locations were verified on the axial, midsagittal, and coronal slices. The Pearson correlation analysis was performed to evaluate the correlation between chin deviation and difference between the measurements of distances in paired craniofacial structures. Statistical analysis was performed at a significance level of 5%. Results: In mandible, the degree of chin deviation was correlated with the mandibular length and mandibular body length. Mandibular length and mandibular body length are shorter on the deviated-chin side compared to that on the non-deviated side (mandibular length, r = -0.897, p value < 0.001; mandibular body length, r = -0.318, p value = 0.045). In the upper and middle facial thirds, the degree of chin deviation was correlated with the vertical asymmetry of the glenoid fossa and zygonion. Glenoid fossa and zygonion are superior on the deviated-chin side than on the non-deviated side (glenoid fossa, r = 0.317, p value = 0.046; zygonion, r = 0.357, p value = 0.024). Conclusion: Lateral deviation of chin is correlated with upper and middle facial third asymmetry as well as lower facial third asymmetry. As a result, treatment planning in patients with chin deviation should involve a careful evaluation of the asymmetry of the upper and middle facial thirds to ensure complete patient satisfaction.

ORTHODONTIC TRACTION OF IMPACTED POSTERIOR TEETH : CASE REPORTS (매복 구치부 치아의 교정적 이동 : 증례 보고)

  • Maeng, Yu-Jin;Oh, So-Hee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.4
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    • pp.613-618
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    • 2009
  • Impacted molars are not usual with the prevalence rate of less than 1%, however problems such as infraocclusion, extrusion of the opposite tooth and lack of space are caused. If molars are impacted, radiographic check-up and observations are needed as they play an important role in skeletal development and mastication. Causes of impaction are underdevelopment of roots, supernumerary teeth, cysts, odontomas, ankylosis and etc. In our first case, we present impacted molar which was surgically exposed and orthodontically traded. As the developmental state of the root was less than half at first visit, we observed until the root was 2/3 in its length and traction was carried out. The second case is orthodontic traded molar with compleate enucleation of the existing cysts. When trading impacted molars, direct bonding of attachments to the tooth and light continuous forces are recommended so as to ankylosis, external absorption and periodontal attachment loss avoid. Fixed appliances tract the teeth on arch and obtain eruption spaces without patient's cooperation. We report surgically exposed and orthodontically traded molars which resulted in good occlusion and patients satisfaction.

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Arthroscopic Treatment of Acute Acromioclavicular Dislocation using $TightRope^{(R)}$ ($TightRope^{(R)}$를 이용한 관절경적 급성 견봉쇄골 관절 탈구의 치료)

  • Kim, In-Bo;Shon, Myung-Hwan;Kim, Moon-Chan;Kim, Dong-Jun
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.1
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    • pp.13-18
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    • 2011
  • Purpose: The purpose of this study is to evaluate the radiologic and clinical results of the arthroscopic coracoclavicular fixation of the acute acromioclavicular dislocation using $TightRope^{(R)}$ (Arthrex, Inc, Naples, FL). Materials and Methods: We performed the arthroscopic coracoclavicular fixation using $TightRope^{(R)}$ in twenty patients with the Rockwood type III or V acute acromioclavicular dislocation between February, 2009, and February, 2010. Mean follow-up was 13.4(range 8~22) months. Radiologic results were evaluated by comparing the distances between the clavicle and the coracoid process with those in the contralateral sides using the acromioclavicular stress radiographs. Clinical results were made according to the KSS(Korean Shoulder Scoring System), and the cosmetic satisfaction of the patient was assessed. Results: Radiologically, 18 cases showed excellent, 1 case showed good and 1 case showed fair results. Clinically, KSS was mean 98.5 (range 92~100) points and all cases revealed satisfactory cosmetic results. Because one case complained of skin tenderness and discomfort of palpation, we closed the knot with surrounding muscle & fascia. Then local wound infection occurred, so we treated it by incision and drainage under local anesthesia and antibiotic therapy for 2 weeks. Conclusion: Arthroscopic coracoclavicular fixation using $TightRope^{(R)}$ for treating the Rockwood type III or V acute acromioclavicular dislocation showed satisfactory radiologic and clinical results. It seems to be a good treatment method that has little postoperative complication, provides an early rehabilitation and an excellent cosmetic result, and does not require secondary operation for removal of metal implant.

