• 제목/요약/키워드: evidence-based guidelines

검색결과 348건 처리시간 0.027초

Treatment Strategies of Improving Quality of Care in Patients With Heart Failure

  • Se-Eun Kim;Byung-Su Yoo
    • Korean Circulation Journal
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    • 제53권5호
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    • pp.294-312
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    • 2023
  • Heart failure (HF) is a global health problem closely related to morbidity and mortality. As the burden of HF increases, it is necessary to manage and treat this condition well. However, there are differences between real-world practice and guidelines for the optimal treatment for HF. Patient-related, healthcare provider-related, and health system-related factors contribute to poor adherence to optimal care. This review article aims to examine HF treatment patterns and treatment adherence in real-world practice, identify clinical gaps to suggest ways to improve the quality of care for HF and clinical outcomes for patients with HF. Although it is important to optimize treatment based on evidence-based guidelines to the greatest extent, it is known that there is still poor treatment adherence, and many patients do not receive guideline-directed medical therapy, especially at the early stages. To improve medication adherence, qualitative evaluation through performance measurement, as well as education of patients, caregivers and medical staff through a multidisciplinary approach are important.

혈액투석 환자의 기능부전 도관관리 실무지침개발 (Development of a Practice Guideline for Catheter Dysfunction in Hemodialysis Patients)

  • 이경미;김미연;홍진영;조용애;양원지
    • 임상간호연구
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    • 제22권2호
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    • pp.238-247
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    • 2016
  • Purpose: This study was done to develop an evidence-based practice guideline for catheter dysfunction in hemodialysis patients. Methods: Development of the guideline process was done according to the De Novo development version 1.0 by NECA which consists of 12 steps. Results: The developed guideline consisted of 5 domains and 14 recommendations. The number of recommendations for each domain were: 3 on catheter dysfunction assessment, 1 on conservative management of catheter dysfunction, 7 on drug management of catheter dysfunction, 1 on catheter function test and 2 on maintenance management. Of the recommendations, 7.15% were marked as A grade, 52.85% of B grade, and 50% of C grade. Conclusion: Findings in this study indicate that this guideline can be added to the evidence-based practice guidelines for fundamentals of practice and that this guideline can be disseminated to nurses nationwide in order to improve the care of hemodialysis patients with catheter dysfunction.

환자안전을 위한 병원건축 설계지침과 디자인 기본구조 비교조사 - 미국과 영국을 중심으로 (Comparative Study of Hospital Architecture Design Guidelines and Frameworks for the Patient Safety - Focused on the US and UK)

  • 김영애;이현진;송상훈
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제27권3호
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    • pp.27-37
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    • 2021
  • Purpose: The purpose of this study is to compare the changes in hospital accreditation evaluations, the changes in hospital building design guidelines, and the development of design indicators for reducing medical accidents in the state-of-the-art healthcare providers. Methods: The changes and tools were carefully investigated and compared that had been taken place and used in the building certification standards, design guidelines, and patient safety design standards to reduce accidents in the United States and the United Kingdom. Results: First, medical accidents are recognized as multiple defense layers rather than personal ones, and a public reporting and learning system is created, reporting the accidents in question publicly and suggesting ways to improve them based on the data at a time. Second, for the accreditation institute that secures the service quality of medical institutions, detailed standards for patient safety are continuously updated with focus on clinical trials. The United States is in charge of the private sector, but on the other hand the United Kingdom is in charge of the public sector. Third, the design guidelines are provided as web-based tools that complement various guidelines for patient safety, and are improved and developed as well. Fourth, detailed approaches are continuously developed and provided to secure patient safety and reduce medical accidents through appropriate research, evidence-based design and strict evaluations. Implications: When medical institutions make efforts to strength patient safety methods through valid design standards, accidents are expected to decrease, whereby hospital finances are also to be improved. A higher level of medical quality service will sure be secured through comprehensive certification evaluation.

코로나19의 증거생성 질병관리 (Evidence-Developing Disease Control of Coronavirus Disease 2019)

  • 박은철
    • 보건행정학회지
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    • 제30권4호
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    • pp.431-432
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    • 2020
  • Coronavirus disease 2019 (COVID-19) has been going on for nearly a year. As of December 1, 2020, more than 60 million confirmed cases and 1.4 million deaths have occurred in 220 countries and territories. There is no effective treatment for COVID-19 so far, and vaccines are being developed. However, the vaccine of COVID-19 can be freed from COVID-19 only if there are positive answers to some questions: "Aren't there any major side effects from the vaccine?"; "Is the vaccine effective for enough time?"; "Does the vaccine sufficiently reduce the mortality rate?"; and "Does the vaccine sufficiently reduce the reproduction number?" The fight against COVID-19 will continue for a long time. Therefore, we need to respond by developing the evidence for control of COVID-19, the emerging infectious disease. Extensive quarantine measures in the early stages of COVID-19 need to be elaborated through developing the evidence. Korea Disease Control and Prevention Agency should establish a database for evidence developing COVID-19 control. In this database, based on more than 3 million tested individuals, epidemiological investigation results, health insurance claims data, and government data such as the Ministry of Public Administration and Security, etc. should be linked. It is necessary to disclose this database to academia, etc. to create the evidences of COVID-19 and manage COVID-19 through these. And through the developed evidences, guidelines for physical health and mental health in the era of Corona 19 should be developed.

