• Korean Journal of Acupuncture
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• v.26 no.4
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• pp.53-66
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• 2009

Objective : Acupuncture has been widely used throughout the world for the treatment of knee osteoarthritis (knee OA). This study investigated whether acupuncture, particularly Sa-am acupuncture, could be effective in relieving pain and improving the symptoms of knee OA. Method : This study was conducted as a prospective, randomized, controlled, and patient- and investigator-blinded clinical trial. Forty volunteers with knee OA participated in the study. All participants were screened through an inclusion and exclusion criteria. Thirty four participants completed the clinical trial. In total, forty subjects were randomly selected to receive Sa-am acupuncture. Eight sessions of acupuncture were given at the contralateral side of the problematic knee for 4 weeks. Korean translation of Western Ontario and McMaster Universities Osteoarthritis Index (KWOMAC) scores were measured twice: at the beginning and end of the clinical trial period. Both the Patient Global Assessment and physical health scores based on the 36-Item Short-Form Health Survey were also used to measure the results. Results : Compared to the pre-trial scores, the Sa-am acupuncture group (n=34) showed a significant decrease in KWOMAC total scores according to a paired t-test. The Sa-am acupuncture group also showed significant improvement in the Patient Global Assessment when compared to the pre-trial. Conclusions : Sa-am acupuncture for knee OA resulted in an improved KWOMAC total score. This was mostly driven by the function component score that was greatly affected by acupuncture. However, further studies with expanded designs are needed to solidify this finding with scientific rigor.

• Clinical and Experimental Pediatrics
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• v.64 no.9
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• pp.473-479
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• 2021

Background: Malnutrition has a high incidence among pediatric surgical patients and contributes to increased risks of postoperative complications and extended hospital stays. Purpose: The present study aimed to determine the influence of preoperative nutritional status on the postoperative outcomes of pediatric patients who underwent elective gastrointestinal (GI) surgery. Methods: This prospective observational study was conducted at Cairo University Specialized Pediatric Hospital. According to the designated inclusion criteria, 75 surgical cases of both sexes were included. A structured questionnaire was developed and administered. This questionnaire included 3 main sections: demographic data and nutritional status parameters at admission and discharge. Pre- and postoperative nutritional statuses were compared. Results: According to both the subjective global nutritional assessment and STRONGKIDS score Questioner, more than 60% of patients in the upper GI patient group were at risk of malnutrition. Wasting status was most common in the upper GI patient group (67%; vs. 39.1% in the lower GI group). Underweight status was more common in the hepatobiliary and upper GI patient groups (nearly 50% for each group) than in the lower GI group (30.4%). On the other hand, stunted patients had a higher incidence of complications and a prolonged hospital stay (P=0.003 and P=0.037, respectively), while underweight lower GI patients experienced a prolonged hospital stay (P=0.02). A higher proportion of patients with preoperative anemia than those without preoperative anemia required a blood transfusion (P=0.003). Conclusion: Nutritional assessment is a crucial component of pediatric surgical patient management. Both underweight and wasting statuses were more common among hepatobiliary and upper GI patients. Postoperative complications and a long hospital stay were more common among stunted patients.

• Health Policy and Management
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• v.21 no.2
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• pp.195-212
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• 2011

Objectives: This study investigates the relationship between nurse staffing levels and differences in patient outcomes in terms of average length of stay, in-hospital mortality rate and 30-day death rate in order to evaluate the effectiveness of a policy that differentiates fees for inpatients on the basis of nurse-to-bed ratios. Methods: We obtained information on inpatients from health insurance claims data published by the Health Insurance Review and Assessment Service(HIRA) in 2008, organizational factors(type of hospital, ownership) from the records of the hospital report system in 2008, and nurse staffing levels, which were graded on a scale of 1 to 7, from data compiled between December 15, 2007, and September 20, 2008. The data were segregated according to type of hospital and quarter and finally 3,517 records of 1,182 hospitals were analyzed using multi-level analysis. Results: The average length of stay in grade 1~6 hospitals was lower than that in grade 7 ones, but the difference was much below one day. No significant difference was found among different grades in tertiary hospitals. Further, variations in staffing levels did not result in any significant difference in the in-hospital mortality rate and 30-day death rate. Conclusions: High nurse staffing levels did not result in better patient outcomes compared with low staffing levels. We therefore recommend modifying the above nurse staffing policy so as to make it more effective in improving patient outcomes.

