• 제목/요약/키워드: Clinical Practices

검색결과 499건 처리시간 0.033초

침무보법(鍼無補法)의 의미에 대한 고찰(考察) -『황제내경(黃帝內經)』의 보사법(補瀉法)을 중심으로- (A Study on the Meaning of Theory that Acupuncture has no Reinforcement -Focusing on the method of reinforcement and reduction in Huangdineijing-)

  • 윤기령;백유상;장우창;정창현
    • 대한한의학원전학회지
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    • 제31권2호
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    • pp.141-153
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    • 2018
  • Objectives : Acupuncture therapy's reinforcement and reduction method is now widely used in the clinical practices. Meanwhile, there has been a voice of concern since the past that acupuncture has no reinforcement. This thought has not been given enough discussion, and the paper attempts to remedy this absence and verify the validity of the concern. Methods : The acupunctural reinforcement and reduction method found in the Huangdineijing is reviewed, and a number of medical books that discuss the idea of lack of reinforcement in acupuncture are studied. Results : Huangdineijing describes the acupunctural unique feature of reduction. The text explains that acupuncture work in a way that is different that medicine, and thus cannot be used for a disease based on deficiency. In addition, it warned the loss of the primordial qi when needling oneself. Reinforcement in the reinforcement and reduction technique as described in Huangdineijing mainly revolves around preventing the loss of the primordial qi. Conclusions : The purpose of the acupunctural reinforcement and reduction is to control the body's disproportional qi deficiency and excess, where some parts of the body has more qi than others. The reinforcement in "acupunctural reinforcement and reduction method" and the reinforcement in "acupuncture only has reduction and no reinforcement" within the thought of "acupuncture has no reinforcement" are different in that one deals with controlling the imbalance of qi in body, and the other deals with dispelling the deficiency by flowing the qi in the viewpoint of entering and out. This calls for a need to establish the proper acupunctural points, numbers, and times for each disease based on the theory of "acupuncture has no reinforcemen."

융합형 초음파 영상을 통한 세 가지 교각운동에 따른 몸통근육의 두께 비교 (Comparison of Trunk Muscles Thickness in Three Different Bridge Exercises by Ultrasound Fusion Imaging)

  • 강지현;심재훈
    • 한국융합학회논문지
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    • 제6권5호
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    • pp.123-130
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    • 2015
  • 본 연구는 융합형 초음파 영상(ultrasound fusion imaging)을 이용하여 세 가지 교각운동(bridge exercise) 방법에 따른 몸통근육의 두께변화를 알아보기 위해 실시되었다. 건강한 성인 남녀 32명을 대상으로 교각 운동을 실시하는 동안 배속빗근(internal oblique), 배바깥빗근(external oblique), 배가로근(transverse abdominis) 그리고 뭇갈래근(multifidus)의 두께를 측정하였다. 연구결과, 세 가지 교각운동 방법에 따라 배속빗근, 배가로근, 뭇갈래근에서 유의한 두께변화를 보였다. 배가로근과 뭇갈래근은 exercise C(sling)에서 두께가 가장 증가하였고, exercise B(gym ball)와 exercise A(fixed support surface) 순으로 증가하였다. 배속빗근은 치료용 볼을 이용한 교각운동 시 두께가 가장 증가하였고, 슬링과 고정된 지지면 순으로 증가하였다. 특히, 슬링에서의 교각운동이 몸통 근육 두께증가에 가장 효과적인 방법이라고 사료된다. 최근까지, 몸통근육을 활성화 시키는 효과적인 방법으로 슬링에서의 교각운동이 많이 제안 되었지만, 융합형 초음파를 이용하여 관찰한 연구는 많지 않았다. 따라서 본 연구의 결과를 통해 임상에서 다양한 교각운동의 처방과 적용 시에 유용한 지침을 제공하고자 한다.

