• 기본간호학회지
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• 제17권2호
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• pp.274-281
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• 2010

Purpose: The purpose of this study was to identify the correlation between level of professional autonomy and clinical decision making abilities in clinical nurses, and to provide basic information for promoting competency nurses in making independent decisions. Method: Data were collected from July 1 to July 18, 2008, and participants were 202 clinical nurses in general hospitals. Collected data were analyzed using descriptive statistics: frequency and percentage and Pearson correlation coefficients with the SPSS WIN 14.0 program. Results: The professional autonomy index for the nurses was 159.63 points. The clinical decision making ability index was 119.79 points. The most highly ranked factor in clinical decision making was search for information and unbiased assimilation of new information. There was a statistically significant difference in professional autonomy according to age, clinical experience, and type of duty. Relation between level of professional autonomy and clinical decision making showed a positive correlation. Conclusion: As a results show a significant correlation between professional autonomy and clinical decision making in clinical nurses, improvement in professional autonomy of clinical nurses, would be promoted through continuous support and training.

• 대한간호학회지
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• 제40권6호
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• pp.892-902
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• 2010

Purpose: This study was done to identify participation by home healthcare nurses in clinical decision making and factors influencing clinical decision making. Methods: A descriptive survey was used to collect data from 68 home healthcare nurses in 22 hospital-based home healthcare services in Korea. To investigate participation, the researcher developed 3 scenarios through interviews with 5 home healthcare nurses. A self-report questionnaire composed of tools for characteristics, factors of clinical decision making, and participation was used. Results: Participation was relatively high, but significantly lower in the design phase (F=3.51, p=.032). Competency in clinical decision making (r=.45, p<.001), perception of the decision maker role (r=.47, p<.001), and perception of the utility of clinical practice guidelines (r=.25, p=.043) were significantly correlated with participation. Competency in clinical decision making (Odds ratio [OR]=41.79, p=.007) and perception of the decision maker role (OR=15.09, p=.007) were significant factors predicting participation in clinical decision making by home healthcare nurses. Conclusion: In order to encourage participation in clinical decision making, education programs should be provided to home healthcare nurses. Official clinical practice guidelines should be used to support home healthcare nurses’ participation in clinical decision making in cases where they can identify and solve the patient health problems.

• 기본간호학회지
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• 제16권3호
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• pp.307-315
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• 2009

Purpose: This study was done to investigate the relationship of self efficacy, self-directedness and practice satisfaction to clinical practice for nursing students. Method: The participants were 122 nursing students in clinical practice. They responded to questionnaires that included measures of self efficacy, self-directedness and clinical practice satisfaction. Results: The average self efficacy score was 3.70, self-directedness, 3.66 and clinical practice satisfaction, 3.44. Self efficacy showed a significant difference according to gender with men having higher scores (t=-2.82, p= .005). Clinical practice satisfaction showed a significant difference according to motivation for nursing (F=3.86, p= .011), and location of clinical practice (F=3.73, p= .006). Self efficacy had a significant positive correlation to self-directedness (r= .755, p< .001) and clinical practice satisfaction (r= .379, p< .001). Self-directedness had a significant correlation with clinical practice satisfaction (r= .412, p< .001). Conclusion: After clinical practice, self efficacy, self-directedness and clinical practice satisfaction in nursing students were relative higher. Self efficacy, self-directedness were affected by clinical practice satisfaction.

• 한국직업건강간호학회지
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• 제22권4호
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• pp.285-294
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• 2013

Purpose: This study aimed to explore professional autonomy, nursing work environment, and clinical decision making ability and to determine predictors of clinical decision making ability among clinical nurses. Methods: A cross-sectional design was used in this study and 263 clinical nurses were selected from advanced-level hospitals with over 500 beds located in D metropolitan city. Independent t-test, ANOVA, Pearson's correlation coefficients and hierarchical multiple regression analyses were done with the SPSS/WIN 20.0 program. Results: Clinical nurses reported moderate levels of professional autonomy, nursing work environment and clinical decision making ability. Marital status, professional autonomy and nursing work environment accounted for 25% of variance in clinical decision making ability required in various clinical settings. Importantly, being married, higher level of professional autonomy, and greater satisfaction with work environment were significantly associated with better decision making ability. Conclusion: Findings indicate that improving the quality of decision making in the healthcare settings requires awareness of the multiple effects of individual, occupational and environmental features. Nurses' ability to make effective clinical decisions may rely on personal characteristics, the degree of autonomy in their job, and nurses' satisfaction with their work environment.

• 사상체질의학회지
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• 제20권3호
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• pp.118-132
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• 2008

1. Introduction This study aims to survey knowledge and attitude of Sasang constitution investigators on the Sasang constitution clinical study. 2. Methods We have made up list of 24 Sasang constitution investigators who have conducted Sasang constitution clinical study before. The study has been surveyed for 20 investigators who has been experiencing clinical study bye-mail or interview. 3. Results 1) The recognition degree on clinical study for sasang constitutional investigators was relatively lower than that for non-oriental investigators. 2) Most investigators have difficulty in designing a Protocol and they thought Protocol is most important in clinical study. 3) The investigators has stressed the need of diagnosis guideline on Sasang Constitution in performing clinical study. 4. Conclusions Special course of clinical study for sasang constitutional investigators should be prepared to activate Sasang constitution clinical study. This course may set up the guideline of sasang constitution clinical study and designing protocol. Also it is urgent to develop constitution diagnosis guideline for clinical study.

