• Title/Summary/Keyword: clinical statistics

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Cost-Effectiveness Analysis of a Hyperlipidemia Mass Screening Program in Korea (성인 고지혈증 선별 검사의 비용-효과 분석)

  • Cha, Yeon-Soon;Khang, Young-Ho;Lee, Moo-Song;Kang, Wee-Chang;Jeon, Sung-Hoon;Kim, Kee-Lak;Lee, Sang-Il
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.2
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    • pp.99-106
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    • 2002
  • Objective : Until now, there have been no evidence-based guidelines produced for the mass screening of hyperlipidemia cases in Korea. This study was done to find the most efficient strategy for a hyperlipidemia-screening program among Korean adults, Method : Seven alternative strategies for hyperlipidemia screening were formulated and compared ir terms of cost-effectiveness. Cost and effectiveness were estimated from social perspectives and using a two-stage screening process (initial testing and additional testing for positives from the first test). A computerized database (based on persons who had visited a health promotion center in one teaching hospital for a routine health check-up) was used to determine the cost and the outcome of various strategies. Official data was used in calculating direct and indirect costs. Effectiveness was measured according to the number of persons who needed clinical intervention for hyperlipidemia. A stratified analysis, considering age group and sex, was then done. Sensitivity analyses, focusing on several uncertain parameters, were also done. Results : Of the seven test alternatives available, the most cost-effective strategy was a screening program, which consisted of an initial test of total cholesterol, high-density lipoprotein cholesterol and triglyceride. There was some variation in the rank of the cost-effectiveness ratios for the seven alternatives dependent on age group or gender. Conclusions : Current hyperlipidemia screening practice, for National Health Insurance beneficiaries, tests only the total cholesterol level with a cut-off value of 260mg/dl as an initial screening test. It is not the best strategy for cost-effectiveness, and should be modified. Different screening strategies taking age group and sex into account should be developed and used for the efficient mass screening of hyperlipidemia cases among Korean adults.

Introduce and Promote the Home-based Hospice and Palliative Care (가정호스피스·완화의료 제도 도입을 위한 국민 인식도 조사)

  • Choi, Jung-Kyu;Tae, Yoon-Hee;Choi, Young-Soon
    • Journal of Hospice and Palliative Care
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    • v.18 no.3
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    • pp.219-226
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    • 2015
  • Purpose: This study was conducted to understand public perception of home-based hospice and identify related factors. Methods: Between August 19, 2014 and August 30, 2014, data were collected using an E-mail questionnaire that was filled by 1,500 adults who were over 20 years of age. Data were analyzed using descriptive statistics, ${\chi}^2$-test and logistic regression. Results: Among the respondents, 15.9% were aware of home-based hospice care, and 61.3% were willing to receive home-based hospice care. The factors that influenced the participants' willingness to use home-based hospice services included residential district, religion and private health insurance. Respondents who lived in Seoul (OR: 1.56, 95% CI: 1.04~2.33), Gwangju/Jeolla province (OR: 2.02, 95% CI: 1.23~3.32), Busan/Ulsan/South Gyeongsang province (OR: 1.81, 95% CI: 1.17~2.82) were more well-aware of home-based hospice care than those who lived in Incheon/Gyeonggi province. The faithful were more informed about the services than those without non-faithful participants (Roman Catholics (OR: 2.03, 95% CI: 1.30~3.17), Protestants (OR: 1.76, 95% CI: 1.22~2.53). Participants who had a private health insurance plan knew more about the services than those without one (OR: 1.45, 95% CI: 1.03~2.04). Conclusion: First, it is necessary to improve perception of the public and healthcare providers regarding home-based hospice care. The government should review a measure to institutionalize operation of a palliative care team at hospitals and community home-based hospice care centers.

