• 제목/요약/키워드: out patient

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Case Report for Severe Hepatitis A Treated in a Korean Hospital

  • Kim, Sul-Ki;Jeon, Cheon-Hoo;Lee, Nam-Heon;Cho, Jung-Hyo;Son, Chang-Gue
    • 대한한의학회지
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    • 제41권4호
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    • pp.100-105
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    • 2020
  • A 25-year-old male presented with influenza-like symptoms and took Western anti-inflammatory analgesic drugs for 2 days. The symptoms aggravated, so the patient decided to rely on Korean medicine (KM). Based on the highly elevated hepatic enzymes (AST 4,621 IU/L and ALT 2,763 IU/L) with a positive result of anti-HAV IgM, he was diagnosed with hepatitis A. The patient was hospitalized and given herbal drugs (Chunggan-plus extract, Innae-Tang) and acupuncture, according to symptom differentiation, the accumulation of damp heat (濕熱蘊結)". The subjective symptoms (fatigue, nausea, gastric discomfort) including jaundice and dark urine as well as laboratory abnormalities gradually improved gradually in 10 hospital days, and the patient completely recovered in 25 days as an out-patient. This case presents a classic case of severe hepatitis A in 2019 Korean outbreak, and is informative to physicians for diagnosis and treatment in the traditional Korean medicine field.

한방 치료로 호전된 결절성 양진에 관한 증례 보고 (A Case Report of Prurigo Nodularis Patient Treated by Korean Medicine Treatment)

  • 김수진;최지영;지선영;황보민
    • 한방안이비인후피부과학회지
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    • 제35권3호
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    • pp.107-113
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    • 2022
  • Objectives : This study was carried out to report the effect of Korean medicine treatment on prurigo nodularis. Methods : We treated a 26-year-old female prurigo nodularis patient. The patient received Korean medicine treatments including acupuncture, herbal-medicine, pharmacopuncture at Daegu Haany University Korean medical hospital. We evaluated the degree of improvement in prurigo nodularis by using the Visual Analogue Scale(VAS) and counting nodules. Results : After treatments, the results of this patient showed improvements on pruritus, nodules. Nodules are removed, and pruritus decreased from VAS 10 to VAS 1. Conclusions : This study suggests that Korean medicine treatment may be effective on prurigo nodularis.

Quadratic Assignment Problem 의 해법(解法) 및 응용(應用) (A Heuristic Algorithm for the Quadratic Assignment Problem and its Application)

  • 황학;전치혁
    • 대한산업공학회지
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    • 제5권1호
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    • pp.45-51
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    • 1979
  • This paper presents a heuristic solution procedure for the quadratic assignment problem, ranking procedure, which can handle the case where not all of the facilities have the same size of area. The ranking procedure is found more efficient than two other existing heuristic procedures from results of computational experience. Based on the out-patients flow pattern and the procedure developed, an improved layout of the three existing general hospitals is developed with the objective of minimizing the total distance travelled by patients in the central and the out-patient clinic.

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체간의 움직임 변화에 따른 요추부 근육의 통증 발현에 대한 임상적 고찰 (A clinical study about painful manifestation on lumbar with regard to movement change of trunk)

