• Title/Summary/Keyword: patient priority

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A study of constructing information of main treating acupoint with priority given to five vicera's Back-su point (배수혈을 중심으로 한 주요 치료혈 정보 구축)

  • Kim, Jong-Yeol;Kwon, O-Sang;Lee, Yu-Jung;Kim, Jae-Hyo;Kim, Eung-Sun;Kim, Yu-Lee;Shon, In-Chul
    • Korean Journal of Acupuncture
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    • v.24 no.4
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    • pp.47-54
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    • 2007
  • Objection : A medicine which is patient-initiative and preventive is required in Korea, which is going to an aging society. On this, we started this study to make a new rule to diagnose and treat more definitely by linking traditional Oriental medicine to Sasang Constitional medicine, which thought to be suitable because of Sasang Constitional medicine has been valued on staying, diet and human's nature which means preventive medical propensity. Methods : On this study, we discriminated Sasang Constition of 161 students, who is in college of oriental medicine, Wonkwang university, by using QSCCII program; and in those students, we checked 30 volunteers's five vicera's Back-su point on riging and depression, tenderness reaction, and color reaction after cupping treatment. Results : As a result of study of riging and depression of five vicera's Back-su point, we could confirm that defecient organ's Back-su point were more depressed than excess organ in Seum-in, Taeeum-in, Soyang-in. As a result of study of tenderness reaction of five vicera's Back-su point, we could confirm that excess organ's Back-su point showed stronger tenderness reaction than defecient organ in Seum-in, Taeeum-in; and excess organ's Back-su point showed weaker tenderness reaction than defecient organ in Soyang-in. As a result of study of color reaction after cupping treatment of five vicera's Back-su point, we could confirm that excess organ's Back-su point showed stronger color reaction than defecient organ in Seum-in, Taeeum-in; and excess organ's Back-su point showed weaker color reaction than defecient organ in Soyang-in. Those data suggest that there are close correlation between Sasang Constition and on riging and depression, tenderness reaction, and color reaction after cupping treatment of five vicera's Back-su point in treditional Oriental medicine. Conclusions : From this study, we can make a new rule to differentiate Sasang Constition by clearfy a relation between Sasang Constition and five vicera's Back-su point; and with this rule, we could contribute to popularization and objectification of Sasang Constition medicine and further more, Oriental medicine by making a Sasang Constition diagnosis instrument. With this, a trait of Sasang Constition medicine that is preventive and valued on character of individuals will contribute to building a patient-initiative and preventive medical system and will expend the domain of Oriental medicine.

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INTENTIONAL REPLANTATION OF THE CROWN-ROOT FRACTURED TOOTH: A CASE REPORT (치관-치근 파절된 치아의 의도적 재식술 치험례)

  • Kim, Soo-Kyoung;Ahn, Seung-Tae;Choi, Sung-Chul;Kim, Kwang-Chul;Park, Jae-Hong
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.3
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    • pp.381-386
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    • 2010
  • As the vertical fracture occurs at the various locations following the long axis of a root, treatment method of crown-root fractured anterior teeth is decided according to the depth. If the fracture line is close to the crown, gingivectomy, orthodontic - forced eruption or surgical extrusion of apical fragment could be done. If the line is over 1/3 length of the root, the prognosis is poor and extraction is usually undertaken. However, extraction of maxillary incisor at growing children causes many complications such as esthetic, phonetic problem and alveolar bone resorption. Therefore, preservation of tooth is the highest priority. Recently, intentional replantation with composite resin could be considered as alternative treatment of crown-root fractured anterior tooth. This report presents a patient in mixed dentition with deep vertical crown-root fracture of the maxillary permanent central incisors by trauma. Intentional replantation of the fractured teeth was performed using composite resin. After 2 years, specific clinical symptom has not been found and the patient was satisfied of esthetic result. This method suggests the new technique to preserve a tooth as an alternative to extraction, although it is technically sensitive and the reports of long-term prognosis is insufficient.

