• 대한안과학회지
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• 제60권2호
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• pp.144-151
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• 2019

목적: 당뇨황반부종 환자에서 항혈관성장인자의 유리체내주입술의 유효성과 안전성을 알아보고자 하였다. 대상과 방법: 연구목적에 부합하는 최근의 고품질의 체계적인 검토를 선정하였고, 선정된 문헌 고찰에 7건의 최근 수행된 무작위 임상시험을 추가하여 메타분석 및 네트워크 메타분석을 시행하였다. 유효성 결과 지표로는 1) 시력의 평균 향상, 2) 15글자 이상의 최대교정시력 개선을 경험한 환자의 비율, 3) 15글자 이상의 최대교정시력 저하를 경험한 환자의 비율을 파악하였고, 안전성 결과에는 전신이상 반응 및 안구 관련 이상 반응을 분석하였다. 결과: 라니비주맙과 베바시주맙의 교정시력의 평균 차이는 0.16 (95% confidence interval [CI]: -0.02, 0.345)이었고, 라니비주맙 대 애플리버셉트의 평균시력 차이는 -0.08 (95% CI: -0.26, 0.10)이었다. 치료 전후의 시력변화를 약제 간의 비교한 최대교정시력 변화지표에서 라니비주맙(-0.20; 95% CI: -0.40, -0.01)과 베바시주맙(-0.34; 95% CI: -0.53, -0.14)이 각각 애플리버셉트에 비해 효과가 낮은 것으로 나타났다. 전신 및 안구 부작용에서 약제 간에 유의한 차이가 없었다. 결론: 당뇨황반부종에서 애플리버셉트는 라니비주맙 또는 베바시주맙에 비하여 최대교정시력의 변화에 있어서 보다 효과적인 것으로 나타났다. 그러나 15글자 이상의 시력향상이나 시력저하에 있어서는 세 가지 약제에서 유의한 차이를 보이지 않았다. 항혈관성장인자의 안전성은 약제 간에 유의한 차이를 보이지 않았다.

• Journal of Nutrition and Health
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• 제55권6호
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• pp.601-616
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• 2022

In the era of the fourth industrial revolution technology, the inclusion of personalized nutrition for healthcare (PNH), when establishing a healthcare platform to prevent chronic diseases such as obesity, diabetes, cerebrovascular and cardiovascular disease, pulmonary disease, and inflammatory diseases, enhances the national competitiveness of global healthcare markets. Furthermore, since the government experienced COVID-19 and the population dead cross in 2020, as well as numerous health problems due to an increasing super-aged Korean society, there is an urgent need to secure, develop, and utilize PNH-related technologies. Three conditions are essential for the development of PNH technologies. These include the establishment of causality between obesity genome (genotype) and prevalence (phenotype) in Koreans, validation of clinical intervention research, and securing PNH-utilization technology (i.e., algorithm development, artificial intelligence-based platform, direct-to-customer [DTC]-based PNH, etc.). Therefore, a national control tower is required to establish appropriate PNH infrastructure (basic and clinical research, cultivation of PNH-related experts, etc.). The post-corona era will be aggressive in sharing data knowledge and developing related technologies, and Korea needs to actively participate in the large-scale global healthcare markets. This review provides the importance of scientific evidence based on a huge dataset, which is the primary prerequisite for the DTC obesity gene-based PNH technologies to be competitive in the healthcare market. Furthermore, based on comparing domestic and internationally approved DTC obese genes and the current status of Korean obesity genome-based PNH research, we intend to provide a direction to PNH planners (individuals and industries) for establishing scientific PNH guidelines for the prevention of obesity.

• 임상간호연구
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• 제21권2호
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• pp.154-168
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• 2015

Purpose: This study aimed to adapt the previously developed, high-quality oral care guideline for the usage in clinical settings in Korea. Methods: Guideline adaptation process was undertaken according to the guideline adaptation manual version 2.0 developed by National Evidence-based Healthcare Collaborating Agency (Kim, et al., 2011) and the standardized methodology for nursing practice guideline adaptation (Gu, et al. 2012). Results: The adapted oral care guideline was consisted of 10 domains and 85 recommendations. The number of recommendations in each domain were: 4 general issues, 2 oral care indications, 10 oral assessment 16 general oral care, 15 oral care for critically ill, 15 oral care for cancer patients, 14 oral care for cancer patients withoral complications, 5 oral careeducation, 2 oral care referral, and 2 documentation and report. Ten point six percent of the recommendations were rated as grade A, 20.0% as grade B grade, and more than half (69.4%) were rated as grade C. Conclusion: The adapted oral care practice guideline is expected to included the evidence-based practice guidelines as fundamentalss of nursing practice. Dissemination of the developed guideline nationwide would contribute improving the efficiency of oral care practice.

• Korean Journal of Radiology
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• 제24권7호
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• pp.601-605
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• 2023

• Journal of Hospice and Palliative Care
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• 제26권3호
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• pp.140-144
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• 2023

Many terminally ill cancer patients grapple with a range of physical, psychological, and social challenges. Therefore, it is critical to offer effective psychological interventions to assist them in managing these issues and enhancing their quality of life. This brief communication provides a concise overview of acceptance and commitment therapy (ACT), along with empirical evidence of its application for patients, caregivers, and healthcare professionals in hospice and palliative care settings and an overview of future directions of ACT interventions in South Korea. ACT, a third-wave type of cognitive behavioral therapy, is a model of psychological flexibility that promotes personal growth and empowerment across all life areas. Currently, there is substantial evidence from overseas supporting the effectiveness of ACT on health-related outcomes among patients with various diseases, caregivers, and healthcare professionals. The necessity and significance of conducting ACT-based empirical research in hospice and palliative care settings in South Korea are discussed.

