• 제목/요약/키워드: clinical practice pattern

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월경통 한의표준임상진료지침 개발을 위한 한의사의 인식과 원발성 월경통 치료에 관한 실태조사 (A Survey on Korean Medicine Doctors' Recognition and Clinical Fields of Treating Primary Dysmenorrhea for Developing Korean Medicine Clinical Practice Guideline for Dysmenorrhea)

  • 우혜린;지해리;박경선;황덕상;이창훈;장준복;이진무
    • 대한한방부인과학회지
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    • 제30권2호
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    • pp.93-106
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    • 2017
  • Objectives: This study is aimed to figure out Korean medicine doctors' recognition of Korean Medicine clinical practice guidelines (CPG) and clinical fields of treating primary dysmenorrhea before developing CPG for dysmenorrhea. Methods: We conducted a questionnaire survey targeting 515 Korean medicine doctors belonging to the Association of Korean Medicine by e-mail and analyzed the answers. Results: 81.2% of the respondents knew the concepts and contents of CPG, and 98.7% agreed about the necessity of CPG. 94.2% were willing to use CPG for dysmenorrhea in learning and treating. Average number of patients visiting the respondents' clinics for dysmenorrhea was 3.9, the main age group was 20s (63.1%), and the treatments the patients given before were mostly Western treatments such as pain killers and hormonal drugs. The respondents answered that they diagnosed patients with dysmenorrhea mainly with pattern diagnosis (41.6%), and treated them with herbal medicine (39.2%), acupuncture (31.6%) and moxibustion (22.6%) for 2-3 months. They answered that the acupoint they use most was San yin jiao, and the prescription was Gui-zhi-fu-ling-wan, They answered that the field considered to need further study was decoction of herbal medicine most (27.4%), and the field considered to need insurance coverage was also decoction of herbal medicine most (40.2%). Conclusions: We figured out Korean Medicine doctors' recognition of CPG, clinical diagnosis, treatment, cost for treating dysmenorrhea, and fields of clinical research and policy they required.

간호진단의 임상적용 활성화를 위한 기초조사 연구 (A Survey Study of Nursing Diagnosis Use in Clinical Practice)

  • 최영희;이향련;김혜숙;김소선;박광옥
    • 대한간호학회지
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    • 제26권4호
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    • pp.930-945
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    • 1996
  • The purpose of this study was to identify the degree to which nursing diagnoses accepted by NANDA are used and to identify problems in application of nursing diagnoses in clinical practice. With the expanding potential for computerization of nursing diagnosis, the survey also included data on the present status of hospital computerization and willingness to use computerized nursing diagnoses. The data collection was done from July 1 to August 3, 1996 using structured questionnaires. The questionnaires were mailed to 1,126 head nurses working in 44 hospitals with on occupacy of over 500 beds located in Korea, of these, 883 were returned from 40 hospitals. Among the 883 questionnaires, 867 were used for the analysis. The results of the analysis are as follows 1. Among 109 nursing diagnoses, pain, constipation, diarrhea, hyperthermia, high risk for infection, sleep pattern disturbance, and anxiety, chronic pain, altered urinary elimination, and altered nutrition : less than body requirements were the ten most frequently used diagnoses. 2. The primary problem in the use of nursing diagnoses was lack of time and personnel. Others were lack of knowledge and motivation, absence of protocols and absence of the appropriate methods to apply nursing diagnoses. 3. Among the 40 hospitals, 27 hospitals used a computerized system and expressed willingness to utilize the computerized system of nursing diagnoses that is planned for the future.

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Effects of Task-Specific Obstacle Crossing Training on Functional Gait Capability in Patients with Cerebellar Ataxia: Feasibility Study

  • Park, Jin-Hoon
    • The Journal of Korean Physical Therapy
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    • 제27권2호
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    • pp.112-117
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    • 2015
  • Purpose: The purpose of this study was to examine the effects of a task-specific obstacle crossing rehabilitation program on functional gait ability in patients with cerebellar ataxia. Overall, we sought to provide ataxia-specific locomotor rehabilitation guidelines for use in clinical practice based on quantitative evidence using relevant analysis of gait kinematics including valid clinical tests. Methods: Patients with cerebellar disease (n=13) participated in obstacle crossing training focusing on maintenance of dynamic balance and posture, stable transferring of body weight, and production of coordinated limb movements for 8 weeks, 2 times per week, 90 minutes per session. Throughout the training of body weight transfer, the instructions emphasized conscious perception and control of the center of body stability, trunk and limb alignment, and stepping kinematics during the practice of each walking phase. Results: According to the results, compared with pre-training data, foot clearance, pre-&post-obstacle distance, delay time, and total obstacle crossing time were increased after intervention. In addition, body COM measures indicated that body sway and movement variability, therefore posture stability during obstacle crossing, showed improvement after training. Based on these results, body sway was reduced and stepping pattern became more consistent during obstacle crossing gait after participation in patients with cerebellar ataxia. Conclusion: Findings of this study suggest that task-relevant obstacle crossing training may have a beneficial effect on recovery of functional gait ability in patients with cerebellar disease.