A Study on Guidelines of Tourism Development in Korea and Japan

  • Jung, Won-Jo;Lee, Han-Seok;Lee, Myung-Kwon
    • 한국항해항만학회지
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    • 제38권3호
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    • pp.277-289
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    • 2014
  • Fishing village is becoming the central base of fishing industry and it plays a major role. However, there is a decrement of marine resources and some difficulties with the deterioration of fishing industry management. In order to solve these problems, there should be some developments(e.g. fishing village toursim development) on various undergoing government and the private organization programs. Nevertheless, there are not guidelines for fishing village tourism development to utilize for practical business. Therefore, it is necessary to understand the current status and guidelines regarding the development of fishing village for coastal planner. The primary purpose of this study is to investigate the characteristics of fishing village development works in Korea and Japan. The second purpose is to identifie success factors after analyzing individual success cases. Based on evidence from the literature and a dialogue with village leader, a literature review on extracting success cases for guidelines were selected according to criteria such as the degree of contribution to an increase in income of the fishing village, the degree of contribution to an increase in consumption of marine products using local natural resources, the number of tourists that visits the village. Finally we propose guidelines for future fishing village development projects. The guidelines based on the successful cases, as well as the major factors about the objectives and direction of fishing village tourism development, suggested as follows. 1)Plans for land use, 2)Development of tourist resources, 3)Plans for views, 4)Plans for resource protection, 5)Plans for operation and marketing.

Korean Society of Heart Failure Guidelines for the Management of Heart Failure: Treatment

  • Jong-Chan Youn;Darae Kim;Jae Yeong Cho;Dong-Hyuk Cho;Sang Min Park;Mi-Hyang Jung;Junho Hyun;Hyun-Jai Cho;Seong-Mi Park;Jin-Oh Choi;Wook-Jin Chung;Byung-Su Yoo;Seok-Min Kang;Committee of Clinical Practice Guidelines, Korean Society of Heart Failure
    • Korean Circulation Journal
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    • 제53권4호
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    • pp.217-238
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    • 2023
  • The Korean Society of Heart Failure (KSHF) guidelines aim to provide physicians with evidence-based recommendations for the management of patients with heart failure (HF). After the first introduction of the KSHF guidelines in 2016, newer therapies for HF with reduced ejection fraction, HF with mildly reduced ejection fraction, and HF with preserved ejection fraction have since emerged. The current version has been updated based on international guidelines and research data on Korean patients with HF. Herein, we present Part II of these guidelines, which comprises treatment strategies to improve the outcomes of patients with HF.

Korean Practice Guidelines for Gastric Cancer 2022: An Evidence-based, Multidisciplinary Approach

  • Tae-Han Kim;In-Ho Kim;Seung Joo Kang;Miyoung Choi;Baek-Hui Kim;Bang Wool Eom;Bum Jun Kim;Byung-Hoon Min;Chang In Choi;Cheol Min Shin;Chung Hyun Tae;Chung sik Gong;Dong Jin Kim;Arthur Eung-Hyuck Cho;Eun Jeong Gong;Geum Jong Song;Hyeon-Su Im;Hye Seong Ahn;Hyun Lim;Hyung-Don Kim;Jae-Joon Kim;Jeong Il Yu;Jeong Won Lee;Ji Yeon Park;Jwa Hoon Kim;Kyoung Doo Song;Minkyu Jung;Mi Ran Jung;Sang-Yong Son;Shin-Hoo Park;Soo Jin Kim;Sung Hak Lee;Tae-Yong Kim;Woo Kyun Bae;Woong Sub Koom;Yeseob Jee;Yoo Min Kim;Yoonjin Kwak;Young Suk Park;Hye Sook Han;Su Youn Nam;Seong-Ho Kong;The Development Working Group for the Korean Practice Guidelines for Gastric Cancer 2022 Task Force Team
    • Journal of Gastric Cancer
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    • 제23권1호
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    • pp.3-106
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    • 2023
  • Gastric cancer is one of the most common cancers in Korea and the world. Since 2004, this is the 4th gastric cancer guideline published in Korea which is the revised version of previous evidence-based approach in 2018. Current guideline is a collaborative work of the interdisciplinary working group including experts in the field of gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology and guideline development methodology. Total of 33 key questions were updated or proposed after a collaborative review by the working group and 40 statements were developed according to the systematic review using the MEDLINE, Embase, Cochrane Library and KoreaMed database. The level of evidence and the grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation proposition. Evidence level, benefit, harm, and clinical applicability was considered as the significant factors for recommendation. The working group reviewed recommendations and discussed for consensus. In the earlier part, general consideration discusses screening, diagnosis and staging of endoscopy, pathology, radiology, and nuclear medicine. Flowchart is depicted with statements which is supported by meta-analysis and references. Since clinical trial and systematic review was not suitable for postoperative oncologic and nutritional follow-up, working group agreed to conduct a nationwide survey investigating the clinical practice of all tertiary or general hospitals in Korea. The purpose of this survey was to provide baseline information on follow up. Herein we present a multidisciplinary-evidence based gastric cancer guideline.

