• Title/Summary/Keyword: Patient-area

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Fluoroscopy examinations for the management of patient dose study on the establishment of diagnostic reference level (UGI, Esophagography standards) (투시 조영 검사 시 환자 선량 관리를 위한 진단참고선량 구축에 관한 연구 (UGI, Esophagography 기준))

  • Hong, Sun-Suk;Park, Eun-Seong;Cho, Joon-Yeong;Seong, Min-Suk;Yang, Han-Joon
    • Korean Journal of Digital Imaging in Medicine
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    • v.14 no.1
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    • pp.1-6
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    • 2012
  • This round of tests in patients with UGI and Esophagography data collected by national and international reference levels based on the original set of guidelines and fluoroscopy, through the provision of medical radiation exposure reduction and further optimization of Defense to realize that is intended. 359 names in our hospital underwent Esophagography 302 patients who underwent UGI average fluoroscopy time and number of images to calculate the average 21 cm Acryl phantom dose for 10 seconds and 20 seconds, average area dose and the area dose of 1 spot image, 5 spot consecutive images by measuring the patient dose and third quartile of the mean area dose was set seonryangin reference dose. Esophagography average patient dose was set to 30.05 $Gy{\cdot}cm^2$, DRL was set at a 25.37 $Gy{\cdot}cm^2$. Average dose of UGI patients were selected as 45.33 $Gy{\cdot}cm^2$, DRL was set at a 34 $Gy{\cdot}cm^2$. UGI patients with established average dose recommended in the 2008 national recommendation from the UGI examination with a dose of less than 49.7 $Gy{\cdot}cm^2$ seonryangin is evaluated. This Note examines the dose of self-aware through education recognizes the importance of dose reduction and examine if their efforts and further reduce patient dose could achieve optimization of the medical exposure is considered.

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Correlation between Chronic Ankle Instability and Center of Pressure Using Pedobrarograph (족압검사를 이용한 만성 발목 불안정성과 압력중심의 연관성)

  • Park, Eun Soo;Seo, Sang Gyo;Lee, Ho Seong
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.1
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    • pp.14-18
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    • 2020
  • Purpose: Chronic ankle instability is a very common abnormality of the ankle, but there is still controversy regarding its evaluation criteria. The stress view has difficulties in reflecting the patient's symptoms and treatment progress. Therefore, this study examined the relationship between the center of pressure (COP) measured by a pedobarograph and the symptoms of the patient. Materials and Methods: Thirty patients with chronic ankle instability from February to August 2018 were included. Each patient was surveyed with the foot and ankle outcome score (FAOS). The COP was measured with a foot pressure scanner, and the travel distance and ellipse area of the COP were calculated. Each patient was measured on one foot and on two feet with his or her eyes closed and open. The relationship between the COP measurement and FAOS score was analyzed using the Pearson correlation coefficient. Results: The participants were consisted of 21 male and nine female, with a mean age of 30 years, mean weight of 72 kg, and mean foot size of 259 mm. With the eyes open, the correlation coefficient between the FAOS and travel distance of the affected side was -0.394 (p<0.05) and that between the FAOS and the ellipse area of the affected side was -0.425 (p<0.05). On the other hand, no significant correlations were found between the travel distance and ellipse area of the affected side when patients closed their eyes. Conclusion: Measurement of the COP using foot pressure scanner could evaluate objectively patients with chronic ankle instability, with measurements in patients with their eyes open being more significant. Based on the findings of this study, an analysis of the COP with the patients with their eyes open and standing on one foot may help determine the management strategy and assess the progress of the patients.

A Preliminary Study on Development and Evaluation of Home Health Care Nurse Clinical Practice Program -Focused on Postoperative Orthopedic Patients- (가정간호사 임상실무 훈련프로그램 개발과 평가를 위한 사전 연구 -정형외과 수술 환자를 중심으로-)

