• Title/Summary/Keyword: Therapy acceptance

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Quality Assurance of Volumetric Modulated Arc Therapy for Elekta Synergy (Elekta Synergy 선형가속기를 이용한 입체적세기조절회전방사선치료(VMAT) 정도관리)

  • Shim, Su-Jung;Shim, Jang-Bo;Lee, Sang-Hoon;Min, Chul-Kee;Cho, Kwang-Hwan;Shin, Dong-Oh;Choi, Jin-Ho;Park, Sung-Ill;Cho, Sam-Ju
    • Progress in Medical Physics
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    • v.23 no.1
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    • pp.33-41
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    • 2012
  • For applying the quality assurance (QA) of volumetric modulated arc therapy (VMAT) introduced in Eulji Hospital, we classify it into three different QA steps, treatment planning QA, pretreatment delivering QA, and treatment verifying QA. These steps are based on the existing intensity modulated radiation therapy (IMRT) QA that is currently used in our hospital. In each QA step, the evaluated items that are from QA program are configured and documented. In this study, QA program is not only applied to actual patient treatment, but also evaluated to establish a reference of clinical acceptance in pretreatment delivering QA. As a result, the confidence limits (CLs) in the measurements for the high-dose and low-dose regions are similar to the conventional IMRT level, and the clinical acceptance references in our hospital are determined to be 3 to 5% for the high-dose and the low-dose regions, respectively. Due to the characteristics of VMAT, evaluation of the intensity map was carried out using an ArcCheck device that was able to measure the intensity map in all directions, $360^{\circ}$. With a couple of dosimetric devices, the gamma index was evaluated and analyzed. The results were similar to the result of individual intensity maps in IMRT. Mapcheck, which is a 2-dimensional (2D) array device, was used to display the isodose distributions and gave very excellent local CL results. Thus, in our hospital, the acceptance references used in practical clinical application for the intensity maps of $360^{\circ}$ directions and the coronal isodose distributions were determined to be 93% and 95%, respectively. To reduce arbitrary uncertainties and system errors, we had to evaluate the local CLs by using a phantom and to cooperate with multiple organizations to participate in this evaluation. In addition, we had to evaluate the local CLs by dividing them into different sections about the patient treatment points in practical clinics.

A Study on Experiences of Total Knee Replacement in Patients with Osteoarthritis (골관절염 환자의 슬관절 전치환술 경험)

  • Park, Hyun-Ok;Park, Kyung-Sook
    • Journal of muscle and joint health
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    • v.3 no.2
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    • pp.135-150
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    • 1996
  • This study was performed to analyze the patient's experience during the progress of disease in the patients with osteoarthritis, who are taken the replacement surgery of knee Joint. The examine was consisted of five patients with osteoarthritis, who are taken the replacement surgery of knee joint from Dec. 4. 1995 to May, 20, 1996 at C university hospital. After hospitalization, the physical and psycho-logical status of the patients during preoperation, postoperation and discharge was examined. The data were examined according to the ethnographic method. The results are as follows. The patients experienced the periods of embarrasment, conflict, before surgery suffering, acceptance period after surgery. In the embarrasment period, the patients take a multiple medication therapy including hospital treatment, oriental medication and folk medication to ameliorate joint pain after first diagnosis on arthritis. The embarrasment period includes compulsive drug medication, oriental medication, folk medication, trouble some, sadness and survey of hospitals. In the conflict period, the patients consider the operation of knee because of working difficulty and severe Joint Pain, while they feel anxiety about the surgery. They condemn their physical situations. They have the conflict and anxiety on surgical operation. they consider the quality of life. They hope the surgery makes patients to improve walking ability. This period includes self-condemned, sorry, tiresomeness, expectation, worrisomeness, anxiety and hesitance. In the suffering period, the patients experience post operation physical discomfort after the total knee replacement. They do physical exercise, including extension and straight leg raising to maintain walking ability, while they endure to wait approximately 6 months for normal walking movements and they are also unstable to environmental people's sight. This period includes postoperative pain, continuous discomfort, inability and communication difficulty to other's people. In the acceptance period, the patients consider longerity of artificial Joint and also endure mild remaining joint pain. Some of them have religions for their wellbeing of life. This period include a self-protesting policy, abandonment, self-consolation, dependence on religions. According to the result from this study I suggested these shown below. 1) After replacement surgery of knee joint, continuous investigation on outcome patient is necessary. 2) It is also necessary to analyze on patient's experiences, who are taken the replacement surgery of hip Joint. 3) Study on disease experiences of patients with rhematoid arthritis, who take drug medication and physical therapy alone without surgery, is necessary. 4) Investigation on patient's favorable folk medication may be helpful to analyze disease experience of patients with osteoarthritis.