Patient's Perception for Developing Research Questions of a Clinical Practice Guideline of Korean Medicine for Degenerative Lumbar Spinal Stenosis: A Descriptive Cross-Sectional Survey (퇴행성 요추 척추관 협착증의 한의표준임상진료지침 핵심질문 설정에 대한 환자 인식 설문 조사: 단면 설문 연구)

  • Choi, Seo Young;Bae, Ji Min;Choi, Ji Won;Yang, Gi Young;Lee, Byung Ryul;Kim, Kun Hyung
    • Korean Journal of Acupuncture
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    • v.35 no.3
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    • pp.130-138
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    • 2018
  • Objectives : The purpose of this study is to explore patients' perceptions that deserve attention when designing core questions for a clinical practice guideline of Korean medicine(KM) for degenerative lumbar spinal stenosis (LSS). Methods : Patients who had been admitted to Pusan National Korean Medicine Hospital from November 1, 2015 to October 31, 2016 were invited to the survey. Patients were eligible if they were both clinically and radiologically confirmed as degenerative LSS. The structured questionnaire was distributed by mail and outpatient visits. Questions included types of experienced Korean/Western medical interventions for LSS, their perceived effectiveness on symptoms, the necessity for studies of KM for degenerative LSS, the types of KM interventions to be investigated and the types of outcome measures after treatments. Data were descriptively analysed. Results : Twenty of thirty-one invited participants responded to the questionnaire. Acupuncture and herbal medicine were the most frequently used KM interventions. Eighteen respondents reported that KM treatments were helpful for their improvement. Sixteen patients who mentioned that research on KM is needed chose acupuncture as the top priority(88%) among KM interventions. The most important outcomes in the view of nineteen respondents included functional recovery (68%) and pain relief (53%). Thirteen respondents (65%) replied that both short-term and long-term outcome were important for them. Conclusions : Our findings may have limited validity due to the small number of respondents and the potential selection and information bias. Further qualitative studies and large-scale surveys to comprehensively identify patients' views are warranted.

The National Hospice Care Service Development in Korea (한국형 호스피스 케어 개발을 위한 기초 조사 연구)

  • Lee, Soo-Woo;Lee, Eun-Ok;Ahn, Hyo-Seog;Heo, Dae-Seock;Kim, Dal-Sook;Kim, Hyun-Sook;Lee, Hiye-Ja
    • The Korean Nurse
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    • v.36 no.3
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    • pp.49-69
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    • 1997
  • The urgent needs to establish hospice care systems in Korea arise from the following reasons: 0) a drastic increase in chronically ill patients with the increase of aged population: (2) rapid changes in living environment from the traditional habitation (e. g., Many Koreans living in apartment complexes, which is the most popular form of modern residence in recent years, prefer to die in the hospital.): the overall increase in patients with advanced cancer: (4) recent trends in early discharge of terminally ill patients from the limited hospital facilities to accomodate other medical insurance beneficiaries; (5) easy acceptance of euthanasia owing to the recent social atmosphere that belittles the dignity of human life; (6) medical and nursing care of AIDS patient in terminal stage; (7) and the problem associated with inhumane medical care system, overtreatment, and groundless fears against narcotics. Terminally ill patients were used to be treated in the hospital in the past. In these days, however, they are forced to have home cares with little assistance from the qualified medical personnel because of insufficient hospital facilities, which are even short for the need of emergency patients and provide priority cares to medical insurance beneficiaries with other acute problems. And yet, neither are there any administrative organizations nor systematic medical studies that deal with the level of terminally ill patient's need, their family's problems and resources of hospice care systems in Korea. Thus, most patients are not able to get appropriate medical care at the terminal stage of their lives. The objective of this study is to make comprehensive database for various hospice care organization currently in operation, link them through medical information system, and develop an easily accessible hospice care model that meets the need of most Korean people. Our survey results may be summarized as follows: Nationally there are 40 organizations that provide partial or full hospice care. However, these organizations are not linked to any formal medical service network. Furthermore, the objective of hospice care, care principles, personnel with appropriate training, educational programs, standard for care, costs, consulting service to patients' family members, the extent of medical care from professional staff members, status of hospice facility, and management of those institutions are neither clearly defined nor organized compared to the international hospice care standards. The surveys on patients of terminal stage. grouped in hospice and non-hospice care patients. reveal what they want visiting nursing care to help their pain control. psychological. social and spiritual demands. While the more than 90% of hospice care patients want to reduce their pains. the non-hospice care patients. in addition to their desire for pain control. demanded more psychological. social and spiritual helps as well. The results of this research could be utilized to 0) define the standard of hospice care. (2) provide the guidance for hospice medical care costs. (3) establish the database of hospice care systems. (4) develop softwares. (5) build communication network through Medinet. and (6) provide an organized visiting home nursing care system. These information should be a valuable resource to many medical staffs who are involved in cancer therapy. nursing care. and social welfare programs.