  • 서영숙
    • Journal of Korean Academy of Nursing
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    • v.26 no.1
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    • pp.15-32
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    • 1996
  • The clinical practice program for home care nurses was implemented in June 1994, to help to set up a hospital-based home care system in the Kwangju City area as a collaborative work between the Department of Orthopedic Surgery at Chunnam University Hospital and Chunnam University School of Nursing. Under the developed clinical practice strategy, the eight week training was given to five licensed home care nurses who had completed Part I and II of the home health care nursing practicum from June 1994. The purpose of this descriptive evaluation study was to identify the effectiveness of the clinical practice program for home care nurses specialized in the area of patient care for people with musculoskeletal function impairment. As a method in data analysis, data triangulation was used in the five home care nurse case evaluations. The variety of data analyzed include confidence score by home care nurse self-evaluation, patient and family member satisfaction scores, and competency score by preceptor evaluation. The study findings revealed that an increase rate in nursing performance didrate necessarily coincide with an increase not in competency score and also, not with the patient /family member satisfaction scores. And an order derived from the clinical performance scores of five home care nurses corresponded to those from three measurements-competency score, patient satisfaction score, and family member satisfaction score. However, it differed from the order associated with the confidence score. Consistency derived from the three objective evaluation methods may lead to the possibility that the level of competency measured by educator can be further explained by the levels of patient/family member satisfaction. The salient finding of this study was that, in case of nurse A who have had little clinical experience in the orthopedic patient care, there was a significant increase in the level of confidence and competency in subscale of professional skill with the home care clinical practice. Therefore, the effect of the clinical practice program would be successful for nurses who have had little experience in the area of specialization. The study results suggest that there might be some time difference in the development of cognitive sense (confidence) in performance and actual clinical performance (competency). In future research, relationships between the confidence and competency score, and between the confidence score and the patient satisfaction score should to be measured in different time frame to achieve a better explanation power of the study outcome.

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A Study of the Family Caregiver's Burden for the Elderly with Chronic disease in a Rural Area (일부 농촌 지역 노인 만성질환자 가족의 부담감에 관한 연구)

  • Jang, In-Sun
    • Journal of Home Health Care Nursing
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    • v.2
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    • pp.19-34
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    • 1995
  • The purpose of this study was to analysis level on family caregiver's burden for the elderly with chronic disease in a rural area and to choose priority care group, thereby facilitating the development of interventions to reduce the caregiver's burden. For this purpose, data were collected by questionaire from June 10 to October 8, 1994. The instruments for data collection were Caregiver Burden Inventory by Novak(1989) and Zarit et al(1982), severity of dementia by Hughes Scales(1982), ADL by Lawton(1971), patients' family caregiving activity by pre-survey and reference review(Lee, 1993 ; Jang, 1990 ; Yoo, 1982). The subjects were 213 family caregiver of elderly with chronic disease in a rural area. The data was analysed by the use of t-test, ANOVA, correlation and multiple regression. The results were as follows ; 1. Total burden was evaluated below average, the mean of family burden was 46.98. By the diagnostic classification, Hypertension was 27.37, DM 32.46, CVA 62.96, Dementia 61.24. 2. Significant variables which were correlated to the family caregiver's burden were the patient's disease diagnosis (F=33.82, p<0.001), severity of dementia(F=30.52, p<0.001), the status of disease management(F=11.53, p<0.001), ADL(F=10.54, p<0.001), PADL(F=7.50, p<0.001), income(F=7.17, p<0.001), caregiver's health status(F=24.53, p<0.001), a view of patient's prognosis (F=22.17, p<0.001), relationship with the patient(F=33.82, p<0.001), the number of hours per day spent on caregiving(F=77.52, p<0.001), level of intimacy of caregiver and patients(F=8.75, p<0.001), level of helping(F=4.90, p<0.01), the frequency of caregiving activity(F=3.80, p<0.01), the number of admission(F=5.54, p<0.01), the length of caregiving(F=4.43, p<0.01), other chronic patient in family(t=2.81, p<0.01), caregiver's job(F=3.11, p<0.01), the duration of illness(F=2.98, p<0.05), caregiver's religion(F=2.93, p<0.05), medical security(F=3.89, p<0.05), caregiving's helper(t=2.42, p<0.05). 3. PADL was the most important predictor to family caregiver burden(R2=0.6611). In addition to this, IADL, caregiver's health status, the length of caregiving. level of intimacy of caregiver and patients, patient's age, the patient's disease diagnosis and patient's job accounted for 76% of family caregiver burden. 4. The criteria of priority care group were as follows ; the mean of family caregiver burden was above 58, above of moderate ADL, the number of hours per day spent on caregiving above of 8 hours, above of moderate dementia. By the diagnostic classification, number of priority care group, Hypertension was 4 (8.0%), DM 4(8.0%), CVA 34(64.1%), Dementia 45(75.0%).

