• Title/Summary/Keyword: 진료가이드라인

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A study of participation in health-related decision and self-care competency in patients with chronic disease (만성질환자의 건강관련 의사결정에 대한 참여 정도와 자가간호역량에 관한 연구)

  • Kim, Su-young;Lee, Jihae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.6
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    • pp.127-136
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    • 2020
  • This study investigated the correlation between the participation in health-related decisions and self-care competency and the factors influencing self-care competence of patients with chronic disease. The participants were 518 patients with chronic illnesses who were admitted to a public health center. Using a structured-questionnaire, the data was collected from January 1, 2019 to 31, 2019. The data was analyzed using descriptive statistics, t-tests, ANOVA, Scheffé tests, Pearson correlation coefficients and multiple linear regression with the IBM SPSS/WIN 22.0 program. The mean scores on the participation in health-related decisions and self-care competency were 3.62±0.20 and 4.57±0.34, respectively. The main variables that distinguish significant differences between participation in healthcare decisions and self-care capabilities are gender, age, education level, diagnosis, and subjective health status. Self-care competency was positively correlated with the participation in health-related decisions (r=.66, p=.043). Factors influencing self-care competence were education (β=-2.23, p<.001), health concerns (β=0.14, p=.003), subjective health statues (β=2.57, p=.011), and age (β=-0.36, p=.048). The input variables explained .56 of self-care competence. The results of the study indicate that approaches focusing on enhancing the participation in health-related decisions could potentially improve self-care competency of patients with chronic disease.

The Guideline of Diagnosis and Treatment of Attention-Deficit Hyperactivity Disorder: Developed by ADHD Translational Research Center (주의력결핍 과잉행동장애 진단 및 치료: ADHD 중개연구센터 가이드라인)

  • Lee, Sumin;Choi, Jae-Won;Kim, Kyoung-Min;Kim, Jun Won;Kim, Sooyeon;Kang, Taewoong;Kim, Johanna Inhyang;Lee, Young Sik;Kim, Bongseog;Han, Doug Hyun;Cheong, Jae Hoon;Lee, Soyoung Irene;Hyun, Gi Jung;Kim, Bung-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.27 no.4
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    • pp.236-266
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    • 2016
  • Attention-deficit hyperactivity disorder (ADHD) is one of the most common childhood psychiatric conditions. In 2007, the Korean Academy of child and Adolescent Psychiatry developed Korean ADHD practice parameter. Advances in the scientific evidence of ADHD caused practice parameter to be modified and updated. The present guidelines developed by ADHD translational research center summarize current literature for the treatment of ADHD in children and adults. This parameter includes the clinical evaluation for ADHD, comorbid conditions associated with ADHD, clinical feature and course, research on the etiology of the disorder, and psychopharmacological and non-pharmacological treatments for ADHD.

Role of Korean Society of Pediatric Infectious Disease during the Middle East Respiratory Syndrome (MERS) Outbreak in Korea, 2015 (2015년 우리나라에서 발생한 중동호흡기증후군과 대한소아감염학회의 역할)

  • Kim, Kyung-Hyo
    • Pediatric Infection and Vaccine
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    • v.22 no.3
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    • pp.136-142
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    • 2015
  • The Korean Society of Pediatric Infectious Diseases (KSPID) has participated in the task force team consisting of government authorities as well as civil medical experts and facilities to block the spread of Middle East Respiratory Syndrome in 2015. KSPID posted the "Middle East Respiratory Syndrome (MERS) Pop-up" in the homepage of The Korean Pediatric Society and The Korean Society of Pediatric Infectious Diseases. KSPID also released the "Guidelines for testing for MERS in children and adolescents" and the "Instructions for the Operation of National Safe Hospital" for children and adolescents in a timely manner. Such actions were aimed to prevent unnecessary anxieties, studies and isolation of pediatric patients with respiratory symptoms and signs caused by other common microbial etiologies as being suspected for MERS patients. This strategy relieved the doctors and parents from unnecessary fear and prevented the loss of unnecessary health care costs, and has proven to be a well-judged guideline and management protocol as evaluated after the final end of MERS outbreak. KSPID and its members should support the presence of pediatric infectious disease (PID) specialists in every medium size hospitals in Korea by developing the need for consultation fees for PID consultation in the hospital based practice and promoting the potential for cost savings related to prevention of health care associated infections and optimal prescription of antimicrobial agents. KSPID and its members need to approach and develop a communication plan to political decision makers to demonstrate and convince them of the importance of a PID specialist service.

