• Title/Summary/Keyword: 임상진료지침

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The Role and Policy of Korean Medicine Doctor for the Prevention and Management of Infectious Diseases: A Mixed-Methods Approach (감염병 예방 및 관리를 위한 한의사의 역할과 정책적 과제: 혼합연구방법론을 적용하여)

  • Juchul Kim;Heasun Chun;HeeJung Lee;Jungtae Leem
    • The Journal of Korean Medicine
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    • v.44 no.2
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    • pp.45-59
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    • 2023
  • Objectives: This study investigated the role of Korean medicine doctors in the national quarantine system and the status of their duties through questionnaire surveys and in-depth interviews with Korean medicine staff who participated in COVID-19 work. Methods: We developed a questionnaire survey to investigate the status and perception of Korean medicine doctors' participation in responding to infectious diseases, and the results were derived by conducting frequency analysis and T-test using SPSS program. The measurement variables of this study were the status of COVID-19 related work participation and perception of Korean medicine doctors' role in infectious diseases, and the maximum significance level was 0.05. Results: There were 300 respondents to the survey, and as for the COVID-19 related work, Korean medicine treatment for COVID-19 patients accounted for the most(52.7%), and various preventive and treatment tasks such as epidemiological investigations and specimen collection were conducted. Conclusion: According to this study, it was confirmed that there are sufficient legal and administrative grounds for Korean medicine doctors to perform specimen collection and epidemiological investigations. Therefore, it is necessary to prepare a policy framework to solidify the status of Korean medicine doctors in national infectious diseases in the future.

A Survey on Korean Medicine Doctors' Recognition for Developing Korean Medicine Clinical Practice Guidelines for Gastric Cancer (위암 한의표준임상진료지침 개발을 위한 한의사 인식조사)

  • Dong-hyeon Kim;Jong-hee Kim;Ji-hye Park;Hwa-seung Yoo;So-jung Park
    • The Journal of Internal Korean Medicine
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    • v.44 no.3
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    • pp.466-484
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    • 2023
  • Objective: The purpose of this study was to provide data for the development of Korean medicine (KM) clinical practice guidelines (CPG) for gastric cancer (GC) by identifying the awareness and knowledge needs of KM doctors (KMD) through an online survey. Methods: A survey questionnaire was produced by referring to the previous recognition survey studies for clinical KMDs. The survey questionnaire was composed of questions regarding the current status of clinical care for GC, the knowledge level of clinicians about GC, and other details that clinicians use during practice. The survey was conducted from September 20 to October 22, 2021. An online survey was conducted with 195 KMDs from the Society of Korean Medicine and the Korean Association of Traditional Oncology of KM. Results: A total of 195 respondents participated in the online survey regarding the current status of GC treatment. Of this number, 10.3% of the respondents specialize in GC, but even if they do not currently specialize in GC, they are more likely to treat patients with GC in the future. In terms of the specifics of KM treatment, there was a demand for information on comprehensive KM treatment methods, such as herbal medicine, acupuncture, moxibustion, cupping, and chuna, as well as on analyzing the effectiveness of combined treatment with chemotherapy and radiation. Conclusion: In this study, we were able to understand the clinical KMDs' perception of GC, knowledge level, and requirements in the CPG. The results of this study will provide the basic data for the development of CPG for GC.

Development Protocol of Korean Medicine Clinical Practice Guideline for Myofascial Pain Syndrome (근막통증증후군의 한의표준임상진료지침 개발 프로토콜)

  • Byeonghyeon Jeon;Hyeonjun Woo;Won-Bae Ha;Cheoung Su Kim;Jung-Han Lee
    • Journal of Korean Medicine Rehabilitation
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    • v.33 no.4
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    • pp.203-213
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    • 2023
  • Objectives This study aimed to develop a Korean medicine (KM) clinical practice guideline for myofascial pain syndrome (MPS) via the collaboration of clinical and methodological experts. Methods The study will include an initial survey to establish a common understanding of MPS. To develop the clinical guideline, a multidisciplinary development group was formed. The group will finalize the clinical questions based on a preliminary draft. The GRADE methodology is going to be applied to determine the level of evidence and grading of the recommendations. Finally, approval from the relevant medical societies will be obtained. Results A protocol for developing a KM clinical guideline for MPS was presented. Before finalizing the clinical key questions, a literature search was conducted according to the protocol, and a draft of 19 clinical key questions was established. Conclusions An evidence-based KM clinical guideline for MPS is expected to contribute to the management of MPS. This may also serve as a reference for the development of other KM clinical practice guidelines in the future.

