• 산업융합연구
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• 제17권2호
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• pp.45-52
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• 2019

본 연구는 조현병 환자 간호 시뮬레이션 교육 중재 연구들에 대한 문헌고찰을 통해 중재의 구체적 내용을 알아보고 그들의 융합적 효과를 확인하기 위해 시행되었다. 4개의 데이터베이스 검색을 통해 확인된 226편의 문헌 중 선정기준에 부합하는 11편을 최종 선택하였다. 5편의 질적연구, 5편의 양적연구, 1편의 혼합설계가 포함되었다. 시뮬레이션에 표준화환자, 역할극, 시뮬레이터, 가상현실 기술이 활용되었고 대부분의 연구에서(63.6%) 표준화환자를 활용한 시뮬레이션이 이루어졌다. 효과평가에 연구마다 다른 변수가 측정되었으며 자신감, 지식, 학습자기효능감, 교육만족도, 자기주도학습이 측정되었다. 향후 조현병환자간호의 고난도와 복잡성을 고려한 결과변수의 선정 및 측정을 통해 시뮬레이션 교육의 효과성을 입증할 수 있도록 잘 설계된 연구가 지속 되어야 할 것이다.

• Journal of Korean Dental Science
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• 제15권1호
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• pp.19-30
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• 2022

Purpose: The purpose of the study was to assess the validity of three-dimensional (3D) facial scan taken with facial scanner and digital photo wrapping on the cone-beam computed tomography (CBCT). Materials and Methods: Twenty-five patients had their CBCT scan, two-dimensional (2D) standardized frontal photographs and 3D facial scan obtained on the same day. The facial scans were taken with a facial scanner in an upright position. The 2D standardized frontal photographs were taken at a fixed distance from patients using a camera fixed to a cephalometric apparatus. The 2D integrated facial models were created using digital photo wrapping of frontal photographs on the corresponding CBCT images. The 3D integrated facial models were created using the integration process of 3D facial scans on the CBCT images. On the integrated facial models, sixteen soft tissue landmarks were identified, and the vertical, horizontal, oblique and angular distances between soft tissue landmarks were compared among the 2D facial models and 3D facial models, and CBCT images. Result: The results showed no significant differences of linear and angular measurements among CBCT images, 2D and 3D facial models except for Se-Sn vertical linear measurement which showed significant difference for the 3D facial models. The Bland-Altman plots showed that all measurements were within the limit of agreement. For 3D facial model, all Bland-Altman plots showed that systematic bias was less than 2.0 mm and 2.0° except for Se-Sn linear vertical measurement. For 2D facial model, the Bland-Altman plots of 6 out of 11 of the angular measurements showed systematic bias of more than 2.0°. Conclusion: The facial scan taken with facial scanner showed a clinically acceptable performance. The digital 2D photo wrapping has limitations in clinical use compared to 3D facial scans.

• Journal of Preventive Medicine and Public Health
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• 제56권2호
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• pp.180-189
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• 2023

Objectives: The coronavirus disease 2019 (COVID-19) pandemic has led to a global shortage of medical resources; therefore, we investigated whether COVID-19 impacted the quality of non-COVID-19 hospital care in Korea by comparing hospital standardized mortality rates (HSMRs) before and during the pandemic. Methods: This retrospective cohort study analyzed Korean National Health Insurance discharge claim data obtained from January to June in 2017, 2018, 2019, and 2020. Patients' in-hospital deaths were classified according to the most responsible diagnosis categories. The HSMR is calculated as the ratio of expected deaths to actual deaths. The time trend in the overall HSMR was analyzed by region and hospital type. Results: The final analysis included 2 252 824 patients. In 2020, the HSMR increased nationwide (HSMR, 99.3; 95% confidence interval [CI], 97.7 to 101.0) in comparison to 2019 (HSMR, 97.3; 95% CI, 95.8 to 98.8). In the COVID-19 pandemic zone, the HSMR increased significantly in 2020 (HSMR, 112.7; 95% CI, 107.0 to 118.7) compared to 2019 (HSMR, 101.7; 95% CI, 96.9 to 106.6). The HSMR in all general hospitals increased significantly in 2020 (HSMR, 106.4; 95% CI, 104.3 to 108.5) compared to 2019 (HSMR, 100.3; 95% CI, 98.4 to 102.2). Hospitals participating in the COVID-19 response had a lower HSMR (HSMR, 95.6; 95% CI, 93.9 to 97.4) than hospitals not participating in the COVID-19 response (HSMR, 124.3; 95% CI, 119.3 to 129.4). Conclusions: This study suggests that the COVID-19 pandemic may have negatively impacted the quality of care in hospitals, especially general hospitals with relatively few beds. In light of the COVID-19 pandemic, it is necessary to prevent excessive workloads in hospitals and to properly employ and coordinate the workforce.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• 제62권2호
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• pp.75-81
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• 2019

