• Title/Summary/Keyword: Self-diagnostic

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A Prioritizing for the Evidence-Based Nursing Practice Guidelines Development (국내 근거기반 임상간호실무지침 주제의 우선순위 결정)

  • Gu, Mee Ock;Cho, Myoung Sook;Cho, Yong Ae;Jeong, Jae Sim;Eun, Young;Jeong, Ihn Sook;Park, Jeong Sook;Kim, Hea Jeong
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.1
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    • pp.39-51
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    • 2012
  • Purpose: Thisstudy was conducted with an aim to get a kind of prioritiesin developing the evidence-based nursing practice guidelines in fields. Methods: This study utilized a two-round Delphi surveys from November to December, 2010 with self-administered questionnaires which had a scale ranged from 0 to 9. A total of 95 head nurses working at the forty different general hospitals was asked to evaluate the priorities in four criteria; patient coverage, certainty, improvement in patient outcome and in nursing practice (first round) and 65 head nurses were asked to decide the importance of the criteria afterwards (second round). Results: The relative importance of 4 criteria was 22.3% in patient coverage, 26.5% in certainty, 23.5% in improvement of patient outcome, and 27.7% in improvement of nursing practice as the results of the 1st round and 20.6%, 26.6%, 24.8%, and 28.0% for the 2nd round, respectively. Top five nursing practices showed high scores after considering the relative importances of the 4 criteria were medication, intravenous therapy, checking vital sign, pain management, and diagnostic test or procedures care. Conclusion: It is recommended to take into account of the priorities that were found in this study when someone intends to develop a evidence-based nursing practice guideline.

Dementia Response Technology Development Strategy through PEST-SWOT Analysis

  • Yu, Tae Gyu
    • International journal of advanced smart convergence
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    • v.9 no.1
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    • pp.185-192
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    • 2020
  • The number of dementia patients in Korea is expected to increase to 3.30 million in 2050, and the cost of dementia management will increase sharply to KRW 106.5 trillion of GDP. In August 2017, the Moon Jae-in government announced the 'Dementia National Responsibility System' through a five-year plan for government operation and expanded the Dementia Peace Center nationwide. However, for this, strategic dementia-related technology development strategies should be established and given the role of government and the role of the private sector. Therefore, in order to derive the corresponding strategy, this study developed the government's 'dementia' response technology development strategy through the situation analysis from the political, economic, social, and technological perspective and the environmental (PEST) analysis of the strengths, weaknesses, opportunities, and threats (SWOT). As a result, the direction of technology development in the dementia-related medical device market is expected to become a trend of developing dementia self-measurement by developing low-cost and high-efficiency diagnostic technology products. It has been shown that the development of various products for consumers should begin. As a result, the dementia market approach strategy should be premised, the related technical support and legal restrictions should be minimized, and the education of related experts should be strengthened to solve the government's development of dementia technology and the social problems of dementia. In addition, by developing joint projects with major companies around the world and actively participating in the technology platform, it is important to naturally build up skills accumulation for the development of dementia technology and competence skills of dementia technology experts in the long term.

The Development of Instrument of Korean Medical Pattern Identification and Functional Evaluation for Five Organ (한의 오장 변증·평가 설문지 개발을 위한 신뢰도 및 타당도 평가)

  • Jang, Eunsu;Kim, Yunyoung;Park, Yang Chun;Jeon, Ju Hyun;Jung, In-Chul
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.31 no.3
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    • pp.173-181
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    • 2017
  • The aim of this study was to identify the reliability and the validity of Five Organs Questionnaire (FOQ). In this study, 335 data was collected from early adulthood of A-city, D-city and C-city in South Korea from Dec. 2016 to Jan. 2017, and the collected data was analyzed with SPSS 23.0 software. The result showed that the Cronbach's ${\alpha}$ of five organs was 0.775-0.853. The reliabilities of test and retest Intra Correlation Coefficient (ICC) for the five organs were .891-.929 in pattern identification and .874-.930 in functional evaluation, respectively. Each organ was divided by two factors, and the factor loadings of Liver, Heart, Spleen, Lung and Kidney were 52.973%, 54.534%, 57.060%, 53.803%, and 46.337%, respectively. The functional evaluation of five organs was associated with self-rated health status as r was -.443 to -.583(p<.001), and quality of life as r was -.5.17 to -.716(p<.001), respectively. The test-retest diagnostic agreement was 67.2% and Kappa was 0.562. This study revealed that FOQ is a reliable and valid questionnaire.