  • 김성렬;이석민;송창호
    • The Journal of Korean Physical Therapy
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    • 제16권3호
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    • pp.86-96
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    • 2004
  • A clinical study about painful manifestation on lumbar with regard to movement change of trunk The purpose of this study is to present the basis of low back pain therapy which is close examined of back muscle that is the main reason for that case of back pain when trunk rotation, flexion and extension. Therefore this study, which is based on literature review and clinical experience, has tried to figure out that back pain which is considered to be significant for the most increasing time, posture, motion, painful area, involved muscle have any influence on trunk rotation, flexion and extension This study has done with the patients in oriental rehabilitation clinic, K-oriental hospital, from Jan, 2003 to Dec, 2003. Total cases were 145(male:$39\%$-52 patients, female:$64.1\%$-93 patients) those who complained lumbosacral pain with radiating that makes patient unable to bending or extending the trunk. And they were surveyed retrospect way, checking the medical record and that of therapist. Results are as followings. 1. For sprain patient, $34.5\%$ complained pain on extension, and among them, the most remarkably, patients who did right rotation extension pattern were $20\%$. Herniated disc patient shows greater limit on flexion when trunk moves bending route, but right rotation with extension pattern shows the most limitation on flexion-extension according to the rotation of trunk 2. Cases of morning back pain($60.5\%$) showed high value on right rotation extension pattern($18.6\%$), right rotation flexion pattern($16.3\%$) but did not show big difference on left flexion and extension pattern 3. Patients those who complain pain on sitting position showed highest value each left, right $14.6\%$ of left and right rotation extension pattern 4. Among extension painful patient, there showed highest value of each $32.5\%$ on right rotation extension pattern, and $20.0\%$ on right rotation flexion pattern. 5. Tenderness distribution of quadratus lumborum showed $34.5\%$ on right rotation extension pattern, $20.7\%$ on left rotation extension pattern, and that of iliopsoas muscle at right rotation flexion pattern showed right muscle $20.0\%$, left $50.0\%$ Derived from the results of survey above, for sprain and HIVD patient showed greatest pain on right rotation pattern, for pain plus patient on right rotation extension among those who has extreme pain on sitting in the morning described tenderness on right quadratus lumborum, and those who complain pain on left rotation extension described tenderness on left lumborum the most Decisively, it is possible to figure out the problem muscle that involved when I found the time, position, motion that aggravating and painful area. Therefore this study would be expected to be able to be a useful clinical materials on diagnosis and therapy of low back pain.

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국소마취 백내장 수술환자의 불안에 대한 직접간호중재로서의 손잡아주기 프로그램 효과 (The Effects of the Hand-holding Program as an Independent Nursing Intervention for the Patients with Anxiety in Local Anesthesia)

  • 김귀분;김광주;이향련;신혜숙;채정숙
    • 동서간호학연구지
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    • 제4권1호
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    • pp.7-20
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    • 1999
  • Operation usually brings about psychological stress as well as physical stress to the patient and it greatly influences the maintenance of the homeostasis. Until now, most of the nursing research concerning the anxiety of the patient undergoing an operation has been done while the patient was under general anesthesia. Under local anesthesia, the anxiety of the patient who undergone operation is short. However, there is much demand of the operational nurses to mediate between the patient who is undergoing operation when fully conscious, as they are aware of the patient's anxiety and to decrease the patient's anxiety of this local anesthesia. Therefore, this research tries to verify the effects of the Hand-holding program on the anxiety of the operational patient undergoing local anesthesia and affirms the role of the nursing intervention. As an unequivalent control group non-synchronized designs, this research selects out 20 control groups and 21 experimental groups at random who have received cataract operation while under local anesthesia and after implementing the Hand-holding program to the experimental groups while undergoing the operation, the effect of the experiment was observed. By observing the Epinephrine, Cortisol, blood pressure, and pulse for the physical indexes before and after the enforcement of the hand-holding, and using the measurement of Speilberger(1972) for the psychological indicators for the anxiety of the patient before and after hand-holding, the results were analyzed through SAS program. As a results, intervention of hand-holding had a remarkable effect to decrease the anxiety felt by the patient and the diastolic blood pressure also was effectively decreased. On the other hand, through the decrease of the systolic blood pressure was also observed, it was not statistically significant. In the Epinephrine and Cortisol indicators, the intervention of hand-holding was revealed to have an insignificant effect. The Hand-holding was revealed to have an indicators, the intervention of Hand-holding was revealed to have an insignificant effect. The Hand-holding program may be said to have an effect which decreases the psychological anxiety of the patient undergoing local anesthesia.

