• Title/Summary/Keyword: 비약물 중재

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The Effectiveness of Non-pharmacologic Interventions for Chronic Nonspecific Low Back Pain: A Systematic Review and Meta-analysis (국내 비특이적 만성 요통 환자에게 적용한 비약물적 중재의 효과: 체계적 문헌고찰 및 메타분석)

  • Jung, Mijung;Lee, Haein
    • Journal of East-West Nursing Research
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    • v.26 no.1
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    • pp.1-16
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    • 2020
  • Purpose: The purpose of this study was to evaluate the effectiveness of non-pharmacologic interventions for chronic nonspecific low back pain (CLBP) in adults aged 18-64 years. Methods: We searched for potentially relevant randomized controlled trials and non-randomized controlled trials through five Korean electronic databases (i.e., Korean Studies Information Service System, Research Information Sharing Service, Korean Medical Database, KoreaMed, and National Assembly Library) published from January 2010 to May 2019. Two investigators independently selected the studies based on the criteria and assessed risk of bias in the included studies. We estimated the effect size of interventions using Comprehensive Meta Analysis 3.3. Results: Of 10,151 studies, 26 studies met the inclusion criteria and 15 studies were included in the meta-analysis. Exercise reduced low back pain (Hedges's g=-1.53, 95% CI: -2.22 to -0.85) and pain-related disabilities (Hedges's g=-0.92, 95% CI: -1.40 to -0.45). We found that taping was effective in decreasing low back pain (Hedges's g=-1.12, 95% CI: -1.51 to -0.73) and pain-related disabilities (Hedges's g=-0.50, 95% CI: -0.93 to -0.07). Manual therapy yielded a marginally significant reduction in low back pain (Hedges's g=-2.32, 95% CI: -4.64 to 0.00), the therapy was not effective in decreasing pain-related disabilities. Conclusion: Although there was little evidence for the effectiveness of manual therapy in adults with CLBP, exercise and taping were effective to relieve pain and pain-related disabilities. Based on these findings, we suggest the development of non-pharmacologic interventions or a nursing intervention protocol for the CLBP management. Also, nurses should consider implementation of effective non-pharmacologic interventions for CLBP.

The Effect of Self-efficacy Promotion Exercise Program for the Elderly Hypertensives (자기효능증진 운동프로그램이 고혈압 노인에게 미치는 영향)

  • Kim, Yu Jeong;Kim, Su Mi
    • Journal of Digital Convergence
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    • v.12 no.11
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    • pp.487-497
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    • 2014
  • This study was to examine the effect of the Self-efficacy Promotion Exercise Program to the elderly hypertensive with Stage 1. This research was the quasi-experimental study. The Self-efficacy Promotion Exercise Program combined to Aerobic exercise which is incrementally at a level of 40~60% HRmax and the source of the Self-efficacy Promotion Exercise. This research was carried out to experimental(33 patients) and control(32 patients), 60 minutes per day, 3 times a week for 12 weeks. The Self-efficacy Promotion Program was effect on enhancing the general(p<.001) and exercise self-efficacy(p<.001), the self-care behaviors(p<.001) and decreasing the systolic blood pressure(p<.001) to the elderly hypertensives. The 12 weeks Self-efficacy Promotion Exercise Program will be considering to useful for various care settings to the elderly hypertensives.

Health behaviors of the elderly with osteoarthritis across gender groups (남성노인과 여성노인의 골관절염 관련 건강행태 비교)

  • Jeon, Eunyoung
    • Journal of the Korean Data and Information Science Society
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    • v.26 no.6
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    • pp.1453-1463
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    • 2015
  • The purpose of this study was to identify health behaviors of elderly with osteoarthritis across gender groups. Total of 1,654 age 65 over from the fifth Korean National health and Nutrition Examination Survey (KNHANES) were selected. The data analysis was performed using the complex sampling function of SPSS version 20. Logistic regression analysis shows the difference of risk factors of osteoarthritis between men and women elderly people. Prevalence of osteoarthritis in men elderly was associated with drinking, education for osteoarthritis, and treatment of osteoarthritis whereas the factors in woman elderly were depression and muscle strengthen exercise. Most of the subjects had not the opportunity of education of the management of the osteoarthritis. These findings from the study are expected to promote the screening strategy for the aged at risk of osteoarthritis in the Korean community and enhance the effect of the nursing intervention for the elderly with osteoarthritis.

