• Title/Summary/Keyword: Standardized patients

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Analysis of Symptom and Care Needs of Home-Based Hospice Palliative Patients - Home-Based Hospice Business Centered on Community Health Centers in Busan- (재가 호스피스완화 대상자의 증상 및 돌봄 요구도 분석 -부산광역시 보건소 중심 재가 호스피스사업을 중심으로-)

  • Kim, Jung-Rim;Choi, Soon-Ock;Kim, Sook-Nam
    • The Korean Journal of Health Service Management
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    • v.12 no.4
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    • pp.173-190
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    • 2018
  • Objectives: This study was conducted to analyze the symptoms and care needs of home-based hospice palliative patients in Busan and to provide a basic reference for developing practical guidelines for their care. Methods: By examining the registration cards of 409 hospice palliative patients, who were registered in community health centers in Busan as of 2016, this study retrospectively analyzed their characteristics, symptoms and care needs. Results: The average age was 70.6 years, 59.4% were receiving medical benefits, and 48.4% lived alone. As per the data obtained from the Palliative Performance Scale, many were able to mobile. Fatigue was the most severe and depression and anxiety were reported together, and their care needs were also high. Most subjects reported mild or low pain, but care needs were high. Furthermore, the medical benefits group showed a high level of symptoms and care needs across areas. Conclusions: To help subjects to live in their homes for as long as possible, it is necessary to identify symptoms and care needs and provide services in accordance with their severity and situation. Thus, it is necessary to develop practical guidelines for standardized community hospice palliative care services.

Pain in amyotrophic lateral sclerosis: a narrative review

  • Kwak, Soyoung
    • 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.

Nondaily dosing schedule of allergen-specific sublingual immunotherapy: efficacy and safety

  • Heba Wagih Abdelwahab;Amina Abd El-Maksoud
    • Clinical and Experimental Vaccine Research
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    • v.12 no.2
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    • pp.121-126
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    • 2023
  • Purpose: Sublingual immunotherapy is currently promoted by various companies, with administration schedules variable in the different products even though almost all are standardized immunologically. So, this study was planned to examine the efficacy of simple nondaily dosing of sublingual immunotherapy instead of the widely used daily schedule. Materials and Methods: Fifty-two patients with allergic rhinitis and bronchial asthma were enrolled. Sublingual immunotherapy (manufactured at the allergen immunotherapy preparation unit at Mansoura University) was given in suitable bottles with a dropper mechanism that permits comfortable dosing under the tongue. The physician recommended that the patient put the drops under his/her tongue and leave the drops beneath the tongue for 2 minutes before swallowing. This was repeated every 3 days, with the drop number and concentration gradually rising. Results: After 2 months of follow-up, 65.8% responded partially to the symptom score and 26.3% responded completely to the medication score. There was a significant decline in the symptom and medication scores from the baseline scores (p<0.0001). After 4 months of follow-up, 95.8% responded partially to symptom scores and no one has not responded; 54.2% responded completely to medication scores; and 81% of studied patients had no side effects. However, the most frequent side effect was a sore throat. Conclusion: Our nondaily schedule of sublingual immunotherapy is tolerable, safe, and effective in patients with allergic rhinitis and bronchial asthma.

Seborrheic Dermatitis Treatment Using a Standardized Medical Insurance-Approved Korean Medicine: a case report

  • Yeonkyoung Pak;Sangwon Shin
    • Journal of Pharmacopuncture
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    • v.27 no.3
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    • pp.264-269
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    • 2024
  • Background: Conventional treatments for seborrheic dermatitis often lead to a recurring cycle of symptom improvement and worsening, resulting in chronic conditions. Thus, safer and more effective alternatives are needed. In Korean medicine, Hwangryunhaedok-tang tablets, targeted at treating the fire-heat syndrome, offer a more fundamental approach to manage seborrheic dermatitis. Clinical Features and Outcomes: In this study, we monitored the changes in the symptoms of two patients with seborrheic dermatitis who were treated with Hwangryunhaedoktang tablets. The patients were administered this medication during the treatment period. The effectiveness of the treatment was assessed by visually recording changes in the affected skin areas using photographs and evaluating symptoms such as heat, itching, and stinging in these areas using a visual analog scale (VAS). Visible improvements in the patients' skin conditions were observed after taking Hwangryunhaedok-tang tablets. Following treatment, VAS scores for subjective symptoms such as heat sensation, itching, and stinging in the affected areas decreased. Conclusion: This study offers evidence of a potential alternative approach for treating seborrheic dermatitis using Kyungbang Hwangryunhaedok-tang tablets. However, it highlights the necessity for further research on the appropriate dosage, side effects, and long-term effectiveness of this treatment.

