• Title/Summary/Keyword: Team efficacy

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Patient-controlled Epidural Analgesia with Ropivacaine and Fentanyl: Experience with 2,276 Surgical Patients

  • Kim, Shin Hyung;Yoon, Kyung Bong;Yoon, Duck Mi;Kim, Chan Mi;Shin, Yang Sik
    • The Korean Journal of Pain
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    • v.26 no.1
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    • pp.39-45
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    • 2013
  • Background: Good postoperative pain control is an important part of adequate postoperative care. Patient-controlled epidural analgesia (PCEA) provided better postoperative analgesia compared to other conventional analgesic methods, but several risks have been observed as well. We therefore surveyed the efficacy and safety of PCEA in this retrospective observational study. Methods: We analyzed collected data on 2,276 elective surgical patients who received PCEA with ropivacaine and fentanyl. Patients were assessed by a PCA service team in the post-anesthesia care unit (PACU), at 1-6 h, 6-24 h, and 24-48 h postoperatively for adequate pain control. The presence of PCEA-related adverse events was also assessed. Results: Numerical pain score (median [interquartile range]) were 3 [1-4], 5 [4-7], 4 [3-5], and 3 [3-5] in the PACU, at 1-6 h, 6-24 h, and 24-48 h postoperatively. Median pain scores in patients underwent major abdominal or thoracic surgery were higher than other surgical procedure in the PACU, at 1-6 h after surgery. Nausea and vomiting (20%) and numbness and motor weakness (15%) were revealed as major PCEA-related adverse events during the postoperative 48 h period. There were 329 patients (14%) for whom PCEA was ceased within 48 h following surgery. Conclusions: Our data suggest that the use of PCEA provides proper analgesia in the postoperative 48 h period after a wide variety of surgical procedures and that is associated with few serious complications. However, more careful pain management and sustainable PCEA monitoring considering the type of surgical procedure undergone is needed in patients with PCEA.

Effects of Hospital-based Home Care Demonstration Project on Physical and Emotional Problems and Cost - effectiveness of Patients having Arthritis (병원중심 가정간호 사업의 평가 연구 -외래 관절염 환자를 대상으로 -)

  • Lim, Nan-Young;Kim, Seong-Yoon;Lee, Eun-Ok;Lee, In-Sook
    • Journal of muscle and joint health
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    • v.3 no.1
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    • pp.4-22
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    • 1996
  • Purposes of this study were to identify a hospital-based home care model and to improve the physical, emotional and economical effectiveness of arthritic patients through medical and nursing team approach. The design in nonequivalent control group pretest-posttest design with matched samples in terms of age, sex and disease severity. Fifty two patients in each group were assigned in Seoul, Kyunggi, Kangwon and Kwangju. Before and after 6-month period of home care, level of pain, duration of morning stiffness, Richie Index, ADL, self efficacy, depression, cost expenditure were measured. Nine patients were excluded from the control group in the period of study because of denial of participation. Contents of home care provided to the experimental group include mainly distribution of prescribed drugs, 'assessment of patients' condition and side-reactions of drug. All of the information related to the home care patient were reported to the physician. On the bases of these data, the physician prescribe the specific drugs to each patient. Each patient visited the physician every 2 or 3 month for laboratory test. Patients assigned to the control group visited the outpatient clinic once a month as usual. Null hypotheses were selected because physicians concerned about the ineffective change of patients' conditions due to indirect communication with patients through nurses. Level of pain, Richie index, ADL, self-efficacy, depression, duration of morning stiffness and direct medical cost were the home care provided to them. If a family member accompany in a home care group can save 10,676 Won/month in Seoul, 34,000 Won/month in other districts. Other in-direct cost for transportation and meal can also be saved. In conclusion, those patients with low level of ADL, high level of pain and Richie index, living in the remote area definitely need the home care.

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Effects of Utilization of Social Network Service on Collaborative Learning (소셜 네트워크 서비스 활용이 협력 학습에 미치는 효과)

  • Shin, Jin;Chon, Eunhwa
    • Journal of the Korea Society of Computer and Information
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    • v.18 no.11
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    • pp.241-254
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    • 2013
  • The purpose of this study is to analyse the effects of social network service on the collaborative learning. Four groups were categorized depending on the use of different types of the social network services - Kakao Talk, Facebook, both Kakao Talk and Facebook, and unused group. A preliminary test revealed that there was no difference in mobile efficacy, career decision making self-efficacy, course interest among the four groups. In the post test, the groups that used either Kakao Talk group or the group that used both Kakao Talk and Facebook retained significantly higher average score in team collaboration scale than Facebook group and unused group. The analysis of the messages in Facebook exhibited that the group used both Kakao Talk and Facebook generated larger number of messages, read, replies, clicks of "good" than the groups used only Facebook. These results strongly support the statistical significance.

