• Title/Summary/Keyword: Clinical Data

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Current Status of Clinical Study on Traditional East Asian Medicine Using Taiwan Health Insurance Claim Data (대만 건강보험청구데이터(NHIRD)를 이용한 전통 동아시아 의학(TEAM) 임상연구의 현황)

  • Jeung, Chang-Woon;Jo, Hee-Geun;Seol, Jae-Uk
    • Journal of Korean Medicine Rehabilitation
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    • v.27 no.2
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    • pp.67-75
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    • 2017
  • Objectives The study of the clinical effects of traditional east asian medicine (TEAM) using Taiwan national health insurance claim dataset (NHIRD) is useful in Korean Medicine research. We reviewed the clinical studies of TEAM using NHIRD as a whole through this study. Methods We comprehensively searched PUBMED and NHIRD DB for clinical effects of TEAM study using NHIRD from inception to 17, January 2017. As a result, 40 studies investigating the contribution of TEAM intervention to health benefit have been confirmed. We analyzed publication time, target disease, sample size, outcome measurement and main result of 40 searched studies. Results The number of TEAM studies using NHIRD grdually increasing. The topics of the team study using NHIRD covered a wide range of subjects including cardiovascular disease, tumor, gynecological disease, diabetes and kidney disease. The studies have shown large samples and reported significant effects on severe diseases. Conclusions The results of this study suggest that the study of Korean Medicine using Big data will be useful for decision making related to health care in Korea. However, considering the limited domestic Korean health insurance data, it will be necessary to activate the big data research of Korean Medicine through the establishment of a separate cohort in Korea.

Study of the Drugs Prescribed on Alzheimer's Disease: from the Insurance Claims Data of Korea National Health Insurance Service (우리나라 건강보험 청구자료를 이용한 알츠하이머성 치매 치료제의 사용현황 분석)

  • Kim, Jungeun;Lee, Jonghyuk;Jeong, Ji Hoon;Kang, Minku;Bang, Joon Seok
    • Korean Journal of Clinical Pharmacy
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    • v.24 no.4
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    • pp.255-264
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    • 2014
  • Objective: The aims of this study are to investigate the total volume of prescribed medicines against Alzheimer's disease (AD) and the trends of usage by analyzing the claims-data from the Korea National Health Insurance Service. Method: The demographic and claims-data were included the major AD treating medicines such as donepezil, galantamine, rivastigmine and memantine, and analyzed during the period of 2010~2012. The assessing criteria were gender, age, habitation, types of medical institution, code of ingredients, outcomes of treatment, volume and amount of claims, and the numbers of patients with dementias. After trimming the data, it were analyzed by the market size, demographic traits, characteristics of medical service, characteristics of each anti-AD medicine, etc. Results: Among the chosen 4 medicines, donepezil had the top prescription volumes. Most prevalent prescribing preparations of donepezil were conventional types. However, among the non-conventional types, oro-dispersible formulation is the fast increasing one in both volume and growth rate. This specialized preparations to improve both toleration and adherence, tend to being prescribed generally at the tertiary medical institutions. While the younger patients with mild-to-moderate AD mostly treated by expensive medicines in resident at the tertiary hospitals, the rest older patients with severe AD have been treated non-expensive one at long-term care facilities. Conclusion: AD is a chronic illness therefore, long-term use of therapeutic medications are highly important. If an anti-AD treatment was applied steadily in the earlier stages, it would be achieved not only improving the quality of life of patient but also reducing the expenses in the medical and nursing cares. As the socioeconomical impacts of AD is expanding, healthcare professionals need to aware the importance of pharmacotherapy and to improve sociopolitical fundamentals.

Comparison of Spinal Canal Expansion Following Cervical Laminoplasty Based on the Preoperative Lamina Angle : A Simulation Study

  • Jung, Jong-myung;Jahng, Anthony L.;Hyun, Seung-Jae;Kim, Ki-Jeong;Jahng, Tae-Ahn
    • Journal of Korean Neurosurgical Society
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    • v.64 no.2
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    • pp.229-237
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    • 2021
  • Objective : Expansion in the spinal canal area (SCA) after laminoplasty is one of the critical factors to relieve the preoperative symptoms. No previous study has compared the increases in SCA achieved by open-door laminoplasty (ODL) and double door laminoplasty (DDL) according to the preoperative lamina angle (LA). This study was designed to clarify the relationship between the laminoplasty opening angle (OA)/laminoplasty opening size (OS) and increases in the SCA following ODL and DDL according to the preoperative LA using a simulation model. Methods : The simulation model was constructed and validated by comparing the clinical data of 64 patients who had undergone C3-C6 laminoplasty (43 patients with ODL and 21 patients with DDL). SCA expansion was predicted with a verified simulation model at various preoperative LAs (from 28° to 32°) with different OAs (40° to 44°) and OSs (10 mm to 14 mm) recruited from patient data. Results : The constructed simulation model was validated by comparing clinical data and revealed a very high degree of correlation (r=0.935, p<0.001). In this validated model, at the same OA, the increase in SCA was higher following ODL than following DDL in the usual LA (p<0.05). At the same OS, the increase in SCA was slightly larger following DDL than following ODL, but the difference was not significant (p>0.05). The difference was significant when the preoperative LA was narrower or much wider. Conclusion : Based on clinical data, a simulation model was constructed and verified that could predict increases in the SCA following ODL and DDL. When applying this model, prediction in SCA increase using the OS parameter was more practical and compatible with clinical data. Both laminoplasties achieved enough SCA, and there was no significant difference between them in the usual range.