Influence of Multicultural Awareness and Cultural Sensitivity on Intercultural Communication Skills of the Korean Nursing Students (간호대학생의 다문화 인식, 문화적 민감성이 문화 간 의사소통능력에 미치는 영향)

  • Lee, Eun-Mi;Kim, Sun-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.4
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    • pp.459-468
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    • 2017
  • This study examined the multicultural awareness, cultural sensitivity, and characteristics of multicultural experiences affecting the intercultural communication skills among Korean nursing students. The study participants were a total of 353 nursing students who had completed one or more clinical practice courses and were in 1 University and 2 Colleges. A self-assessment instrument was used. The descriptive statistics, t-test, one way ANOVA, Pearson's correlation coefficient, and simple and multiple regression were used to analyze the data. Statistically significant differences in the intercultural communication skill were observed in multicultural education, foreign friends, proficiency in English, stay in foreign countries, and length of stay in foreign countries. The intercultural communication skills was correlated with both multicultural awareness and cultural sensitivity. Multiple regression analysis showed that the multi-cultural awareness, multi-cultural education, and proficiency in English could explain 41.3% of the variances for the intercultural communication skill. Simple regression analysis also showed that the length of stay in foreign countries explained 2.5% of the intercultural communication skill among nursing students, who had stayed in foreign countries. Therefore, nursing educators should improve their multi-cultural awareness and develop various multi-cultural education programs, consider living abroad, and improve their language proficiency to strengthen nursing students' intercultural communication skill.

Clinical study of Chronic Urticaria (만성두드러기에 대한 임상적 고찰)

  • Kim, Hye-Jeong
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.15 no.2
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    • pp.252-260
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    • 2002
  • Introduction Urticaria is widely spread disease. About 15-20 $\%$ of population has experienced at least once in a life time. The etiology of urticaria is uncertain till now, and the affcting factors are various chemical material, physical factors, alcohol, fever, exercise, and hormone, etc. The symptoms of urticaria are small or large wheal-erythema reaction and itching or tingling sense. Cause there is no probe to detect the urticaria clearly, the treatment of urticaria is symptomatic. And mostly urticaria can be chronic and very hard to treat it fundamentally. Nowadays, many trials to treat the urticaria in oriental medical way show good curability. In this paper I'd like to report the treatment rate and degree of urticaria patients mostly using anti-histamine medication. Subjects From the outpatients who visited Korean Hospital of Kyunghee Kangnam during 2000-4 and 2002-1, the 36 chronic urticaria patients, at least more than 4 weeks from onset and 2weeks of treatment period, were chosen. Methods I evaluated the results of treatment with the following scale. Very Good: The all symptoms are clearly disappeared or one third of symptoms remain and sometimes eruption is appeared. Good: Half of the symptoms are improved but most of symptoms remain. No Change: No change appears before and after treatment. Worse: The degree and duration of eruption get worse than pre-treatment state. Results For Acupuncture treatment, I chose the several Acu points like Hapgok(합곡), Taichung(대충), Gokji(곡지), Yanggok(양곡), Yanggea(양계), and lmeup(족임읍), and usually lasted it 15 minutes. With the acupuncture treatment and herb medicine, 2-3 times a week, the patients whose treatment period was 2 to 4 weeks were 17(47.2$\%$), 4 to 8 weeks were 11(30.5$\%$), 8 to 12 weeks were 3(8.3$\%$), 12 to 16 weeks were 3(8.3$\%$), longer than 16 weeks were 2(5.5$\%$) Collecting the statistics of the frequency of prescripted herb medicine, Hyangsosan(향소산) was prescripted 21 times(58.3$\%$), Hyangsapyungwisan(향사평위산) was 15 times(41.6$\%$), Hwapisan(화피산) was 9 times(25$\%$), Yangwitang(양위탕) was 6 times(16.6$\%$), Bojungikkitang(보중익기탕가미) was 4 times(11.1$\%$), Yongdamsagantang (용담사간탕가미) was 4 times(11.1$\%$). The result of the treatments, evaluating with mentioned rate scale, was 11 cases(30.5$\%$) were Very Good degree, 19 cases(52.7$\%$) were Good , 6 cases(16.6$\%$) were No Change. No cases were Worse degree. Conclusion According to this research, we could say that chronic urticaria can be treated with Oriental medical methods. But more precise probes in both Oriental and Western medicine to diagnose the chronic urticaria should be established and we need to make standards for testing and diagnosing the chronic urticaria.

