• 대한한방부인과학회지
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• 제30권3호
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• pp.92-116
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• 2017

Objectives: The purpose of this study were to researched a Korean medicine doctors' recognition about coldness of hands and feet, and developing of korean medicine clinical practice guidelines (CPG) for coldness of hands and feet. Methods: We conducted a questionnaire survey targeting 399 Korean medicine doctors belonging to the Association of Korean Medicine by e-mail and analyzed the answers. Results: 1. 86.86% of the respondents agreed about the necessity of CPG for coldness of hands and feet. 2. 84.2% of respondents wanted coding of Korean Standard Classification of Diseases (KCD) on coldness of hands and feet. 3. To diagnosis a coldness of hands and feet, the respondents used a Subjective symptoms (98.5%), Infrared thermographic imaging device (DITI) (26.32%) Heart rate variablity test (HRV) (17.04%), Thermometer (9.77%), Cold stress test (2.76%) 4. Causing of coldness of hands and feet, the respondents considered a constitution or heredity (84.71%), stress (73.66%), lack of exercise (64.91%), irregular eating habits (51.63%), Cold meals (32.83%), depression (31.33%), etc. 5. Treating coldness of hands and feet, the respondents used a herbal medicine (66.85%), acupuncture (70.7%) Pharmacopuncture (23.85%) and moxibustion (60.08%) for $10.91{\pm}8.03week$. Conclusions: We researched a Korean Medicine doctors' recognition of CPG, clinical diagnosis, treatment on a coldness of hands and feet, and policy they required.

• Journal of Korean Biological Nursing Science
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• 제20권4호
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• pp.252-260
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• 2018

Purpose: This study aimed to investigate the relationships between the level of knowledge, attitude and compliance of preventive behaviors of the Middle East respiratory syndrome (MERS) among nursing students. Methods: The study sample consisted of 219 nursing students. Through the use of a structured questionnaire, data collection was conducted from June 1st to June 30th 2015. The descriptive statistics, independent t-tests and Pearson's correlation coefficient were employed to analyze the data. Results: The score of the MERS-related knowledge was 9.15 out of 13. The participants had a positive attitude toward the MERS. The level of MERS-related knowledge was high in the case of temporary school closure or break in clinical practice because of the clinical training in hospitals that MERS occurred (t= 2.42, p= .016). The compliance level of the preventive behavior for MERS was high in female students (t= -2.11, p= .036), in the case of temporary school closure or break in clinical practice due to the clinical training in hospitals that MERS occurred (t = 3.29, p= .001), and in students that had MERS-related education for prevention (t = 2.80, p= .006). The MERS-related knowledge was positively correlated with the level of compliance for preventive behavior (r= .18, p= .009). Conclusion: To prevent MERS infection in nursing students, the level of knowledge on MERS should be enhanced so that they can practice preventive behaviors against it. Additionally, the MERS infection control education should include etiology and treatment products based on the MERS response guideline issued by the Centers for Korea Disease Control and Prevention.

• 대한한방소아과학회지
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• 제36권1호
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• pp.65-77
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• 2022

Objectives The purpose of this study was to understand the public's perception of Korean medical treatment for growth disorders to develop Korean medicine clinical practice guidelines and critical pathways for growth disorders in children and adolescents. Methods A survey was conducted using an online platform targeting 252 adults aged 19 years from May 16, 2021 to May 17, 2021. The questionnaire consisted of questions about the demographic characteristics of respondents; overall perception, experience, and satisfaction with Korean medical treatment for growth disorders; willingness to use or recommend Korean medical treatment for growth disorders; and points for improvement. Results The overall perception of treatment for growth disorders was 3.30 ± 0.892 on a 5-point scale. Concerning the negative reasons, 54.4% of the respondents were concerned about safety; regarding the positive reason, expectations for overall health as well as height growth were the highest at 46.5%. Additionally, there was a high demand for information, such as providing safety information on treatment, presenting evidence for the efficacy of treatment, and standardized clinical process, as points requiring improvement. Conclusions To raise public perception of Korean medical treatment for growth disorders, it is necessary to satisfy the opinions of the public identified through this survey. Therefore, the development and utilization of Korean medicine clinical practice guidelines and critical pathways for growth disorders would play an important role.

