• Title/Summary/Keyword: patients' satisfaction

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Split-thickness Skin Graft on the Face from the Medial Arm Skin (상완내측 피부를 이용한 안면부의 부분층 식피술)

  • Moon, Seong Won;Noh, Bok Kyun;Kim, Eui Sik;Hwang, Jae Ha;Lee, Sam Yong
    • Archives of Plastic Surgery
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    • v.34 no.1
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    • pp.70-76
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    • 2007
  • Purpose: Full-thickness skin grafts are usually used in facial reconstruction, but on occasion, split-thickness skin graft is also used from the scalp due to the limitation of donor site. However, there were complications, such as alopecia, folliculitis and blood loss. In addition, it can not be used in patients with baldness. Under the circumstances, we used medial arm skin as split-thickness skin graft donor site in lieu of scalp. We investigated the efficacy of the medial arm skin as a donor site of facial skin graft in comparison with scalp. Methods: From 2000 to 2005, the split-thicknesss skin grafts were performed using the medial arm skin in 10 patients and the scalp in 10 patients. We inspected the skin color match, texture match by the visual analogue scale. Scar contracture was estimated by the Visitrak $grade^{(R)}$(Smith & Nephew). The statistical analysis was performed by SPSS 12.0. Results: There was a more satisfaction in color match, texture, and scar contracture in medial arm skin than in scalp. Conclusion: According to these results, medial arm skin may be used efficiently as an alternative donor site of scalp in the facial reconstruction.

Effect of Music Therapy on Anxiety and Vital Sign of Nasal Closed Reduction Under General Anesthesia (전신마취 하 비골골절 수술 환자에서 음악요법이 환자의 불안 및 활력징후에 미치는 영향)

  • Suh, Bum-Sin;Na, Young-Cheon
    • Archives of Plastic Surgery
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    • v.37 no.4
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    • pp.369-374
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    • 2010
  • Purpose: Most of the patients who underwent surgery feels variable kinds of fear or anxiety; an uncomfortable mood state that happens without specific object affects patient's satisfaction before and after the surgery. As music therapy is rather noninvasive method generally used in reducing patient's anxiety, the authors researched about the extent of anxiety with the change of vital sign before the operation while comparing with the cases of patients who took the music therapy at closed reduction under general anesthesia. Method: We divided the patients in 4 groups; A with the premedication (Midazolam, Dormicum$^{(R)}$) before the operation, B with the premedication and music therapy, C with only music therapy, D with no premedication or therapy. And we measured the vital signs after the arrival at the operation room, after induction and 20 minutes after the operation. Also we observed the changes of anxiety index with the STAI (State Trait Anxiety Inventory)-K (Korea)YZ 1 hour before and 8 hours after the surgery. Result: The group B showed the least changes in blood pressure as the group D showed the highest change. Both group C and A showed increase in blood pressure but the upswing in group A was lower than group C. At the change of pulse rate group B showed the lowest upswing also group D showing the highest. Group B showed quite a few upswing but lower than group D, but, at the same time, group A showed lower upswing when comparing two cases. After analysis of STAI-KYZ score, the anxiety relatively decreased in group B and C in comparison with group D. And the index of anxiety state of group A showed just as much to group D. Conclusion: The music therapy is better healthcare method compared to other therapies in reducing anxiety also with satisfying effect who underwent operation. The authors recommend music therapy assisted with use of premedication for better relief of anxiety.

Legal Issues of Medical Institution Remodeling (의료기관 리모델링의 법적 제문제)

  • Shin, Tae-Seop;Chung, Mi-Young
    • The Journal of the Korea Contents Association
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    • v.21 no.8
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    • pp.294-304
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    • 2021
  • Medical institutions remodel existing hospital buildings rather than construct buildings to satisfy patient satisfaction and enhance competitiveness with other medical institutions. Medical institution remodeling is gradually increasing due to enhanced laws and systems to improve the quality of medical services and the level of patient safety. However, prior studies were discussed only within a limited range, including architectural elements, about medical institution remodeling. Therefore, this study aims to provide basic data to medical institutions planning future remodeling by examining the legal issues of medical institution remodeling in various ways. Medical institution remodeling extends the construction period due to restrictions on construction conditions, and causes damage such as noise and dust to patients. So it is necessary to prevent damage to patients in advance and to support appropriate remodeling of medical institutions. Therefore, it is necessary to prepare an Act on promotion of and support for remodeling of medical institutions. In addition, medical institutions should prepare a checklist for voluntary compliance with construction standards, preventive measures and post-improvement measures, and measures for infection and radiation exposure in hospitals.

