• Title/Summary/Keyword: Patient outcome

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A Clinical Study on the Outcome of Chuna Treatment of Adolescent Structural Scoliosis (청소년기의 구조적 척추측만증에 대한 추나치료 결과 고찰)

  • Heo, Su-Young
    • The Journal of Korea CHUNA Manual Medicine
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    • v.2 no.1
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    • pp.121-132
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    • 2001
  • Objectives The present study retrospectively investigated clinical outcome of patients with structual scoliosis during Chuna treatment. Methods : The study population consisted of 34 patients(14 patients of adolescent and 20 patients of adult) who were diagnosised as scoliosis with radiological finding. All patients were treated with Chuna treatment, and after treatment, evaluated with radiological measurement by calculating the scoliosis correction angle from the Initial and follow-up spine AP and lateral views. Also the evaluation of clinical outcome was done twice pre and post treatment during this study. Results : The results were summarized as follows ; 1) The 85.3 percent of patients complained physical pain. and adult group had various painful lesion compared with adolescent group. 2) Adult group had treated $18.0{\pm}7.2$ times and adolescent group treated $13.5{\pm}5.7$ times with Chuna treatment. 3) Scoliotic angle is reduced in 92.9 percent of adolescent group and had all of adult group after Chuna treatment, especially, statistically significance appeared in adult group. 4) Adult group was superior to adolescent group in correctability and scoliotic angle change. 5) Correction effect was better in the group which initial scoliotic angle was lessor, or had more time of treatment. 6) According to grade of vertebral body rotation, scoliotic angle is larger and correctability was lower. Conclusions : Chuna treatment was efficacious against scoliosis. And it is necessary for adolescent scoliosis patient to be more carefully treated and observed.

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Effect of Chest Physical Therapy in Pediatric Patients (소아 폐염 환자에서 시행한 흉부 물리치료의 효과)

  • Ahn, Mi-Kyung;Woo, Kwang-Seog
    • Journal of Korean Physical Therapy Science
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    • v.5 no.4
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    • pp.831-836
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    • 1998
  • Object: We evaluated the efficacy of chest physical therapy in pediatric patients with pneumonia. Method: Retrospective study was performed in 89 pneumonia patients admitted to pediatric unit. The subjects were divided into two groups: control group; treatment group. Control group included 42 patients who didn't receive chest physical therapy. Treatment group included 47 patients who received chest physical therapy. The chest physcial therapy employed were postural drainage, chest percussion, deep breathing training and enhancement of coughings. The efficacy was evaluated by x-ray outcome before discharge. Results: There were no significant difference in age, sex, type of pneumonia, and symptom duration between two groups. However the duration of fever after admission, duration of antibiotic use and hospital stay were longer in treatment group. In treatment group, longer the day to initiate chest physical therapy, longer the hospital stay. The final outcome was not different between groups. Conclusion: The results suggest that the referred patients for chest physical therapy tends to be of severe cases. Nevertheless, the result that the outcome was not different in two groups means that the chest physical therapy could be used as a effective treatment method in pediatric patient with pneumonia.

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Difference in Length of Stay and Treatment Outcome of Pulmonary Tuberculosis Inpatients between Health Insurance Types (의료보장유형에 따른 폐결핵 입원환자의 재원기간과 치료결과 차이분석)

  • Kim, Sang Mi;Lee, Hyun Sook;Hwang, Seul ki
    • Korea Journal of Hospital Management
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    • v.21 no.4
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    • pp.45-54
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    • 2016
  • The purpose of this study is to identify patient and hospital characteristics with pulmonary tuberculosis and to analyze factors which were influencing length of stay and treatment. The Korean National Hospital Discharge In-depth Injury Survey database from 2006 to 2012 was used for analysis. Study subjects were 4,704 patients and analyzed by using frequency, chi-square and logistic regression through using STATA 12.0. To avoid selection bias, we used propensity score matching. Analysis results show that the length of stay and treatment of pulmonary tuberculosis was different between insurance types. Patients characteristic(female, comorbidity, admission by outpatient department, medical insurance type) and hospital characteristic(500-999 beds, over 1000 beds) significantly influence length of stay. Admission by outpatient department and over 1000 beds are significantly influence treatment. Based on these findings, it is necessary to clarify between length of stay and treatment outcome by medical aids beneficiaries and audit hospitals follow discharge guidelines in pulmonary tuberculosis patients.

