• 제목/요약/키워드: out patient

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레트 증후군(Rett syndrome) 환자(患者) 1례(例)에 대(對)한 임상적(臨床的) 고찰(考察) (Clinical study on 1 case of patient with Rett syndrome)

  • 박춘하;윤여충
    • 대한한의학방제학회지
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    • 제9권1호
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    • pp.405-417
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    • 2001
  • Objective : Rett syndrome is a neurological disorder occurring primarily in girls. By process of treatment for a case which was diagnosed as Rett syndrome and out patient department treatment from the 12th, April, 1999 to November, 2001, the results are as follows. Method & Results : This patient was diagnosed as five-development disorders categories(五遲, 五軟), medicated with Yukmijihwang-tang(Liuweidihwang-tang, 六味地黃湯) and Kyejigayonggolmoryu-tang(Guizhijialonggu-tang, 柱枝加龍骨牡蠣湯). And acupunture therapy was taken on Shinjyungkyuk(shenchongge, 腎正格) and Paekoe(百會 GV 20), Taechu(大椎 GV 14), Renzhong(人中 GV 26). As a result, the patient's hypotonia and intermittent seizures were improved. Conclusion: Rett syndrome is most often misdiagnosed as autism, cerebral palsy or non-specific developmental delay. In oriental medicine, RS can be diagnosed as five development disorders categories (五遲, 五軟) and oriental medication with acupuncture treatment can improve RS patient's conditions.

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Dexmedetomidine intravenous sedation using a patient-controlled sedation infusion pump: a case report

  • Chi, Seong In;Kim, Hyun Jeong;Seo, Kwang-Suk
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제16권1호
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    • pp.55-59
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    • 2016
  • Dental treatment under sedation requires various sedation depths depending on the invasiveness of the procedure and patient drug sensitivity. Inappropriate sedation depth may cause patient discomfort or endangerment. For these reasons, patient-controlled sedation (PCS) pumps are commonly used. Patients are able to control the sedation depths themselves by pushing the demand button after the practitioner sets up the bolus dose and lock-out time. Dexmedetomidine is an ${\alpha}$-2 adrenoreceptor agonist with sedative, analgesic, and anxiolytic properties. It has been widely used for sedation for its minimal respiratory depression; however, there are few studies on PCS using dexmedetomidine. This study assessed the applicability of dexmedetomidine to PCS.

암환자의 심리사회영적 간호

  • 최화숙;김수지
    • 호스피스학술지
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    • 제6권1호
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    • pp.24-31
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    • 2006
  • Psycho-social-spiritual care should be included with comprehensive nursing care of cancer patient. Because of human being have four dimensions as physical, psychological, social and spiritual dimension and they do interactional relationship with themselves, others and God. So caregivers of cancer patient have to recognize what they have psycho-social-spiritual needs and have to consider how caregivers can combine these in comprehensive nursing care. Cancer patient will be experienced shock, feeling of crisis and fear of death and will be showed denial, anger, bargaining, depression, accept or give-up, hope, spiritual distress and spiritual needs to which help them to do some rituals or interactions according their religion. Loving attitude is essential of cancer patient care especially of psycho-social-spiritual care. Dr. Kim and her some colleques investigated about this and find out 10 concepts(Caring Behaviors) by Graunded Theory Methodology. They are Noticing, Participating, Sharing, Active Listening, Complimenting, Companioning, Comforting, Hoping, Forgiving, Accepting.

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Disseminated Cytomegalovirus Infection and Protein Losing Enteropathy as Presenting Feature of Pediatric Patient with Crohn's Disease

  • Cakir, Murat;Ersoz, Safak;Akbulut, Ulas Emre
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제18권1호
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    • pp.60-65
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    • 2015
  • We report a pediatric patient admitted with abdominal pain, diffuse lower extremity edema and watery diarrhea for two months. Laboratory findings including complete blood count, serum albumin, lipid and immunoglobulin levels were compatible with protein losing enteropathy. Colonoscopic examination revealed diffuse ulcers with smooth raised edge (like "punched out holes") in the colon and terminal ileum. Histopathological examination showed active colitis, ulcerations and inclusion bodies. Immunostaining for cytomegalovirus was positive. Despite supportive management, antiviral therapy, the clinical condition of the patient worsened and developed disseminated cytomegalovirus infection and the patient died. Protein losing enteropathy and disseminated cytomegalovirus infection a presenting of feature in steroid-naive patient with inflammatory bowel disease is very rare. Hypogammaglobulinemia associated with protein losing enteropathy in Crohn's disease may predispose the cytomegalovirus infection in previously healthy children.