Audit of Appropriateness of Fresh Frozen Plasma Transfusion (신선동결혈장의 적정수혈 분석)

  • Seo, Youkyung;Kim, Moon Jung;Kim, Sinyoung;Kim, Hyun Ok
    • The Korean Journal of Blood Transfusion
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    • v.23 no.2
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    • pp.136-144
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    • 2012
  • Background: Fresh frozen plasma (FFP) transfusion is administered primarily for management of acquired bleeding disorders. However, in practice, FFP transfusion is increasing without a solid rationale. Methods: We conducted an audit to evaluate the appropriateness of the indications for FFP transfusion during the period from July 2010 through June 2011. Assessment of the appropriateness of the indications was based on the national transfusion guidelines and the transfusion criteria promulgated by the Severance Hospital. Results: In total, 17,733 units of plasma were transfused to 1,949 patients over 4,982 events. We found that administration of FFP was not in compliance with the recommended guidelines in 1,990 events. The number of total FFP transfusions was higher in medical departments (Gastroenterology) than in surgical departments (Thoracic and cardiovascular surgery, General surgery). However, the proportion of cases of inappropriate transfusion was higher in surgical departments than in medical departments. Both the total number of FFP transfusion and the proportion of inappropriate transfusion were high in patient with neoplasm, disease of the digestive system, and diseases of the circulatory system. Conclusion: Continuous monitoring on appropriateness for FFP transfusion and feedback to the physician are critical in securing the transfusion safety as well as maintaining the quality of FFP transfusion. New-found indication for FFP transfusion should be investigated and applied in timely manner.

Status of Interchange of Medical Imaging in Korea: A Questionnaire Survey of Physicians (영상정보교류 실태 파악을 위한 의사 설문조사)

  • Choi, Moon Hyung;Jung, Seung Eun;Kim, Sungjun;Shin, Na-Young;Yong, Hwan Seok;Woo, Hyunsik;Jeong, Woo Kyoung;Jin, Kwang Nam;Choi, SeonHyeong
    • Journal of the Korean Society of Radiology
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    • v.79 no.5
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    • pp.247-253
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    • 2018
  • The purpose of this study was to summarize the results of a survey for physicians with specialties other than radiology about imaging studies of patients referred from other institutions. The survey was promoted through individual contacts or social network service and physicians who voluntarily responded to the survey were the subjects of the study. The questionnaire consisted of 11 questions about basic information and referrals about medical imaging. A total of 160 physicians from 30 specialties participated in the survey and 95.6% of the respondents worked in tertiary care center or general hospital. Patients were frequently referred with outside medical images. The most frequently referred imaging modalities were computed tomography and magnetic resonance imaging. However, radiological reports from outside institutions were rarely referred. Most physicians thought that reinterpretation for outside imaging is necessary to acquire a secondary opinion. In conclusion, considering that outside radiological reports are frequently missing and there are high demands on reinterpretation for outside imaging, guidelines for referral of radiological reports with medical imaging, basic elements of radiological reports, and reinterpretation need to be developed.

