• 제목/요약/키워드: Standardized patients

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3차 병원 통증 클리닉에 의뢰되어 오는 환자들의 특성 분석: 전라북도 지역의 다기관 연구 (An analysis of patients referred to the advanced general hospital pain clinic center: multicenter study in province of Jeollabuk-do, Korea)

  • 김연동;이철형
    • 한국융합학회논문지
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    • 제12권2호
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    • pp.311-316
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    • 2021
  • 통증클리닉에 의뢰되어 오는 환자들의 수는 증가하는 추세에 있다. 본 연구는 3차 병원의 통증클리닉에 의뢰되어 오는 환자들을 분석하여 그 특성을 파악하고자 시행되었다. 2011년 1월부터 2015년 12월까지 전라북도 지역의 3개 대학병원 통증클리닉에 의뢰되어 온 환자 587명을 대상으로 연구를 수행하였다. 데이터는 외래 진료 기록지를 참고하여 후향적으로 수집되었다. 이들 환자를 연령, 성별, 주된 증상, 통증 위치, 동반 질환, 의뢰 부서, 의뢰 원인에 따라 분석하였다. 통증 클리닉에서는 많은 의학적 문제에 봉착하게 된다. 따라서 통증클리닉에서 표준화된 진료지침이 필요하며, 이를 위해서는 환자들의 특성을 파악할 필요가 있다. 더 많은 환자를 대상으로 한 전국단위의 연구가 이루어진다면, 환자들의 특성을 더욱 정확히 파악할 수 있을 것으로 생각된다.

뇌혈관질환자와 관련된 간호진단 및 간호진단별 특성 규명과 타당성 조사연구 - 가정간호 대상자를 중심으로 - (Validation of Nursing Diagnose and Defining Characteristics for Patients with Cerebrovascular Accidents - Home Health Care Nursing)

  • 김혜영
    • 가정간호학회지
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    • 제2권
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    • pp.35-51
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    • 1995
  • This study was done to define nursing diagnose and to test the validity of the characteristics for patients with cerebrovascular accidents being seen at home by home health care nurses. This study was a descriptive study. The sample consisted of 10 experts(professors and home health care nurses) who had had a variety of experience using nursing diagnoses in clinical practice, and 336 nurse progress notes for 18 patients with cerebrovascular accidents. First, 32 nursing diagnoses were defined by the analysis of 336 nurse progress notes, and ten nursing diagnoses were selected according to a criteria of frequency and four nursing diagnoses from home health care clinical practice. Second, content validity was examined by an expert group which considered the sign / symtoms of the fourteen nursing diagnoses. The instrument used for this was a checklist for sign / symtoms based on the nurse progress notes and literature : Carpenito(1993), Kim Cho Ja et al (1994), Lee Sun Ok et al.(1994), Kim Mae Ja et al. (1992), Seoul University Hospital (1993) , Kim Mi Ja et al. (1991). The data were collected from March 1995 to April 1995. Data were analyzed using Content Validity Incidence where if 80% or more of the expert group agreed, characteristics were defined as a major sign/symtoms, if between 50% and 79% of the expert group agreed with the characteristic it was defined as a minor sign / symtoms. The results of this study are summarized as follows : 1. Thirty-two nursing diagnoses related to patients with cerebrovascular accidents were defined. There was a high frequency for the following : 'Potential for disuse syndrome (61%)', 'Impaired physical mobility(50%)', 'Impaired skin integrity (44.4%)', Potential for aspiration(33.3%)', 'Potential for infection: respiration(33.3%)', 'Self-care deficit : bathing /hygine(27.8%)', 'Ineffective family coping(22.2%)', 'Potential for trauma(22.2%)', 'Alteration in nutrition: less than body requirements(22.2%)'. The following diagnoses were also used in home health care clinical practice : 'Anxiety in family (50%)', 'Caregiver fatigue(27.8%)', 'Ineffective treatment behavior (22.2%)', 'Ineffective Levin tube management and Levin tube feeding(22.2%)'. Fourteen nursing diagnoses were selected. 2. Ten of the nursing diagnoses for patients with cerebrovascular accident were listed as nursing diagnoses by NANDA but four nursing diagnoses were new nursing diagnoses used in home health care clinical practice. 3. Characteristics of the ten Nursing Diagnoses from NANDA were developed from the sign /symtoms in the literature and in the nurse progress notes. These characteristics was verified as major or minor sign / symtoms by the expert group. 4. Characteristics of the four nursing diagnoses used in home health care were not defined by the literature but only by the nurse progress notes and verified as major or minor signs /symtoms by the expert group. On the basis of the findings of this study, the following recommendations are made : 1. Continual study is necessary to identify other signs /symtoms not verified in this study. 2. It is necessary to use verified signs /symtoms in home health care clinical practice. 3. It is necessary to define related factors which define each diagnoses in this study. 4. It is necessary to develop of standardized nursing are plans which include defined signs and symtoms. 5. It is necessary to study the outcomes of the standardized nursing care plans.

