• Title/Summary/Keyword: Standardized patients

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Reliability and Responsiveness of the Korean Version of the Trunk Impairment Scale for Stroke Patients

  • Ko, Jooyeon;You, Youngyoul
    • The Journal of Korean Physical Therapy
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    • v.27 no.4
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    • pp.175-182
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    • 2015
  • Purpose: The purposes of this study were to develop the Korean version of the trunk impairment scale (K-TIS) and to examine reliability and responsiveness of the K-TIS in patients with stroke. Methods Subjects of the study were 51 stroke patients (mean age: 57.78 years) recruited from two stroke clinics. For the interrater and test-retest reliability, two raters measured the K-TIS two times using video clips with an interval of 2 weeks. For the responsiveness, intensive physical therapy training was provided to all participants 2 times a day for one month or three months depending on the onset of the stroke and the admission rules of the two clinics. Inter-rater reliability and test-retest reliability of the K-TIS three subscales (static sitting balance, dynamic sitting balance, and coordination) scores and total scores were examined using intra-correlation coefficient ($ICC_{3,1}$) and Pearson's correlation coefficient (r). To examine responsiveness, the minimally important difference (MID) was calculated with effect size. Results: Inter-rater reliability of the K-TIS subscales and total scores were all high (ICC3,1=0.920-0.983 and r=0.924-0.984). For the test-retest reliability, $ICC_{3,1}$=0.805-0.901 and r=0.806-0.903, and the MID for acute and post-acute as well as chronic stroke patients remained in the mean change range. Conclusion: It is suggested that the K-TIS might be used for clinical and research purposes as a standardized tool for stroke patients. In addition, it can also be useful in establishment of treatment goal(s) and planning treatment program(s) for patients with stroke.

Development of Algorithms for the Home Care of Cancer Chemotherapy Patients (재가 항암화학요법을 받는 암환자의 가정간호중재 알고리즘 개발)

  • Park, Jung-Ho;Kim, Mae-Ja;Hong, Kyung-Ja;Han, Kyung-Ja;Park, Sung-Ae;Yun, Soon-Nyoung;Lee, In-Sook;Cho, Hyun;Shin, Gye-Young;Bang, Kyung-Sook
    • Journal of Home Health Care Nursing
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    • v.5
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    • pp.32-46
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    • 1998
  • Cancer is a leading cause of death, and the number of cancer patients is increasing in Korea. The needs for the home care of cancer patients are increasing recently, but the standardized home care protocols are not developed yet. This study was designed to develop nursing assessment -intervention algorithms for the cancer chemotherapy patients at home. These algorithms suggest guidelines when we assess the patient's condition, and find appropriate nursing interventions, so that standardization and quality control of home care can be attained. The algorithms were processed by yes-no tree. Eleven common problems of cancer chemotherapy patients were identified by the literature review and oncology nurses' experience. These were digestive dysfunction, pain, fatigue, infection, respiratory difficulties, activity intolerance, hemorrhage, sensory disorder, edema, skin problem, and mucosal problem. The algorithm needs to be validated and modified by using for the cancer chemotherapy patients at home.

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A Comparative Study on Hospital Choice Factors between First-visit and Revisit patients in General Hospitals (초진과 재진환자의 종합병원 선택요인 비교분석)

  • Yang, Jong-Hyun
    • Journal of Digital Convergence
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    • v.15 no.7
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    • pp.231-238
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    • 2017
  • The purposes of this study is to analysis the differences of the hospital choice factors between first-visit and revisit patients in general hospitals. The samples used for data analysis are 499 outpatients of G, H, S, U hospitals using a standardized questionnaires in 4 provinces. In case of first-visit patients, human, effectiveness and accessibility factors were found to have a significant positive(+) effect on hospital choice factors. In case of revisit patients, human, physical, accessibility, image of hospital and salary factors were found to have a significant positive(+) effect on hospital choice factors. Based on these results, this study suggests implications to improve customer satisfaction, profitability and provide a high-quality medical service by making effectively use of planning strategies of hospital management with a variety of factors.

