• Journal of Yeungnam Medical Science
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• v.39 no.3
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• pp.181-189
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• 2022

Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative condition characterized by loss of motor neurons, resulting in motor weakness of the limbs and/or bulbar muscles. Pain is a prevalent but neglected symptom of ALS, and it has a significant negative impact on the quality of life of patients and their caregivers. This review outlines the epidemiology, clinical characteristics, underlying mechanisms, and management strategies of pain in ALS to improve clinical practice and patient outcomes related to pain. Pain is a prevalent symptom among patients with ALS, with a variable reported prevalence. It may occur at any stage of the disease and can involve any part of the body without a specific pattern. Primary pain includes neuropathic pain and pain from spasticity or cramps, while secondary pain is mainly nociceptive, occurring with the progression of muscle weakness and atrophy, prolonged immobility causing degenerative changes in joints and connective tissue, and long-term home mechanical ventilation. Prior to treatment, the exact patterns and causes of pain must first be identified, and the treatment should be tailored to each patient. Treatment options can be classified into pharmacological treatments, including nonsteroidal anti-inflammatory drugs, antiepileptic drugs, drugs for cramps or spasticity, and opioid; and nonpharmacological treatments, including positioning, splints, joint injections, and physical therapy. The development of standardized and specific assessment tools for pain-specific to ALS is required, as are further studies on treatments to reduce pain, diminish suffering, and improve the quality of life of patients with ALS.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.8
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• pp.662-672
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• 2016

The purpose of this study was to develop an integrated-simulation practice program using standardized patients and to identify the effects of such program. The present study used a pretest-posttest design with a single group applied to 30 fourth-year nursing students in a university and developed a case scenario for alcoholism patients with diabetes mellitus in a community. As results showed, communication skills were significantly improved (t = 4.24, p < .001), but the learning of self-efficacy and motivation of transfer were insignificantly improved compared with the pretest. Moreover, motivation of transfer showed a positive correlation with the learning of self-efficacy (r = .758, p < .01). The purpose of utilizing an appropriate case development based on practical experience and hands-grade students was to improve the motivation of transfer and increase self-efficacy through problem solving. Therefore, we identified that an integrated-simulation practice program using standard patients was useful in the improvement of client centered nursing competence, such as communication skills. In addition, further studies would help develop various scenarios for the integrated-simulation practice program to improve not only communication skills but also increase self-efficacy and motivation of transfer.

• Asian Oncology Nursing
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• v.10 no.1
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• pp.68-79
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• 2010

Purpose: The purposes of this study were to identify job definition, duties and tasks of Korean oncology Advanced Practice Nurses (APNs) and assess frequency, importance, and difficulty for each of duty and task using the DACUM method. Methods: The DACUM committee was organized with nine oncology APNs. The committee documented the job definition, duties and tasks based on their daily job descriptions. Validity of the elicited duties and tasks was tested by a study team and 6 oncology APNs. Data were collected using a questionnaire survey from 53 oncology APNs. Results: The job description of oncology APNs was identified 12 duties and 66 tasks. Among the twelve duties, 'education for patients/families' was the most frequently performed and was the most important duty. 'Case management' was the most difficult duty. Among 66 tasks, 'providing education for patients/families' was most frequently performed. 'Providing education for patients/families' and 'assessing patient condition comprehensively' were the most important tasks. 'Implementation research' as the principal investigator was perceived as the most difficult task. Conclusion: In this study, Korean oncology APNs' job performances were identified and analyzed. It is recommended that job description for oncology APNs needs to be standardized and reshaped in advanced way in future.

• The Journal of Korean Medicine
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• v.40 no.2
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• pp.1-16
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• 2019

Objectives: The purpose of this study was to increase the utilization of Korean Medicine Clinical Practice Guidelines(KMCGP) for ankle sprain by investigating the recognition of guideline developed in 2015 and evaluating the current status of treatment. Methods: An e - mail questionnaire survey was conducted for Korean medicine doctor(K.M.D) registered in Korean Medicine Association. Survey data were analyzed through Excel. Results: The most common Korean medicine treatments used in clinic were acupuncture(adjacent points)(28.5%), cupping therapy(19.7%) and pharmacopuncture(9.8%). The treatments with high patient satisfaction were acupuncture (adjacent points)(27.9%), moxibustion(22.4%) and herbal medicine(10.4%). Herbal medicine(17.9%), tuina(10.7%) and embedding therapy(9.2%) were difficult to perform during treatment because of cost. In the case of a later revision, respondents most thought it is necessary to update evidence and adjust recommendation ratings. A majority of all respondents said they would like to know about the revised guideline through the Internet. In the expected revision effect, the first order was 'presentation of standardized treatment method', the second was 'establishing the basis of Korean medicine treatment', and the third was 'strengthening the status of Korean medicine as therapeutic medicine'. Many respondents wished to add exercise therapy. In order to increase the utilization rate of the guideline, many respondents thought it should be included in textbooks and 90.6% of respondents answered that they would use more than 50% of the revised guideline. Conclusion: It is necessary to update evidence and adjust recommendation ratings and to promote KMCGP. At the same time treatment methods should be taught to K.M.D