A Study on Changes of Confidence in Core Basic Nursing Skill by Each Period of Clinical Practicum of Nursing Students (간호대학생의 임상실습 시기별 핵심기본간호술 수행자신감의 변화양상)

  • Choi, Mi-Suk;Dong, Hwa-Jin
    • Journal of Digital Convergence
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    • v.16 no.9
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    • pp.329-338
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    • 2018
  • The purpose of this longitudinal study was to investigate confidence in core basic nursing skill each period of clinical practicum and discover the changes, depending on characteristics of periods. The data was collected for 94 nursing students attending a university located in J-do from Mar. 9 to Dec. 16 2016 for 4 times in total. For data analysis, the frequency analysis, descriptive statistics and paired t-test were used. The research findings showed that confidence in core basic nursing skill by each period of clinical practicum was lowest before clinical practicum in general but gradually increased depending on lapse of time and experience of clinical practicum. However, it decreased in all items after having first clinical practicum in the $2^{nd}$ semester, compared to after first clinical practicum in the $1^{st}$ semester. In addition, the difference of confidence in core basic nursing skill between clinical practicum periods was higher after the first clinical practicum in the $1^{st}$ semester and after clinical practicum at the end of school year, compared to before clinical practicum and after the first clinical practicum in the $2^{nd}$ semester respectively. Therefore, this study suggested that it's necessary to have efficient and systematic clinical practicum education strategy, reflecting the characteristics of periods in clinical practicum in order to improve the confidence in core basic nursing skill of nursing students.

A Study of Clinical Nurses' Knowledge, Need and Clinical Performance about Pathophysiology (임상간호사가 인지한 병태생리학 지식, 필요도와 임상실무와의 연계성)

  • Cho, Mi-Kyoung;Shin, Gisoo;Choe, Myoung-Ae
    • Journal of Korean Biological Nursing Science
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    • v.15 no.3
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    • pp.139-146
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    • 2013
  • Purpose: The purpose of this study was to identify knowledge and the Need of pathophysiology, perceived connectivity between knowledge of pathophysiology and clinical practice, and confidence and satisfaction with clinical performance by applying the knowledge to clinical practice, and to analyze the correlation between the knowledge, perceived connectivity, and confidence and satisfaction of clinical nurses. Methods: Subjects consisted of 149 clinical nurses who work at 7 general hospitals and 6 university hospitals located in Seoul, Incheon, and Gyeonggi province in Korea. Those who learned pathophysiology during their undergraduate program were recruited by using a convenient sampling. The data were collected between April 23 and May 24 in 2012. Participants responded to self-administered questionnaires about knowledge and the need of pathophysiology, and the perceived connectivity between knowledge and clinical practice, and confidence and satisfaction with clinical performance by applying knowledge to clinical practice. Results: Mean scores of knowledge and the need of pathophysiology were $2.88{\pm}0.34$ and $2.33{\pm}0.39$ each. Scores of knowledge and the need of 3 units such as fluid and electrolyte imbalance, acid-base imbalance, and alterations in the respiratory system were high among 23 units while that of adolescent disorders was the lowest. The mean score of perceived connectivity between knowledge and clinical practice was $7.32{\pm}1.57$, and those of confidence and satisfaction with clinical performance by applying the knowledge to clinical practice were $7.66{\pm}1.66$ and $7.42{\pm}1.67$ respectively. Knowledge of pathophysiology was positively correlated with the perceived connectivity between knowledge and clinical practice, and confidence, and satisfaction with clinical performance. Conclusion: The results indicate that knowledge and the need of pathophysiology in clinical nurses is above average, and that knowledge of pathophysiology is important in promoting perceived connectivity with clinical practice and increasing confidence and satisfaction with clinical performance by applying knowledge to clinical practice.

A Preliminary Study for Development of Clinical Practice Guidelines of Korean Medicine in Colorectal Cancer (결장직장암 치료에 대한 한의 임상 가이드라인 개발을 위한 기초연구)

  • Kim, Junyoung;Yoo, Hwaseung;Cho, Junghyo
    • Journal of Haehwa Medicine
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    • v.24 no.2
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    • pp.65-83
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    • 2016
  • Objectives : The purpose of this study is to present the clinical practice guidelines for colorectal cancer through the analysis of existing clinical practice guidelines and randomised clinical trials (RCTs) in Western and Chinese medicine. Methods : The data related to Western and Oriental medical treatment of colorectal cancer were collected using various search engines such as Google Scholar, KIOM OASIS, PUBMED and Jisan library of Daejeon university. Results & Discussion : Colorectal cancer is the third most common cancer in Korea. In recent studies, applying combined oriental and western medicine can improve the survival, quality of life, immune function, and suppress of tumor growth in colorectal cancer. However there isn't still an objective and systemic clinical guideline for colorectal cancer, so we have difficulty in clinical application. This study will be a preliminary study to establish clinical practice guidelines of Korean Medicine for colorectal cancer. Conclusions : Further objective and systemic clinical studies related to Korean Medicine are needed to develop more advanced clinical practice guidelines of colorectal cancer.