• 대한수의학회지
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• 제61권4호
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• pp.34.1-34.4
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• 2021

An 11-year-old obese dog was referred for a liver mass. Cytologic examination revealed vacuolated hepatocytes with mild pleomorphism. A partial liver lobectomy was performed. On histopathologic examination, the mass was diagnosed as hepatocellular carcinoma composed of hepatocytes with clear vacuoles. These findings were consistent with clear cell hepatocellular carcinoma (CCHCC). The CCHCC is a rare subtype of hepatocellular carcinoma in dogs, and clinical features are poorly defined. This is the first report on the cytological, histological and clinical aspects of CCHCC, suggesting that obesity and hyperlipidemia are potential risk factors for CCHCC in dogs.

• 한국인터넷방송통신학회논문지
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• 제16권5호
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• pp.205-212
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• 2016

최근 의학기술의 발전과 더불어 서양의학 뿐만 아니라 한의학 분야에서도 임상 데이터에 대한 통합 및 표준화에 관한 연구가 활발히 진행 중에 있다. 유사한 임상시험 뿐만 아니라 전혀 다른 임상시험의 데이터도 하나의 표준에 맞춰 통합 구축된다면 통합된 의료데이터는 암묵적 한의의료지식 도출연구에 활용될 수 있다. 따라서 본 논문에서는 한의임상 정보를 효율적으로 저장하기 위하여 국제표준으로 널리 사용되는 CDISC 표준안을 기반으로 한의임상 데이터베이스를 구축하였고, 임상현장에서 편리한 데이터 입력을 위해 E-CRF를 구축하였다. 아울러, 실제 4개의 임상연구에 대한 데이터 저장과정을 거쳐 한의임상 데이터 통합에 대한 예를 보였다. 우리의 연구 결과는 통합된 데이터로부터 암묵적 의료지식도출을 위한 기반을 마련하였고, 데이터 통합을 통한 효율적 관리뿐만 아니라 반복적이거나 불필요한 임상시험 방지, 정제 된 데이터의 재배포를 통하여 연구의 편리성과 협업을 촉진할 수 있다.

• 보건행정학회지
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• 제20권2호
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• pp.1-16
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• 2010

Background : Clinical practice guidelines are an increasingly familiar part of clinical practice. Moreover, rigorously developed evidence based guidelines has been widely used. However, in Korea, some of published documents as clinical practice guidelines have shown considerable disparity in structure, contents and quality. This is mainly because there is no consensus on the definition and quality standard of clinical practice guidelines. The purpose of this study was to draw consensus on the definition and the quality standard about clinical practice guidelines. Method : We developed a questionnaire about the definition of clinical practice guidelines with inclusion criteria(23 items) and the quality standard(30 items). We selected 9 experts who had prior experience in developing and implementing guidelines. Rating methods for appropriateness of items were adopted from the RAND method. Consensus was drawn in three rounds. Results : Of the 47 items agreed, 40 items were determined to be appropriate. Clinical practice guidelines were defined as "scientifically and systematically developed statements to assist practitioners and patients on making decisions about appropriate health care for specific clinical circumstances." Narrative reviews, systematic reviews or health technology assessment without recommendations, translation of foreign guidelines, guidelines for patients only and training manuals were not considered as clinical practice guidelines. For the quality standard of clinical practice guidelines, 27 items were deemed necessary. Conclusions : The consensus on the definition with inclusion criteria and the quality standard of clinical practice guidelines carries an important meaning as the first attempt to draw a general agreement in our society. The unique achievement of the consensus reflects the current status of clinical practice guidelines that there has been a high tendency to adapt foreign guidelines. We hope efforts of this kind will continue to bring improvement in clinical practice guidelines.

• 한국치위생학회지
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• 제10권5호
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• pp.887-895
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• 2010

Objectives : In this study, 233 dental hygiene students in Seoul and Gyeonggi areas were surveyed in order to provide the basic data for more effective clinical practice by investigating the stress they experience during the clinical practice and how they cope with stress; Methods : 5 areas in stress factors as environmental factor, interpersonal factor, role and activity, ideal and value, and the amount of BEPSI and 4 areas in their coping methods as problem-oriented, social support, emotion-oriented, and wishful thinking were measured by Liker 5-point scale. Results : 1. The satisfaction level of subjects on their major was the highest as 'generally satisfied (50.6%),' and their satisfaction level of clinical practice was also the highest as 'generally satisfied (32.6%).' 2. The clinical practice stress was 2.76 points on average, and their stress factors were ideal and value (3.18), environmental factor (2.98), role and activity (2,70), the amount of BEPSI (2.55), and interpersonal factor (2.37). And the way how they cope with stress were 3.29 points on average, wishful thinking (3.71), social support (3.36), problem-oriented (3.13), and emotion-oriented (2.95). 3. The clinical practice stress according to clinical training institutions showed significant differences: university dental hospitals and general hospitals (2.83), dental clinics (2.65), and dental hospitals (2.63). 4. The clinical practice stress showed a negative correlation between the satisfaction level of major and the satisfaction level of clinical practice (p<0.01), and the more satisfaction they had in their major and clinical practice, the less stress during the clinical practice. 5. In the correlation between each subordinate factor of the stress in clinical practice and how to cope with it, interpersonal factor and emotion-oriented factor, the amount of BEPSI and wishful thinking showed a positive correlation (p<0.05). Conclusions : In this study, it is necessary to develop clinical practice program that is to increase satisfaction and provide motivation in order to reduce the stress during clinical training.

• 대한영양사협회학술지
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• 제21권1호
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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.