• Title/Summary/Keyword: Clinical Circumstances

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Satisfaction to College Life and Stress of Clinical Practice among Nursing Students (간호학생의 임상실습 스트레스와 대학생활만족에 대한 융합연구)

  • Jung, SungWon;Hwang, RahIl;Lee, YoungShin
    • Journal of the Korea Convergence Society
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    • v.8 no.4
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    • pp.265-272
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    • 2017
  • This study was to investigate the relationship among clinical practice stress, major satisfaction, campus life satisfaction of nursing students. Data was collected from university students in C. do province and college students in S city. All 81 subjects was analyzed by SPSS 21.0ver. Campus life satisfactions were differences on gender and major satisfaction. Satisfied nursing students with campus life had lower level of clinical practice stress than unsatisfied students, especially in health care giver's attitude, patient's attitude, clinical circumstances and mental factors. This study suggested that the convergent extracurriculum program should be paid to interpersonal relationship competence before clinical practice.

The Strategy for Restructuring the Clinical Departments at Small and Medium Size Hospitals - With Cases of the Provincial Hospitals - (중소병원의 진료과목개설전략 - 지방공사의료원을 중심으로 -)

  • Jung, Key-Sun;Jung, Soo-Kyung;Rhyu, Kyu-Soo
    • Korea Journal of Hospital Management
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    • v.6 no.1
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    • pp.147-163
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    • 2001
  • The purpose of this study was to find out the restructuring strategy for five provincial hospitals through the business analysis and survey of the service area. Through the survey of the service area of 5 hospitals. service area was classified into three groups, such as underserved area, adequate area, and overserved area. The strategy for the restructuring the clinical departments was set up based on the result of the business analysis and characteristics of the service area. The result of the study was as follows; 1) Whether or not a provincial hospital has specialized in specific area according to the circumstances and the needs of the community was the major factor influencing on the operating result of the hospital. 2) Provincial hospitals at the underserved area has to invest according to the changes of the occupancy rate and increasing pattern of the number of patients while maintaining the status as a general hospital. 3) Provincial hospitals at the adequate area has to lower the grade from the general hospital down to the hospital first and has to upgrade the competency through the restructuring the clinical departments and investment in specific area. 4) Provincial hospitals at the overserved area has to lower the grade from the general hospital down to the hospital first and has to seek ways to change the hospital fundamentally into geriatric hospital, pneumoconiosis hospital or psychiatric hospital etc. Provincial hospitals incapable to compete with private hospitals and clinics has to lower the grade from the general hospital down to the hospital first, to specialize in specific area and to restructure some clinical departments into rental base or self-operating basis. In case such methods are judged not so good solution, provincial hospitals has to find out ways such as shut-down of several departments or operating under the attending system.

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Radiation Doses and Quality Assurance in Cone Beam CT(CBCT) (임상가를 위한 특집 4 - CBCT 검사법의 정도관리 및 선량)

  • Choi, Yong-Suk;Kim, Gyu-Tae;Hwang, Eui-Hwan
    • The Journal of the Korean dental association
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    • v.52 no.3
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    • pp.153-163
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    • 2014
  • 3-dimensional information for anatomic stucture plays a role as integral part in clinical aspect of dental practice. CBCT(cone beam computed tomography) has been accepted as useful diagnostic tool offering Volume data and images for evaluating teeth and jaws in lower radiation dose than conventional CT. CBCT equipment is essential for the quality assurance of it to ensure continued satisfactory performance and result of adequate images. Dental practitioner and oral and maxillofacial radiologist should have a responsibility and critical thinking to deliver this technology to patients in a responsible way, so that diaganostic value is maximised and radiation doses kept as low as resonably achievable. CBCT imaging modality should be used only after a review of the patient's health and imaging history and the completion of a thorough clinical examination. Clinical guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances Dental practitioners should prescribe CBCT imaging only when they expect that the diagnostic yield will benefit patient care, enhance patient safety or improve clinical outcomes significantly. Knowledge of patient dose is essential for clinicians who are making the decision regarding the justification of the exposure. There are some limitation in the measurement of patient dose in CBCT for the approval and adaptation of conventinal methodolgy in CT. It is also important to ensure that doses are optimised and in line with any national and international guidelines. The higher radiation doses of CBCT compared with conventional radiography, mean that high standards must be maintained. The Quality Assurance(QA) programme should entail surveys and checks that are performed according to a regular timetable. QA programme should be maintained by staff to ensure adherence to the programme and to raise its importance among staff.