Perception of Nurse Experts on the Contribution of Nursing Interventions to NOC Nursing Outcomes in General Hospitals in Korea

  • Lee Byoungsook
    • Journal of Korean Academy of Nursing
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    • v.35 no.4
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    • pp.649-655
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    • 2005
  • The purpose of this study was to identify the perception of nurse experts on the contribution of nursing interventions to Nursing Outcomes Classification NOC nursing outcomes. A nursing outcome is a nursing-sensitive patient outcome primarily affected by nursing interventions. As one of the standardized language systems of nursing outcomes, the NOC must be examined for applicability before it is used in Korea. Data were collected in February and March 2003 using a 5-point Likert scale. For data collection, 230 quality improvement (QI) or quality assurance (QA) nurses from general hospitals in Korea were asked to rate the extent that nursing interventions contribute to each of the NOC nursing outcomes (2000) in their hospitals. Ninety-six nurses from 63 hospitals responded and the response rate was $41.7\%$. Mean scores for perception of contribution of nursing interventions to each of the NOC nursing outcomes ranged from 2.18 to 4.54. Vital Signs Status had the highest score (M = 4.54), and Abuse Recovery: Financial, the lowest score (M = 2.18). Of the seven NOC domains, the mean score was highest for Physiologic Health (M = 3.91) and lowest for Community Health (M = 2.92). Of the 29 NOC classes, the mean score for perceived contribution was highest for Metabolic Regulation (M = 4.32) and lowest for Community Well-Being (M = 2.92). Participants perceived that nursing interventions in general hospitals in Korea contributed, at least to a certain extent, to most of the NOC nursing outcomes. Based on these results, NOC should have relatively good applicability in Korea.

Chiari Type III : Experience of Outcome for 15 Cases

  • Gabr, Mohamed;Elmataeshy, Mahmoud;Abdullah, Ahmed A.
    • Journal of Korean Neurosurgical Society
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    • v.65 no.6
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    • pp.841-845
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    • 2022
  • Objective : Chiari III malformations are extremely rare hindbrain malformations that are associated with a high early mortality rate, or severe neurologic deficits in the survivors. The treatment is early operative closure and cerebrospinal fluid diversion (CSF) shunting. Methods : We operated on 15 patients by repair and excision between July 2014 till June 2020 and retrospective data collection was done. Only one patient doesn't need ventriculoperitoneal (VP) shunt and the other 14 patients need a VP shunt. We described stepwise dissection and untethering of the cerebellum from the bony edge to regrowth and herniation of cerebellum again into this potential space and simple dural closure or repair with graft was done. Results : We started with VP in eight patients (53%) and the other seven patients (46.7%) started with excision and then six patients need VP shunt later on because four patients developed CSF leak and two patients developed increased high intracranial tension. Only four patients (26.7%) needed a blood transfusion. Conclusion : There are variations in the outcome and not all cases of Chiari malformation III will die and severe developmental delay is not a must. Proper management and repair carry a good prognosis.

Effect of lower extremity resistance exercise on gait performance in a patient with systemic lupus erythematosus with cerebral infarction and lower extremity vasculitis: a case study