Effects of different anesthetic techniques on the incidence of phantom limb pain after limb amputation: a population-based retrospective cohort study

  • Cho, Hyun-Seok;Kim, Sooyoung;Kim, Chan Sik;Kim, Ye-Jee;Lee, Jong-Hyuk;Leem, Jeong-Gill
    • The Korean Journal of Pain
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    • v.33 no.3
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    • pp.267-274
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    • 2020
  • Background: General anesthesia (GA) has been considered the anesthetic technique which most frequent leads to phantom limb pain (PLP) after a limb amputation. However, these prior reports were limited by small sample sizes. The aims of this study were to evaluate the incidence of PLP according to the various anesthetic techniques used for limb amputation and also to compare the occurrence of PLP according to amputation etiology using the Korean Health Insurance Review and Assessment Service for large-scale demographic information. Methods: The claims of patients who underwent limb amputation were reviewed by analyzing the codes used to classify standardized medical behaviors. The patients were categorized into three groups-GA, neuraxial anesthesia (NA), and peripheral nerve block (PNB)-in accordance with the anesthetic technique. The recorded diagnosis was confirmed using the diagnostic codes for PLP registered within one year after the limb amputation. Results: Finally, 7,613 individuals were analyzed. According to the recorded diagnoses, 362 patients (4.8%) developed PLP after amputation. Among the 2,992 patients exposed to GA, 191 (6.4%) were diagnosed with PLP, whereas 121 (4.3%) of the 2,840 patients anesthetized with NA, and 50 (2.8%) of the 1,781 patients anesthetized under PNB developed PLP. The relative risks were 0.67 (95% confidence interval [CI], 0.53-0.84; P < 0.001) for NA and 0.43 (95% CI, 0.32-0.59; P < 0.001) for PNB. Conclusions: In this retrospective cohort study, using large-scale population-based databases, the incidence rates of PLP after limb amputations were, in the order of frequency, GA, NA, and PNB.

Effect of Acupuncture on Inflammatory Lesions and Body Image Disturbance in Patients with Acne Vulgaris (염증성 여드름 환자에 대한 침 치료 효과와 신체이미지 인식에 대한 연구)

  • Lee, Ah-Reum;Lee, In-Seon;Kim, SongYi;Lee, Hyangsook;Park, Hi-Joon;Lee, Hyejung;Chae, Younbyoung
    • Korean Journal of Acupuncture
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    • v.30 no.2
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    • pp.114-121
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    • 2013
  • Objectives : The purpose of this study is to evaluate the efficacy of acupuncture treatment on the inflammatory lesions and body image disturbances in patients with vulgaris acnes. Methods : Fifteen inflammatory acne patients were enrolled and treated with facial acupuncture during 4 treatment sessions. We evaluated the number of papules and nodules using the Korean Acne Grading System (KAGS). We also evaluated patients' general subjective satisfaction and objective changes of inflammatory acnes symptoms using DermaVision-pro. Moreover, we observed the skin quality-of-life scale with skindex-29 and body image disturbance questionnaire (BIDQ) as secondary outcome. Adverse events were recorded as well at every visit. Results : After 4 treatment sessions, there were significant reductions in the number of papules and nodules of the patients. We found that subjective satisfactions of patients were enhanced as well as the objective inflammatory symptoms. We also found significant improvements in the quality of life and BIDQ. No serious treatment-related adverse events were reported. Conclusions : This study demonstrated that standardized facial acupuncture were effective and safe in the treatment of facial inflammatory acnes.

