• 제목/요약/키워드: clinical discussions

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The Effects of Medication and Symptom Management Education Program Based on Self Efficacy Theory for the Psychiatric Patients

  • Shon, Kyung-Hee
    • 대한간호학회지
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    • 제33권8호
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    • pp.1145-1152
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    • 2003
  • Propose. An effective rehabilitation program had been developed for psychiatric patients' self management of medication and symptoms in Korea. The rehabilitation program was designed to allow the patients to understand their illness, cope with their medical regimen, and prevent a relapse by recognizing any of the symptoms when they recur. Methods. The developed program utilizes the self efficacy method reported by Bandura, it includes manuals and videotapes focusing on real life situations, small group discussions, and telephone coaching. This study investigated the effects of this program with respect to various predictable variables in psychiatric rehabilitation. Thirty eight patients were selected for this study, 18 in the experimental program and 20 as controls. Results. The results showed that the subjects who attended this educational program reported significantly more improvement in attitude toward medication compliance (p=0.033), and significantly less relapse warning symptom scores (p=0.000) than the controls. Conclusion. This program may be a useful psychoeducational resource for professionals in the field of clinical practice in psychiatry.

Bilateral Atrioventricular Valve Dysplasia in a Middle Aged Turkish Angora Cat: A Case Report

  • Ju, Jae-Beom;Kim, Keon;Park, Hee-Myung;Lee, Chang-Min
    • 한국임상수의학회지
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    • 제36권6호
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    • pp.336-339
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    • 2019
  • A castrated, 6-year-old, male Turkish Angora cat with a history of respiratory distress was referred to the hospital. Physical examination revealed a cardiac murmur, and thoracic radiographic findings revealed pleural effusion and cardiomegaly. Echocardiography showed abnormality of the tricuspid and mitral valve, and color-flow Doppler imaging revealed regurgitation between both atrium and ventricle. Based on the echocardiographic examination, tricuspid valve dysplasia concurrent with mitral valve dysplasia was diagnosed. However, the patient died a week after treatment. In necropsy, bilateral atrioventricular valve dysplasia and left ventricular hypertrophy were confirmed. This is the first report to describe a middle age Turkish angora cat having bilateral atrioventricular valve dysplasia which has high mortality and only been reported rarely in cats. This case report also describes its clinical signs, diagnostic imaging findings, treatment and discussions how the patient could live long.

비대면 음성언어치료의 현황과 전망 (Current Status and Perspectives of Telepractice in Voice and Speech Therapy)

  • 이승진
    • 대한후두음성언어의학회지
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    • 제33권3호
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    • pp.130-141
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    • 2022
  • Voice and speech therapy can be performed in various ways depending on the situation, although it is generally performed in a face-to-face manner. Telepractice refers to the provision of specialized voice and speech therapy by speech-language pathologists for assessment, therapy, and counseling by applying telecommunication technology from a remote location. Recently, due to the pandemic situation and the active use of non-face-to-face platforms, interest in telepractice of voice and speech therapy has increased. Moreover, a growing body of literature has been advocating its clinical usefulness and non-inferiority to traditional face-to-face intervention. In this review, the existing discussions, guidelines, and preliminary studies on non-face-toface voice and speech therapy were summarized, and recommendations on the tools for telepractice were provided.

WHO 침구임상 지침서 개정을 위한 국제회의 보고 (Reports on 'Meeting on the Revision of Guidelines for Clinical Research on Acupuncture')

  • 박히준;서정철;김세현;김상우;안경애;임사비나;김용석;최도영;강성길
    • Journal of Acupuncture Research
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    • 제22권5호
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    • pp.195-199
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    • 2005
  • The Working Group on the revision of Clinical Research Methodology for Acupuncture met in Seoul, Republic of Korea from 24 to 26 August 2005. The main objectives of the meeting were to review the regional publication guidelines for Clinical Research on Acupuncture, to make necessary revisions in the guidelines, to make recommendations on further collaboration and activities in the field of research on acupuncture, and to discuss scientific evidence-based approaches in the clinical research on acupuncture. Fourteen members from the eight Member States, one secretariat staff from the WHO Regional Office for the Western Pacific and ten observers from the Republic of Korea attended the meeting. The members presented their papers to review the current status of clinical research on acupuncture. The drafts of proposed revision to the previous guidelines for clinical research methodology on acupuncture were discussed extensively. The issues covered during the discussion included: the definition of the new terms; reorganization of clinical research design; revision and update of contents (e.g., control group); introduction of Institutional Review Board (IRB) on the section of ethical approval; additional outcomes including health-related quality of life (HRQOL), qualitative measures, etc. In the course of these discussions, the working group developed the revised guidelines for clinical research on acupuncture and made recommendations for promoting the dissemination of the revised guidelines.

