• Title/Summary/Keyword: clinical practice recommendation

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Influence of Critical Thinking Disposition on Satisfaction with Clinical Practice and Intention of Recommendation among Paramedic Students (응급구조학과 학생들의 비판적 사고성향이 임상실습만족도와 추천의도에 미치는 영향)

  • Choi, Mi-Young;Moon, Tae-Young;Lee, Hyun-Ji
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.3
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    • pp.1301-1312
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    • 2013
  • The purpose of this study was to examine the relationship of the critical thinking disposition of paramedic students to their satisfaction with hospital clinical practice and intention of recommendation. As for data analysis, the statistical packages SPSS WIN 20.0 and AMOS 20.0 were employed, and frequency analysis, factor analysis, multiple regression analysis and structural equation modeling were utilized. Besides, Cronbach alpha coefficients were calculated to check item internal consistency. The level of significance was all set at .05. A survey was conducted to collect data from May 12 to August 25, 2012, and the answer sheets from 305 respondents were gathered and analyzed. The critical thinking disposition of the paramedic students was found to have a significant impact on their satisfaction with clinical practice, and the hypothesis about that was accepted. Their critical thinking disposition was found to exert a significant influence on their intention of recommendation as well, and the hypothesis about that was accepted. Finally, their satisfaction with clinical practice was found to affect their intention of recommendation in a significant way, and the hypothesis about that was accepted. The findings of the study suggested that in order to nurture professional and competent paramedics, the content of clinical practice should systematically be managed on a regular basis, and prolonged research efforts should be directed into program development.

Complementary and Alternative Medicine in Clinical Practice Guideline for Insomnia

  • Kwon, Chang-Young;Suh, Hyo-Weon;Choi, Eun-Ji;Chung, Sun-Yong;Kim, Jong-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.27 no.4
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    • pp.235-248
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    • 2016
  • Objectives: The aim of this review was to investigate whether evidence of complementary and alternative medicine (CAM) was reflected in clinical practice guidelines (CPGs) for insomnia based on relevant clinical trials. Methods: We conducted a systematic search on domestic and international CPG databases and medical databases. In addition, we conducted manual searches of relevant articles. Three authors independently searched and selected relevant studies; any disagreement was resolved by discussion. We extracted and analyzed the following data: published language, country, development group, participants, interventions, presence or absence of recommendations for CAM, level of evidence, grade of recommendation for CAM, and methods of development. Results: We identified 8,241 records from domestic and international databases, and 22 CPGs were included. Eleven of the 22 CPGs mentioned CAM interventions including herbal medicine, relaxation, acupuncture moxibustion, Tai Chi, meditation, hypnosis, biofeedback, Tuina, and external herbal medicine. However, most of the CPGs indicated 'no recommendation' or 'weak recommendation' for CAM interventions. Only Valeriana dageletiana Nakai and relaxation were considered to have experimental evidence. Valeriana dageletiana Nakai was recommended for improvement of sleep latency, sleep maintenance, total sleeping time, and sleep cycle. Relaxation was recommended as effective intervention for relieving physical and psychological arousal. Conclusions: Despite systematic reviews and randomized controlled trials on CAM for insomnia, most of the CPGs for insomnia did not reflect the evidence obtained. Further CPGs for insomnia should be developed by considering the current advanced studies in the field of CAM.

Suggestions for developing Korean Medicine Clinical Practice Guideline for Allergic Rhinitis - Based on 2018 Chinese Clinical Practice Guideline (알레르기 비염 한의표준임상진료지침 방향 제언 - 2018 중국 임상진료지침을 바탕으로)

