• Title/Summary/Keyword: Clinical Practices

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Efficacy of Acupuncture for Parkinson's Disease over the Last Decade: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

  • Yeonju Kim;Yigun Lim;Subin Ahn;Junyeop Oh;Yoonbyeong Chae;Yoomin Choi;Jong Uk Kim
    • Journal of Acupuncture Research
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    • v.41 no.1
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    • pp.29-52
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    • 2024
  • The aim of this review is to consolidate findings from clinical investigations spanning the past decade regarding the impact of acupuncture on Parkinson's disease (PD). The objective is to assess the efficacy of acupuncture as a therapeutic approach to PD, with the intention of informing future clinical practices and advancing the foundation for subsequent research endeavors in this area. A comprehensive literature search was conducted to identify clinical trials exploring the effects of acupuncture on PD between January 2014 and August 2023. Databases search included PubMed, EMBASE, CNKI, OASIS, KISS, KMBASE, RISS, and ScienceON. Quantitative evidence from randomized controlled trials (RCTs) was systematically reviewed, and the methodological quality of the included studies was assessed using Cochrane's risk of bias tool. Meta-analysis was performed using Review Manager (RevMan) 5.4.1 software. The systematic review encompassed a total of 38 RCTs involving 2,786 participants. Meta-analysis of 12 studies revealed that individuals treated with a combination of acupuncture and Western medicine exhibited notable improvements compared to those receiving Western medicine alone or sham acupuncture alongside Western medicine. However, the overall quality of the RCTs was deemed low, and no serious adverse events were reported. Across clinical investigations conducted in the past decade, acupuncture appears to hold promise as a complementary treatment for PD patients when administered alongside Western medicine. Nevertheless, this study identifies certain limitations that warrant consideration in future research endeavors. Enhanced emphasis on conducting high-quality RCTs is imperative to comprehensively evaluate the efficacy of acupuncture in managing PD.

Evidence-based Clinical Guidelines for Optimizing the Use of Standing Frame: A Systematic Review of Dosing Recommendations Among Cerebral Palsy

  • Changho Kim;Hyunsuk Park
    • Physical Therapy Korea
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    • v.31 no.2
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    • pp.131-141
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    • 2024
  • Background: Standing frames are a common intervention for children with cerebral palsy (CP), yet there is a lack of standardized dosing recommendations, impeding the enhancement of treatment outcomes in this population. Objects: This paper aims to optimize dosing strategies for standing frame programs in children with CP. It evaluates effective durations and frequencies for using standing frames to improve gait, hip joint integrity, functional activities, joint range of motion, and muscle tone. The goal is to provide evidence-based clinical recommendations to guide practitioners in treating pediatric CP patients. Methods: A comprehensive research was conducted across seven databases, yielding 23 studies meeting inclusion criteria. Strength of evidence was assessed using established tools. Clinical recommendations were formulated based on the amalgamation of existing evidence. Results: The paucity of evidence-based dosing recommendations for children with CP supported standing device is highlighted in this review. Key findings suggest that standing frames implemented 5 days per week demonstrate positive effects on gait (45 minutes/day, 3 times/week), hip joint integrity (60 minutes/day), functional activities (60 minutes/day in 30° to 60° of bilateral hip abduction), joint range of motion (60 minutes/day), and muscle tone (30 minutes/day). Conclusion: This systematic review of the treatment regimens for children with CP is providing useful insights to the dosing strategies of standing frames. The evidence supports a 30-60 minutes per day and 3-5 days a week intervention with specified durations for optimal outcomes. In enhancing the effectiveness of standing frames, as well as promoting evidence-based practices in the management of children with CP, these clinical recommendations offer guidance for practitioners.

Knowledge and Compliance with Hand Hygiene by Nursing Students in Clinical Practice (병원실습 경험이 있는 간호 대학생의 손 위생 지식과 이행에 관한 연구)

  • Yoon, Eun Joo;Kim, Mi Hyang
    • The Journal of Korean Academic Society of Nursing Education
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    • v.19 no.3
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    • pp.455-464
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    • 2013
  • Purpose: The goal of the study was to investigate nursing students' knowledge and compliance with hand hygiene to find out the variables associated with compliance with hand hygiene. Methods: The participants were 1,020 nursing college students located in Seoul, Ansan and Suncheon. The variables analyzed in this study were; hand hygiene knowledge, hand hygiene compliance, hand washing habits, hand hygiene education with emphasis in school, emphasis on hand washing and role modeling in hospital, and hand hygiene beliefs. Data were analyzed by frequency, $x^2$-test, t-test and Pearson correlation coefficient. Results: 1. The correct answer average percentage of hand hygiene knowledge was 78.4%. 2. The average rates of hand hygiene compliance rate was 78.0% 3. Compliance rate had significant correlation with variables such as hand washing habit, hand hygiene education with emphasis in school, emphasis on hand washing and role modeling in hospital, and hand hygiene belief. Conclusion: 1. It is nessassery for nursing students to receive proper educational on hand hygiene knowledge during practices in nursing school curriculum. 2. Nurses should be encouraged to be a good mentor to nursing students on appropriate hand hygiene compliance in clinical practice.