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The Empirical Exploration of the Conception on Nursing (간호개념에 대한 기초조사)

  • 백혜자
    • Journal of Korean Academy of Nursing
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    • v.11 no.1
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    • pp.65-87
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    • 1981
  • The study is aimed at exploring concept held by clinical nurses of nursing. The data were collected from 225 nurses conviniently selected from the population of nurses working in Kang Won province. Findings include. 1) Nurse's Qualification. The respondents view that specialized knowledge is more important qualification of the nurse. Than warm personality. Specifically, 92.9% of the respondents indicated specialized knowledge as the most important qualification while only 43.1% indicated warm personality. 2) On Nursing Profession. The respondents view that nursing profession as health service oriented rather than independent profession specifically. This suggests that nursing profession is not consistentic present health care delivery system nor support nurses working independently. 3) On Clients of Nursing Care The respondents include patients, family and the community residents in the category of nursing care. Specifically, 92.0% of the respondents view that patient is the client, while only 67.1% of nursing student and 74.7% of herself. This indicates the lack of the nurse's recognition toward their clients. 4) On the Priority of Nursing care. Most of the respondents view the clients physical psychological respects as important component of nursing care but not the spiritual ones. Specially, 96.0% of the respondents indicated the physical respects, 93% psychological ones, while 64.1% indicated the spiritual ones. This means the lack of comprehensive conception on nursing aimension. 5) On Nursing Care. 91.6% of the respondents indicated that nursing care is the activity decreasing pain or helping to recover illness, while only 66.2% indicated earring out the physicians medical orders. 6) On Purpose of Nursing Care. 89.8% of the respondents indicated preventing illness and than 76.6% of them decreasing 1;ai of clients. On the other hand, maintaining health has the lowest selection at the degree of 13.8%. This means the lack of nurses' recognition for maintaining health as the most important point. 7) On Knowledge Needed in Nursing Care. Most of the respondents view that the knowledge faced with the spot of nursing care is needed. Specially, 81.3% of the respondents indicated simple curing method and 75.1%, 73.3%, 71.6% each indicated child nursing, maternal nursing and controlling for the communicable disease. On the other hand, knowledge w hick has been neglected in the specialized courses of nursing education, that is, thinking line among com-w unity members, overcoming style against between stress and personal relation in each home, and administration, management have a low selection at the depree of 48.9%,41.875 and 41.3%. 8) On Nursing Idea. The highest degree of selection is that they know themselves rightly, (The mean score measuring distribution was 4.205/5) In the lowest degree,3.016/5 is that devotion is the essential element of nursing, 2.860/5 the religious problems that human beings can not settle, such as a fatal ones, 2,810/5 the nursing profession is worth trying in one's life. This means that the peculiarly essential ideas on the professional sense of value. 9) On Nursing Services. The mean score measuring distribution for the nursing services showed that the inserting of machine air way is 2.132/5, the technique and knowledge for surviving heart-lung resuscitating is 2.892/s, and the preventing air pollution 3.021/5. Specially, 41.1% of the respondents indicated the lack of the replied ratio. 10) On Nurses' Qualifications. The respondents were selected five items as the most important qualifications. Specially, 17.4% of the respondents indicated specialized knowledge, 15.3% the nurses' health, 10.6% satisfaction for nursing profession, 9.8% the experience need, 9.2% comprehension and cooperation, while warm personality as nursing qualifications have a tendency of being lighted. 11) On the Priority of Nursing Care The respondents were selected three items as the most important component. Most of the respondents view the client's physical, spiritual: economic points as important components of nursing care. They showed each 36.8%, 27.6%, 13.8% while educational ones showed 1.8%. 12) On Purpose of Nursing Care. The respondents were selected four items as the most important purpose. Specially,29.3% of the respondents indicated curing illness for clients, 21.3% preventing illness for client 17.4% decreasing pain, 15.3% surviving. 13) On the Analysis of Important Nursing Care Ranging from 5 point to 25 point, the nurses' qualification are concentrated at the degree of 95.1%. Ranging from 3 point to 25, the priorities of nursing care are concentrated at the degree of 96.4%. Ranging from 4 point to 16, the purpose of nursing care is concentrated at the degree of 84.0%. 14) The Analysis, of General Characteristics and Facts of Nursing Concept. The correlation between the educational high level and nursing care showed significance. (P < 0.0262). The correction between the educational low level and purpose of nursing care showed significance. (P < 0.002) The correlation between nurses' working yeras and the degree of importance for the purpose of nursing care showed significance (P < 0.0155) Specially, the most affirmative answers were showed from two years to four ones. 15) On Nunes' qualification and its Degree of Importance The correlation between nurses' qualification and its degree of importance showed significance. (r = 0.2172, p< 0.001) 0.005) B. General characteristics of the subjects The mean age of the subject was 39 ; with 38.6% with in the age range of 20-29 ; 52.6% were male; 57.9% were Schizophrenia; 35.1% were graduated from high school or high school dropouts; 56.l% were not have any religion; 52.6% were unmarried; 47.4% were first admission; 91.2% were involuntary admission patients. C. Measurement of anxiety variables. 1. Measurement tools of affective anxiety in this study demonstrated high reliability (.854). 2. Measurement tools of somatic anxiety in this study demonstrated high reliability (.920). D. Relationship between the anxiety variables and the general characteristics. 1. Relationship between affective anxiety and general characteristics. 1) The level of female patients were higher than that of the male patient (t = 5.41, p < 0.05). 2) Frequencies of admission were related to affective anxiety, so in the first admission the anxiety level was the highest. (F = 5.50, p < 0.005). 2, Relationship between somatic anxiety and general characteristics. 1) The age range of 30-39 was found to have the highest level of the somatic anxiety. (F = 3.95, p < 0.005). 2) Frequencies of admission were related to the somatic anxiety, so .in first admission the anxiety level was the highest. (F = 9.12, p < 0.005) 0. Analysis of significant anxiety symptoms for nursing intervention. 1. Seven items such as dizziness, mental integration, sweating, restlessness, anxiousness, urinary frequency and insomnia, init. accounted for 96% of the variation within the first 24 hours after admission. 2. Seven items such as fear, paresthesias, restlessness, sweating insomnia, init., tremors and body aches and pains accounted for 84% of the variation on the 10th day after admission.

