• 제목/요약/키워드: clinical practice pattern

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다주파수 생체임피던스 저항을 이용한 당뇨병 환자의 허증 변증 예측 (Prediction of Deficiency Pattern in Diabetic Patients Using Multi-frequency Bioimpedance Resistance)

  • 김가혜;김슬기;차지윤;유호룡;김재욱
    • 동의생리병리학회지
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    • 제36권3호
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    • pp.94-99
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    • 2022
  • The discovery of biomarkers related to pattern identification (PI), the core diagnostic theory of Korean medicine (KM), is one of the methods that can provide objective and reliable evidence by applying PI to clinical practice. In this study, 40 diabetic patients and 41 healthy control subjects recruited from the Korean medicine clinic were examined to determine the human electrical response related to the deficiency pattern, a representative pattern of diabetes. Qi-Blood-Yin-Yang deficiency pattern scores, which are representative deficiency patterns for diabetes mellitus, were obtained through a questionnaire with verified reliability and validity, and the human electrical response was measured non-invasively using a bioimpedance meter. In ANCOVA analysis using gender as a covariate, the 5 kHz frequency resistance and 5-250 kHz frequency reactance were significantly lower in the diabetic group than in non-diabetic control group. In addition, the multiple regression analysis showed a positive correlation (R2=0.11~0.19) between the Yang deficiency pattern score and resistance value for the diabetic group; the correlation was higher at higher frequencies of 50kHz (R2=0.18) and 250kHz (R2=0.19) compared to 5kHz(R2=0.11). In contrast, there was no such significant association in the control group. It implies that bioimpedance resistance measured at finite frequencies may be useful in predicting Yang deficiency, which is closely related to diabetic complications by reflecting the decrease in body water content and metabolism. In the future, large-scale planned clinical studies will be needed to identify biomarkers associated with different types of PI in diabetes.

애주(艾炷)의 형태별(形態別) 연소(燃燒) 특성(特性)에 대한 연구(?究) - 연소온도(燃燒溫度)의 유형(類型)을 중심(中心)으로 - (An Experimental Study on the Characteristics of Moxa Combustion in the Moxa Cone size - On the Pattern of Combustion temperature -)

  • 박영배;강성길;김창환;고형균;오환섭;허웅
    • 대한한의학회지
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    • 제16권1호통권29호
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    • pp.370-378
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    • 1995
  • In order to consider the clinical efficacy of moxa combustion, understand the quality and quantity of heat stimulation and get the basic data for the development of electric moxibustion apparatus, the pattern of combustion temperature was measured by size of moxa(small, medium, large and maximum size). The results were as follows. 1. The pattern of combustion temperature by moxa burning was classified into input period, consisting of preheating and heating periods, and output period, consisting of heat retaining and cooling periods, in all experimental groups. But it was difficult to observe the preheating period in small sized moxa. 2. It was inclined that the more moxa size was large, the more the heating and heat retaining periods were long and the maximum temperature was high. The characteristics of moxa combustion is primarily by the rate of combustion temperature, gradient temperature and duration of combustion, and their correlation among these factors and their clinical effects in practice.

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한국간호대학생의 임상실습 스트레스와 스트레스 대처 (Relationships between Nursing Practice Stress and Stress Coping of Nursing Students in Korea)