• Physical Therapy Rehabilitation Science
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• v.11 no.1
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• pp.8-15
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• 2022

Objective: Post stroke motor recovery is facilitated by the brain reorganization or the neuroplastic changes. The therapeutic approach mentioned in the current case is one of the approaches for enhancing motor recovery by stimulating the damaged neural networks directing the motor behaviour of a person. The aim of the present study was to establish the changes in the balance and gait pattern of an individual through multi target stimulation of areas of cerebral cortex by utilising multichannel trans cranial direct current stimulation (M-tDCS) in a sub-acute stroke survivor. Design: A Case Report Methods: The present patient was the participant of the trial (CTRI/2021/02/031044).The patient was intervened with M-tDCS (anodes over left primary motor cortex that is C3 point and left dorsolateral prefrontal cortex i.e., F3 point and cathodes over supraorbital areas, Intensity - 1.2mA) for the duration of 20 minutes along with turbo med extern - an AFO to facilitate ankle dorsi flexion and conventional physiotherapy rehabilitation. The Fugl-Meyer assessment lower extremity (FMA-LE), Berg Balance Scale (BBS), Wisconsin Gait Scale (WGS) and the Stroke Specific Quality of Life (SSQOL) measures were used for outcome assessment. Baseline assessment was done on day 0 followed by assessment on 10 and 20 post intervention. Results: Improvement was seen in all the tools i.e. (FMA -LE), BBS, SSQOL and WGS over the time period of 20 days. Conclusions: M-tDCS resulted in improvement in gait parameters, balance and motor functions of lower extremity of the patient.

• Physical Therapy Rehabilitation Science
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• v.9 no.4
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• pp.318-323
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• 2020

Objective: Reacquisition of motor functions following stroke depends on interhemispheric neural connections. The intervention highlighted in the present case is an insight for augmenting motor recovery by stimulating the lesioned area and adjacent areas governing the motor behaviour of an individual. The purpose of this study was to determine the changes in the motor and cognitive outcomes through multi target stimulation of cortical areas by application of multichannel transcranial direct current stimulation (M-tDCS) in a stroke survivor. Design: A case report. Methods: The patient was a participant of a trial registered with the clinical trial registry of India (CTRI/2020/01/022998). The patient was intervened with M-tDCS over the left primary motor cortex i.e. C3 point and left dorsolateral prefrontal cortex i.e. F3 point with 0.5-2 mA intensity for the period of 20 minutes. SaeboFlex-assisted task-oriented training, functional electrical stimulation over the lower extremity (LE) to elicit dorsiflexion at the ankle and eversion of the foot, and conventional physiotherapy rehabilitation including a tailored exercise program were performed. Outcome assessment was done using the Fugl-Meyer assessment scale (FMA) for the upper and lower extremity (UE and LE), Montreal Cognitive Assessment (MOCA), Wisconsin Gait Scale (WGS) and the Stroke Specific Quality of Life (SSQOL) measures. Assessment was taken at Day 0, 15 and 30 post intervention. Results: Improvement was observed in all the outcome measures i.e FMA (UE and LE), MOCA, SSQOL and WGS across the span of 4 weeks. Conclusions: M-tDCS induced improvement in motor functions of the UE and LE, gait parameters and cognitive functions of the patient.