Development of an Optical Tissue Clearing Laser Probe System

  • Yeo, Changmin;Kang, Heesung;Bae, Yunjin;Park, Jihoon;Nelson, J. Stuart;Lee, Kyoung-Joung;Jung, Byungjo
    • Journal of the Optical Society of Korea
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    • v.17 no.4
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    • pp.289-295
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    • 2013
  • Although low-level laser therapy (LLLT) has been a valuable therapeutic technology in the clinic, its efficacy may be reduced in deep tissue layers due to strong light scattering which limits the photon density. In order to enhance the photon density in deep tissue layers, this study developed an optical tissue clearing (OTC) laser probe (OTCLP) system which can utilize four different OTC methods: 1) tissue temperature control from 40 to $10^{\circ}C$; 2) laser pulse frequency from 5 to 30 Hz; 3) glycerol injection at a local region; and 4) a combination of the aforementioned three methods. The efficacy of the OTC methods was evaluated and compared by investigating laser beam profiles in ex-vivo porcine skin samples. Results demonstrated that total (peak) intensity at full width at half maximum of laser beam profile when compared to control data was increased: 1) 1.21(1.39)-fold at $10^{\circ}C$; 2) 1.22 (1.49)-fold at a laser pulse frequency of 5 Hz; 3) 1.64 (2.41)-fold with 95% glycerol injection; 4) 1.86 (3.4)-fold with the combination method. In conclusion, the OTCLP system successfully improved the laser photon density in deep tissue layers and may be utilized as a useful tool in LLLT by increasing laser photon density.

A Case Study about the Effects of Online PBL on Students' 4C Competencies (온라인 PBL이 학습자의 4C 역량에 미치는 영향에 관한 사례 연구)

  • Tami Im
    • Journal of Practical Engineering Education
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    • v.15 no.1
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    • pp.13-22
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    • 2023
  • The purpose of this paper is to explore the impact of online problem-based learning (PBL) on learners' 4C competencies and learning experience. The results of the study showed that, first, online PBL had a statistically significant effect on learners' problem-solving skills, communication skills, and pre-service teacher efficacy. Second, learners were very satisfied with the online PBL experience and perceived it to be very beneficial to their learning and to themselves as preservice teachers. Third, learners perceived that the real-time video conferencing system and instant messenger were very helpful for successful online PBL. Fourth, regarding the important factors for successful online PBL, the participants in this study perceived that communication and sincerity are very important, and the role of the leader is also important, but personal intimacy among team members is relatively less important. Fifth, learners perceive that instructor feedback is very important for successful online PBL. Finally, the implications of this study are discussed along with suggestions for future research.

Exploring the Impact of Appetite Alteration on Self-Management and Malnutrition in Maintenance Hemodialysis Patients: A Mixed Methods Research Using the International Classification of Functioning, Disability and Health (ICF) Framework

  • Wonsun Hwang;Ji-hyun Lee;Se Eun Ahn;Jiewon Guak;Jieun Oh;Inwhee Park;Mi Sook Cho
    • Clinical Nutrition Research
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    • v.12 no.2
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    • pp.126-137
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    • 2023
  • Hemodialysis (HD) patients face a common problem of malnutrition due to poor appetite. This study aims to verify the appetite alteration model for malnutrition in HD patients through quantitative data and the International Classification of Functioning, Disability, and Health (ICF) framework. This study uses the Mixed Method-Grounded Theory (MMGT) method to explore various factors and processes affecting malnutrition in HD patients, create a suitable treatment model, and validate it systematically by combining qualitative and quantitative data and procedures. The demographics and medical histories of 14 patients were collected. Based on the theory, the research design is based on expansion and confirmation sequence. The usefulness and cut-off points of the creatinine index (CI) guidelines for malnutrition in HD patients were linked to significant categories of GT and the domain of ICF. The retrospective CIs for 3 months revealed patients with 3 different levels of appetite status at nutrition assessment and 2 levels of uremic removal. In the same way, different levels of dry mouth, functional support, self-efficacy, and self-management were analyzed. Poor appetite, degree of dryness, and degree of taste change negatively affected CI, while self-management, uremic removal, functional support, and self-efficacy positively affected CI. This study identified and validated the essential components of appetite alteration in HD patients. These MM-GT methods can guide the selection of outcome measurements and facilitate the perspective of a holistic approach to self-management and intervention.

A Study on the Effect of Transformation Leadership on the Job Performance of Employees by AMO Model (AMO모델에 의한 직원의 직무수행에 미치는 혁신적 리더십의 효과에 관한 연구)

  • Li, Nan;Jung, Gi-Young;Kim, Hyung-Ho
    • Journal of the Korea Convergence Society
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    • v.11 no.1
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    • pp.41-50
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    • 2020
  • This paper analyzed leadership behavior and employee performance through empirical analysis method based on AMO theory. In this study, the ability of the leader (A), task motivation (M), and opportunity (O) were chosen as factors to analyze the relationship between transformative leadership and job performance of the subordinate staff, and the self-efficiency (O) and intrinsic motivation (M) were selected at the individual level and team atmosphere (O) at the organizational level to build a research model. 507 valid data were obtained from the survey and statistical analysis was conducted using SPSS23. Studies have shown that transformative leaders have a significant impact on employee performance. This study provides research results of empirical theory to understand the behavior of the leader in the performance of the employees and also suggests implications for the management of the company's human resources.