중국 논문에 나타난 건선의 변증 분석 및 변증체계에 대한 고찰 (A Review on Patterns and Classification Criteria of Psoriasis by analyzing Chinese Theses)

  • 조은채;김규석
    • 한방안이비인후피부과학회지
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    • 제33권2호
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    • pp.112-129
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    • 2020
  • Objectives : The aim of this study is to explore the types of pattern identification (PI, 辨證) and the differential points of PI used for the treatment of psoriasis in Traditional Chinese Medicine (TCM) based on the Chinese references and to provide the evidences applying PI for the treatment of psoriasis in clinical practice. Methods : This study extracted patterns of psoriasis through database CNKI (China National Knowledge Infrastructure) and analysis the patterns and classification criteria of the patterns. Those examined in the study are dermal symptoms, general symptoms, formula and herbs which are different depending on the patterns. Results : Total 60 studies were selected and 44 pattern types were extracted from them. We categorized the main pattern types on psoriasis used in TCM as 'blood-heat syndrome(BHS, 血熱證)', blood-stasis syndrome(BSS, 血瘀證), and 'blood-dryness syndrome(BDS, 血燥證)', 'dampness-heat syndrome(DHS, 濕熱證)' and 'yang-deficiency syndrome(YDS, 陽虛證)'. Among these patterns, BHS was the most common. In TCM, the pattern of BHS tended to have skin symptoms and signs related to inflammatory erythema and heat. Both BSS and BDS were characterized by long disease duration and poor healing. In addition, DHS tended to have the skin symptoms and signs such as oozing and severe itching. The symptoms and signs related to coldness mainly showed in YDS. For PI criteria, 'qi-blood-essence criteria(氣血津液辨證)' and 'eight-doctrine criteria(八鋼辨證) are commonly used. Conclusions : Our findings show that each PI on psoriasis in TCM has different characteristics related to dermal and general symptoms or signs. Further studies are needed to develop the diagnostic tool of PI on psoriasis reflecting on clinical practices in Korean Medicine by referring to the findings of this study about PI on psoriasis in TCM.

PNF 다리 굽힘 패턴 시 복부 드로잉-인 기법 동시적용이 동측 몸통과 다리의 근활성도에 미치는 효과 (Effect of PNF Leg Flexion Pattern on Muscle Activity of Ipsilateral Trunk and Leg with and without Abdominal Drawing-in Maneuver)

  • 안수홍;이수경;조현대
    • PNF and Movement
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    • 제18권1호
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    • pp.35-44
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    • 2020
  • Purpose: The purpose of this study was to investigate the effect of the simultaneous abdominal drawing-in maneuver (ADIM) on the muscle activity of the ipsilateral trunk and leg during proprioceptive neuromuscular facilitation (PNF) leg flexion, adduction, and external rotation with knee flexion (D1) patterns. Methods: The participants were 20 healthy adult males and females (18 males and 2 females). The maneuvers were performed by a physical therapist who fully understands the PNF leg patterns (D1) and their application in clinical practice. The participants were trained and allowed to practice for 15 minutes prior to applying ADIM, to ensure adequate learning as evidenced by the pressure biofeedback unit. In this study, we measured the muscle activity of the trunk and leg when the PNF leg pattern (D1) was performed by the physical therapist either sustaining or releasing the ADIM. Muscle activity was measured on the right transverse abdominis muscle (TRA), the external abdominal oblique muscle (EO), the internal abdominal oblique muscle (IO), the erector spinae muscle (ES), the vastus medialis oblique muscle (VMO), the vastus lateralis oblique muscle (VLO), and the tibialis anterior muscle (TA) and compared using the mean values from averaging three repeated measurements. Results: The muscle activity of the transversus abdominis, the external abdominal oblique, the internal abdominal oblique, the vastus medialis oblique, and the vastus lateralis oblique was significantly greater (p < 0.05), and the muscle activity of the erector spinae was significantly less (p < 0.05) during PNF leg pattern (D1) when the ADIM contraction was sustained compared to when it was not. Conclusion: These results suggest that sustaining ADIM during PNF leg pattern (D1) training increases the trunk and leg muscle activity, resulting in more effective training.

