• Title/Summary/Keyword: 사전 치료에 대한 계획

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Good Death Awareness, Attitudes toward Advance Directives and Preferences for Care Near the End of Life among Hospitalized Elders in Long-term Care Hospitals (요양병원 입원 노인의 좋은 죽음 인식, 사전의료의향서에 대한 태도 및 임종치료선호도)

  • Kim, Eunju;Lee, Yoonju
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.26 no.3
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    • pp.197-209
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    • 2019
  • Purpose: This study was done to examine good death awareness, attitudes toward advance directives (ADs), and preference for care near the end-of-life (PCEOL) of hospitalized elders in long-term care hospitals. Relevant characteristics were investigated as well as correlation of the variables. Methods: This descriptive research study involved 161 hospitalized elderly patients in long-term care hospitals. A self-report questionnaire was used to measure Good Death Scale, ADs Survey, PCEOL Scale, and general characteristics. Collected data were analyzed using descriptive statistics, t-test, ANOVA, and Pearson correlation with SPSS/WIN 23.0. Results: In terms of good death awareness, a significant difference was observed; in according to age (F=3.35, p=.037), payer of treatment costs (F=3.98, p=.021), mobility (F=3.97, p=.021), heard discussion about ADs (t=-3.89, p<.001), and willing to complete ADs (t=2.12, p=.036). As far as attitudes toward ADs, the participants presented significant difference depending on religion (t=2.38, p=.018), average monthly income (F=3.91, p=.022), duration of hospital admission (F=5.33, p=.006), person to discuss ADs (t=-2.76, p=.006). On PCEOL, there was a significant difference, depending on religion (t=-3.59, p<.001) and perceived health status (F=3.93, p=.022). Finally, as for how the variables were related to each other, good death awareness and attitudes toward ADs had a weak positive correlation with PCEOL. Conclusion: To help seniors staying in nursing homes face a good death and enjoy autonomy, there should be educational and support systems that reflect each individual's sociodemographic characteristics so that the seniors can choose what kind of care they want to receive near the end-of-life.

Usefulness assessment of secondary shield for the lens exposure dose reduction during radiation treatment of peripheral orbit (안와 주변 방사선 치료 시 수정체 피폭선량 감소를 위한 2차 차폐의 유용성 평가)

  • Kwak, Yong Kuk;Hong, Sun Gi;Ha, Min Yong;Park, Jang Pil;Yoo, Sook Hyun;Cho, Woong
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.1
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    • pp.87-95
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    • 2015
  • Purpose : This study presents the usefulness assessment of secondary shield for the lens exposure dose reduction during radiation treatment of peripheral orbit. Materials and Methods : We accomplished IMRT treatment plan similar with a real one through the computed treatment planning system after CT simulation using human phantom. For the secondary shield, we used Pb plate (thickness 3mm, diameter 25mm) and 3 mm tungsten eye-shield block. And we compared lens dose using OSLD between on TPS and on simulation. Also, we irradiated 200 MU(6 MV, SPD(Source to Phantom Distance)=100 cm, $F{\cdot}S\;5{\times}5cm$) on a 5cm acrylic phantom using the secondary shielding material of same condition, 3mm Pb and tungsten eye-shield block. And we carried out the same experiment using 8cm Pb block to limit effect of leakage & transmitted radiation out of irradiation field. We attached OSLD with a 1cm away from the field at the side of phantom and applied a 3mm bolus equivalent to the thickness of eyelid. Results : Using human phantom, the Lens dose on IMRT treatment plan is 315.9cGy and the real measurement value is 216.7cGy. And after secondary shield using 3mm Pb plate and tungsten eye-shield block, each lens dose is 234.3, 224.1 cGy. The result of a experiment using acrylic phantom, each value is 5.24, 5.42 and 5.39 cGy in case of no block, 3mm Pb plate and tungsten eye-shield block. Applying O.S.B out of the field, each value is 1.79, 2.00 and 2.02 cGy in case of no block, 3mm Pb plate and tungsten eye-shield block. Conclusion : When secondary shielding material is used to protect critical organ while irradiating photon, high atomic number material (like metal) that is near by critical organ can be cause of dose increase according to treatment region and beam direction because head leakage and collimator & MLC transmitted radiation are exist even if it's out of the field. The attempt of secondary shield for the decrease of exposure dose was meaningful, but untested attempt can have a reverse effect. So, a preliminary inspection through Q.A must be necessary.