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A Study on The Actual Condition and Demand Assessment of First Aid Education on Higher Grade Students in Elementary School (초등학교 고학년생의 응급처치 교육실태 및 교육 요구도)

  • Cho, Keun-Ja;Choi, Eun-Sook;Lee, Hyeun-Ju
    • The Korean Journal of Emergency Medical Services
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    • v.11 no.3
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    • pp.175-189
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    • 2007
  • Background and Purpose : Higher grade students in elementary schools are most adequate subjects for first aid training. The purpose of this study was to assess first aid education and needs of higher grade students in elementary schools. Method : The subjects of this study were 183 higher grade students from 8 elementary schools. Data were collected by the questionnaire during the period from March 19 to April 13, 2007. The data were analyzed through frequency, Cronbach's ${\alpha}$, Independent Two samples t-test, One Way ANOVA by SPSS win 12.0. Result : 1. It showed that 78.1%(143 persons) of sujects answered that they learned first aid. 65% of sujects learned in the school(65%). 61.2% of sujects were taught by health teachers. 36.7%(67 person) of subjects was educated using practice with demonstration including lecture. Learned contents were action at emergency(50.8%), CPR(36.6%), splint (33.9%). 2. It showed that 90.2%(165 persons) of subjects answered that first aid and CPR education are necessary. Also 74.9%(137 persons) of subjects answered that will be educated first aid and CPR if opportunities is given. The 53.3%(73 persons) of subjects wanted teaching method using practice with demonstration including lecture. 3. The total mean showed $2.29{\pm}.48$ in needs of first aid education by 3 points Likert scale. Needs of first aid education was ranked Heimlich maneuver($2.41{\pm}.65$), splint and bandaging($2.38{\pm}.59$). Priority of intensive training showed patient assessment(38.0%) and CPR(19.7%) in first, splint and bandging(22.6%), CPR(21.9%) and Heimlich maneuver(21.9%) in second. 4. The needs assessment of first aid education showed statistically significant differences according to teaching method(F = 2.563, p = .025), education necessity yes or no(F = 2.474, p = .015), attending future education yes or no(F = 2.253, p = .026). Conclusion : These results suggest that First aid education for higher grade students in elementary schools must be consisted of most adequate content and method based on current education condition and needs assessment.

