• 제목/요약/키워드: clinical practice training

검색결과 484건 처리시간 0.028초

수술 후 보조적 항암화학요법을 받는 대장암 환자의 일상영양관리 순응도에 대한 질적 연구 (Qualitative Study of Compliance with Nutritional Management in Colorectal Cancer Patient Undergoing Chemotherapy)

  • 박희정;길현선;조우균
    • 대한지역사회영양학회지
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    • 제25권4호
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    • pp.303-316
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    • 2020
  • Objectives: The nutritional status of cancer patients undergoing chemotherapy is closely related to the compliance of nutrition education. However, as chemotherapy is conducted repeatedly, compliance with nutrition management is lowered, leading to malnutrition. Malnutrition is related directly to the quality of life after surgery in cancer patients. Therefore, this study examined the factors related to compliance with nutrition management during chemotherapy. Methods: In this study, five subjects with colorectal cancer undergoing adjuvant chemotherapy were interviewed in-depth using the Giorgi study method. The contents of the nutrition education visits and in-depth interviews were transcribed in the language of the subject after recording, and the appropriateness of the data was improved by reflecting the subject's actions and facial expressions. Results: After conducting the in-depth interviews for each subject, the experience of the subject's diet and adjuvant chemotherapy was drawn into two domains, six elements, and 26 sub-elements. In the cognitive domain, the patients experienced physical and psychological changes, and the need for nutrition management was recognized by analyzing the dietary causes of the diseases. In the domain of practice, a knowing-doing gap was formed, unlike the patient's will. Factors that inhibited compliance with nutritional management included digestive problems, sensory changes, loss of appetite, and social interaction stress. Conclusions: Dietary management is very important for patients receiving periodic anticancer therapy, and step-by-step training and personal monitoring based on the chemotherapy order is necessary to maintain the patient's will and social and environmental support.

Chest wall perforator flaps for partial breast reconstruction: Surgical outcomes from a multicenter study

  • Soumian, Soni;Parmeshwar, Rishikesh;Chandarana, Mihir;Marla, Sekhar;Narayanan, Sankaran;Shetty, Geeta
    • Archives of Plastic Surgery
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    • 제47권2호
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    • pp.153-159
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    • 2020
  • Background Perforator artery flaps based on the branches of intercostal arteries and lateral thoracic artery can be used for reconstruction after breast-conserving surgery (BCS). Although described more than a decade ago, these have not been adopted widely in clinical practice. We report on short-term and long-term surgical outcomes of partial breast reconstruction using chest wall perforator flaps from a prospective multicenter audit. Methods All patients operated for BCS and partial breast reconstruction using intercostal artery perforator or lateral thoracic artery perforator flaps from January 2015 to October 2018 were included in the analysis. Oncoplastic breast surgeons with appropriate level of training performed all tumor excisions and reconstructions as a single-stage procedure. Patient characteristics, treatment details and surgical outcomes were noted. Specific outcomes recorded were margin re-excision and complication rates. Results One hundred and twelve patients underwent the procedure in the given study period. The median age was 54 years. Median specimen weight was 62.5 g and median volume of excision was 121.4 mL. Fifteen patients (13.39%) underwent a margin re-excision for close or positive margins without additional morbidity. One patient required a completion mastectomy. Eight patients (7.14%) had an early complication. None of the patients required a contralateral symmetrization procedure. The results were comparable across the participating centers. Conclusions Chest wall artery perforator-based flaps are an excellent option for lateral and inferior quadrant partial breast reconstructions. The short and long-term surgical outcomes are comparable across sites and can be performed with minimal morbidity. Patient-reported outcome measures need to be studied.