Affecting Factors on Stress of Clinical Practice in Nursing Students (간호학생의 임상실습 스트레스 영향요인)

  • Lee, Ae Kyong;You, Hye Sook;Park, In Hyae
    • Journal of Korean Academy of Nursing Administration
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    • v.21 no.2
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    • pp.154-163
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    • 2015
  • Purpose: This descriptive study was done to identify factors that influence stress related to clinical practice for nursing students. Methods: Structured questionnaires were used to collect data from 278 students from two nursing colleges located in G metropolitan city and one nursing college in C region. Results: The factors that most influenced stress for the nursing students during their clinical practice were critical thinking disposition, clinical competence, year, and gender. Especially, the result showed that higher critical thinking disposition and clinical competence correlated with lower stress in clinical practice. Conclusion: The results indicate that improving nursing students' critical thinking ability and clinical competence would help to relieve stress during clinical practice and increase the ability to cope with stress efficiently. The development of a variety of teaching and learning strategies and education in both theoretical and clinical practice education would be necessary to achieve this goal.

Influence of Professional Self-concept and Self-leadership on Clinical Competence in Nursing Students (간호대학생의 전문직 자아개념과 셀프리더십이 임상수행능력에 미치는 영향)

  • Dong, Hwa Jin;Choi, Mi Suk
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.23 no.4
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    • pp.373-382
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    • 2016
  • Purpose: This study was done in order to identify nursing students' professional self-concept, self-leadership and clinical competence and to analyze the correlation among the variables and the factors influencing clinical competence. Methods: The research participants were 294 senior nursing students in the nursing departments of 3 universities located in Jeollabuk-do. The students had completed 3 semesters of clinical practice. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, and Multiple Regression. Results: Participants' scores for professional self-concept, self-leadership, clinical competence were $2.78{\pm}0.36$, $3.63{\pm}0.47$, $3.80{\pm}0.40$ respectively. Professional self-concept, self-leadership and clinical competence had positive correlations. Factors influencing nursing students' clinical competence included professional self-concepts in professional practice, self-expectations in self-leadership, constructive thinking, self-compensation and self-criticism in that order, and these variables explained 48%of the variance in clinical competence. Conclusion: Based on these results, it is important to develop and apply educational programs to increase professional self-concept and self-leadership in order to improve nursing students' clinical competence.

Development and Psychometric Testing of the Clinical Nursing Competency Scale for Clinical Preceptor Use (CNCS-CP) (임상간호실습 현장지도자용 임상간호역량 평가도구 개발)

  • Kwak, Eunmi;Oh, Heeyoung
    • Journal of Korean Academy of Nursing
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    • v.48 no.4
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    • pp.419-431
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    • 2018
  • Purpose: The purpose of this study was to develop and establish the psychometric properties of a clinical nursing competency evaluation tool to be utilized by clinical preceptors. Methods: The initial items were identified through in-depth literature review and field interviews based on a hybrid model. Content validation of the items was evaluated through three rounds of content validity testing. Participants were 34 clinical preceptors and 443 nursing students participating in clinical practice. Data were analyzed using exploratory and confirmatory factor analysis, convergence and discriminant validity, internal consistency and inter-rater reliability. Results: The final scale consisted of 23 items and four factors, fundamental nursing skills performance, critical thinking skills based on the nursing process, basic nursing knowledge, and professional attitude; these factor explained 69.7% of the total variance. The analysis with multi-trait/multi-item matrix correlation coefficients yielded 100.0% and 95.7 % convergence and discriminant validity, respectively. Cronbach's alpha for the total items was .95. The four subscale model tested by confirmatory factor analysis was satisfactory. Inter-rater reliability ranged from .912 to .967. Conclusion: This scale was found to be a reliable and valid instrument that clinical preceptors can apply for evaluating the clinical nursing competency of nursing students in clinical settings.

The Effect of Simulation Practice Education on the Clinical Judgment, Self-confidence and Clinical Performance Ability in Nursing Student (시뮬레이션 실습교육이 간호대학생의 임상판단력, 자신감, 임상수행능력에 미치는 효과)

  • Lee, Sook-Keyong
    • The Journal of the Korea Contents Association
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    • v.17 no.11
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    • pp.577-587
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    • 2017
  • The purpose of this study was to test the effects of simulation practice education on clinical judgment, self-confidence, and clinical performance ability of nursing student. This study used a one group, pre-post test design. The subject of this study were 45 second grade nursing students who participated in the simulation practice education. Data were collected before and after the simulation practice education using the questionnaire. As a result of this research, the improvements of the clinical judgment, self-confidence, and clinical performance ability were statistically significant. Therefore, the simulation practice education has a positive effect on nursing students in terms of the clinical judgment, self-confidence, and clinical performance ability.