• Title/Summary/Keyword: evidence-based

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근거기반 욕창간호 실무지침 개정 (Updates of Evidence-Based Nursing Practice Guidelines for Pressure Injury)

  • 김정윤;박경희;박옥경;박주희;이윤진;황지현
    • 임상간호연구
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    • 제29권1호
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    • pp.12-23
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    • 2023
  • Purpose: This study was conducted to update the previous evidence-based nursing clinical practice guidelines for pressure injury. Methods: The guideline was revised in 22 steps based on the international standards. Results: The updated nursing practice guideline for pressure injury consisted of four domains and 494 recommendations. The numbers of recommendations in each domain was: 31 hospital policy, 64 assessment, 386 prevention and management, and 13 education. The recommended grade was 10.3% for A, 13.8% for B, and 75.9% for C. Of these, the major revision was done in 40 recommendations (8.1%). A total of 55 recommendations (11.0%) were newly added. 25 recommendations had minor revisions such as changes or additions for some words, and only one recommendation was deleted. Conclusion: The revised nursing practice guidelines for pressure injury are expected to serve as an evidence-based practice guideline for pressure injury in Korea. This guideline will provide healthcare providers, patients, and caregivers with information to help prevent and manage pressure injuries, leading to improving patient outcomes.

우울증의 자기 관리 방법 (Self Care in Depression)

  • 이선혜;박용천
    • 생물정신의학
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    • 제14권1호
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    • pp.5-13
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    • 2007
  • Objectives : Depression disturbs the individual life from the loss of productivity to suicide. Furthermore the whole society is also influenced by depression in social and economic areas. Many scientific treatment methods are known to be effective in depression. But in reality more than half of patients with depression prefer self help treatment rather than medically based treatment. For the patients with mild depression and primary physicians, it is reasonable to provide the evidence based self care including self help or alternative treatment. This study is supported by the Korean Health 21 R&D Project for the Depression Center to establish the Korean treatment guideline for depression. Methods : The members of Depression Center including the authors attended the workshops where the methods of evidence based medicine such as literature search, quality evaluation of the articles, making the level of evidence were educated. The professional librarians helped the authors for get the searched articles. Among the total of 354 abstracts of systemic review and 300 abstracts of random controlled trials, 3 systemic reviews and 2 random controlled trials were the main structure of evaluation. Result : Among the 37 self care methods known to be effective for depression, 11 kinds of methods were worth of evaluation. The first step for the self care of mild depression is to use St. John's wort, exercise, bibliotherapy, and light therapy in depression during winter season. Acupuncture, negative ion therapy, massage, relaxation technique are known to be efective with evidence. Music therapy, hypnotherapy, and aromatherapy are known to be effective but until now the evidences is insufficient and further evaluations are needed. Conclusion : Among 11 listed self-care methods, several methods need more evidence especially in Korean situation. Exercise is the most recommendable evidence based self care method in Korea nowadays. St. John's wort is effective with evidence, but it is not the OTC drug in Korea, so it is not recommendable now. For the bibliotherapy, there is no book such as "Feeling Good" in Korea. Only the introductory book about depression is available. Publishing the self help book based upon cognitive behavioral approach or psychodynamic approach is needed. Light therapy is practiced in a few clinics, but not self-help style. Exposure to the sunlight is recommended in the level of commen sense. These self care methods are for the mild patient. Moderate to severe patients with depression should seek the professional treatment.

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성인 발열 환자를 위한 근거기반 간호 지침 개발 및 평가 (Development and Evaluation of an Evidence-Based Nursing Protocol for Fever Management in Adult Patients)

  • 신용순;김성렬;유성희;김선화;김정희;김현정;나라;채지선;이혜진;안영희;김경옥
    • 성인간호학회지
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    • 제25권3호
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    • pp.250-262
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    • 2013
  • Purpose: This study was designed to develop, to implement and evaluate a fever management nursing protocol for adult patients. Methods: This study was conducted through seven steps following both the guideline development procedures of the Scottish Intercollegiate Guidelines Network and the Model of the Asan Medical Center Evidence-Based Practice, as follows: 1) identifying the clinical needs and composition of the protocol development group; 2) identifying and evaluating the evidence; 3) assessing the level of evidence and grading recommendations; 4) forming a protocol; 5) evaluating the protocol using an expert group validity test and identifying barriers to its implementation; 6) protocol development; and 7) evaluation of practical improvement measures following implementation of the protocol. Results: The evidence-based protocol for fever management in adult patients was completed and includes five domains and 15 items. The protocol had good content validity (CVI=.90) and nursing practice could be improved after implementation of the protocol. Conclusion: This nursing protocol can be used as a guide for nursing in febrile adult patients. We recommend that further guidelines be updated in an interdisciplinary manner in order to foster local adaptation of the best clinical practices.