치과종사자의 손 위생 신념 및 손 위생 활동과 손 위생 수행률의 관련성 (Correlation between belief in the importance of hand hygiene, related activities and performance among dental staff)

  • 정주희;노희진;유자혜;문소정
    • 한국치위생학회지
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    • 제17권2호
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    • pp.247-258
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    • 2017
  • Objectives: This study was conducted to identify the correlation between belief in hand hygiene, activities and related hand hygiene performance rates among dental staff. Methods: This study was based on the evaluation of 329 dental practitioners, including dental hygienists who work at dental clinics, dental hospitals, general and university dental hospitals in Seoul, Gyeonggi-do Province, and Incheon. The questionnaire consisted of a total of 46 questions, including 7 questions on general characteristics, and 25 questions on hand hygiene beliefs, and 5 questions on hand hygiene activities, and 9 questions on hand hygiene practices. This study used 291 subjects for the final analysis, excluding subjects who had provided incomplete or inappropriate responses to the questionnaire. The collected data were analyzed using an independent t-test, ANOVA, $x^2$ test, correlation analysis, and multiple linear regression analysis, where p-values of <0.05 were considered statistically significant. Results: Longer clinical career was associated with a significant increase in behavior and norm beliefs, but no sequential difference in control beliefs. The hand hygiene performance was higher in staff at larger hospitals after contact with pollutants and contaminated environments. Higher age was associated with a significant increase in hand hygiene performance rates, but profession was not statistically significant in the performance rate of hand hygiene. The hand hygiene performance rate was ranked higher among those with average work hours per week of greater than 8 hours followed by those who worked fewer than 8 hours. Fewer work hours per week, a stronger belief in hand hygiene, less frequent exposure to contaminated environments, and a greater number of hand hygiene performance had a positive effect on higher hand hygiene performance rates. Conclusions: In order to increase the hand hygiene performance rate of dental practitioners, it is considered that required time for hand washing should be ensured sufficiently. Proper usage of hand sanitizers should also be promoted efficiently.

Marriage in Korea III. Age at Marriage, Family Planning Practices, and Other Variables as Correlates or Fertility

  • Kim, Mo-Im;Rider, Rowland V.;Harper, Paul A.;Yang, Jae-Mo
    • Clinical and Experimental Reproductive Medicine
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    • 제1권1호
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    • pp.1-14
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    • 1974
  • Data from this study support the View that the following factors are not sufficiently important in Korea to invalidate the relationships observed between age of marriage and fertility: (1) Premarital pregnancy and common law marriage, (2) shortening of birth intervals in late marriages, (3) adverse effects of very eary marriage in reproductive capacity, and (4) postponement of first pregnancy among early marriages. Thirteen variables which were considered to be potential predictors of fertility were studied to determine their influence on three indices of fertility. Age of marriage and family planning praetice are the strongest predictors and account for about 10% and 7% of the total variance, respectively. Seven other factors each account for an intermediate amount of variability; these are ideal number of children, rural versus urban study area, education, aspiration for daughter, index of exposure to mass media, economic index of respondent's home at survey, and residence before marriage. The remaining variables have no consistently significant relationship to fertility. Most of the relationships appear to be stable and consistent over time; others appear to be changing. The latter group include those variables which are associated with modernization indices of family planning practice, mass media exposure. and aspiration for daughters. Thus, the index of family planning practice is of limited significance for the $40{\sim}49$ age group but is the most important variable for the $20{\sim}29$ year women. The relationship is a direct one for the two age groups between 30 and 49 years which suggests that these groups already had high fertility when family planning services became available and that this high fertility then became an inducement to acccept contraception. The pattern of relationship is not yet clear for the $20{\sim}29$ year group. Similar interactions are observed for the other indices of modernity and are discussed. The thirteen variables together can account for a maximum of about 40% of the variance in the number of live births in the age group $30{\sim}39$, and for lesser amounts of variance in other age and fertility groupings.