뇌졸중 환자에서 상지 회복을 위해 컴퓨터-인간 연동을 이용한 가상현실 기반 훈련 프로그램 (Virtual Reality-based Training Program Using Computer-human Interface for Recovery of Upper Extremity Use in Stroke Patients)

  • 이경희;황기철
    • 디지털융복합연구
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    • 제14권1호
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    • pp.285-290
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    • 2016
  • 본 연구는 뇌졸중 환자의 상지 재활에 사용되는 컴퓨터-인간 연동을 이용한 가상현실 기반 훈련 프로그램 중재의 효과를 알아보고자 하였다. 2015년 2월까지 Medline 데이터베이스에서 뇌졸중 환자의 상지 재활을 위한 가상 현실 중재를 다루는 무작위 대조군 임상 연구들을 검색하였다. PEDro 스케일이 연구의 질을 사정하기 위해 사용되었다. 선정된 8개의 연구가 분석되어졌다. PEDro 스케일은 5 부터 8/10까지 다양했다. 모든 연구들은 가상현실 기반 훈련 그룹에서 상지 기능 회복에 유의한 결과를 보였다. 본 연구는 뇌졸중 환자의 상지 회복을 위해 사용되는 가상 현실 기반 훈련 프로그램의 적용이 다양하고 예측할 수 없는 실행으로 구성된 과제 지향적이고 점진적인 학습을 제공함을 통해 특히 배움에 효과가 있음을 보여주었다. 본 연구에서는 가상현실 훈련 프로그램을 뇌졸중 환자의 상지 기능 재활에 탁월한 학습 효과를 기대할 수 있으며 과제-지향과 등급화된 학습을 제공하는데 효과적이다.

좋은 수업을 하는 현장 교사들이 제안한 과학 교사교육 개선방안 (Exemplary Science Teachers' Suggestions for How to Improve Science Teacher Education)

  • 곽영순
    • 한국지구과학회지
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    • 제24권3호
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    • pp.117-127
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    • 2003
  • 본 질적 연구에서는 사범대학에서의 예비교사 교육과 현직 교사 재교육의 개선방안에 대한 현장 교사들의 의견을 수렴하였다. 현장에서 좋은 수업을 실천하고 있는 사례로 선정된 10명의 과학 교사들과의 심층면담을 통하여 그들이 진단하는 교사양성 교육과 재교육 실태 및 개선방안을 분석하였다. 사범대학에서의 예비교사 교육과 관련하여 좋은 수업을 하는 현장의 과학교사들은 (1) 사범대학이 교사양성 기관으로서의 정체성을 확보해야 하며, (2) 이론과 실제가 조화된 교육과정을 통하여 현장과의 연계성을 고려한 교사양성 교육을 실시해야 하고, 이를 위하여 (3) 사범대학 교수진에 교과교육 전공자를 확보해야 한다고 주장하였다. 또한, 교사들은 현직 교사 연수와 관련하여 (1) 현직 교사들 스스로 계속교육에 대한 인식을 전환하여 교사로서의 전문성 개발을 위하여 끊임없이 노력하여야 하며, (2)교사 연수 내용과 방법의 현장성을 높여서 교사들이 필요로 하는 교사연수로 바뀌어야 하며, (3)교직 사회에 진정한 의미의 수업장학 풍토의 정착이 필요하다고 강조하였다. 성공적인 교실개혁을 위한 교사 (재)교육의 필요성도 논의하였다.

핵심기본간호술 VR 교육 콘텐츠 개발을 위한 융복합 연구 (A Convergence Research for Development of VR Education Contents for Core Fundamental Nursing Skills)

  • 김정기;유혜연;이영수
    • 한국콘텐츠학회논문지
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    • 제21권9호
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    • pp.714-722
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    • 2021
  • 본 연구에서는 가상현실을 이용한 VR 기본간호술 교육 콘텐츠를 제안하고자 하였다. 핵심기본간호술 20가지 중 간이혈당검사와 인슐린피하주사 항목은 간호술 항목에서 빈번히 수행하는 기본간호술 중 하나이며, 당뇨환자들에게 자가관리 교육을 할 때도 사용할 수 있는 항목이다. 본 연구는 이 항목을 가지고 학습자의 체험을 중심으로 가이드, 미션, 피드백의 3단계로 나누어 몰입형 VR기반 핵심기본간호술 콘텐츠를 설계하였다. 이 콘텐츠에서는 실제 간호술처럼 콘트롤러를 사용하지 않고 손가락 관절인식을 통해 손의 움직임을 트랙킹하여 몰입하며 훈련할 수 있다. 이 연구는 임상 수행 능력 향상을 도울 수 있는 VR 간호술 교육 콘텐츠 개발에 도움이 될 것이다.

