• 제목/요약/키워드: Patient Participation

검색결과 231건 처리시간 0.03초

외국 약사 국가시험 문항관리 분석연구 (The Analysis of Item Management on Foreign Pharmacists Examination)

  • 권경희;임성실;손의동
    • 약학회지
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    • 제59권5호
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    • pp.235-244
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    • 2015
  • The goal of this study is to help for the utilization the national pharmacists test through the analysis of item development management to the foreign pharmacists examination. The United States is going to NABP (National Association of Boards of Pharmacy) initiative under the curriculum in question on the basis of this assessment and develop standards and unified, systematic system to conduct tests pharmacist. Practice oriented (patient scenario, the participation of a pharmacist or perform work, clinical practice) examination is doing in Canada, The UK is asking the for more than 70 percent and the prescription needed for actual calculation in practice prior to testing program, and by the including that allows references use. Our country may introduce the job as a clinical pharmacist, positively. Item management system is integrated into four regions based on the six-year curriculum should be done in harmony proportion of each region. Integration of fusion of each region in accordance with the duties should be come out. It has gradually been able to item management system developed by the United States or Canada. This item notice pharmacist judging the results of the work must be carried out for management upgrading to a form of management with an emphasis on clinical practice in developed countries. Foundation design, development, production and management and test after actively reviewing ways to improve management system for to management systems, a pharmacist to improve the quality of the national examination could be contributing are involved.

Effects of and barriers to hospital-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease

  • Kim, Sang Hun;Jeong, Jong Hwa;Lee, Byeong Ju;Shin, Myung-Jun;Shin, Yong Beom
    • Physical Therapy Rehabilitation Science
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    • 제9권2호
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    • pp.82-89
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    • 2020
  • Objective: The purpose of this study was to assess the effect of hospital-based pulmonary rehabilitation (PR) on exercise capacity and quality of life as well as barriers to participation in persons with chronic obstructive pulmonary disease (COPD) in South Korea. Design: One-group pretest-posttest design. Methods: A total of 14 patients were enrolled in this study in an 8-week PR program with two 60-minute sessions per week. The program included: flexibility exercises, breathing techniques, strengthening exercises, and aerobic exercises. The outcomes were defined as changes in the variables before and after the PR program. A change in the 6-minute walk distance (6MWD) was defined as the primary outcome, and changes in pulmonary function test, respiratory and grip strength, and the St. George's Respiratory Questionnaire (SGRQ) about quality-of-life results were secondary outcomes. A dropout was defined as missing >3 of the 16 sessions. Results: Patients who completed the program showed a significant improvement of 43.57±39.43 m in the 6MWD (p<0.05), but no significant differences were noted for the other function tests. The SGRQ showed a significant improvement in the activity and total score (p<0.05). The total dropout rate was 53.3%. Newly developed symptoms, exacerbation of COPD, transport problems, and lack of motivation were major barriers to PR. Conclusions: Our study showed that an 8-week hospital-based PR program improved exercise capacity and quality of life but had a high dropout rate in individuals with COPD. Since comprehensive PR has only recently been established in South Korea, patient motivation and education are critical.

요하지통 환자에서 선택적 경추간공 경막외강 블록의 예후 인자 (The Prognostic Factors of Selective Transforaminal Epidural Block in Patients with Low Back Pain)

  • 최병인;한정미;권태동;이윤우
    • The Korean Journal of Pain
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    • 제20권1호
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    • pp.54-59
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    • 2007
  • Background: Selective transforaminal epidural block (STEB) has showen effectiveness as a diagnostic and therapeutic option for the management of patients with low back pain or sciatica. This study was carried out in order to determine the short-term effects and prognostic factors associated with STEB in patients with low back pain or sciatica. Methods: Ninety-seven patients were selectedfor participation in this study. Their diagnosis were based werewason the clinical symptoms and MRI findings. We performed STEB under fluoroscopic guidance and injected 3 ml of radio opaque dye in order to confirm the technical success of the procedure. We then injected 20 mg of triamcinolone mixed into 3 ml of 0.5% mepivacaine. One month later, we classified the patient outcomes as excellent, good, moderate or poor, according to the degree of reduction in VAS score from baseline. The independent variables assessed included symptom duration, block level, number of blocks, primary diagnosis, prior caudal block, anterior epidural space filling of dye, medication history, demographic data, radiating pain, back surgery and spondylolisthesis. Results: At a mean follow-up period of 1 month after STEB, excellent results were noted in the patients diagnosed with herniated lumbar disc (70%), non-specific spondylosis (54%), spinal stenosis (44%), and failed back syndrome (28%). The patients with epidural adhesion and combined spondylolisthesis were associated with poorer outcomes. Combined caudal block, symptom duration and the extent of epidural spread of the drug were not related to the effectiveness of the treatment. Conclusions: Selective transforaminal epidural block is effective in treating patients with radiculopathy, such as herniated lumbar disc, but it isrelatively ineffective in treating patients with structural deformities, such as failed back syndrome and spondylolisthesis.