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Effects of Horticultural Therapy on the Improvement of the Self-Esteem and Sociality of Mentally Retarded Persons (원예치료프로그램의 적용이 정신지체장애인의 자기주장 및 사회성 향상에 미치는 영향)

  • 박민희;차영주;유영원;부희옥;이숙영
    • Korean Journal of Plant Resources
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    • v.17 no.3
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    • pp.339-351
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    • 2004
  • This study was conducted to evaluate the effect of phased horticultural therapy(HT) program on the experience of psychologic therapy and the development of job and social integration in the mentally handicapped persons. In this study, the mentally handicapped persons participated in HT program were chosen in disabled person's welfare institute of Jeonnam. HT program was performed twice a week with 1 hour activity for 4 months. As a results, the mentally handicapped persons participated in HT program showed high interest of horticulture and improvement of self-respect and the high satisfactory degree of HT program. Therefore, the mentally handicapped persons were showed the experience of both physical and mental therapy, improvement of self-esteem scale and sociality in HT program. Also, the application of HT program with continuously interest will be showed high improvement of physical, psychological and sentimental. In the course of this HT program progress, horticultural therapist and social welfare officer were showed the limitation of role. Therefore the leaders of group for successful HT program be required the comprehensive plan of more efficient HT program and induced technique of continuously up-phased improvements in HT program progress.

Fixed implant rehabilitation of maxillary edentulous patient using intraoral scanning digital workflow: a case report (상악 완전 무치악 환자에서 구강 스캐닝 디지털 워크플로우를 활용한 완전 고정성 임플란트 수복 증례)

  • Seung Min Park;YoungBum Park
    • The Journal of Korean Academy of Prosthodontics
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    • v.62 no.1
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    • pp.38-46
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    • 2024
  • In order to treat edentulous patients with fixed implant prosthesis, the final prosthesis form should be predetermined based on the anatomic structures of the arch, the opposing dentition, and the occlusal plane. The design and occlusion of the interim prosthesis can provide useful information when fabricating the definitive prosthesis. In this case report, scan data of the edentulous region and the interim prosthesis were superimposed through an intraoral scanning digital workflow. In this way, the interim prosthesis information was incorporated into the design of the final prosthesis. Furthermore, the interim prosthesis data acquired through intraoral scanning was utilized to plan the positions and angles of the implants based on the final prosthesis design. Surgical guides were used to accurately place the implants in the planned three-dimensional positions. In this case report, satisfactory esthetic and functional clinical outcomes were achieved through application of digital techniques.

The Effectiveness of Global Start-up Education Program Experience (글로벌 Start-up 교육 프로그램 체험의 효과성 분석)

  • Rhee, Esther
    • Journal of Convergence for Information Technology
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    • v.9 no.6
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    • pp.164-174
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    • 2019
  • This study aimed to analyze the effectiveness of the experiences of the global start-up education program. With 10 study subjects selected from 'Eklya Global Entrepreneurship Camp' among global education programs in K University, pre- and post-survey and FGI were conducted. The collected surveys were analyzed by SPSS (24.0) and FGI. The results of this study are as follows: First, According to a comparison of the average score of the global start-up education program experience pre-post, 3.1 points showed that the program affected students' start-ups. Second, in the interviews conducted after the program participation, it was shown that detailed planning for their global start-ups, systematic education on finance, improved self-confidence for start-ups, and discussion-based education influenced their start-ups. Finally, this study expects that the comparative analysis of the college students participating in entrepreneurship education would lay the basis for more effective global entrepreneurship education in the future.

