• 제목/요약/키워드: Standardized patients

검색결과 838건 처리시간 0.026초

Fluorodeoxyglucose positron-emission tomography ratio in non-small cell lung cancer patients treated with definitive radiotherapy

  • Kang, Hyun-Cheol;Wu, Hong-Gyun;Yu, Tosol;Kim, Hak Jae;Paeng, Jin Chul
    • Radiation Oncology Journal
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    • 제31권3호
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    • pp.111-117
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    • 2013
  • Purpose: To determine whether the maximum standardized uptake value (SUV) of [$^{18}F$] fluorodeoxyglucose uptake by positron emission tomography (FDG PET) ratio of lymph node to primary tumor (mSUVR) could be a prognostic factor for node positive non-small cell lung cancer (NSCLC) patients treated with definitive radiotherapy (RT). Materials and Methods: A total of 68 NSCLC T1-4, N1-3, M0 patients underwent FDG PET before RT. Optimal cutoff values of mSUVR were chosen based on overall survival (OS). Independent prognosticators were identified by Cox regression analysis. Results: The most significant cutoff value for mSUVR was 0.9 with respect to OS. Two-year OS was 17% for patients with mSUVR > 0.9 and 49% for those with mSUVR ${\leq}0.9$ (p = 0.01). In a multivariate analysis, including age, performance status, stage, use of chemotherapy, and mSUVR, only performance status (p = 0.05) and mSUVR > 0.9 (p = 0.05) were significant predictors of OS. Two-year OS for patients with both good performance (Eastern Cooperative Oncology Group [ECOG] ${\leq}1$) and mSUVR ${\leq}0.9$ was significantly better than that for patients with either poor performance (ECOG > 1) or mSUVR > 0.9, 23% (71% vs. 23%, p = 0.04). Conclusion: Our results suggested that the mSUVR was a strong prognostic factor among patients with lymph node positive NSCLC following RT. Addition of mSUVR to performance status identifies a subgroup at highest risk for death after RT.

Management of Infections with Rapidly Growing Mycobacteria after Unexpected Complications of Skin and Subcutaneous Surgical Procedures

  • Lim, Jong-Min;Kim, Jong-Hwan;Yang, Ho-Jik
    • Archives of Plastic Surgery
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    • 제39권1호
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    • pp.18-24
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    • 2012
  • Background : Infection caused by rapidly growing mycobacteria (RGM) is not uncommon, and the prevalence of RGM infection has been increasing. Clinical diagnosis is difficult because there are no characteristic clinical features. There is also no standard antibiotic regimen for treating RGM infection. A small series of patients with RGM infections was studied to examine their treatments and outcomes. Methods : A total of 5 patients who had developed postoperative infections from January 2009 to December 2010 were retrospectively reviewed. Patients were initially screened using a mycobacteria rapid screening test (polymerase chain reaction [PCR]-reverse blot hybridization assay). To confirm mycobacterial infection, specimens were cultured for nontuberculous mycobacteria and analyzed by 16 S ribosomal RNA and rpoB gene PCR. Results : The patients were treated with intravenous antibiotics during hospitalization, and oral antibiotics were administered after discharge. The mean duration of follow-up was 9 months, and all patients were completely cured of infection with a regimen of a combination of antibiotics plus surgical treatment. Although none of the patients developed recurrence, there were complications at the site of infection, including hypertrophic scarring, pigmentation, and disfigurement. Conclusions : Combination antibiotic therapy plus drainage of surgical abscesses appeared to be effective for the RGM infections seen in our patients. Although neither the exact dosage nor a standardized regimen has been firmly established, we propose that our treatment can provide an option for the management of rapidly growing mycobacterial infection.