Cost-Minimization Analysis of Biologic Disease-Modifying Antirheumatic Drugs Administered by Subcutaneous Injections in Patients with Rheumatoid Arthritis (피하주사로 투여하는 생물학적 항류마티스 제제의 비용 최소화 연구)

  • Park, Seung-Hoo;Lee, Min-Young;Lee, Eui-Kyung
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.1
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    • pp.59-69
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    • 2016
  • Background: The subcutaneous formulation of biologic disease-modifying antirheumatic drugs (DMARDs) was preferred due to favored self-administration and would be an economical treatment option for patients with rheumatoid arthritis. This study was to compare the economic impact of biologic DMARDs administered by subcutaneous injection in patients with rheumatoid arthritis who had inadequate response to conventional DMARDs. Methods: The cost-minimization analysis was conducted to estimate the lifetime health care costs of treatment sequences with subcutaneous biologic DMARDs as first-line therapy from a health care system perspective. The Markov model was developed to represent the transitions through treatment sequences based on American College of Rheumatology response rate and discontinuation rate. The health care costs comprised the cost of medications, administration, dispensing, outpatient visits, test/diagnostic examination, palliative therapy and treatment of serious infection. All costs were expressed in 2016 Korean Won (KRW) and discounted at 5%. Results: The mean lifetime health care cost per patient was lowest in the etanercept sequence, which was estimated at KRW 63,441,679. The incremental costs of the treatment sequence started with adalimumab, golimumab, abatacept, and tocilizumab were KRW 7,985,730, KRW 4,064,669, KRW 2,869,947, and KRW 4,282,833, respectively, relative to etanercept sequence. These differences in costs mainly were attributable to medication costs. One-way and probabilistic sensitivity analyses confirmed that etanercept represented the option with the lowest cost compared with comparators. Conclusion: This study found that etanercept is likely a cost-saving treatment option among subcutaneous biologic DMARDs in patients with rheumatoid arthritis.

One Year Naturalistic Outcome Study of Panic Disorder Patients (공황장애 환자의 1년 자연 경과 추적 연구)

  • Kim, Min-Hoo;Lee, Dong-Eoun;Chung, Seock-Hoon;Song, Hae-Cheol;Hahn, Oh-Su;Lee, Seon-Hyung;Kwon, Soo-Hee;Hong, Jin-Pyo
    • Anxiety and mood
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    • v.2 no.2
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    • pp.108-114
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    • 2006
  • Objectives : Only a few prospective studies of panic disorder are available. This study investigated naturalistic outcome of panic disorder patients at twelve months after the initial diagnosis. Methods : A total of 84 subjects were diagnosed with panic disorder by diagnostic interview, Structured Clinical Interview for DSM-IV (SCID-IV) and Anxiety Disorder Interview Schedule for DSM-IV (ADISIV). Among them, 80 subjects could be evaluated by means of Panic Disorder Severity Scale (PDSS) at follow-up interview after twelve months. Treatment continuation was also examined at follow-up interview. Results : At initial intake, 80 patients were classified into 22% with mild, 33% with moderate-to-marked, and 45% with severe symptoms on the basis of their PDSS total score. At twelve months, 20% of patients reached remission, 65% had mild and 15% had moderate-to-marked symptoms. Initial panic symptom severity, presence of agoraphobia, panic symptom duration before diagnosis, number of comorbid Axis I disorders were associated with significantly higher PDSS total score at twelve months. Forty six percent of total patients continued medication and 23% have stopped treatment by clinician's recommendation and 31% have selfdiscontinued their medication. At twelve months, all three groups were improved but self-discontinuation group had significantly higher PDSS total score. Conclusion : In the one-year naturalistic outcome study of panic disorder patients, high percentage of patients achieved remission or had mild symptoms.

