• Title/Summary/Keyword: patient compliance

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A Study on Muscle Architectural and Tissue Compliance of Biceps Brachii in Stroke Patient Based on Elbow Joint Angle (뇌졸중 환자에서 주관절 각도 변화에 따른 상완이두근의 근구조 및 탄성 변화에 관한 연구)

  • Bae, Sea-Hyun;Jeong, Chan-Joo;Kim, Kyung-Yoon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.12
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    • pp.5867-5874
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    • 2012
  • The aim of this study was to find on muscle architectural and tissue compliance of biceps brachii in stroke patient based on elbow joint angle. The subjects of this study were twelve hemiplegic adults after stroke with passive range of motion in the elbow from $10^{\circ}$ to $90^{\circ}$ and Modified Ashworth Scale score 1 to 3 were recruited. Ultrasonography and Myotonometer was used to measure biceps brachii muscle pennation angle, fascicle length, and tissue compliance at the rest condition and pennation angle, fascicle length, and tissue compliance of the biceps brachii muscle were measured in the affected and unaffected sides of people after stroke at 9 different elbow angles ranging from $10^{\circ}$ to $90^{\circ}$ at the rest condition. The results of this study, comparisons found that the pennation angles of the affected biceps brachii muscle were significantly larger(p<.05) than the unaffected muscle in the most extended positions($<40^{\circ}$), whereas the affected fascicle lengths were significantly shorter(p<.05) than the unaffected muscle in most flexed positions($>20^{\circ}$), and the affected tissue compliance were significantly lower(p<.05) than the unaffected muscle in most extended positions($<50^{\circ}$) Therefore, pennation angles, fascicle lengths, and tissue compliance were found to be joint-angle-dependent in both the affected and unaffected sides at the rest condition. Suggest that, the results data can be used as a muscle architectural changes and clinical treatment research in stroke patients.

Survey of Pharmacy Practice for Compounding Parenteral Nutrition in Hospital Setting - 2009 (병원약국 대상으로 정맥영양제 조제 실행에 관한 연구-2009)

  • Sin, Hye-Yeon;Jung, Ki-Hwa
    • YAKHAK HOEJI
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    • v.54 no.4
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    • pp.244-251
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    • 2010
  • Standardized parenteral nutrition is required to improve patient's safety, clinical appropriateness and to increase uniformity between institution and institutions. We assessed the consistency with the American society for parenteral and enteral nutrition (A.S.P.E.N.) practice guideline for PN by evaluating current practice process for parenteral nutrition formulation in inpatients pharmacies in Korea. Each question in this survey was based on 2007 A.S.P.E.N. recommendations of standard parenteral nutrition formulation, the American society of health-system pharmacists (ASHP), and the United State Pharmacopoeia (USP) Chapter 797 guideline for compounding parenteral nutritions. All 90 Korean society of hospital pharmacist (KSHP) member directors of pharmacy were requested to respond to the survey in order to compare the survey results to ASHP national survey of pharmacy practice in hospital settings (2002) in compliance with A.S.P.E.N. guideline. We had final response rate of 35.6%. 25 (100%) hospitals complied with this Garb guideline (response rate was 84.4%) which was the highest compliance. Only 17.9% of hospital pharmacies were actively involved in complications monitoring. Monitoring complications and efficacy were least in compliance with the A.S.P.E.N. guideline. 69.0% of Korean pharmacists adjusted medication dosage based on disease state or monitoring laboratory data in compliance with the A.S.P.E.N. guideline. Over 50% of the hospital pharmacies failed to provide and evaluate staff training in aseptic manipulation skills periodically. Korean hospital pharmacies need to comply with the standard practice guideline for compounding sterile preparation in order to provide better quality of parenteral nutrition service for specific patient population.