뇌졸중 환자 가족의 부담감과 병원서비스 만족도 (The Family Burden and Hospital Satisfaction of Family Caregivers f Cerebral Ischemia Patients)

  • 김은정;김순례
    • 가정간호학회지
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    • 제7권1호
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    • pp.83-93
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    • 2000
  • This study was conducted to provide the data for the improvement of cerebral ischemia patient nursing services through the investigation of burden and hospital service satisfaction by family caregivers who were nursing the cerebral ischemia inpatients. The study subjects consisted of 125 family caregivers who were enrolled in four university hospitals with over 300 beds and one Chinese medicine hospital with over 100 beds. The Data were collected from all of the personal subjects using standardized questionnaires by interview from March 1 to March 30 in 2000. Data were analyzed by using t-test, ANOVA. Scheffe's multiple comparison, and Pearson's Correlation Coefficients. The results were as follows: 1. The mean score of burden felt by family caregivers who were nursing the stroke patient was 2.18. In relation to the characteristics of patients, higher scores were shown in male patients who were over 80 years old, and patients who had from 4 to 12 days care giving, over three month duration of admission, from one month to three month duration of illness. The burden felt by family caregivers revealed higher score of dependency in the Activities of Daily Living. 2. The mean score of hospital service satisfaction perceived by family caregivers was 3.35. The highest hospital service satisfaction score was shown in female caregivers, and caregivers whose patients graduated from element school, and treatment method was Chinese medicine, the duration of admission was under 1 month. As a result. the family caregivers' burden was seemed to be high when the patients who were old, male and as care giving time, duration of admission, duration of illness were getting longer. In conclution, hospital service satisfaction was good, but the satisfaction was tend to decrease that family caregivers who were male, higher education background and duration of patients' admission getting longer.

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NIC에 근거한 척수손상환자의 가정간호 중재 프로토콜 개발 (Development of Home Care Nursing Intervention Protocols for Spinal Cord Injury Patients Based on NIC)

  • 문성미;김선희
    • 가정간호학회지
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    • 제8권1호
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    • pp.25-37
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    • 2001
  • Spinal cord injury patients need rehabilitation after the acute stage. They should be cared for at home to decrease hospitalization. Home care nurses play an important role in making spinal cord injury patients who have physical. and psychosocial problems do their best. For effective care, home care nurses need standardized nursing intervention protocols for spinal cord injury patients, but they are rarely developed. Therefore, this study was conducted to develop home care nursing protocols, based on NIC, that are applicable to spinal cord injury patients at home. Forty home care nursing charts of spinal cord injury patients registered in a home care nursing agency from July 1st, 1994 to August 31st, 1999 in S city were analyzed. Fifteen home care nurses participated in this study as a user validity validation group, The results of this study are as follows. 1. Fifteen nursing diagnoses were classified through the frequency analysis of home care nursing charts and previous literature for 40 spinal cord injury patients: altered urinary elimination, constipation, high risk for impaired skin integrity, chronic pain, impaired skin integrity, impaired social interaction, knowledge deficit, bowel incontinence, high risk for injury, altered role performance, care giver role strain, impaired physical mobility, sexual dysfunction, dysreflexia, and ineffective breathing pattern. 2. Based on validation by experts and user validities, 93 nursing interventions which were above ICV(Index of Content Validity) .80 were chosen. 3. Nursing intervention protocols which showed above ICV .80 were developed.

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Utility of Spinal Injury Diagnosis Using C-Spine Lateral X-Ray and Chest, Abdomen and Pelvis Computed Tomography in Major Trauma Patients with Impaired Consciousness