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수면위생의 실행과 효과에 대한 연구 (A Study on the Practice and Effects of Sleep Hygiene)

  • 최윤경;김인;서광윤;신동균
    • 수면정신생리
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    • 제4권2호
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    • pp.156-163
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    • 1997
  • 연구배경: 불면증을 경험한 적이 있는 일반인들을 대상으로 어떤 수면위생 수칙들을 얼마나 실행하고 있으며 또 실행했을 때 수면에 얼마나 도움이 되는지를 살펴보고자 하였다. 특히, 실행이 많이 되고 있지는 않지만 수면에 특이하게 도움이 된다고 보고된 항목들이 있다면, 불면증 치료 프로그램을 계획 적용하기 전에 그에 대한 경험적, 이론적 근거를 확립하고 이를 실제 임상에서 적극적으로 적용할 수 있을 것이다. 방 법: 불면증을 경험한 적이 있는 만 18세 이상의 성인 226명을 대상으로, 인구통계학적 변인, 불면증 경험, 수면위생 수칙에 대한 실행과 효과를 평가하는 항목들로 구성된 질문지를 실시하였다. 조사원이 일대일로 면담을 실시하여 질문지에 답하도록 하였다. 결 과: 잠자리에서의 각성과 관련된 수면위생 수칙은 비교적 많이 실행되고 또 수면에 효과가 있는 것으로 보고되었다. '매일 규칙적인 운동을 한다'. '잠자기 전에 뜨거운 물에 목욕을 한다'와 같은 수면의 항상성 추동과 관련된 수면위생 수칙들과 '잠자기 전 긴장을 풀어준다'와 같은 항목들은 평상시 실행도는 낮으나, 불면증이 있을 때 실행을 하면 매우 효과적이라 평가되었다. 결 론: 본 연구의 결과, 좀 더 강조해서 교육해야 하고 실행하도록 지도해야 할 필요가 있는 항목들을 발견할 수 있었다. 따라서, 불면증의 치료 프로그램에 이러한 수면위생 수칙에 대한 교육을 포함시키고 좀 더 실제적인 실행을 할 수 있도록 항목별로 자세하게 주지시킬 필요가 있겠다. 특히, 평소에 실행도는 낮지만 실행하였을 때 효과적이라고 평가된 세가지 항목들에 대해서는, 임상실제에서 불면증환자들을 대상으로 개별 항목별 치료효과를 측정하는 후속 연구가 시도될 만 하다고 사료된다.

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일부 노인의 보완대체요법 이용행태와 영향요인 (Utilization Behaviour and Influencing Factors of Complementary and Alternative Medicine Therapies Among the Elderly)

  • 문기원;김준호;김춘배
    • 농촌의학ㆍ지역보건
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    • 제38권1호
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    • pp.25-38
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    • 2013
  • 이 연구목적은 일부 지역 재가 노인을 대상으로 보완대체요법 이용행태와 그 영향요인을 구명하는데 있다. 2단계 집락추출로 선정된 대구광역시와 경상남도의 2개 시 군의 노인복지시설(9개)을 이용한 60세 이상 노인 233명을 대상으로 보완대체요법 이용현황, 보완대체요법 인지 여부, 만성질환유형에 따른 이용실태 등을 파악하기 위해 교차분석 및 로지스틱 회귀분석을 실시하였다. 그 결과 조사대상 노인의 70.4%(164명)가 지난 1년간 보완대체요법 이용 경험이 있었다. CAM 종류별로 48.8%(64명)~60.7%(88명)의 노인들이 보건의료 전문가와의 상담 없이 이용하고 있었다. 보완대체요법을 인지하고 있는 경우의 이용 경험은 2 이상 높았으며, 이환된 만성질환 수가 많은 경우의 이용경험은 수기요법 5.85(95% CI 1.97-17.34), 영양요법 2.92(95% CI 1.07-7.97), 약물요법 2.92(95% CI 1.04-8.17)로 높았으며, 만성질환 중 당뇨병을 진단받은 경우의 영양요법 이용 경험은 3.76(95% CI 1.49-9.47) 높았다. 노인 만성질환관리를 위해서는 보완대체요법에 대한 명확하고 체계적인 분류, 효과 및 안전성에 대한 객관적 검증과 함께 노인들의 건강상태를 고려한 전문가 및 의료인의 보완대체요법 이용 중재가 필요하다.