논의기반 탐구에서 협상이 중학생들의 주장-증거 변화에 미치는 영향 (The Effect of Negotiation in Argument-Based Inquiry on Middle School Students’ Claim and Evidence)

  • 장경화;남정희
    • 대한화학회지
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    • 제60권1호
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    • pp.39-47
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    • 2016
  • 이 연구의 목적은 논의기반 탐구 활동에서 협상이 중학생의 주장과 증거 생성 능력에 미치는 영향을 알아보기 위한 것으로 논의기반 탐구 활동에서 학생들이 작성한 주장과 증거의 수준을 분석하였다. 이 연구는 남녀공학 중학교 1학년 4개 학급 학생(126명)을 대상으로 1년에 걸쳐 5개의 활동을 적용하였다. 활동을 분석하기 위한 평가틀을 개발하여 주장과 증거를 분석하였으며 주장과 증거의 생성 과정을 알아보고자 활동 후에 학생 인터뷰를 실시하여 분석하였다. 연구 결과는 논의기반 탐구 활동에서 학생들이 제시한 주장과 증거는 개별 활동에서 조 활동으로 진행됨에 따라 주장과 증거의 수준이 높아졌고, 활동이 거듭됨에 따라 전반적으로 향상되는 경향을 나타냈다. 이는 논의기반 탐구 활동을 통하여 학생들이 내적 및 외적 협상을 경험하면서 수준 높은 주장 및 증거를 형성하게 된 것임을 보여준다.

간호연구 질 평가 도구 및 보고지침 고찰 (Quality Assessment Tools and Reporting Standards in Nursing Research)

  • 김경희;김주현;임경춘;이경숙;정재심;최명애;채영란
    • Journal of Korean Biological Nursing Science
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    • 제14권3호
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    • pp.221-230
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    • 2012
  • Purpose: Quality of nursing research should be evaluated before it is applied as an evidence for evidence-based nursing practice. This study attempted to analyze and to compare tools for the quality assessment and reporting standards of nursing research using CONSORT and STROBE checklist by types of research design. Methods: We searched the tools for quality assessment in nursing research based on the National Evidence-based Healthcare Collaborating Agency (NECA) publication. Then, we analysed and compared the tools for quality evaluation by types of research design. Results: According to the analysis using CONSORT checklist, ROB shows coherence in 17 items, Jadad shows coherence in 3 items, SIGN (for RCT) shows coherence in 26 items, and Downs & Black shows coherence in 24 items. According to the analysis using STROBE checklist, MINORS shows coherence in 25 items, NOS shows coherence in 21 items, SIGN (for Cohort studies & Case-control studies) shows coherence in 29 items, and RoBANS shows coherence in 21 items. Conclusion: Based on our analysis, we recommend that nursing researchers should report according to the reporting standards of tools for quality evaluation. We hope that our analysis can be helpful to develop evidence-based nursing.

해방 이후 한의학의 현대화 논쟁 - 1950년대와 1990년대 이후의 논의를 바탕으로 - (The Dispute on the Modernization of Korean Medicine after the Restoration of Independence -Based on the 1950s and from the 1990s to the Present-)

  • 이태형;정유옹;이덕호;김남일
    • 대한예방한의학회지
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    • 제16권3호
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    • pp.53-73
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    • 2012
  • Objectives : The inclusion of Korean Medicine in the national health care system led to the need of a serious discussion on its modernization. This paper looked at how these discussions were progressed. Especially, a difference in the meaning of 'science' in the 1950s and the 1990s was observed. Methods : Articles related to the medical dispute between Korean and Western Medicine in "EE LIM", especially the ones from the 1950s, were selected, classified and analyzed. Research papers on Evidence-Based Medicine were also analyzed. Evidence-Based Medicine was a new medical research methodology in the 1990s. Articles on Evidence-Based Medicine were searched and selected from journal databases: DBpia, KISS, RISS, and OASIS. Results : The problem of establishment of modernity of Korean Medicine in the recent times was addressed in the context of scientification and systematization. Accordingly, the academic societies of Korean Medicine aimed for scientification. But efforts to secure the identity of Korean Medicine opposed to western science were also made. Meanwhile, Evidence-Based Medicine established in 1992 presented a different concept of science. This led to a new means of acknowledgement of Korean Medicine in the modern society. Conclusions : The modernization process of Korean Medicine up to now was a course of scientification. But as this process did not fully reflect its characteristics, the modernization of Korean Medicine still remains a pending question. A modern study methodology that fully reflects the identity of Korean Medicine needs to be established.

