• Clinics in Shoulder and Elbow
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• 제6권2호
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• pp.143-148
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• 2003

Objectives: To analyze the postoperative functional outcome of shoulder in patients with arthroscopically assisted repair of large to massive rotator cuff tears with or without acromioplasty and role of acromioplasty. Materials and Methods: From June 1996 to June 2002, twenty six patients with large to massive rotator cuff tears were undergone arthroscopically assisted repair. Mean follow up was over one year. Fourteen were male and twelve were female. Mean age was 51 years old(39-66). Mean duration was 9 months. Acromioplasty was done in 14 cases concomitantly. They were divided into two groups. Group I: arthroscopic cuff repair with acromioplasty(14 cases). Group II: arthroscopic cuff repair without acromioplasty(12 cases). Each shoulder was evaluated at preoperative and final follow-up with Visual Analogue Scale(VAS), University of Pennsylvania Patient self-assessment of pain, University of Pennsylvania Patient self-assessment of function, ASES standardized shoulder assessment form, Simple Shoulder Test, UCLA score and range of motion(ROM). We analyzed the differences between the two groups. Shoulder ROM and acromioplasty were determining factors. Statistics was tested by correlation analysis and repeated measure ANOVA test. Results: At the final follow up, functional outcome and pain were improved but they had no statistical significance between the two groups(p>0.05). Combined procedure, acromioplasty, didn't affect on VAS. UCLA score, University of Pennsylvania Patient self-assessment of pain, University of Pennsylvania Patient self-assessment of function, ASf:S standardized shoulder assessment form and Simple Shoulder Test(p>0.05). In group II, forward flexion and abduction were statistically improved at the final follow up than in group I(p<0.05). Conclusions: It appears that arthroscopic repair is satisfactory procedure in patients with large to massive cuff tears. Combined procedure, acromioplasty, doesn't affect on postoperative functional outcome of shoulder.

• 간호행정학회지
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• 제9권3호
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• pp.337-352
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• 2003

Purpose: The purpose of this study is to analyse research trends related to the evaluation of quality of nursing, thereby obtaining basic data relating to the identification of current situation of instrument development of quality of nursing, and of future research orientation and to the development of performance index of nursing organization. Method: The data were collected from June to December, 2002 through the review of total of 32 research papers which had evaluated quality of nursing among published papers in Korea from 1976 to August 2002. The analysis was done in terms of research period, the periodicals in which research papers were published, domains and the approaches of evaluation of nursing quality. The content analysis of lowest-level items amounting was performed using NIC developed by McCloskey & Bulecheck(1998) and consequential indices of quality of nursing developed by Chi(1995). Results: Twenty-three of 32 papers(71.8%) turned out to be published after 1995, indicating surging interest in the evaluation of quality of nursing from the mid 1990s. Also, ten of 12 research papers dealing with subjects' diseases were published after 1995. In content analysis of lowest-level items of the process-oriented evaluation of quality of nursing, the highest nursing intervention was patient education about procedure and treatment; followed in descending order by patient education about disease process, strengthening of communication, managing environment, infection control, admission care, defecation and urination care. In content analysis of lowest-level items of the outcome-oriented evaluation of quality of nursing, items of physical and psychological state, of patient and family satisfaction, of knowledge and home care, of change of patients' state, of addressing nursing issues, and of patient recovery were the outcome indicators in more than 60 percent research papers. Conclusion: The findings provided the foundation for their effective use in nursing practice with comparing and presenting various core evaluation items representing process and outcome domains.

• Clinics in Shoulder and Elbow
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• 제26권3호
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• pp.245-251
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• 2023