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자동차보험 한방진료비 증가요인 분석 (A Study on the Analysis of Factors for the Increase of Oriental Medicine Expenditure in the Automobile Insurance)

  • 이창수;이현주;채정미
    • 한국산학기술학회논문지
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    • 제20권1호
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    • pp.121-130
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    • 2019
  • 자동차보험 총 진료비는 2014년 대비 2015년 12% 증가하였으나 그 중 한방진료비는 36% 증가하였다. 본 연구 목적은 진료비 항등식을 이용하여 자동차보험 한방진료비의 급격한 증가 원인을 구체적으로 파악하는 것이다. 2014년~2015년 기간 중 진료하여 심사 완료된 34,351,120건의 데이터를 이용하여 분석한 결과 한방 환자수는 해당 기간 중 27%, 환자당 진료비는 7% 증가하였다. 환자당 진료비를 세분화하여 분석한 결과, 환자당 입(내)원 일수는 변하지 않았으며 일당진료비만 7% 증가하였다. 환자수 증가를 보면 한방진료만을 받은 환자는 32%, 의과와 한방을 함께 진료 받은 환자는 24% 증가한 반면 의과진료만을 받은 환자는 오히려 4% 감소하였다. 일당진료비 증가에 영향을 미치는 요인으로는 한방물리요법 등 표준화되지 않은 진료행위의 비용 상승이 있다. 그럼에도 불구하고 한방 진료비 증가에 가장 크게 영향을 미친 요인은 환자수의 증가였다.

심장재활에서의 운동 프로그램 (Exercise program in cardiac rehabilitation)

  • 김좌준;김대경;김민수
    • PNF and Movement
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    • 제8권3호
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    • pp.17-25
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    • 2010
  • Cardiac disease is the class of diseases related to the heart that plays an important role in supplying blood to our body and the number of deaths is increasing every year. Cardiac Rehabilitation has been conducted as treatment and prevention in such patients with cardiac disease. Cardiac rehabilitation programs in general contain pat~ient education and consulting service in order to improve physical strength in patients with cardiac disease, decrease cardiac symptoms, promote fitness, and minimize the risk of following cardiac problems including cardiac arrest. Among them therapeutic exercise is the mainstream of cardiac rehabilitation, however, to accomplish more efficient patient care, standardized guideline based on each disease and researches from a physical therapy perspective are required.

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뇌졸중 환자를 돌보는 가족의 가족기능 영향요인 (Influencing Factors on Family Functioning of Caregivers in Families with Stroke Patients)

  • 유수정;박연환
    • 성인간호학회지
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    • 제18권3호
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    • pp.457-467
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    • 2006
  • Purpose: The purpose of this study was to identify the main factors influencing family functioning of caregivers in families with stroke. Method: A Convenient sample of 173 primary family caregivers who take care of a stroke patient at an Oriental medicine hospital in Jeonbuk. Interviews were done with a standardized questionnaire including family functioning by nurses. Results: In Pearson's correlation analysis, the influencing factors related to family functioning were ADL(p=.017), level of paralysis(p=.019) as stressors, Quality of relation(p=.000) as situational variables, and family caregivers' burden(p=.000). Stepwise multiple regression analysis showed 29.9% of the variance family functioning was significantly accounted for by the quality of relationship between stroke patient and caregiver(26.8%), and caregiver burden(3.1%). Conclusions: Findings indicate that families of stroke patients need family-focused nursing intervention as supported care to improve the relationship between patient and primary caregiver and relieve caregiver burden by culturally tailoring to Korean.

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실어증 선별검사 도구개발을 위한 예비연구 (A Preliminary Study for Development of the Aphasia Screening Test)

  • 김향희;이현정;김덕용;허지회;김용욱
    • 음성과학
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    • 제13권2호
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    • pp.7-18
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    • 2006
  • An aphasia screening test can serve a main purpose of differentiating aphasics from non-aphasic patients in a quick as well as efficient manner. As a preliminary study for developing a standardized aphasia screening test for Korean patients, we constructed an aphasia screening test constituting items from the Paradise' Korean version-the Western Aphasia Battery(P K-WAB). All test items were analyzed in order to extract items with optimal item discrimination and adequate item difficulty indices. From the results, we were able to select some items from each subtest with optimal results of discriminant function analysis for aphasic and normal control groups. It is expected, thus, that information on the item analysis could be utilized in developing a Korean aphasia screening test.