Factors related to Resilience of Coronavirus Infectious Diseases-19 Patients (코로나바이러스감염증-19 환자의 극복력 관련 요인)

  • Lee, MinHee;Park, MinJeong
    • The Journal of the Korea Contents Association
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    • v.22 no.10
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    • pp.349-358
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    • 2022
  • This study was aim to understand the relationship between uncertainty, social isolation, social support and resilience of coronavirus infectious diseases-19 (COVID-19) patients and to identify factors related to resilience. Data were carried out from March 7 to May 5, 2021, and a total of 200 questionnaires were used for data analysis. Data were analyzed with descriptive statistics, t-test, ANOVA, Pearson correlation coefficient and multiple regression using SPSS WIN 24.0 program. As a result of the analysis, the lower the sense of social isolation, the higher the social support, the satisfaction with the explanation of isolation and the economic status of 'medium' were identified as related factors for resilience. Based on the above results, a systematic program should be developed and applied to improve the resilience of COVID-19 patients including strengthening social support through families and health care providers, reducing social isolation through non-face-to-face counseling, providing sufficient information about diseases, and providing economic support.

Ultrasonographic Assessment of the Cutaneous Changes Induced by Topical Use of Novel Peptides Comprising Laminin 5

  • Park, Kyong Chan;Kim, Se Young;Khan, Galina;Park, Eun Soo
    • Archives of Plastic Surgery
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    • v.49 no.3
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    • pp.304-309
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    • 2022
  • Background Laminin 5, which is found in the basement membrane of dermal-epidermal junction (DEJ), is a major adhesive component and associated with proliferating and migrating keratinocytes. In this study, we hypothesized that the topical application of the skin care products containing the novel peptides might restore the DEJ structure by deriving deposition of laminin 5 and promoting the keratinocyte migration. Here, we evaluated the restoration of DEJ by measuring the skin thickness. Methods Single-center retrospective analysis was performed on a total of 13 patients who underwent skin care using Baume L.C.E. (France, Laboratories d' Anjou) between January and March 2021. All patients applied the skin care agent for 2 weeks only on their left hand dorsum. Before the initiation of the application and after 2 weeks, both their hands were evaluated on photography and ultrasound. And the patients were asked to rate their satisfaction with the questionnaire after 2 weeks. Results There was no obvious improvement in photographic assessment and questionnaire. The post-pre difference of skin thickness in ultrasound images was, in left hand, 0.1 ± 0.37 in distal point and 0.1 ± 0.35 in proximal point; and, in right hand, 0 ± 0.17 in distal point and 0 ± 0.15 in proximal point, respectively. The pre-post difference was statistically significant in proximal point (p = 0.035). Conclusion Topical application of novel peptide derivative comprising laminin 5 demonstrated cutaneous changes including skin thickness, as assessed by ultrasound. Further studies using other modalities including dermal density measurement, three-dimensional photography, optical coherence tomography, or skin biopsy would be helpful to determine the skin-improving effects.

Comparison of vital sign stability and cost effectiveness between midazolam and dexmedetomidine during third molar extraction under intravenous sedation

