• Title/Summary/Keyword: Standardized patients

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Comparison of Standardized Peristomal Skin Care and Crusting Technique in Prevention of Peristomal Skin Problems in Ostomy Patients

  • Park, Seung-Mi;Lee, Yun-Jin;Oh, Doo-Nam;Kim, Ji-Yun
    • Journal of Korean Academy of Nursing
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    • v.41 no.6
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    • pp.814-820
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    • 2011
  • Purpose: This study was performed to compare the effects of standardized peristomal skin care (SPSC) and crusting technique (CT) on the peristomal skin of ostomates. SPSC was developed by a consensus among the expert group based on a comprehensive review of the relevant literature and hospital protocols. Methods: A randomized controlled pilot trial with 2 parallel arms was used. A total of 81 ostomates, who were recruited from a tertiary hospital, completed the baseline, 1-month, 2-month, and 3-month follow-up (SPSC group, n=45; CT group, n=36). SPSC consisted of water cleansing and direct application of ostomy appliances. CT involved crusting hydrocolloid powder and patting with water sponge or protective barrier liquid film. The outcomes of the study were assessed by skin problems, such as discoloration, erosion and tissue overgrowth; the domains of the evaluation tool used in examining the peristomal skin. A generalized estimating equation model was used to examine the effects according to time and group. Results: In both SPSC and CT groups, the likelihood of occurrence of discoloration (OR, 1.99; 95% CI, 1.61-2.46), erosion (OR, 1.87; 95% CI, 1.55-2.25) and tissue enlargement (OR, 1.94; 95% CI, 1.36-2.77) increased with time. There was no significant difference in discoloration between the groups, whereas the probability of erosion (OR, 0.38; 95% CI, 0.16-0.89) and tissue overgrowth (OR, 0.09; 95% CI, 0.02-0.55) was lower in the SPSC group than in CT group. Conclusion: SPSC was sufficient in preventing peristomal skin problems of ostomates compared to the CT.

Epidemiology Characteristics and Trends of Incidence and Morphology of Stomach Cancer in Iran

  • Almasi, Zeinab;Rafiemanesh, Hosein;Salehiniya, Hamid
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.7
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    • pp.2757-2761
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    • 2015
  • Background: Stomach cancer is the fourth most common cancer and the second leading cause of cancer-related death through the world. It is predicted that the number of new cancer cases will be more than 15 million cases by 2020. Regarding the lack of studies on this topic in the country, we have thoroughly examined the patho-epidemiology of stomach cancer in Iran. Materials and Methods: In this cross- sectional study data were collected retrospectively reviewing all new stomach cancer patients in Cancer Registry Center report of health deputy for Iran during a 6-year period (2003-2008). The study also examined the morphology of common stomach cancers. Trends in incidence and morphology underwent joinpoint regression analysis. Results: During the six-year period, a total of 35,171 cases of stomach cancer were registered. Average age standardized rate for females and males were equal to 7.1 and 15.1 per 100,000 persons, respectively. Most common histological type was adenocarcinoma, NOS with 21,980 cases (62.50%). The annual percentage change (APC) in age-standardized incidence rate (per 100,000) was increase in both females and males at 11.1 (CI: 4.3 to 18.3) and 9.2 (CI: 5.2 to 13.4), respectively. Conclusions: According to our results, the incidence of gastric cancer is increasing in Iran, so further epidemiological studies into the etiology and early detection are essential.

Standardizing the evaluation criteria on treatment outcomes of mandibular implant overdentures: a systematic review