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Study on the Food Therapy for the Aged as Discussed in 『천금방』 (『천금방』의 노인식이요법연구)

  • Jeong Sook Ei;Keum Kyung Soo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.6
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    • pp.1580-1584
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    • 2004
  • On the basis of the widely collected fork prescriptions, long clinical practice of himself, together with integration of all the good points of earlier medical specialists, 孫思邈 wrote 『千金方』 of thirty volumes. Among them Volumes 『食治』 (Food Therapy) and 『養性』(Cultivating the Character) are especially meaningful for in gerontology. Thirty years after its completion, as a supplement, he wrote another thirty volumes of 『千金翼方』. Mr. Sun integrated his discoveries in the treatments of the aged patients, and his opinions for longevity into the Volumes 『養性』 (Cultivating the Character), 『?穀』(Fasting), 『退居』(Retirement), 『補益』(Supplementation). Thus he laid down the basic foundation for the gerontology of Chinese medicine. 『千金要方』 and 『千金翼方』 by Mr. Sun discuss mainly the prevention of illness for aged patients. As for the function of food therapy, he explains: 'Food can dispel evil elements of the body and settle down its organs. It can further bring pleasure to man's spirit and help the circulation of blood and breath.' He then propose the major method of food therapy: 'For a medical doctor, he should understand the causes of disease, then treat it with food. Only after the food treatment fails, medicine is employed.' He thinks that medicine does work in treatment, but it also creates imbalance in the body, and makes the latter vulnerable to outside harms. Therefore, a good doctor is the one who cures the disease and bring pleasure to the patient with food. He stresses that food therapy is always a priority. Mr. Sun prefers animal's organs in the food therapy for aged. For example, he uses powder of sheep's kidney to treat the lumbago. He suggests the viewpoint of 'Curing man's organs with animal's organs' and 'Strengthening man's organs with animal's organs,' and sets the theoretical foundation of 'Organic Treatment.' Mr. Sun's gerontology and food therapy received further development latter. The prescriptions contained therein had been widely used in 王懷隱's 『太平聖惠方』 and 陳直's 『養老奉親書』, both in the Song Dynasty. Eventually they had become a science of food therapy for aged patients.

Hospice and Palliative Care in Chronic Obstructive Pulmonary Disease (만성 폐쇄성 폐질환의 호스피스 완화의료)

  • Shin, Jinyoung;Park, Hye Yun;Lee, Jungkwon
    • Journal of Hospice and Palliative Care
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    • v.20 no.2
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    • pp.81-92
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    • 2017
  • Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation that is usually progressive. It is a major cause of morbidity and mortality worldwide, leading to substantial and increasing economic and social burden. Palliative care for COPD patients aims to reduce symptoms and exacerbations and improve exercise tolerance and quality of life. It is difficult to make a prognosis for COPD patients due to the variable illness trajectory and advanced care of patients. However, severity of breathlessness, assessment of lung function impairment, and frequency of exacerbations can help to identify palliative care needs and determine effective methods to mitigate symptoms, which is discussed in this paper. In these patients, it is recommended to provide individualized palliative care along with curative/restorative care at the onset of COPD symptoms. Before launching a palliative care system in Korea, it is necessary to prepare pulmonary rehabilitation resources, patient-centered communication, timely palliative responsiveness, and a program for effective advanced care planning. A multidisciplinary approach involving collaboration with not only the respiratory and palliative care teams but also primary care offers a new model of care for these patients and should be considered with a priority.