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병원 이용자의 의료서비스 만족도 조사 (Patient's Satisfaction with Medical Care Services in Hospital)

  • 성정애;남철현;김성우;김귀숙;구현진;유은주
    • 대한예방한의학회지
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    • 제10권1호
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    • pp.109-121
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    • 2006
  • The purpose of this study was to determine factors influencing patient satisfaction with medical services in hospital, which is classified into environmental aspect, human services and procedural services. Based on the results of literature review, the study focused on effects of social-demographical factors on patient satisfaction. The environmental aspect of medical care services included medical equipment and facilities, hygiene, ventilation, heating and air-conditioning, waiting and resting space, ward space and parking facilities. Procedural service included registration process, bill payment, waiting time after registration, examination and prescription as well as appointment process. Human services consisted of physicians listening to stories of patients, examination duration, physicians' explanation and physicians' service. As for nurses, explanation about disease, examination procedure and results, kindness and nursing care were evaluated. Services provided by other staff members were also evaluated. Patient satisfaction, defined as individual attitude toward medical service as a whole, was measured using a questionnaire. A total of 700 in-or out-patients were surveyed in 6 hospitals with more than 300 beds in North Gyeongbuk Province. 1. The level of patient satisfaction varied with characteristics of patients. Male patients and those in their 30s had a low level of satisfaction. Dissatisfaction level was positively related to education level but negatively related to economic condition. 2. As for patient satisfaction with medical service providers and other employees in hospital, satisfaction level with physician's explanation about treatment was higher. But dissatisfaction levels with treatment duration and the lack of explanation about examination procedures were high, calling for improvement. Dissatisfaction level with nursing care was high, calling for training of nurses for better service. Given the low level of satisfaction with human services, hospital employees need to be trained to improve their service. 3. It Was found that administrative service was also a significant factor influencing patient satisfaction in addition to medical service. It is therefore important for hospitals to provide patients with prompt and convenient procedural service. 4. Environmental factors such as medical equipment and amenity facilities also affected patient satisfaction. Thus environmental condition, procedural service and human service are all important to improve medical service in hospital. In summary, procedural service was the most significant factor for patient satisfaction. The level of satisfaction in patients was also affected by human service and environmental condition. It is therefore necessary to take patient-oriented approach in providing medical service in an effort to improve patient satisfaction. The finding of a lower level of satisfaction with human service signifies the need for training of healthcare providers and other hospital employees for better services. The introduction of advanced management programs is also needed to improve procedures that patients go through in hospitals.

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한국형 환자분류체계의 개정연구 (Study for Revision of the Korean Patient Classification System)

  • 송경자;최완희;최은하;조성현;유미;박미미;이중엽
    • 임상간호연구
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    • 제24권1호
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    • pp.113-126
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    • 2018
  • Purpose: The purpose of this study was to revise the KPCS-1 and to standardize the three patient classification systems for general ward, ICU and NICU. The actual utilization of the KPCS-1 score and each nursing activity was evaluated and the relationships between KPCS-1 score and nursing related variables were reviewed. Methods: The 47,711 KPCS-1 scores of 6,931 patients who discharged from $1^{st}$ to $30^{th}$ April 2017 were analyzed and the statistical significance between KPCS-1 score and nursing related variables was reviewed by Generalized Estimating Equation. The revision of the KPCS-1 was carried out by Partial Least Square model. The 3 patient classification systems (KPCS-1,KPCSC and KPCSN) were standardized by professional reviews. Results: KPCS-1 was a valid instrument to express nursing condition adequately and was revised as a new version which has 34 nursing activity items. The names and terminologies of pre-existing 3 patient classification systems developed by KHNA were standardized as KPCS-GW, KPCS-ICU, KPCS-NICU. Conclusion: KPCS-1 was a valid instrument to represent diverse nursing conditions precisely and was revised as a 34-item KPCS-GW. The terminologies of the other patient classification systems by KHNA were standardized as KPCS-ICU and KPCS-NICU.

일반외과 환자의 환자위험지수에 따른 수술창상감염 발생률 (Surgical Site Infection Rates according to Patient Risk Index after General Surgery)