Effects of a Patient Educational Video Program on Bowel Preparation Prior to Colonoscopy (동영상 교육이 대장내시경 대상자의 장 정결 이행에 미치는 영향)

  • Cho, You Young;Kim, Hyeon Ok
    • Journal of Korean Academy of Nursing
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    • v.45 no.5
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    • pp.704-712
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    • 2015
  • Purpose: The purpose of this study was to evaluate the effects of an educational video program on bowel preparation for a colonoscopy. Methods: The study used a non-equivalent control group and non-synchronized design as a quasi-experimental research involving 101 participants undergoing bowel preparation for a colonoscopy (experimental group 51, control group 50 subjects) at W. university hospital, from Aug. 7 to Oct. 31, 2013. The control group received verbal education with an explanatory note while the experimental group received education using a video program. To measure knowledge of diet restrictions and compliance with ingesting bowel preparation solutions, a questionnaire, based on The Korean Society of Gastrointestinal Endoscopy's Guide (2003), developed by Sam-Sook You, was used after revisions and supplementation was done. To measure bowel cleanness, the 'Aronchick Bowel Preparation Scale' was adopted. Data were analyzed using the SPSS WIN 12.0 program. Results: A higher proportion of the experimental group showed a positive change in knowledge level on diet restrictions (U=1011.50, p =.035) and ingestion of bowel preparation solutions (U=980.50, p =.019), a higher level of compliance with diet restrictions (U=638.50, p <.001), ingesting bowel preparation solutions (U=668.00, p <.001) and the level of bowel cleanness (${\chi}^2$=17.00, p <.001) than the control group. Conclusion: The results of this study indicate that a video educational program for patients having a colonoscopy can improve knowledge, level of compliance with diet restrictions, ingestion of bowel preparation solutions, and bowel cleanness. Therefore video educational program should be used with this patient group.

Antispastic Effects of Electroacupuncture, TENS and NMEs in Stroke Patient (중풍경직에 전침, TENS 및 신경근 자극기의 효과에 대한 연구)

  • Kim, Yong-suk
    • Journal of Acupuncture Research
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    • v.17 no.2
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    • pp.209-220
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    • 2000
  • Spasticity, an abnormal increase in resting muscle tone, is one of the most common symptoms of stroke, and its management is becoming a major issue in rehabilitation. The aims of this study are to determine the effects of electroacupuncture(EA), TENS and neuromuscular electric stimulation(NMES) on spasticity, as well as the possibility of tissue comliance method as a spasticity scale. 45 stroke patients participated in a study of the effects on hemiplegic spasticity of EA, TENS and NMES. Spasticity was measured by modified Ashworth scale on the upper extremity and tissue compliance measurement, penetration mm/kg, on Susamni(LI10) area at just before and after stimulation, and 30 minutes, 1 hour, 2 hours and 24 hours after stimulation. The acupuncture points were applied to Kokchi(LI11), Susamni(LI10), Hapkok(LI4) and Oegwan(TE5) of the affected limb. The electrodes were placed unilaterally on LI11 to LI10 and TE5 to LI4. EA with biphasic wave, 60Hz, 0.4 msec pulse duration and low intensity was applied continuously for 20 minutes. TENS with high frequency, low intensity was applied. NMES was applied with spasticity program for 20 minutes. Each electric stimulation was done on extensor muscles group of forearm for 20 minutes. EA and NMES groups were found to produce a statistically significant decrease(p〈0.05) of spasticity and these effects lasted up to 30 minutes after stimulation. There was no definite correlation between the modified Ashworth scale and tissue compliance measurement. But tissure compliance method was found to be possible as a quantitative measurement on spasticity. There was no significant correlation between the effects of EA and NMES and the characteristics of patient, but significant correlation between the effects of EA and NMES and the modified Ashworth scale.

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Estimation of Blood Pressure Diagnostic Methods by using the Four Elements Blood Pressure Model Simulating Aortic Wave Reflection (대동맥 반사파를 재현한 4 element 대동맥 혈압 모델을 이용한 혈압 기반 진단 기술의 평가)

