• 제목/요약/키워드: Patient outcome assessment

검색결과 213건 처리시간 0.188초

GRBAS 음성평가와 음성장애지수 (GRBAS and Voice Handicap Index)

  • 손진호
    • 대한후두음성언어의학회지
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    • 제19권2호
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    • pp.89-95
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    • 2008
  • 주관적 음성평가는 음향분석기기를 이용한 객관적 음성 평가와 함께 음성분석에 유용하고 의미있는 평가방법이며 현재 알려진 검시법정 중에서 GRBAS 음성평가, VHI, patient self-perceptual voice rating이 가장 널리 사용되고 있고 인정받는 방법이다. 주관적 음성평가는 음성의 상태를 모두 대변할 수은 없으며 객관적인 음성평가에 대한 보완적인 의미를 가진다. 현재 개발되어 있는 주관적 음성평가 방법들이 유용한 평가도구이긴 하지만 나름대로의 문제점과 제한점을 가지고 있기 때문에 이에 대한 개선과 보완을 위한 지속적인 연구와 개발이 요구된다.

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Targeting motor and cognitive networks with multichannel transcranial direct current stimulation along with peripheral stimulation in a subacute stroke survivor: single case study

  • Midha, Divya;Arumugam, Narkeesh
    • Physical Therapy Rehabilitation Science
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    • 제9권4호
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    • pp.318-323
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    • 2020
  • Objective: Reacquisition of motor functions following stroke depends on interhemispheric neural connections. The intervention highlighted in the present case is an insight for augmenting motor recovery by stimulating the lesioned area and adjacent areas governing the motor behaviour of an individual. The purpose of this study was to determine the changes in the motor and cognitive outcomes through multi target stimulation of cortical areas by application of multichannel transcranial direct current stimulation (M-tDCS) in a stroke survivor. Design: A case report. Methods: The patient was a participant of a trial registered with the clinical trial registry of India (CTRI/2020/01/022998). The patient was intervened with M-tDCS over the left primary motor cortex i.e. C3 point and left dorsolateral prefrontal cortex i.e. F3 point with 0.5-2 mA intensity for the period of 20 minutes. SaeboFlex-assisted task-oriented training, functional electrical stimulation over the lower extremity (LE) to elicit dorsiflexion at the ankle and eversion of the foot, and conventional physiotherapy rehabilitation including a tailored exercise program were performed. Outcome assessment was done using the Fugl-Meyer assessment scale (FMA) for the upper and lower extremity (UE and LE), Montreal Cognitive Assessment (MOCA), Wisconsin Gait Scale (WGS) and the Stroke Specific Quality of Life (SSQOL) measures. Assessment was taken at Day 0, 15 and 30 post intervention. Results: Improvement was observed in all the outcome measures i.e FMA (UE and LE), MOCA, SSQOL and WGS across the span of 4 weeks. Conclusions: M-tDCS induced improvement in motor functions of the UE and LE, gait parameters and cognitive functions of the patient.

The Surgical and Cognitive Outcomes of Focal Cortical Dysplasia

  • Choi, Sun Ah;Kim, Ki Joong
    • Journal of Korean Neurosurgical Society
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    • 제62권3호
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    • pp.321-327
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    • 2019
  • Focal cortical dysplasia (FCD) is the major cause of intractable focal epilepsy in childhood leading to epilepsy surgery. The overall seizure freedom after surgery ranges between 50-75% at 2 years after surgery and the long-term seizure freedom remain relatively stable. Seizure outcome after surgery depends on a various factors such as pathologic etiologies, extent of lesion, and types of surgery. Therefore, seizure outcome after surgery for FCD should be analyzed carefully considering cohorts' characteristics. Studies of pediatric epilepsy surgery emphasize the early surgical intervention for a better cognition. Early surgical intervention and cessation of seizure activity are important for children with intractable epilepsy. However, there are limited data on the cognitive outcome after surgery in pediatric FCD, requiring further investigation. This paper reviews the seizure and cognitive outcomes of epilepsy surgery for FCD in children. Several prognostic factors influencing seizure outcome after surgery will be discussed in detail.

뇌졸중 환자의 결과지표에 영향을 주는 요인: 다변량 회귀분석과 다수준분석 비교 (Factors Affecting the Outcome Indicators in Patients with Stroke)

  • 김선희;이해종
    • 보건행정학회지
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    • 제25권1호
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    • pp.31-39
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    • 2015
  • Background: The purpose of this study is comparison of the results between regression and multi-level analysis to find out factors influencing outcome indicators (in-hospital death, length of stay, and medical charges) of stroke patients. Methods: By using patient sample data of Health Insurance Review & Assessment Service, patients admitted with stroke were selected as survey target and 15,864 patients and 762 hospitals were surveyed. Results: For the results of existing regression analysis and multi-level analysis, models were assessed through model suitability index value and as a result, the value of results of multi-level analysis decreased compared to the results of regression, showing it is a better model. Conclusion: Factors influencing in-hospital death of stroke patients were analyzed and as a result, intra-class correlation (ICC) was 13.6%. In factors influencing length of stay, ICC was 11.4%, and medical charges, ICC was 17.7%. It was found that factors influencing the outcome indicators of stroke patients may vary in every hospital. This study could carry out more accurate analysis than existing research findings through analysis of reflecting structure at patient level and hospital level factors and analysis on random effect.