Inter-Rater Reliability of the Korean Triage and Acuity Scale (한국형 응급환자 분류도구의 간호사-응급구조사 간 신뢰도 평가)

  • Son, Jeong Ah;Lee, Eun Ja
    • Journal of Korean Clinical Nursing Research
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    • v.26 no.1
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    • pp.107-116
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    • 2020
  • Purpose: This study was a prospective survey to evaluate the Korean Triage and Acuity Scale (KTAS) inter-rater reliability and to identify discordant areas in the KTAS classification between nurses and paramedics in emergency department (ED). Methods: Inter-rater reliability were evaluated using triage deta from January 11 to May 31, 2019. A convinience sample of a total of 800 patients who visited an emergnecy medical center in Incheon (400 adult and 400 pediatric patients in this study) were selected. The triages of this study a pair of one nurse and one paramedic performed triage at the same time, using the KTAS, Inter-rater reliability for the KTAS was evaluated with the weighted kappa. Results: The inter-rater reliability of the KTAS evaluated by weighted Kappa between nurse-paramedic KTAS score of adult patients was .71, and .66 for pediatric patients. Both were in the level considered as substantial. Among causes of triage discordance, the most frequently identified discordant item in triaging adults was the difference in the measurement of pain intensity (28.0%). For both adult and pediatric patients, multiple chief complaint was identified as the major discordant factor. In triaging pediatric patients the body temperature assessment by subjective judgments was the highest discordant item (50.7%). Conclusion: The study result suggested that the KTAS demonstrated a reasonable level of inter-rater reliability and functioned as a standardized triage tool for emergency medical services. In order to improve the inter-rater reliability and classification competence, it is necessary to revise the current all-integrated KTAS provider course to be differentiated for each job group.

Clinical Characteristics of Ureteral Duplication in Children

  • Park, Min Ji;Baek, Hee Sun;Jang, Hae Min;Lee, Jun Nyung;Chung, Sung Kwang;Jeong, Shin Young;Lee, So Mi;Cho, Min Hyun
    • Childhood Kidney Diseases
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    • v.23 no.2
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    • pp.100-104
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    • 2019
  • Purpose: Ureteral duplication is a relatively common congenital urinary tract abnormality that can be associated with various clinical problems such as vesicoureteral reflux (VUR), hydronephrosis, and ectopic ureters. The purpose of this study was to analyze the clinical characteristics of pediatric patients with recently diagnosed ureteral duplication and to identify any differences from those described in previous reports. Methods: We retrospectively reviewed the clinical characteristics and course of pediatric patients who were diagnosed with ureteral duplication between January 2008 and June 2017. Results: A total of 32 pediatric patients were diagnosed with ureteral duplication during the study period. The male to female ratio was 1:2.2. Twenty-seven patients (84.4%) were first diagnosed with ureteral duplication at less than 3 months of age, and 26 (81.3%) were first diagnosed by prenatal ultrasonography. Four of the 32 patients were diagnosed with bilateral ureteral duplication, for a total of 36 occurrences of ureteral duplication. In 17 occurrences of complete ureteral duplication (47.2%), other urinary tract anomalies were also found; namely, ureterocele (7), VUR (11), and ectopic ureter (5). However, none of the patients with incomplete ureteral duplication had ureterocele or VUR. Conclusions: With the advent of routine prenatal ultrasound, ureteral duplication is being diagnosed earlier than was previously possible, enabling timely treatment of the various accompanying urinary tract anomalies. Multicenter studies are needed to establish guidelines for standardized evaluation and treatment of ureteral duplication.

Aprepitant in combination with palonosetron for the prevention of postoperative nausea and vomiting in female patients using intravenous patient-controlled analgesia

  • Yoo, Jae Hwa;Kim, Soon Im;Chung, Ji Won;Jun, Mi Roung;Han, Yoo Mi;Kim, Yong Jik
    • Korean Journal of Anesthesiology
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    • v.71 no.6
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    • pp.440-446
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    • 2018
  • Background: The aim of this study was to evaluate aprepitant in combination with palonosetron as compared to palonosetron alone for the prevention of postoperative nausea and vomiting (PONV) in female patients receiving fentanyl-based intravenous patient-controlled analgesia (IV-PCA). Methods: In this randomized single-blinded study, 100 female patients scheduled for elective surgery under general anesthesia were randomized to two groups: Group AP (80 mg aprepitant plus 0.075 mg palonosetron, n = 50) and Group P (0.075 mg palonosetron, n = 50). The patients in group AP received 80 mg aprepitant per oral 1-3 h before surgery, while all patients received 0.075 mg palonosetron after induction of standardized anesthesia. All patients had postoperative access to fentanyl-based IV-PCA. The incidence of nausea and vomiting, use of rescue medication, and severity of nausea were evaluated at 6 and 24 h after surgery. Results: The incidence of nausea (54%) and vomiting (2%) in group AP did not differ significantly from that in group P (48% and 14%, respectively) during the first 24 h after surgery (P > 0.05). Patient requirements for rescue medication in group AP (29%) were similar to those in group P (32%) at 24 h after surgery (P > 0.05). There was no difference between the groups in severity of nausea during the first 24 h after surgery (P > 0.05). Conclusions: Aprepitant combined with palonosetron did not reduce the incidence of PONV as compared to palonosetron alone within 24 h of surgery in women receiving fentanyl-based IV-PCA.

