• 제목/요약/키워드: Clinical Practice Guidelines

검색결과 469건 처리시간 0.03초

Adaptation of Evidence-based Surgical Wound Care Algorithm

  • Han, Jung-Yeon;ChoiKwon, Smi
    • 대한간호학회지
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    • 제41권6호
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    • pp.768-779
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    • 2011
  • Purpose: This study was designed to adapt a surgical wound care algorithm that is used to provide evidence-based surgical wound care in a critical care unit. Methods: This study used, the 'ADAPTE process', an international clinical practice guideline development method. The -'Bonnie Sue wound care algorithm' - was used as a draft for the new algorithm. A content validity index (CVI) targeting 135 critical care nurses was conducted. A 5-point Likert scale was applied to the CVI test using a statistical criterion of .75. Results: A surgical wound care algorithm comprised 9 components: wound assessment, infection control, necrotic tissue management, wound classification by exudates and depths, dressing selection, consideration of systemic factors, wound expected outcome, reevaluate non-healing wounds, and special treatment for non-healing wounds. All of the CVI tests were ${\leq}$.75. Compared to existing wound care guidelines, the new wound care algorithm provides precise wound assessment, reliabilities of wound care, expands applicability of wound care to critically ill patients, and provides evidence and strength of recommendations. Conclusion: The new surgical wound care algorithm will contribute to the advancement of evidence-based nursing care, and its use is expected as a nursing intervention in critical care.

암 생존자의 이차암 검진 영향요인에 대한 경로분석: 위암, 대장암, 유방암 생존자 대상으로 (A Path Analysis on Factors Influencing Second Primary Cancer Screening Practices in Stomach, Colon, and Breast Cancer Survivors)

  • 양영희
    • 대한간호학회지
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    • 제44권2호
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    • pp.139-148
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    • 2014
  • Purpose: This study was conducted to identify the factors influencing second primary cancer (SPC) screening practice by examining the relationships of physical symptoms, knowledge and attitudes regarding SPC screening, perceived risk, primary cancer type, and demographic factors of cancer survivors. Methods: Participants were 308 survivors of stomach, colon, or breast cancer recruited from 2 university hospitals in Korea. Data were collected using a questionnaire and analyzed using IBM SPSS 21.0 and AMOS 18.0. Results: The proportion of participants taking all cancer screenings according to national guidelines was 40%. They had moderate knowledge and a relatively positive attitude regarding SPC screening and high cancer risk perception. The participants had taken fewer SPC screenings after than before cancer diagnosis. The factors influencing cancer risk perception were age, physical symptoms, knowledge regarding SPC and primary cancer type (stomach). The factors influencing SPC screening practice were age, gender, economic status, knowledge regarding SPC screening, and primary cancer types (colon). Conclusion: It is important for clinical professionals to recognize that survivors of cancer are susceptible to another cancer. Education on SPC screening for these survivors should focus on communicating with and encouraging them to have regular cancer screenings.

Being a front-line dentist during the Covid-19 pandemic: a literature review

  • Fallahi, Hamid Reza;Keyhan, Seied Omid;Zandian, Dana;Kim, Seong-Gon;Cheshmi, Behzad
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제42권
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    • pp.12.1-12.9
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    • 2020
  • Coronavirus is an enveloped virus with positive-sense single-stranded RNA. Coronavirus infection in humans mainly affects the upper respiratory tract and to a lesser extent the gastrointestinal tract. Clinical symptoms of coronavirus infections can range from relatively mild (similar to the common cold) to severe (bronchitis, pneumonia, and renal involvement). The disease caused by the 2019 novel coronavirus (2019-nCoV) was called Covid-19 by the World Health Organization in February 2020. Face-to-face communication and consistent exposure to body fluids such as blood and saliva predispose dental care workers at serious risk for 2019-nCoV infection. As demonstrated by the recent coronavirus outbreak, information is not enough. During dental practice, blood and saliva can be scattered. Accordingly, dental practice can be a potential risk for dental staff, and there is a high risk of cross-infection. This article addresses all information collected to date on the virus, in accordance with the guidelines of international health care institutions, and provides a comprehensive protocol for managing possible exposure to patients or those suspected of having coronavirus.

심폐소생술금지(Do-Not-Resuscitate)에 대한 환자보호자의 윤리적 인식 및 태도 (Ethical Awareness and Attitudes of Patients' Families towards DNR(Do-Not-Resuscitate))

  • 송경옥;조현숙
    • 임상간호연구
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    • 제16권3호
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    • pp.73-84
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    • 2010
  • Purpose: The purpose of this study was to investigate the ethical awareness and attitude of patients' families towards Do-Not-Resuscitate(DNR), and thus provide basic information required to develop Korean appropriate DNR instructions and practice informed consent for DNR. Methods: During April 2010, 219 patient family members visiting the hospital were surveyed using a questionnaire. Results: Most of the participants preferred DNR to meaningless treatment for incurable patients. They recognized the necessity of explaining DNR to the patient with a terminal disease. They also requested DNR orders for themselves if they were in the same medical condition. In making a DNR decision, the patient's family agreed and preferred that it reflect the opinion of the patient and the doctor in charge. They also agreed that treatment should be given with the best efforts even if a DNR decision had been made for the patient. Conclusion: To make a decision on DNR for a patient who is terminally ill or for whom survival is not possible, a practice of informed consent and guidelines for executing the DNR reflecting the patient's opinion are required.