  • Jang, Yoon Soo;So, Byung Hak;Jeong, Won Jung;Cha, Kyung Man;Kim, Hyung Min
    • Journal of Trauma and Injury
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    • 제31권3호
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    • pp.151-158
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    • 2018
  • Purpose: The regional emergency medical centers manage the patients with major blunt trauma according to the process appropriate to each hospital rather than standardized protocol of the major trauma centers. The primary purpose of this study is to evaluate the effectiveness and influence on prognosis of additional cervical-thoracic-lumbar-spine computed tomography (CTL-spine CT) scan in diagnosis of spinal injury from the victim of major blunt trauma with impaired consciousness. Methods: The study included patients visited the urban emergency medical center with major blunt trauma who were over 18 years of age from January 2013 to December 2016. Data were collected from retrospective review of medical records. Sensitivity, specificity, positive predictive value, and negative predictive value were measured for evaluation of the performance of diagnostic methods. Results: One hundred patients with Glasgow coma scale ${\leq}13$ underwent additional CTL-spine CT scan. Mechanism of injury was in the following order: driver, pedestrian traffic accident, fall and passenger accident. Thirty-one patients were diagnosed of spinal injury, six of them underwent surgical management. The sensitivity of chest, abdomen and pelvis CT (CAP CT) was 72%, specificity 97%, false positive rate 3%, false negative rate 28% and diagnostic accuracy 87%. Eleven patients were not diagnosed of spinal injury with CAP CT and C-spine lateral view, but all of them were diagnosed of stable fractures. Conclusions: C-spine CT scan be actively considered in the initial examination process. When CAP CT scan is performed in major blunt trauma patients with impaired consciousness, CTL-spine CT scan or simple spinal radiography has no significant effect on the prognosis of the patient and can be performed if necessary.

혈액투석과 근감소증의 연관성에 관한 문헌고찰 (Association of Hemodialysis and Sarcopenia : A systematic review)

  • 최경욱;이화경;김수아;오윤재
    • 대한통합의학회지
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    • 제11권3호
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    • pp.185-194
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    • 2023
  • Purpose : This study aimed to investigate the relationship between the characteristics of hemodialysis patients and the occurrence of sarcopenia through a comprehensive literature review. Methods : A systematic literature search was conducted to identify eligible studies in the Cochrane library, PubMed and Embase. In this review, we included all papers published since the initiative's inception and summarized results as of december 2022. Studies that investigated association between sarcopenia diagnosis and hemodialysis patients (aged≥18 years) were included. Ultimately, 16 studies met our selection criteria. The risk of bias was assessed using the Newcastle-Ottawa scale. Results : Fourteen of the sixteen studies (88 %) reported that significant association between sarcopenia diagnosis and hemodialysis patients. However, two studies reported no association between sarcopenia diagnosis and hemodialysis patients. As a factor statistically related to sarcopenia in hemodialysis patients, Mortality (6 studies, 38 %), age (5 studies, 31 %), body composition (4 studies, 25 %), physical activity (2 studies, 13 %), diabetes (2 studies, 13 %), cardiovascular abnormalities (1 studies, 6 %), nutritional status (3 studies, 19 %), and gender (3 studies, 19 %). Conclusion : Our findings highlight the necessity of developing a physical therapy program that accurately reflects the health status of hemodialysis patients. To further investigate the association between the diagnosis of sarcopenia and hemodialysis patients, it is recommended to conduct large-scale longitudinal studies using standardized diagnostic criteria and evaluation methods, as well as analyze potential risk factors. Consequently, this study emphasizes the importance and potential of developing physical therapy programs that effectively address the health consequences associated with hemodialysis. The significance of this research lies in its ability to provide valuable insights and lay the foundation for future studies focused on developing preventive and therapeutic interventions targeting muscle wasting syndrome resulting from hemodialysis.

가정간호 환자의 가족기능도와 만족도 조사 (A Study of Family Functioning Level and Satisfaction Level of Home Health Care Patient)

  • 서향숙
    • 가정간호학회지
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    • 제3권
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    • pp.67-74
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    • 1996
  • The purpose of this study was to determine the level of family functioning and the degree of patient satisfaction for 102 patients who received home health care nursing service. The results are as follows ; 1. The score assessed for the family functioning was averaged at the score of $4.95{\pm}3.11$ (10 perfect score) and this was regarded as low, especially for the patients with chronic illness, and the reason was assumed due to poor psychological support from the family members and high expectations from the patients. 2. Patient satisfaction levels were toward the received services were high, according to the 13 items which consited of 3 point scales, with average score of $1.27{\pm}0.53$. Based on the above study results, the author suggests the followings : 1. A new nursing service program and model devolopment should be established and utilized because of low family functioning levels of those who receive family nursing service. 2. More standardized tool explorations for the study of family nursing service and patient satisfaction are required.