Individualized Acupuncture versus Standardized Acupuncture in Symptomatic Treatment of Osteoarthritis of the Knee-a Randomized Controlled Trial (ISRCTN 40706107) (퇴행성 슬관절염에 대한 맞춤형 침 치료 효과 검증 무작위 대조군 임상연구(RCT) (ISRCTN 40706107))

  • Byun, Hyuk;Kim, Sun-Woong;Ahn, Ji-Hyun;Kim, Yong-Suk;Seo, Jung-Chul;Choi, Sun-Mi;Park, Ji-Eun;K., Kawakita;N., Takahashi;E., Sumiya;Lee, Seung-Deok
    • Journal of Acupuncture Research
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    • v.24 no.4
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    • pp.183-195
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    • 2007
  • Objectives : To determine whether individualized acupuncture (IA) provides greater pain relief and improved function compared with standardized acupuncture (SA) in patients with osteoarthritis of the knee. Methods: Design is a randomized single blind controlled trial with two intervention arms (IA vs SA) of 6 weeks' duration and 3 months follow up. An orthopedist diagnosed 50 patients' symptoms as knee osteoarthritis. Interventions were applied by 2 residents studying the acupuncture and moxibustion specially in Dongguk University International Hospital. Primary outcome measure is pain as measured by visual analogue scale (VAS). Secondary measures of pain and disability include WOMAC, SF-36, LFI and KHAQ. Results : The 50 participants were well matched for age, sex, bad side, VAS, WOMAC, SF-36, LFI and KHAQ scores at the baseline. 3 participants dropped out. There have not been any adverse events in both groups. Participants in both groups experienced great improvement in all measures except SF-36at 3 and 6 weeks. At 18 weeks, the IA group experienced significantly greater improvement than the SA group in VAS but not in WOMAC, SF-36, LFI and KHAQ. Conclusions : Manipulation of IA seems to provide pain relief longer for osteoarthritis of the knee when compared with SA.

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Oral cancer incidence based on annual cancer statistics in Korea

  • Sun, Ju-Rim;Kim, Soung-Min;Seo, Mi-Hyun;Kim, Myung-Jin;Lee, Jong-Ho;Myoung, Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.1
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    • pp.20-28
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    • 2012
  • Introduction: The objective of this research was to determine the incidence of oral cancer in Korea. Materials and Methods: The classifications of oral and maxillofacial cancer (OMFC) that we used are based on possible locations of OMFC: lip, tongue, mouth, salivary glands, tonsil, oropharynx, nasopharynx, hypopharynx, pharynx unspecified, and nose, sinuses. Results: 1) There were 2,848 OMFC cases, accounting for 1.6% of all cancers. The male to female ratio was 2.72:1. 2) The estimated crude rates (CRs) were 5.7 overall, 8.4 for males, and 3.1 for females. The age-standardized incidence rates (ASRs) were 4.6 overall, 7.3 for males and 2.3 for females. 3) The incidence of mouth cancer was highest. The mouth and salivary glands were the most frequent sites for cancer among males and females, respectively. 4) Patients who were 40 years or older accounted for 91% of OMFC cases, with the highest proportion of cases in the 60-69 year-old age group for both sexes. 5) Tongue cancer was the most prevalent OMFC overall. Nasopharyngeal cancer was highest among males, and salivary gland cancer was highest among females. 6) From 2004 to 2008, the relative 5-year survival rate of OMFC patients was 57.5%. There was a trend of increasing survival among OMFC patients during the study period. The survival rate for females (69.3%) was much higher than that for males (53.1%). Conclusion: Social and personal efforts should be required to increase the survival rates of OMFC patients and Korean national cancer management policy should establish new measures for economic and social management and support.