Fertility preservation for patients with hematologic malignancies: The Korean Society for Fertility Preservation clinical guidelines

  • Lee, Dong-Yun;Kim, Seul Ki;Kim, Miran;Hwang, Kyung Joo;Kim, Seok Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.44 no.4
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    • pp.187-192
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    • 2017
  • Although the survival rate of hematologic malignancies in young patients is very high, cytotoxic therapies such as chemotherapy and total body irradiation therapy can significantly reduce a patient's reproductive capacity and cause irreversible infertility. Early ovarian failure also commonly occurs following additional cancer treatment, bone marrow transplantation, or autologous transplantation. Because the risk of early ovarian failure depends on the patient's circumstances, patients with a hematologic malignancy must consult health professionals regarding fertility preservation before undergoing treatments that can potentially damage their ovaries. While it is widely known that early menopause commonly occurs following breast cancer treatment, there is a lack of reliable study results regarding fertility preservation during hematologic malignancy treatment. Therefore, an in-depth discussion between patients and health professionals about the pros and cons of the various options for fertility preservation is necessary. In this study, we review germ cell toxicity, which occurs during the treatment of hematologic malignancies, and propose guidelines for fertility preservation in younger patients with hematologic malignancies.

The Value and Limitations of Guidelines, Expert Consensus, and Registries on the Management of Patients with Thoracic Aortic Disease

  • Pacini, Davide;Murana, Giacomo;Leone, Alessandro;Marco, Luca Di;Pantaleo, Antonio
    • Journal of Chest Surgery
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    • v.49 no.6
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    • pp.413-420
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    • 2016
  • Doctors are often faced with difficult decisions and uncertainty when patients need a certain treatment. They routinely rely on the scientific literature, in addition to their knowledge, experience, and patient preferences. Clinical practice guidelines are created with the intention of facilitating decision-making. They may offer concise instructions for the diagnosis, management (medical or surgical treatments), and prevention of specific diseases or conditions. All information included in the final version are the result of a systematic review of scientific articles and an assessment of the benefits and costs of alternative care options. The final document attempts to meet the needs of most patients in most circumstances and clinicians, aware of these recommendations, should always make individualized treatment decisions. In this review, we attempted to define the intent and applicability of clinical practice guidelines, expert consensus documents, and registry studies, focusing on the management of patients with thoracic aortic disease.

Reviewing Articles Related to Recent Advances in Non-invasive Prenatal Testing and Nursing Implications (최신 비침습적 산전 유전 검사(NIPT)의 임상 적용과 간호학적 의미)

  • Jun, Myunghee;Shin, Gyeyoung;Hur, Myung Haeng;Choi, Kyung-Sook
    • The Journal of Korean Academic Society of Nursing Education
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    • v.19 no.4
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    • pp.675-683
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    • 2013
  • Purpose: Nineteen articles were analyzed to gather opinions and nursing implications about NIPT recently launched. Methods: Nineteen articles were selected from EBSCO (eBook business collection), Google Scholar, and two Korean academic d-bases with key words 'prenatal screening testing', 'prenatal genetic diagnostic testing', NIPT or 'cell free DNA (cfDNA)'. Authors developed a framework for analyzing the 19 articles including opinions and suggestions for future implications. Results: Eleven articles written by the first author affiliated with medicine or genetics, viewed NIPT as promising because of safety, accuracy, early detectability and cost effectiveness. Articles written by journalists or authors affiliated with history and ethics were concerned with the possible risk of ELSI (ethical, legal, social issues), erratic interpretation of test results, and lack of genetic counseling service. Conclusion: With consideration of Korean clinical, and legal circumstances, not only pregnant women and families but also health professionals must prepare for clinical NIPT implications including updating prenatal genetic testing, counseling services, protecting ELSI and amulticultural team approach.

Pain Physiology and Principles of Physical Therapy (통증 생리와 물리치료 원리)

  • Kim, Jong-Man;Ahn, Duck-Hyun
    • Physical Therapy Korea
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    • v.5 no.2
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    • pp.106-117
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    • 1998
  • The pain is common among individuals with physical disabilities. It can interfere with therapy since patients with pain can become uncooperative and reluctant to move. This paper reviews the natural physiological mechanisms that can reduce pain perception, and considers physiological mechanisms which contribute to clinical pain by describing how the pain system changes its sensitivity depending upon the body's needs. The peripheral and central mechanisms contributing to sensitised nociceptive system are described with reference to the symptoms of clinical pain such as hyperalgesia, allodynia sopntaneous 'on-going'-projected and referred pain. It is suggested that in some chronic pain the nociceptive system maintains a state of sensitivity despite the absence of on-going tissue damage and under such circumstances the nociceptive system itself may have become dysfunctional. Such situations are often initiated by damage to nervous tissue which results in changes in the activity and organization of neuronal circuits within the central nervous system. The ability of the nociceptive system to operate in a suppressed state is also discussed with reference to pain modulation. The physical therapist can help facilitate the activation of these mechanisms through a combination of noninvasive modalities, functional activities, and the therapeutic use of self.