Current Status and Problems of PET/CT Data on CD for Inter-hospital Transfer (병원간 전송용 PET/CT 영상 CD자료의 현황 및 문제점)

  • Hyun, Seung-Hyup;Choi, Joon-Young;Lee, Su-Jin;Cho, Young-Seok;Lee, Ji-Young;Cheon, Mi-Ju;Cho, Suk-Kyong;Lee, Kyung-Han;Kim, Byung-Tae
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.2
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    • pp.137-142
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    • 2009
  • Purpose: This study was performed to find the current problems of positron emission tomography/computed tomography(PET/CT) data on CD for inter-hospital transfer. Materials and Methods: The subjects were 746 consecutive $^{18}F$-fluorodeoxyglucose PET/CT data CDs from 56 hospitals referred to our department for image interpretation. The formats and contents of PET/CT data CDs were reviewed and the email questionnaire survey about this was performed. Results: PET/CT data CDs from 21 of 56 hospitals(37.5%) included all transaxial CT and PET images with DICOM standard format which were required for authentic interpretation. PET/CT data from the others included only secondary capture images or fusion PET/CT images. According to this survey, the main reason of limited PET/CT data on CD for inter-hospital transfer was that the data volume of PET/CT was too large to upload to the Picture Archiving and Communication System. Conclusion: The majority of hospitals provided limited PET/CT data on CD for inter-hospital transfer, which could be inadequate for accurate interpretation and clinical decision making. It is necessary to standardize the format of PET/CT data on CD for inter-hospital transfer including all transaxial CT and PET images with DICOM standard format.

Current Status and Improvements of Transfered PET/CT Data from Other Hospitals (외부 반출 PET/CT 영상 현황 및 개선점)

  • Kim, Gye-Hwan;Choi, Hyeon-Joon;Lee, Hong-Jae;Kim, Jin-Eui;Kim, Hyun-Joo
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.38-40
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    • 2010
  • Purpose: This study was performed to find the current problems of PET/CT data from other hospitals. Materials and Methods: The subjects were acquired from 64 hospitals referred to our department for image interpretation. The formats and contents of PET/CT data were reviewed and the phone questionnaire survey about these were performed. Results: PET/CT data from 39 of 64 hospitals (61%) included all transaxial CT and PET images with DICOM (Digital Imaging Communications in Medicine) standard format which were required for authentic interpretation. PET/CT data from the others included only secondary capture images or fusion PET/CT images. Conclusion: The majority of hospitals provided limited PET/CT data which could be inadequate for accurate interpretation and clinical decision making. It is necessary to standardize the format of PET/CT data to transfer including all transaxial CT and PET images with DICOM standard format.

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Caregivers' adherence factors affecting maintenance treatment in children with well-controlled asthma : A qualitative analysis through in-depth interview (천식 조절 상태 환아의 유지 치료에 대한 보호자 순응 요인: 심층 면담을 통한 질적 분석)

  • Choi, Ic Sun;Cho, Saeng Koo;La, Kyong Suk;Byeon, Jung Hye;Song, Dae Jin;Yoo, Young;Choung, Ji Tae
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.364-372
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    • 2010
  • Purpose : Good adherence of caregivers is essential for successful health outcomes in the treatment of childhood asthma. The purpose of this study was to identify the factors contributing to good adherence of maintenance treatment in children with well-controlled asthma. Methods : Children with well-controlled asthma being treated with a daily controller for at least 3 months in Korea University Anam Hospital were selected. Their caregivers who had good adherence to maintenance treatment were recruited. Qualitative study through in-depth interviews was conducted with 18 caregivers who agreed to the study. Results : The 18 caregivers (mean age, 40.0 years) consisted of 15 mothers, 2 grandmothers, and 1 father. The resulting consensus were identified and grouped into 2 domains: the caregiver/patient aspect with 8 theme factors and the treatment aspect with 4 theme factors. The main theme factors in the caregiver/patient aspect were enabling participation in physical activities and exercise (77.8%), perceptions regarding asthma and the need for long-term treatment (50.0%), and perceived value of the medications outweighing the risk of side effects (38.9%). The main theme factors in the treatment aspect were trust in the physician (77.8%), general satisfaction with the manner and attitude of the physician (77.8%) and verification of the necessity of further treatment by performing tests (38.9%). Conclusion : Efforts to improve caregivers' adherence to the treatment of childhood asthma must include a range of factors related to both caregiver/patient aspects and treatment aspects. Among all of these factors, it may be most important to establish a physician-caregiver partnership.