Noninvasive Testing for Colorectal Cancer Screening: Where Are We Now?

  • Jaeyoung Chun;Jie-Hyun Kim;Young Hoon Youn;Hyojin Park
    • Journal of Digestive Cancer Research
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    • 제11권2호
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    • pp.85-92
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    • 2023
  • Colorectal cancer (CRC) is one of the most prevalent cancers and is the leading cause of cancer-related mortality worldwide. Based on the current screening guidelines by the American Cancer Society and Korean multi-society expert committee, CRC screening is recommended in asymptomatic adults starting at the age of 45 years. Fecal immunochemical test-based screening programs reduce the development of CRC and related mortality in the general population. However, this most popular CRC screening strategy demonstrates a crucial limitation due to modest diagnostic accuracy. Colonoscopy may be considered as an alternative primary method for CRC screening; however, its implementation can still be challenging due to concerns regarding invasiveness, low adherence, cost-effectiveness, and quality assurance. To overcome the limitations of current screening tests, innovative noninvasive tests for CRC screening have been developed with advances in molecular biology, genetics, epigenetics, and microbiomics for detecting CRC, which may enhance the approach to CRC screening and diagnosis in clinical practice in the near future. This review explores the emerging screening methods and discusses their potential for integration into current practice.

경항통 및 경추 추간판 탈출증의 한의진료 임상현황조사를 위한 웹기반 설문조사 (A Web-based Survey for Assessment of Korean Medical Treatment Clinical Practice Patterns for Neck Pain and Cervical Intervertebral Disc Displacement)

  • 서창용;이윤재;김미령;배영현;김호선;김노현;양규진;이기범;하인혁
    • Journal of Acupuncture Research
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    • 제33권4호
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    • pp.65-72
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    • 2016
  • Objectives : While neck pain is highly prevalent in Korea, studies examining its Korean medical treatment are currently lacking. The aim of this study was to assess current Korean medical treatment practice patterns for neck pain. Methods : A preliminary questionnaire was developed to investigate current practice patterns of neck pain and cervical intervertebral disc displacement (IDD) treatment, and underwent further revision through external review. The final questionnaire was distributed as a web-based survey to 18,289 potential respondents by email. Results : The response rate was 3.34 %. Most participants replied that they received multiple Korean medicine interventions for neck pain treatment consisting of such methods as acupuncture, wet cupping, interferential current therapy and electroacupuncture. A total of 378 respondents acknowledged that diagnostic testing was needed for neck pain treatment. The most commonly used Korean Standard Classification of Diseases (KCD) principal diagnosis code for neck pain was M542, and for cervical IDD was M501. Conclusion : This survey study helps determine current practice patterns of neck pain, and recognizes the need for use of diagnostic devices in neck pain treatment. These results are further anticipated to provide basic data for clinical practice guidelines (CPGs) and future studies using Korean National Health Insurance and Health Insurance Review & Assessment Service data.

한의표준임상경로에 기반한 치매 안심 한의주치의 모형 개발 연구 (A Study on the Development of a Korean Medicine Clinical Pathway for Primary Care of Patients with Dementia Based on Clinical Pathway Methodology)

  • 권도영;권기태;허영진;김동수;조성훈
    • 동의신경정신과학회지
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    • 제34권4호
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    • pp.359-368
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    • 2023
  • Objectives: This study aims to establish a Korean medicine doctor's range of services in the dementia relief primary care system based on the previously developed dementia clinical practice guidelines (CPGs). Developing a dementia relief primary care Clinical Pathway (CP) can aid clinically when the Korean medicine primary care doctor conducts treatment. Methods: We analyzed Dementia Korean Medicine Primary Care Model Data and then applied CP Methodology to develop the configuration of the Korean Medicine Primary Care Model. For patients with Alzheimer's dementia (AD), vascular dementia (VD), and mild cognitive impairment (MCI), the Korean Medicine Primary Care Model focuses on improving cognitive function, everyday living abilities and easing symptoms through interventions described in CPGs. The contents of the draft model later include references to already-existing CPs. Results: The study sites were chosen as Korean medical clinics connected to primary care physicians in the dementia-friendly model. The CP used a time task matrix version to arrange the clinical chronology, which included all examinations, diagnoses, and treatment procedures, from the initial appointment to follow-ups and the end of therapy. Conclusions: It anticipates that Korean primary care doctors familiar with dementia can use the offered therapies for the first time by creating the dementia Korean medicine primary care model in this study. This is expected to maximize the range of medical services provided by Korean medicine and improve the standard of medical treatment.