A Delphi Study of Korean Medicine for Anorexia in Children for Clinical Practice Guidelines (소아 식욕부진의 한의표준임상진료지침 개발을 위한 델파이 연구)

  • Bang Miran;Lee Sun Haeng;Chang Gyu Tae
    • The Journal of Pediatrics of Korean Medicine
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    • v.38 no.2
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    • pp.21-31
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    • 2024
  • Objectives This study aimed to develop consensus-based recommendations for establishing standard clinical practice guidelines for pediatric anorexia through the utilization of a Delphi study. Methods We analyzed existing randomized controlled trials for pediatric anorexia treatment using the Delphi method-a structured process for achieving consensus among a panel of experts. A questionnaire was distributed among a select panel of nine specialists in the field. Results The initial Delphi round led to consensus on 30 distinct recommendations; however, consensus was not reached for 19 other recommendations, prompting a second Delphi round. In the subsequent round, adjustments were made based on feedback from the initial round, and deliberations were held on recommendations that previously lacked consensus. Following these adjustments, consensus was achieved on all recommendations. Additionally, a third Delphi iteration was conducted to address three specific queries that required amendment due to a reevaluation of the evidence levels of certain recommendations. In total, three Delphi rounds were carried out to produce informed recommendations related to the diagnosis, treatment, and general management of anorexia. Conclusions This investigation successfully generated evidence-based recommendations for the diagnosis and treatment of pediatric anorexia. The recommendations encompassed various practices, including herbal medicine, acupuncture, moxibustion, cupping, and Chuna manual therapy, which can be integrated into clinical settings.

A Survey on the Public's Experience of Medical Use for Developing Korean Medicine Clinical Practice Guideline of Female Infertility (여성 난임 한의표준임상진료지침 개작을 위한 일반인 대상 의료 이용 경험 조사)

  • Sung-Joo Lee;Soo-Hyun Sung;Doing-Il Kim;Young-Jin Yoon;Jang-Kyung Park
    • The Journal of Korean Obstetrics and Gynecology
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    • v.37 no.2
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    • pp.109-119
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    • 2024
  • Objectives: This study is aimed to survey public's experience of medical use for developing Korean medicine clinical practice guideline of female infertility. Methods: The study engaged women who had experienced infertility despite regular conjugal relations, selected from an online survey company's national panel. Participants were surveyed from November 3 to 8, 2021. The questionnaire, developed from prior studies on Korean medicine, was emailed to 29,465 adults; 550 responses were analyzed after exclusions. The study received an IRB exemption from Pusan National University Korean Medicine Hospital and utilized Microsoft Excel for statistical analysis. Results: Among 550 respondents, 32.2% had experienced infertility, predominantly due to unexplained causes (52%). About half had received medical treatment (49.3%), primarily at hospitals and general hospitals (54.2%) and obstetrics and gynecology clinics (49.4%), with Korean medicine facilities also utilized (24.7% for clinics, 14.4% for hospitals). The most common treatments included herbal medicine in Korean medicine and ovulation induction in Western medicine, with most treatments lasting less than six months (71.4%) and costing between 1 to 5 million won (50.5%). Efforts to conceive included lifestyle adjustments such as maintaining a warm lower abdomen, supplement intake, and avoiding alcohol and tobacco. Conclusions: It is necessary that the guidelines be revised to address female infertility and to integrate recommendations for combining Korean medical treatments and Western medical treatments, which will enhance patient care in managing female infertility.