  • Jun-Yeop, Kim;Su-Yun, Park;Yoon-Sic, Han;Ho, Lee
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.6
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    • pp.348-355
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    • 2022
  • Objectives: To compare the vital sign stability and cost of two commonly used sedatives, midazolam (MDZ) and dexmedetomidine (DEX). Patients and Methods: This retrospective study targeted patients who underwent mandibular third molar extractions under intravenous sedation using MDZ or DEX. The predictor variable was the type of sedative used. The primary outcome variables were vital signs (heart rate and blood pressure), vital sign outliers, and cost of the sedatives. A vital sign outlier was defined as a 30% or more change in vital signs during sedation; the fewer changes, the higher the vital sign stability. The secondary outcome variables included the observer's assessment of alertness/sedation scale, level of amnesia, patient satisfaction, and bispectral index score. Covariates were sex, age, body mass index, sleeping time, dental anxiety score, and Pederson scale. Descriptive statistics were computed including propensity score matching (PSM). The P-value was set at 0.05. Results: The study enrolled 185 patients, 103 in the MDZ group and 82 in the DEX group. Based on the data after PSM, the two samples had similar baseline covariates. The sedative effect of both agents was satisfactory. Heart rate outliers were more common with MDZ than with DEX (49.3% vs 22.7%, P=0.001). Heart rate was higher with MDZ (P=0.000). The cost was higher for DEX than for MDZ (29.27±0.00 USD vs 0.37±0.04 USD, P=0.000). Conclusion: DEX showed more vital sign stability, while MDZ was more economical. These results could be used as a reference to guide clinicians during sedative selection.

Development and usability test of transfer device with customized sling lifts

  • SeYeon Jeong;KiHun Cho;SoungKyun Hong;WonJae Choi;Kwangkook Lee;Kyeongbong Lee;GyuChang Lee
    • Journal of Korean Physical Therapy Science
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    • v.30 no.4
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    • pp.9-16
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    • 2023
  • Background: Bedridden patients and disabled persons need help from a guardian or caregiver even in performing simple activities of daily living. In particular, for body transfer of them, the use of a transfer lift has been recommended. However, the devices currently in use have limitations in terms of support according to the individual's characteristics. This study aimed to develop a transfer lift device utilizing the patients' body-fitting sling equipped with an air tube inside the sling. In addition, we have conducted usability tests to examine the safety, effectiveness, and satisfaction with this device. Design: This study conducted usability tests with 10 healthy adults. Methods: Customized sling lifts are generally floor-based devices that consisted of a sling that holds the patient's body and a lift that moves the sling to the desired position. One characteristic feature of the device is an air tube, which is used on the sling to allow the patient's body can be adjusted. A usability test was performed in terms of the operators, who operated the device to transfer the patients. Ten operators tried the device and tested its usability. Results: The mean of 10 question for Questions was 4.18. Conclusion: The device can be useful in the advance- ment and commercialization of customized sling lifts, to ensure the safe and efficient transfer of persons with disabilities.

Importance of Sacrotuberous Ligament in Transgluteal Approach for Sciatic Nerve Entrapment in the Greater Sciatic Notch (Piriformis Syndrome)

  • Byung-chul Son
    • Journal of Korean Neurosurgical Society
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    • v.67 no.2
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    • pp.217-226
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    • 2024
  • Objective : The efficacy of sciatic nerve decompression via transgluteal approach for entrapment of the sciatic nerve at the greater sciatic notch, called piriformis syndrome, and factors affecting the surgical outcome were analyzed. Methods : The outcome of pain reduction was analyzed in 81 patients with sciatic nerve entrapment who underwent decompression through a transgluteal approach. The patients were followed up for at least 6 months. The degree of pain reduction was analyzed using a numerical rating scale-11 (NRS-11) score and percent pain relief before and after last follow-up following surgery. Success was defined by at least 50% reduction in pain measured via NRS-11. To assess the degree of subjective satisfaction, a 10-point Likert scale was used. In addition, demographic characteristics, anatomical variations, and variations in surgical technique involving sacrotuberous ligamentectomy were analyzed as factors that affect the surgical outcome. Results : At a follow-up of 17.5±12.5 months, sciatic nerve decompression was successful in 50 of 81 patients (61.7%), and the pain relief rate was 43.9±34.17. Subjective improvement based on a 10-point Likert scale was 4.90±3.43. Among the factors that affect the surgical outcome, only additional division of the sacrotuberous ligament during piriformis muscle resection played a significant role. The success rate was higher in the scarotuberous ligementectomy group (79.4%) than in the non-resection group (42.6%), resulting in statistically significant difference based on average NRS-11 score, percent pain relief, and subjective improvement (p<0.05, independent t-test). Conclusion : Sciatic nerve decompression is effective in pain relief in chronic sciatica due to sciatic nerve entrapment at the greater sciatic notch. Its effect was further enhanced by circumferential dissection of the sciatic nerve based on the compartment formed by the piriformis muscle and the sacrotuberous ligament in the greater sciatic notch.