• Physical Therapy Rehabilitation Science
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• 제11권2호
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• pp.224-234
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• 2022

Objective: The purpose of this study was to identify the practitioner and organizational characteristics that either detracted from or encouraged the use of evidence-based practice (EBP) by physical therapists. Design: A cross-sectional survey study Methods: Participants were 260 physical therapists currently practicing in South Korea. They completed a questionnaire designed to determine attitudes, beliefs, interest, self-efficacy and barriers to EBP, as well as demographic information about themselves and their practice settings. Logistic regression was used to examine relationships between socio-demographic and work environment characteristics and each practitioner factor. Results: Respondents agreed that the use of evidence in practice was necessary. Although 80% of them agreed that research findings are useful, 71% felt that a divide exists between research and practice. In terms of confidence in their skills, the ability to interpret results of statistical procedures ranked lowest. Despite internet access at work for 63% of respondents, only 14% were given protected work time to search and appraise the literature. Only 2% of respondents stated that their organization had a written requirement to use current evidence in their practice. The primary barrier to implementing EBP was a reported lack of time. Conclusions: In conclusion, most physical therapists stated they had a positive attitude toward EBP and were interested in learning or improving the skills necessary for implementation. Most recognized a need to increase the use of evidence in their daily practice, but a lack of ability to understand the results of research represents a significant barrier to implementing EBP.

• 한국산업보건학회지
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• 제33권4호
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• pp.395-402
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• 2023

Objectives: Microbial contamination of face masks used by healthcare professionals can vary depending on the degree of exposure to bioaerosols in various healthcare environments. However, research on this topic is limited. Therefore, we analyzed microbial contamination of N95 respirators used in hospital offices, wards, and outpatient settings. Methods: Samples isolated from N95 respirators worn for 2, 4, and 6 hours were incubated at a temperature of 35-37℃ or 25-28℃ for 24 hours or for 3-7 days, and colony-forming units were counted in chocolate agar, tryptic soy agar, and Sabouraud dextrose agar plates. Total indoor airborne bacteria were also measured in the healthcare environments. Finally, microbial species were identified using Gram staining with a microscopic speculum. Results: The three types of environments did not deviate from the maintenance of standard indoor air quality. There was no difference between the microbial species identified in the healthcare environment and mask contamination. However, the number of bacteria in the masks worn in each environment differed, and the degree of contamination increased with mask-wearing time (p<0.05). Conclusions: Therefore, care must be taken to avoid recontamination of masks due to improper use and exposure to biological hazards in healthcare environments. In conclusion, scientific evidence is necessary for safe mask-wearing times. Based on the results of this study, we hope to conduct further research to establish guidelines for the safe use of face masks during respiratory disease epidemics.

• 한국의료질향상학회지
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• 제23권1호
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• pp.69-90
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• 2017

Purpose: The purpose of this study was to analyze the impact of healthcare accreditation and to provide empirical evidence to validate positive effectiveness. Methods:Six electronic databases (KERIS, KoreaMed, NDSL, Ovid-medline, Embase, Cochrane library) were accessed in May 2016. Keywords used were 'accreditation' and 'Joint Commission on Accreditation of Healthcare Organization (JCAHO)'. Of the initially identified 3,008 articles, 60 studies on healthcare accreditation were selected based on inclusion criteria that are hospital accreditation, accreditation by disease and clinical center accreditation. These were retrieved and analyzed. Result: The 60 study results were on the impact of healthcare accreditation. Results were classified into four perspectives of Balanced Score Card (Financial, Customer, Internal Process, Learning & Growth). In internal process perspective, results revealed that healthcare accreditation has made a positive impact on "care process and procedure". In learning & growth perspective, healthcare accreditation has made a positive influence on "leadership", "organizational cultures" and "change mechanisms". However, it revealed that healthcare accreditation does not directly affect financial performance. It is also difficult to reach a definitive conclusion that healthcare accreditation programs affect patient satisfaction of customer and clinical outcome of the internal process. Conclusion: Healthcare accreditation programs provide positive impact on change of care process and building communication-oriented hospital culture. However, more rigorous and diverse research is needed on financial effects and clinical outcomes of healthcare accreditation.

• 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.

• The Korean journal of internal medicine
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• 제39권1호
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• pp.160-171
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• 2024

Background/Aims: The effectiveness of remdesivir treatment in reducing mortality and the requirement for mechanical ventilation (MV) remains uncertain, as randomized controlled trials (RCTs) have produced conflicting results. Methods: We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and other data resources to find RCTs published prior to April 10, 2023. The selection of studies, assessment of risk of bias, and meta-analysis were conducted according to PRISMA guidelines. The primary outcomes were all-cause mortality and the need to initiate MV. Results: A total of 5,068 articles were screened, from eight RCTs comprising 11,945 patients. The meta-analysis found that, compared to standard care or placebo, remdesivir treatment provided no significant all-cause mortality benefit (pooled risk ratio [RR], 0.93; 95% confidence interval [CI], 0.85-1.02; 8 studies; high certainty evidence), while subgroup analyses revealed a trend towards reduced mortality among patients requiring oxygen but not MV (pooled RR, 0.88; 95% CI, 0.77-1.00; 6 studies; I² = 4%). The need to initiate MV (pooled RR, 0.74; 95% CI, 0.59-0.94; 7 studies; moderate certainty evidence) in remdesivir-treated patients was also reduced compared to controls. Remdesivir significantly increased clinical improvement and discharge and significantly reduced serious adverse events. Conclusions: In this systematic review and meta-analysis of RCTs, it was found that remdesivir treatment did not show a substantial decrease in the risk of mortality. However, it was linked to a reduction in the necessity for additional ventilator support, suggesting remdesivir could be beneficial for COVID-19 patients, particularly those who are not on MV.