• 한국임상약학회지
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• 제26권3호
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• pp.213-219
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• 2016

Objective: Although guideline recommends beta blockers (BBs) as first line antianginal agent and calcium channel blockers (CCBs) as alternatives after percutaneous coronary intervention (PCI), the prescription patterns in real practice are not in accordance with the guideline. We aimed to investigate the prescribing patterns of primary antianginal drug and relating factors in patients who underwent PCI. Methods: Patients who have undergone PCI without myocardial infarction (MI) from November 2012 to June 2014 and followed up at least one year in a tertiary teaching hospital were included. Prescribing patterns of primary antianginal drug before, at the time of, and one year after PCI were described. Factors affecting drug selection, and their relationship with incidence of clinical outcomes defined as MI and repeated PCI, unscheduled admission or visit related with heart problem were analyzed with multivariate logistic regression. Results: A total of 506 patients were included and as primary antianginal drugs, BB, CCB, and both were prescribed in 32.2%, 24.5%, and 17.8% of patients, respectively. Also, neither BB nor CCB was prescribed at the time of PCI in 25.5% of patients. Compared with BB, CCBs were more likely prescribed in patients who had hypertension (Odds Ratio, OR 2.18, 95% confidence interval, CI 1.16-4.07), use of same class before PCI (OR 7.18, 3.37-15.2) and concomitant angiotensin receptor blocker (ARB) use (OR, 1.92, 95% CI 1.10-3.33). Incidence of clinical outcomes were not significantly greater in patients who prescribed CCB compared with BB at the time of PCI (aOR 1.32, CI 0.65-2.68). Conclusion: This study demonstrated that half of the patients who underwent PCI were prescribed BB. CCB were favored in patients with hypertension, use of same class before PCI, and concomitant ARB use. Significant difference in clinical outcome was not observed between BB and CCB selection as primary antianginal drug.

• 농촌의학ㆍ지역보건
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• 제31권1호
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• pp.35-46
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• 2006