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Recognition of Medical Consumer over the Infection Control of Dental Clinic (감염관리에 관한 치과의료소비자들의 인식도)

  • Kim, Ji-Hwa;Kim, Gi-Wook
    • The Journal of the Korea Contents Association
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    • v.13 no.11
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    • pp.306-312
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    • 2013
  • The purpose of this study was to grasp the recognition of medical consumer over the infection in dental clinic. The study performed the questionnaire by selecting the patients visiting 3 dental clinics of Daegu area as targets and analyzed 213 question papers collected. The result revealed that the infection control, which was most important for the patients, was 'instrument disinfection' (64.3%) and it was significant in age factor(P<0.01). For the responsibility of infection control, 72.3% replied that 'dentist or dental clinic staff' should be responsible for it and it was significant in academic background factor(P<0.001). For the importance of cleaning and sanitation, 70.0% replied that 'it is very important' and it was gender(P<0.05)and the age factor.((P<0.01) The person who experienced the information about the infection control of dental clinic observed hand washing(P<0.001), replacement of suction tip(P<0.001) and replacement of teeth washing cup (P<0.01) more carefully and considered whether dentist wears protective goggle more importantly than the person who did not experience it(P<0.01). If dental clinic recognizes the evaluation of infection control notified by the Ministry of Health & Welfare and performs the infection control suitable for the eye level of general medical consumer on the basis of the study result above, it can improve the reliance of hospital as well as patient's satisfaction.

Financial Hardship Factors affecting the Cancer Patient's Quality of Life (암 환자의 삶의 질에 영향을 미치는 재정 관련 어려움 요인)

  • Rhee, Young-Sun;Kim, Su-Yeon;Park, Jeong-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.10
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    • pp.299-307
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    • 2020
  • Purpose: The purpose of this study was to investigate the financial hardships affecting the quality of life of cancer survivors. Method: Data were collected from five convalescent hospitals using self-administered questionnaires, and 422 questionnaires were used for the final analysis. We used a 5-step hierarchical multiple-regression analysis by entering each sociodemographic variable, medical variable, and three types of financial hardship (a material situation, the psychological response, and coping behavior coming from cancer treatment cost) into each step. Results: The results of statistical analysis indicate that the most influential factor in the quality of life was the financial difficulty, which was the frustration that they could not work as usual or support their family financially. In addition, the performance of physical activity, accompanying diseases, women patients, psychological burden on cancer treatment cost, the satisfaction of communication with medical staff for medical expenses, and the feeling unsuccessful financial coping strategy were predictors for the quality of life of cancer survivors. Conclusion: This study provides a blueprint for the development of intervention programs in practice to improve the quality of life of cancer patients, clinical intervention plans, and health policies.

Development of a Tool to Measure Suffering in Patients with Cancer (암환자의 고통 측정도구 개발에 관한 연구)

  • 강경아
    • Journal of Korean Academy of Nursing
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    • v.29 no.6
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    • pp.1365-1378
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    • 1999
  • This study is a methodological research study to develop an instrument to measure in patients with cancer and to test the validity and reliability of the instrument. The research procedure was as follows : 1) The first step was to develop conceptual framework based on a comprehensive review of the literature and in-depth interviews with patients with cancer. This conceptual framework was organized in to three dimensions (the intrapersonal dimension, the significant-other and context related dimension, the transcendental dimension). Initially 59 items were adopted. 2) These items were analyzed through the index of content validity(CVI) and 53 items were selected which met more than 80% on the CVI. 3) The pretest was carried out with 87 patients with cancer. After the pretest results were analyzed by item analysis, 44 items were selected. A second test of content validity was conducted and 6 items were eliminated considering the 80% CVI. 4) To test for reliability and validity, data collection was done during the period from January 25, 1999, to February 26, 1999. The subjects for the test were 160 patients with cancer and 185 healthy persons. analysis, item analysis and multitrait-multimethod method to analyze validity. The findings are as follows : 1) The Cronbach's alpha coefficient for internal consistency was .92 for the total 38 items and .79, .82, .85, for the three dimensions in that order. 2) The item analysis was based on the corrected item to total correlation coefficient( .30 or more) and information about the alpha estimate if this item was dropped from the scale. 3) As a result of the initial factor analysis using principal component analysis and varimax rotation, one item was deleted because of factor complexity (indiscriminate factor loadings). In the secondary factor analysis, 7 factors with eigenvalue of more than 1.0 were extracted and these factors explained 56 percents of the total variance. The seven factors were labeled as 'family relationship', 'emotional condition', 'physical discomfort', 'meaning and goal of life', 'contextual stimuli', 'change of body image', 'guilt feelings'. 4) The convergence effect between this instrument and the life satisfaction scale was identified and there was significant positive correlation(r= .52, p= .00). The discriminant validity between this instrument and the depression scale(CES-D) was tested and there was significant negative correlation(r= -.50, p= .00). The instrument for accessing the suffering of patients with cancer developed in this study was identified as a tool with a high degree of reliability and validity. In this sense, this tool can be effectively utilized for assessment in caring for patients with cancer.