  • Kang, Jeong-In;Lee, Dong-Hyo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.32 no.4
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    • pp.130-140
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    • 2019
  • Objective : The purpose of this study is to examine the treatment of allergic rhinitis introduced in the Chinese guideline, and to find out the direction of evidence-establishment and applicability in developing Korean Medicine clinical practice guideline for allergic rhinitis. Method : We studied Traditional Chinese Medicine treatment of allergic rhinitis introduced in the 2018 Chinese society of allergy guidelines for diagnosis and treatment of allergic rhinitis. The treatment are classified into three categories; herbal medicines, acupuncture and the others. And we compared this guidelines with other guidelines for how they differ in description of the database, evidence of level, and strength of recommendation. Results : Herbal medicines are presented based on syndrome differentiation. The basic acupoints for allergic rhinitis are introduced as follows; Fengchi(GB20), Yingxiang(LI20), Feishu(BL13) and Taiyuan(LU9). And in comparison with other guidelines for allergic rhinitis, the Chinese guideline showed lack of description in the database, evidence of level, and strength of recommendation, though they used evidence-based models. Conclusions : Clinical practice guideline projects are also underway in Korea for benefit expansion and improving quality of medical services. It is important to develop guidelines which should be evidence-based and reflect Korean medical environment.

Clinical Practice Guideline on Prostate Cancer in Korean Medicine (전립선암 치료의 한방 임상 진료 지침)

  • Song, Bong-Keun;Lee, Eun-Jung;Yoo, Hwa-Seung
    • Journal of Korean Traditional Oncology
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    • v.21 no.2
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    • pp.1-35
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    • 2016
  • Objectives : The aim of this preliminary study is to suggest a clinical approach on prostate cancer through the analysis of existing clinical practice guidelines or clinical studies. Materials and Methods : The data related on the treatment of prostate cancer were collected using various search engines such as Pub Med, KIOM OASIS, CNKI. Then, data were analyzed to evaluate the validity of recommendation of treatment. Results : Prostate cancer has the highest prevalence around the world. Recently, the incidence of prostate cancer in Korea is rapidly increasing. Especially, it was reported that incidence rate rose up to 80% by age 80 years. In recent studies, applying combined traditional and conventional medicine were reported to improve the survival, quality of life, immune function, and suppress of tumor growth in prostate cancer. However there has not been an objective and systemic clinical guideline for prostate cancer in Korean Medicine. Accordingly, it has been difficult for doctors to apply optimized therapeutic treatment in clinics. This study will show a preliminary approach to establish clinical practice guideline for prostate cancer of Korean Medicine. Conclusion : Further objective and systemic clinical studies by Korean Medicine are needed to develop more advanced clinical practice guidelines of prostate cancer.

Clinical practice recommendations for Bangpungtongseong-san (Bofutsusho-san) and Bangkihwangki-tang(Boiogito) in obesity (비만치료 및 체중 감량에서 방풍통성산과 방기황기탕 사용에 대한 임상 권고안)

  • Park, Jung-Hyun;Kim, Ho-Jun
    • Journal of Korean Medicine for Obesity Research
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    • v.12 no.1
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    • pp.48-58
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    • 2012
  • Objectives These prescribing recommendations have been written to guide clinicians on the appropriate use of Bangpungtongseong-san(BT) and Bangkihwangki-tang(BH) in the treatment of obesity. These recommendation are aimed at providing evidence based information concerning diagnosis and management of obesity. Methods We collected all relevant references about treatment effect of BT and BH on obesity in the forms of meta-analysis, systematic review, randomized controlled trial, case-control study, observational study and practice guideline from international and domestic databases and paper journals. We examined treatment effect, side effects, recommendations for dose, indication and contraindication of BT and BH. Results The treatment effect of BT and BH on obesity has been proved through clinical trial. BT is indicated for obese patients (Body mass index, $BMI{\geq}25$) with strong abdomen and a tendency to constipation, BH is indicated for obese patients ($BMI{\geq}25$) with a fair skinned, soft muscled, edematous and sweat easily. Conclusion We wish the information contained in theses recommendations will help clinicians reach a reasonable and beneficial decision with evidence-based results. Further studies are strongly needed to develop better treatment strategies for herbal medicines on obesity.