A Survey on Korean Medicine Treatment of Autonomic Dysfunction: Preliminary Research for Clinical Practice Guidelines (자율신경실조증 한의표준임상진료지침 개발을 위한 한의임상 실태조사)

  • Hui-Yeong Park;Geum-Ju Song;Hyun Woo Lee;Chan Park;Seok-In Yoon;Jung Hwan Park;Sun-Yong Chung;Jong Woo Kim
    • Journal of Oriental Neuropsychiatry
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    • v.34 no.4
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    • pp.335-347
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    • 2023
  • Objectives: The study aimed to understand the current treatment patterns in Korean medicine to develop clinical practice guidelines for autonomic dysfunction in Korean medicine. Methods: This study sent an online survey vai text message to 25,900 Korean medicine doctors whose contact information was registered with the Association of Korean Medicine. A total of 1,410 Korean medical doctors completed the online survey. Results: When autonomic treating dysfunction clinically, 77% of the cases included only a description without entering a diagnosis code. The most commonly used information to diagnose o autonomic dysfunction was history-taking and symptoms (79%), and the main symptoms of autonomic dysfunction were palpitations, dizziness, sleeping difficulties, anxiety/nervousness, and depression/lethargy. The most frequently mentioned cause of autonomic dysfunction was mental problems (54%). The most commonly used Korean medicine treatment method for autonomic dysfunction was herbal medicine (70%), and Soyo-san/Gamisoyo-san is the most frequently used herbal medicine preparation. Liver qi depression used to indicate the most often mentioned Korean medicine pattern identification used to indicate autonomic dysfunction (31%). When asked whether cardiac neurosis in Chinese medicine can be considered autonomic dysfunction, opinions for and against it are determined almost equally. Conclusions: Our results serve are a foundation for developing clinical practice guidelines for autonomic dysfunction in Korean medicine and are expected to catalyst promoting future clinical research on autonomic dysfunction.

Survey on practice behavior and model acceptance of traditional Korean medicine(TKM) doctors in order to develop health insurance payment model related with TKM clinical practice guidelines(CPGs). (한의임상진료지침 연계 건강보험 지불모형 개발을 위한 한의사 진료행태 및 모형 수용도 조사)

  • Kim, Dongsu;Lim, Byungmook;Han, Dongwoon;Park, Ji-eun;Jung, Hyoung-Sun
    • Journal of Society of Preventive Korean Medicine
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    • v.21 no.3
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    • pp.1-10
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    • 2017
  • Objectives : The purpose of this study is to investigate the practice patterns of traditional Korean medicine (TKM) doctors and the acceptance of payment model in order to develop a new TKM health insurance payment model linked with TKM clinical practice guidelines (CPGs). Methods : Lumbar herniated intervertebral disc (HIVD) and idiopathic facial palsy (IFP) were selected as a test diseases to develop a new TKM payment model. The level of benefit coverage in the National Health Insurance (NHI) was designed. The survey asked 228 TKM doctors about their practice patterns in HIVD and IFP patients and acceptance of new payment model. Results : Mean of medical cost for treatment of HIVD was 441,000 KW, mean of treatment period ranged from 4.9 to 17.5 weeks, and mean of number of treatment ranged from 14.6 to 50.4 HIVD patients. In the case of IFP, mean of medical cost for treatment of IFP was 468,000 KW, mean of treatment period was at least 4.2 and up to 15.9 weeks and mean of number of treatment ranged from 14.2 to 52 IFP patients. Conclusions : Current study suggests that mixed payment model of per-visit and episode-based model seem to be proper. The model 1 bundles both items which were covered and not covered by NHI in a rational way. The model 2 is based on the development and application of critical pathway. Lastly, model 3 suggests bundling of items covered by current NHI. Acceptance of TKM doctors is expected to be highest in the model 3.