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Cryoanalgesia for the Post-thoracotomy Pain (늑간 신경 냉동요법에 의한 개흉술후 흉부 동통 관리)

  • Kim, Uk-Jin;Choe, Yeong-Ho;Kim, Hyeong-Muk
    • Journal of Chest Surgery
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    • v.24 no.1
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    • pp.54-63
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    • 1991
  • Post-thoracotomy pain is so severe that lead to postoperative complications, such as sputum retention, segmental or lobar atelectasis, pneumonia, hypoxia, respiratory failure due to the patient`s inability to cough, deep breathing and movement. Many authors have been trying to reduce the post-thoracotomy pain, but there is no method of complete satisfaction. In 1974, Nelson and associates introduced the intercostal nerve block using the cryoprobe. The application of cold directly to the nerves causes localized destruction of the axons while preserving the endoneurium and connective tissue, thereby introducing a temporary pain block and able to complete regeneration of intercostal nerves. One hundred and two patients, who undergoing axillary or posterolateral thoracotomy at the Department of Thoracic and Cardiovascular Surgery in Korea University Medical Center between April 1990 and August 1990, were evaluated the effects of cryoanalgesia for the post-thoracotomy pain reduction. The patients were divided into two groups: Group A, control, the patients without the cryoanalgesia[No.=50], Group B, trial, the patients with cryoanalgesia[No.=52]. Before the thorax closed, in the group A, local anesthetics, 2% lidocaine 3cc, were injected to the intercostal nerves[one level with the thoracotomy, one cranial and caudal intercostal level and level of drainage tube insertion]. In the group B, cryoprobe was directly applied for 1 minute at the same level. Postoperative analgesic effects were evaluated by the scoring system which made arbitrary by author: The pain score 0 to 4, The limitation of motion score 0 to 3, The analgesics consumption score 0 to 3, The total score, the sum of above score, 0 to 10. For the evaluation of immediate analgesic effects, the score were evaluated at the operative day, the first postoperative day, the second postoperative day, and the seventh postoperative day. The effects of incision type, and rib cut to the post-thoracotomy pain were also evaluated. The results were as follows; 1. The intercostal block with cryoanalgesia reduced the immediate postoperative pain significantly compare with control group. 2. The intercostal block with cryoanalgesia improved the motion of the operation side significantly compare with control group. 3. The intercostal block with cryoanalgesia reduced the analgesics requirements at the immediate postoperative periods significantly. 4. The intercostal block with cryoanalgesia lowered the total score significantly compare with control group. 5. The intercostal block with cryoanalgesia were more effective to the mid-axillary incision than to the posterolateral incision 6. The intercostal block with cryoanalgesia were more effective to the patients without rib cut than to the patients with rib cut. 7. No specific complication need to be treated were not occurred during follow-up.

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Education Evaluation of Basic CPR on Guard Major Collegian in Gwangju and Jeonnam Region (광주·전남지역 경호학과 대학생의 심폐소생술(CPR) 교육평가)