The objective of this study was to perform a systematic review of the literature for application of intranasal sodium citrate in the patients with olfactory dysfunction to help determine the sodium citrate treatments for this condition. Two authors independently searched the data base (Medline, Scopus, and the Cochrane database) for relevant studies from inception to January 2018. Included studies were randomized controlled studies published in English comparing topical sodium citrate application (treatment group) with saline (control group) in patients who had olfactory dysfunction. Outcomes of interest included the change of olfactory identification and threshold during 2 hours post-treatment. Three studies were enrolled in the meta-analysis. Compared with control group, treatment group did not increase posttreatment score of olfactory identification [standardized mean difference (SMD)=-0.03; 95% confidence interval (CI)=-0.29-0.24; I²=0%] and olfactory threshold (SMD=0.18; 95% CI=-0.09-0.45; I²=0%) significantly. In the degree of pre-post improvement of two outcomes, although treatment group statistically showed the significant improvement in olfactory threshold (SMD=0.30; 95% CI=0.05-0.55; I²=17%), the clinical significance of this outcome was meaningless. Similarly, there was no significant difference in olfactory identification between two groups (SMD=0.17; 95% CI=-0.11-0.45; I²=22%). Unlike the recent favorable results, our summated results presented the uselessness for the local application of sodium citrate in improving patient's olfactory function. However, we also had some limitation such as small sample size and inconsistent application methods. Therefore, larger trials and standardized methodology are needed to reach more stronger and exact results.

• 한국산학기술학회논문지
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• 제10권2호
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• pp.425-431
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• 2009

고혈압과 당뇨병으로 치료를 받고 있는 환자들을 대상으로 일정한 보건교육이 치료순응도에 미치는 영향을 파악하기 위하여 2007년 9월부터 2008년 2월까지 대전시에 내과 및 가정의로 개업하고 있는 의교기관중 본 연구의 취지에 동의한 의료기관에 내원한 환자 1,213명에 대하여 2회 설문조사한 결과는 다음과 같다. 조사대상자 1,213명 중 고혈압만 있는 환자가 49.2%, 당뇨만 있는 환자는 26.3%, 고혈압과 당뇨병을 동반하고 있는 환자는 22.4%이었으며, 성별에는 차이가 없었다. 개원의들이 생각하는 환자들의 자신의 질병에 대한 관리태도는 소극적으로 한다가 56.7%로 가장 높았고, 비약물적 치료방법도 88.9%에서 병행하고 있었다. 본 연구에서 실시한 교육의 효과가 있다고 생각하는 사람이 63.7%로 높았으며, 생활양식으로 운동, 음식습관의 변화, 음주의 변화가 있었지만 낮았고, 체중과 흡연은 변화가 거의 없었다.

• 재활간호학회지
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• 제5권1호
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• pp.27-37
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• 2002

During acute stages of hospitalized stroke patients, family caregivers face many challenges. They often experience emotional distress, social isolation, and financial constraints. However, the burden of caregiving of stroke patients in acute stages has never been studied properly. The purpose of this study was to investigate the factors related to the caregivers' burden with acute stroke. The subjects were 123 acute stroke patients and their caregivers who were admitted to neurology and neurosurgery units at Dan Kook University Hospital in Chung-Nam area. An interview was performed with the use of standardized questionnaire which included data pertaining to the patients/caregivers characteristics, caregiver burden (Modified Zarit's Burden Scale), and social support (Personal Resource Questionnaire). Our results showed that the mean burden score was 3.11, indicating high level of burden. Among the sub-domain scores, financial burden was the highest. In univariate analysis, the factors related to caregiver burdens were: inability to communicate between patients and caregiver(p<.001); low cognitive function of the patients(p<.001); low level of ADL(p<.001); the gender of caregiver(p<.001); the current employment status of caregivers(p<.01); the presence of social support for caregiver(p<.001); and the availability of alternative caregivers(p<.001). In multiple regression analysis, social support for family caregivers (87%), low level of patient's cognition (2%), availability of 2nd caregiver (1%), and gender of caregiver (female, 0.4%) were significant explanatory factors of overall burden. The caregivers' burden in acute stages during hospitalization following stroke was high. Recognition of high levels of caregivers' burden and those relating factors affecting caregiver burden may allow us to develop different nursing strategies to unload the level of burden for caregivers in acute stages of stroke.

• The Korean Journal of Pain
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• 제31권2호
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• pp.116-124
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• 2018

Background: We aimed to investigate the prevalence of unrecognized depression in patients with chronic pain, but with no history of psychiatric diseases. Methods: Patients with chronic pain who did not have a history of psychiatric disease were selected for this study. The Beck Depression Index (BDI) was used to evaluate depression. Participants' socio-demographic characteristics and pain-related characteristics were also recorded. Results: The study included 94 consecutive patients with chronic pain (28 men and 66 women). Based on the BDI scores, 33/94 (35.1%) patients with chronic pain had comorbid depression. The prevalence of depression was significantly higher in our cohort than it was in the general population (P < 0.001). The standardized incidence ratio, adjusted for age and sex, was 2.77 in men and 2.60 in women. Patients who were unmarried (odds ratio [OR] = 3.714, P = 0.044), and who had subjective sleep disturbance (OR = 8.885, P < 0.001), were more likely to have moderate to severe depression. Patients with high education levels (OR = 0.244, P = 0.016), and who were economically active (OR = 0.284, P = 0.023), were less likely to have moderate to severe depression. Conclusions: Our results indicate that unrecognized depression in patients with chronic pain is common. Therefore, pain physicians should actively seek to identify these problems rather than relying on the patient to volunteer such information.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1337-1340
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• 2016