The Approach of Robot-assisted Gait Therapy for Locomotor Recovery of Chronic Stroke Patients: a Case Report

  • Shin, Hee-Joon;Lee, Ju-Hyeok;Seo, Dong-Kyu;Kim, Hong-Rae;Moon, Ok-Kon;Park, Si-Eun;Park, Joo-Hyun;Kim, Nyeon-Jun;Min, Kyung-Ok
    • 국제물리치료학회지
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    • 제2권1호
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    • pp.207-213
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    • 2011
  • In this case report, we investigated the effects of robot-assisted gait therapy in a chronic stroke patient using motor assessment and gait analysis. A patient who suffered from the right hemiparesis following the left corona radiata and basal ganglia infarction received 30 minutes of robot-assisted gait therapy, 3 times a week for 4 weeks. Outcome was measured using Motoricity index(MI), Fugl-Meyer assessment(FMA), modified motor assessment scale(MMAS), isometric torque, body tissue composition, 10-meter gait speed and gait analysis. After robot-assisted gait therapy, the patient showed improvement in motor functions measured by MI, FMA, MMAS, isometric torque, skeletal muscle mass, 10-meter gait speed. In gait analysis, cadence, single support time, double support time, step length, walking speed improvement in after robot-assisted gait therapy. The results of this study showed that robot-assisted gait therapy is considered to facilitate locomotor recovery of the chronic hemiparetic stroke patient.

Location of Death and End-of-Life Care

  • Rhee, YongJoo
    • Journal of Hospice and Palliative Care
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    • 제19권1호
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    • pp.5-10
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    • 2016
  • Purpose: This study reviewed what the location of death (LOD) means as an outcome and how to use LOD to assess end-of-life (EOL) care. This study also examined the reason why LOD is significant for the quality of EOL care. Methods: A literature review was performed, using LODs and home deaths as outcomes in the field of EOL care, and analyzed the findings associated with key fields in regards to LOD. Results: Palliative care research used LOD, in particular, hospital death (versus home death) as a significant outcome when examining cost savings, quality of life care, and patient and family preferences. Based on substantial evidence from previous research, home hospice or continuous palliative care in non-hospital settings (i.e. homes, nursing homes) have been designed and available for dying patients in developed countries. Conclusion: The LOD delivers practical significance as an outcome for diverse reasons. In-depth examination on LOD in South Korea is needed despite limitations to interpretation of its meaning in the country.

신열두통(身熱頭痛) 망음증(亡陰證)으로 진단하여 형방사백산(荊防瀉白散)으로 호전된 국소다한증(多汗症) 환자 3례 보고 (A Case Study of Soyangin Patient with Hyperhidrosis Treated Successfully with Hyungbangsabaek-san(荊防瀉白散))

  • 홍승민;이선영;황민우
    • 사상체질의학회지
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    • 제26권4호
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    • pp.379-388
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    • 2014
  • Objectives The aim of this study was to report significant improvement of hyperhidrosis after treatment with Hyungbangsabaek-san (荊防瀉白散), in a Soyangin Mangeum Symptomatic pattern Patient. Methods The patients were diagnosed with Soyang Sin-Yeol Du-Tong Mang-Eum Symptomatology(身熱頭痛亡陰證) and treated with Hyungbangsabaek-san(荊防瀉白散). The primary outcome measure for this study were sweat using a questionnaire with visual analogue scale(VAS). Secondary outcome assessment included change of odinary symptoms such as patient's sleep, feces and digestion. Results The symptoms of hyperhidrosis disappeared by the end of the accure period without side effect. Original symptoms were also changed. Conclusions This result show Hyungbangsabaek-san(荊防瀉白散) can be used to treat hyperhidrosis in a Soyangin Heat-related diarrhea accompanied by headache Mangeum(身熱頭痛亡陰) symptomatic pattern patient. Meaning and process of hyperhidrosis are different according to Sasang Constitutions.