  • Kim, Ha-Young;Shin, Sang-Wan;Lee, Jeong-Yol
    • The Journal of Advanced Prosthodontics
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    • v.6 no.5
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    • pp.325-332
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    • 2014
  • PURPOSE. The aim of this review was to analyze the evaluation criteria on mandibular implant overdentures through a systematic review and suggest standardized evaluation criteria. MATERIALS AND METHODS. A systematic literature search was conducted by PubMed search strategy and hand-searching of relevant journals from included studies considering inclusion and exclusion criteria. Randomized clinical trials (RCT) and clinical trial studies comparing attachment systems on mandibular implant overdentures until December, 2011 were selected. Twenty nine studies were finally selected and the data about evaluation methods were collected. RESULTS. Evaluation criteria could be classified into 4 groups (implant survival, peri-implant tissue evaluation, prosthetic evaluation, and patient satisfaction). Among 29 studies, 21 studies presented implant survival rate, while any studies reporting implant failure did not present cumulative implant survival rate. Seventeen studies evaluating peri-implant tissue status presented following items as evaluation criteria; marginal bone level (14), plaque Index (13), probing depth (8), bleeding index (8), attachment gingiva level (8), gingival index (6), amount of keratinized gingiva (1). Eighteen studies evaluating prosthetic maintenance and complication also presented following items as evaluation criteria; loose matrix (17), female detachment (15), denture fracture (15), denture relining (14), abutment fracture (14), abutment screw loosening (11), and occlusal adjustment (9). Atypical questionnaire (9), Visual analog scales (VAS) (4), and Oral Health Impact Profile (OHIP) (1) were used as the format of criteria to evaluate patients satisfaction in 14 studies. CONCLUSION. For evaluation of implant overdenture, it is necessary to include cumulative survival rate for implant evaluation. It is suggested that peri-implant tissue evaluation criteria include marginal bone level, plaque index, bleeding index, probing depth, and attached gingiva level. It is also suggested that prosthetic evaluation criteria include loose matrix, female detachment, denture fracture, denture relining, abutment fracture, abutment screw loosening, and occlusal adjustment. Finally standardized criteria like OHIP-EDENT or VAS are required for patient satisfaction.

Epidemiology and Histopathological Spectrum of Head and Neck Cancers in Bihar, a State of Eastern India

  • Siddiqui, Md. Salahuddin;Chandra, Rajeev;Aziz, Abdul;Suman, Saurav
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.3949-3953
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    • 2012
  • Head and neck cancers are amongst the commonest malignancies, accounting for approximately 20% of the cancer burden in India. The major risk factors are tobacco chewing, smoking and alcohol consumption, which are all preventable. This retrospective study presents data from the histopathology register for a five year period from 2002-2006 at Patna Medical College and Hospital, a tertiary care hospital drawing patients from the entire Bihar state, the 3rd most populous state of India with the majority of the population residing in rural areas. Incidence rates based on sex, age, site of lesion, including age standardized incidence rates for males and females, with mean age of presentation, distribution of histological variants and year wise trend were calculated. Out of 455 head and neck neoplasias, 241 were benign while 214 were malignant. The most common age group for all malignant biopsies was 7th decade for males and the 5th decade for females. Malignant cases were commoner in males than females with the male:female ratio of 3.1:1, which was found to be statistically significant by the chi-square (${\chi}^2$) test. The crude rate and age standardized incidence rate was 0.05 and 0.06 per 100,000 population respectively. Squamous cell carcinoma (SCC) contributed about 96% of all cases, with grade I being the most common. Larynx was the most common site for malignancy, the supraglottic region being its most commonly affected sub-site. This observed incidence patterns in the region are a reminder of widespread unawareness, low healthcare utilization with virtually non-existent cancer programs. It also underlines the need to advocate for reliable cost-effective programs to create awareness, for early detection and plan appropriate management strategies. There is a compelling demand for a cancer registry in this region as well as proper implementation of preventive measures to combat this growing threat of cancer, many of whose risk factors are preventable.

Increasing Frequency of Soft Tissue Sarcomas in Vojvodina - Comparison with the Literature

  • Dugandzija, Tihomir;Mikov, Marica Miladinov;Solajic, Nenad;Nikolin, Borislava;Trifunovic, Jasna;Ilic, Maja
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.1011-1014
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    • 2014
  • Background: Soft tissue sarcomas (STS) represent 1% of all malignant lesions. In this study the authors analyzed the incidence of STS in Vojvodina (the north region of Serbia) in the period from 1985 to 2009. A number of studies conducted worldwide indicate that STS incidence rates are tending to increase. Materials and Methods: On the basis of data from the Cancer Registry of Vojvodina, age standardized STS incidence rates were established as well as their linear trend, with data on histological structure, age, gender and STS distribution at specific locations. Results: The total number of registered patients was 1,308. Average age standardized rate was 1.90/100,000 per year. The investigated period showed a slight increase in the incidence rate (average annual percent increase=0.77%). The most frequent histological type was sarcoma not otherwise specified-NOS (27%), followed by leiomyosarcoma (21%), liposarcoma (14%), rhabdomyosarcoma (11%) and malignant fibrous histiocytoma (9%). The male/female ratio was 0.73:1. Every fifth patient was younger than 39. Conclusions: Comparison among eight international STS epidemiology studies show that the incidence rate range is between 1.4/100,000-5.0/100,000, though our finding is closer to the lower limit. Furthermore, the incidence rate increase was lower than that characteristic for the half of the analyzed studies. A partial explanation for that should be looked for among changes in diagnostic criteria and STS classifications.