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Contents and Severity of Worries in Outpatients with Generalized Anxiety Disorder Compared to Normal Control (범불안장애 환자와 일반인의 걱정 내용 및 심각도의 비교)

  • Kim, Hwigon;Kim, Daeho;Oh, Daeyoung;Seo, Ho Jun;Huh, Hyu Jung;Chae, Jeong Ho
    • Anxiety and mood
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    • v.11 no.1
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    • pp.47-53
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    • 2015
  • Objective : Generalized anxiety disorder (GAD) is a common anxiety disorder characterized by excessive worries and anxiety symptoms. To distinguish between pathological and normal worries, this study compared the contents and severity of worries among patients with GAD with those of matched non-psychiatric control Methods : Thirty outpatients with GAD receiving treatment at the psychiatric department of Hanyang University Guri Hospital were recruited. As a matched control group, we selected 30 adults without psychiatric history who participated in the Anxiety Disorder Survey, during the Mental Health Exposition held in Seoul in April, 2014. Matched demographic data were age, sex, education, and household income. Self-questionnaires included demographic data, contents of worry (10 categories of worries and each severity), and the Pennsylvania State Worry Questionnaire (PSWQ). Results : There was no statistical difference in the contents of worry between patient and control groups. However, the total PSWQ scores significantly higher in the GAD group. Conclusion : Our findings suggest that patients and non-patients worry about the similar contents and worries in GAD cannot be differentiated by what people worry about. Only the severity of worry was a distinguishable feature. Our finding supported inclusion of the diagnostic criterion of "excesslve wornes" in GAD.

Premature Ejaculation and Erectile Dysfunction in Iranian Prostate Cancer Patients

  • Lin, Chung-Ying;Burri, Andrea;Pakpour, Amir H
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1961-1966
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    • 2016
  • Background: To investigate the prevalence of premature ejaculation (PE) and erectile dysfunction (ED) in a sample of patients with prostate cancer and to determine the utility of the previously suggested cutoffs of the Premature Ejaculation Diagnostic Tool (PEDT) for the diagnosis of PE and that of International Index of Erectile Function (IIEF-5) for ED. Materials and Methods: A total of 1,202 men with prostate cancer were invited from urology clinics at the universities of Iran, Tehran, Qazvin, Ahvaz, Guilan and Tabriz. Clinical characteristics were collected through medical records. PE and ED diagnoses were made by trained urologists. In addition to the clinical diagnoses, PE and ED were measured through self-report using the PEDT and the IIEF-5. Questionnaire cutoff scores were determined using receiver operating characteristic (ROC) curves and confirmed by predictive ability using logistic regression. Results: The prevalence of PE was 63.7% and that of ED was 66.2%. Prevalences of PE decreased and that of ED increased with advanced TNM stages. According to ROC, the suggested cutoff for the PEDT to diagnose a PE was ${\geq}11$ (sensitivity=0.988, 1-specificity=0.084, and predictive ability=0.914) and ${\leq}17$ for the IIEF-5 (sensitivity=0.966, 1-specificity=0.031, and predictive ability=0.967). Conclusions: Prevalence of sexual problems was high in prostate cancer patients in Iran, therefore oncologists should take into account these potential problems when deciding on treatment modalities.

Musculoskeletal Symptoms Prevalence and Its Related Factors of Workers in Manufacturing Industry of Automobile Parts in Gimhae City (김해시 자동차 부품 생산직 근로자의 근골격계 증상 유병률과 관련요인)