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Role of Endoscopic Vacuum Therapy as a Treatment for Anastomosis Leak after Esophageal Cancer Surgery

  • Lee, Dong Kyu;Min, Yang Won
    • Journal of Chest Surgery
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    • 제53권4호
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    • pp.205-210
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    • 2020
  • Esophageal anastomotic leak is the most common and serious complication following esophagectomy. However, the standard treatment for anastomotic leaks remains unclear. Recently, endoscopic vacuum therapy has become an important non-surgical alternative treatment method for patients with esophageal anastomotic leak. This treatment involves the endoscopic placement of a sponge connected to a nasogastric tube into the defect cavity or lumen. Subsequently, continuous negative pressure is delivered to the cavity through the tube. Several studies have reported a treatment success rate of 80% to 100%. In this study, we review the mechanism of action, the method of performing the procedure, its safety and efficacy, and prognostic factors for failure of endoscopic vacuum therapy in the management of patients with anastomotic leak, and on this basis attempted to confirm the possibility of establishing a standardized treatment protocol using endoscopic vacuum therapy.

공감에 대한 개념분석 (Concept Analysis of Empathy)

  • 최선엽
    • 기본간호학회지
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    • 제26권3호
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    • pp.145-154
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    • 2019
  • Purpose: This study was done to analyze and clarify the concept of empathy in nursing. Methods: Using the concept analysis framework of Walker & Avant 68 articles about empathy were selected for this study. Results: Defining attributes of empathy included recognizing others' perspective and thought, understanding others' emotion, and communicating with them. The antecedents of empathy included contact with patients, respect and trust for patients, a certain level of cognitive ability, and communication skills. Consequences of empathy were increasing patient self-understanding, self-awareness as a therapeutic subject and improving quality of nursing. The concept was clarified through presentation of model, borderline, related, and contrary cases. Conclusion: The results of this study are meaningful in that the concept and attributes of empathy are explored in the area of nursing. Also, based on results of this study, development of standardized tools to measure patient-perceived empathy and measure the three attributes of empathy is recommended as well as the development of educational programs to enhance empathy.

표준화 환자 시뮬레이션 실습교육에서 동영상을 활용한 동료학습의 효과: 수술 전후 간호를 중심으로 (The Effects of Video-based Peer assisted Learning in Standardized Patients Simulation: Pre and Post Operative Care)

  • 박인희;신수진
    • 성인간호학회지
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    • 제27권1호
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    • pp.73-82
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    • 2015
  • Purpose: This study examined the effects of peer assisted learning (PAL) using video recordings in standardized patients (SP) simulation. Methods: A mixed-method approach was adopted, in which quantitative data were supplemented with qualitative data. Research participants consisted of 49 nursing students, 24 of whom were assigned to the experimental group, and 25 to the control group. The 12 item instrument was used to measure perioperative care knowledge, while performance confidence was assessed with the 10 item questionnaire, and clinical critical thinking skills with the Clinical Critical Thinking Skill Test (CCTS). Qualitative data were collected using a reflective journaling and in-depth interviews. Results: Participants in the experimental group exhibited significantly higher levels of knowledge than those in the control group (t=5.43, p<.001), and were significantly more confident in their performances (F=52.33, p<.001). However, no significant differences were found between the experimental and the control groups with regard to CCTS (t=0.72, p=.477). A qualitative content analysis was conducted using the interview and reflective journaling data, in which six major themes were elicited from three codes. Conclusion: PAL employing video recordings is expected to be utilized as a teaching and learning strategy in simulation-based nursing practicum with greater frequency and longer period, given the positive effects observed in this study.

대구지역 한의학의 전문화 과정에 대한 연구- 제한의료원을 중심으로 - (Study of the Process of the Professionalization of Korean Oriental Medicine of Taegu - Focusing on the Case of Je-Han Medical Center -)

  • 홍승표;이현지
    • 동의생리병리학회지
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    • 제19권1호
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    • pp.52-60
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    • 2005
  • This study explored the process of the professionalization of Korean Oriental medicine in Je-Han Medical Center. Je-Han Medical Center has fulfilled the requisites of the professionalization. The process of professionalization of Je-Han Medical Center is different from the process of professionalization of Western medical profession. Firstly, the Korean Oriental medical doctors of Je-Han Medical Center had been educated the standardized Korean Oriental medical knowledges. But the medical practices of them were not fully standardized. Secondly, the Korean Oriental medical doctors of Je-Han Medical Center have occupied the exclusive rights in the areas of Korean Oriental medicine. But there still exists the restriction of the range of license. Thirdly, the Korean Oriental medical doctors of Je-Han Medical Center had pride as a Korean Oriental medical doctor. They had the ideology as the national medical doctors. But the patients' use of Korean Oriental medicine were based on the practical reasons, not based on the ideological reasons. Fourthly, the inner hierarchy of Je-Han Medical Center was very strict. But the hierarchical and authoritarian relations between medical doctors and patients were very weak. Like this, we can find the unique process of professionalization of Korean Oriental medicine in Je-Han Medical Center. These findings can contribute to the extend the horizon of the sociology of profession.