Surgical Decision Making for the Elderly Patients in Severe Head Injuries

  • Lee, Kyeong-Seok;Shim, Jae-Jun;Yoon, Seok-Man;Oh, Jae-Sang;Bae, Hack-Gun;Doh, Jae-Won
    • Journal of Korean Neurosurgical Society
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    • 제55권4호
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    • pp.195-199
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    • 2014
  • Objective : Age is a strong predictor of mortality in traumatic brain injuries. A surgical decision making is difficult especially for the elderly patients with severe head injuries. We studied so-called 'withholding a life-saving surgery' over a two year period at a university hospital. Methods : We collected data from 227 elderly patients. In 35 patients with Glasgow Coma Score 3--8, 28 patients had lesions that required operation. A life-saving surgery was withheld in 15 patients either by doctors and/or the families (Group A). Surgery was performed in 13 patients (Group B). We retrospectively examined the medical records and radiological findings of these 28 patients. We calculated the predicted probability of 6 month mortality (IPM) and 6 month unfavorable outcome (IPU) to compare the result of decision by the International Mission for Prognosis and Analysis of Clinical Trials in TBI (IMPACT) calculator. Results : Types of the mass lesion did not affect on the surgical decision making. None of the motor score 1 underwent surgery, while all patients with reactive pupils underwent surgery. Causes of injury or episodes of hypoxia/hypotension might have affected on the decision making, however, their role was not distinct. All patients in the group A died. In the group B, the outcome was unfavorable in 11 of 13 patients. Patients with high IPM or IPU were more common in group A than group B. Wrong decisions brought futile cares. Conclusion : Ethical training and developing decision-making skills are necessary including shared decision making.

The grading of cognitive state comparisons with different distances across three conditions in stroke survivors

  • Kim, Yumi;Park, Yuhyung
    • Physical Therapy Rehabilitation Science
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    • 제3권2호
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    • pp.134-141
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    • 2014
  • Objective: The purpose of this study was to compare with different distance across three conditions in stroke survivors with the grading of cognitive state. Design: Cross-sectional study. Methods: Twelve stroke patients who agreed to active participation were included. Participants were allotted to normal cognitive (CN) group (n=7) and cognitive impairment (CI) group (n=5) and then walked on a self-paced walkway at three conditions on the Time Up and Go (TUG) test and the 6 minute walk test (6MWT): 1) walking with your comfortable speed, 2) walking while carrying a tray with glasses, 3) walking with a verbal cognitive task. The TUG test was repeated three successful times on each condition. For the 6MWT, participants were tested one time. Results: The CI group walked slower than the CN group at the three conditions on the TUG test. However, there was no significant difference between two groups to each condition. A significant effect of dual tasking was found only in error of verbal cognitive task condition for the TUG test (p<0.05). On the 6MWT, the participants in the CI group walked short distance rather than the CN group (p<0.05). There were significant differences between two groups not only at all conditions but also at error of verbal cognitive task condition as well (p<0.05). Conclusions: To consider the results of different distances such as the TUG test and the 6MWT, we think that exercises in long distance would be more effective to patients with CI. Those would be improved patient's endurance in cognitive problem.