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A Case Study on the Family Therapy to Remarried Wife with Alcoholic Problem (알코올 중독문제를 가진 재혼한 부인에 대한 가족치료사례 연구)

  • Park, Tai-Young;Kim, Tae-Han;Kim, Hye-Sun
    • Korean Journal of Social Welfare
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    • v.61 no.1
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    • pp.293-322
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    • 2009
  • This study investigated the problems of remarried wife with alcoholic problem. Specifically, this study regarded the wife's alcoholic problem as the problems of dysfunctional interaction among family members rather than an individual problem. The study had three purposes as follows. First, what were the interactions sustaining the conflict of remarried family? Second, what were the characteristics of remarried family relating to family conflict? Third, what were the interventions of family therapy to resolve the conflicts of remarried family? The total family counseling was 9 sessions, which included individual, couple, and family counseling. The study used constant comparative analysis by using open coding method to find the factors relating interactions sustaining the conflict of remarried family, the characteristics of remarried family relating to family conflict, and the interventions of family therapy to resolve the conflicts of remarried family. Also, the study used Miles and Huberman's matrix and graphical network display to show the interaction of family members. The study found intriguing factors, counteracting factors, relationship level, and relational elements to wife's alcoholic problems among family members. The study revealed husband's rigid family rules, husband's execution of patriarchal authority, husband's pursuit of family identity, and husband's emphasis of union among family members as the characteristics of remarried family. On the other hand, the study found the reinforcement of spousal subsystem, the pursuit of change in communication pattern between husband and wife, the amelioration of rigid family rules, and the acceptance of differences among family members as the intervention of family therapy to resolve the conflicts of remarried family.

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A Musical Play Program for Promoting Interaction Between Immigrant and Korean Preschoolers (다문화통합어린이집 내 이주배경아동-한국가정아동 간 또래상호작용 증진을 위한 음악극 프로그램 개발)

  • Kim, ChanMi
    • Journal of Music and Human Behavior
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    • v.19 no.1
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    • pp.21-41
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    • 2022
  • The purpose of this research was to develop and verify applicability of a musical play program aimed at promoting interaction between immigrant preschoolers and Korean preschoolers. A daycare center serving the preschool-age children of Korean nationals and immigrant families were the site for this research. Utilizing the elements of a musical play (e.g., role playing, narration, and joint music activity), the program was developed for improving interaction among preschoolers, while promoting intercultural acceptance by providing the opportunity to be exposed to music from different cultures and engage in the joint activity using such music. For the purpose of investigate the applicability of the developed program, the program was implemented with two groups of preschoolers and each group received the musical play program for 30 minutes twice a week for a total of 6 sessions. The results of this preliminary study indicate that the musical play program promoted interaction between peers from different cultural background. Based on the results of this study, musical play programs may be helpful in promoting interactions between preschoolers from different cultural backgrounds and increase of acceptance of immigrant students in Korean daycares and schools.