• Journal of the Health Care and Life Science
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• v.8 no.2
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• pp.83-93
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• 2020

In this study, a practical model for health information management education using the EMR education system at universities for nurturing health care information managers was studied. Currently, there is no practical training course for health care information management in the standards for evaluation and certification of health care information management education introduced to strengthen the job competency of health care information managers. Accordingly, the program was constructed so that the practice program suggested as an educational environment in the Health and Medical Information Management Education Evaluation and Certification Manual can be practiced in the EMR education system. In addition, a practical model that can be performed according to the on-site practice guidelines for health and medical information management for each program was studied. Using the health care information management education EMR system, master data management, patient registration, doctor prescription, medical cost calculation, health insurance claim management, form management, discharge registration, cancer registration, unrecorded management, health care data management, health care statistics, A practice model was studied so that practice on information protection/security management can be performed. It will be possible to play a role as a health care information management expert by raising the quality level of health care information management education through systematic and standardized health care information management practice courses at universities. Accordingly, it is necessary to cultivate health care information management experts who develop and manage medical services based on medical data analysis through practical training of health care information managers.

• Nutrition Research and Practice
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• v.4 no.2
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• pp.163-172
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• 2010

The purposes of this study were to assess hospital foodservice quality and to identify causes of quality problems and improvement strategies. Based on the review of literature, hospital foodservice quality was defined and the Hospital Foodservice Quality model was presented. The study was conducted in two steps. In Step 1, nutritional standards specified on diet manuals and nutrients of planned menus, served meals, and consumed meals for regular, diabetic, and low-sodium diets were assessed in three general hospitals. Quality problems were found in all three hospitals since patients consumed less than their nutritional requirements. Considering the effects of four gaps in the Hospital Foodservice Quality model, Gaps 3 and 4 were selected as critical control points (CCPs) for hospital foodservice quality management. In Step 2, the causes of the gaps and improvement strategies at CCPs were labeled as "quality hazards" and "corrective actions", respectively and were identified using a case study. At Gap 3, inaccurate forecasting and a lack of control during production were identified as quality hazards and corrective actions proposed were establishing an accurate forecasting system, improving standardized recipes, emphasizing the use of standardized recipes, and conducting employee training. At Gap 4, quality hazards were menus of low preferences, inconsistency of menu quality, a lack of menu variety, improper food temperatures, and patients' lack of understanding of their nutritional requirements. To reduce Gap 4, the dietary departments should conduct patient surveys on menu preferences on a regular basis, develop new menus, especially for therapeutic diets, maintain food temperatures during distribution, provide more choices, conduct meal rounds, and provide nutrition education and counseling. The Hospital Foodservice Quality Model was a useful tool for identifying causes of the foodservice quality problems and improvement strategies from a holistic point of view.

• Journal of Korean Academy of Nursing
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• v.40 no.2
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• pp.151-160
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• 2010

Purpose: The purpose of this study was to evaluate the effects of teaching method using Standardized Patients (SPs) on nursing competence, self-directed learning readiness, and problem solving ability-focusing on subcutaneous insulin injection. Methods: This research was a nonequivalent control group non-synchronized post-test design. The subjects consisted of 62 junior nursing students at E University. Scenarios to train SPs and checklists to evaluate the students' competence were developed by our research team. The experimental group (n=31) participated in the teaching class using SPs. The control group (n=31) received traditional practice education. The collected data were analyzed with descriptive analysis, $\chi^2$/Fisher's exact test, t-test, Pearson's correlation coefficient, and Cronbach's $\alpha$ using SPSS WIN 14.0 Program. Results: The mean scores of competence, self-directed learning readiness, and problem solving were significantly higher in the experimental group than the control group. Conclusion: As confirmed by this research findings, the teaching method using SPs was more effective than the traditional method to improve junior nursing students' competence, self-directed learning readiness, and problem solving. Therefore, It is necessary to develop a various of scenarios and to testify their effectiveness.