A Basic Study for Development of Clinical Practice Guidelines of Korean Medicine in Autism Spectrum Disorder -Based on Pre-existing Clinical Practice Guidelines of Autism Specturm Disorder- (자폐스펙트럼장애의 치료에 대한 한의 임상 가이드라인 개발을 위한 기초연구 -기존에 개발된 자폐스펙트럼장애 가이드라인을 중심으로-)

  • Kim, Sang Min;Lee, Jin Yong;Lee, Sun Haeng;Chang, Gyu Tae
    • The Journal of Pediatrics of Korean Medicine
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    • v.31 no.1
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    • pp.52-62
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    • 2017
  • Objectives The purpose of this study is to review pre-existing clinical practice guidelines for autism spectrum disorders, and refer those in developing a new practice guideline. Methods A total of 9 existing clinical practice guidelines for autism spectrum disorder developed from 2010 to 2016 were searched by Google scholar and Pubmed, and were reviewed those literatures in three parts: general, diagnosis & evaluation, and intervention. Results There were no consistency in the recommendation methods of 9 clinical care guidelines (such as the method of rating and recommendation intensity for diagnosis, evaluation, and treatment). However, in the diagnosis and evaluation section, frequently used evaluation and diagnostic tools are mentioned in most clinical practice guidelines, and the types of pharmacologic and non-pharmacological treatments that are mainly recommended in treatment are equally mentioned in most clinical practice guidelines could confirm. Conclusions 1. Some guideline recommendations are graded according to each criterion. Recommendations presented in various databases were based on systematic reviews or other literatures. The most utilized database were PsycINFO, CINAHL, Cochrane. 2. DSM-5 and ICD-10 were the most common used diagnostic criteria, and DSM-IV was used as a diagnostic standard in the guideline published before 2013. The tools used for diagnosis and evaluation were also varied. However, most recommended ones were ADI-R, ADOS-G, and DISCO. 3. Treatment was largely divided into pharmacological intervention and non-pharmacological intervention. In some guideline, the interventions were divided into pediatric and adult. Most of the pharmacological interventions were not recommended due to lack of evidence, but in cases in which specific symptoms were aimed, they recommended to seek professional help. 4. In addition to interventions, each guideline referred to supportive interventions that may be helpful in the daily life of patients with ASD, which may need to be addressed in future clinical guidelines.

Clinical Practice Guideline of Korean Medicine for Stroke : Preliminary Guideline and Recommendation (중풍환자에 대한 일차 한의임상진료 가이드라인)

  • Han, Chang-Ho
    • The Journal of Internal Korean Medicine
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    • v.33 no.4
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    • pp.347-366
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    • 2012
  • The aim of this new statement is to provide comprehensive and timely evidence-based recommendations on stroke management for clinical practitioners. Many countries are already well engaged in developing and releasing their own clinical practice guidelines, whereas Korean Medicine (KM) is still beginning. It will take time and effort to develop evidence-based guidelines and recommendations of KM or other traditional medicine because they are weak in the area of scientific evidence. The clinical practice guideline of Korean medicine for stroke was formulated through extensive review of published literature and consensus meeting of Korean medicine specialists. This project was supported by a grant of the Oriental Medicine R&D Project, the Ministry of Health and Welfare. Referring to guidelines developed in other countries, the experts in the subject tried to organize and develop guidelines and recommendations adequate for domestic medical circumstances. In December, 2008, a multi-disciplinary team called the Evidence Based Clinical Practice Guidelines Development Group (EBCPGsDG) for Stroke was organized. The writing committee was comprised of experts in internal medicine, acupuncture, rehabilitation, and Sasang constitution. Outside specialists and associated panels were invited for consultation. The scope of the guideline encompasses acupuncture, moxibustion and herbal medicine (including Korean medicine, traditional Chinese medicine, Kampo medicine) as interventions for stroke patients. It includes statements about ischemic stroke (I63), stroke not specified as hemorrhage or infarction (I64), and sequelae of cerebrovascular disease (I69) according to the International Classification of Disease (ICD). The committee subdivided the description of herbal medications into acute stroke management, subacute stroke management, post-stroke management, and secondary prevention of stroke. Guidelines on the practice of acupuncture and moxibustion were described in order for acute stroke management, subacute stroke management, chronic stroke management, and post-stroke rehabilitation. Clinicians who are working in the field of stroke care can adopt this guideline for their practice.