Effectiveness of Non-Pharmacologic Interventions in Chemotherapy Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis (항암화학요법 관련 말초신경병증에 적용한 비약물적 중재의 효과: 체계적 문헌고찰 및 메타분석)

  • Oh, Pok-Ja;Kim, You Lim
    • Journal of Korean Academy of Nursing
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    • v.48 no.2
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    • pp.123-142
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    • 2018
  • Purpose: This study was conducted to evaluate the effectiveness of non-pharmacologic interventions in chemotherapy-induced peripheral neuropathy (CIPN). Methods: PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL, and several Korean databases (Until August 2017) were searched. The main search strategy combined terms for peripheral neuropathy and presence of neoplasms. The risk of bias was assessed using the Cochrane's Risk of Bias tool for randomized studies and the Risk of Bias Assessment tool for non-randomized studies. To estimate the effect size, a meta-analysis of the studies was performed using the Rev Man 5.3 program of the Cochrane Library random-effects models were used in the analyses. Results: Twenty-two studies with a total of 954 participants met the inclusion criteria. Of the 22 studies, 12 were used to estimate the effect size of the non-pharmacologic interventions. The non-pharmacologic interventions used in patients with CIPN were exercise, acupuncture, massage, and foot bath. The acupuncture significantly reduced CIPN symptoms and signs (d=-0.71) and CIPN pain (d=-0.73) (p<.001). Massage and foot bath were also effective in reducing CIPN symptoms (d=-0.68; 95% CI=-1.05, -0.30; p<.001; $I^2=19%$).Exercises were effective in improving muscle strength and endurance(d=-0.55) and quality of life (d=-2.96), but they were not significantly effective in improving CIPN. Conclusion: Although these results provide little evidence of the effectiveness of acupuncture, massage, and foot bath in the treatment of CIPN, they suggest that these interventions can reduce CIPN symptoms in patients with cancer. However, the findings of this study should be interpreted with caution as there is a relative lack of data in this field, and additional well-designed studies are needed. PROSPERO registration: CRD42017076278.

The Effectiveness of Non-pharmacological Interventions on Anxiety in Children Undergoing Surgery: A Systematic Review and Meta-analysis (수술 환아의 불안에 적용한 비약물적 중재의 효과: 체계적 문헌고찰 및 메타분석)

  • Kim, Hyeon-Young;Shin, Sun Hwa
    • Journal of East-West Nursing Research
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    • v.27 no.1
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    • pp.1-13
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    • 2021
  • Purpose: The purpose of this study was to examine the effectiveness of non-pharmacological interventions for reducing perioperative anxiety in children undergoing surgery. Methods: A systematic review of randomized controlled trials (RCTs) with the primary outcome of children's perioperative anxiety was conducted. The literature search was performed using various databases, including Cochrane Library, CINAHL, EMBASE, PubMed, and Korean electronic databases with confined to RCTs between 2000 and 2020. A total of sixteen studies were suitable the inclusion criteria and were systematically reviewed. The bias risk of randomized studies was evaluated using Cochrane's risk of bias tool. For the meta-analysis, RevMan 5.4 was used to analyze effect sizes of interventional factors. Results: Finally, twelve RCTs studies were used for meta-analysis. The non-pharmacological interventions implemented to reduce perioperative anxiety in children were therapeutic play, clown therapy and information provision. First, therapeutic play had a significant effect on reducing preoperative anxiety, with an effect size of -1.46 (95% CI=-1.78~-1.14). Second, clown therapy had a significant effect on reducing preoperative anxiety, with an effect size of -0.97 (95% CI=-1.45~-0.49). Finally, the provision of information had a significant effect on reducing preoperative anxiety, with an effect size of -0.75 (95% CI=-0.99~-0.51). Conclusion: This meta-analysis suggests that non-pharmaceutical interventions provide effective methods of reducing perioperative anxiety in children. Therefore, the findings verify evidence that various non-pharmacological interventions are effective means for reducing children's preoperative anxiety.