• Journal of Korean Academy of Nursing
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• v.4 no.1
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• pp.22-37
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• 1974

Through the examination of hospitalized patient's records, this study purports to determine. the extent to which nursing record behaviors meet general expectations held for nursing records and the differences in nursing record behavior in relation to different nursing categories, period of recording and hospitals with different management patterns. Nursing record behaviors of 802 patient's records in four hospitals in Seoul were examined. by use of a check list, which was prepared by the author as an instrument for the study. Data obtained from this examination were processed into percentage values for percentage. test and chi-square test in order to determine their significance. Results are as follows; 1. Records pertaining to treatment ranked highest among all care categories in their extent of coverage, averaging 65.6 percent. 2. Of the treatment category records, records of medication led others at 94.3 percent. followed by records of test and collection of specimens at 59.9 percent. diet at 58.8 percent and treatment at 41.0 percent. 3. Records in the category of physical assessment and care averaged 44.1 percent, the second highest next to treatment category records, 4. Of the records in the category of physical assessment and care, records in vital signs. placed first at 98.9 percent, followed by sleep at 76.2 percent, body weight at 74.7 percent, symptoms and signs at 69.3 percent, rest at 44.5 percent, hygiene at 39.7 percent, activities and participation at 16.9 percent, positions at 10.3 percent, level of consciousness at 9.8 percent and physiological dysfunction at 1.1 percent in that order. 5. Records in the category of psychological assessment and care averaged 3.2 percent, the lowest of the -three major categories. 6. Of the records in the category of psychological assessment and care, records on emotional responses ranked top at 10.5 percent, followed by self-concern at 2.1 percent, adjustment at 2.0 percent, family, occupational and social relations at 0.7 percent and preferences. and interest at 0.5 percent in that order. 7. Records in relation to the category of specific conditions were found in 9.1 percent of the total records. 8. Of the records in the category of specific conditions, consultation and transfer records, stood first at 25.0 percent, followed by precautionary measurements at 1.4 percent and isolation at 0.9 percent 9. A great difference in nursing record behavior was observed between the first week of hospitalization and the last week, with the first week's recordings much higher than the last week in the categories of treatment and specific conditions (p<0.01). and of physical assessment and care (p <0.05). 10. A big difference was also observed among the hospitals (p<0.01). 11. A big difference was also observed between the government-run hospitals and the private hospitals in the categories of physical assessment and care and specific conditions in the first week of hospitalization (P<0.05l), and in the category of psychological assessment and care in the last week (P<0.05). 12. Between the hospitals established with foreign aid and the other hospitals, the difference in nursing record behavior was significant only in the category of physical assessment and care both in the first week and the last week (P<0.01). 13. The average nursing record behavior in all care categories stood at 45.1 percent in the extent of its coverage in relation to the general expectations.

• Journal of Korean Academy of Nursing Administration
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• v.8 no.4
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• pp.633-643
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• 2002

Purpose : This study was conducted to develop a patient classification system for hemodialysis and to test its validity and reliability. Method : The process of the system development was as below. The lists of hemodialysis nursing activities were collected from literature and hemodialysis practice guideline and they were classified into 10 factors and 16 elements. And then, 4 classification levels were identified for each element. The content validity and interrater reliability of developed patient classification system were tested. Result & Conclusion : 10 factors of patient classification system for hemodialysis were consisted of psychosocial support, mobility, access, teaching, assessment, stability, supportive therapy, test, general nursing during hemodialysis, hemodialysis room management. According to validity and reliability results and experts' opinions, 4 classification levels revised to 3 classification levels and 2 elements were deleted. Finally, patient classification system were consisted of 10 factors, 14 elements, 3 classification levels, 3 categories.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.1
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• pp.14-17
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• 2016