  • Oh, Yongseop;Woo, Youngkeun
    • Physical Therapy Rehabilitation Science
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    • v.5 no.2
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    • pp.106-112
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    • 2016
  • Objective: This study was conducted to investigate the effects of resistant exercise on the gait performance of a patient with systemic lupus erythematosus (SLE) patient. Design: A case study. Methods: A 30-year-old male adult who had been diagnosed with systemic lupus erythmatosus (SLE) in April 2013, right middle cerebral artery infarction, and with left hemiplegia agreed to participate in this case study. Patient was unable to walk due to being affected with adynamia. Due to developing necrotizing vasculitis on the left lower extremity, patient underwent a myotomy on the left thigh. The patient was trained with a progressive resistant exercise program for 8 weeks. An intensity of 15 RM was used for the resistant exercises and the resistance level was increased progressively in order to improve the muscle power of the patient. Methods used to increase resistance included changing positions, providing mechanical resistance instead of manual resistance, transitioning from open kinetic chain to closed kinetic chain exercises, and changing the colors of the theraband to those with increase level of resistance. Outcome measures included the 5-repetition sit-to- stand test (5RSST), Timed Up & Go (TUG), and 10-meter walk test (10MWT). In addition, the GAITRite was used to assess the spatio-temporal gait variables, including gait speed, cadence, stride length of the left side, and double limb support pre and post-intervention. Results: The patient was able to perform sit-to- stand after two weeks of performing the resistant exercises. The patient was able to walk after 4 weeks, and the patient's overall gait performance had improved after 8 weeks. All of the variables had improved after each week. Conclusions: The results of this case study may be used to enhance future efforts to objectively evaluate resistant exercises during gait performance in persons affected by SLE.

Scar Revision Surgery: The Patient's Perspective

  • Miranda, Benjamin H;Allan, Anna Y;Butler, Daniel P;Cussons, Paul D
    • Archives of Plastic Surgery
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    • v.42 no.6
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    • pp.729-734
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    • 2015
  • Background Insufficient satisfaction outcome literature exists to assist consultations for scar revision surgery; such outcomes should reflect the patient's perspective. The aim of this study was to prospectively investigate scar revision patient satisfaction outcomes, according to specified patient-selection criteria. Methods Patients (250) were randomly selected for telephone contacting regarding scar revisions undertaken between 2007-2011. Visual analogue scores were obtained for scars pre- and post-revision surgery. Surgery selection criteria were; 'presence' of sufficient time for scar maturation prior to revision, technical issues during or wound complications from the initial procedure that contributed to poor scarring, and 'absence' of site-specific or patient factors that negatively influence outcomes. Patient demographics, scar pathogenesis (elective vs. trauma), underlying issue (functional/symptomatic vs. cosmetic) and revision surgery details were also collected with the added use of a real-time, hospital database. Results Telephone contacting was achieved for 211 patients (214 scar revisions). Satisfaction outcomes were '2% worse, 16% no change, and 82% better'; a distribution maintained between body sites and despite whether surgery was functional/symptomatic vs. cosmetic. Better outcomes were reported by patients who sustained traumatic scars vs. those who sustained scars by elective procedures (91.80% vs. 77.78%, P=0.016) and by females vs. males (85.52% vs. 75.36%, P<0.05), particularly in the elective group where males (36.17%) were more likely to report no change or worse outcomes versus females (16.04%) (P<0.01). Conclusions Successful scar revision outcomes may be achieved using careful patient selection. This study provides useful information for referring general practitioners, and patient-surgeon consultations, when planning scar revision.

Effective consultation strategy for patients of aesthetic case (심미 증례 환자의 효과적인 상담 전략)

  • Kim, Jumee
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.22 no.1
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    • pp.74-82
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    • 2013
  • In the modern society, the awareness of images is affecting the body-related consumer behavior through mass media such as TV and internet, and SNS that has grown explosively with the wide availability of smartphones. As a consequence, the demands for aesthetic treatments by patients who wish to improve their inferiority complex are increasing. Patients who want aesthetic treatments display more active inclinations than those receiving general treatments, and have the expectation for the improvement in images along with the anxiety over potential functional problems and satisfaction about the outcomes. In the consultation of the patient of aesthetic case, the basic starting point is that the surgeon and the patient recognize improvement points that the patient expects through the aesthetic treatment. The consultation starting from the viewpoint of the patient proceeds in a way that the consensus is reached through the medical approach, eventually finding the balance between ideals and naturalness. The consultation process from the initial meeting is established at each stage of treatment, at which the consultation is correctly recorded and shared by the surgeon and the care staff. In addition, the consistent policy is implemented from the initial consultation through to the maintenance care. Together, these will result in the consultation based on the true communications leading to the outcome that satisfies the patient, the surgeon and the care staff, rather than the one that gives the patient an unfounded hope and leads to the unsympathetic outcome. This article introduces the consultation strategy for patients of aesthetic case based on the sympathy with them through cases of aesthetic treatment by type.

