Objectives: This study was carried out to develop a standard tool of pattern identifications for insomnia in Korean Medicine. Methods: The advisory committee for this study was organized by 17 Korean Medicine neuropsychiatry professors who were faculty members of different Korean Medicine colleges. The pattern identifications and symptoms for this tool were extracted from published Korean and Chinese literature. The Instrument on Pattern Identifications for Insomnia was developed following discussions among internal experts and after consultations with members of the advisory committee. Results: 1) Five pattern identifications were set for the tool. 2) The mean weights which represent the importance of each symptom and scored on a hundred-point scale were obtained. 3) The Instrument on Pattern Identifications for insomnia was designed in the self-reporting format composed of 47 questions. Conclusions: An Instrument on Pattern Identifications for Insomnia was created in this study. However, owing to any clinical trials has not been set yet. Therefore its validity and reliability were not confirmed. To make up for this limitation, the further clinical study would be performed in the near future.
Background: Breast cancer is the most common cancer diagnosed among women in Sri Lanka. Early detection can lead to reduction in morbidity and mortality. The objective here was to identify perceptions of public health midwives (PHMs) on the importance of early detection of breast cancer and deficiencies of and suggestions on improving existing breast cancer early detection services provided through Well Woman Clinics. Materials and Methods: A qualitative study using four focus group discussions (FGDs) were conducted among 38 PHMs in the Gampaha district in Sri Lanka and the meetings were audio-recorded, transcribed and analyzed using constant comparison and identifying themes and categories. Results: All the PHMs had a firm realization on the need of breast cancer early detection. The four FGDs among PHMs revealed non-availability of guidelines, inadequacy of training, lack of skills and material to provide health education, inability to provide privacy during clinical examination, shortage of stationery, lack of community awareness and motivation. The suggestions for the improvements of the programme identified in FGDs were capacity building of PHMs, making availability of guidelines, rescheduling clinics, improving the supervision, strengthening the monitoring, improving coordination between clinical and preventive sectors, and improving community awareness. Conclusions: Results of the FGDs can provide useful information on components to be improved in breast cancer early detection services. Study recommendations were training programmes at basic and post basic levels on a regular basis and supervision for the sustainance of the breast cancer early detection program.
Medical humanities education (MHE) is as essential as basic medical sciences and clinical medicine education. Despite the importance of MHE, MHE curriculum development (CD) has proven to be challenging. This critical review examines the MHE CD at one medical school. The critical review methodology was developed based on Kern's six step CD model to systematically examine the CD of "Doctoring and Medical Humanities (DMH)" at the Yonsei University College of Medicine. Five review questions were developed related to (1) necessity, (2) direction and purpose, (3) design, (4) operation, and (5) evaluation of CD based on Kern's model. The review showed that the process of DMH CD mapped to components of Kern's model. The DMH curriculum content selected was closely related to medical practice and aimed to combine the acquisition of understanding and skills by designing a student-participatory curriculum based on clinical cases. Assessment methods that emphasized students' reflections were actively introduced in the evaluation section. Since the regular committee for DMH continued the work of the special ad hoc committees for DMH CD, the CD was effectively completed. However, the planning and evaluation functions and responsibilities of the DMH committee need to be strengthened. Despite the apparent limitations, the fact that students showed a high satisfaction rate and preferred small group discussions based on clinical cases has significant implications in the instructional design of MHE, where changes in self-awareness and attitude are more important than the acquisition of information. It is necessary to systematically review and study students' reflection results produced by the changed assessment methods and to develop assessment indicators for MHE that reflect the achievements of the MHE competencies of students.
To develop cardiovascular simulator capable of implementing pulse waves similar to the human body, accurate information about reflection wave is required. However, the conclusion is still not clear and various discussions are underway. In this study, the pulse wave velocity of the tube used in the experiment was first determined by measuring the pressure waves at two points in a single tube system with the experimental device to implement the pulse wave transmission of blood vessels, and the superposition time and characteristics of the reflection wave were confirmed. After that, an air chamber was set at the reflection site, and the effect of the change of air volume on the reflection wave was investigated. Finally, the effect of the number of branches connected to a single tube on the reflection wave was investigated. The superposition time of the reflection wave can be controlled by the air volume of the air chamber, and the magnitude of the reflection wave is influenced by the number of reflection sites that generate the reflection wave. The results of this study may be of practical assistance to simulator researchers who want to implement pulse wave similar to clinical data. It is expected that the more results similar to clinical are provided, the greater the scope of the simulator's contribution to clinical cardiovascular research.
Pratomo, Hadi;Amelia, Tiara;Nurlin, Fatmawati;Adisasmita, Asri C.
Clinical and Experimental Pediatrics
/
v.63
no.11
/
pp.433-437
/
2020
Background: Indonesia is one of the countries with the highest preterm birth rate. Preterm infants are more likely than term and normal weight infants to experience neonatal mortality and morbidity due to acute respiratory, gastrointestinal, immunologic, central nervous system, hearing, and vision problems. Kangaroo mother care (KMC) is a proven cost-effective intervention to help reduce mortality rates among preterm infants; however, it has not been fully implemented in hospitals. Purpose: Assess KMC knowledge and perceptions among health providers. Methods: This qualitative study was conducted from December 2015 to April 2016 and consisted of 21 in-depth interviews and 3 focus group discussions (FGDs). The 3 categories of health personnel in the study were clinical providers, hospital management representatives, and Indonesian Midwife Association members. Results: Most health providers know about the benefits of KMC including stabilizing temperatures, weight gain, and maternal-infant bonding and reducing human resources and labor costs. They were also aware of which newborns were eligible for KMC treatment. Their knowledge was mostly gained from observation or obtained from pediatricians and personal experience. They believed that a low birth weight infant in an incubator could not be treated with KMC and that it could only be practiced if a special gown was used when holding the baby. This perception could be caused by a lack of formal KMC training, leading to misunderstanding of its aspects. Conclusion: In conclusion, KMC knowledge of clinical providers in the 2 hospitals was sufficient, primarily due to their health-related educational background. Some perceptions could be potential barriers to or facilitate the implementation of KMC practice. These perceptions should be considered in future KMC training designs.