임상물리치료에 있어서 아로마테라피의 활용 (The Utilization of Aromatherapy in Clinical Physical Therapy)

  • 장정훈;정동혁;박래준
    • The Journal of Korean Physical Therapy
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    • 제15권1호
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    • pp.82-95
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    • 2003
  • Our health is intimately connected to the health of our environment. The contemporary world view which sees a radical distinction between humans as subjects and world as object can obscure our recognition of how much we rely on nature for health and survival. Indigenous traditions and contemporary scholars remind us that we live in a universe in which all things are connected, and in which nature continues to offer its gifts in co-creative partnership for the health and wellbeing of all. Living in awareness of our relationship with nature enables us to open more to the experience of nature's nurturing. Many complementary therapies derive from ancient practices that involve nature in healing partnership. Essential oils have been used for thousands of years. Hippocrates claimed that the way to health was through aromatic baths and massages. Much anecdotal evidence exists regarding aromatherapeutic positive effects on recipients. Aromatherapy is a branch of complementary or alternative therapy which is increasing in popularity, yet has scant scientific credibility. Aromatherapy should be defined as treatment using odors and practised as such. However, essential oils are usually used in conjunction with therapeutic massage and often combined with counselling of some kind. Aromatherapy complements and enhances the therapeutic powers of massage. Massage is one of the most wonderful ways to relax and is throughly beneficial to health. Massage can help unknot tense and aching muscles and other minor symptoms of stress, leaving patients fresh and energized. As the use of aromatherapy within a health care setting has grown so rapidly in recent years, and will continue to do so, the need for suitable training has become apparent. No health service can afford the risk of having staff who are inadequately trained in the practice of aromatherapy using essential oils incorrectly on those in a state of ill-health, especially if the essential oils used are not to a standard suitable for therapeutic use. Training to an acceptable level in aromatic therapy is essential for safety and effectiveness. Knowledge of the nature and make-up of essential oils, their effect on the body and the emotions, and how, when, and where to apply them is imperative in order for them to be beneficial to a patient's health. In order to achieve best practice, further research is necessary to explore the use of aromatherapy in the management of multiple disorder.

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컴퓨터 단층 촬영 혈관 조영술을 이용한 심하복벽 혈관과 천공지의 박리 용이성에 따른 분류 (Classification of Deep Inferior Epigastric Perforator Courses Based on Computed Tomography Angiography: Incidences and Clinical Implications)

  • 이연훈;김성찬;엄진섭;김은기
    • Archives of Hand and Microsurgery
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    • 제23권4호
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    • pp.281-289
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    • 2018
  • 목적: 우리는 미세혈관 유방 재건술 수술 계획에 참고하기 위하여 컴퓨터 단층 촬영(computed tomography, CT)혈관 조영술을 이용하여 심하복벽혈관과 천공지의 주행을 세부 유형으로 나누어 보고 영상 및 임상 소견의 상관성과 각 유형의 빈도를 보고하고자 한다. 방법: 하복부 조직을 이용한 유방 재건을 받은 연속한 115명의 환자를 전향적으로 분석하였다. 심하복벽동맥과 천공지를 주로 근육 내 주행의 특징에 따라 박리하기 용이한 것과 박리에 곤란한 것으로 특징짓고 각각의 빈도를 조사하였다. 결과: 확인된 425개의 천공지 중 89개(20.9%)의 천공지는 박리에 용이한 주행을 하였으며 긴 근육 아래 주행(34.8%), 긴 근막 아래 주행(15.6%), 근육 주위 주행(13.9%)이 그에 속하였다. 반면 심하복벽동맥이 없거나 적절한 천공지가 조영되지 않는 경우가 3예와 8예에서 보고되었다. 총 65명(56.5%)의 환자가 적어도 한 개 이상의 박리가 용이한 천공지를 가지고 있었다. 결론: 수술 전 CT 혈관 조영술을 통하여 심하복벽동맥과 천공지의 주행을 분석하여 박리에 용이한 유형과 곤란한 유형을 미리 파악함으로써 수술 계획의 수립에 도움을 받을 수 있다.