중환자실에서의 인간중심 간호와 가족 만족도 관계 (The Relationship between Person-Centered Nursing and Family Satisfaction in ICUs)

  • 강지연;신은자
    • 중환자간호학회지
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    • 제12권3호
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    • pp.1-12
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    • 2019
  • Purpose : This study aims to identify the relationship between person-centered critical care nursing (PCCN) and family satisfaction for intensive care unit (ICU) nurses. Methods : This research used a cross-sectional survey. The participants were 142 nurses and 121 family members from 8 ICUs in 4 hospitals in B city. The questionnaire survey was conducted between December 2018 and March 2019. The eight ICUs were divided into those that scored high and those that scored low for person-centered care relative to the average score for PCCN, and the difference in family satisfaction between the ICUs with high and low scores was compared using t-test. Results : The mean score of PCCN was $3.68{\pm}0.40$ out of 5. In the subcategories of PCCN, "comfort"was the highest at $3.95{\pm}0.49$, followed by "respect" at $3.73{\pm}0.57$, "compassion" at $3.59{\pm}0.57$, and "individuality" at $3.47{\pm}0.54$. The average score of family satisfaction with the ICUs was $3.45{\pm}0.67$ out of 5. In its subcategories, "emotion" was the highest at $3.69{\pm}0.72$, followed by "information" at $3.61{\pm}0.75$, "participation" at $3.30{\pm}0.79$, and "resources" at $3.20{\pm}0.80$. The family satisfaction ($3.75{\pm}0.54$) with the ICU of the highest-scoring PCCN was significantly higher than the family satisfaction ($3.25{\pm}0.53$) with the ICU with the lowest-scoring PCCN (t=4.97, p<.001). Conclusion: The results suggest that the PCCN scores of ICU nurses should be promoted to improve family satisfaction. It is necessary to pursue a variety of ways to secure the provision of person-centered nursing practice in ICUs.

메르스(Middle East Respiratory Syndrom)의 유행이 의사의 정신건강에 미치는 영향 : 확진자 발생 병원 근무 여부, 메르스 진료 참여 여부에 따른 비교 (Psychological Effects on Medical Doctors from the Middle East Respiratory Syndrome (MERS) Outbreak : A Comparison of Whether They Worked at the MERS Occurred Hospital or Not, and Whether They Participated in MERS Diagnosis and Treatment)

  • 엄대현;김장섭;이해우;이소희
    • 신경정신의학
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    • 제56권1호
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    • pp.28-34
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    • 2017
  • Objectives The purpose of this study was to evaluate psychological effects of an outbreak of Middle East respiratory syndrome (MERS), a newly emerged infectious disease, on doctors. Methods After the MERS outbreak was over, we conducted an online survey of doctors who worked at the hospitals in which exposure to MERS cases had been confirmed or who were directly involved in MERS diagnosis and treatment. The Patient Health Questionnaires-9 (PHQ-9) and the Impact of Event Scale-Revised (IES-R) assessment methods were used to assess the severity of depressive and posttraumatic stress symptoms among the 64 doctors participating in the survey. Results The results of the survey indicate that 26.6% (n=17) of participants exhibited depressive symptoms and 7.8% (n=5) had post-traumatic stress symptoms. The doctors employed at hospitals with MERS cases had higher PHQ-9 and IES-R mean scores than those in doctors were not so employed. In contrast, there was no significant difference in those test scores between doctors who participated directly in MERS diagnosis and treatment and those doctors who did not. Conclusion The survey demonstrated that 28.1% (n=18) of doctors involved in MERS care suffered from depressive or posttraumatic stress symptoms, even though the MERS infection was being controlled. Working at a hospital with MERS cases was the primary determinant of the adverse psychological outcomes among doctors ; however, direct participation in the diagnosis and care of MERS patients was not significantly related to such outcomes.

발의 형태학적 특성에 따른 시공간 보행 변인과 하지의 기능 및 통증 차이 (Differences in Spatiotemporal Gait Parameters and Lower Extremity Function and Pain in Accordance with Foot Morphological Characteristics)