Analysis of Pain Records Using Electronic Nursing Records of Hospitalized Patients in Medical Units at a University Hospital (일개 대학병원 내과 병동 입원환자의 전자의무기록에 사용된 통증간호 기록 분석)

  • Park, Ihn Sook;Jang, Mi;Rew, Soon Ae;Kim, Hee Jin;Oh, Phil Joo;Jung, Hee Jung
    • Journal of Korean Clinical Nursing Research
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    • v.16 no.3
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    • pp.123-132
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    • 2010
  • Purpose: This study was done to analyse nursing records to identify the nature of pain and actual conditions of pain management in patients hospitalized in one university hospital. Methods: The participants in this study were 783 patients with a length of stay of 3 to 30 days who were discharged from medical wards between June 1 and June 30, 2009. Data on nursing records related to pain management from these patients were reviewed using the Electronic Nursing Records (ENRs) system. Results: Over 30 percent of 10,702 nursing records related to pain assessment had no record on region, severity, nature or frequency of pain. About 30 percent of 13,638 nursing records related to pain intervention showed non-drug pain management techniques. Conclusion: Accurate and complete records on pain assessment including region, severity, nature and frequency of pain are essential to effectively manage patients' pain. Improvement in ENRs system for better assessment and management of pain is required as well as education programs on a standardized measuring tool for both nurses and patients.

Health-related quality of life in female patients with reumatoid arthritis: a structural equation model (여성 류마티스 관절염 환자의 건강관련 삶의 질 구조모형)

  • Bukyung Kim;Mi-Hae Sung
    • Women's Health Nursing
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    • v.29 no.2
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    • pp.91-103
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    • 2023
  • Purpose: This study aimed to construct a structural equation model to explain and predict factors affecting the health-related quality of life (QoL) in female rheumatoid arthritis (RA) patients based on the health-related QoL model by Ferrans et al. (2005) and a literature review. Methods: Patients (N=243) who were either registered members of an internet cafe composed of patients with RA or rheumatology outpatients at two tertiary general hospitals in Busan, Korea, were recruited via convenience sampling. Data were collected from July 2 to September 9, 2021, and the survey was conducted using a web-based questionnaire. The data were analyzed by SPSS and AMOS 26.0. Results: The goodness-of-fit statistics of the final model exhibited good results (χ2/degree of freedom=2.68, Turker-Lewis index=.94, comparative fit index=.96, standardized root mean-squared residual=.04, root mean- square error of approximation=.08), and 11 out of 14 paths of the model were supported. The squared multiple correlation, which reflected the explanatory power of the environmental characteristics, symptoms, functional status, and perceived health status on health-related QoL, was 80%. In the hypothesis model, 10 paths had significant direct effects, 6 paths had significant indirect effects, and 12 paths had significant total (direct and indirect) effects. Conclusion: Considering that factors directly affecting the health-related QoL of female patients with RA were social support, symptoms (fatigue and depression), resilience, and perceived health status, and that resilience was the most influential factor, clinicians can encourage resilience. Hence, to improve the health-related QoL of female patients with RA, continuing management is necessary, using various intervention methods that focus on enhancing resilience from the early stage to the end of treatment for RA.