Glomerular Filtration Rate Test Methods and Guidelines (Glomerular Filtration Rate 검사방법 및 가이드라인)

  • Park, Min-Ho;Lee, Ha-Young;Ryu, Hwa-Jin;Yoo, Tae-Min;Noh, Gyeong-Woon
    • The Korean Journal of Nuclear Medicine Technology
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    • v.22 no.2
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    • pp.97-100
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    • 2018
  • Purpose The glomerular filtration rate (GFR) test is an important indicator of glomerular filtration and has been used to test renal function and the extent of its function. The GFR test is performed by intravenous injection of radioactive medicines made of $^{51}Cr$-EDTA, and blood concentration is measured by taking blood according to the elapsed time. also, PET-CT, bone scan, transfusion and so on will affect the outcome. Therefore, we will improve the quality of the test by providing guidelines for the GFR test for more accurate testing. Materials and Methods 5 mL of physiological saline solution and 2 mL of $^{51}Cr$-EDTA solution are used to make 5 mL of the radiopharmaceutical solution to be injected into the patient. First, the syringe weight is measured before the injection, and then the radioactive medicine is injected into the patient's vein and the syringe weight is measured after the injection. Blood sampling is performed twice in total. In adults, blood is collected 3 hours / 5 hours after injection and in children 2 hours / 5 hours after injection. The blood sample is centrifuged at 3300 rpm for 5 minutes. Standard solution is prepared by filling diluent water up to the scale indicated in the 200-mL volumetric flask, discarding $500{\mu}L$, injecting $500{\mu}L$ of GFR reagent and mixing well. $500{\mu}L$ each of the standard solution is dispensed into two test tubes, and $500{\mu}L$ of each of the plasma samples collected in time is dispensed into two test tubes and measured with a Cobra Counter. Results At present, the reference range applied in this study is $119.5{\pm}30.3ml/min/1.73m2$ for males and $125.2{\pm}28.2ml/min/1.73m^2$ for females. Conclusion The GFR test is conducted using radioactive medical products. GFR testing is performed as a scheduled test, but PET-CT, dialysis and transfusion, which may affect GFR testing, may be scheduled during GFR testing. Therefore, we could get accurate GFR test results by notifying the ward and department beforehand when booking.

A Study on the Characteristics of Intentional Self-Poisoning Patients : Comparison between Non-Prescription and Prescription Drugs (일반의약품과 전문의약품 의도적 음독 자살 시도자 특성 분석 연구)

  • Cho, Eulah;Cho, Ji Hyun;Jho, Kyeng Hyeng;Sim, Hyun-Bo
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.2
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    • pp.116-125
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    • 2020
  • Objectives : Self-poisoning is the leading cause of visits to the emergency departments after a suicide attempts. This study is aimed to compare the patient characteristics according to the category of drugs ingested by the patients who attempted suicide. Methods : All medical charts were retrospectively reviewed from patients who visited the emergency center, at Seoul Medical Center, due to intentional self-poisoning from April of 2011 to July of 2019. We investigated the information regarding the subtype and quantity of the intoxication drug, how it was obtained, suicidal history, and psychiatric history, as well as, sociodemographic information. Variables were compared between prescription drug (PD) and non-prescription drug (NPD) poisoning groups. Results : The mean age of the NPD poisoning group was significantly lower than that of the PD poisoning group. The patient ratio of those enrolled in national health insurance and living with spouses were significantly higher in the NPD poisoning group. Compared to the NPD poisoning group, the PD poisoning group had a higher incidence of mental illnesses, underlying diseases and ratio of involuntary visit to the emergency department. Among the prescription drugs, the benzodiazepine poisoning group had a higher rate of self-prescription than the non-poisoning group, while the zolpidem poisoning group had a higher rate of the using someone else's prescription than other drugs. Each single drug poisoning group (benzodiazepine, zolpidem, and antidepressant single-agent) had a higher rate of no mental illness than each of the mixed-poisoning group. Conclusions : Guidelines for regulating non-prescription drugs are needed as a matter of suicide prevention. Also, this study suggests that clinicians need to be careful when issuing prescriptions and should suicidal risk according to patients' characteristics, duration of follow-up and type of drug packaging.