Background: There is a noticeable change in the approach with which women nowadays seek help for diseases like breast cancer, primarily due to awareness campaigns, but what happens after surgical procedures is of great significance too. This study focused on the several psychological connotations attached to mastectomy and how the patients cope. Objective: To understand the pattern of anxiety and level of depression among Pakistani patients undergoing mastectomy. Materials and Methods: The sample size consisted of 88 patients who had undergone mastectomy at the different surgical units of the Civil Hospital, Karachi, from January 2012-December 2014; The questionnaire was administered before they were discharged i.e. within 3 days of surgical procedures. The patients were asked if they were willing to participate in this study, those who agreed signed the consent form and then we preceded by asking questions with a standardized tool. A self made questionnaire was constructed keeping in mind the nature and specification of the disease, which consisted of 20 questions related to anxiety and depression, focusing on a mixture of psychological and physiological symptoms. Results: There were a total of 88 patients out of which 36 (41%) were aged 51 to 60 years, 24 (27.2%) of the patients were in the age category of 41 to 50 years, 17 aged 61 and above (19.3%) and only 11 (12.5%) 30-40 years of age, the youngest of all the age categories. The pattern of depression and anxiety was found to be similar among all age categories, severe depression and anxiety predominating over moderate level of such symptoms, with only relatively few patients sufering mild or no depression symptoms. Conclusions: It was concluded that going through mastectomy leads to moderate to severe levels of depression and anxiety, primarily because the females feel incomplete and insecure after losing a part of themselves.

• 대한영양사협회학술지
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• 제22권1호
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• pp.53-69
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• 2016

The purpose of this study was to analyze the importance-performance of clinical nutrition management in convalescent hospitals. The research was carried out based on questionnaires administered from March to April, 2015 to 73 dietitians at 40 convalescent hospitals in the Gyeongnam area. There was a statistically significant difference between the mean scores for importance (4.01/5.00) and performance (2.95/5.00) of clinical nutrition management. The importance and performance grid analysis showed that participation in a nutritional management committee, administration of patients using a cooperation program among hospital departments, cooperation with a medical team on patient's nutrition status, nutrition initial assessment, nutrition care process for patients showing malnutrition, nutrition care process for tube feeding patients, management of a therapeutic diet, meal management using dietary slip instructions including a therapeutic diet, and explication of a therapeutic diet for patients scored high regarding importance and performance (doing great area). Medical records on patient's nutrition management, and nutrition counseling for requested patient scored low regarding the importance and high regarding performance (overdone area). Participation in medical rounds, personal nutrition education for patients, group nutrition education for patients, nutrition education for medical teams, development of a menu for therapeutic diet and standardized recipes, and provision of information on diet therapy for patients after discharge scored low regarding importance and performance (low priority area). Accreditation of convalescent hospitals and interest of medical professionals in clinical nutrition management were effective variables for the importance-performance gap of clinical nutrition management. In conclusion, the accreditation process and positive awareness of medical professionals with regard to clinical nutrition management had positive effects on reduction of the importance-performance gap in clinical nutrition management at convalescent hospitals. The strength of clinical nutrition management in the accreditation and development of an education program for increasing medical team or administrator interest in clinical nutrition management could lead to improvement of clinical nutrition management for elderly patients in convalescent hospitals.

• Journal of Oral Medicine and Pain
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• 제40권2호
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• pp.72-78
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• 2015

Purpose: The purpose of this research was twofold: to compare the short-term efficacy of once-off education versus repetitive education (RE) of patients suffering from temporomandibular disorders (TMDs) and to determine whether there was any correlation amongst patient demographics, recommendation adherence degree and pain levels. Methods: A total of 848 patients with TMDs were enrolled. The control group consisted of patients who received a standard conservative treatment (STD) over at least 6 visits with education provided only during the first visit. The experimental group consisted of patients who received STD but had also been given RE (STD+RE). The RE was delivered through a standardized self-assessment questionnaire (SAQ) that was completed by the patient during each visit. Pain, which included maximum comfortable opening (MCO) of the mouth and limitation of mouth opening (LOM), was compared between the two groups. Behavior pattern and reported pain level changes in the group who used the SAQ were also analyzed. Results: The LOM was significantly improved in all of the experimental group patients (especially in females under 30 years of age, p<0.05). The MCO was significantly higher in females (p=0.029). All of the patients displayed improvements in their habits following RE, which resulted in a strong correlation with pain reduction. Adhering to the recommendations regarding questions 14 and 15 of the SAQ appeared to have the greatest effect on pain reduction. Conclusions: These results clearly demonstrate that RE is more effective than once-off education for TMD patients who are female or under 30 years of age.