  • 이혜령
    • 한국직업건강간호학회지
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    • 제11권1호
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    • pp.44-51
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    • 2002
  • Purpose: Surgical Site Infection(SSI) is the third most common cause of nosocomial infection, so that it results in serious socioeconomic impact such as extra hospitalization, mortality and health care cost. The aim of this study was to analyses the SSI that based on the degree of wound contamination and patient risk index after general surgery and to generate a reference data for the effective management and reducing SSI. Method: From July, 1999 to June, 2000, 1080 cases which presented with surgical site infection after general surgery at S hospital in chunchon city were included in this study. The data were collected by review of the medical records retrospectively. The collected data, in accordance with the test purpose, is analyzed by SPSS/PC+ program, using real numbers, percentage, $X^2$ test, Pearson's correlation and stepwise logistic regression. Result: The overall wound infection rate was 4.7%(51 cases out of 1,080). The infection rate of clean wounds was 1.4%. Surgical site infection rate for patient risk index scores of 0, 1, 2 and 3 was 1.9%, 8.0%, 13.1% and 20.0%, respectively and increased significantly according to patient risk index(p=.000). Sixteen of the fifty one(31.4%) surgical site infections were found during an outpatient visit after discharge. Multivariate analysis, identified two independent variables : duration of postoperation stay(p=.000), age(p=.037). The most frequent isolated organisms were Pseudomonas aeruginosa(21%) and Staphylococcus aureus(21%). Also Staphylococcus aureus were all MRSA(Methicillin Resistant S. aureus). Conclusion: In this study, SSI was analysed according to the degree of wound contamination and patient risk index after general surgery. The data that obtained from this study is expected that it would be available for surveillance and control of SSI.

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소음인(少陰人) 전환장애(轉換障碍) 환자(患者) 1례(例)에 대한 증례보고(症例報告) (A clinical report of Soeumin patient with conversion disorder)

  • 이승현;정성민;차재덕;정효창
    • 동의신경정신과학회지
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    • 제13권2호
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    • pp.233-239
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    • 2002
  • 본 증례는 전환장애(轉換障碍) 환자(患者)를 소음인(少陰人) 한관결흉증(寒寬結胸證)으로 진단(診斷)하여 49일간 치료하여 유의한 호전을 볼 수 있었던 예이다. 입원당시 환자는 진전(振顫), 전신마비(全身麻痺), 복창만(腹脹滿), 대소편불리(大小便不利) 등의 주소중과 심한 우울증상(憂鬱症狀)을 보였으나 치료를 받으면서 진전(振顫)의 소멸(消滅)과 보행(步行)이 가능해짐은 물론 복창만(腹脹滿), 대소편불리(大小便不利)에 있어서도 유의한 효과를 보였고 우울증상(憂鬱症狀) 또한 한방정신료법(韓方精神療法)에 의하여 호전되었다. 본 저자는 심신의학(心身醫學)인 사상의학적(四象醫學的)인 진단(診斷)과 처방(處方)에 의해 전환장애(轉換障碍) 환자(患者)의 증세(症勢)에 대하여 유의한 호전(好轉)을 경험하였기에 보고하는 바이다.

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신장이식 환자와 가족의 퇴원후 교육요구 (A Study on the Educational Needs of Patients with Kidney Transplants and their Family Members after Discharge from Hospital)

  • 안재현;김남초
    • 대한간호학회지
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    • 제29권6호
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    • pp.1324-1335
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    • 1999
  • The purpose of this study was to explore the educational needs of patients with, kidney transplants and their family members to develop a rehabilitational and educational program. Data were collected from January 29, 1999 to April 20, 1999 with interviews using a structured questionnaire. There were 184 subjects in this study. of them, 107 were patients who had kidney transplants and had visited at the out-patient department of three general hospitals located in Seoul and 77 were family members. The questionnaire used for this study was developed by the investigator through a literature review and from data collected from 11 professional personnel and three kidney transplant patients and their families. The data were analyzed using the SAS program with t-test, ANOVA, Scheff test, Pearson correlation coefficient. The results are as follows; 1) In the patient group, total mean score for educational needs was 154.61 and the item mean score was 3.96. For the family group, total mean score for educational needs was 168.84 and the item mean score was 4.15. So in the family group, educational needs were scored higher than by the patient group. With regard to domains, both patient and family groups had as the highest educational needs, the domain of physical health and the top ten items in the educational needs were also in the domain of physical health. 2) In the patient group, women and the divorce/ bereavement group had higher educational needs in the domain of nutritional management, those who had been admitted longer than four weeks from their kidney transplant had higher educational needs in the domain of physical health and those who were less than 4 years from their transplant had higher educational needs in the domain of follow-up care. In the family group, those who were Catholics and had high school education had higher educational needs in the domain of nutritional management. 3) In the patient group, academic background was positively correlated(r=.208, p=.031) to educational needs.

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