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Systemic use of fluoroquinolone in children

  • Choi, Soo-Han;Kim, Eun Young;Kim, Yae-Jean
    • Clinical and Experimental Pediatrics
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    • v.56 no.5
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    • pp.196-201
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    • 2013
  • Fluoroquinolones are an important class of antibiotics that are widely used in adult patients because of their broad spectrum of activity, good tissue penetration, and oral bioavailability. However, fluoroquinolone use in children is limited because juvenile animals developed arthropathy in previous experiments on fluoroquinolone use. Indications for fluoroquinolone use in patients younger than 18 years, as stated by the U.S. Food and Drug Administration, include treatment of complicated urinary tract infections and postexposure treatment for inhalation anthrax. In Korea, the systemic use of fluoroquinolones has not been approved in children younger than 18 years. Although concerns remain regarding the adverse musculoskeletal effects of fluoroquinolones in children, their use in the pediatric population has increased in many circumstances. While pediatricians should be aware of the indications and adverse effects of fluoroquinolones, recent studies have shown that the risk for musculoskeletal complications in children did not significantly increase following fluoroquinolone treatment. In addition, fluoroquinolones may be particularly helpful in treating multidrug-resistant infections that have not responded to standard antibiotic therapy in immunocompromised patients. In the present article, we provide an updated review on the safety and current recommendations for using fluoroquinolones in children.

Factors Influencing Use of de Facto Mental Health Service Systems in Persons with Chronic Mental Illnesses (대리(de Facto) 정신보건 서비스체계의 이용에 영향을 미치는 요인에 관한 분석)

  • Lee, Sun-Hae
    • Korean Journal of Social Welfare
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    • v.42
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    • pp.340-371
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    • 2000
  • The paradigm of care for persons with chronic mental illnesses has recently been shifted in Korea from institutionalization to community integration. Numerous changes in the service environment tend to target clients of mental health care organizations while a considerable proportion of people with similar clinical conditions have been institutionalized in various types of organizations whose auspices are other than mental health care. Under the current circumstances in which the subgroup of people, who tend to be socio-economically disadvantaged, has no viable alternative in the community to using such de facto mental health organizations, their chances of deinstitutionalization may decrease. This study thus aims at providing an increased understanding of the characteristics of the users and their service utilization, which in turn enables us to establish differentiated strategies within the current service context. In this study, a survey is conducted on the residential history of those with chronic mental illnesses both in the community and in institutions. Major characteristics of the users of de facto services are investigated along with the extent of their use of various existing mental and non-mental health services. Included is also an examination of the subjects' clinical and individual factors that may influence their use of de facto services. The study findings demonstrate relative disadvantages in deinstitutionalization in a subgroup of the population with chronic mental illnesses under the current mental health policies, and the author suggests intervening strategies specific to this population.

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A Conceptual Study 'Heo(虛)' in Shanghanlun : Based on 2 Cases Treated by Chijasi-tang (『상한론(傷寒論)』 '허(虛)'에 대한 고찰 : 변병진단체계(辨病診斷體系)를 통한 치자시탕(梔子豉湯) 증례 2례에 근거하여)

  • Choi, Woon-yong;Lee, Sung-jun
    • 대한상한금궤의학회지
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    • v.12 no.1
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    • pp.49-60
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    • 2020
  • Objective: To explore the meaning of 虛in Shanghanlun through two cases. Methods: We analyzed the original form of 虛and the contexts in Shanghanlun. Concurrently, we report two clinical cases treated with Chijasi-tang according to the newly deduced definition of 虛. Results: 虛is composed of 丘and 虍, which means a tiger on a large hill. Here, the meaning of "empty"was derived. In both cases, sleep disorders and heart stuffiness were the chief complaints, which were confirmed to occur under 虛's circumstances. Therefore, Chijasi-tang was administered to two patients with a feeling of emptiness as a pathogenic factor, and improvements were confirmed in both cases. Conclusions: In 15 provisions of Shanghanlun, 虛is defined as "a feeling of emptiness"instead of of "deficient,"which was widely used previously, and appears clinically as "emptiness after being hurt by someone."This definition was applicable in both cases.Further study of the other characters is needed because the previously used meaning may be different in the 15-character provisions of the Shanghanlun.