지연성 외상성 뇌실질내 출혈 환자의 치료를 결정하는 임상적, 영상학적 예후인자에 대한 평가 (Assessment of the Clinical and the Radiological Prognostic Factors that Determine the Management of a Delayed, Traumatic, Intraparenchymal Hemorrhage (DTIPH))

  • 류제일;김충현;김재민;정진환
    • Journal of Trauma and Injury
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    • 제28권4호
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    • pp.223-231
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    • 2015
  • Purpose: Delayed, traumatic, intraparenchymal hemorrhage (DTIPH) is a well-known contributing factor to secondary brain damage that evokes severe brain edema and intracranial hypertension. Once it has occurred, it adversely affects the patient's outcome. The aim of this study was to evaluate the prognosis factors for DTIPH by comparing clinical, radiological and hematologic results between two groups of patients according to whether surgical treatment was given or not. Methods: The author investigated 26 patients who suffered DTIPH during the recent consecutive five-year period. The 26 patients were divided according to their having undergone either a decompressive craniectomy (n=20) or continuous conservative treatment (n=6). A retrospective investigation was done by reviewing their admission records and radiological findings. Results: This incidence of DTIPH was 6.6% among the total number of patients admitted with head injuries. The clinical outcome of DTIPH was favorable in 9 of the 26 patients (34.6%) whereas it was unfavorable in 17 patients (65.4%). The patients with coagulopathy had an unexceptionally high rate of mortality. Among the variables, whether the patient had undergone a decompressive craniectomy, the patient's preoperative clinical status, and the degree of midline shift had significant correlations with the ultimate outcome. Conclusion: In patients with DTIPH, proper evaluation of preoperative clinical grading and radiological findings can hamper deleterious secondary events because it can lead to a swift and proper decompressive craniectomy to reduce the intracranial pressure. Surgical decompression should be carefully selected, paying attention to the patient's accompanying injury and hematology results, especially thrombocytopenia, in order to improve the patient's neurologic outcomes.

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소아심장외과 중환자실에서의 실무의사소통 프로토콜이 수술 후 성과에 미치는 영향 (Practical Communication Strategies to Improve the Surgical Outcomes in a Pediatric Cardiac Intensive Care Unit)

  • 엄주연;이월숙
    • 간호행정학회지
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    • 제21권3호
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    • pp.243-253
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    • 2015
  • Purpose: The purpose of this study was to identify the impact of practical communication strategies (PCS) on the reduction of AEs (Adverse Events) in pediatric cardiac ICU (PCICU). Methods: Intra-operative findings and care plans were documented and shared between staff members on a daily basis from the day of operation to the day of general ward transfer. Incidence of AEs was investigated in all patients who were admitted to the PCICU and was compared with incidence of AEs one year after establishment of PCS. Results: The study population consisted of 216 patients in pre-PCS group and 156 patients in post-PCS group. Incidence of readmission decreased from 6.0% (13/216) in pre-PCS group to 0.6% (1/156) in post-PCS group (${\chi}^2=7.23$, p=.010). Incidence of other major complications decreased from 4.2% (9/216) to 0.6% (${\chi}^2=6.66$, p=.012). Minor AEs such as intervention omission, order error, and protocol misunderstanding were reduced from 23.3 cases per 100 patient-days to 7.5 cases per 100 patient-days (${\chi}^2=20.31$, p<.001). Conclusion: Handover protocol is an effective strategy to reduce AEs for critically ill patients after pediatric cardiac surgery. Efforts to develop effective communication strategies should be continued and outcome research about communication strategies for patient safety should be further studied.

암생존자를 대상으로 한 사상체질에 따른 건강수준 평가기준 개발 연구 (A Study on the Development of Criteria for the Assessment of the Sasang Constitutional Health Level of Cancer Survivors)

  • 권진혁;박성운;박병주;홍승민;김아리;오현주;이준희
    • 사상체질의학회지
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    • 제35권4호
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    • pp.23-41
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    • 2023
  • Objectives This study is aimed to develop criteria for assessing the health level of cancer survivors through patient reported outcome based on sasang constitutional symtomology. Methods As a result of the researchers' meetings and the first round of expert group consultation, the constitutional health level assessment items that would be common to all Sasang constitutions were extracted, and constitutional health level assessment items for cancer survivors were selected. A second round of expert group consultation was conducted to determine the importance and weighting of these items for each constitution. Results & Conclusions For soeumin, the importance ranking and calculated weight were as follows: 'I had sweats even when I was not hot or exercising.(1st, 4.09)', 'I had night sweats while sleeping(2nd, 3.94)', 'I lost weight.(3rd, 3. 75)', etc. For soyangin, as follows: 'I had night sweats while sleeping.(1st, 3.08)', 'I had vomiting.(2nd, 3.02)', 'I felt hot flashes in the afternoon or at night. (3rd, 2.73)', etc. For taeumin, as follows: 'I was out of breath.(1st, 3.48)', 'My heart was pounding for no reason.(2nd, 3.45)', 'My body was swollen.(3rd, 3.22)', etc. For taeyangins, as follows: 'I couldn't urinate well.(1st, 4.49)', 'I vomited(2nd, 4.44).', 'My upper abdomen were hard.(3rd, 3. 14)', etc. Based on the results, we developed a draft of a questionnaire to assess the Sasang constitutional health level of cancer survivors, weighted for each item.