뇌졸중 환자의 손가락 재활운동을 위한 손 및 손가락 고정장치 개발 (Development of Hand and Fingers Fixing System for Stroke Patient's Rehabilitation Exercise)

  • 김현민;김갑순
    • 한국정밀공학회지
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    • 제29권7호
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    • pp.753-761
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    • 2012
  • This paper describes development of a hand and finger fixing system for the rehabilitation exercise of patient's fingers. In order to exercise the finger rehabilitation using a finger rehabilitation robot, a patient's hand or fingers are fixed safely. In this paper, The hand and fingers fixing system can safely fix stroke patient's hand and fingers by pressing with force control system. The characteristic test of the system was carried out. It is thought that the system could be used for fixing their fingers in stroke patient's finger rehabilitation exercise.

요인별 치과 의료서비스 질이 환자만족과 서비스 가치에 미치는 영향 (The effects of the quality of dental care service by factors on the patient satisfaction and service value)

  • 김정숙
    • 한국치위생학회지
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    • 제6권1호
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    • pp.25-35
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    • 2006
  • The purpose of this study is to forecast patient satisfaction and service value through the staged regression analysis of the relation between each factor and its satisfaction and service value, following the measurement of the quality of dental care service that patients recognize. And a self-administered survey was used for this study. The subjects of this survey were 394 outpatients of dental clinics located in K city in the period from Dec. 5, 2004 to Feb. 19, 2005, the questionnaire was composed of a total of 31 questions to measure the quality of overall dental care service(22 questions), the patient satisfaction(6 questions) and the service value(3 questions). The 7 points Likert scale ranging from "very poor"(1-point) to "very high"(7-point) was used for these questions The results of study could be summarized as follows: 1. The most useful index to predict patient satisfaction turned out to be "internal environment", followed by "treatment process and waiting time", "dentist", "external environment", and "dental hygienist". 2. The service value had a significant effect on the "internal environment", "dentist", "treatment process and waiting time". 3. The most useful index to predict the service value turned out to be "treatment process and waiting time", followed by "internal environment" and "dentist". Today, the quality of dental care service is becoming a prime concern since it is directly connected to a matter of survival of medical service organizations. Dental clinics desperately need patient-oriented marketing strategies in order to actively cope with changing medical environment. They also need to thoroughly examine possible measures to maximize the service value by establishing a variety of service strategies which can promote service quality that patients recognize.

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사물인터넷(IoT) 환경의 응급실에 있어서 진료테스크 선정 지원 알고리즘 개발 (A Study on Priority of Patient's Medicine Task for the Emergency Department in IoT Environment)

  • 김대범
    • 한국시뮬레이션학회논문지
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    • 제25권2호
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    • pp.51-61
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    • 2016
  • 최근 응급의료 서비스의 환자 만족도에 대한 관심이 높아지고 있는 가운데 사물인터넷(IoT: Internet of Things)을 활용한 프로세스 개선에 많은 노력을 기울이고 있다. 본 연구는 IoT기술을 응급실 운영에 활용한 스마트 응급실의 핵심 기술을 살펴보고, 의사와 간호사의 의사결정을 지원하는 진료테스크 우선순위 결정 알고리즘을 제시한다. 제시한 알고리즘은 진료테스크 선정에 따른 책임소재, 환자 불평, 위급환자 진료 지연, 체류시간 길어짐 등의 의사결정 리스크를 최소화한다. 이를 통해 의료진의 감정 육체 소진(Burn-out)을 줄이고 친절과 배려가 있는 환자 진료 케어를 가능하게 하여 환자 만족도와 응급실 의료진의 근무 만족도를 높이고 나아가 간호사의 정체성 제고에 도움을 줄 수 있다. 가상의 응급실을 대상으로 시뮬레이션을 수행한 결과 환자 체류시간 측면에서도 우수한 성능을 보였다.