Correlation between glucose transporter type-1 expression and $^{18}F$-FDG uptake on PET in oral cancer

  • Kim, Chul-Hwan;Kim, Moon-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.4
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    • pp.212-220
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    • 2012
  • Objectives: Fluorine-18 fluorodeoxyglucose positron emission tomography ($^{18}F$-FDG PET) is a non-invasive diagnostic tool for many human cancers wherein glucose uptake transporter-1 (GLUT-1) acts as a main transporter in the uptake of $^{18}F$-FDG in cancer cells. Increased expression of glucose transporter-1 has been reported in many human cancers. In this study, we investigated the correlation between $^{18}F$-FDG accumulation and expression of GLUT-1 in oral cancer. Materials and Methods: We evaluated 42 patients diagnosed with oral squamous cell carcinoma (OSCC) and malignant salivary gland tumor as confirmed by histology. 42 patients underwent pre-operative $^{18}F$-FDG PET, with the maximum standardized uptake value ($SUV_{max}$) measured in each case. Immunohistochemical staining was done for each histological specimen, and results were evaluated post-operatively according to the percentage (%) of positive area, intensity, and staining score. Results: For OSCC, $SUV_{max}$ significantly increased as T stage of tumor classification increased. For malignant salivary gland tumor, $SUV_{max}$ significantly increased as T stage of tumor classification increased. For OSCC, GLUT-1 was expressed in all 36 cases. GLUT-1 staining score (GSS) increased as T stage of tumor classification increased, with the difference statistically significant. For malignant salivary gland tumor, GLUT-1 expression was observed in all 6 cases; average GSS was significantly higher in patients with cervical lymph node metastasis than that in patients without cervical lymph node metastasis. Average GSS was higher in OSCC ($11.11{\pm}1.75$) than in malignant salivary gland tumor ($5.33{\pm}3.50$). No statistically significant correlation between GSS and $SUV_{max}$ was observed in OSCC or in malignant salivary gland tumor. Conclusion: We found no statistically significant correlation between GSS and $SUV_{max}$ in OSCC or in malignant salivary gland tumor. Studies on the various uses of GLUT during $^{18}F$-FDG uptake and SUV and GLUT as tumor prognosis factor need to be conducted through further investigation with large samples.

Reliability and Validity of the Behavioral Observation Method for Assessing Low Back Pain in Patients with Spinal Diseases (척추질환자의 요통사정을 위한 통증행위 관찰법의 신뢰도 및 타당도 검정)

  • Yoon, Ho-Soon;Lee, Eun-Ok
    • Journal of muscle and joint health
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    • v.1 no.1
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    • pp.97-115
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    • 1994
  • The purpose of this study was to examine the reliability and validity of the observed behaviors of subjects who suffered from low back pain with spinal diseases, Thirty two low back pain patients admitted on the neurosurgical unit in an army hospital were compared with 30 normal controls belonged to an army unit, by means of matching the age, hight and weight. Observed pain behaviors were developed by the researcher on the bases of literature and patient observation. This tool consists of 18 behaviors seperated into two major groups : mutually exclusive and concomittent behaviors. The mutually exclusive behaviors included coding cathegories for 6. body motions assumed by the subjects during the observation session. These 6 standardized motions consisted of sitting from standing first, and serially tying down, reclining, sitting again, and then standing, 6 steps walking. Concomittent behaviors consisted of 12 observable patterns that can be observed systematically from the face, grimacing, bracing, rubbing, walking with arms fixed, support with hands on sitting or standing, guarded movement, limping, unbalaced weightbearing, stopped movement from tying position to sitting, sighing and graoning. Subjects were videotrecorded as they performed a 6-standardized sequence of motions, simultanously researcher measured the time spent performing each motion and step length. Patients were asked torate their subjective pain score on the 10 mm graphic rating scale ranging from 'no pain' to 'sever pain'. For scoring of the pain behaviors, two trained nursing officiers independently and simutanously viewwd each videorecording and checked subject 'pain behaviors at the observational item checklist. The result of the study are summarized as follows : 1. Reability of the observational tool was a=.845. 2. Spearman's rho and percentage agreement were p=.97 and 81.7 persent respectively, that indicate adequate interrater reability of this tool. 3. The sensitivity rate of the tool was .875 while specificity rate .866 for differentiating patient from the normal. 4. When difference in the objective pain indices between patient group and control were compared, there was significant difference of all indices, such as pain behavior(t=7.71, p=.0001). spent time performing motion(t=14.2, p=.0001), step length (t=-10.72, p=.0001). 5. There were differences in the objective indices the subjective pain subgroups (low, medium, high). Differences in the mean score of objective pain behavior (F=6.376. p=.005) and spent time for moyion(F=4.631, p=.018). But there were no significant differences in the step length among the subgroups(F=.667, p=.521). 6. Highly correlated pain behavior items wiyh subjective pain score were 'stopped movement from lying position to sitting', 'limping', 'support with hands on sitting or standing', 'bracing', 'guarding' and 'walking with arms fixed'. In summary, although some of rho behavior items such as sighing and groaning in this study could not be observed because of videotaped datd, the reliability and validity of the over all observation method were satifactory. Thus, the results of the present study demonstrate rye potetional utility of the tool in assessing objective pain complementing self-reported pain in low back pain patients.