  • Jang, Chul-Won
    • Journal of the Society of Disaster Information
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    • v.7 no.4
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    • pp.266-272
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    • 2011
  • This study is focused on guard major collegians who are composed of factor in medical emergency system. In the case of cardiac failure, it is to make its basic data develop its education program of CPR which can increase the patient's survival rate before his hospitalization. The subject of study is composed of 120 persons who are 94 boy-collegians(78.3%) and 26 girl-collegians(21.7%) in sex and 66 first-grade collegians(55.0%) and 54 second-grade collegians(45.0%) in a school year. There is significant difference in the practices of artificial respiration and the thorax pressure after the education of basic CPR in sex(p<0.01). The practices of artificial respiration in boy-collegians($93.72{\pm}4.21$) is higher than in girl-collegians($82.31{\pm}6.36$) and the practices of thorax pressure in boy-collegians($92.45{\pm}4.44$) is higher than in girl-collegians($88.08{\pm}6.49$). The satisfaction degree of boy-collegians($4.33{\pm}0.59$) is higher than that of girl-collegians($3.73{\pm}0.67$) after theory & practice education of basic CPR(p<0.01). It is necessary to develop the education program and educate its knowledge & technology in proportion to collegians characteristics of sex and school year. Also, education authorities should develop a subject of the accident provided the practical education of CPR for guard major collegians.

A Study on the Effect of Caregiver Burden on Suicidal Ideation among Caregiver for the Elderly with Dementia (치매노인의 증상정도가 부양자의 자살생각에 미치는 영향에 대한 연구: 부양부담의 매개효과를 중심으로)

  • Kim, JaeYop;Kim, JoonBeom;Jang, DaeYeon;Song, InHan
    • 한국노년학
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    • v.36 no.3
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    • pp.883-903
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    • 2016
  • The purpose of the study is examining the mediation effect of caregiver burden's segmentalized sub factors between dementia caregivers on the relationship between Symptom extent of dementia patients and Suicidal Ideation of dementia caregiver, and suggesting social welfare intervention methods for dementia caregiver The survey is targeted to demented elderly people and caregivers, and currently using medical care institution and day care center in Seoul, Gyeonggi Province and Pusan city. As a result of the survey, 415 cases were collected for the final analysis. In data analysis process, we used SPSS 21.0 for the mediation effect of conversational satisfaction and its significance, and the results are following. First, 21% of the caregivers responded that they had thoughts of suicide in the past year. Second, Symptom extent of dementia patients was positively related to caregiver burden. Third, worse in family relationships, which is sub factors of mediate variable, has partial mediate effect on the model. Based on these outcomes, we suggest the importance and necessity of improved approach about dementia elderly and caregiver between elderly couple as way to reduce caregiver burden and proposed social work-based intervention program for enhancing this.

A Study on Weight Loss Effect and Safety of Integrated Korean Medicine Treatment on Obese Patients in Local Clinics: A Restrospective Chart Review (한의원 진료환경에서 비만환자 대상 한의통합치료의 체중 감량 효과 및 안전성에 관한 연구: 후향적 차트 리뷰)

  • Ojin Kwon;Changsop Yang;Young Jin Kim;Won Hae Ku;Won Gu Lee;Ki Byung Kim;Kyung Hwan Jegal
    • Journal of Korean Medicine for Obesity Research
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    • v.22 no.2
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    • pp.125-135
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    • 2022
  • Objectives: A restrospective chart review were conducted to investigate the overall weight loss effect of the integrated Korean medicine treatment on obese patients (body mass index [BMI] ≥25 kg/m2) in Korean medicine clinic and analyze the difference in the effect according to lifestyle behaviors. Methods: The medical records of 43 obese patients were retrospectively analyzed including body weight, BMI, waist circumference, hip circumference, and body composition who received integrated Korean medicine treatment for 4 weeks at 24 Korean medicine clinics in Daejeon metropolitan city. All outcome measures were evaluated again 8 weeks after the end of treatment at week 12 for follow-up. EuroQol-5D (EQ-5D), the Korean version of the obesity-related quality of life scale (KOQOL) and patient's satisfaction were also evaluated. The analysis was divided according to the treatment period and observation period, and subgroup analysis was performed according to drinking and exercise habits. Results: Body weight, body fat, waist circumference, hip circumference, body fat were significantly reduced at week 4 and week 12. Theses weight reduction effects were significantly greater within treatment period (0 to 4 week) than observation period (4 to 12 week). Especially in the non-exercise group, the changes in body fat mass and body fat percent showed a significant difference between the treatment period and the observation period. KOQOL were also significantly improved at 12 week, but not in EQ-5D. No severe adverse events were observed. Conclusions: The integrated Korean medicine treatment could be effective to treat obesity including weight loss. It is necessary to prevent additional weight regain through regular exercise even after Korean medicine treatment.