• Title/Summary/Keyword: Standardized patients

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A Case Report on a Hwabyung Patient with Binge Eating (폭식을 주소로 한 화병(火病)환자 치험(治驗)1예(例))

  • An, Tae-Han;Jang, Jeong-A;Park, Eun-Young;Jeong, Seong-Sik;Kim, Jin-Won;Seo, Ho-Seok;Kim, Jin-Yi
    • The Journal of Korean Medicine
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    • v.32 no.5
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    • pp.139-146
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    • 2011
  • Hwabyung is a culture-bound anger syndrome in Korea. It manifests as one or more of a wide range of physical symptoms, in response to emotional stress. This case describes a 26-year old woman diagnosed as Hwabyung by HBDIS. She complained chiefly of binge eating and sleep disorder. She also complained of chest discomfort, abdominal discomfort, foreign body sensation in the throat, burning sensation and so on. We treated the patient with herbal medication, acupuncture, cupping, and moxa. After treatment, her condition improved. Standardized patients (SP) were used in teaching and practicing interviewing and physical examination skills for This report suggests that traditional Korean treatment such as herbal medication, acupuncture, cupping, moxa is effective for the treatment of Hwabyung patients.

Can Perioperative Chemotherapy for Advanced Gastric Cancer Be Recommended on the Basis of Current Research? A Critical Analysis

  • Bauer, Katrin;Porzsolt, Franz;Henne-Bruns, Doris
    • Journal of Gastric Cancer
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    • v.14 no.1
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    • pp.39-46
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    • 2014
  • Purpose: According to current guidelines, perioperative chemotherapy is an integral part of the treatment strategy for advanced gastric cancer. Randomized controlled studies have been conducted in order to determine whether perioperative chemotherapy leads to improved R0 resection rates, fewer recurrences, and prolonged survival. The aim of our project was to critically appraise three major studies to establish whether perioperative chemotherapy for advanced, potentially resectable gastric cancer can be recommended on the basis of their findings. Materials and Methods: We analyzed the validity of the three most important studies (MAGIC, ACCORD, and EORTC) using a standardized questionnaire. Each study was evaluated for the study design, patient selection, randomization, changes in protocol, participating clinics, preoperative staging, chemotherapy, homogeneity of subjects, surgical quality, analysis of the results, and recruitment period. Results: All three studies had serious shortcomings with respect to patient selection, homogeneity of subjects, changes in protocol, surgical quality, and analysis of the results. The protocols of the MAGIC and ACCORD-studies were changed during the study period because of insufficient recruitment, such that carcinomas of the lower esophagus and the stomach were examined collectively. In neither the MAGIC study nor the ACCORD study did patients undergo adequate lymphadenectomy, and only about half of the patients in the chemotherapy group could undergo the treatment specified in the protocol. The EORTC study had insufficient statistical power. Conclusions: We concluded that none of the three studies was sufficiently robust to justify an unrestrained recommendation for perioperative chemotherapy in cases of advanced gastric cancer.

Development of Job Standards for Clinical Dietitians Administering Clinical Nutrition Therapy to Diabetic Patients in Hospitals (당뇨병 환자의 임상영양치료를 위한 임상영양사의 직무표준 개발)

  • Gwon, Su-Jin;Woo, Mi-Hye;Ju, Dal Lae;Kim, Eun Mi;Park, Mi-Sun;Sohn, Cheongmin;Wie, Gyung-Ah;Lee, Song-Mi;Cha, Jin-A;Seo, Jung-Sook
    • Journal of the Korean Dietetic Association
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    • v.21 no.1
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    • pp.37-56
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    • 2015
  • This study was conducted to develop job standards for clinical dietitian administering clinical nutrition therapy to diabetic patients in hospitals. Based on DACUM (Developing A Curriculum) analysis of 17 members including clinical dietitians, professors majoring in clinical nutrition and researchers, information on duties, tasks and task elements of clinical dietitians for diabetes care were derived and applied to diabetes mellitus-specific clinical nutrition care in hospitals for evaluation. The final developed job standards for clinical dietitians for diabetes care included four duties, 19 tasks and 56 task elements. The duties consisted of nutrition assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring evaluation. For application of diabetes mellitus-specific job standards in clinical nutrition care, 108 work activities were developed and classified into 90 basic and 18 recommended types. Performance rates of standardized jobs were 80.2% at nutrition assessment, 99.6% at nutrition diagnosis, 78.5% at nutrition intervention, and 32.9% at nutrition monitoring evaluation. These results can be applied as guidelines to implement jobs for diabetes mellitus-specific clinical nutrition services in clinical settings. In addition, they would be useful for education standards in educational institutions for education and training of clinical dietitian.

Are There Standardized Cutoff Values for Neutrophil-Lymphocyte Ratios in Bacteremia or Sepsis?