Level of perception of changed lip protrusion and asymmetry of the lower facial height (하안면부에서 입술의 돌출 정도와 안면 비대칭의 인지도에 관한 연구)

  • Kim, Kyu-Sun;Kim, Young-Jin;Lee, Keun-Hye;Kook, Yoon-Ah;Kim, Young-Ho
    • The korean journal of orthodontics
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    • v.36 no.6
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    • pp.434-441
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    • 2006
  • Objective: While one of the most prevailing motivations for seeking orthodontic treatment is to achieve good facial esthetics, understanding the level of a person's perception to the changes that have occurred on the face after orthodontic treatment is critical to the process of orthodontic diagnosis and treatment planning. Methods: 40 students attending art school participated in determining the level of their perception of changed lip position and facial asymmetry. Computer-graphic frontal face and facial profile photographs with balanced proportions were used to evaluate the level of a participant's perception of the changes in facia! asymmetry and in lip position. Results: Change of lip position over 2 mm and over a 3 mm change of facial asymmetry was perceived significantly. Conclusion: The results indicated that at least a 2 mm change of lip position was needed to be perceived after orthodontic treatment. The level of perception of the change in facial asymmetry was lower than that of the change in lip position. Information about facial changes given prior to the evaluation enhanced the level of perception.

A Survey of Non-Emergency and Emergency Deep Sedation using Sevoflurane Inhalation for Pediatric or Disabled Patients (세보플루란 깊은 진정의 응급과 비응급적 사용에 관한 실태조사)

  • Kim, Seungoh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.1
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    • pp.18-26
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    • 2014
  • Deep sedation is considered for the dental treatment of pediatric or disabled patients who have severe anxiety or involuntary movement. Deep sedation using sevoflurane inhalation in emergency dental practice, therefore, is also preferred for fast induction and recovery. This survey consists of 121 people with pediatric or disabled patients who underwent dental treatment under deep sedation using sevoflurane inhalation from January 2013 to October 2013. Patients who were scheduled for deep sedation were classified into a non-emergency sevoflurane sedation group, whereas patients who underwent emergency sedation due to trauma and patients with disabled characteristics itself were classified into an emergency sevoflurane sedation group. Of 121 patients studied, 95 patients received dental care under non-emergency sedation, 26 patients received dental care under emergency sevoflurane sedation. The two groups were analyzed according to: gender; age; primary reason for sedation; duration of sedation; treatment time; induction methods; treatment information; and departments. Non-emergency sevoflurane sedation in pediatric or disabled patients was safe and effective for controlling the behavior. Emergency sevoflurane sedation was a useful method for younger pediatric patients with traumatic injury who need simple, short time emergency treatment. Deep sedation using sevoflurane inhalation not only will reduce the use of general anesthesia gradually but also will be a useful method to emergency treatment for pediatric or disabled patients.

Accuracy Evaluation of Tumor Therapy during Respiratory Gated Radiation Therapy (호흡동조방사선 치료 시 종양 치료의 정확도 평가)

  • Jang, Eun-Sung;Kang, Soo-Man;Lee, Chol-Soo;Kang, Se-Sik
    • The Journal of Korean Society for Radiation Therapy
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    • v.22 no.2
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    • pp.113-122
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    • 2010
  • Purpose: To evaluate the accuracy of a target position at static and dynamic state by using Dynamic phantom for the difference between tumor's actual movement during respiratory gated radiation therapy and skin movement measured by RPM (Real-time Position Management). Materials and Methods: It self-produced Dynamic phantom that moves two-dimensionally to measure a tumor moved by breath. After putting marker block on dynamic phantom, it analyzed the amplitude and status change depending on respiratory time setup in advance by using RPM. It places marker block on dynamic phantom based on this result, inserts Gafchromic EBT film into the target, and investigates 5 Gy respectively at static and dynamic state. And it scanned investigated Gafchromic EBT film and analyzed dose distribution by using automatic calculation. Results: As a result of an analysis of Gafchromic EBT film's radiation amount at static and dynamic state, it could be known that dose distribution involving 90% is distributed within margin of error of 3 mm. Conclusion: As a result of an analysis of dose distribution's change depending on patient's respiratory cycle during respiratory gated radiation therapy, it is expected that the treatment would be possible within recommended margin of error at ICRP 60.