요양병원 간호사의 환자안전인식도와 업무수행도 비교 (Perception and Work Performance of Patient Safety among Nurses Working in Long-term Care Hospitals)

  • 문옥년;김영임;근효근
    • 한국직업건강간호학회지
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    • 제25권2호
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    • pp.118-129
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    • 2016
  • Purpose: This study aims to examine the levels of the perception and work performance of patient safety based on the healthcare accreditation criteria among long-term care hospital nurses. Methods: A cross-sectional study was performed using questionnaires. Out of 205 criteria, 39 items relevant to patient safety were selectively adapted for this study. Data were analyzed with descriptive statistics, t-test, ANOVA, and Pearson correlation coefficient. Results: The mean scores of perception and work performance were 4.36 and 4.24 out of 5, respectively, and the difference between them was significantly different (t=5.78, p<.001). The two variables were both significantly higher among those nurses who were older, married, head nurses, had many nursing experiences, and aware of Healthcare Accreditation than the other nurses. Positive correlations were observed between perception and work performance in all three sub-systems. The relations between these two in the patient care system was the most highly correlated (r=.894, p<.001). The lowest scores of perception and work performances were fire-related criteria (i.e., reporting). Conclusion: Overall, subject's perception proves to be higher than their work performance. It is necessary to develop some viable environment and training programs to enhance their work performance up to the level of their perception of patient safety.

입원환자 데이터를 이용한 예약부도환자 이탈방지 모형 연구 (Informally Patients Prediction Model of Admission Patients)

  • 김은엽;함승우
    • 한국산학기술학회논문지
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    • 제10권11호
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    • pp.3465-3472
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    • 2009
  • 본 병원에 축적된 의무기록과 데이터베이스에 있는 퇴원 환자 정보를 이용하여 이탈에 영향을 미치는 특성을 파악하여 활용 가능한 예측모형을 제시하고자 한다. 외래진료 방문환자 3,503명 중 충성고객 2,118명 60.5%, 이탈 고객 1,385명 39.5%을 추출하여 분석에 사용하였다. 생존한 변수는 성별, 연령(연령대), 지역, 보험구분, 입원경로, 진료과, 퇴원과, 퇴원형태, 협진여부, 수술여부, 진료예약여부, 환자구분을 기반으로 예측모형을 만들었다. 로지스틱 회귀분석을 실시한 결과 66.0%의 정확도를 나타냈고, 신경망을 통하여 예측한 결과 분석용 결과는 정분율은 69.79%이고, 검정용 결과 정분율은 63.64%였다. CHAID를 통하여 예측한 결과 분석용 결과 정분율을 83.75% 이고, 검정용 결과 정분율은 42.74%였다. 예측 모형을 활용한 이탈고객을 위한 관리와 병원의 신뢰를 높여야 할 것이다.

Restructuring Primary Health Care Network to Maximize Utilization and Reduce Patient Out-of-pocket Expenses

  • Bardhan, Amit Kumar;Kumar, Kaushal
    • Asian Journal of Innovation and Policy
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    • 제8권1호
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    • pp.122-140
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    • 2019
  • Providing free primary care to everyone is an important goal pursued by many countries under universal health care programs. Countries like India need to efficiently utilize their limited capacities towards this purpose. Unfortunately, due to a variety of reasons, patients incur substantial travel and out-of-pocket expenses for getting primary care from publicly-funded facilities. We propose a set-covering optimization model to assist health policy-makers in managing existing capacity in a better way. Decision-making should consider upgrading centers with better potential to reduce patient expenses and reallocating capacities from less preferred facilities. A multinomial logit choice model is used to predict the preferences. In this article, a brief background and literature survey along with the mixed integer linear programming (MILP) optimization model are presented. The working of the model is illustrated with the help of numerical experiments.