  • Gurol, Gonul;Ciftci, Ihsan Hakki;Terzi, Huseyin Agah;Atasoy, Ali Riza;Ozbek, Ahmet;Koroglu, Mehmet
    • Journal of Microbiology and Biotechnology
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    • v.25 no.4
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    • pp.521-525
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    • 2015
  • Bacteremia and sepsis are common causes of morbidity and mortality worldwide, with incorrect or delayed diagnoses being associated with increased mortality. New tests or markers that allow a more rapid and less costly detection of bacteremia and sepsis have been investigated. The aim of this study was to clarify the cutoff value of the neutrophillymphocyte ratio (NLR) according to procalcitonin (PCT) level in the decision-making processes for bacteremia and sepsis. In addition, other white blood cell subgroup parameters, which are assessed in all hospitals, for bacteremia and sepsis were explored. This retrospective study included 1,468 patients with suspected bacteremia and sepsis. Patients were grouped according to the following PCT criteria: levels <0.05 ng/ml (healthy group), 0.05-0.5 ng/ml (local infection group), 0.5-2 ng/ml (systemic infection group), 2-10 ng/ml (sepsis group), and >10 ng/ml (sepsis shock group). One important finding of this study, which will serve as a baseline to measure future progress, is the presence of many gaps in the information on pathogens that constitute a major health risk. In addition, clinical decisions are generally not coordinated, compromising the ability to assess and monitor a situation. This report represents the first study to determine the limits of the use of NLR in the diagnosis of infection or sepsis using a cutoff value of <5 when sufficient exclusion criteria are used.

A Survey of the Implication of the Cancer Screening Program in Health District Centers (보건소의 국가 암 검진사업 실태)

  • Hwang, In-Young;Lee, Won-Chul;Baek, Hee-Chong;Kim, Nam-Cho
    • Journal of Korean Public Health Nursing
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    • v.19 no.2
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    • pp.229-240
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    • 2005
  • Purpose: To evaluate every step of the cancer screening program. Method: 146 of 233 health centers participated in this study. Data were collected by mailing questionnaires between December 2002 and January 2003. The response rate was 65.5%. Result: The government cancer screening program was directed by a variety of departments of the health centers. 41.1% of persons in charges were nurses. 41.3% of the health centers received a list of the appropriate person from the National Health Insurance Cooperation within one or two months. 26.1% of health centers received ??? after five month from when the program started. All the health centers advertised their services, and most of them used mail and mass media 56.4%, used other institute's materials, and 72.2% of them used the government's materials. 76.7% of the heath centers recommended secondary health screening to the persons who had positive results at the first screening. 71.6% of the health centers ascertained the patients with cancer who were diagnosed at secondary screenings. 67.9% of the health centers had registered home-based cancer patients at the health center. 137 out of 146 health centers had a local institute for cancer screening; an average of 4.9 institutes had cancer screening. 80.1% of the persons in charge of the programs felt they needed this program, but 80.8% of them thought the program should be modified. Conclusion: Organized and standardized programs are needed to promote the efficiency of National Cancer Screening Program.

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Case Control Study Identifying the Predictors of Unplanned Intensive Care Unit Readmission After Discharge (집중치료실 퇴실환자의 비계획성 재입실 예측 인자를 규명하기 위한 사례대조군 연구)

  • Park, Myoung Ok;Oh, Hyun Soo
    • Journal of Korean Critical Care Nursing
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    • v.11 no.3
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    • pp.45-57
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    • 2018
  • Purpose : This study was performed to identify the influencing factors of unplanned intensive care unit (ICU) readmission. Methods : The study adopted a Rretrospective case control cohort design. Data were collected from the electronic medical records of 844 patients who had been discharged from the ICUs of a university hospital in Incheon from June 2014 to December 2014. Results : The study found the unplanned ICU readmission rate was to be 6.4%(n=54). From the univariate analysis revealed that, major symptoms at $1^{st}$ ICU admission, severity at $1^{st}$ ICU admission (CPSCS and APACHE II), duration of applying ventilator application during $1^{st}$ ICU admission, severity at $1^{st}$ discharge from ICU (CPSCS, APACHE II, and GCS), and application of $FiO_2$ with oxygen therapy, implementation of sputum expectoration methods, and length of stay of ICU at $1^{st}$ ICU discharge were appeared to be significant; further, decision tree model analysis revealed that while only 4 variables (sputum expectoration methods, length of stay of ICU, $FiO_2$ with oxygen therapy at $1^{st}$ ICU discharge, and major symptoms at $1^{st}$ ICU admission) were shown to be significant. Conclusions : Since sputum expectoration method was the most important factor to predictor of unplanned ICU readmission, a assessment tool for the patients' capability of sputum expectoration needs to should be developed and implemented, and standardized ICU discharge criteria, including the factors identified from the by empirical evidences, might should be developed to decrease the unplanned ICU readmission rate.

Bio-signal Based Rehabilitation Program and Data Management (국내 연하장애 기능적 전기 자극치료기 사용 현황과 장비관리 실태 분석)

  • Heo, S.Y.;Park, J.H.;Rhee, K.M.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.8 no.1
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    • pp.57-66
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    • 2014
  • This study has been conducted to identify the current status and practices of electrical stimulation for patients with dysphagia in Korea. Main goal of the study is to find evidences of developing and distributing a quality indicator and organized performance exam. This study analyzed 50 survey questionnaires given to clinical professionals in upper-scale general hospitals, university hospitals, nursing homes and professional rehabilitation hospitals. The survey sent out and collected by E-mails or interviews from August 21, 2013 to November 10, 2013. Most of the hospitals showed lack of using a quality indicator and organized performance exams in device maintenance, pre-operational tests and post-operational tests. It is strongly recommended to develop a standardized guideline of a higher quality indicator and organized performance exam in using neuromuscular electrical stimulator for patients who are suffering from dysphagia.