Journal of the Korea Academia-Industrial cooperation Society
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v.21
no.2
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pp.74-84
/
2020
This study was conducted to discover the meaning and the essential structure of the experiences of nursing students' introductory clinical practice. The participants were eight nursing students who had carried out the introductory clinical practice at a hospital. The data was collected from July 15 2019 to July 31, 2019 through focus group discussions and in-depth individual interviews using non-structured questionnaires. The data was analyzed by Colaizzi's phenomenological analysis methodology. The introductory clinical practice experienced by nursing students was categorized as followed: 'Feel worried and concern about expectations at the same time', 'Hospital experience as reality', 'Becoming accustomed to complexed emotion's, 'The first step of becoming a nurse', and 'Preparation for the future'. The five categories were expanded in the same context according to time. The essential structure of the clinical introductory practice experiences of the nursing students revealed by the study is that they begin to practice feeling worried and concerned about expectations, and concern about experience and adaption to various situations, emotions and preparation for the future. Based on the results obtained from this study, it is necessary to develop a realistic and effective education program before starting clinical practice.
Purpose: This report aims to administer methodologic issues around recently conducted multicenter study for evaluating the effects of acupuncture on menopusal hot flashes and discuss practical issues for further implementation of acupuncture clinical trial for hot flashes. Methods: Study process were mentioned, and issues related to avoiding risk of bias, designing appropriate control group, optimal outcome measurement, potential different effects of menopausal status on study outcomes, and suggestions for developing future clinical trials are discussed. Results: Shortcomings of our multicenter study include lack of allocation concealment and assessor blinding, subjective outcome measurement, short-term follow-up, and fixed acupuncture regimen despite pragmatic purpose of this study. Improving trial design, using objective or validated outcomes, assessing long-term effects of acupuncture, and individualizing acupuncture regimen are needed in future clinical trials. Conclusion: We expect these practical discussions to enable researchers to plan and develop future well-designed clinical trials for evaluating the effects of acupuncture on hot flashes or other women's health issues.
The effects of mentoring education bring positive effects such as mentees' capacity building, knowledge improvement and positive attitude. The major difficulties that nursing college students experience in clinical practice are low adaptability, lack of confidence, etc. Therefore, this study developed mentoring education program to improve the problem-solving ability, learning attitude, and confidence in nursing skill before clinical practice for nursing college students and evaluated their effectiveness. In order to develop the program, a group of experts consisting of professors and clinical nurses selected 11 topics after discussing nursing skills and knowledge, which were most required in clinical practice. The program involved 14 mentors who operated practice, counseling, video clips, and contextual discussions for two days to a group of 9 to 10 people. Nursing college students who received the mentoring education program showed a significant increase in learning attitude and confidence in performance of nursing skills, but there was no statistically significant difference in problem-solving ability. This study is meaningful in that it has improved the educational effect by using mentoring methods, away from formal in-school practice education. In the future, it will be necessary to evaluate whether the mentoring education program affect the problem-solving ability of nursing students by applying it before, during, and after clinical practice rather than in a short period.
Purpose: The purpose of this study was to identify students' experiences of performance and their satisfaction with clinical nursing practice in Women's health nursing. Methods: Data was collected using questionnaire consisting of 104; 89,; and 82 nursing activities with 12; 10; and 7 domains for delivery floor, obstetric, and gynecologic wards retrospectively. Five hundred ninety nursing students from 10 four year and one three year colleges, were recruited and selected for data collection. Results: Site specific core nursing activities among top 15 items of performed experience were: interpreting fetal monitoring; massage for pain reduction; breathing technique; perineal pad change; non stress test; manual check for uterine contraction; and position change for the delivery floor. Experiences of clinical nursing practice for the obstetric ward and the gynecologic ward were identified and ranked as well. Observation of delivery, measurement & test during labor and observation of anesthesia and operation were the highest ranked activity domains of satisfaction for delivery floor, obstetric and gynecologic wards retrospectively. Conclusion: Discussions are needed to standardize curriculum for clinical practice in women's health nursing initiated at the level of Korean Society of Womens' Health Nursing by reflecting this result. Strategic approaches are emphasized in order to enhance a collaboration between clinical fields and colleges.
This was a descriptive study aiming to verify the effects of work environment, job satisfaction, and organizational commitment on the turnover intention of Clinical Research Coordinator(CRC) nurses. In the results of this study, the organizational commitment had significant effects on the turnover intention of CRC nurses. On the other hand, the work environment and job satisfaction had no statistically significant effects on the turnover intention of CRC nurses. Based on the results of this study, the main discussions were drawn as follows. In order to increase the organizational commitment, it would be necessary to have the institutional improvement like the increase of opportunity to participate in the hospital operation, administration, and the establishment of affiliated institution for improving a sense of belonging. It would be also necessary for each hospital to establish the standard of welfare, wage system for the improvement of work environment. If the organizational commitment of CRC nurses who are the actual performers, supporters of researches is ignored, it is unavoidable that the performance and quality of clinical tests would be declined. Therefore, there should be some changes, so that CRC nurses could play a pivotal role in the whole process of clinical test, by changing the employment status from contract position to more stable employment status, to increase their commitment to organization and work continuity.
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