Expression Levels of Tetraspanin KAI1/CD82 in Breast Cancers in North Indian Females

  • Singh, Richa;Bhatt, Madan Lal Brahma;Singh, Saurabh Pratap;Kumar, Vijay;Goel, Madhu Mati;Mishra, Durga Prasad;Srivastava, Kirti;Kumar, Rajendra
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3431-3436
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    • 2016
  • Background: Carcinogenesis is a multifaceted intricate cellular mechanism of transformation of the normal functions of a cell into neoplastic alterations. Metastasis may result in failure of conventional treatment and death Hence, research on metastatic suppressors in cancer is a high priority. The metastatic suppressor gene CD82, also known as KAI1, is a member of the transmembrane 4 superfamily which was first identified in carcinoma of prostate. Little work has been done on this gene in breast cancer. Herein, we aimed to determine the gene and protein level expression of CD82/KAI1 in breast cancer and its role as a prognosticator. Materials and Methods: In this study, 83 histologically proven cases of breast cancer and a similar number of controls were included. Patient age ranged from 18-70 years. Quantitative Real Time Polymerase Chain Reaction (q-RT PCR) and immunohistochemistry (IHC) were used to investigate KAI1 expression at gene and protein levels, respectively. Statistical analysis was done to correlate expression of KAI1 and clinicopathological parameters. Results: It was revealed that: (i) KAI1 was remarkably diminished in metastatic vs non metastatic breast cancer both at the gene and the protein levels (P < .05); (ii) KAI1 expression levels were strongly correlated with TNM staging, histological grade and advanced stage (p<0.001) and no association was found with any other studied parameter; (iii) Lastly, a significant correlation was observed between expression of KAI1 and overall median survival of BC patients (P = 0.04). Conclusions: Our results suggest that lack of expression of the KAI1 might indicate a more aggressive form of breast cancer. Loss of KAI1 may be considered a significant prognostic marker in predicting metastatic manifestation. When evaluated along with the clinical and pathological factors, KAI1 expression may be beneficial to tailor aggressive therapeutic strategies for such patients.

Application of Critical Pathway in Trauma Patients (외상 환자 관리에서 Critical Pathway의 적용)

  • Shim, Hongjin;Jang, Ji Yong;Lee, Jae Gil;Kim, Seonghwan;Kim, Min Joung;Park, You Seok;Park, Inchel;Kim, Seung Ho
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.159-165
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    • 2012
  • Purpose: For trauma patients, an early-transport and an organized process which are not delayed in hospital stage are necessary. Our hospital developed a procedure, the trauma Critical Pathway (CP), through which a traumatic patient has the priority over other patients, which makes the diagnostic and the therapeutic processes faster than they are for other patients. Methods: The records of patients to whom Trauma CP were applied from January 1, 2011 through April 15. 2012. were reviewed. We checked several time intervals from ER visiting to decision of admission-department, to performing first CT, to applying angio-embolization, to starting emergency operation and to discharging from ER. In addition, outcomes such as duration of ICU stay, hospital stay and mortality were checked and analyzed. Results: The trauma CP was applied to a total of 143 patients, of whom, 48 patients were excluded due to pre-hospital death, ER death, transferring to other hospital and not severe injury. Thus 95 patients (male 64, 67.3%) were enrolled in this study. Fifty-nine patients(62.1%) were injured by the traffic accident. The mortality rate was 10.5% and the mean Revised Trauma Score (RTS) of the patients was $6.4{\pm}2.0$. After visiting ER, decision making for admission was completed, on average, in 3 hours 10 seconds. The mean time intervals for the first CT, angio-embolization, surgery and discharge were 1 hour 20 minutes, 5 hours 16 minutes, 7 hours 26 minutes and 6 hours 13 minutes, respectively. Conclusion: The trauma CP did not show the improvement of time interval outcome, as well as mortality rate. However, this test did show that the trauma CP might be able to reduce delays in procedures for managing trauma patients at the university-based hospitals. To find out the benefit of CP protocol, a large scaled data is required.