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A Study on the Spatial Composition and Area Planning of the Intensive Care Units in the Public District Hospitals (지역거점공공의료원 중환자부 공간구성 및 면적계획에 관한 연구)

  • Yun, Woo Yong;Chai, Choul Gyun
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.23 no.2
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    • pp.47-61
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    • 2017
  • Purpose: This study aims to suggest the spatial composition and area of the intensive care units through analysis of current situation for the standards establishment of the intensive care units in public district hospitals in the future. Methods: Three Methods have been used in this paper. 1) Literature reviews about composition, location, foreign standards on intensive care units. 2) Comparative analysis on the architectural drawing for the space program and the area. 3) Field survey in order to confirm differences between architectural drawing and current situation. Results: 1) The intensive care units is required to be linked by the operating department, the emergency department and the sterile supply department upon considerations of accessibility of emergency patients and the infection control. 2) The intensive care unit consists of five areas such as the patient area, the medical staff area, the material and equipment area, the patient family area, and the public area. 3) The location of spaces in the intensive care unit is classified by three methods such as connection by view, circulation and connection to corridor. The [table 20] summarizes the type of space and the average size of the space in intensive care unit. Implications: This study is a basic research for guideline of intensive care units, and need to be followed by further study using various perspectives and methods in the future.

Review on Patient Outcomes Research (환자진료결과연구에 대한 고찰 -미국의 PORT 연구를 중심으로-)

  • Park, Eun-Cheol;Kim, Han Joong;Cho, Woo Hyun;Sohn, Myongsei
    • Quality Improvement in Health Care
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    • v.5 no.1
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    • pp.152-165
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    • 1998
  • Background : In this paper patient outcomes research is going to be reviewed and described, to be compared with relevant studies, and to consider the application in Korea. Methods : We compiled and reviewed the articles and materials related to patient outcomes research especially by PORT(Patient Outcomes Research Team) and rearranged them for seeking the main point and comparing with relevant studies. Results : Patient outcomes research emphasizes patient outcomes as well as conventional clinical outcomes. It is prospective study observing effectiveness in real situation instead of efficacy in ideal condition. Patient outcomes research comprises of 6 fields ; literature review and meta-analysis, use of claims data, decision modeling, outcomes assessment, cost of care, dissemination of research findings. SAA(small-area variations analysis), appropriateness study and clinical practice guideline are connected with patient outcomes research. Conclusion : In view of the fact that current medical policy in Korea is shifting its focus from accessibility to the improvement in quality and cost containment, and is stressing patient-based research, patient outcomes research is one direction for which the medicine is accountable and assessable. Considering that the number of patient receiving medical treatment in Korea is higher than the West, patient outcomes research has competitive power as against the West.

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Implementation of Patient Monitoring System based on Mobile Healthcare (모바일 헬스케어 기반의 환자 모니터링 시스템 구현)

  • Kim, Kyoung-Mok
    • Journal of the Korea Society of Computer and Information
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    • v.17 no.12
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    • pp.1-10
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    • 2012
  • In this paper, we propose an patient monitoring system which is suitable for mobile healthcare system. The mobile healthcare system is using portable device such as smartphone and it consists of small computing device. The mobile healthcare system is carry out same performance with desktop computer. We designed medical message structure based on TinyOS to transmit patient's biometric data on the smartphone of medical team, patient and family over the mobile carrier environment, and ported successfully in HBE-Ubi-ZigbeX using NesC. And We confirmed reliable transmission of biometric data on the smartphone by implementing the Android OS based patient information monitoring application to check the status of patient for medical team, patient and family.