  • 김지현
    • 디지털융복합연구
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    • 제12권2호
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    • pp.409-415
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    • 2014
  • 본 연구는 일 지역 간호대학생의 임상실습 스트레스와 그에 대한 스트레스 대처의 관련성을 알아보기 위한 것이다. 한국의 C 도시에 위치한 2개 대학의 간호학생을 대상으로 하였으며, 자료수집은 연구참여에 동의한 사람 160명을 대상으로 2012년 3월부터 9월까지 구조화된 설문지를 이용하여 수행하였다. 수집된 자료는 SPSS 18.0을 이용하여 분석하였고, 서술통계, 피어슨 상관분석 등을 이용하였다. 연구결과 임상실습 스트레스 점수는 평균 $2.72{\pm}6.2$였으며, 스트레스 대처점수는 $2.60{\pm}0.37$ 이었다. 스트레스 대처양상 중 희망적 사고는 오리엔테이션(r=0.32, p<0.01), 집담회의(r=0.52, p<0.01), 과제하기(r=0.29, p<0.01)시의 스트레스가 발현시에 관련성이 높았고, 임상실습 시험시의 스트레스는 문제집중대처양상과 관련성이 높았다(r=0.31, p<0.05). 간호사 대하기(r=0.31, p<0.01), 또는 기타 보건전문인과 대인관계하기(r=0.35, p<0.01)시의 스트레스는 긍정적 관점으로 대처하기 양상과 관련성이 높았다. 학생들은 긍정적이고 활동적인 대처양상을 보여주었으며, 이는 임상현장에서 경험하는 스트레스를 효과적으로 다룰 수 있는 충분한 능력을 향상시키는데 좋은 경험이 될 것이다.

호흡기능장애와 관련된 간호진단의 타당도 조사 (Validity of Nursing Diagnoses Related to Difficulty in Respiratory Function)

  • 김조자;이원희;유지수;허혜경;김창희;홍성경
    • 대한간호학회지
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    • 제23권4호
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    • pp.569-584
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    • 1993
  • This study was done to verify validity of nursing diagnoses related to difficulty in respiratory function. First, content validity was examined by an expert group considering the etiology and the signs / symptoms of three nursing diagnoses - ineffective airway clearance, ineffective breathing pattern, impaired gas exchange. Second, clinical validity was examined by comparing the frequencies of the etiologies and signs / symptoms of the three nursing diagnoses in clinical case studies with the results of the content validity. This study was a descriptive study. The sample consisted of 23 experts (professors, head nurses and clinical instructors) who had had a variety of experiences using nursing diagnoses in clinical practice, and 102 case reports done by senior student nurses of the college of nursing of Y-university. These reports were part of their clinical practice in the ICU. The instrument used for this study was a checklist for etiologies and signs and symptoms based on the literature, Doenges and Moorhouse (1988), Kim, McFarland, McLane (1991), Lee Won Hee et al. (1987), Kim Cho Ja et at. (1988). The data was collected over four month period from May 1992 to Aug. 1992. Data were analyzed using frequencies done with the SPSS / PC+ package. The results of this study are summarized as follows : 1. General Characteristics of the Expert Group A bachelor degree was held by 43.5% and a master or doctoral degree by 56.5% of the expert group. The average age of the expert group was 35.3 years. Their average clinical experience was 9.3 years and their average experience in clinical practice was 5.9 years. The general characteristics of the patients showed that there were more women than men, that the age range was from 1 to over 80. Most of their medical diagnoses were diagnoses related to the respiratory. system, circulation or neurologic system, and 50% or more of them had a ventilator with intubation or a tracheostomy. The number of cases for each nursing diagnoses was : · Ineffective airway clearance, 92 cases. · Ineffective breathing pattern, 18 cases. · Impaired gas exchange, 22 cases. 2. The opinion of the expert group as to the classification of the etiology, and signs and symptoms of the three nursing diagnoses was as follows : · In 31.8% of the cases the classification of etiology was clear. · In 22.7%, the classification of signs and symptoms was clear. · In 17.4%, the classification of nursing interventions was clear. 3. In the expert group 80% or mere agreed to ‘dysp-nea’as a common sign and symptom of the three nursing diagnoses. The distinguishing signs and symptoms of (Ineffective airway clearance) were ‘sputum’, ‘cough’, ‘abnormal respiratory sounds : rales’. The distinguishing sings and symptoms of (Ineffective breathing pattern) were ‘tachypnea’, ‘use of accessory muscle of respiration’, ‘orthopnea’ and for (Impaired gas exchange) it was ‘abnormal arterial blood gas’, 4. The distribution of etiology, and signs and symptoms of the three nursing diagnoses was as follows : · There was a high frequency of ‘increased secretion from the bronchus and trachea’ in both the expert group and the case reports as the etiology of ineffective airway clearance. · For the etiologies for ineffective breathing pat-tern, ‘rain’, ‘anxiety’, ‘fear’, ‘obstructions of the tract, ca and bronchus’ had a high ratio in the ex-pert group and ‘decreased expansion of lung’ in the case reports. · For the etiologies for impaired gas exchanges, ‘altered oxygen -carrying capacity of the blood’ and ‘excess accumulation of interstitial fluid in lung’ had a high ratio in the expert group and ‘altered oxygen supply’ in the case reports. · For signs and symptoms for ineffective airway clearance, ‘dyspnea’, ‘altered amount and character of sputum’ were included by 100% of the expert group. ‘Abnormal respiratory. sound(rate, rhonchi)’ were included by a high ratio of the expert group. · For the signs and symptoms for ineffective breathing pattern. ‘dyspnea’, ‘shortness of breath’ were included by 100% of the expert group. In the case reports, ‘dyspnea’ and ‘tachypnea’ were reported as signs and symptoms. · For the sign and symptoms for impaired gas exchange, ‘hypoxia’ and ‘cyanosis’ had a high ratio in the expert group. In the case report, ‘hypercapnia’, ‘hypoxia’ and ‘inability to remove secretions’ were reported as signs and symptoms. In summary, the similarity of the etiologies and signs and symptoms of the three nursing diagnoses related to difficulty in respiratory function makes it difficult to distinguish among them But the clinical validity of three nursing diagnoses was established through this study, and at last one sign and symp-tom was defined for each diagnosis.