명동의, 실습기록에 관한 취급과 지도실태를 파악, 검토하여 앞으로 환자실습 시에 도움이 되는 자료를 얻고자 한국과 일본의 전국간호교육기관의 성인간호학, 아동간호학 및 정신간호학을 담당하는 교수를 대상으로 우편조사를 실시한 결과, 30.9%(한국), 45.2%(일본)의 응답율을 보였다. 조사내용은 일반적 특성 4문항, 학생실습에 관한 환자 설명동의 내용으로 구성된 29문항, 교수의 실습기록에 대한 지도와 관리에 관한 15문항 및 병동의 간호기록에 대한 학생의 기록에 대한 3문항으로 총 54문항으로 구성하였다. 분석방법으로 일반적 실태는 백분율을 보았으며, 영역별로는 ${\chi}^2-test$ 및 프리드만 검정을 하였으며, 개방식질문(자유기술)에 대해서는 응답자의 내용을 카드화하고 KJ법에 기초하여 관심내용을 추출하였다. 조사결과는 다음과 같다. 간호대학생의 임상실습 시에 "환자를 정해서 실습한다"고 응답한 비율은 50.0%(한국), 99.0%(일본)였으며, 주로 "수간호사"가 환자에게 설명하였는데, 분야별로는 성인, 아동, 정신간호학의 순으로 통계적으로도 유의한 차이를 보였다. 환자의 승인을 얻는 방법으로는 "구두승인"이 대부분이었으며, 실제로 동의서를 받는 경우는 두나라 모두 없는 것으로 조사되었다. 환자배정 시 설명에서는 한국과 일본 모두 "학생이 실습으로 맡게 된다" 49.0%, 100.0%로 가장 높았고, 반대로 가장 낮은 비율은 "실습기록을 보이면서 설명한다" 7.8%(한국), "환자는 실습기록을 볼 수 있다" 0.7%(일본)로 거의 비슷한 상황이었다. 환자실습 시 설명동의에 관한 교수의견에서 일본은 "환자에 대한 설명방법의 현상", "설명동의에 관한 사고와 설명동의의 바람직한 모습", "설명동의서를 받는 것과 관련된 불안과 딜렘마", "설명동의의 도입과 교육적 기대", "설명동의에 필요한 환경", 및 "과제"의 6개로 분류되었다. 한국에서는 "환자에 대한 설명방법의 현상", "설명동의서를 받는 것과 관련된 어려움" 및 "과제"의 3개로 분류되었다. 간호대학생이 실습 시 간호기록지에 기록은 "기재한다"가 한국이 46.1%로 일본의 17.7%보다 2.6배 높게 나타났다. 환자 개인정보가 기재되고 있는 학생의 실습기록의 취급에 관한 것으로 병원 밖으로 "가지고 나간다"가 한 일 각각 50.0%, 89.7%로 유의한 차이가 있었다. 실습기록의 지도에서는 두 나라 모두 "비밀을 지킬 것을 지도하고 있다"는 것이 가장 높아 한국과 일본이 각각 92.2%, 98.3%이었으며, 가장 낮은 항목은 한국이 "실습기록에 워드프로세스를 사용하지 않도록 지도한다" 17.6% 인 반면 일본은 "실습기록에 워드프로세스를 허용하는 경우, 규칙을 정하고 있다" 6.3%로 나타났다. 학생이 병동의 간호기록지에 기재하는 것에 대한 교수의 의견을 개방식으로 질문한 결과를 범주화하여 분류한 결과, "학생이 간호기록에 기재하지 않는 것이 좋다", "과제이다", "기재하고 있다. 기재할 수 있다", "기재하는 것은 의미가 있다", "상황에 따라 판단한다", "현재는 판단하기 어렵다"의 6개 범주로 구분할 수 있었다. 결론적으로 간호대학생의 임상실습 시 환자의 설명동의는 절대적으로 필요하며 실습기록의 관리지도도 교육과 학습의 목적뿐만 아니라 환자의 개인정보의 보호라는 맥락에서 고려되어야 할 것이다. 임상현장에서는 교육적 관점에서만 해결할 수 없는 문제도 있으므로 실습기관과의 대화를 통한 실습기록과 교육의 개선을 시도할 필요가 있음을 제언한다.

• Journal of Audiology & Otology
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• 제24권1호
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• pp.40-47
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• 2020

Because the psychophysical symptoms of hearing loss and dementia in the elderly are very similar, untrained healthcare professionals in dementia facilities can easily overlook a severity of hearing loss in their patients. The present study identifies their knowledge, attitudes, and practices (KAP) on hearing loss using a survey whether they may help hearing problem of the patients with dementia. A total of 29 health-care professionals responded to the KAP survey. Also, 2 family members participated. The results showed that most of the nurses and caregivers in elderly medical welfare facilities who worked with dementia patients did not have knowledge of their hearing loss. Even the facility managers did not know how to conduct hearing tests for their patients although they did recognize that some of their patients had a hearing loss. Eventually, actual practice was not possible at this moment by the professionals. However, our respondents did have a positive attitude toward screening for hearing loss and help their patients with dementia wear hearing aids if a clinical guideline was provided. We suggest to develop clear and precise clinical guidelines of the hearing screening test for the dementia patients due to the interrelationship between dementia and hearing loss. When these guidelines apply to elderly residents in a medical welfare facility, early diagnosis and treatment of their sensory loss will help alleviate their dementia as well.

• 대한청각학회지
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• 제24권1호
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• pp.40-47
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• 2020

Because the psychophysical symptoms of hearing loss and dementia in the elderly are very similar, untrained healthcare professionals in dementia facilities can easily overlook a severity of hearing loss in their patients. The present study identifies their knowledge, attitudes, and practices (KAP) on hearing loss using a survey whether they may help hearing problem of the patients with dementia. A total of 29 health-care professionals responded to the KAP survey. Also, 2 family members participated. The results showed that most of the nurses and caregivers in elderly medical welfare facilities who worked with dementia patients did not have knowledge of their hearing loss. Even the facility managers did not know how to conduct hearing tests for their patients although they did recognize that some of their patients had a hearing loss. Eventually, actual practice was not possible at this moment by the professionals. However, our respondents did have a positive attitude toward screening for hearing loss and help their patients with dementia wear hearing aids if a clinical guideline was provided. We suggest to develop clear and precise clinical guidelines of the hearing screening test for the dementia patients due to the interrelationship between dementia and hearing loss. When these guidelines apply to elderly residents in a medical welfare facility, early diagnosis and treatment of their sensory loss will help alleviate their dementia as well.