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Psychosocial Assessment and Related Factors for Kidney Transplantation Candidates in South Korea: A Descriptive Correlational Study (한국 신장이식 대기자의 심리사회적 평가 및 영향 요인)

  • Chong, Hye Jin
    • Journal of Korean Biological Nursing Science
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    • v.21 no.4
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    • pp.249-258
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    • 2019
  • Purpose: The purpose of this study was to assess the psychosocial status of candidates for deceased donor kidney transplantation (DDKT) in South Korea and identify factors associated with high-risk psychosocial status. Methods: The descriptive cross-sectional design included application of a standardized transplantation-specific assessment tool, the Psychosocial Assessment Candidacy Transplantation (PACT) instrument, and review of candidates' medical records. A total of 157 patients awaiting DDKT were recruited from a Korean organ transplantation center. The collected data were analyzed using descriptive statistics and binary logistic regression. Candidates were divided into high- and low-psychosocial risk groups using 3 as the cutoff point of PACT. Results: The mean score for the PACT final rating was 2.10, and the lowest average subscale score was 2.30 for understanding the processes of transplantation and follow up. Poor physical candidacy, especially due to comorbidities, and older age were associated with high psychosocial risk. Conclusion: The results of this study showed that the psychosocial status of Korean DDKT candidates was problematic. Development of systematic management programs for effective clinical strategies in the care of candidates is crucial to maintain their desirable psychosocial status in case of an emergency DDKT operation and improve post-transplantation outcomes. Continuous education is absolutely necessary to enhance understanding of the transplantation process for high-risk psychosocial candidates. Additionally, nurses and transplantation professionals should screen candidates with high-risk psychosocial status early in the process using transplantation-specific assessment tools and provide intensive interventions, particularly for poor physical candidacy patients and older candidates.

Assessing educational needs in the development of a simulation-based convergence training program on mental health nursing (시뮬레이션 융합 프로그램 개발을 위한 정신건강간호 교육요구도 조사)

  • Kim, Sun-Kyung
    • Journal of the Korea Convergence Society
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    • v.11 no.9
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    • pp.425-432
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    • 2020
  • This study was to identify the educational needs for mental health nursing among undergraduate nursing students, prioritizing the areas where require extensive convergence learning via simulation. One hundred and forty students completed the survey where data accrued from between March-May 2020. The educational needs for mental health nursing and nursing care schizophrenia patients were assessed using a self-reporting questionnaire, which included 19 and 15 items, respectively. Additional three essay questions were used to obtain information regarding previous simulation education experience. Higher educational needs in nursing care for schizophrenia were identified and the highest-priority need is communication skills. Factors, including realistic experience with standardized patients, teamwork, and feedback from the lecturers, affect positive experiences in mental health nursing simulation. The findings suggest that educational programs to improve communication skills are necessary for better mental health nursing competency. Well-designed and convergence based simulation programs providing real-like clinical experience would ensure optimal learning outcomes.

Clinical Study of Twenty-seven Case of Treating Acne scar Using Microneedle Therapy and Subcision Combined with Beevenom Pharmacopuncture Therapy (미세피부침, 절개침법과 봉독 약침 복합 요법의 여드름 흉터 치료 27례 임상 보고)

  • Kim, Hye-Yoon;Hong, Seok-Hoon;Park, In-Hae;Heo, Eun-Sun;Noh, Hyeon-Min;Shin, Sun-Ho
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.28 no.3
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    • pp.101-113
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    • 2015
  • Objectives : Microneedle therapy and Subcision are commonly used for therapeutic modalities of acne scars in Korean medicine. Beevenom could promote the expression of various cytokines, enzymes and receptors related to increasing collagen content of connective tissues. Through this mechanism, we considered that Beevenom pharmacopuncture therapy is applicable to the treatment of acne scars. We investigated twenty-seven patients with acne scars treated by Microneedle therapy and Subcision combined with Beevenom pharmacopuncture therapy and evaluated the clinical effect.Methods : Twenty-seven patients with acne scars were treated by Microneedle therapy and Subcision combined with Beevenom pharmacopuncture therapy and evaluated the clinical effect. for twelve weeks. The severity of acne scars and treatment effect were evaluate by standardized photography, GASC, ECCA scale and patient`s satisfaction. And side effects was also checked.Results : After twelve weeks for treatment, there was an improvement in GASC, ECCA scale. 77.8% of patient replied excellent or good on patient satisfaction survey. One patient sufferied from pruritus, papules and comedones as side effect of treatment.Conclusion : It can be considered that Microneedle, Subcision, Beevenom pharmacopuncture combining therapy are effective method for treating acne scars.