  • Choi, Seong Wook
    • Journal of Biomedical Engineering Research
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    • v.36 no.5
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    • pp.183-190
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    • 2015
  • Invasive blood pressure (IBP) is measured for the patient's real time arterial pressure (ABP) to monitor the critical abrupt disorders of the cardiovascular system. It can be used for the estimation of cardiac output and the opening and closing time detection of the aortic valve. Although the unexplained inflections on ABP make it difficult to find the mathematical relations with other cardiovascular parameters, the estimations based on ABP for other data have been accepted as useful methods as they had been verified with the statistical results among vast patient data. Previous windkessel models were composed with systemic resistance and vascular compliance and they were successful at explaining the average systolic and diastolic values of ABP simply. Although it is well-known that the blood pressure reflection from peripheral arteries causes complex inflection on ABP, previous models do not contain any elements of the reflections because of the complexity of peripheral arteries' shapes. In this study, to simulate a reflection wave of blood pressure, a new mathematical model was designed with four elements that were the impedance of aorta, the compliance of aortic arch, the peripheral resistance, and the compliance of peripheral arteries. The parameters of the new model were adjusted to have three types of arterial blood pressure waveform that were measured from a patient. It was used to find the relations between the inflections and other cardiovascular parameters such as the opening-closing time of aortic valve and the cardiac output. It showed that the blood pressure reflection can bring wide range errors to the closing time of aortic valve and cardiac output with the conventional estimation based on ABP and that the changes of one-stroke volumes can be easily detected with previous estimation while the changes of heart rate can bring some error caused by unexpected reflections.

Indirect palatal skeletal anchorage (PSA) for treatment of skeletal Class I bialveolar protrusion (Indirect palatal skeletal anchorage (PSA)를 이용한 골격성 I급 양악 치성 전돌 환자의 치험례)

  • Chae, Jong-Moon
    • The korean journal of orthodontics
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    • v.34 no.5 s.106
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    • pp.458-464
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    • 2004
  • Anchorage plays an important role in orthodontic treatment especially in the maxillary arch. In spite of many efforts for anchorage control. it was difficult for clinicians to predict the result of treatment because most of the treatment necessitated an absolute compliance of patients, But recently, skeletal anchorage has been used widely because it does not necessitate patient compliance but produces absolute anchorage. In addition titanium miniscrews have several advantages such as ease of insertion and removal. possible immediate leading and use in limited implantation spaces. In this case, a skeletal Class I bialveolar protrusion Patient was treated with standard edgewise mechanics using indirect active P.S.A. (palatal skeletal anchorage). The miniscrews in the paramedian area of the hard palate provided anchorage for retraction of the upper anterior teeth and remained firm and stable throughout treatment This indicates that the PSA can be used to reinforce anchorage for orthodontic treatment in the maxillary arch Consequently, this new approach can help effective tooth movement without patient compliance, when used with various transpalatal arch systems.

Comparison of Compliance, Time Required for Diagnosis and Pain of Patients with Finger Tendon Injury Between Gross and Ultrasonographic Confirmation (손가락 힘줄 손상환자에서 육안 검사와 초음파 검사의 순응도, 시간, 통증의 비교)

  • Lee, Seo-Woo;Park, Hyun-Jae;Lee, Jung-Won;Park, Sae-Hoon;Kim, Jae-Woo
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.83-88
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    • 2010
  • Purpose: It is not always easy to determine the existence of tendon injuries when it comes to patients with finger lacerations. Thus, we tried to find the difference in effectiveness and in compliance of patients when we employed two different types of diagnosis, conventional gross confirmation and ultrasonographic confirmation. Methods: From December 2009 to March 2010, we enrolled 14 patients with finger tendon injury at Soonchunhyang University Cheonan Hospital. The median age of the patients was $35.9{\pm}14.4$, and the ratio of females to males was 1:2.5 We evaluated the compliance of each patient by measuring four different categories (level of cooperativeness in showing their wound and in following the instructions, level of movement of their fingers during the diagnosis and total number of attempts to diagnose) by using a score from 1 to 3 for each category, for a total possible score of 12 for each patient. We also measured the painfulness of each patient by using a score of 1 to 10 and the time required for each diagnosis. Results: The levels of patients' compliance was $8.9{\pm}2.1$ when diagnosed with gross confirmation and $9.8{\pm}2.1$ when diagnosed with ultrasonographic confirmation (p value=0.042). The pain score of the patients was $3.7{\pm}1.7$ with gross confirmation and $2.9{\pm}1.2$ with ultrasonographic confirmation (p value=0.020). The median duration of time in each test was $6.7{\pm}4.8$ minutes with gross confirmation and $10.5{\pm}4.2$ minutes with ultrasonography (p value=0.006). Conclusion: Comparing gross confirmation and ultrasonographic confirmation, gross confirmation is a better method than ultrasonography because of time efficiency. However, ultrasonographic confirmation has advantages over gross confirmation in pain scale and better compliance of patients. Emergency physicians generally employ gross confirmation rather than ultrasonography in determining the existence of tendon injury in patients. In patients with finger lacerations without bone injury, ultrasonography can be considered as a secondary diagnostic tool, especially when patients have much pain.