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뇌신경계 중환자실 전담 약사의 활동에 따른 약물 조정 효과 및 회피비용 분석 (Effects of Medication Reconciliation and Cost Avoidance Analysis by Clinical Pharmacists in a Neurocritical Care Unit)

  • 조의상;송영주;정영미;최경숙;이은숙;김은경;한문구
    • 대한신경집중치료학회지
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    • 제11권2호
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    • pp.110-118
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    • 2018
  • Background: The role of clinical pharmacists in medication therapy to improve clinical and economic outcomes has been reported in the literature. This study was conducted to analyze the changes in details of medication interventions before and after the introduction of clinical pharmacists into the care of neurocritical care unit (NCU) patients, and to evaluate the economic effects of clinical pharmacists by calculating the avoidance cost. Methods: A retrospective study was conducted reviewing the electronic medical records from June 2013 to May 2014 (before), and from June 2016 to May 2017 (after). We calculated the number and rates of intervention, the acceptance rates of it, and also reviewed the list of interventions. We calculated avoidance cost if there was no intervention. Results: The monthly mean number of interventions increased from 8.0 (${\pm}5.7$) to 31.7 (${\pm}12.8$) (P<0.001) and the frequency of intervention also increased from 0.8% to 1.6% (P=0.003). The most frequently provided pharmacist intervention was nutritional support before introduction of clinical pharmacists and discussions on the medication plan after. The number of classified interventions was 14 before introduction of clinical pharmacist services and 33 after. The calculated cost avoidance associated with a clinical pharmacists' integration was 77,990,615 won per year. Conclusion: Introduction of clinicals pharmacist into the NCU was associated with increased intervention rates and expanded types of clinical interventions. The cost avoidance achieved by the pharmacists' interventions can be further explored to evaluate if similar expansions of pharmacists' services achieve similar results in other settings.

'임상간호연구' 학술지 게재논문(1995-2008년)의 연구동향 분석 (Research Trend of Studies Published in Journal of Korean Clinical Nursing Research, 1995-2008)

  • 최명애;정재심;임경춘;김주현;김금순;권정순;김성재;김경희;곽찬영;박광옥;이경은;김을순;이경숙
    • 임상간호연구
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    • 제16권2호
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    • pp.95-105
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    • 2010
  • Purpose: The purpose of this study was to identify the research trend of 341 studies published in Journal of Korean Clinical Nursing Research from 1995 to 2008. Methods: This study was conducted from May to November, 2009. The tool for analysis developed through literature reviews and discussions of researchers consisted of 7 categories such as characteristics of researchers, research designs, subjects, data collection methods, ethical consideration, nursing interventions, and dependent variables. Data were analyzed by frequency and percentage. Results: The mean number of author per study was 4.7, and clinical nurses were the most frequent as the first author (79.7%) and as a corresponding author (67.1%). Quantitative study was 97.6% and nonexperimental study was 51.7%. The most frequently used research designs were quasi-experimental study (73.9%) among experimental studies and survey study (79.1%) among nonexperimental studies. Patients were the most frequent subjects for studies (55.8%). 46.1% of studies gathered data with questionnaire, 57.7% of studies had consent from patients, and 44.3% of studies used nursing skills for nursing interventions, and 60.0% of studies used clinical end points for dependent variables. Conclusion: The research trend of clinical nursing studies shows that clinical nurses mostly perform quasi-experimental researches to solve patients' problem and frequently use nursing skills for nursing intervention and explore the effect of nursing interventions on clinical end points.