Survey on Value Elements Provided by Artificial Intelligence and Their Eligibility for Insurance Coverage With an Emphasis on Patient-Centered Outcomes

  • Hoyol Jhang;So Jin Park;Ah-Ram Sul;Hye Young Jang;Seong Ho Park
    • Korean Journal of Radiology
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    • v.25 no.5
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    • pp.414-425
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    • 2024
  • Objective: This study aims to explore the opinions on the insurance coverage of artificial intelligence (AI), as categorized based on the distinct value elements offered by AI, with a specific focus on patient-centered outcomes (PCOs). PCOs are distinguished from traditional clinical outcomes and focus on patient-reported experiences and values such as quality of life, functionality, well-being, physical or emotional status, and convenience. Materials and Methods: We classified the value elements provided by AI into four dimensions: clinical outcomes, economic aspects, organizational aspects, and non-clinical PCOs. The survey comprised three sections: 1) experiences with PCOs in evaluating AI, 2) opinions on the coverage of AI by the National Health Insurance of the Republic of Korea when AI demonstrated benefits across the four value elements, and 3) respondent characteristics. The opinions regarding AI insurance coverage were assessed dichotomously and semi-quantitatively: non-approval (0) vs. approval (on a 1-10 weight scale, with 10 indicating the strongest approval). The survey was conducted from July 4 to 26, 2023, using a web-based method. Responses to PCOs and other value elements were compared. Results: Among 200 respondents, 44 (22%) were patients/patient representatives, 64 (32%) were industry/developers, 60 (30%) were medical practitioners/doctors, and 32 (16%) were government health personnel. The level of experience with PCOs regarding AI was low, with only 7% (14/200) having direct experience and 10% (20/200) having any experience (either direct or indirect). The approval rate for insurance coverage for PCOs was 74% (148/200), significantly lower than the corresponding rates for other value elements (82.5%-93.5%; P ≤ 0.034). The approval strength was significantly lower for PCOs, with a mean weight ± standard deviation of 5.1 ± 3.5, compared to other value elements (P ≤ 0.036). Conclusion: There is currently limited demand for insurance coverage for AI that demonstrates benefits in terms of non-clinical PCOs.

The Effect of Patient-Centered Goal Setting on Rehabilitation Outcomes in Patients With Subacute Stroke (환자중심 목표설정이 아급성기 뇌졸중 환자의 재활치료 성과에 미치는 영향)

  • Won, Jong-im;An, Chang-man;Park, Min-hee
    • Physical Therapy Korea
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    • v.25 no.1
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    • pp.31-38
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    • 2018
  • Background: Patient-centered care has recently become highly recommended, because it can improve health outcomes more effectively than problem-oriented care. The goal attainment scale (GAS) is one of the methods used for patient-centered care. It was originally developed as an outcome measurement tool, but it can also be used as a therapeutic intervention when setting quantifiable patient-centered goals. Objects: We sought to identify the effect of setting patient-centered goals on rehabilitation outcomes in patients with subacute stoke using GAS. Methods: Overall, 46 subjects with subacute stroke were divided into experimental ($n_1=23$) and control ($n_2=23$) groups. Subjects in both groups attended physical therapy sessions five times a week for four weeks. Those in the experimental group set goals using goal-attainment scaling. The mobility of each subject was evaluated using the Rivermead mobility index (RMI); daily-living activities, using the K-modified Barthel index (K-MBI); participation, using the Hopkins rehabilitation-engagement rating scale (HRERS); satisfaction, using the patient-satisfaction scale (PSS). Results: Subjects in the experimental group experienced more significant increases in RMI, HRERS, and PSS than those in the control group (p<.05, p<.05 and p<.01, respectively). After four weeks, GAS scores of the experimental group had increased more significantly than those of baseline (p<.01). Conclusion: Setting patient-centered goals is effective in improving the mobility and satisfaction of patients with subacute stoke. Setting patient-centered goals needs to be performed more frequently in clinical settings.