• Korean Journal of Radiology
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• 제24권8호
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• pp.719-728
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• 2023

Radiofrequency ablation (RFA) has been widely used to manage hepatocellular carcinomas (HCCs) equal to or smaller than 3 cm. No-touch RFA has gained attention and has recently been implemented in local ablation therapy for HCCs, despite its technical complexity, as it provides improved local tumor control compared to conventional tumor-puncturing RFA. This article presents the practice guidelines for performing no-touch RFA for HCCs, which have been endorsed by the Korean Society of Image-Guided Tumor Ablation (KSITA). The guidelines are primarily designed to assist interventional oncologists and address the limitations of conventional tumor-puncturing RFA with describing the fundamental principles, various energy delivery methods, and clinical outcomes of no-touch RFA. The clinical outcomes include technical feasibility, local tumor progression rates, survival outcomes, and potential complications.

• 대한불안의학회지
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• 제3권2호
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• pp.77-90
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• 2007

In this special article, we presented the organization of the work group, basic principles of the algorithm, future plan and methods for developing a treatment algorithm for panic disorder in Korea. The psychiatrist work group from the Korean Association of Anxiety Disorders began to develop a treatment algorithm designed to improve the management of Korean patients with panic disorder by incorporating better evaluation techniques and treatment procedures. We have reviewed the treatment guidelines and algorithms for panic disorder published thus far, including the Practice Guideline for the Treatment of Patients with Panic Disorder established by the American Psychiatric Association, the Management of Anxiety (Panic Disorder, with or without Agoraphobia, and Generalized Anxiety Disorder) in Adults in Primary, Secondary and Community Care established by the National Institute for Clinical Excellence, and the Clinical Practice Guidelines established by the Canadian Psychiatric Association. We developed the basic materials to be used in the treatment algorithm for the management of panic disorder in Korea. Therefore, in this special article, we intro-duce the goal of the algorithm and the details of the algorithm development.

• 대한한방부인과학회지
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• 제36권3호
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• pp.114-128
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• 2023

Objectives: This study was conducted to reflect Korean Medicine doctors (KMD)' perception of lifestyle management in the process of developing a Korean Medicine (KM) Clinical Practice Guidelines (CPG) of female infertility. Methods: We sent four e-mails containing links to online questionnaires to 25,286 KMD belonging to the Association of Korean Medicine. The questionnaire consisted of sexual intercourse, weight, diet, exercise, drinking, smoking, caffeine intake, stress etc. KMD responded to self-administered questionnaires, and we analyzed 786 responds. Results: KMD put stress first among the infertile women's lifestyle management items, weight and sexual intercourse were next. Also KMD put stress first among the spouses' lifestyle management items, drinking and sexual intercourse were next. In relation to sexual intercourse, 'Recognizing the Fertile Window' was the most important. In relation to stress in the emotional domain, 'Depression' and 'Anxiety' were the most important, and in relation to stress in the relationship domain, 'Deteriorating of marital relationship' was the most important. Conclusions: We surveyed the status of KMD' awareness of infertility lifestyle management for patient education, and reflected it in the modification of the CPG for female infertility.