Research of the Development of Training Program for Quality Improvement Experts (의료의 질 개선 전문가 양성을 위한 체계 개발 연구)

  • Park, Seong-hi;Hwang, Jeong-hae;Choi, Yun-kyoung;Lee, Sun-gyo
    • Quality Improvement in Health Care
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    • v.21 no.1
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    • pp.12-31
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    • 2015
  • Objectives : The purpose of this study was to develop the qualification system for training of Quality improvement professionals who work for improving patients' safety and healthcare quality. Methods : Based on the various laws and regulations, and the operational status of other professionals' qualification systems, a basic plan of professional qualification system of QI was drawn. And through meetings with QI experts, the final scheme of the concrete qualification system was developed. Results : For management of professionals's certification or qualification, fairness and reliability are important. To do this, setting the official standard, providing a standardized training program and having appropriate qualification test are required. In order to operate the qualification system strategically, 1) the introduction step, 2) dissemination and expansion step, and 3) fusing step should be considered. As a governing body for QI specialists' qualification, 'QI professionals' qualification Center (tentative)' must have the committee to assure fairness, professionalism, and reliability. In addition, 'QI Experts Certification Department (tentative)" to develop standards for the qualification tests and conduct the tests program,' QI experts Education Department (tentative name)" must be able to operate and maintain the QI training for professional qualifications. QI professional qualification exam must be taken by everyone regardless of age, gender, race, occupation, education, and work experience. The examination should include management, leadership, strategic planning and design, quality management, health care information, patient safety culture. Practical training courses can have three step programs; beginning, intermediate and special level. Conclusion : The QI qualification system need strategic approaches for the experts working for healthcare quality improvement and patient safety. It should include the program of standardized contents and test, and operating protocol of the qualificaton system.

Evaluation of the Standardized Patients(SP) Managed Instruction for a Clinical Maternity Nursing Course (표준화 환자를 활용한 모성간호학 실습 학습방법 효과 분석)

  • Lee, Seoung-Eun
    • The Journal of Korean Academic Society of Nursing Education
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    • v.17 no.1
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    • pp.14-24
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    • 2011
  • Purpose: The purpose of this study was to investigate the learning effect of a standardized patient managed instruction program for a clinical maternity nursing course. Methods: The SP managed instruction was made for clinical cases in intrapartum and postpartum nursing care. The SP managed instruction was evaluated by using a quasi-experimental, nonequivalent control group post-test design with separate classes of students attending clinical maternity nursing classes at a nursing school in Incheon. Control groups were taught by traditional lecture/model method and experimental groups were taught by SP managed instruction. Data was collected from September 2009 to February 2010. Results: 1. There was no significant difference between the experimental group and control group in identifying relevant data (z=-1.418, p=.156) and necessary nursing skills performance (z=-.643, p=.520) for intrapartum nursing care. In addition, there was no significant difference between the two groups in identifying relevant data (z=-.264, p=.782) and necessary nursing skill (z=-.342, p=.732) for postpartum nursing care. 2. In clinical nursing skill performances the total score was statistically significantly higher in the experimental group than the control group (intrapartum care z=-4.181, p=.000, postpartum care z=-4.279, p=.000). 3. There was a statistically significant difference between the two groups (intrapartum care z=-3.731, p=.000, postpartum care z=-4.066, p=.000). Conclusion: In conclusion, the SP methodis effective in teaching clinical maternity nursing for student nurses and it is necessary to develop SP instruction courses for many areas in the clinical nursing education field.

