• Title/Summary/Keyword: Patient preference

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Partial Resection of Osteosarcoma in Proximal Tibia - A Case Report - (근위 경골 골육종의 부분 절제술 - 증례 보고 -)

  • Song, Won-Seok;Lee, Seung-Jun;Won, Ho-Hyun;Jeon, Dae-Geun
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.140-145
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    • 2008
  • After limb salvage operation becomes popular, reconstruction method of epi-metaphyseal osteosarcoma is relatively standardized though it may be operator's matter of preference. Most limb salvage techniques presently used are prosthesis reconstruction and osteoarticular allograft. In the case of prosthesis, it is very stable and shows good postoperative functional score, however, finally, it has a weak point of requirement for removal procedure due to failure. In the long run, allograft reconstruction has a good merit. But, it has a weak point of difficulties in securing the demanded size and shape. Allograft reconstruction should be performed only in the case of safe margin and established indication. In limb salvage operation, intercalary reconstruction is useful method in diaphyseal osteosarcoma, however, in metaphyseal osteosarcoma, the indication is not confirmed. We treated 17 year old osteosarcoma patient with localized in the tibial medial condyle with proximal medial condylectomy and pasteurized bone reconstruction in the conviction of safe surgical margin. We report this case because we guess if this procedure may be applied to premature patients, despite failure hemiarthroplasty can be tried successfully.

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Effect of nutrition care process-based nutrition intervention on improvement of intake in the elderly in-patients with malnutrition (영양관리과정에 근거한 영양중재가 노인 영양불량 입원환자의 식사섭취량 증진에 미치는 효과)

  • Park, Ji-Hyun;Kang, Min-Ji;Seo, Jung-Sook
    • Journal of Nutrition and Health
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    • v.51 no.4
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    • pp.307-315
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    • 2018
  • Purpose: This study evaluated the effects of personalized nutrition intervention for increasing hospital meal intake by elderly patients with malnutrition. Methods: The subjects were 30 elderly patients with malnutrition who visited a general hospital located in Daegu. An individual nutrition intervention such as change of meal types or special meal service was given to the patients according to nutrition diagnosis related to inadequate intake of hospital meals. Nutritional intake status of the subjects was assessed by analyzing energy intake, protein intake, index of nutritional quality (INQ), nutrient adequacy ratio (NAR) and mean adequacy ratio (MAR). Results: The causes of inadequate intake in the subjects were poor appetite or preference problems (46.7%), symptom-related problems (30.0%) and mastication problems (23.3%). The INQ of protein in the subjects was significantly increased from $0.81{\pm}0.17$ to $1.41{\pm}0.25$ after the nutrition intervention (p < 0.05). The NAR of protein (before $0.50{\pm}0.21$, after $0.58{\pm}0.17$), iron (before $0.72{\pm}0.30$, after $0.84{\pm}0.29$) and vitamin $B_2$ (before $0.31{\pm}0.16$, after $0.37{\pm}0.14$) was also increased after the nutrition intervention (p < 0.05). The MAR of five nutrients, protein, calcium, iron, vitamin A and vitamin $B_2$, was significantly increased by the nutrition intervention (p < 0.05). Conclusion: Personalized nutrition intervention according to nutrition diagnosis related to inadequate intake of hospital meals may improve the intake amount of elderly patients with malnutrition.

Exploratory Study of Dimensions of Health-related Quality of Life in the General Population of South Korea