• 한국컴퓨터정보학회논문지
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• 제26권7호
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• pp.65-73
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• 2021

본 연구의 목적은 간호대학생의 임상실습 경험에 따른 임상수행능력, 환자안전관리지식 및 환자안전관리 수행자신감의 차이를 비교하기 위함이다. 간호대학생 3학년을 대상으로 임상실습을 경험한 73명, 임상실습을 경험하지 못한 35명으로 총 108명 분석하였다. 분석방법으로는 동질성 검정은 X²-test, 두 그룹간의 차이비교는 independent t-test로 분석하였다. 연구결과로 두 그룹간의 임상수행능력(t=.88, p=.377), 환자안전관리지식(t=-.29, p=.773) 및 환자안전관리 수행자신감(t=1.11 p=.267)의 차이는 통계적으로 유의하지 않았다. 두 그룹에서 각 변수의 하위영역별 가장 점수가 낮은 항목을 살펴보면, 첫째, 임상수행능력에서는 간호과정에 대한 영역에서 대체로 점수가 낮았고, 둘째, 환자안전관리 지식은 근접오류에 대한 개념에 대한 지식 측정 영역에서 가장 낮았으며, 셋째, 환자안전관리 수행자신감에서는 오류 발생 시 사건 보고서 작성에 대한 수행 자신감 영역에서 점수가 가장 낮은 것으로 확인되었다. 따라서 간호대학생의 임상수행능력의 질적 향상을 위해서 임상실습교육환경 개선이 절실하게 요구되며, 간호대학생의 환자안전관리 역량 증진 및 환자안전관리에 대한 올바른 태도 함양을 위해 전략적인 교육지침의 개발이 필요하다.

• 한국의료질향상학회지
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• 제20권1호
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• pp.42-57
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• 2014

Objective: The objective of this research was to develop a guideline for more effective use of physical restraint on patients in the intensive care unit and training the nurses on it and applying it on clinical practice to assess its effectiveness. Method: This research analyzed the before and after effect of the development of a guideline for physical restraint by dividing the category into nurse and patient. In the case of nurse, a comparison of knowledge and nursing service regarding the use of physical restraint from before the training on physical restraint guideline(Jan. 2011) and after the training on physical restraint guideline(Dec. 2011) was made. In the case of patient, a comparison of physical restraint usage rate and average usage time, the number of unplanned extubation cases were compared from before the use of physical restraint (Jan.~Apr. 2011) and after the use of physical restraint (Sep.~Dec. 2011) were made. Result: After the training on the physical restraint guideline, the knowledge of the nurse and the nursing practice showed notable improvement by (p<0.000) and (p<0.048) respectively and in patient, physical restraint usage rate and average time of usage decreased by (p<0.001) and (p<0.001) respectively. And despite the decrease in the number of cases in which the physical restraint was used, the number of unplanned extubation cases remained the same. Conclusion: Physical restraint guideline training and guideline usage can be stated to have brought out positive effect in both the nurse and patient. In order to maintain such positive effects, continuous training is necessary and continuous revaluation is necessary, regarding knowledge and nursing practices.

• 한국응용약물학회:학술대회논문집
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• 한국응용약물학회 1997년도 추계학술대회
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• pp.57-74
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• 1997

To make a proposal for the revision of KGCP, ICH Harmonized Tripartite Guideline for Good Clinical Practice, which is on the stage of worldwide implementation, was compared with current GCPs of tripartite countries of ICH, namely USA, Europe and Japan as well as Korea. On the basis of the classification in ICH GCP, comprehensive comparisons among the corresponding articles of 4 regions or countries were made in the order of IRB / IEC, Investigator, Sponsor and Clinical Trial Protocol. Based on the comparisons of the contents in ICH-GCP with those in current GCPs, major suggestions for the revision of current KGCP can be made as follows. Firstly, the function of IRB / IEC needs to be strengthened for the initiation and continuation of clinical trial. Current 2-step approval system of IRB / IEC and Health Authorities requires to be converted into the system similar to that of developed countries. Secondly, sponsor's obligation needs to be tightened to control and assure the quality of clinical trial. Inspection of regulatory authorities should be made to perform during and / or after clinical trial, when it is necessary. In other words, sponsor should be made to establish written Standard Operating Procedures (SOPs) for all aspects of clinical trial including monitoring to ensure that trials are conducted and data are generated, documented, and reported in compliance with the protocol, GCP, and the applicable regulatory requirement (s). Besides, the provision of ‘Quality Control and Quality Assurance’ should be added to the protocol to establish the credibility of the result of the clinical trial.