Hoarseness is a postoperative complication of thyroidectomy, mostly due to damage to the recurrent laryngeal nerve (RLN). Hoarseness may also be brought about via vocal cord dysfunction (VCD) due to injury of the vocal cords from manipulations during anesthesia, as well as from psychogenic disorders and respiratory and upper-GI related infections. The clinician or surgeon should 1) document assessment of the patient's voice once a decision has been made to proceed with thyroid surgery ; 2) examine vocal fold mobility, or refer the patient to a clinician who can examine vocal fold mobility 3) examine vocal fold mobility, or refer the patient to a clinician who can examine vocal fold mobility, once a decision has been made to proceed with thyroid surgery 4) educate the patient about the potential impact of thyroid surgery on voice once a decision has been made to proceed with thyroid surgery ; 5) inform the anesthesiologist of the results of abnormal preoperative laryngeal assessment in patients who have had laryngoscopy prior to thyroid surgery ; 6) take steps to preserve the external branch of the surperior laryngeal nerve(s) when performing thyroid surgery ; 7) document whether there has been a change in voice between 2 weeks and 2 months following thyroid surgery ; 8) examine vocal fold mobility or refer the patient for examination of vocal fold mobility in patients with a change in voice following thyroid surgery ; 9) refer a patient to an otolaryngologist when abnormal vocal fold mobility is identified after thyroid surgery ; 10) counsel patients with voice change or abnormal vocal fold mobility after thyroid surgery on options for voice rehabilitation.

• Archives of Plastic Surgery
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• v.45 no.4
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• pp.367-374
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• 2018

Background This analysis presents patient-reported outcomes of breast augmentation procedures performed in Singapore using an inframammary fold incision and the "5 Ps" best practice principles for breast augmentation. These data are the first of their kind in Southeast Asian patients. Methods Through a retrospective chart review, patients who underwent primary breast augmentation with anatomical form-stable silicone gel breast implants using an inframammary fold incision were followed for ${\geq}6$ months postoperatively. The BREAST-Q Augmentation Module (scores standardized to 0 [worst] - 100 [best]) and Patient and Observer Scar Assessment Scale (POSAS; 1 [normal skin] to 10 [worst scar imaginable]) were administered. Responses were summarized using descriptive statistics. Patient-reported events were collected. Results Twenty-two Southeast Asian patients (mean age, 35.1 years) completed ${\geq}1$ postoperative BREAST-Q and POSAS assessment and were assessed 11 months to 5.5 years postoperatively. The mean postoperative BREAST-Q satisfaction with breasts and psychosocial well-being scores were 69.2 and 84.0, respectively. The mean POSAS score for their overall opinion of the scar was 4.2; the mean scores for all scar characteristics ranged from 1.2 to 4.2. Over 90% of patients (20/22) said that they would recommend the procedure. Patient complaints following surgery included anisomastia (possibly pre-existing; n=2), sensory loss at the nipple (n=2) or around the nipple (n=3), scarring (n=4), and slight capsular contracture (n=1). No patients required reoperation. Conclusions Southeast Asian patients reported high long-term satisfaction scores on the BREAST-Q scale and with their scar characteristics following breast augmentation using an inframammary fold incision, and nearly all said they would recommend this procedure. No reoperations were necessary in patients assessed for up to 5.5 years postoperatively.

• Korean Journal of Adult Nursing
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• v.12 no.1
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• pp.77-87
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• 2000

This study tried to suggest the basic materials that can be efficiently applied in clinical cases by understanding problems through a content analysis of an adult nursing assessment tool and opinion agreement about nurse's practical usage presently used in the hospital. The study was carried out in 36 attached hospitals in nationwide universities from May to December, 1999, the two hundred and twenty five reports were for analysis. The contents of the collected nursing assessment tool were analyzed. It was found that the tool had been used with various names and content and there were instances of partial omission of a number of items, such as documentation and time records. Other results revealed that they mostly had a systematic classification of items, formation of details a form of a check list, and the effect of saving time. In spite of the adult nursing assessment tool, it was suggested that its style be subdivided according to the specialized of a department and that standardized style be amended and supplemented. The respondents also answered that there had to be education about continuous and sufficient health assessment skills on the physical examination record. The most frequently suggested items to be added were: past history, marital status, patient and caregiver's address and telephone number. It was found that a patient's education career, economic status, religion, hygienic practice, sexual life and hobby were the most frequently omitted items on record. The reason given wes because the items were associated with his/her privacy. These results highlight the importance of analyzing the content with an complete data collection, supplying basic content for a more accurate nursing record, computerization, sharing information and standardization of the form.