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The Effectiveness of Ultrasound-Guided Soyeom Pharmacopuncture Therapy at Acromioclavicular Joint of Shoulder in Patients with Anterior Shoulder Pain: A Retrospective Study (견관절 전방 통증 환자에서 초음파 유도하 견쇄관절 소염약침요법 병행 치료의 효과: 후향적 연구)

  • Kim, Sang Woo;Jeon, Dong-Hwi;Kim, Byung-Jun;Park, Jeong-Wook;Oh, Min-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.3
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    • pp.95-104
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    • 2021
  • Objectives The purpose of this study was to observe effectiveness of ultrasound-guided Soyeom pharmacopuncture therapy at acromioclavicular joint of shoulder in patients with anterior shoulder pain. Methods We analyzed medical records of 9 patients hospitalized with anterior shoulder pain who had admitted to Department of Korean Rehabilitation Medicine, College of Korean Medicine, Daejeon University from March 1, 2021 to June 13, 2021. 9 patients were treated the treatment of Soyeom pharmacopuncture therapy on acromioclavicular joint under ultrasonic guidance with Korean medicine treatment (such as herbal medicine, acupuncture, moxabustion, etc). The study was conducted as a retrospective observation study which analyze the patient's medical records. We used numeric rating scale (NRS) to evaluate pain reduction and the shoulder range of motion (ROM) to evaluate function improvement twice (before pharmacopuncture treatment and 5 days later treatment). Statistical analysis was performed using the IBM SPSS Statistics version 25 program (IBM Co., Armonk, NY, USA). Results The average of numeric rating scale reduced statistically significantly from 5.56±1.13 to 3.11±1.36 (p=0.004). The average of shoulder flexion ROM increased statistically significantly from 166.67±8.17° to 175.00±8.37° (p<0.05). And the average of shoulder abduction ROM increased statistically significantly from 158.57±20.35° to 172.86±12.53° (p<0.05). Both NRS and shouler ROM showed statistically significantly improve after treatment. Conclusions This study shows ultrasound-guided Soyeom pharmacopuncture therapy at acromioclavicular joint of shoulder has a meaningful clinical effect on the improving shoulder pain and ROM especially on flexion and abduction.

End of Life Care Competencies and Terminal Care Stress of Nurses in Long Term Care Hospitals (요양병원 간호사의 생애말 환자간호 역량과 임종간호 스트레스)

  • Jeong, Young-Hee;June, Kyung Ja
    • Journal of Hospice and Palliative Care
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    • v.22 no.3
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    • pp.125-133
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    • 2019
  • Purpose: The purpose of this study was to investigate the relationship between end of life care competencies and terminal care stress of nurses in long term care hospitals. Methods: For this study, 140 nurses were sampled among those that have over 6-month end of life care experience and were working at long term care hospitals located in A city and C city of Chungcheongnam-do. Using a questionnaire, data were collected from January 2018 through March 2018. Data were analyzed using the SPSS, Windows version 21.0, according to the purpose of the study and analyzed by descriptive statistics, t-test, one way ANOVA, $Sch\acute{e}ffe^{\prime}s$ test, and Pearson's correlation coefficient. Results: The mean score on terminal care stress of nurses was above the normal level. The scores on end of life care competencies significantly varied by age, total career at hospitals, death/hospice and palliative care education, and bereavement experience. The mean score of end of life care competencies was negatively correlated with the mean score of lack of knowledge and skills among the subitems of the terminal care stress category (r=-0.260, P=0.002). Conclusion: To decrease the terminal care stress of long term care hospital nurses, it is suggested to carry out end of life care education tailored to nurses characteristics.