• Annals of Clinical Neurophysiology
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• 제9권2호
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• pp.59-62
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• 2007

Electroencephalogram (EEG) is an indispensable tool for diagnosis of epilepsy and is the only assisting barometer of complete remission of epilepsy, which means prolonged, persistent suppression of cortical excitement in epileptic focus in addition to the clinical control of epileptic seizure. The specific morphologies or distribution of epileptic form discharges give us good information for the classification of seizure or epilepsy and epileptic syndromes, which consists of "Pros." in terms of diagnostic approach. In contrast, the EEG as a tool for long-term follow up might be limited due to the various clinical situation of each patient, which consists of "Cons." in terms of the usefulness of EEG for clinical decision. "Cons." aspect of EEG, which clinicians are more frequently coped with than those of "Pros", is an obstacle of utilization of follow up EEG in clinical practice. This is an overview about controversies in usefulness of EEG and the detailed aspects of "Pros." and "Cons." of EEG for clinical decision will be discussed following two articles. We tried to make consensus for the usefulness of EEG especially in the situation of "Cons." with plausible guideline.

• 동의신경정신과학회지
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• 제34권1호
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• pp.1-12
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• 2023

Objectives: To standardize treatment, improve quality of medical service, and reduce medical costs of patients with depression by developing a clinical pathway (CP) of Korean medicine. Methods: CP was developed based on clinical practice guideline (CPG) for depression. To consider the degree of economic burden and satisfaction, the current status of management for patients with depression was examined. After CP was primarily developed, contents of the CP were supplemented by referring to previously developed CPs. Results: Based on CPG, current status survey and previous CP, four types of CP (Korean medicine clinics, Korean medicine hospitals, Western-Korean medicine collaborative hospitals, public medical center) were developed and shown in the algorithm version. However, in the case of Korean medicine hospitals and Western-Korean medicine collaborative hospitals, CPs were detailed according to different clinical scenes of outpatients and inpatients. This study also shows six different time task matrix version. Conclusions: CP for depression is expected to not only reduce financial burden of patients and health insurance, but also increase the quality of treatment and satisfaction.

• 기본간호학회지
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• 제19권1호
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• pp.87-97
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• 2012

Purpose: This study was done to evaluate nursing guidelines for patients with acute stroke, developed by adapting the guidelines of Registered Nurses Association of Ontario, Canada to clinical settings on a large scale and evaluating the effectiveness as a research study. Method: The general characteristics of the 319 patients and the effectiveness of guideline application were evaluated in terms of structure, process, and outcome using questionnaires on the guidelines application with reference to the medical records of patients with acute stroke hospitalized on a ward of the stroke center of S General Hospital in Seoul. Results: Structures as a guidance system for assessment were consistent with the recommendations. With respect to the process of the guidelines, for items on nursing assessment, improved performance was found to be statistically significant. For outcomes of the guidelines, complications occurred in 8 patients (5.3%) prior to application of the guidelines and 11 patients (6.5%) after application of the guidelines, but this result was not statistically significant (p=.841). Conclusion: The results of the study indicate that for the effectiveness of the guidelines, accessibility to the guidelines and effectiveness of quality improvement need to be evaluated, in addition to complications of a stroke.

• 한국임상약학회지
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• 제25권4호
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• pp.246-253
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• 2015

Background & Object: Ankylosing spondylitis (AS) is a chronic inflammatory disease that causes ankylosis and deformation of axial joints. Since current medicine cannot cure the disease yet, alleviating pain and preventing deformation with medications are the main therapy for patients with AS. The key medications for these purposes include nonsteroidal anti-inflammatory drugs (NSAIDs), and tumor necrosis $factor-{\alpha}$ ($TNF-{\alpha}$) inhibitors. This study aims to analyze prescribing patterns of AS patients in South Korea. Method: National Patients Sample data compiled by the Health Insurance Review and Assessment Service from 2013 was analyzed. Patients with AS were identified with Korean Standard Classification of Diseases code-6, which was M45. The rates of prescription, discontinuation, and switching ingredients were calculated for each medication during 2013. Results: Total number of patients was 655, and most of them were male (n = 514, 78.5%). Of all age groups, the proportion of 30-40 year old patients was the greatest (35.1%). The most utilized drug class was NSAIDs (82.4%). Less than half of patients were prescribed $TNF-{\alpha}$ inhibitors (n = 212, 32.4%). Meloxicam, aceclofenac, and celecoxib were the most frequently prescribed NSAIDs. In case of $TNF-{\alpha}$ inhibitors, adalimumab, etanercept and infliximab were the top three most prescribed drugs. Although not recommended by the current practice guideline, significant proportions of patients were identified using disease modifying anti-rheumatic drugs (DMARDs). Conclusion: Considering the current practice guideline and previous studies about the efficacy, the use of DMARDs should be reduced and medical insurance term in South Korea should be re-examined.