Arthroscopic matched osteoplasty of the radial head for painful radiocapitellar osteoarthritis: surgical technique and case series

  • Dani Rotman;Adam C Watts
    • Clinics in Shoulder and Elbow
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    • v.27 no.3
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    • pp.309-315
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    • 2024
  • Background: Radiocapitellar arthritis can cause pain, loss of motion, and impaired elbow function. Current surgical treatment options are limited. We have developed an original and simple surgical technique to address this, called arthroscopic matched osteoplasty of the radial head (AMOR). In AMOR, the radial head is partially resected and recontoured to match the capitellum and decompress the degenerate radiocapitellar articulation while preserving the ulnohumeral articulation where the cartilage is usually well preserved. Methods: Indications and the surgical technique of the AMOR procedure are described. A retrospective observational service evaluation study was conducted from electronic patient records. Collected clinical outcomes included range of motion, pain level, subjective functional score, and general satisfaction with the results of the procedure. The radiographic outcome was radiocapitellar joint space. Results: Between 2017 and 2021, eight consecutive patients underwent AMOR as part of an arthroscopic osteocapsular arthroplasty procedure. Radiographically, the mean radiocapitellar joint space improved from an average of 1.7 mm to 4.6 mm. Clinically, the mean pain score decreased from 8/10 to 3/10. Six of the eight patients (75%) were satisfied with their results. In two cases, initial improvement following surgery lasted less than 1 year, and one of these patients underwent total elbow arthroplasty for painful ulnohumeral osteoarthritis. There were no complications of surgery recorded. Conclusions: AMOR is a safe treatment option for painful radiocapitellar osteoarthritis and can be incorporated as an "add-on" procedure by surgeons performing elbow osteocapsular arthroplasty in cases with a positive grip and grind test and radiographic evidence of radiocapitellar OA. Level of evidence: IV.

The Development and Evaluation of Web-based Education Program for Lung Cancer Patient (폐암환자를 위한 웹기반 교육프로그램 개발 및 평가)

  • Yoo, Han-Jin
    • Asian Oncology Nursing
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    • v.5 no.1
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    • pp.11-21
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    • 2005
  • The purpose of this study were to develop an web-based education program for Lung cancer patients and to test its effects on patients' self-care knowledge, compliance to medical regimen, nutrition status and pain. The program was developed by the following process: first, Lung cancer patients demand on the web-based program was investigated. and second, the program was developed with the help of various reference books and then validation of experts group. last, educations effects on the patients is evaluated and compared the differences in self-care knowledge, compliance to medical regimen, nutrition status and pain between on experimental group and a control group on before discharge 1day and 3weeks after. SPSS/Win 11.0 program was used for data analysis. It was proven with $x^2$ test and t-test, and Pearson Correlation coefficient, and Chronbach's alpha coefficient were done for the reliability of measuring instruments. 1. The summary of the Program development is as follows. The program is based on patients' questionnaire and reference material and is made for users friendly. Not only Bigger font size and bright colors but also illustrations or pictures were adopted to help enhance patients' understanding. 2. The summary of the study results is as follows. 1) Compared with control group, the web-based educated experimental group showed a statistical significant difference on self-care knowledge, Especially disease, radiation treatment, medication & analgesics, chemotherapy side effect, but there was no significant difference in the field of chemotherapy, in the fields of operation, diet & general knowledge. 2) Compared with control group, the web-based educated experimental group showed a statistical significant difference on compliance to medical regimen, especially in the field of follow up care, everyday life, diet, but there was no significant difference in the field of medication, exercise. 3) Compared with control group, web-based educated experimental group showed no significant difference in nutrition status, but partially significant difference in body weight. 4) Compared with control group, the web-based educated experimental group showed no significant difference in pain level. 5) The significantly positive correalation self-care knowledge with the compliance to medical regimen. 6) Users satisfaction with the web-based education program of the contents quality, the level of recommendation to others, content layout, medical information quality, but interesting got a low mark.

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