Foreign Body Removal in Children Using Foley Catheter or Magnet Tube from Gastrointestinal Tract

  • Choe, Jae Young;Choe, Byung-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제22권2호
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    • pp.132-141
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    • 2019
  • Foreign body (FB) ingestion of children is a common pediatric emergency requiring medical attention. Pediatric emergency physicians and gastroenterologists often encounter nervous and distressed situations, because of children presenting with this condition in the common clinical practice. When determining the appropriate timing and indications for intervention, physicians should consider multiple patient- and FB-related factors. The utilization of a flexible endoscopy is considered safe and effective to use in these cases, with a high success rate, for the effective extraction of FBs from the gastrointestinal tract of a child. Additionally, a Foley catheter and a magnet-attached Levin tube have been used for decades in the case of FB removal. Although their use has decreased significantly in recent times, these instruments continue to be used for several indications. Using a Foley catheter for this purpose does not require special training and does not necessarily require sedation of the patient or fluoroscopy, which serve as advantages of utilizing this method for foreign object retrieval. An ingested magnet or iron-containing FB can be retrieved using a magnet-attached tube, and can be effective to retrieve an object from any section of the upper gastrointestinal tract that can be reached. Simple and inexpensive devices such as Foley catheters and magnetattached tubes can be used in emergencies such as with the esophageal impaction of disk batteries if endoscopy cannot be performed immediately (e.g., in rural areas and/or in patients presenting at midnight in a facility, especially in those without access to endoscopes or emergency services, or in any situation that warrants urgent removal of a foreign object).

무릎관절 전치환술 환자에게 적용한 무릎 안정화 운동이 균형과 보행능력에 미치는 영향 (Effect of Knee Stabilization Exercise on Balance and Walking Ability in Patients with Total Knee Replacement)

  • 박근홍;김태원;송형봉
    • 대한정형도수물리치료학회지
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    • 제27권2호
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    • pp.69-76
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    • 2021
  • Background: Degenerative arthritis accounts for a large portion of the elderly, causing a lot of inconvenience in daily life. Total knee replacement (TKR) are performed to relieve pain in the knee joint. The purpose of this study was to determine whether knee joint stabilization exercises are effective in improving balance and walking ability in degenerative arthritis patients who have undergone TKR. Methods: A total of 30 TKR patients participated in this study. They were assigned to two groups. The experimental group, the group that underwent knee stabilization exercises, joint mobilization and general physical therapy. On the other hand, and the controlled group, the group that underwent joint mobilization and general physical therapy. All exercises were conducted thrice a week, for four weeks. The main balance outcomes were evaluated using the posture balance training system, while walking ability was assessed using a wireless 3-axis accelerometer. Results: The experimental group had significantly higher scores in postural stability testing (PST), limits stability testing, and waling ability. The post-intervention evaluation, there were significant differences in all variables between the two groups. However, no significant difference was noted in the foam eyes closed test in PST. Conclusion: This study suggests that knee joint stabilization exercises effectively improve the balance and walking ability of TKR patients. Thus, it could be presented as useful in clinical practice.

전신진동 자극 훈련이 경직형 뇌성마비 아동의 고유수용감각 및 촉각에 미치는 영향 (Effect of Whole Body Vibration Training on Proprioception and Tactile in Spastic Cerebral Palsy)