Korean physicians' attitudes toward the prenatal screening for fetal aneuploidy and implementation of non-invasive prenatal testing with cell-free fetal DNA

  • Kim, Soo Hyun;Kim, Kun Woo;Han, You Jung;Lee, Seung Mi;Lee, Mi-Young;Shim, Jae-Yoon;Cho, Geum Joon;Lee, Joon Ho;Oh, Soo-young;Kwon, Han-Sung;Cha, Dong Hyun;Ryu, Hyun Mee
    • Journal of Genetic Medicine
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    • 제15권2호
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    • pp.72-78
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    • 2018
  • Purpose: Physicians' attitudes may have a strong influence on women's decision regarding prenatal screening options. The aim of this study is to assess the physicians' attitudes toward prenatal screening for fetal aneuploidy including non-invasive prenatal testing (NIPT) in South Korea. Materials and Methods: Questionnaires were distributed and collected at several obstetrics-gynecological conferences and meetings. The questionnaire included 31 multiple choice and 5 fill-in-the-blank questions. Seven questions requested physicians' demographic information, 17 questions requested information about the NIPT with cell-free fetal DNA, and 12 questions requested information about general prenatal screening practices. Results: Of the 203 obstetricians that completed the survey. In contrast with professional guidelines recommending the universal offering of aneuploidy screening, only 53.7% answered that prenatal aneuploidy testing (screening and/or invasive diagnostic testing) should be offered to all pregnant women. Physicians tended to have positive attitudes toward the clinical application of NIPT as both primary and secondary screening methods for patients at high-risk for fetal trisomy. However, for patients at average-risk for fetal trisomy, physicians tended to have positive attitudes only as a secondary screening method. Physicians with more knowledge about NIPT were found to tend to inform their patients that the detection rate of NIPT is higher. Conclusion: This is the first study to investigate expert opinion on prenatal screening in South Korea. Education of physicians is essential to ensure responsible patient counseling, informed consent, and appropriate management after NIPT.

한의사의 의료기기 사용과 주의의무에 있어서 한방의료행위의 새로운 이해 (The New Understanding of Korean Medicine Practice in Korean Medicine Doctor's Medical Devices Using and Duty of Care)

  • 박용신
    • 대한예방한의학회지
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    • 제23권2호
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    • pp.117-127
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    • 2019
  • Objectives : Korean medicine practice is not specifically described in medical law, and then has always been a quarrel. So far The criteria for judgment in Korean Medicine Doctor's Medical Devices Using should clinically prove it only by Korean medicine theory and academic Traditionally descending from old ancestors. Comprehensively review of Korean Medicine Doctor's Medical Devices Using and Duty of Care, and then present a new understandings to determine future Korean Medicine Practice. Method : An existing court cases of Korean Medicine Doctor's Medical Devices Using and Duty of Care were reviewed. After reviewing various papers published for several years, various opinions were reviewed and suggested. Results : The range of Korean Medicine Doctor's Medical Devices Using has changed since the 1951 National Medical Law stipulated Korean medicine as medical professionals. The issue of the recent ruling that distinguishes medical practice from Korean medicine practice were condensed into what emphasis to interpret amongst 1) The basic principles of learning, 2) Curriculum and professionalism, 3) Risks. The Constitutional Court's ruling was important in order of 'Risk', 'curriculum and expertise', and 'basic principles of learning.' A duty of Care means an obligation to pay attention to something. A duty of Care does not mean a "highest level," but requires a "best care" and does "best under given conditions." Even in the duty of Care, Because Korean medicine has a purpose to protect and promote the health of the people, Some standards of western medicine have to be adapted to the current general medical technology. Korean Medicine doctors can recognize the duty of care in the "some basic range" of knowledge belonging to western medicine. Conclusions : The interpretation of Korean Medicine practice are currently in compatible the argument that should clearly divide Korean medicine from Western medicine, and that should be changed in light of the changing medical environment. Therefore If Korean medicine's standard is applied to the extent to which Korean Medicine doctors are educated, it is necessary to define a new definition to actively interpret Korean Medical practice. The academic basis of Korean medicine and the level of Korean medicine practice based on the books that are traditionally available, and then current textbooks of Korean Medicine College, Korean Medicine Clinical Care Guidelines, and classification of Korean standard medical practices should be standardized. Increasingly, Korean Medicine practice should be interpreted according to reality, focusing on protecting and promoting the health of the people rather than academic differences.