The Analysis of Registration Status of Herbal Medicine and Medication Interventional Clinical Trials for Simple Obesity in Children and Adolescents -Focused on WHO ICTRP- (소아청소년 단순 비만에 대한 한약 및 약물 중재 임상시험 등록 현황 분석 - WHO ICTRP를 중심으로 -)

  • Jeong Yoon Kyoung;Choi Seo Yeon;Bang Miran;Lee Boram;Chang Gyu Tae
    • The Journal of Pediatrics of Korean Medicine
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    • v.38 no.1
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    • pp.55-77
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    • 2024
  • Objectives This study aimed to analyze the registration status and characteristics of clinical trials on herbal medicine (HM) and medication interventions for simple obesity in children and adolescents. Methods All interventional clinical trials registered in the International Clinical Trials Registry Platform of the World Health Organization until December 12, 2024, were collected. The study design, interventions, inclusion and exclusion criteria, and outcome measures were extracted. Results A total of 24 clinical trials (23 medications and 1 HM) were analyzed. The most common study designs were single-center, randomized controlled, parallel, and phase 2. Placebo controls were used in 87.5% of the studies, blinding was used in 79.1%, and quadruple blinding was the most common. Informed consent was obtained from 70.8% of the participants. Among the oral medications (66.6%), metformin was the most common (25%). Among the non-oral medications (29.1%), exenatide (Bydureon) was the most common intervention (42.8%). Body mass index was the most commonly reported primary outcome measure (79.1%), with most assessments performed at 6 months. Conclusions Based on the characteristics of the medication interventional clinical trial design analyzed in this study, additional high-quality multicenter traditional Korean medicine trials need to be designed in the future.

Effect of Magnetic Field Therapy Applied to Acupuncture Point on Dysmenorrhea Experienced by High School Girls (경혈점에 적용한 자장요법이 여고생의 월경통에 미치는 효과)

  • Jang, Hyun-Jung;Park, Jeong-Eon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.11
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    • pp.7367-7376
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    • 2015
  • This study was investigate the effects of the magnetic field therapy applied to the acupuncture point on dysmenorrhea experienced by high school girls and to verify the possibility to use this therapy as an effective in-home nursing intervention. Data were collected from Feburary to April, 2006. The research procedure was that female students who visited in public health center had to fill in questionnaires with dysmenorrhea Grapic Rating Scale(GRS) and Adjective Labor Pain Rating Scale(ALPRS), the gauge of pain, before participating the experiment. And then each group was tested for 3 hours. Participants before and after applying magnetic treatment filled each questionnaires with dysmenorrhea GRS and ALPRS. The GRS points and ALPRS points in the experimental group, applied by Magnetic Field therapy on acupuncture point is lower than that in the comparison group. The above result has proved that the magnetic field therapy on acupuncture has an effect on the pain alleviation of dysmenorrhea of female students in high school. Therefore, propose this therapy to dysmenorrhea of female students. In this research, ALPRS indicated validity on dysmenorrhea, so for verifying validity, further research is necessary.