The Distribution and Treatment of Outpatients with General Anesthesia in Chonbuk National University Dental Hospital for 9 Years (최근 9년간 전북대학교 치과 병원 외래 전신마취 환자 분포 및 치료)

  • Moon, Yujin;Lee, Daewoo;Kim, Jaegon;Baik, Byeongju;Yang, Yeonmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.2
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    • pp.158-163
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    • 2015
  • General anesthesia (GA) for dental care in handicapped patients is necessary to facilitate the provision of safe, efficient, and effective quality treatment. The aims of this study were to determine the anesthetic characteristics of handicapped patients in need of dental treatment in these day care units, and to establish for plan to provide better services. 325 patients who had outpatient general anesthesia from January 2005 to March 2014 were assessed for this study. Patients' distribution and treatment patterns were examined. The proportion of male patients (202, 62.2%) was higher than female patients (123, 37.8%) and the largest group of patients were 5 to 10 years old (85, 26.2%). The reasons for general anesthesia included mental and physical disabilities (207, 63.7%), behavior management (84, 25.8%), parent needs (14, 4.3%), and so on. Restorative treatment was the most common procedure with the average of 4.2 teeth treated per one patient and 43 (13.2%) patients underwent general anesthesia for dental treatment more than once. To expand and improve access to the dental care of the disabled, improvement of the health care system, enhancement of their training for dental care by professionals, and enlarging caregivers'understanding of the importance of oral care in the early stages are required.

Agents Used for Pediatric Dental Sedation (소아치과 진정법에 사용되는 약제)

  • Kim, Jiyeon;Jeong, Taesung;Yang, Yeonmi;Yoo, Seunghoon;Choi, Sungchul;Shin, Teojeon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.1
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    • pp.109-116
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    • 2016
  • Sedation is an indispensable part of contemporary pediatric dentistry. The Korean Academy of Pediatric Dentistry (KAPD) organized the dental sedation committee to help members perform safer and more effective sedation. The committee surveyed 111 members who practice dental sedation to figure out the present state of sedation in 2014. According to the survey, 86% of the respondents indicated that they were interested in continuing education of sedation. The most interesting topic was sedation related emergency management, followed by safe dosages of sedative drugs. However, it is not realistic to establish the recommended dosages as a guideline since the selection of agents and dosages depend on various factors. In order to provide successful sedation, pediatric dentist should make an individual sedation plan for each procedure. It is important to understand not only the properties of each sedative, but also interactions with other drugs. This article reviews useful information of commonly used agents for dental sedation and summarizes the recommended dosages from the Physicians' Desk Reference (PDR) and some famous pediatric dentistry textbooks.

Development of Clinical Practice Guidelines in a Hospital (병원단위의 임상진료지침 개발과정)

  • Shin, Youngsoo;Kim, Chang-Yup;Oh, Byung-Hee;Han, Kyou-Sup;Yoon, Byung-Woo;Han, Joon-Koo;Khang, Young-Ho
    • Quality Improvement in Health Care
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    • v.4 no.1
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    • pp.82-103
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    • 1997
  • Background : With increased concerns about variation among physician's practice pattern and their impact on the quality of care, clinical practice guidelines have been developed by many different organizations, with differing aims and incentives. From the same point of view, there is growing interest in the development of clinical practice guidelines in Korea, but with only a few examples. As a result, there is not much exploration on the incentive and barrier to develop guidelines as well as description on the development process. The purposes of this study are to describe the process of the four different clinical practice guidelines in a hospital setting, and to identify incentives and barriers in the development of guidelines. Methods : For this research, a clinical practice guideline development committee and four clinical practice guideline development teams were organized in a university hospital which has more than 1,200 bead. Twenty eight doctors, three nurses, and one technician participated as members of development teams for eight months. Four to six meetings were held, and three to seven departments in the hospital were involved. Results : The topics which developed into clinical practice guidelines were cardiopulmonary resuscitation(CPR), blood transfusion, anticoagulation, and angiography. The main goals set by teams were education(CPR, angiography), risk management(blood transfusion), and to enhance quality of care(anticoagulation). Among four teams, only in the team for anticoagulation guideline medical record review and pilot-testing were performed. Also literature review was not carried out systematically. However, all the guidelines were developed by multidisciplinary be used as standard protocols in the practice. Conclusion : Experience and skill in developing process has to be improved to have a more valid and useful practice guideline. In particular, literature review and problem identification by examining medical record should be emphasized. Also further studies on the clinical outcomes of the guidelines application and changes in physicians' behaviors would be required.

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