퇴행성 슬관절염의 맞춤형 침구 임상시험 프로토콜 개발을 위한 전화조사 (Telephone Survey for Developing Clinical Trial Protocol on Individualized Acupuncture Treatment for Knee Osteoarthritis)

  • 서병관;이상훈;서정철;이승덕;김선웅;최선미;김용석
    • Journal of Acupuncture Research
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    • 제22권5호
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    • pp.141-150
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    • 2005
  • Objectives : This study was accomplished in order to find out how Korean medical doctors take acupuncture prescription for knee osteoarthritis in clinical practice Methods : The survey questions were developed by the consensus from 4 professors and 10 residents who major in acupuncture & moxibustion for developing clinical trial protocol on individualized acupuncture treatment for knee osteoarthritis. 206 persons having more than 10 years experience were randomly selected from a list of Korean medical doctors. Telephone interviews with them were conducted by the well-trained interviewers between May 21 and May 27 in 2005. Results : 139 of 206 Korean medical doctors made an acupuncture prescription prior to treatment of knee osteoarthritis. 103 of 139 Korean medical doctors used both local and remote points, and 26 of them used remote points only, and 10 of them used local points only. In case of doctors who use remote points, the five element (45 of 129) or Saam (28 of 129) acupoints were used dominantly, and its was based on the pattern identification of the Jangbu organs related with the pain (56 of 129) or of the pain location (35 of 129). Conclusion : This study showed that Koran medical doctors prefer to use remote points such as five element or Saam acupoints based on the pattern identification of the Jangbu organs related with the pain or the pain location. These result may be useful for developing protocols for clinical trial on acupuncture on knee osteoarthritis.

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양도락의 진단적 활용에 대한 문헌 고찰 - 국내문헌을 중심으로 - (Ryodoraku Application for Diagnosis : a Review of Korean Literature)

  • 노승희;김건형;윤영진;양기영;김재규;이병렬;임윤경
    • Korean Journal of Acupuncture
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    • 제28권4호
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    • pp.125-135
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    • 2011
  • Objectives : This study is aimed to evaluate the diagnostic value of Ryodoraku for traditional Korean medicine practice reported in the Korean literature. Methods : A search of seven Korean databases was performed up to May 2011 using the search term 'Ryodoraku(in Korean)'. All clinical studies on diagnostic Ryodoraku characteristics were included. Results : The search yielded 59 studies, of which 5 were considered suitable for this analysis. Four were observational studies. Only one was a controlled trial. Average Ryodoraku score(RS), mean values for each measure point, physiologic limit, number of Pyesaek and Gyeokcha, and pattern classification were used as references for the analysis. Correlations were observed between average RS and idiopathic Parkinson's disease, some sub-groups of respiratory disease, chronic low back pain, and menopause. Some mean values for measure points showed particularly high or low tendencies in patients with idiopathic Parkinson's disease, chronic low back pain, and menopause. Positive correlations were observed between the number of Pyesaek and H-Y stage in idiopathic Parkinson's disease and F2(肝) and the modified Kupperman's index with menopausal women. The four classes, organized based on Ryodoraku pattern, showed differences in various characteristics. Conclusions : Since only five studies met the experimental conditions, this evaluation of the diagnostic value of Ryodoraku in various situations is limited. Future studies should be conducted using various physiologic and pathologic situations.

웹기반 진단 보조 시스템의 진단 일치도 연구 (A Study for Diagnostic Agreement between Web-based Diagnosis Support System and Korean Medical Doctors' Diagnosis)

  • 이승엽;강민지;임현정;양웅모
    • 대한융합한의학회지
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    • 제6권1호
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    • pp.37-42
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    • 2024
  • Objectives: This study aims to evaluate the clinical validity of the system by conducting a clinical study to assess the diagnostic agreement between the system and Korean medical doctors. Methods: This study was conducted from September 7, 2023, to December 7, 2023, across five Korean medicine institutions, involving 100 adult participants aged 20-64 who consented to participate. Participants first entered their symptoms into a web-based program, which utilized an AI-based algorithm to diagnose 36 types of pattern differentiation. Subsequently, Korean medical doctors conducted face-to-face diagnoses using the same 36 types. The diagnostic agreement between the system and the doctors' diagnoses was analyzed using descriptive statistical analysis, and the results were expressed as a percentage agreement. Results: Analysis of the diagnostic data from 100 participants revealed that the web-based diagnosis support system identified an average of 7.76±0.79 patterns per patient, while Korean medical doctors identified an average of 7.99±0.10 patterns per patient. The diagnostic agreement between the system and the doctors showed an average of 7.08±1.08 patterns per patient, with an overall diagnostic agreement rate of 88.57±13.31%. Conclusion: This study developed a web-based diagnosis support system for traditional Korean medicine and evaluated its clinical validity by assessing diagnostic agreement. Comparing the diagnoses of the system with those of Korean medical doctors for 100 patients, the system showed an approximately 89% agreement rate with the clinical diagnoses. The system holds potential for aiding Korean medical doctors in pattern differentiation diagnosis in clinical practice.