Cardiac Intracoronary Stenting vs CABG: Prevention of Medical Accident (심장 스텐트 시술과 의료사고 예방)

  • Kim, Kyoung Reay;Park, Kook Yang
    • The Korean Society of Law and Medicine
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    • v.18 no.2
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    • pp.163-194
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    • 2017
  • Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

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Risk Assessment of Arsenic by Human Exposure of Contaminated Soil, Groundwater and Rice Grain (오염된 토양, 지하수 및 쌀의 인체노출에 따른 비소의 위해성 평가)

  • Lee Jin-Soo;Chon Hyo-Taek
    • Economic and Environmental Geology
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    • v.38 no.5 s.174
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    • pp.535-545
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    • 2005
  • Environmental survey from some abandoned metal mine areas was undertaken on to assess the risk of adverse health effects on human exposure to arsenic influenced by past Au-Ag mining activities. Elevated levels of As were found in tailings from the studied mine areas. This high concentration may have a impact on soils and waters around the tailing piles. In order to perform the human risk assessment, chemical analysis data of soils, rice grains and waters fur As have been used. The HQ values fer As via the rice grain and groundwater consumption were significantly higher compared with other exposure pathways in all metal mine areas. However, there were minimal soil and water dermal contact risks. The resulting Hl values of As from the Dongil, Okdong and Hwacheon mine areas were higher than 5.0, and their toxic risk due to drinking water and rice grain was strong in these mine areas. The cancer risk of being exposed to As by the rice grain route from the Dongil, Okdong and Hwacheon mine areas was $5.2\times10^{-4},\;6.0\times10^{-4}\;and\;8.1\times10^{-4}$, respectively. The As cancer risk via the exposure pathway of drinking water from these mine areas exceeded the acceptable risk of 1 in 10,000 fer regulatory purposes. Thus, the daily intakes of groundwater and rice grain by the local residents from the Dongil, Okdong and Hwacheon mine areas can pose a potential health threat if exposed by long-term arsenic exposure.

Weight loss effects of Bariatric Surgery after nutrition education in extremely obese patients (고도비만환자에서 베리아트릭 수술 (Bariatric Surgery) 후 영양교육이 체중감량에 미치는 효과)

  • Jeong, Eun-Ha;Lee, Hong-Chan;Yim, Jung-Eun
    • Journal of Nutrition and Health
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    • v.48 no.1
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    • pp.30-45
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    • 2015
  • Purpose: This study was planned to determine the characteristics of extremely obese patients during Bariatric surgery and to evaluate how the difference in the number of postsurgical personal nutritional educations they received affected the weight loss. Methods: This is a retrospective study on the basis of the medical records of extremely obese patients for 15 months after receiving gastric banding. A total of 60 people were selected as the study subjects and they were divided into the Less Educated Group and the More Educated Group according to the average number of personal nutritional educations they received. We investigated both groups to determine the general characteristic, health related lifestyle habits, obesity related complications and symptoms in possession, and eating habits before their surgery, the body composition measurement result, obesity determination indices at 1, 3, 6, 9, 12, and 15 months before and after their surgery, and the biochemical parameters at 6 months before and after their surgery. Results: Body fat and weight showed rapid reduction until 6 months after the surgery, but thereafter reduced slowly depending on the result of body composition measurement. Regarding body fat and weight, the More Educated Group, who received nutrition education more often, showed significantly lower levels than the Less Educated Group at 15 months after surgery. Regarding BMI and degree of obesity, the More Educated Group showed significantly lower levels than the Less Educated Group at 15 months after surgery. Here, we were assured that BMI is reversely proportional to the number of personal nutritional educations at 15 months, which is more outstanding after surgery than before surgery. Conclusion: Long-term nutritional education is a key factor for the extremely obese patient in maintaining the effects of Bariatric surgery on weight and body fat reduction onwards. In the next stage, considering the characteristics of the study subjects, adoption of individual nutrition education is recommended for postsurgical prospective arbitration of obesity in order to monitor blood pressure, obesity related complications, symptoms in possession, and how eating habits and health related life habits change, and to judge the actual effect of the nutritional education method at the same time.