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대상자 중심의 만성질환 자가관리 프로그램: 고혈압, 당뇨병을 중심으로 (Client-Centered Self Management Program for Chronic Disease Patients: Focusing on Hypertension, Diabetes Mellitus)

  • 송연이;이강숙;조현영;이빛나
    • 보건교육건강증진학회지
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    • 제31권4호
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    • pp.93-106
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    • 2014
  • Objectives: The aim of this study was to develop the efficient program protecting shift to cerebrovascular disease as complication for patients with diabetes and hypertension. Methods: Chronic disease self management program(CDSMP), implement manual, action plan, Q&A card and motivation methods were suggested based on Bandura's social learning theory through reviewing various literatures and cases. Results: This program can increase self-efficacy, individual health behavior change and quality of life and it makes to continuous care of chronic disease. Conclusion: In order to operate chronic disease self-management program, standardized education courses training of specialist leaders and expert patients leaders would be required. And the development enlargement of self-management program for various other chronic disease such as arthritis, back pain, atopy, asthma would be required in the future.

퇴행성 슬관절염 환자를 포함한 만성 슬통환자의 설문분석과 경락허실변증 진단일치도에 관한 연구 (The Study on the Questionnaire Analysis and Agreement Diagnosis of the Same Patients Using Differentiation of Symptoms and Signs on Chronic Knee Joint Pain Including Osteoarthritis of Knee Joint)

  • 이종덕;이상관;이성용;문형철;최선미;정영해;김성철
    • Journal of Acupuncture Research
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    • 제23권1호
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    • pp.71-93
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    • 2006
  • Objectives : This study is performed for proposing reasonable clinical study protocol at International standard clinical study of osteoarthritis of Knee Joint. Methods : We gave the eighteen oriental medicine doctors the questionnaire and the video about female patient who diagnosed Knee joint of osteoarthritis above 60 years old and they tested same patients using differentiation of symptoms and signs. Then they retested it after We educated them with diagnosis education text. Conclusion : The improvement of diagnosis agreement can be possible by developing standardized the same patients using differentiation of symptoms and by reeducation about it.

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2017 의료법 개정에 따른 병실 모듈변화 연구 (Changes of Ward Modules according to the 2017 Revision of Medical Law)

  • 이현진;주연옥
    • KIEAE Journal
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    • 제17권1호
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    • pp.55-61
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    • 2017
  • Purpose : As the necessity of reinforcement of infections management in medical facilities after MERS increased, Ministry of Health and Welfare promulgated the enforcement regulations of medical law on February 3, 2017. Its main objective is to improve patients' safety and medical-care quality through the establishment of isolation facilities from infectious diseases and the set-up of standards for In-patient and ICU facilities. The purpose of this study is necessarily to propose a standardized spatial composition model for ward modules by analyzing changing environments of in-patient facilities according to the strengthened medical law. Method: Theoretical studies will be undergone of Evidence-based Designs to improve patients' safety, medical quality, and domestic/overseas in-patient room guidelines. With reference to the status of 24 general hospitals over 500 beds, the spatial compositions of the in-patient rooms and the types of multi/single bed room modules will be analyzed. The directions of future in-patient room module changes through the study of the minimum ward module types and various ward types will be presented. Result: This paper will hopefully provide guidelines for hospitalization rooms that can be applied to the revised rules of medical law enforcement and provide a basis for a comprehensive study of patients' safety and efficient infection control as well.