• Journal of Trauma and Injury
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• v.33 no.1
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• pp.1-12
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• 2020

Purpose: Despite recent developments in the management of trauma patients in South Korea, a standardized system and guideline for trauma treatment are absent. Methods: Five guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation II instrument. Results: Restrictive volume replacement must be used for patients experiencing shock from trauma until hemostasis is achieved (1B). The target systolic pressure for fluid resuscitation should be 80-90 mmHg in hypovolemic shock patients (1C). For patients with head trauma, the target pressure for fluid resuscitation should be 100-110 mmHg (2C). Isotonic crystalloid fluid is recommended for initially treating traumatic hypovolemic shock patients (1A). Hypothermia should be prevented in patients with severe trauma, and if hypothermia occurs, the body temperature should be increased without delay (1B). Acidemia must be corrected with an appropriate means of treatment for hypovolemic trauma patients (1B). When a large amount of transfusion is required for trauma patients in hypovolemic shock, a massive transfusion protocol (MTP) should be used (1B). The decision to implement MTP should be made based on hemodynamic status and initial responses to fluid resuscitation, not only the patient's initial condition (1B). The ratio of plasma to red blood cell concentration should be at least 1:2 for trauma patients requiring massive transfusion (1B). When a trauma patient is in life-threatening hypovolemic shock, vasopressors can be administered in addition to fluids and blood products (1B). Early administration of tranexamic acid is recommended in trauma patients who are actively bleeding or at high risk of hemorrhage (1B). For hypovolemic patients with coagulopathy non-responsive to primary therapy, the use of fibrinogen concentrate, cryoprecipitate, or recombinant factor VIIa can be considered (2C). Conclusions: This research presents Korea's first clinical practice guideline for patients with traumatic shock. This guideline will be revised with updated research every 5 years.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.4
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• pp.33-44
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• 2021

PURPOSE: This study analyzed the research trends related to the International Classification of Functioning, Disability, and Health (ICF) to suggest an ICF utilization plan in the Korean clinical field. METHODS: In the RISS, KISS, NSDL, and PubMed databases, papers published between 2016 and July 2021 were collected by applying the search terms, 'ICF', 'international classification of functioning, disability and health', 'clinic', 'patient', and 'diagno'. The 44 papers selected were classified according to the analysis criteria, and the frequency and percentage were calculated. RESULTS: In domestic clinical trials, the frequency of ICF-related studies was in the order of physical therapy (n = 19) and occupational therapy (n = 14). The frequency of each study subject was observed in the order of studies related to a specific disease (n = 34) and prior studies (n = 7). The research topics were in the order of studies using ICF as a measurement tool (n = 21) and case studies with patients with specific diseases (n = 11). There were 18 studies using ICF codes and 14 papers applying the ICF domains. CONCLUSION: Over the last five years, ICF-related research in the domestic clinical field targeted patients with more diverse diseases in more expertise fields. Research for the unification of terms should be conducted for communication among various experts in clinical practice. To promote the use of ICF in the clinical field, it will be necessary to conduct research, such as the unification of terms, standardized education, development of ICF casebook, and development of ICF coding programs and guidelines.

• The Journal of Korean Academic Society of Nursing Education
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• v.17 no.2
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• pp.168-177
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• 2011

Purpose: The purpose of this study was to investigate the attitude toward death in Korean nursing students. Method: The sample consisted of 365 baccalaureate nursing students. The questionnaires included questions on sociodemographics and death-related characteristics of the participants, and the Fear of Death and Dying Scale (FODS) to measure the attitude toward death. Result: The mean of the FODS score was 2.63 out of 4, so the participants had a slightly negative attitude toward death. There were statistically significant differences between gender, religion, religion activity, perceived health status, experience of parents' death, experience of friend's death, and overall FODS score. Among the four subscales of overall FODS, the score of the fear of death of self was significantly higher in the participants who experienced clinical practice and who experienced patient's death in the intensive care unit compared to the emergency room. Conclusion: Based on the study results, educational programs to change the attitude toward death are required before clinical practice. Programs need to consider nursing students' gender and religion, and give opportunity to share experiences and feelings about death of family or friend. In addition, using standardized patients and simulators is advised in the need for simulation training.