  • Jeon, Hyung Gyu;Lee, Inje;Lee, Sae Yong;Ha, Sunghe
    • 한국운동역학회지
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    • 제31권2호
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    • pp.95-103
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    • 2021
  • Objective: The aim of this study was to investigate the differences in spatiotemporal gait performance, function, and pain of lower-extremity according to foot morphological characteristics. Method: This case-control study recruited 42 adults and they were classified into 3 groups according to foot morphology using navicular-drop test: pronated (≥ 10 mm), normal (5~9 mm), and supinated (≤ 4 mm) feet. Spatiotemporal gait analysis and questionnaires including Foot and Ankle Ability Measure activities of daily living / Sports, Western Ontario and McMasters Universities Osteoarthritis Index, Lower Extremity Functional Scale, International Physical Activity Questionnaire, and Tegner activity score were conducted. One-way analysis of variance was used for statistical analysis. Results: The pronated feet group showed longer loading response and double limb support in both feet and increased pre-swing phase in non-dominant feet. The supinated feet group demonstrated a longer swing phase in non-dominant feet and single limb support in dominant feet. However, there was no significant group difference in function and pain of knee joint and lower-extremity between groups. Conclusion: Our results indicated that abnormal spatiotemporal gait performance according to foot morphology. Although there was no difference in lower extremity dysfunction and pain according to the difference in foot morphology, they have the possibility of symptom occurs as a result of continuous participation in activities of daily living and sports. Therefore, individuals with pronated or supinated foot should be supplemented by utilizing an orthosis or training to restore normal gait performance.

ICF 모델 기반 신경계 환자 물리치료 평가 도구 사용 조사 (Evaluation Tools for Patients with Neurologic Disorders Based on the ICF Model: A Survey of Korean Physical Therapists)

  • 이지아;우영근;원종임;김수진
    • PNF and Movement
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    • 제20권3호
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    • pp.359-370
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    • 2022
  • Purpose: Physical therapists are required to properly choose the most appropriate treatment for each patient within the framework of the International Classification of Functioning, Disability, and Health (ICF model). The aims of this study were to determine whether neurological physical therapists in clinical settings in South Korea know about the ICF model and to investigate the current trends of outcome measures (OMs) used by them. Methods: Two hundred and one physical therapists who worked with patients with neurological disorders participated in this study. The survey was conducted via e-mail and asked about commonly used OMs and the considerations for selecting OMs. Results: All physical therapists involved in this study responded completely, and 45.8% of participants learned about the ICF model, while 37.3% understood the detailed information related to the ICF model. The rest of the participants did not know or just heard about the ICF model. The most frequently used tools at the body function/structure level were the Range of Motion (98%), Manual Muscle Test (97%), Berg Balance Scale (83.1%), and Modified Ashworth Scale (70.6%) when allowing repetition. At the activity level, the 10-meter walk test (71.1%), 6-minute walk test (54.2%), and Functional Ambulatory Category (43.3%) were used, while the Activity-Specific Balance Confidence Scale (23.9%) was used at the participation level. There was a positive relationship between the number of tools used and years of work, as well as the level of understanding of the ICF model. Conclusion: The results of this study suggest that it is necessary to learn the ICF model in a clinical setting. In addition, the medical system needs to be modified to encourage physical therapists in South Korea to use proper OMs within the ICF model.

휠체어 동력 보조장치 개발 국제 동향 (International Trends in Wheelchair Power Assist Add-ons Development )

  • 이석민;최기원;문인혁;박상수
    • 문화기술의 융합
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    • 제9권2호
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    • pp.143-150
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    • 2023
  • 우리나라의 1인당 국민소득이 증가하면서 장애인의 삶의 질 향상을 위한 다양한 여가 활동에 참여가 장려되고있다. 그러나 여가활동 참여를 위해서는 여가가 행해지는 장소까지의 이동이 선행되어야 하므로, 장애인의 여가활동을 위한 이동수단에 대한 관심이 커지고 있다. 수동 및 전동 휠체어는 여가활동을 위한 이동수단으로서 각각의 단점을 가지고 있어서 수동 휠체어에 전동 휠체어의 기능을 접합하는 휠체어 동력보조 장치에 대한 관심이 높아지고있다. 본 연구에서는 휠체어 동력보조 장치 제품들의 FDA 승인 과정을 조사하고, 세계 각국에서 생산하는 측면부착형, 전방부착형, 하방부착형, 후방부착형 휠체어 동력보조 장치들의 특성을 파악하였다. 이러한 정보들은 국내 장애인 및 보조인들이 환자의 상태에 따라 최적의 제품을 선택하는데 큰 도움이 될 것이다. 장애인들이 자신에게 적합한 동력 보조 장치를 선택할 수 있도록 많은 사용적합성 시험과 임상사례 연구가 필요하다.