Background: For anatomic total arthroscopic repair, cementless humeral fixation has recently gained popularity. However, few studies have compared clinical, radiographic, and patient-reported outcomes between cemented and press-fit humeral fixation, and none have performed follow-up for longer than 5 years. In this study, we compared long-term postoperative outcomes in patients receiving a cemented versus press-fit humeral stem anatomic arthroscopic repair. Methods: This study retrospectively analyzed 169 shoulders that required primary anatomic total shoulder arthroplasty (aTSA). Shoulders were stratified by humeral stem fixation technique: cementation or press-fit. Data were collected pre- and postoperatively. Primary outcome measures included range of motion, patient reported outcomes, and radiographic measures. Results: One hundred thirty-eight cemented humeral stems and 31 press-fit stems were included. Significant improvements in range of motion were seen in all aTSA patients with no significant differences between final cemented and press-fit stems (forward elevation: P=0.12, external rotation: P=0.60, and internal rotation: P=0.77). Patient reported outcome metrics also exhibited sustained improvement through final follow-up. However, at final follow-up, the press-fit stem cohort had significantly better overall scores when compared to the cemented cohort (visual analog score: P=0.04, American Shoulder and Elbow Surgeon Score: P<0.01, Simple Shoulder Test score: P=0.03). Humeral radiolucency was noted in two cemented implants and one press-fit implant. No significant differences in implant survival were observed between the two cohorts (P=0.75). Conclusions: In this series, we found that irrespective of humeral fixation technique, aTSA significantly improves shoulder function. However, within this cohort, press-fit stems provided significantly better outcomes than cemented stems in terms of patient reported outcome scores. Level of evidence: III.

• Journal of Korean Neurosurgical Society
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• 제29권3호
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• pp.324-329
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• 2000

Objective : Psychological factors may have a major influence on the outcome of treatment for back pain. We investigated the relationship between the outcome and some psychological factors, such as self-reported pain intensity, disability, sleep disturbance and fatigue. Method : The study was conducted as a survey using a questionnaire and telephone interviews. The survey included consecutive 294 patients who visited the neurosurgical out-patient department complaining of low back pain and contacted by telephone on average seven months after the first visit. Pain intensity was measured by visual analog scale, and disability was assessed by Waddell's chronic disability index. Results : The outcome of treatment for back pain was recovered in 36.7%, improved in 30.6%, almost same in 28.6%, and aggravated in 4.1%. Overall rate of improvement was 67.3%. The rate of improvement was related to the duration, patterns and intensity of the symptom, and Waddell index. It was not influenced by the doctors, special studies, and methods of treatment. When the duration was more than 6 months, there were the symptoms of both back and legs, and the self-reported Waddell index was 1-3, the rate of improvement was relatively low. Although the intensity of the pain and disability was closely related to the degree of sleep disturbance, fatigue, appetite, or indigestion, the outcome of treatment for back pain was not always bad in patients with high psychological stress. Actually the outcome of the patients who complained severe pain and disability was better than the outcome of the others. Conclusion : The outcome of the back pain can be predicted by the duration, patterns and intensity of the symptom, and Waddell index. The multidisciplinary treatment will be necessary for the patients whose expected outcome is not good to reduce not only the physical symptoms but also the psychological stress.

• The Journal of Korean Physical Therapy
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• 제15권2호
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• pp.1-11
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• 2003

Patients satisfaction continues to receive attention as a measure of the outcome of physical therapy intervention. This study measures patient satisfaction among physical therapists' patients and clients and to identify factors of patient satisfaction that will affect patients decision. The instrument developed by Goldstein et. al(2000) was used. PAtients' opinions of service in each domain were measured using 5-point Likert-type scales. A 20-item instrument designed to measure the domains of patient satisfaction and 8 additional items were included. Data were collected at 8 hospital in Kwang-ju city Descriptive statistics, reliability, ANOVA, cross-tabs and regression analysis were computed. A total 365 individuals completed the instrument. Waiting time, treatment and cost domain predicted the satisfaction of physical therapy

• 동의신경정신과학회지
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• 제28권4호
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• pp.391-399
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• 2017

Objectives: To determine the effects of Korean medicine on behavioral and psychological symptoms of dementia (BPSD) of an Alzheimer's disease (AD) patient. Methods: A 85-year old female patient diagnosed with AD was treated with herbal medicine formula Chungsimyeonja-tang (淸心蓮子湯), Woohwangchungsim-won (牛黃淸心元), and acupuncture. Korean version of Mini-mental State Examination (MMSE-K) scores were used at baseline and post treatment as outcome measures to evaluate clinical symptoms of the patient. Results: Improvements in MMSE-K post treatment scores were observed compare to those at baseline. BPSD were also alleviated. Such changes were visually noticeable. Conclusions: Herbal medicine and acupuncture treatment were effective in alleviating symptoms of AD. Further studies with a larger sample size and randomized clinical trials are needed to obtain more reliable and valid treatment outcomes.