Piroxicam, Mitoxantrone, and Hypofractionated Radiation Therapy with Volumetric Modulated Arc Therapy for Treating Urinary Transitional Cell Carcinoma in a Dog: A Case Report

  • Hwang, Tae-Sung;An, Soyon;Choi, Moon-Young;Huh, Chan;Song, Joong-Hyun;Jung, Dong-In;Lee, Hee Chun
    • Journal of Veterinary Clinics
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    • v.39 no.1
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    • pp.16-22
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    • 2022
  • A 12-year-old spayed female beagle dog was presented with pollakiuria and stranguria. Abdominal ultrasonography identified irregular a marginated, hyperechoic mass in the urethra and trigon area of the bladder. Computed tomography (CT) revealed a heterogeneous mass in the trigone area leading to a urethra. There was no evidence of regional or distant metastasis. Cytologic analysis suspected transitional cell carcinoma (TCC). The patient was treated with piroxicam, mitoxantrone, and once weekly fractionated radiation therapy (RT) with volumetric modulated arc therapy (VMAT). A follow-up CT scan at 6 months after RT revealed a reduction in tumor size. At 17 months after the start of RT, the patient became severely anorectic and lethargic. Ultrasound examination revealed a hyperechoic mass in the apex area of bladder while the trigone area of the bladder and urethra appeared normal. Multiple hypoechoic nodules of various sizes were found in the liver and spleen. The patient was humanely euthanized at the request of the owner. A combination of piroxicam, mitoxantrone, and hypofractionated RT with VMAT protocol was well tolerated. This case described tumor response and survival time of a canine TCC treated with piroxicam, mitoxantrone, and once weekly palliative RT using computer-assisted planning and VMAT.

A study of the Ethical Values of Korean Nurses (간호사의 윤리적 가치관에 관한 연구)

  • 이영숙
    • Journal of Korean Academy of Nursing
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    • v.20 no.2
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    • pp.249-270
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    • 1990
  • The purpose of this study is to identify whether ethical values of korean nurses are deontological or utilitarian. Nurse's ethical value questionnaire was developed from review of literature and interview of nurses in the clinical settings. Content validity was tested from three nursing faculties and staffs. Ethical problems are categorized into four areas : 1) human life area 2) nurse-patient relationship area 3) nurse - nursing task relationship area 4) nurse-collegue relationship area The data were obtained from the 404 nurses in the clinical settings from Feb. to Mar. in 1990 by ethical value questionnaire. The analysis of data was done by Pearson's correlation coefficient, t-test, anova. The results of this study were as follows : 1. The ethical values of human life slightly took up the position of utilitarian. 2. The ethical values of nurse - patient relationships slightly took up deontological position. 3. The ethical values of nurse - nursing task relationships slightly took up deontological position. 4. The ethical values of nurse - colleague relationships greatly took up deontological position. 5. The ethics of nurses related to demographic characteristics of religion, attitude of nursing, ethical standards, education level and post. Those who have religion took up more deontological position than those who have not. Those who have positive attitude of nursing and firm ethical standards took up more deontological position than those who have not. Those who have higher education level and post took up more deontological position than those who have not.

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Back Pain of Muscular Origin (근긴장성 요통의 치료에 대한 새로운 소견)

  • Choi, Joong-Rieb
    • The Korean Journal of Pain
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    • v.6 no.1
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    • pp.83-95
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    • 1993
  • In out-patient clinic, it seems to be common that most back pain arise from muscular origins rather than from skeletal origins. Most physicians have wished to diagnose lower back pain from the radiologic findings only. From clinical experiences and anatomical studies, I have gotten a different opinion from common sense about backaches. If I met a patient who had lower back pain around the posterior superior iliac crest(P.S.I.C.) area, I would had to search a trigger point in the erector spinae muscles at the level of thoraco-lumber junction rather than at the level of the painful site. It is why that sensory innervation over the posterior superior iliac crest area is the posterior primary branch of T12 spinal nerve running down through the erector spinae muscles. Pain on the iliac crest area is supposedly due to hyperirritability of the sensory nerve distributing to this area. Hyperirritability of the posterior primary branch of $T_{12}$ spinal nerve may be due to the spasm of the longissimus thoracis muscle in the erector spinae muscles at the level of the thoraco-lumbar junction. So finally, I would like to insist that spasmolytic treatment on the muscle at the level of the thoraco-lumbar junction would be better for pain relief around P.S.I.C. than treatment at the painful site only.

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