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전문가시스템을 활용한 사상체질과 팔강변증, 기혈변증, 병사변증간의 상관관계 (Correlation between Sasang Constitution and Eight Principle Pattern Identification, Qi-Blood Pattern Identification, Bing-Xie Pattern Identification by using Oriental Diagnosis System)

  • 황교성;박준관;최성운;노윤환;조영석;신동하;권영규
    • 동의생리병리학회지
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    • 제32권6호
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    • pp.370-374
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    • 2018
  • Oriental Diagnosis System(ODS) is an artificial intelligence program that utilize entered diagnosis knowledge, determine patient's disease and decide right medicine. The purpose of this study is to find a correlation between pattern Identification in Korean medicine and each sasang types(Tae-Eum and So-Yang) by analyzing ODS diagnosis result. Eventually our study secure availability of using ODS program at clinical training or developing diagnosis program. Subject of this study is 50 patients who was performed Sasang constitution diagnosis (28 patients were Tae-Eum and 22 patients were So-Yang). We analyize patient's diagnosis records by using ODS program and obtained result about pattern Identification. We used SPSS statistics 23 in analyzing the differences of the scores of Eight Principle Pattern Identification, Qi-Blood Pattern Identification, and Bing-xie Pattern Identification in each Sasang types (Tae-Eum, So-Yang). The Heat and Heat-moisture scores were significantly different(p<0.05) and Qi-Blood Pattern Identification scores were not different in each Sasang types(p>0.05). And Weight was significantly different in each Sasang types(p<0.05). It is hard to generalize the result because subject of this study was not enough and had sample speciality(tinnitus patients). However, we explained correlation between pattern Identification in korean medicine and each sasang types based on quantifiable and objective evidence system. it can be used at education of korean medicine and evidence of practice diagnosis. Futhermore, there have been no studies about anaylizing correlation between pattern Identification in Korean medicine and each sasang types using ODS program. So it is worthy of being utilized at clinical evidence data of ODS program.

국내 한의사의 팔강변증에 관한 인식 및 활용현황 조사 (An On-line Survey on the Perception and Usage of Korean Medicine Doctors about Pattern Identification of Eight Principles)

  • 배정현;박신형;이인선;김종원;전수형;강창완;지규용
    • 동의생리병리학회지
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    • 제35권6호
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    • pp.211-218
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    • 2021
  • In order to increase the clinical value of an identification of patterns according to the eight principles (IPEP) in Korean medicine practice, The research on the Clinical Practice Guideline (CPG) of IPEP should comprehend the situation of clinical usage of IPEP practiced by Korean medicine doctors at first. Google survey form were emailed to Korean Medicine doctors registered in the Association of Korean Medicine on 04/15/2021 and the survey was closed at 04/22/2021. Data of 505 answered cases were analyzed by Frequency analysis, Chi-Square analysis, correlation analysis for understanding differences by groups. Out of 505 respondents, 57.6% have answered that they are using IPEP. It means that 42.4% of KM doctors don't use in the medical practice reversely in spite of fundamental diagnostic theory. The 64.7% respondents of no using IPEP presented their opinion about the theoretical problem that it is difficult to use because the concept of IPEP is ambiguous. And next, the 52.1% of the respondents expressed that there is no objective tools to measure and record the IPEP evidences in actual implementation. And 49.6% of the respondents also suggested that it is hard to trust and use IPEP similar to the previous comment. Even about 50% of the respondents are carrying out diagnosis and treatment using IPEP, it showed that there were several unsolved problems such as lack of understanding and practical tools or objective indicators for diagnosis of IPEP. Through the above results, the concept, usage, measurement requirements with indices and discriminant logic of IPEP were manifested as the main hopes of attending members of Korean medicine in the survey, so the IPEP CPG should make clear about these difficult but necessary assignment in the near future.