Developmental procedures for the clinical practice guidelines for conscious sedation in dentistry for the Korean Academy of Dental Sciences

  • An, So-Youn;Seo, Kwang-Suk;Kim, Seungoh;Kim, Jongbin;Lee, Deok-Won;Hwang, Kyung-Gyun;Kim, Hyun Jeong
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.4
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    • pp.253-261
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    • 2016
  • Background: Evidence-based clinical practice guidelines (CPGs) are defined as "statements that are scientifically reviewed about evidence and systematically developed to assist in the doctors' and patients' decision making in certain clinical situations." This recommendation aims to promote good clinical practice for the provision of safe and effective practices of conscious sedation in dentistry. Method: The development of this clinical practice guideline was conducted by performing a systematic search of the literature for evidence-based CPGs. Existing guidelines, relevant systematic reviews, policy documents, legislation, or other recommendations were reviewed and appraised. To supplement this information, key questions were formulated by the Guideline Development Group and used as the basis for designing systematic literature search strategies to identify literature that may address these questions. Guideline documents were evaluated through a review of domestic and international databases for the development of a renewing of existing conscious sedation guidelines for dentistry. Clinical practice guidelines were critically appraised for their methodologies using Appraisal of guidelines for research and evaluation (AGREE) II. Results: A total of 12 existing CPGs were included and 13 recommendations were made in a range of general, adult, and pediatric areas. Conclusion: The clinical practice guidelines for conscious sedation will be reviewed in 5 years' time for further updates to reflect significant changes in the field.

Clinical Practice Guideline for Assessment and Prevention of Falls in Adult People (낙상위험요인 평가 및 낙상예방활동 임상진료지침)

  • Chun, Ja-Hae;Kim, Hyun-Ah;Kwak, Mi-Jeong;Kim, Hyuo-Sun;Park, Sun-Kyung;Kim, Moon-Sook;Choi, Ae-Lee;Hwang, Jee-In;Kim, Yoon-Sook
    • Quality Improvement in Health Care
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    • v.24 no.2
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    • pp.41-61
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    • 2018
  • Purpose: Falls are one of the most frequent health events in medical institutions, however, they can be predicted and prevented. The Quality Improvement Nurse Society clinical practice guideline Steering Committee developed the Clinical Practice Guideline for the assessment and prevention of falls in adult people. The purpose of this study was to assess the risk factors for falls in adults aged 19 years and older, to present an evidence for preventing falls, formulate a recommendations, and indicators for applying the recommendations. Methods: This clinical practice guideline was developed using a 23-step adaptation method according to the Handbook for clinical practice guideline developer (version 1.0) by National Evidence-based Healthcare Collaborating Agency. Evidence levels and recommendation ratings were established in accordance to SIGN 2011 (The Scottish Intercollegiate Guidelines Network). Results: The final 15 recommendations from four domains were derived from experts' advice; 1) assessment of risk factor for falls in adult 2) preventing falls and reducing the risks of falls or falls-related injury 3) management and reassessment after a person falls 4) leadership and culture. Conclusion: This clinical practice guideline can be used as a basis for evaluation and prevention of fall risk factors for adults, to formulate recommendations for fall risk assessment and fall prevention, and to present monitoring indicators for applying the recommendations.

Middle East respiratory syndrome clinical practice guideline for hemodialysis facilities

  • Park, Hayne Cho;Lee, Young-Ki;Lee, Sang-Ho;Yoo, Kyung Don;Jeon, Hee Jung;Ryu, Dong-Ryeol;Kim, Seong Nam;Sohn, Seung Hwan;Chun, Rho Won;Choi, Kyu Bok;The Korean Society of Nephrology MERS-CoV Task Force Team
    • Kidney Research and Clinical Practice
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    • v.36 no.2
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    • pp.111-116
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    • 2017
  • The Korean Society of Nephrology participated in the task force team consisting of government authorities and civilian experts to prevent and control the spread of Middle East respiratory syndrome (MERS) in 2015. The Korean Society of Nephrology MERS Task Force Team took an immediate action and drafted 'the clinical recommendation for hemodialysis facilities' to follow when the first and the only confirmed case was reported in the hemodialysis unit. Owing to the dedicated support from medical doctors, dialysis nurses, and related medical companies, we could prevent further transmission of MERS infection successfully in hemodialysis units. This special report describes the experience of infection control during MERS outbreak in 2015 and summarizes the contents of 'the clinical practice guideline for hemodialysis facilities dealing with MERS patients' built upon our previous experience.