Development and Effects of a Comprehensive Web-Based Nursing Process for Nursing Students (간호학생을 위한 웹 기반 간호과정 프로그램의 개발 및 만족도 평가)

  • Hong, Sung-Jung;Kim, Hwa-Sun
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.18 no.4
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    • pp.497-505
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    • 2011
  • Purpose: This study was conducted to develop a comprehensive web-based nursing process program to assist nursing students and to evaluate the effects of the program. Methods: The system provides nursing students with guidelines based on NNN (NANDA, NOC, NIC) when the nursing students conduct a series of nursing procedures on diagnosis-outcome-intervention for a specific symptom. It also maintains and manages nursing processes actually conducted by students for clinical practices, and provides an environment where the patient information and nursing process can be converted into a formatted document for printing. This web-based program was used to surgical patients from April to June 2011. Results: The overall satisfaction rate was 3.64. The item with the highest score was, 'Do you think a web-based nursing process program is necessary?' (3.87), followed by 'Do you want to use this program when you become a nurse and implement the nursing process?' (3.33). Conclusion: These results indicate that implementation of web-based programs needs to be continued as an effective tool, but more research is needed on the best way to implement web-based programs in various clinical setting.

Effects of the Schematized Alarm-managing Manual for Continuous Renal Replacement Therapy on the Alarm Resolution Rate and Nursing Competence of Nurses in Intensive Care Units (지속적 신대체요법 시 도식화된 알람 관리 매뉴얼 사용이 중환자실 간호사의 알람 해결률과 간호수행능력에 미치는 효과)

  • Choi, Aeng Ja;Yi, Young Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.20 no.5
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    • pp.535-544
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    • 2014
  • Purpose: This study was done to develop a schematized alarm-managing manual for continuous renal replacement therapy (CRRT) and to investigate its effects in maintaining continuity in the patients' treatment and promptly resolving alarms when CRRT is being carried out. Methods: Sixtynurses from two medical intensive care units (ICUs) (one experimental and one control) at one hospital were asked to answer a questionnaire including their CRRT nursing competency and satisfaction with the manual. Data on alarm resolution rate were collected by analyzing existing data, such as the details of each alarm and the number of resolutions around the clock in the CRRT device. Results: The alarm resolution rate and some of CRRT nursing competency scores in the experimental group were higher than those in the control group. The experimental group was also satisfied with the manual. Conclusion: The study confirmed that the schematized alarm-managing manual can be useful for ICU nurses to resolve alarms and can be used as a guideline. Application of this manual to clinical practices and its use can therefore, be encouraged through continuous education and promotion.

Analysis of the Nursing Practice in a Medical ICU Based on an Electronic Nursing Record (간호기록을 이용한 중환자실 간호업무 조사연구)

  • Song, Kyung-Ja
    • Journal of Korean Academy of Nursing
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    • v.37 no.6
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    • pp.883-890
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    • 2007
  • Purpose: The purpose of this study was to identify the entity of critical care nursing practices through analyzing nursing statements described by electronic nursing records in a MICU. Methods: 176,459 nursing statements of 188 patients during a 6 month-stay were analyzed statement by statement according to the nursing process(nursing phenomena, nursing diagnosis, & nursing activity) and 21 nursing components of Saba's Clinical Care Classification. Results: Among 176,459 single statements, the statements of nursing activity ranked first in number. The contents of the statements were analyzed and categorized by main themes. Among 489 categorized themes, the number of themes of nursing phenomena statements was the highest. When analyzed by Saba's clinical Care Classification, the nursing statements mainly included a physiological component. Among 21 components, the respiratory component ranked in the first position in nursing phenomena, nursing diagnosis and nursing activity. The extra statements not included in the 21 components were 9,294(15.1%) in nursing phenomena and 21,949(22.7%) in nursing activity. Most are statements related to tests and the doctor. Conclusion: The entity of MICU nursing practice expressed by electronic nursing records was mainly focused on physiological components and more precisely on respiratory components.