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Sparganum infections in normal adult population and epileptic patients in Korea: A seroepidemiologic observation (항체검사에 의한 한국인 스파르가눔 감염의 혈청역학적 조사)

  • Yoon Kong;Seung-Yull Cho;Woo Shik Kang
    • Parasites, Hosts and Diseases
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    • v.32 no.2
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    • pp.85-92
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    • 1994
  • A seroepidemiologic observation of anti-Spirometrc erinacei plerocercoid (sparganum) antibody (IgG) in serum was made in normal adult and epileptic patients in Korea from february, 1987 to September, 1990. Sera were tested by enzyme-linked immunosorbent assay (ELISA) for anti-sparganum antibody together with anti-Taenic soEiun metacestode, and anti-Parusonimus westermcni antibodies. Sera reacted positively to sparganum antigen only were considered. Positive rate for anti-sparganum antibody in 850 normal adults was 1.9% (standardized rate by provincial population was 1.7%). In 2,667 randomly selected patients of epilepsy at 28 local centers of the Changmi Club, positive rate was 2.5% (standardized rate: 2.3%). In both normal adult and patient groups, the higher antibody rates were observed in Kangwon and Chonnam Provinces. Positive rates were 10 times higher in male than in female in normal adults and 4.5 times in male epileptic patients. The rates were elevated especially with age over 30-year. odd ratio of the antibody was 1.32 which indicated an ambiguous etiologic factor for epilepsy.

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Perception on the Importance of Items on Psychosocial Assessment among Hospice and Palliative Care Social Workers (호스피스·완화의료 사회복지사의 심리사회적 사정항목에 대한 중요도 인식)

  • Kim, Won-Chul;Hwang, Myung Jin
    • Journal of Hospice and Palliative Care
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    • v.17 no.4
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    • pp.259-269
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    • 2014
  • Purpose: This preliminary study is aimed at developing standardized tools for psycho-social assessment of patients in needs for hospice/palliative care. To accomplish the purpose, investigators examined effects of perceptions of social workers on the importance of psycho-social domains of assessment in hospice/palliative care settings. Moreover, investigators paid attention to variances of perceptions of social workers' along with types of institution and credentials of those family settings. Methods: A form of questionnaire was first explored from an initial interview assessment of 10 government-certified hospice care providers and a literature review, second constructed with eight domains and 80 items, and sent by e-mail to 55 institutions and hospitals providing hospice/palliative cares in Korea. Lastly, a total of 31 agencies returned with a completed responses and consent form (56% response rate). SPSS program (version 18.0) was used for data analysis. Results: Study found that social workers perceived patients' family background (m=4.53, 5-point scale) as the most important assessment domain, whereas economic conditions (4.06 point) the least important. Social workers' perception varied by credentials (i.e., license types, training, full-time position, types of care facility). Conclusion: Based upon study findings, investigators can conclude strong needs for developing a assessment tool that measures multiple domains (i.e., psychological, social and ecological aspects) of patients. A standardized assessment tool should be structured with 2 axis (center/core and expanded/peripheral) and tailored for institution type. Second, professional trainings must be provided by strengthening legal institutionalization and fostering qualified social workers with full responsibilities of hospice and palliative care patients.