Case Study of Auditory Training for the Acquired Hearing loss Adult with Cochlear Implant (후천성 인공와우 이식 성인의 청능훈련 사례 연구)

  • Hong, Ha Na
    • 재활복지
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    • v.17 no.4
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    • pp.371-382
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    • 2013
  • Recently, the number of those who were transplanted cochlear implants increased as health insurance increases has expanded. Last six years between 2005 to 2009, patients who received a cochlear implant surgery were about 3,300 and number of cochlear implants in adults of them have shown growing aspects. In the case of young children, they actively participated auditory training program after cochlear implant surgery and the studies related to auditory training in child are many, but the studies related to auditory training in adults is insufficient. In this study, we perform the auditory training for the female adult (age 54) received cochlear implant after language acquisition used Ling 6 sounds test, standardized consonants, vowels and sentences listening test and word recognition and confirmation test. As a result after auditory training for 10 weeks, she identified all phonemes in Ling 6 sound test and performed close to 100% in standardized consonants, vowels and sentences listening tests. Also, she improved the ability of real-world environmental sound and real-world words identifications by 57-95%. The results of this study showed the need of auditory training program with systematic and effective planning and considering the characteristics of the individual for adults.

Presentation on Research Trends and Suggestion for further research and education on Objective Structured Clinical Examination and Clinical Performance Examination in Korean Medicine Education: Scoping Review (한의학교육에서 객관구조화진료시험과 진료수행평가에 대한 연구 동향과 후속 연구 및 교육에 대한 제언: 주제범위 문헌고찰)

  • Shin, Jinyeong;Go, Yerim;Song, Changjin;Cho, Eunbyul;Leem, Jungtae
    • Journal of Society of Preventive Korean Medicine
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    • v.26 no.2
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    • pp.87-112
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    • 2022
  • Objectives : This study reviewed existing studies on clinical examination of Korean medicine to investigate the trends and gaps of existing research on clinical performance examination (CPX) or objective structured clinical examination (OSCE) in Korean medicine education. Methods : We conducted a scoping review according to the five steps suggested by Arksey and O'Malley. Six databases(RISS, OASIS, KMBASE, KISS, ScienceON, and DBpia) were searched and studies published from 2012 to July 15, 2022 were considered. The subjects of the study were limited to domestic studies about OSCE or CPX conducted in Korean medicine education. Results : Among the 25 selected papers, 17 studies implemented OSCE or CPX in practice. Those studies were conducted in 8 clinical departments and 9 of them used standardized patients. All 14 survey studies reported positive answers in satisfaction, efficacy, and self-assessment. OSCE, CPX scoring items were developed by modifying existing tools or developing through expert surveys or through literature review and significant cases. Conclusions : This study is expected to be used as basic data for following studies and promote clinical examination. From now on, the colleges of Korean medicine should proceed research on large-scale students about extended subjects through various research methods to obtain objective results that can be generalized and acquire validity and reliability. In order to promote such research, it is necessary to induce cooperation from institutions related to Korean Medicine and local universities to develop modules, implement, and conduct post-evaluation.

$^{18}F-FDG$ Positron Emission Tomography in Patients with Concomitant Malignancy and Tuberculoma

  • Lee, Jung-Cheol;Ryu, Jin-Sook;Park, I-Nae;Choi, Chang-Min;Oh, Yeon-Mok;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Shim, Tae-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.1
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    • pp.1-5
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    • 2010
  • Background: To analyze the result of $^{18}F-FDG$ positron emission tomography (PET) in patients with a concomitant malignancy and tuberculoma in a tuberculosis (TB)-endemic area. Methods: Twelve patients with a concomitant malignancy and tuberculoma, who underwent whole-body $^{18}F-FDG$ PET, were evaluated retrospectively. The maximal standardized uptake values (SUVmax) of the malignancy and tuberculoma were compared. In 6 patients, $^{18}F-FDG$ PET was repeated during the anti-TB treatment and the changes in SUVmax were analyzed. Results: Of the 12 patients, 10 were male. The mean age was $67.2{\pm}7.9$ years. Tuberculomas were located in the lung (n=10) and lymph nodes (n=2), and tumors were located in the lung (n=6), colon (n=3), stomach (n=1), ovary (n=1) and liver (n=1). Although the mean SUVmax of malignant lesions was higher than that of tuberculomas ($5.2{\pm}3.2$ vs $3.5{\pm}2.0$), the difference was not significant. In 4 patients, the SUVmax was higher in the tuberculoma than the tumor. After anti-TB treatment in 6 patients, the mean SUVmax of the tuberculomas decreased significantly, from $3.5{\pm}2.0$ to $1.6{\pm}0.9$ (p=0.028). Conclusion: In patients with a concomitant malignancy and tuberculoma, SUVmax alone could not differentiate between them. However, $^{18}F-FDG$ PET may be useful in monitoring the response to anti-TB treatment.