Study on Chinese User Resistance of SNS : Focus on Renren Wang (SNS사용에 대한 중국 사용자 저항에 관한 연구: 런런왕(人人网)을 중심으로)

  • Fan, Peng-Fei;Lee, Sang-Joon;Lee, Kyeong-Rak
    • Journal of Digital Convergence
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    • v.12 no.2
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    • pp.183-191
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    • 2014
  • SNS uses the Internet as its base. It is created in order to achieve communication between the users. Up until now, most previous research were focused on the users of SNS. But, there are still a great deal of people who do not use or discontinuously use SNS. This is because users have natural resistance against SNS when using the service. In this study, time shortage perception, awareness of SNS, self-efficacy, suitability, information quality of SNS, subjective norm and privacy concern are considered as influence factors by previous research. An empirical study for Chinese students and internet users was conducted to identify how these factors influence perceived risk and perceived usefulness, and how this influence to user's resistance. This study can explain the reason why users don't use SNS and resist SNS use.

A case study on benefit coverage of complementary medicine in public health insurance by the referendum in Switzerland (스위스에서의 국민투표에 의한 보완의학 건강보험 급여화 사례 연구)

  • Kim, Dongsu;Lim, Byungmook;Park, Inhyo;Lee, Yoon Jae
    • Journal of Society of Preventive Korean Medicine
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    • v.21 no.3
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    • pp.29-42
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    • 2017
  • Background : Efforts towards increasing insurance coverage for traditional Korean medicine (TKM) are being continued. However, various difficulties are faced in generating evidence for TKM due to limited financial support and the low quality of research methodology. Objectives : The objectives of this study were to review the Swiss evaluation program for complementary and alternative medicine (CAM) and assess the expansion in public health insurance coverage of complementary medicine as approved by referendum in Switzerland. Methods : The regulations of CAM in the European Union were assessed. Research articles, reports, government publications and websites which deal with the 'Programm Evaluation $Komplement{\ddot{a}}rmedizin$ (PEK)' and the referendum in Switzerland were searched for and analyzed. Results : The PEK was conducted from 1998 to 2005. The PEK evaluated the efficacy, utilization and cost-effectiveness of anthroposophical medicine, homeopathy, neural therapy, phytotherapy and traditional Chinese medicine. However, clear conclusions could not be drawn from the evaluation according to the PEK Report. Later, a referendum was implemented in which 5 therapies would be added to the Switzerland Constitution with the support of the public. The coverage of CAM was approved by Swiss a plebiscite with an approval rate of 67.0%. Conclusions : The reason for the successful referendum is suggested to be public support and the solidarity with CAM experts and politicians. It may be surmised that recognition of the political efforts and scientific aspects required to expand insurance coverage of TKM, and towards obtaining public support, is necessary.

Effects of Application of Myofascial Release of Neck and Upper Trunk on the Pain, Insomnia and Sleep Disturbances in Patients with Chronic Neck Pain (경부 및 체간 상부 근막이완기법 적용이 만성 경부통 환자의 통증, 불면증 및 수면에 미치는 영향)

  • Bae, Kyeong;Park, Se-Jin;Chon, Seung-Chul
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.2
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    • pp.43-52
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    • 2021
  • Purpose : Chronic neck pain negatively impacts the quality of life and causes various problems in daily life due to pain, insomnia, and sleep disturbances in patients with this condition. Therapeutic interventions to solve these problems in rehabilitation and physical therapy are being introduced; however, the evidence of the efficacy of myofascial release (MFR) is still insufficient. This study aimed to investigate the effects of applying MFR on pain, insomnia, and sleep disturbances in patients with chronic neck pain. Methods : Ten patients with chronic neck pain were randomly selected and grouped into the experimental group (n1 = 10) and control group (n2 = 10) by cross-over design. Pain was measured before and after MFR intervention. Moreover, insomnia was measured only after MFR intervention. Polysomnography was performed after MFR intervention. Wilcoxon signed rank test and Mann-Whitney U test were used for the visual analog scale (VAS). Independent sample t-test was separately performed to measure insomnia and sleep. Results : After MFR intervention, the VAS score of the experimental group (p = 0.005) significantly decreased than that of the control group (p = 0.002). The insomnia score of the experimental group significantly decreased than that of the control group (p = 0.001). The total sleep time (p = 0.001), sleep efficiency (p = 0.001), and sleep latency (p = 0.001) of the experimental group significantly increased than those of the control group in the polysomnographic measurement. Conclusion : The application of MFR of the neck and upper trunk may have a positive effect on pain, insomnia, and sleep disturbances in patients with chronic neck pain. It was also suggested that an objective and quantitative polysomnography can be used more often in the field of rehabilitation and physical therapy.