Intraoperative Neurophysiological Monitoring for Optimal Brain Mapping

  • Park, Sang-Nam;Park, Sang-Ku
    • Korean Journal of Clinical Laboratory Science
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    • v.45 no.4
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    • pp.170-179
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    • 2013
  • There is a correct way to avoid any sequale in the central motor area during neurosurgery procedures. A clear way to find the circumference of the central sulcus, central motor, and sensory areas by giving cortical electrical stimulation to the central motor area immediate after surgery is proposed. Looking at patients who underwent brain surgery September 2009 to July 2013, the central sulcus and speech areas around the central area of the brain was investigated, using the practices of either a localized brain map check or a direct cortical electrical stimulation test. Brain maps localized around the surgical site through functional movement or speech areas were identified. Accurate tests done during surgery without damage to motor neurons or after surgery were conducted smoothly. Although successful brain map test localization can be accomplished, there are some factors that can interfere. The following phenomena can reverse the phase: (1) the first sensory / motor in the case of patients severe nerve damage; (2) placement of the electrode on top of the vessel; (3) presence of a brain tumor near the brain cortex; (4) use of anesthesia if patient cooperation is difficult; and (5) location of the electrode position and stimulus is inappropriate.

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A Review of Studies for Acupuncture Therapy of Attention Deficit Hyperactivity Disorder in Traditional Chinese Medicine (주의력결핍·과잉행동장애의 침치료에 대한 최신 연구동향 - 2011-2013년 중국 논문 중심으로 -)

  • Kang, Mun Su;Kim, Woo Kyoung;Kim, Lak Hyung
    • The Journal of Pediatrics of Korean Medicine
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    • v.27 no.4
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    • pp.10-16
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    • 2013
  • Objectives The purpose of this study was to investigate the acupuncture therapy about Attention Deficit Hyperactivity Disorder (ADHD) in China. Methods We searched for the studies on ADHD at China National Knowledge Infrastructure (CNKI, http://www.cnki.net) from 2011.1 to 2013.8. Results Selected 12 studies were divided into 7 case reports and 5 control studies. 7 case reports reported significant improvements with acupuncture therapy in ADHD. 5 control studies reported results that the acupuncture therapy groups were similar or better than western medicine treatment groups. Frequently used acupuncture points were EX-HN23 (7 times), GV20 ${\bullet}$ P6 ${\bullet}$ SP6 (6 times), G13 ${\bullet}$ EX-HN1 (5 times). Conclusions There have been reported many ADHD clinical studies in China and these studies can be applied to the clinical practices in Korea.

Educational Intervention on Breast Cancer Early Detection: Effectiveness among Target Group Women in the District of Gampaha, Sri Lanka

  • Vithana, PVS Chiranthika;Ariyaratne, MAY;Jayawardana, PL
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2547-2553
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    • 2015
  • Purpose: The present study concerns the effectiveness of an educational intervention for improving knowledge, attitudes and practices (KAP) of breast cancer early detection among target group women (TGW) in the district of Gampaha, Sri Lanka. Materials and Methods: The study was a community-based intervention. Two medical officer of health areas in Gampaha district were selected using random sampling as intervention (IA) and control (CA). Public health midwives (PHMs) in the IA were exposed to the educational intervention first, conducted the same among the TGW through PHMs. KAP was assessed using an interviewer- administrated questionnaire among 260 TGW from each area selected using cluster sampling before and six months after the intervention. Results: The overall median scores for KAP among TGW in IG increased significantly from pre intervention level of 54% (IQR: 46-59%), 50% (IQR: 41-59%), and 0% (IQR: 0-20%) to post intervention level of 77% (IQR: 72-82%), 68% (IQR: 59- 76 %) and 40% (IQR: 20-60%) respectively. In CG, overall median scores for KAP remained almost the same at pre intervention 54% (IQR:44-59%), 50% (IQR:36-59%) and 0% (IQR: 0-20%) and post intervention 54% (IQR:46-59%), 50% (IQR:36-64%) and 0% (IQR: 0-20%) respectively. Conclusions: The educational intervention was found to be effective.

Legal Analysis and Development of managerial guideline to nursing activities related to observation (간호사의 경과관찰업무에 대한 판례분석 및 관리지침 개발)

  • Kim, In-Sook;Kim, Ki-Kyoung;Kim, Dae-Ran
    • Journal of Korean Academy of Nursing Administration
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    • v.8 no.2
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    • pp.273-281
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    • 2002
  • Purpose. The study was done to develop nursing guidelines to prevent nursing negligence in the clinical setting that would lead to malpractice. Method. A comprehensive review of the literature and focus groups interviews were used to search for malpractice cases related to "observation", one of the most basic nursing activities. The cases were analyzed with respect to nursing practice and a legal expert was consulted on the content. Results. 4 malpractice cases related to observation negligence were selected for this study; 1) a case of failing to observe dyspnea after a thyroidectomy, 2) a case of failing to observe a depressed patient for suicide attempts, 3) a case of failing to observe a VP shunt obstruction, 4) a case of failing to observe a cardiac ischemia after a bronchoscopy. 11 guidelines were developed for clinical nurses and 13 guidelines for nursing managers. Conclusion. These guidelines are useful in preventing malpractice due to nursing negligence. Therefore nurses need to apply them to their practices and continue to make an effort to develop guidelines for other malpractice situations.

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