• Korean Journal of Acupuncture
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• 제35권3호
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• pp.130-138
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• 2018

Objectives : The purpose of this study is to explore patients' perceptions that deserve attention when designing core questions for a clinical practice guideline of Korean medicine(KM) for degenerative lumbar spinal stenosis (LSS). Methods : Patients who had been admitted to Pusan National Korean Medicine Hospital from November 1, 2015 to October 31, 2016 were invited to the survey. Patients were eligible if they were both clinically and radiologically confirmed as degenerative LSS. The structured questionnaire was distributed by mail and outpatient visits. Questions included types of experienced Korean/Western medical interventions for LSS, their perceived effectiveness on symptoms, the necessity for studies of KM for degenerative LSS, the types of KM interventions to be investigated and the types of outcome measures after treatments. Data were descriptively analysed. Results : Twenty of thirty-one invited participants responded to the questionnaire. Acupuncture and herbal medicine were the most frequently used KM interventions. Eighteen respondents reported that KM treatments were helpful for their improvement. Sixteen patients who mentioned that research on KM is needed chose acupuncture as the top priority(88%) among KM interventions. The most important outcomes in the view of nineteen respondents included functional recovery (68%) and pain relief (53%). Thirteen respondents (65%) replied that both short-term and long-term outcome were important for them. Conclusions : Our findings may have limited validity due to the small number of respondents and the potential selection and information bias. Further qualitative studies and large-scale surveys to comprehensively identify patients' views are warranted.

• 대한한방소아과학회지
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• 제35권1호
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• pp.122-138
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• 2021

Objectives The purpose of this study is to widely utilize the clinical practice guideline for autism spectrum disorder (ASD) by investigating parents who have children with ASD about their perception in ASD and their thoughts on Korean medicine treatment to treat ASD. Methods We conducted a survey on 'perception of ASD' and 'perception and preference of Korean medicine treatment for ASD' on the parents of 22 children with ASD (age 4-6) who visited department of pediatrics of Korean medicine at Kyunghee University Korean medicine hospital at Gangdong and Kyunghee University Korean medicine hospital. Results Of the parents, 20 (90.91%) said their children had no experience with Korean medicine treatment. Among them, 11 (35.48%) chose 'I didn't know that Korean medicine treats ASD' for the reason (multiple choice). When questioned what the worries are for Korean medicine treatment, 13 (30.95%) chose 'worries about probability of side effects of herbal medicine' as the most worrisome reason (multiple choice). On the question about the necessity of Korean medicine for the treatment of ASD, most chose 'Korean medicine treatments are necessary for children with ASD' (9, 40.91%). Conclusions It is necessary to develop a clinical practice guideline that reflects comprehensive evidence for side effects as well as the effectiveness of Korean medicine for ASD, and is necessary to promote the effectiveness and evidence-based Korean medicine treatment to patients and their caregivers through various distribution tools.

• 대한골대사학회지
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• 제25권4호
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• pp.195-211
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• 2018

Background: To develop guidelines and recommendations to prevent and treat glucocorticoid (GC)-induced osteoporosis (GIOP) in Korea. Methods: The Korean Society for Bone and Mineral Research and the Korean College of Rheumatology have developed this guideline based on Guidance for the Development of Clinical Practice Guidelines ver. 1.0 established by the National Evidence-Based Healthcare Collaborating Agency. This guideline was developed by adapting previously published guidelines, and a systematic review and quality assessment were performed. Results: This guideline applies to adults aged ${\geq}19years$ who are using or plan to use GCs. It does not include children and adolescents. An initial assessment of fracture risk should be performed within 6 months of initial GC use. Fracture risk should be estimated using the fracture-risk assessment tool (FRAX) after adjustments for GC dose, history of osteoporotic fractures, and bone mineral density (BMD) results. All patients administered with prednisolone or an equivalent medication at a dose ${\geq}2.5mg/day$ for ${\geq}3months$ are recommended to use adequate calcium and vitamin D during treatment. Patients showing a moderate-to-high fracture risk should be treated with additional medication for osteoporosis. All patients continuing GC therapy should undergo annual BMD testing, vertebral X-ray, and fracture risk assessment using FRAX. When treatment failure is suspected, switching to another drug should be considered. Conclusions: This guideline is intended to guide clinicians in the prevention and treatment of GIOP.