근거기반 정맥주입요법 간호실무지침 실무적용 프로그램 개발 및 평가 - 중소병원을 대상으로 (Development and Effectiveness of Practice Application Program of Intravenous Infusion Evidence-Based Nursing Practice Guideline - for Small and Medium Sized Hospitals)

  • 홍인화;은영
    • 대한간호학회지
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    • 제50권6호
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    • pp.863-875
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    • 2020
  • Purpose: This study was conducted to develop and test the effects of a program for practice application of intravenous infusion evidence based nursing practice (EBP) guidelines in small and medium-sized hospitals. Methods: A mixed method research design was used, combining non-equivalent control group pre-post test design with qualitative study analysis. The subjects consisted of 55 nurses. The practice application program was developed based on the Advancing Research and Clinical practice through close Collaboration (ARCC) model. Data were collected for analysis in the following areas: nurses' EBP organizational culture and readiness, EBP beliefs, EBP implementation, importance about intravenous infusion, and performance about intravenous infusion, with data assessed using valid and reliable instruments. Patient outcomes were collected from the hospital's medical records. Data were analyzed using t-test, χ2-test, and Shapiro-Wilk test, with qualitative content analysis used for interview data. Results: Following the intervention, nurses' EBP organizational culture and readiness, EBP beliefs, EBP implementation, and performance of intravenous infusion and perceptions of its importance showed significant improvement in the experimental group. Phlebitis rates decreased in the experimental group compared to the control group. Conclusion: This program is effective to improve nurse's perception and practice of evidence based nursing. Therefore we recommend to use this program at same levels of hospitals.

The Primary Process and Key Concepts of Economic Evaluation in Healthcare

  • Kim, Younhee;Kim, Yunjung;Lee, Hyeon-Jeong;Lee, Seulki;Park, Sun-Young;Oh, Sung-Hee;Jang, Suhyun;Lee, Taejin;Ahn, Jeonghoon;Shin, Sangjin
    • Journal of Preventive Medicine and Public Health
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    • 제55권5호
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    • pp.415-423
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    • 2022
  • Economic evaluations in the healthcare are used to assess economic efficiency of pharmaceuticals and medical interventions such as diagnoses and medical procedures. This study introduces the main concepts of economic evaluation across its key steps: planning, outcome and cost calculation, modeling, cost-effectiveness results, uncertainty analysis, and decision-making. When planning an economic evaluation, we determine the study population, intervention, comparators, perspectives, time horizon, discount rates, and type of economic evaluation. In healthcare economic evaluations, outcomes include changes in mortality, the survival rate, life years, and quality-adjusted life years, while costs include medical, non-medical, and productivity costs. Model-based economic evaluations, including decision tree and Markov models, are mainly used to calculate the total costs and total effects. In cost-effectiveness or costutility analyses, cost-effectiveness is evaluated using the incremental cost-effectiveness ratio, which is the additional cost per one additional unit of effectiveness gained by an intervention compared with a comparator. All outcomes have uncertainties owing to limited evidence, diverse methodologies, and unexplained variation. Thus, researchers should review these uncertainties and confirm their robustness. We hope to contribute to the establishment and dissemination of economic evaluation methodologies that reflect Korean clinical and research environment and ultimately improve the rationality of healthcare policies.

침(鍼)의 근거중심적(根據中心的) 연구동향(硏究動向)에 관(關)한 고찰(考察) - Systematic review & Meta-analysis를 중심으로 - (The Review on the Evidence-Based Study of Acupuncture - Systematic review and Meta-analysis -)

  • 백용현;박동석;강성길
    • Journal of Acupuncture Research
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    • 제19권3호
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    • pp.138-155
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    • 2002
  • Objective : The purpose of this study is to work on the problems and on the direction of the study regarding the evidence-based study of Acupuncture. Methods : We reviewed the PubMed electronic database. Eight articles of systematic review without meta-analysis and six articles without meta-analysis were selected. Results : In the study of eight articles of systematic review without meta-analysis, there were two articles on effectiveness of acupuncture and one on non-effectiveness of acupuncture. Four articles were about the changes according to the quality of randomized controlled trials. Also, one article was about the side-effect of acupuncture. In the study of six articles of systematic review with meta-analysis, there were two articles on Odds Ratio, two on Relative Risk, one on number-needed-to-treat, and two on 18 predefined methodological criteria. Conclusion : As the quality of RCTs was high, positive response decreased and as the quality of RCTs was low, positive response increased. For the study of evidence-based acupuncture, it is necessary that we conduct research on well-planned placebo acupuncture, large sample size, statistical method, method of searching and assessing literature and method of meta-analysis.

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