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소아 식욕부진의 병인, 변증, 치료에 대한 고찰 -중의학 논문을 중심으로- (A Review of Etiology, Pattern Identification, Treatment of Traditional Chinese Medicine for Childhood Anorexia)

  • 서혜선;김혜연;박슬기;이선행;이진용;장규태
    • 대한한방소아과학회지
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    • 제36권1호
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    • pp.1-37
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    • 2022
  • Objectives This study aimed to provide a basis for applying Korean medical treatment for childhood anorexia in clinical practice by examining Korean medical etiology, pattern differentiation, and treatment, and focusing on research articles on Chinese medicine. Methods Articles on Chinese medicine related to childhood anorexia published before November 4, 2021, in the China National Knowledge Infrastructure (CNKI), were analyzed. The etiology, pattern differentiation, and Chinese medical treatment were summarized. Results Of a total of 73 studies, 13 were randomized controlled trials (RCT), 32 were case studies, and 28 were review papers. The most common Chinese medical etiology of childhood anorexia was emotional instability, and the western medical etiology was problems with diet and lifestyle. The most frequently reported pattern differentiations were spleen-stomach-qi deficiency (脾胃氣虛), stomach-yin deficiency (胃陰不足), and spleen failing in transportation syndrome (脾失健運). The most frequent prescriptions were modified Yangwijeungaektang (养胃增液湯加減), Samryongbakchulsan (蔘苓白术散加减), and Ekongsan (異功散加減). As frequntly used tuina acupoints, Naepalgwae (内八卦), Joksamli (足三里), and Bigyeong (脾經) were mentioned. Conclusions This study analyzed the etiology, pattern differentiation, and Korean medical treatment of anorexia in children. Based on this study, standardization and well-designed clinical studies on Korean medical treatments for childhood anorexia can be expected in the future.