  • Kim, Seon-Ha;Jo, Min-Woo;Ock, Minsu;Lee, Sang-il
    • Journal of Preventive Medicine and Public Health
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    • v.50 no.6
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    • pp.361-368
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    • 2017
  • Objectives: This study aimed to explore dimensions in addition to the 5 dimensions of the 5-level EQ-5D version (EQ-5D-5L) that could satisfactorily explain variation in health-related quality of life (HRQoL) in the general population of South Korea. Methods: Domains related to HRQoL were searched through a review of existing HRQoL instruments. Among the 28 potential dimensions, the 5 dimensions of the EQ-5D-5L and 7 additional dimensions (vision, hearing, communication, cognitive function, social relationships, vitality, and sleep) were included. A representative sample of 600 subjects was selected for the survey, which was administered through face-to-face interviews. Subjects were asked to report problems in 12 health dimensions at 5 levels, as well as their self-rated health status using the EuroQol visual analogue scale (EQ-VAS) and a 5-point Likert scale. Among subjects who reported no problems for any of the parameters in the EQ-5D-5L, we analyzed the frequencies of problems in the additional dimensions. A linear regression model with the EQ-VAS as the dependent variable was performed to identify additional significant dimensions. Results: Among respondents who reported full health on the EQ-5D-5L (n=365), 32% reported a problem for at least 1 additional dimension, and 14% reported worse than moderate self-rated health. Regression analysis revealed a $R^2$ of 0.228 for the original EQ-5D-5L dimensions, 0.200 for the new dimensions, and 0.263 for the 12 dimensions together. Among the added dimensions, vitality and sleep were significantly associated with EQ-VAS scores. Conclusions: This study identified significant dimensions for assessing self-rated health among members of the general public, in addition to the 5 dimensions of the EQ-5D-5L. These dimensions could be considered for inclusion in a new preference-based instrument or for developing a country-specific HRQoL instrument.

Case Analysis of Pulmonary Sequestration (폐격리증에 대한 임상적 고찰)

  • Jeon, Yang-Bin;Shin, Sung-Ho;Chung, Tae-Yul;Kim, Hyuk;Ham, Si-Young;Lee, Chul-Bum;Chung, Won-Sang;Kim, Young-Hak;Kang, Jung-Ho;Jee, Heng-Ok
    • Journal of Chest Surgery
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    • v.31 no.12
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    • pp.1206-1211
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    • 1998
  • Background: Pulmonary sequestration is not common and it's diagnosis needs special care such as an aortogram ar tomography. Material and Method: We have experienced 13 patients who had pulmonary sequestration from January 1990 to September 1997. Result: Six men and seven women were treated and their mean age was 25.8±14.3 years. Their chief complaints were coughing, chest pain, and no symptoms in decreasing order. There were nine intralobar(ILS) and three extralobar(ELS) pulmonary sequestrations and one patient had both. There was no preference in location of either left or right. They were mainly diagnosed by aortography and their feeding arteries commonly originated from the lower thoracic aorta. The patients with ILS were treated by lobectomy and those with ELS by sequestrectomy. Conclusion: to treat pulmonary sequestration properhy, aortogram or chest CT is warranted to iidenty the abnormal origin of feeding artery.

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A Study on the optimum scale of the number of beds of both the standard and the high-class (기준병상수와 상급병상수의 적정규모에 관한 연구)