Comparison of Fornix and Stria Terminalis Connectivity among First-Episode Schizophrenia, Chronic Schizophrenia and Healthy Controls (초발 조현병, 만성 조현병과 건강 대조군의 뇌활과 분계섬유줄 연결성 비교)

  • Lee, Arira;Yun, Mirim;Yook, Ki Hwan;Choi, Tai Kiu;Lee, Kang Soo;Bang, Minji;Lee, Sang-Hyuk
    • Korean Journal of Biological Psychiatry
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    • v.26 no.1
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    • pp.8-13
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    • 2019
  • Objectives Disrupted integrities of the fornix and stria terminalis have been suggested in schizophrenia. However, very few studies have focused on the fornix and stria terminalis comparing first-episode schizophrenia (FESZ), chronic schizophrenia (CS), and healthy controls (HCs) with the application of diffusion-tensor imaging (DTI) technique. The objective of this study is to compare the connectivity of the fornix and stria terminalis among FESZ, CS, and HCs. Methods We included the 44 FESZ patients, 39 CS patients and 20 HCs in this study. Voxel-wise statistical analysis of the fractional anisotropy (FA) data was performed using Tract-Based Spatial Statistics to analyze the connectivity of fornix and stria terminalis. In addition, the Scale for the Assessment of Positive Symptoms (SAPS) and the Scale for the Assessment of Negative Symptoms (SANS) were used to evaluate clinical symptom severities. Results There were no significant differences between the FESZ, CS, and HCs in age, sex, education years. The SAPS and SANS scores of the schizophrenia groups showed no significant differences. FA values of the right fornix cres/stria terminalis in the CS group were significantly lower than those in FESZ and HCs. There were no significant differences of FA values of the right fornix cres/stria terminalis between the FESZ and the HCs. Pearson correlation analyses revealed that significant correlation between FA values of the right fornix cres/stria terminalies of the the FESZ group and positive, negative symptom scales, and FA values of the right fornix cres/stria terminalis of the CS group and negative symptom scales. Conclusions This study shows that FA values of the fornix and stria terminalis in the CS were lower than in the FESZ and the HCs. These results suggest that the fornix and stria terminalis can play a role in pathophysiology of schizophrenia. Thus current study can broaden our understanding of the pathophysiology of schizophrenia.

Radiographic Study of Cobey Method and Modified Cobey Method (Cobey 검사법과 Modified Cobey 검사법에 대한 방사선학적 연구)

  • Go, Yu-Rim;Joo, Young-Cheol;Lee, Seung-Keun
    • Journal of radiological science and technology
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    • v.42 no.3
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    • pp.167-173
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    • 2019
  • The Cobey method and the modified Cobey method are most commonly used in clinical practice. Therefore, the purpose of this study was to investigate the radiological differences between Cobey and modified Cobey and provide radiographic information about changes of hindfoot image with X-ray entrance center and tube angle change in modified Cobey. This study was performed on foot and ankle phantom. First, for image comparison of Cobey and modified Cobey, the images obtained by applying the same X-ray entrance center to the ankle joint were compared and analyzed. Second, in the modified Cobey, the X-ray entrance center is set as ankle joint and lateral malleolus. The X-ray tube angle was varied from $10^{\circ}$ to $40^{\circ}$ at $5^{\circ}$ intervals for each X-ray entrance center. The images obtained by varying the X-ray tube angle from $10^{\circ}$ to $40^{\circ}$ at intervals of $5^{\circ}$ for each X-ray entrance center were compared and analyzed. The irradiation conditions were the same with 110 kVp, 200 mA, 10 ms, and 110 cm of source - image receptor distance (SID). Image evaluation was performed by two radiologists. Measurements were made on the lateral point, middle point, and calcaneus width based on a hypothetical line parallel to the calcaneal tuberosity. Data were analyzed by using descriptive statistics as the mean of the distance to each measurement location. The modified Cobey was longer than the Cobey by an average of 3 to 4 mm lateral and medial points, and the calcaneus width was similar (ICC = 0.939). In modified Cobey method, when the X-ray entrance center is ankle joint, the lateral point is about 3 mm and the medial point is about 4.3 mm longer than lateral malleolus. Also, when the X-ray tube angle is more than $20^{\circ}$, the degree of distortion is large. The ICCs for the lateral, medial point, and calcaneus width were 0.998, 0.961, and 0.997, respectively, as the X-ray entrance center and tube angle were changed. There was no significant difference between Modified Cobey and Cobey. Modified Cobey showed no need to compensate the $20^{\circ}$ detector angle of the Cobey. In addition, we suggest that tube angle should be limited within $20^{\circ}$ when modified Cobey is performed.