Herbal Medicine for Pediatric Epilepsy: Clinical Research Trends in Traditional Chinese Medicine

  • Kim, Sang-Ho;Kim, Da-Woon
    • 동의신경정신과학회지
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    • 제33권2호
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    • pp.181-214
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    • 2022
  • Pediatric epilepsy, a chronic, recurrent brain disorder, is the most common neurological disorder in children. Its prevalence is increasing. Early management is very important since 30~40% of cases persist into adulthood. To provide basic data for future clinical research on pediatric epilepsy using Korean medicine treatment and cooperation between Western medicine doctors and Korean medicine doctors, we reviewed recent clinical research in traditional Chinese medicine (TCM) using herbal medicine for pediatric epilepsy. A total of 23 articles (1 clinical practice guideline, 3 systematic reviews, 15 randomized controlled trials (RCTs), and 4 non-RCTs) were reviewed in this study. The authors summarized characteristics of included studies regarding study subjects, diagnostic tools, pattern identification tools, treatment period, evaluation tools, detail of herbal medicines, treatment effects, and adverse events. Combination therapy using both herbal medicine (HM) and anti-epileptic drugs (AEDs) was performed more frequently than herbal medicine alone. Liver-pacifying medicinal, water-draining medicine, and orifice-opening medicine were frequently used. The main single HMs were Cheonma, Boglyeong, Jogudeung, and Seogchangpo. Combined therapy using HM and AEDs had significant benefits in improving total effective rate. It also appeared to be safer than AEDs. However, since the quality of clinical trials was poor and only studies in the last 10 years were included, the clinical evidence was uncertain. Finally, the authors provided limitations of this study and several suggestions for future research based on our analysis results.

자율신경실조증 한의표준임상진료지침 개발을 위한 한의임상 실태조사 (A Survey on Korean Medicine Treatment of Autonomic Dysfunction: Preliminary Research for Clinical Practice Guidelines)

  • 박희영;송금주;이현우;박찬;윤석인;박정환;정선용;김종우
    • 동의신경정신과학회지
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    • 제34권4호
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    • pp.335-347
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    • 2023
  • Objectives: The study aimed to understand the current treatment patterns in Korean medicine to develop clinical practice guidelines for autonomic dysfunction in Korean medicine. Methods: This study sent an online survey vai text message to 25,900 Korean medicine doctors whose contact information was registered with the Association of Korean Medicine. A total of 1,410 Korean medical doctors completed the online survey. Results: When autonomic treating dysfunction clinically, 77% of the cases included only a description without entering a diagnosis code. The most commonly used information to diagnose o autonomic dysfunction was history-taking and symptoms (79%), and the main symptoms of autonomic dysfunction were palpitations, dizziness, sleeping difficulties, anxiety/nervousness, and depression/lethargy. The most frequently mentioned cause of autonomic dysfunction was mental problems (54%). The most commonly used Korean medicine treatment method for autonomic dysfunction was herbal medicine (70%), and Soyo-san/Gamisoyo-san is the most frequently used herbal medicine preparation. Liver qi depression used to indicate the most often mentioned Korean medicine pattern identification used to indicate autonomic dysfunction (31%). When asked whether cardiac neurosis in Chinese medicine can be considered autonomic dysfunction, opinions for and against it are determined almost equally. Conclusions: Our results serve are a foundation for developing clinical practice guidelines for autonomic dysfunction in Korean medicine and are expected to catalyst promoting future clinical research on autonomic dysfunction.

임상실습기간 중 간호대학생의 수면 영향요인: Spielman의 수면장애모델을 근간으로 (Factors Influencing Sleep Patterns during Clinical Practice Weeks among Nursing Students : Based on Spielman's Model)