  • Back, Seung-Joon;Yu, Seung-Hum;Sohn, Tae-Yong
    • Korea Journal of Hospital Management
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    • v.6 no.3
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    • pp.109-129
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    • 2001
  • The purpose of this study was the acquisition of the optimum scale of the apportionment of standard & high-class bed for the maximum profit representative of the desire of customers in a General Hospital with 1,100 beds located in Seoul. This investigation was proceeded by the analysis of the result of the simulation with the survey of both the patients' needs for bed and the degree of the medical service by the grade of the ward. And finally the consequence was obtained as follows: 1. The result of the investigation of the inpatients' preference for the grade of ward classes shows that a private ward reflected 4.3 percent, a semi-private ward 1.7 percent, a three-bed ward 0.1 percent, and a ward with six beds 93.9 percent each other. 2. A questionnaire poll was paralleled of service terms of a medical doctor and a nurse by ward class, the data were used for the standard of the allotment of labor cost by the ward class. The poll shows that the service tenn of a medical doctor and a nurse based on a ward with six beds by ward class showed 1.7 times in internal medicine and 1.9 times in surgery at a private ward; 1.4 times in internal medicine and 1.7 times in surgery at a semi-private room; and 1.2 times both in internal medicine and in surgery at a three-bed ward 3. The resultant findings revealed the most profit per bed and per patient in a private ward. However, an analysis of profit with a standard of unit area by ward class represented a higher profit in both the internal medicine and the surgery semi-private ward than other ward classes. 4. The result of the analysis through simulation based on the data of the prime cost per the ward class proved the optimum scale of the distribution of beds by class as follows: sixteen beds of the internal medicine and twenty three beds of the surgery in the private ward; two hundreds and two of the internal medicine and one hundred and ninety eight of the surgery in the semi-private room; three of both the internal medicine and the surgery each other in the three-bed ward; one hundred and ninety eight of the internal medicine and two hundred and fifty two of the surgery in the ward with six beds. The result of this research exhibits that the income and expenditure of the hospital could be improved by changing parts of wards into private ones(containing the maximum profit per a unit of width) in case the scale of the number of beds is reset with the consideration of the profit per the unit width. In the near future it's strongly expected that the research for the more scientific standard of the allotment of labour cost by ward class and for definition of the optimum scale of the number of beds that actualize the maximum profit with the change of the three elements of the prime cost: cost of materials; labor costs; management expenses.

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Quality Characteristics of Vanilla Sauce with Various Sweeteners (감미료의 종류를 달리한 바닐라 소스의 품질특성)

  • Lee, Dong-gue;Kim, Ki-bbeum;Park, Ki-hong;Choi, Soo-keun
    • Culinary science and hospitality research
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    • v.22 no.7
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    • pp.36-46
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    • 2016
  • The study examined the kinds of sweeteners(xylitol, sorbitol, acesulfame K, aspartame, stevioside) instead of sugar for vanilla sauce to satisfy customers' health needs. According to the results, the sauce with sugar had lowest salinity, highest sugar content, and sauce with aspartame had lowest sugar content. pH were highest in sauce with sorbitol, with aspartame were lowest. L-value, a-value was the highest in sauce with aspartame, while b-value was the lowest. The moisture content was the lowest, while viscosity was the highest in the sauce with xylitol. In a sensory evaluation, texture and overall preference was the highest in vanilla sauces with aspartame which have proper color intensity and strong flavor in mouth feel. The result indicated that health-oriented consumers and satisfy the health of modern people's needs when using the vanilla sauce with aspartame instead of sugar. It is also advised to vanilla sauce with aspartame for preventing adult disease and using the diets for patient.

The Research of Pain and Functional Disability Assessment Scales for Knee Joint Disease (슬관절의 통증과 기능장애의 평가도구에 관한 연구)

  • Jung, Chan-Yung;Kim, Eun-Jung;Hwang, Min-Seop;Cho, Hyun-Seok;Kim, Kyung-Ho;Lee, Seung-Deok;Kim, Kap-Sung
    • Journal of Acupuncture Research
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    • v.27 no.2
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    • pp.123-142
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    • 2010
  • Objectives : The knee pain is the main reason of getting acupuncture treatment. In order to have confidence in the results of a study, it is necessary to establish that questionnaire is both valid and reliable in questionnaire related study. The aim of this study was to review the instruments that are currently in sue for assessing the knee joint. Methods : A literature study was performed to choose appropriate scales for assessment for pain and the function of the knee. Theoretically based scales were selected for review. Therefore, 18 scales for knee and 9 scale for pain were reviewed. the status of scales involved in knee treatment of acupuncture throughout several countries was evaluated. Results & Conclusion : Lysholm Knee Scoring Scale, Cincinnati knee rating system(CKRS) are adequate for ligament injury in knee. International Knee Documentation Committee scoring system(IKDC) may become a publication requirement for journals in view of the international standing of the committee. The available outcome measure for use in osteoarthritis are Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC), Lequesne Functional Severity Index(LFI) and Knee Injury and Osteoarthritis Outcome Score(KOOS), and in rheumatoid arthritis are McMaster-Toronto Arthritis patient function preference questionnaire(MACTAR), Quality of Life-Rheumatoid Arthritis Scale(QoL-RA Scale). Visual analog scale(VAS), verbal rating scale(VRS) are commonly used for the standard pain scale. For long term follow-up study The Medical Outcomes Study Short Form-36(SF-36), Arthritis Impact Measurement Scales(AIMS), Health Assessment Questionnaire(HAQ) should be included. Each measurement has its own composition and characteristics. Their validity, reliability, responsiveness and practical characteristics were already evaluated. We found 20 domestic and 28 overseas papers about knee treatment using acupuncture assessed with knee scales.