Stereotactic radiotherapy of the prostate: fractionation and utilization in the United States

  • Weiner, Joseph P.;Schwartz, David;Shao, Meng;Osborn, Virginia;Choi, Kwang;Schreiber, David
    • Radiation Oncology Journal
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    • v.35 no.2
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    • pp.137-143
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    • 2017
  • Purpose: To analyze the utilization and fractionation of extreme hypofractionation via stereotactic body radiotherapy (SBRT) in the treatment of prostate cancer. Materials and Methods: Data was analyzed on men diagnosed with localized prostate cancer between 2004-2012 and treated with definitive-intent radiation therapy, as captured in the National Cancer Database. This database is a hospital-based registry that collects an estimated 70% of all diagnosed malignancies in the United States. Results: There were 299,186 patients identified, of which 4,962 (1.7%) were identified as receiving SBRT as primary treatment. Of those men, 2,082 had low risk disease (42.0%), 2,201 had intermediate risk disease (44.4%), and 679 had high risk disease (13.7%). The relative utilization of SBRT increased from 0.1% in 2004 to 4.0% in 2012. Initially SBRT was more commonly used in academic programs, though as time progressed there was a shift to favor an increased absolute number of men treated in the community setting. Delivery of five separate treatments was the most commonly utilized fractionation pattern, with 4,635 patients (91.3%) receiving this number of treatments. The most common dosing pattern was $725cGy{\times}5fractions$ (49.6%) followed by $700cGy{\times}5fractions$ (21.3%). Conclusions: Extreme hypofractionation via SBRT is slowly increasing acceptance. Currently $700-725cGy{\times}5fractions$ appears to be the most commonly employed scheme. As further long-term data regarding the safety and efficacy emerges, the relative utilization of this modality is expected to continue to increase.

Psychotherapy for Couples based one Short-Term Body and Mind Korean Medicine: A Case Report (단기 심신일여 부부치료를 통한 관계 개선 증례 보고)

  • Kim, Bung-Hak;Lim, Jung-Hwa;Kim, Bo-Kyung
    • Journal of Oriental Neuropsychiatry
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    • v.32 no.2
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    • pp.129-140
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    • 2021
  • Psychotherapy in Korean Medicine is characterized not only by management of mental issues, but also a holistic perspective of the mind and body, which includes physical treatment. In this case report, we describe the efficacy of Korean psychotherapy for couples with physical symptoms of heartache, emotional tension and marital relationships by addressing the challenges at the Mind and Body levels. For the physical treatment of the couple, the wife was treated with a Bunshimgi-Eum and the husband was administered a Cheonwangbosimdan, combined with a psychiatric interview based on Korean Medicine. It involves listening to the couple's story, YiJungBeongi therapy, understanding and learning about vases and defense mechanisms, self-understanding and understanding of the husband through self-understanding and expansion, and husband's understanding of the wife's position, self-interpretation and acceptance. Based on counseling, the couple's personal characteristics and expansion for self-growth, the progress and results of the couple's challenges and relationship improvement in a relatively short period of time are presented. In response, we hope that the evidence based on Korean Psychotherapy supporting the counseling for couples will continue to accumulate. We would like to report and share a few opinions.

Development and Usability Evaluation of Hand Rehabilitation Training System Using Multi-Channel EMG-Based Deep Learning Hand Posture Recognition (다채널 근전도 기반 딥러닝 동작 인식을 활용한 손 재활 훈련시스템 개발 및 사용성 평가)

  • Ahn, Sung Moo;Lee, Gun Hee;Kim, Se Jin;Bae, So Jeong;Lee, Hyun Ju;Oh, Do Chang;Tae, Ki Sik
    • Journal of Biomedical Engineering Research
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    • v.43 no.5
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    • pp.361-368
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    • 2022
  • The purpose of this study was to develop a hand rehabilitation training system for hemiplegic patients. We also tried to find out five hand postures (WF: Wrist Flexion, WE: Wrist Extension, BG: Ball Grip, HG: Hook Grip, RE: Rest) in real-time using multi-channel EMG-based deep learning. We performed a pre-processing method that converts to Spider Chart image data for the classification of hand movement from five test subjects (total 1,500 data sets) using Convolution Neural Networks (CNN) deep learning with an 8-channel armband. As a result of this study, the recognition accuracy was 92% for WF, 94% for WE, 76% for BG, 82% for HG, and 88% for RE. Also, ten physical therapists participated for the usability evaluation. The questionnaire consisted of 7 items of acceptance, interest, and satisfaction, and the mean and standard deviation were calculated by dividing each into a 5-point scale. As a result, high scores were obtained in immersion and interest in game (4.6±0.43), convenience of the device (4.9±0.30), and satisfaction after treatment (4.1±0.48). On the other hand, Conformity of intention for treatment (3.90±0.49) was relatively low. This is thought to be because the game play may be difficult depending on the degree of spasticity of the hemiplegic patient, and compensation may occur in patient with weakened target muscles. Therefore, it is necessary to develop a rehabilitation program suitable for the degree of disability of the patient.