  • 김미예;최희정
    • Journal of Korean Biological Nursing Science
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    • 제18권4호
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    • pp.203-212
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    • 2016
  • Purpose: The purpose of this study was to identify the sleep patterns of nursing students using self-report questionnaire and physiologic measurement, to examine the factors influencing sleep patterns in based on Spielman's model. Methods: Participants were 119 nursing students who were in the clinical practice period. Self-report questionnaires and actigraphy were used to collect the data. Data were analyzed using descriptive statistics, correlation and regression by the SPSS/WIN 21.0 programs. Results: When sleep was measured by self-report questionnaire, 84 students (70.6%) showed poor sleep quality. The mean sleep efficiency was 82.6%, and 67 students(56.3%) showed low sleep efficiency (less than 85.0%). The factors affecting subjective sleep pattern measured by KMLSEQ were circadian sleep type (${\beta}=.28$, ${\rho}=.003$) and alcohol (${\beta}=.20$, ${\rho}=.031$). The factors affecting total sleep time were sedentary behavior (${\beta}=-.27$, ${\rho}=.003$) and daytime sleepiness (${\beta}=-.33$, ${\rho}$<.001). Conclusion: Many nursing students in their clinical practice period expressed sleep disturbance. Factors affecting the perceived sleep measured by the self-report questionnaire and objective sleep evaluated by physiologic measures were different. The evening type of students perceived poor sleep quality, however, sedentary life style and daytime sleepiness resulted in short sleep time. Therefore, more studies measuring the objective sleep characteristics are needed using subjective and objective characteristics.

2021 한국 갑상선영상 판독과 자료체계의 임상적용 (Clinical Application of the 2021 Korean Thyroid Imaging Reporting and Data System (K-TIRADS))

  • 나동규
    • 대한영상의학회지
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    • 제84권1호
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    • pp.92-109
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    • 2023
  • 갑상선 결절 환자에서 초음파 검사는 일차적 영상 진단법으로 정립되어 있으며 치료 결정을 위한 핵심적인 진단 역할을 갖는다. Korean Thyroid Imaging Reporting and Data System(이하 K-TIRADS)는 초음파 유형에 기초한 암 위험도 분류체계로서 실시간 초음파 검사를 시행하면서 쉽게 결절 진단이 가능하다는 장점을 갖고 있다. 개정된 2021 K-TIRADS는 결절의 초음파 분류 기준을 보다 명확히 하였고, 고위험 갑상선암의 의심 소견이 없는 환자에서 병리진단검사를 결정하는 결절 크기 기준을 개정하여 불필요한 병리진단검사를 최소화하고 적절한 갑상선암 진단 예민도가 유지되도록 개정하였다. 갑상선영상의학진료는 갑상선 결절 환자의 진단 및 비수술적 치료를 수행하는 중요한 임상적 역할을 가지고 있으며, 적절한 환자 진료를 위해서는 표준적 진료 지침에 근거하여 진료가 수행되어야 한다.

간호학생의 간호관 형성과 변화양상 (Formation and Changing Pattern of Nursing Perspectives of Nursing Students)

  • 조결자;송미령
    • 간호행정학회지
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    • 제3권1호
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    • pp.17-35
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    • 1997
  • The purpose of this study was to identify the formation and changing pattern of nursing perspectives of nursing students. 176 subjects were composed of 118 nusing students and 58 non-nursing students. The data were collected through openended question and structured questionair. The result were as follows : 1. Nursing perspectives were classified six categories(nature of nursing, image of nursing, component of nursing, meaning of nursing, range of nursing, function of nursing) 2. As increased major lecture period, the item of ${\lceil}$Nursing is helping${\rfloor}$ was changing positively. 3. As incresed clinical practice, the student's perception about items of ${\lceil}$Nursing has gap between theory and practice${\rfloor}$, ${\lceil}$Nursing is helping${\rfloor}$ was increased. 4. As increased self-concept, the students were considered the item of ${\lceil}$Nursing is action that giving knowledge and helping to effective coping for individual and group${\rfloor}$ significantly. 5. 1) The students having religion were considered the item of ${\lceil}$Nursing must doing politely${\rfloor}$ significantly relatively to the students don't have religion. 2) The students having experience of admission to hospital in their or their family had negative nursing perspectives. 3) Against the students who select nursing major for his high school perfoermonce and advice of their significant others, the students who select nursing major for service had positive nursing perspectives.

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