  • 윤혜령;이은주
    • PNF and Movement
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    • 제20권1호
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    • pp.103-113
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    • 2022
  • Purpose: The purpose of this study was to investigate the effects of whole-body vibration stimulation on proprioception and tactile in patients with spastic cerebral palsy. Methods: This study was conducted on 9 children diagnosed with spastic cerebral palsy. Of the single case study methods, the ABAB design was employed in this study. Out of a 12-week study period, three weeks were allocated to each of two baseline periods and two intervention periods. The exercise was performed twice a week for 30 minutes. A general trunk stabilization exercise was performed during the baseline period and a trunk stabilization exercise accompanied with whole-body vibration was performed during the intervention period. Evaluation was performed five times in total: before the experiment, after baseline 1, after intervention 1, after baseline 2, and after intervention 2. To determine the effect of the exercise method, a skin sensory evaluation tool (monofilament kit) and a trunk proprioception sensor (digital dual inclinometer) were used. To compare the effects of the exercises at baseline and after intervention, an analysis of variance on repeated measures (repeated ANOVA) was performed to analyze the data. Results: The results showed that there were statistically significant increases from baseline in the means of proprioception and tactile during the intervention period with whole-body vibration (p <.05). Conclusion: Whole-body vibration can be proposed as an effective intervention method for improving the proprioception and tactile in children with spastic cerebral palsy, and this exercise method is expected to be actively used in clinical practice.

Difficulties experienced by endodontics researchers in conducting studies and writing papers

  • Betul Aycan Alim-Uysal;Selin Goker-Kamali;Ricardo Machado
    • Restorative Dentistry and Endodontics
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    • 제47권2호
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    • pp.20.1-20.14
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    • 2022
  • Objectives: The study investigated the difficulties experienced by endodontics researchers around the world in conducting studies and writing papers. Materials and Methods: A survey consisting of 18 questions on the difficulties experienced by endodontics researchers in performing studies and writing papers was e-mailed to academics in the field of endodontics working at 202 universities. The independent risk factors were analyzed using binary logistic regression at a significance level of 0.05. Results: A total of 581 individuals (10.7%) agreed to participate in the study. Almost half the participants (48.2%) reported that they had received some type of training in conducting studies and writing papers. In response to the question, "Do you get help from a statistician to perform the statistical analyses of your studies?," 77.1% answered "yes." Around 40% of the participants stated that the need to obtain ethical approval negatively affected their desire to conduct studies. The participants' regions had no effect on the reported difficulties associated with writing papers in English or conducting statistical analyses (p > 0.05). Most participants (81.8%) reported difficulties in writing the Discussion section, regardless of their region, academic degrees, or years of experience. Conclusions: The participants stated they experienced difficulties in many areas, such as conducting statistical analyses, finding new ideas, and writing in English. Engaging in a detailed examination of ethics committee rules, expanding biostatistics education, increasing the number of institutions providing research funding, and increasing the number of endodontics journals can increase the enthusiasm of endodontics researchers to publish papers.

보건의료계열 다직종 연계 교육프로그램의 효과 (Effect of interprofessional education programs in Healthcare)

  • 박정희;김현일;이미향
    • 문화기술의 융합
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    • 제10권1호
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    • pp.81-87
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    • 2024
  • 이 연구는 보건의료계열 3학년 재학생을 대상으로 환자안전 중심의 서비스를 제공하고 전문성을 발휘할 수 있도록 IPE 프로그램을 개발하고 5일간 프로그램을 적용하여 환자안전에 대한 지식과 환자안전 수행자신감에 미치는 효과를 확인하기 위해 시도되었다. 주된 내용으로는 직종별 직무 역할 이해, 환자위험 예지 훈련, 시나리오 기반 환자경험, 개선전략 도출 등이었다. 연구 결과 IPE 프로그램 적용 후 환자안전지식은 39점에서 37점으로 통계적으로 유의하게 낮아졌다(p=.007). 환자안전 수행자신감이 6.71점에서 7.50점으로 통계적으로 유의하게 높아졌다(p<.001). 또한 임상실습을 경험한 학생이 IPE 프로그램 적용 후 환자안전 지식이 더 높았으나 환자안전 수행 자신감은 유의한 차이가 없었다. IPE 프로그램의 효과성을 입증할 수 있도록 반복연구를 제언하며 IPE 프로그램의 확대운영과 지속적으로 관리될 수 있는 구체적인 방안을 모색해야 할 것이다.