• Journal of Chest Surgery
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• 제28권5호
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• pp.518-520
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• 1995

Leiomyoma is the most common benign tumor of the esophagus,and surgical enucleation is the treatment of choice. Recently we successfully performed thoracoscopic enucleation of large esophageal leiomyoma without complication in one patient. The 46 years old male patient complained epigastric discomfort and showed a submucosal mass in lower esophagus under the endoscopic ultrasonography . During operation minimal perforation occurred, it was closed with clipping without conversion to an open procedure.The tumor size was 8cm x 3cm x 1.5cm respectively. There were less post-operative pain,minimal wound size, and early recovery time.Patient was satisfactory these outcome. These result suggest that esophageal enucleation was performed more large size benign tumor and esophageal perforation during operation was treated thoracoscopically.

• 한국임상수의학회지
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• 제31권4호
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• pp.288-292
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• 2014

A critical assumption of the standard sample size calculation is that the response (outcome) for an individual patient is completely independent to that for any other patient. However, this assumption no longer holds when there is a lack of statistical independence across subjects seen in cluster randomized designs. In this setting, patients within a cluster are more likely to respond in a similar manner; patient outcomes may correlate strongly within clusters. Thus, direct use of standard sample size formulae for cluster design, ignoring the clustering effect, may result in sample size that are too small, resulting in a study that is under-powered for detecting the desired level of difference between groups. This paper revisit worked examples for sample size calculation provided in a previous paper using nomogram to easy to access. Then we present the concept of cluster design illustrated with worked examples, and introduce design effect that is a factor to inflate the standard sample size estimates.

• Journal of Chest Surgery
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• 제46권3호
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• pp.220-222
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• 2013

Although thrombotic thrombocytopenic purpura (TTP) is a rare disease, when it develops in a post-cardiac surgery patient, it may have a fatal outcome. Since the frequency of early-onset thrombocytopenia in post-cardiac surgery patients is high, platelet concentrates are commonly transfused during postoperative management. However, when TTP is the likely diagnosis, platelet transfusion is not recommended. We experienced a postoperative TTP in a cardiac surgery patient and discovered the importance of identifying the etiology of postoperative thrombocytopenia. Here, we report the case with a brief review of the literature.

• 간호행정학회지
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• 제13권3호
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• pp.311-320
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• 2007

연구 목적: 사례 관리(CM) 환자 만족도 측정에 관한 연구 결과를 고찰하여 사례관리 실무에서 활용할 수 있는 근거를 제공하고자 한다. 연구 방법: MedLine, CINAHL에서 주요용어로 case management, care management, 주제어로 patient satisfaction, client satisfaction을 이용해 문헌 검색을 실시하였다. 연구 결과: 만족도에 대한 개념은 관련 연구가 매우 부족하며, 서로 다른 이론적 접근을 하고 있으므로 그 측정에 어려움이 있다. 신뢰할 만한 만족도 측정을 위해서는 설문 문항을 서술하는 여러 가지 방법들, 측정 척도의 종류, 만족도에 영향을 미치는 혼란변수들을 주의 깊게 고려하여야 한다. 만족도는 사례관리 연구에서 흔히 측정되는 성과이지만 대부분의 관련 연구에서 사례관리의 특징이 반영된 측정 도구를 사용하지 않고 있었다. 따라서 본 논문은 다섯 개의 사례관리 만족도 측정 도구를 제시하고 그 특징을 소개하였다. 또한, 간호성과분류체계(The Nursing Outcomes Classification)에 제시된 만족도 측정항목들 중 사례관리와 관련이 높은 약 40%의 항목들을 발견하였다. 결론: 사례관리 만족도 측정 도구가 매우 부족하므로 표준 사례관리 측정도구 개발이 시급하다. 한편 사례관리사들은 만족도 측정에 대한 이해를 높이고 기존 연구 결과를 활용함으로써 보다 정확한 사례관리 만족도 평가가 이뤄지도록 노력해야 한다.