첨단 디지털 헬스케어 의료기기를 진료에 도입할 때 평가원칙 (Principles for evaluating the clinical implementation of novel digital healthcare devices)

  • 박성호;도경현;최준일;심정석;양달모;어홍;우현식;이정민;정승은;오주형
    • 대한의사협회지
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    • 제61권12호
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    • pp.765-775
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    • 2018
  • With growing interest in novel digital healthcare devices, such as artificial intelligence (AI) software for medical diagnosis and prediction, and their potential impacts on healthcare, discussions have taken place regarding the regulatory approval, coverage, and clinical implementation of these devices. Despite their potential, 'digital exceptionalism' (i.e., skipping the rigorous clinical validation of such digital tools) is creating significant concerns for patients and healthcare stakeholders. This white paper presents the positions of the Korean Society of Radiology, a leader in medical imaging and digital medicine, on the clinical validation, regulatory approval, coverage decisions, and clinical implementation of novel digital healthcare devices, especially AI software for medical diagnosis and prediction, and explains the scientific principles underlying those positions. Mere regulatory approval by the Food and Drug Administration of Korea, the United States, or other countries should be distinguished from coverage decisions and widespread clinical implementation, as regulatory approval only indicates that a digital tool is allowed for use in patients, not that the device is beneficial or recommended for patient care. Coverage or widespread clinical adoption of AI software tools should require a thorough clinical validation of safety, high accuracy proven by robust external validation, documented benefits for patient outcomes, and cost-effectiveness. The Korean Society of Radiology puts patients first when considering novel digital healthcare tools, and as an impartial professional organization that follows scientific principles and evidence, strives to provide correct information to the public, make reasonable policy suggestions, and build collaborative partnerships with industry and government for the good of our patients.

한의 외래환자분류체계 개선 및 평가 (Revision and Evaluation of Korean Outpatient Groups-Korean Medicine)

  • 류지선;임병묵;이병욱;김창훈;한창호
    • 대한한의학회지
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    • 제35권3호
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    • pp.93-102
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    • 2014
  • Objectives: This study aimed at revising the Korean Out-patient Groups for Korean Medicine (KOPG-OM, version 1.0) based on clinical similarity and resource use, by using the accumulated claims data, and evaluating the validity of the revised classification system. Methods: A clinical specialist panel involving 19 specialists from 8 Korean medicine (KM) specialty areas reviewed the classification tree, diagnosis groups and procedure groups in terms of clinical similarity. Several models of outpatient grouping were formulated, with the validity of each tested based on the $R^2$ coefficient of determination for the treatment costs of all visits. To add age splits, the variances of treatment costs by age groups were also analyzed. These statistical analyses were performed using KM claims data of National Health Insurance from 2010 to 2012. Results: The classification tree designed via panel discussions was used to allocate outpatient cases to 26 diagnosis groups, with cases involving procedures such as acupuncture, moxibustion and cupping, then allocated to 9 procedure groups in each diagnosis group. The cases without procedures were categorized into the visit index - medication group. This process resulted in 298 outpatient groups. The $R^2$ values for treatment costs of all visits ranged from 0.38 to 0.69 depending on the providers' types. Conclusions: The revised model of KOPG-KM has a higher validity for outpatient classification than the current system and can provide better management of the costs of outpatient care in KM.

불면증 변증도구 개발을 위한 기초 연구 (Preliminary Study to Develop the Instrument on Pattern Identifications for Insomnia)

  • 이헌수;김환;윤용기;이수진;전주현;김보경;이은정;정인철
    • 동의신경정신과학회지
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    • 제27권4호
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    • pp.223-234
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    • 2016
  • 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.

Qualitative Assessment of Breast Cancer Early Detection Services Provided through Well Woman Clinics in the District of Gampaha in Sri Lanka

  • Vithana, Palatiyana Vithanage Sajeewanie Chiranthika;Hemachandra, Nilmini Nilangani;Ariyaratne, Yasantha;Jayawardana, Pushpa Lalani
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권12호
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    • pp.7639-7644
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    • 2013
  • 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.