A Study on Hip Arthroplasty Patient Compliance of Medical Regimen (인공고관절 치환술 환자의 치료지시 이행에 관한 연구)

  • Ryu, Kyong-Ae;Kim, Young-Hae;Lee, Hwa-Ja;Kim, Myung-Hee;Kang, In-Soon
    • The Korean Journal of Rehabilitation Nursing
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    • v.6 no.2
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    • pp.239-247
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    • 2003
  • Purpose: The purpose of this study is to examine how well patients who had hip arthroplasty comply with medical regimens given to them after the operation. Method: The subjects of the study were patients who had arthroplasty at P Hospital between April 1, 2001 and August 30, 2002. 20 patients of the subjects experienced complications after the operation and the other 20 did not. Data from a survey using the qustionnaire were statistically analyzed in terms of real number, percentage point, mean and standard deviation by using $X^2$-test, t-test and ANOVA. Result: 1) the surveyed patients were significantly different in the compliance of medical regimen among them according to their education background as one of the subjects general characteristics. 2) It was found that the group of complication was higher in the compliance of medical regimen than that of non-complication. The two groups showed statistically significant difference with each other in the degree of compliance with therapeutic instructions than the experimental group in terms of the maintenance of abduction after the operation, training instructions on step-by-step basis, urination cotrol on bed, accurate use of crutch, compliance with medication, balance among medical treatment, training, leisure, rest and nutrition, instructions by physicians, nurses and physical therapists, use of low armchairs and toilet bowels and no bending of the body forward, and use of a non-operated leg in case of go upstairs or downstairs. Conclusion: It seems necessary to develop systematic and sessional education programs for improving the compliance of medical regimen, ultimately reducing complications following hip arthroplasty.

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Measuring and Analyzing WiMAX Security adopt to Wireless Environment of U-Healthcare (유헬스케어의 무선환경에 적합한 WiMAX 보안 측정 및 분석)

  • Jeong, Yoon-Su
    • Journal of Digital Convergence
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    • v.11 no.3
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    • pp.279-284
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    • 2013
  • Wireless access network section needs strong security which supports high data rate and mobility not to invade patient's privacy by exposing patient's sensitive biometric from automatic implantable device that is adapted to u-healthcare service. This paper builds test bed and performs assessment and measurement of security ability of WiMAX network to transmit and receive mobile patient's biometric by building WiMAX network in wireless access network not to expose paitne's biometirc at wireless access network section to the third person. Specially, this paper compares and assesses data security, MAC control message security, handover conection delay, and frame loss and bandwidth of ECDH at the layer of WiMAX security compliance, WiMAX MAC IPSec, and MAC.

Nutrition Evaluation Screening Tool: An Easy to Use Screening Tool for Hospitalised Children

  • Dokal, Kitt;Asmar, Nadia;Shergill-Bonner, Rita;Mutalib, Mohamed
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.1
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    • pp.90-99
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    • 2021
  • Purpose: Nutrition screening is vital to ensure patients are appropriately managed in hospital. In paediatrics there is currently no universally accepted nutrition screening tool. The Nutrition Evaluation Screening Tool (NEST) was developed as an easy to use and practical screening tool for hospitalised children. We aim to evaluate compliance of the NEST and assess agreement of the NEST with the already validated nutrition screening tools, Screening Tool for Risk on Nutritional Status and Growth (STRONGkids), Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) and the Subjective Global Nutritional Assessment (SGNA) tool. Methods: Retrospective review of 102 patient episodes at the Evelina London Children's Hospital. Electronic records were used to assess NEST compliance and to complete the nutrition tools for each patient episode. Cohen's kappa was used to determine the level of agreement between each nutrition tool. Results: There was moderate agreement between the NEST and the two screening tools, STRONGkids (κ=0.472) and STAMP (κ=0.416) for patients on initial screening at admission. 87.2% of patient episodes were NEST compliant within 24 hours of admission to hospital. Conclusion: The moderate agreement between these two already validated screening tools enhances the NEST's validity as a paediatric screening tool. The NEST had the strongest correlation with the SGNA tool compared to other screening tools. The NEST is user friendly screening tool for hospitalised children.