Effect of Nurse's Self-Leadership, and Self-Efficacy on Job Involvement (간호사의 셀프리더십, 자기효능감이 직무몰입에 미치는 영향)

  • Kwon, Sang Min;Kwon, Mal-Suk
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.4
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    • pp.284-292
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    • 2019
  • The purpose of this study was to analyze the factors influencing the clinical nurse's self-leadership and self-efficacy on job involvement. The survey was conducted from October 20 to December 15, 2017 for 205 nurses working at hospitals located in D city and K province of Korea. Analysis was performed with descriptive statistics, independent t-test, one-way ANOVA analysis, Scheffe's post-hoc test, Pearson correlation analysis, and stepwise multiple regression using the SPSS 21.0 for Windows. The results of the study were as follows. Average score for self-leadership was 3.58, for self-efficacy was 3.56, and for job involvement was 3.36. This study showed positive correlations between self-leadership, self-efficacy and job involvement. Self-leadership, marital status, self-efficacy, and job position were significant influences on job involvement. The explanatory power of influence factors was 43.7%. Based on the results of this study, it is necessary for nursing organizations and hospitals to actively support programs that enhance self-leadership and self-efficacy, which will be used to increase nurses' job involvement and improve productivity and efficiency of nursing work.

Predictive Factors for Improvement of Atrophic Gastritis and Intestinal Metaplasia: A Long-term Prospective Clinical Study (위축성 위염과 장상피화생의 호전에 영향을 미치는 인자에 대한 전향적 연구)

  • Hwang, Young-Jae;Kim, Nayoung;Yun, Chang Yong;Kwon, Min Gu;Baek, Sung Min;Kwon, Yeong Jae;Lee, Hye Seung;Lee, Jae Bong;Choi, Yoon Jin;Yoon, Hyuk;Shin, Cheol Min;Park, Young Soo;Lee, Dong Ho
    • The Korean journal of helicobacter and upper gastrointestinal research
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    • v.18 no.3
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    • pp.186-197
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    • 2018
  • Background/Aims: To investigate the predictive factors for improvement of atrophic gastritis (AG) and intestinal metaplasia (IM). Materials and Methods: A total of 778 subjects were prospectively enrolled and followed up for 10 years. Histological analysis of AG and IM was performed by using the updated Sydney system. To find the predictive factors for reversibility of AG and IM, 24 factors including genetic polymorphisms and bacterial and environmental factors were analyzed. Results: In all subjects, the predictive factor by multivariate analysis for improvement of both antral and corpus AG was successful eradication. The predictive factors for improvement of antral IM were age and successful eradication. The predictive factor for improvement of corpus IM was successful eradication. In patients with Helicobacter pylori infection, age and cagA were predictive factors for improvement of AG and IM. In patients with H. pylori eradication, monthly income and cagA were predictive factors for improvement of AG and IM. Conclusions: H. pylori eradication is an important predictive factor of regression of AG and IM and would be beneficial for the prevention of intestinal-type gastric cancer. Young age, high income, and cagA are additional predictive factors for improving AG and IM status. Thus, various factors affect the improvement of AG and IM.