의약분업 예외지역 약국의 스테로이드 외용제 복약지도 실태조사 (A Survey on Pharmacists' Prescription Behaviors for Topical Steroids in Regions without Separation of Dispensary from Medical Practice in Korea)

  • 김광묘;김보리;이정선;한옥연;박미선;임현우;나현오;박영민
    • 한국임상약학회지
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    • 제21권2호
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    • pp.161-169
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    • 2011
  • The purpose of this study is to survey on the pharmacists' medication teaching service for topical steroids in regions without separation of dispensary from medical practice. The questionnaire was sent to 199 pharmacists who work inregions without separation of dispensary from medical practice via mail, e-mail or fax. 112 out of 199 pharmacists requested have answered the survey (response rate 56.28%). The questionnaire was composed of 4 categories with demographic characteristics, generally explained contents, adverse effects and precaution in pregnancy, breastfeeding and children. We analyzed the questionnaire by the 6 items with reference to the practical guidelines for medication teaching service. The medication teaching service for topical steroids in terms of generic name, physical characteristics, efficacy, usage and dosage, warning and precaution has been well provided by pharmacists in regions without separation of dispensary except for means and duration of optimal storage. The majority of pharmacists provided their patients with 4 and more kinds of items (69.64%), but the generally recommended 4 kinds of items such as generic name, efficacy, usage and dosage, warning and precaution were provided in as low as 48.22% of the respondents. These results show that the medication teaching service for topical steroids in terms of means and duration of optimal storage (45.54%) and the generally recommended 4 kinds of items have not been enough provided by pharmacists in regions without separation of dispensary. Taken together pharmacists in these regions should make a proper guideline for medication teaching service that can prevent the adverse effects of topical steroids.

의사들의 정보추구행태를 반영한 의학정보시스템 개발 및 평가 (Construction and Feedback of an Information System by Analyzing Physicians' Information-Seeking Behavior)

  • 김나원;이지연
    • 정보관리학회지
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    • 제33권1호
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    • pp.161-180
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    • 2016
  • 의사들은 학술연구와 환자진료에 관한 정보요구를 가지고 있고, 전자정보원을 이용하여 해결하고 있으나 정보원의 선택이나 검색에서 어려움을 겪는다. 본 연구는 의사들의 연구와 진료정보요구를 지원할 수 있는 검색시스템을 설계하고 개발하는 것이 목적이다. 이를 위해 의사들의 정보요구에 적합한 정보원 개발을 위해서 정보이용행태에 관하여 심층인터뷰를 하였고, 그 결과를 바탕으로 검색 시스템인 MediSearching을 개발하였다. 개발된 시스템은 효용성 검증과 제안을 얻기 위해 추가 인터뷰와 테스트검색을 통하여 피드백을 받았다. 의사들의 정보이용행태에 관한 인터뷰 결과 소속병원의 종류나 진료 과목에 따라서 차이를 보였다. 대학병원 의사들은 연구와 관련된 정보요구가 컸으며 학술지 논문을 주로 이용하고 있었으나, 전문병원이나 개인병원 의사들은 진료와 관련된 정보요구가 대부분으로 동료와의 대화로 해결하는 형태를 보였다. MediSearching은 연구와 진료정보요구를 동시에 지원할 수 있는 검색시스템으로 개발되었고, 인터페이스와 검색효용성이 검증되었다. 기존의 한국 의학 정보 사이트에서는 제공 정보의 종류나 검색방법에 따라 서비스 범위가 모두 달라 의사들은 동일한 검색 과정을 반복하는 불편함이 있었으나 이를 해결한 것으로 파악되었다. 또한 파일 형태나 언어와 상관없이 정보원의 추가가 가능하도록 한 점에서 유용한 것으로 평가되었다.

B형간염 바이러스 보유 환자의 질환 활성도에 따른 B형간염 지식, 자가간호수행 및 삶의 질 비교 (Comparison for Hepatitis B Knowledge, Self Care Practice and Quality of Life according to the Disease Activity among Patients with the Hepatitis B Virus)

  • 서임선;송명준;유양숙;김형숙
    • 한국보건간호학회지
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    • 제31권2호
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    • pp.257-271
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    • 2017
  • Purpose: The hepatitis B virus is a major cause of chronic liver disease. The clinical guidelines recommend that inactive chronic hepatitis (ICH) patients also check their liver function every 6 to 12 months and manage the potential risks. This study compared the hepatitis B knowledge, self-care practice, and quality of life in patients with HBV according to the disease activity. Methods: This study was conducted in a university hospital and surveyed on 65 ICH patients and 68 progressive chronic liver disease (PCLD) patients from November in 2012 to September in 2013. Results: The knowledge of hepatitis B was lower in the group of a lately perceived HBV infection and ICH. Self-care practice was lower in the male and the patients group with a perceived HBV infection within 5 years. The "taking regular liver function test" score was lower in the ICH. Eight out of 12 Liver Disease Quality of Life instrument (LDQOL) subscales were lower in PCLD. Conclusion: The hepatitis B knowledge and self-care practice are relatively lacking in ICH and the patients group with a perceived HBV infection within 5 years. More effective education programs will be necessary to enhance the hepatitis B knowledge and self-care for patients with HBV and even for ICH.