A Study on the Operation Regional Emergency Medical Center and the Using Behavior by Visiting Patients (한 지역 권역 응급의료센터 내원환자의 이용 행태 분석)

  • Ryu, Hwang Gun;Song, Hyun Kyung;Kim, Hye Suck;Kim, Tae Gon
    • The Korean Journal of Health Service Management
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    • v.1 no.1
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    • pp.110-124
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    • 2007
  • Currently, we have seen sudden increase of demand for emergency medical services by reason for high-speed economic development increase of traffics, etc. in this society. Consequently the government enforced & operated emergency medical system in 1991 as a link of more positive countermeasure against it, but many problem; still remain in reality. In particular, the regional emergency medical center designated by the Ministry of Health and Welfare falls short of our expectations for its essential role by the reason of such as insufficiency in professional manpower and institutions concerned in small-scale hospital, matters with transportation system, preference of large hospital, etc. Therefore, this study was conducted grasp for the actual conditions of emergency medical system based upon literature research & the preceding studies and interview research the motive of coming hospital, satisfaction & understand to the subject of 150 persons of patients and their guardians who used regional emergency center of Pusan National University Hospital, thereby examining & analysing the cause of emergency room overcrowding by non-emergency cases, one of the problem; enumerated from preceding studies. The main result of this study is as follows. First the actual condition of non-emergency patients coming hospital for examining overcrowding of emergency medical center showed that, of the patients who used the emergency medical center, non-emergency patients accounted for 49.3%, which acted as the main cause of delaying medical care for emergency cases, cases of which medical person or first-aid man decided to come hospital accounted for 36.1 %, thereby suggesting essential need for re-education & wide public information to even the professional manpower besides patients & guardians for their using emergency medical system. Second, as the result of researching patient acknowledgement with reference to their using emergency medical center, the rate of their giving right answer is no more than 60%, which means that non-emergency cases' using as such is due to the shortage of their knowledge of the said emergency medical center, which suggests us that wider P.R for emergency medical system to common people who may be one of the patients of it at any time is still in need. Third, the result of researching for finding out a future remedy of emergency medical system showed that the users who know well of the way of using emergency medical center had relatively high satisfaction of it, ones who have lesser knowledge of it lower satisfaction and users who feel in need of emergency specialized manpower feel the necessity of public information of emergency medical information center(1339) at the same time. The finding of examining the subject of study, in conclusion, showed that the degree of the patients & their guardians' understanding of emergency medical system is lower and the medical persons concerned also had no distinct difference in their understanding of it from the common people's, which suggests us for extensive enforcement of systematic education and public information in aspect of the government via various media for the purpose of effective operation of emergency medical center.