  • Park, Su-Hyung;Moon, Deog-Hwan;Kim, Chi-Hyok
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.19 no.1
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    • pp.9-20
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    • 2013
  • Background: This study was conducted to provide preventive measure for the musculoskeletal disorders in automobile parts manufacturing workers. Method: The author surveyed to the musculoskeletal symptoms prevalence and its related factors from 10th to 17th April 2011 with structured self administered questionnaires. 223 out of 225 collected questionnaires were used for final analysis, excluding 2 questionnaires with no valid response. Based on the diagnostic criteria of NIOSH (National Institute for Occupational and Health), an investigation was made into the prevalence of musculoskeletal symptoms as well as into the factors related to individual items. Results: The prevalence of musculoskeletal symptoms according to the criteria of NIOSH was the highest in the shoulder (52.9%), followed by the neck (39.%), the hand/wrist (35%), the waist (29.6%), the arm/elbow (24.7%), and the leg/food (23.8%). One-way analysis showed that among general characteristics, age was the musculoskeletal risk factor with the greatest effect. Whereas among work-related characteristics, significant risk factor didn't find. Yet it was shown that among ergonomic work postures, high degree of musculoskeletal risk was shown by the posture involving frequent and repetitive movement of the arm and the hand/wrist and also by the posture involving standing for a long time. Multiple regression analysis showed that musculoskeletal risk was 1.795 times higher in those age 50 and over than in those under age 50; 1.67 times higher in the high risk stress group than in the low risk stress group; and 1.131 higher in the group involving the repetitive use of the hand/arm than in the other groups (p<.05). Conclusion: The prevalence and stress score of automobile parts manufacturing workers were higher than other occupation workers. Among general characteristics, drinking and smoking were shown to be related to stress score; while age was shown to have significant effect on musculoskeletal risk.

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Physiochemical Properties of Binary Pluronic Systems for Reversal of Multi-drug Resistant (MDR) Cancers

  • Yun, Jung-Min;Park, Ga-Young;Kim, Ha-Hyung;Lee, Jae-Hwi;Lee, Eun-Seong;Youn, Yu-Seok;Lee, Beom-Jin;Oh, Young-Taik;Oh, Kyung-Taek
    • Journal of Pharmaceutical Investigation
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    • v.40 no.4
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    • pp.255-261
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    • 2010
  • Pluronic as pharmaceutical excipients are listed in the US and British Pharmacopoeia. In particular, Pluronics exist as different compositions and display abundant phases as self-assembling into polymeric micelles with various morphologies depending on the aqueous solvent quality, the composition of structure, and hydrophilic-lipophilic balance (HLB). Pluronics were also known as a P-gp modulator, which was exploited as a reversal molecule of multi-drug resistant (MDR) cancers. We selected a lamella forming Pluronic L92 which has high hydrophobicity and relatively long PEO block among L series of Pluronics. The dispersion of L92 showed great size particles and low stability. To increase the stability and to decrease the particle size, secondary Pluronics (F68, F88, F98, F127, P85, P105, and P123) with relatively long PEO chain were added into 0.1 wt% Pluronic L92 dispersion. The stability of binary systems was increased due to incorporated long PEO chain. Their particle sizes slightly decreased to over 200~400 nm and their solubilization capacity of binary systems didn't change except Pluronic L92/P123 mixtures. The L92/P123 systems showed ca. 100 nm sizes and lowest turbidity among the all systems. The solubilization capacity of 0.1 wt% L92/0.1 wt% P123 was slightly increased compared to 0.1 wt% L92 mono system and other binary systems. These nano-sized binary systems may have potential as alternative drug delivery systems with simple preparation method and overcome the drawbacks of mono systems such as low stability and loading capacity.

A case of restless legs syndrome in a child presenting with growing pains (성장통으로 발견된 하지 불안 증후군 1예)

  • Kim, Dong Soon;Shin, Hong Beom;Ahn, Young Min
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1222-1227
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    • 2008
  • Restless legs syndrome (RLS) is a common neurological sleep disorder in adults characterized by the following diagnostic criteria: an urge to move that is usually associated with unpleasant sensations and symptoms that are worse at rest, relieved by movement, and most severe at night. The definite diagnosis of RLS in children is stricter and consists of self-description of leg discomfort or the presence of 2 of 3 supportive criteria combined with 4 essential criteria for diagnosis in adults. RLS in childhood has often been misdiagnosed as growing pains or a part of normal development. As a result, physicians have often missed the chance for proper management. We diagnosed a case of RLS in a 5-year-old boy presenting with growing pains, whose mother was found to have had RLS since childhood. We confirmed RLS by using a polysomnograph, in which the indices of periodic limb movement syndrome (PLMS) and periodic limb movement during wakefulness (PLMW) were recorded to be compatible with RLS criteria. The patient's ferritin level was low normal, and his symptoms improved after taking iron supplements.