The Effect of Brand Evidence on Positive Emotion, Negative Emotion, and Attitude in Restaurant Industry

  • KIM, Eun-Jung
    • 한국프랜차이즈경영연구
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    • 제12권1호
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    • pp.45-55
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    • 2021
  • Purpose: How to build the positive emotion of customer is very important, because it affects the positive attitude. Brand evidence has a significant impact on consumer behavior in terms of reinforcing consumers' perception of food service companies and differentiating them from competing brands. Thus, this study examines the effect of brand evidence on emotion (positive emotion and negative emotion), and attitude in restaurant industry. Research design, data, and methodology: This study examines the structural relationship among brand evidence, emotion, and attitude. Brand evidence divide into three sub-dimensions such as physical evidence, core service, and employee service. In order to test the purposes of this study, research model and hypotheses were developed. The questionnaire items were modified and used according to the content of this study based on previous studies. All constructs were measured by multiple items tested and developed in the previous research. The data were collected from 439 restaurant users from Seoul area were analyzed using SPSS 22.0 and SmartPLS 3.0 program. A total of 460 questionnaires were distributed and a survey was conducted for 4 weeks, and a total of 439 were used for analysis, excluding non-response data and 21 unusable response data among the collected questionnaires. Frequency analysis was conducted to identify the general characteristics of the survey subjects. To measure the reliability and validity of the measurement tools, confirmatory factor analysis was conducted. Structural model analysis was conducted to verify the research model. Result: The findings demonstrate that physical evidence, core service, employee service had positive effects on positive emotion. And core service and employee service had negative effects on negative emotion while physical evidence did not have. Also, positive emotion had positive effect on attitude and negative emotion had negative effect on attitude. Conclusions: The findings of this study provide guidelines on how to enhance competitiveness in restaurant industry through understanding brand evidence's effects on raising perceived consumer's emotion and attitude. Therefore, food service companies should establish a marketing strategy that can stimulate positive emotions through brand evidence, which is all factors related to service brands that influence consumers' evaluation of service products and purchase decision-making process.

틱장애 혹은 뚜렛장애의 비약물치료 (Non-Psychopharmacologic Therapy of Tic or Tourette's Disorder)

  • 임명호;이영림;김붕년
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제25권2호
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    • pp.53-64
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    • 2014
  • Tic disorder is a childhood neuropsychological disorder characterized by abrupt, involuntary, and repetitive stereotyped muscle movement or vocal sound. Tourette's disorder shows a chronic prognosis, and can last for life if no treatment is applied. Although tic disorder has been known for ages, the underlying cause is still not well known. Non-pharmacological treatments have long been used for the tic disorder, but few clinical studies were conducted. However, the European Society for the Study of Tourette's Syndrome recently issued non-pharmacologic guidelines for treatment of tic disorders based on the research findings obtained so far. In addition, guidelines for non-pharmacologic evidence-based treatment were reported in Canada, North America. By synthesizing the newly reported foreign guidelines for treatment and review articles, the aim of this study is to investigate the non-pharmacologic therapies used for treatment of tic disorder or Tourette's disorder.

The Value and Limitations of Guidelines, Expert Consensus, and Registries on the Management of Patients with Thoracic Aortic Disease

  • Pacini, Davide;Murana, Giacomo;Leone, Alessandro;Marco, Luca Di;Pantaleo, Antonio
    • Journal of Chest Surgery
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    • 제49권6호
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    • pp.413-420
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    • 2016
  • Doctors are often faced with difficult decisions and uncertainty when patients need a certain treatment. They routinely rely on the scientific literature, in addition to their knowledge, experience, and patient preferences. Clinical practice guidelines are created with the intention of facilitating decision-making. They may offer concise instructions for the diagnosis, management (medical or surgical treatments), and prevention of specific diseases or conditions. All information included in the final version are the result of a systematic review of scientific articles and an assessment of the benefits and costs of alternative care options. The final document attempts to meet the needs of most patients in most circumstances and clinicians, aware of these recommendations, should always make individualized treatment decisions. In this review, we attempted to define the intent and applicability of clinical practice guidelines, expert consensus documents, and registry studies, focusing on the management of patients with thoracic aortic disease.