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Effect of embossed new dental pick on periodontitis (Embossed new dental pick이 치주염에 미치는 영향)

  • Suk, Hun-Joo;Kim, Chong-Kwan
    • Journal of Periodontal and Implant Science
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    • v.34 no.3
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    • pp.563-572
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    • 2004
  • Since bacterial plaque is known as the major cause of every oral disease, it is necessary to control plaque to maintain periodontal health. Although tooth brushing has been the typical method of plaque control, additional use of plaque control devices are necessary for cleansing interdental areas. Dental floss has been used for a long time as the additional plaque control device and proved to be effective. The newly developed embossed new dental pick is composed of elastic plastic material in form with its tip longer than other toothpick. In addition, as thickness of the tip gradually increases, it can be adapted easily with minimal trauma to interdental gingiva. The embossed tip can remove dental plaque easily, and the opposite end can approach lingual and palatal areas through triple angulation. Therefore, the authors studied the effect of embossed new dental pick and dental floss on periodontally involved 15 patient. The following results were obtained. 1. For embossed new dental pick, probing depth at baseline, 1 week, 4 weeks were $3.6{\pm}0.6mm$, $3.4{\pm}0.5mm$, $3.2{\pm}0.5mm$, respectively, and $4.2{\pm}0.9mm$, $4.1{\pm}0.9mm$, $4.0{\pm}0.9mm$, respectivly for clinical attachment level. 2. In case of embossed new dental pick, bleeding on probing at baseline, 1 week, 4 weeks were $43.0{\pm}4.4%$, $28.5{\pm}5.1%$, $22.2{\pm}5.6%$, respectively, and, at 1 week and 4 weeks, they were significantly different from that of dental floss. 3. Gingival index of toαhpick at baseline, 1 week, 4 weeks were $1.7{\pm}0.5$, $1.0{\pm}0.3$, $0.9{\pm}0.2$, respectively, and, $1.7{\pm}0.5$, $1.1{\pm}0.4$, $1.0{\pm}0.4$, respectively for plaque index, and $3.0{\pm}0.5$, $1.7{\pm}0.5$, $1.4{\pm}0.4$, respectively for proximal plaque index. proximal plaque index at 4 weeks was significantly different from that of dental floss. 4. The result of questionnaire showed that the two types of device were both satisfactory, however, embossed new dental pick had higher preference as well as satisfaction. As a result, embossed new dental pick is thought to be clinically effective for its simplicity and good accessibility.

A Study on dental hygienist subjectivity toward relationship with inaccessible patients: the cases of Seoul, Gyeonggi province and Incheon (치과위생사가 경험한 어려운 환자와의 관계에 대한 주관성 연구 -서울, 경기, 인천 지역을 중심으로-)

  • Han, Kyung-Soon;Kim, Young-Nam;Lee, Myeong-Ju
    • Journal of Korean society of Dental Hygiene
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    • v.5 no.2
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    • pp.279-296
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    • 2005
  • The purpose of this study was to examine what types of experiences dental hygienists underwent with patients who were unapproachable in an effort to find out the latter group's needs and expectations, explore how to treat them of different personality type, and provide better dental services in response to their needs. To attain the purpose, Q-methodology was employed, which made a subjective and systematic assessment of human subjectivity. There were three types of subjectivity among dental hygienists in conjunction with their experiences with patients who were hard to please. Each group whose subjectivity was different also had a different preference for patients, which was not exclusive to one another but unique. Type 1 was "avoiding patients who showed off". Dental hygienists of this type found it unpleasant to treat patients who boasted of their background, position or relations with the head of hospital and wanted to be given special treatment. They avoided those patients, since giving special treatment to specific patients was likely to do damage to others. They believed that better medical services could be provided through mutual concern and good manners between medical personnels and patients. Dental hygienists of type 2 considered it hard to treat patients who were picky and looked at treatment or its outcome negatively. Those who had to be separated from others on account of possible cross-infection or who called for special decontamination methods of dental instruments were also difficult to deal with. Dental hygienists of this type could be said to "avoid picky patients", as they preferred to fare with patients by offering good, faithful treatment rather than by giving special treatment. Dental hygienists of type 3 believed that smooth and successful treatment hinged on mutual trust, confidence and collaboration between medical personnels and patients. According to them, patients who choose a specific hospital or a particular medical team at their own option have to cooperate if necessary, listen carefully to medical personnels and treat them without any hostility or bias. Therefore, they could be said to "avoid patients who were not cooperative".

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