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A Study on the Development of Case Management Program for Arthralgia in Customized Visiting Health Care (맞춤형 방문건강관리사업에서의 관절통증 사례관리 프로그램 개발 연구)

  • Lee, Moo-Sik
    • Proceedings of the KAIS Fall Conference
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    • 2009.12a
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    • pp.474-478
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    • 2009
  • 본 연구는 2008년 맞춤형 방문건강관리사업에 사용되고 있는 관절통증을 중심으로 한 사례관리를 수정 보안하여 우리나라 실정에 맞는 관절통증 사례관리 프로그램을 개발, 제안하며, 맞춤형 방문건강 관리사업의 활성화와 완성도를 높이는데 있다. 연구방법으로는 2007년 전국 12주 관절통증 사례관리 결과자료 분석하고, 전국 253개 보건소의 맞춤형 방문건강관리사업 인력에 대한 자료 분석과 전국 보건소 전문가 자문회의와 토론 결과를 통해 설문지를 수정 보완하여 2008년도 충청남도 관절통증 12주 사례관리를 실시하였다. 자료분석은 SPSS 12.0 통계 프로그램을 이용하여, p-value가 0.05 미만과 0.01미만인 경우를 통계적으로 유의한 것으로 판정하였으며, 전국자료는 빈도분석, wilcoxon 부호순위 검정과 McNemar's 검정을 실시하였으며, 12주의 관절통증 사례관리의 연구기간동안 수집된 자료를 1주와 8주간, 1주와 12주간, 8주와 12주간을 paired t-test 검정과 McNemar's 검정을 실시하여 유의성 평가를 실시하였다. 연구결과는 다음과 같다. 12주 기간 동안 사전 사례관리 방문간호사의 교육을 통한 사례관리 서비스의 강도의 조절 및 매주로 서비스의 횟수를 조절하여 사례관리를 실시한 결과 총 109개 항목에서 1주와 8주간에 유의한 항목은 TG(mg/dl)를 비롯한 51개 항목, 1주와 12주간에는 콜레스테롤(mg/dl)을 비롯한 53개 항목, 8주와 12주간에는 지난 48시간동안 관절통증 점수를 비롯한 3개 항목으로 유의한 차이를 볼 수 있었으며, 1주와 8주간은 유의하나 1주와 12주간은 유의하지 않게 나타나는 항목은 TG(mg/dl)를 비롯한 3개 항목, 1주와 8주간은 유의하지 않다가 1주와 12주간은 유의하게 나타나는 항목은 콜레스테롤(mg/dl)를 비롯한 6개 항목, 1주, 8주, 12주간의 모든 기간에서 유의한 항목은 지난 48 시간동안 관절통증 점수를 비롯한 3개 항목으로 조사되었다. 결론적으로 현재 우리나라에서 추진되고 있는 맞춤형 방문건강관리 사업의 사업지침에 대한 보완을 위해 관절통증사례관리 프로그램에 있어 중재 서비스 또는 프로그램의 기간은 12주간에서 8주간으로 조정 되어야 하며, 추가가 필요한 항목으로는 교육, 자기역량 강화, 운동처방, 물리치료, 약물치료, 대체요법, 식이, 영양, 생활지도 등이며, 어골도 분석을 위한 기본 틀 및 주요 구성요소를 제시 및 기여 요인 및 결정요인을 위한 논리적 모형 제시가 필요하며, 개선목표를 위한 유지증진 및 관리능력, 지기 관리 수행도 개선과 대상자별 맞춤형 사례관리를 위한 표준화된 행동 체크리스트 제작 보급 및 사례별 운동, 물리치료 지도 방법 계획 수립에 대한 인력 충원이 필요하다.

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Full mouth rehabilitation of a worn dentition using digital guided tooth preparation: a case report (과도한 구치부 마모를 보이는 환자에서 digital guided tooth preparation을 이용한 완전 구강 회복 증례)

  • Kim, Yong-Kyu;Yeo, In-Sung Luke;Yoon, Hyung-In;Lee, Jae-Hyun;Han, Jung-Suk
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.1
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    • pp.80-90
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    • 2022
  • With the development of digital dentistry, it is being applied in various ways of dental treatment. This case report presents the definitive prosthesis designed in advance with a re-established vertical dimension and the digital technology, which determined the amount of tooth preparation, in order to preserve as much tooth structure as possible in a patient with pathological wear of the posterior teeth and loss of vertical dimension. For accurate tooth preparation, the guides of the occlusal and axial surfaces were digitally and additively manufactured. Then, aesthetics and anterior guidance were established at the provisional stage. The information of the provisional restoration was delivered to the definitive stage by double scanning. The digital technology, including the virtual planning and the guided tooth removal, produced the definitive restorations satisfactory to both the patient and clinician.