Nurses' Attitudes Toward Complementary and Alternative Therapies (간호사의 보완대체요법에 대한 태도)

  • Son, Haeng-Mi
    • Korean Journal of Adult Nursing
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    • v.14 no.1
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    • pp.62-72
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    • 2002
  • Purpose: This study was performed to develop a scale for evaluation of attitudes toward complementary and alternative therapies (CAT) and to investigate nurses' attitudes toward CAT. Method: The subjects were 263 nurses working at a university hospital in Seoul and Inchon. The personally designed questionnaire was tested for its reliability and validity. Nurses' attitudes to CAT were evaluated using the questionnaire. Results: Cronbach's $\alpha$ coefficient was 0.7405. 23 items were selected by item analysis and 4 factors including application, therapeutic effect, social interest and communication about CAT were classified by factor analysis. The mean score of attitudes and its subcategories were high, especially that of communication was very high. Nurses had a positive response to CAT in several items; acceptance as nursing intervention, its therapeutic value, complement for conventional medicine, and open communication about CAT. Attitudes were different significantly according to education and number of working years. There were high relationships between attitudes and its subcategories except communication. Conclusion: The Scale of attitudes toward CAT was proven to be reliable and valid. Positive nurses' attitudes toward CAT will help the patients be provided with a proper and safe way to take CAT.

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The Process of Acceptance of Complementary and Alternative Therapies (CATs) among Nurses: Grounded Theory Approach (간호사의 보완대체요법 수용과정에 관한 연구: 근거이론 접근)

  • Kim, Ae-Kyung;Lee, Young-Shin;Kim, Hyun-Jung
    • Journal of Korean Academy of Nursing
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    • v.43 no.5
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    • pp.669-680
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    • 2013
  • Purpose: This study was done to explore the process of accepting CATs among nurses who experienced CATs in Korea. Methods: Grounded theory methodology was utilized. Data were collected from 10 nurses during individual in-depth interviews. Theoretical sampling was used until the data reached saturation. Data were analyzed using the constant comparative analysis method. Results: The core category emerged as "resolving the doubt and integrating" explaining the process of accepting CATs. The nurses engaged in three stages: need awareness, look for solution and integration. Causal conditions were interest as a nursing intervention and orthodox medical limitations. Context was lack of basis for application and increase in social interest. Strategies were new knowledge acquisition, having a strong will, combined with existing knowledge, and individualized intervention. Intervening conditions were others' eye, exhaustion for nurses and physical environment. Consequences were expanding of the nursing role and improved nurse satisfaction. Conclusion: The results of the study should facilitate application of CATs in nursing practice. To help nurses who are interested in CATs, there is a need for education programs, and further research on CATs.

Implementation of the CAI System Based on Gram-Stain Images for Medical Technologists Under Web

  • Lee Yong-Chul;Park Byung-Rae;Koo Bong-Oh;Shim Choon-Bo
    • Biomedical Science Letters
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    • v.10 no.4
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    • pp.495-499
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    • 2004
  • Because the education system that based on objective data is needed for the beginning technologists in the department of medicine laboratory, development of the CAI system based on Gram-Stain images is needed in clinical microbiology field. So, in this study, we implemented CAI system based on Gram-Stain images for medical technologists under Web using multimedia toolbook. Because this system is implemented under Web, more and more beginning technologists can have a remote-education beyond time and space, can save human power and time that needed due to hold in common of educational information, and cannot learn mistaken microbiology images because of learning execution based on objective data. Also, implemented system brings a higher interest and a learning effect to medical technologies because of hyper-media method that offered from toolbook. In the future, it will be needed a continuous acceptance of changing knowledge and it will be useful system for technologist in case of applying various examinations based Gram-Stain method of this study.

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