• The Journal of Korea Assosiation for Disability and Oral Health
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• v.10 no.2
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• pp.61-67
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• 2014

The aim of this study was to analyze the clinical characteristics of patients with cognitive and behavioral impairments receiving dental treatment under general anesthesia (GA-dental treatment). From August 2007 to April 2014, information was collected from 475 patients who received GA-dental treatment at the Clinic for Persons with Disabilities, Seoul National University Dental Hospital. The demographic factors (gender, age, disability, medication, GA history, residency type, caregiver, meal type, oral hygiene maintenance, and cooperation level) and dental status (operating duration, DMFT, malocclusion, periodontal disease, tooth defect, and treatment protocol) of the patients were evaluated. DMFT and malocclusion levels were compared among the patients with ANOVA and Sheffe's post-hoc test, and chi-square test, respectively. The correlation between the demographic characteristics and dental status of the patients were analyzed with the Pearson's correction test. The mean age of the patients was 27.1 (7 - 83) years and they had intellectual disabilities (55.4%), developmental disorders (17.9%), brain disorders (16.6%), neurocognitive disorders (4.6%), or others (5.5%). The mean DMFT (DT) was 8.6 (5.2) with a significant difference among the disability types (p<0.05). The incidence of malocclusion was higher in patients with intellectual disabilities and brain disorders than in the other types (p<0.05). The operation time ($191.4{\pm}91.2min$) was correlated with decayed or endodontically-treated teeth (p<0.05). Special needs patients requiring GA-dental treatment showed unfavorable oral conditions. Dental practitioners experience time restrictions and additional costs under a GA setting. Treatment planning and decision-making can be efficiently facilitated by evaluating the clinical characteristics of the patients.

• Journal of Korean Neurosurgical Society
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• v.63 no.4
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• pp.470-476
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• 2020

Objective : The objective of this study was to develop a score to predict patients with acute ischemic stroke (AIS) who will not benefit from endovascular treatment (EVT) using computed tomographic angiography (CTA) parameters. Methods : The CTA-ABC score was developed from 3 scales previously described in the literature: the Alberta Stroke Program Early CT Score (0-5 points, 3; 6-10 points, 0), the clot burden score (0-3 points, 1; 4-10 points, 0), and the leptomeningeal Collateral score (0-1 points, 2; 2-3 points, 0). We evaluated the predictive value of CTA parameters associated with symptomatic intracranial hemorrhage (sICH) or malignant middle cerebral artery infarction (MMCAI) after EVT and developed the score using logistic regression coefficients. The score was then validated. Performance of the score was tested with an area under the receiver operating characteristic curve (AUC-ROC). Results : The derivation cohort consisted of 115 and the validation cohort consisted of 40 AIS patients. The AUC-ROC was 0.97 (95% confidence interval [CI], 0.94-0.99; p<0.001) in the derivation cohort. The proportions of patients with sICH and/or MMCAI in the derivation cohort were 96%, 73%, 6%, and 0% for scores of 6, 5, 1, and 0 points, respectively. In the validation group, the proportions were similar (90%, 100%, 0%, and 0%, respectively) with an AUC-ROC of 0.96 (95% CI, 0.90-1.00; p<0.001). Conclusion : Our CTA-ABC score reliably assessed risk for sICH and/or MMCAI in patients with AIS who underwent EVT. It can support clinical decision-making, especially when the need for EVT is uncertain.

• Korean Journal of Adult Nursing
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• v.14 no.2
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• pp.296-305
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• 2002

Purpose: The purpose of this research was to describe how nurses in intensive care units (ICU) work. Method: A total of 18 ICU nurses participated in the research. The data was collected through individual in-depth interviews and analyzed by grounded theory method using NUDIST 4.0 software program. Results: Three different patterns regarding nursing performance among ICU nurses were identified. These are 1) nursing performance of nurses who perform excellently, 2) nursing performance of nurses who do not perform well because of their lack of experience, and 3) nursing performance of nurses who do not perform well in spite of their good years of experience. These three different nursing performances were described in terms of seven different categories; 1) assessing and monitoring nursing problems, 2) clinical decision making, 3) interpersonal relationships, 4) holistic care, 5) technical skills, 6) problem solving, 7) working independently and creatively. This study also identified two intervening factors that influenced the advancement of their expertise. Conclusion: The results of this study might help nurse managers in developing continuing educational programs for inexperienced nurses or those nurses not performing well to become experts by a deeper understanding of the nature of nursing performance and the factors that influence nursing performance in ICU settings.

• Journal of the Korea Convergence Society
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• v.11 no.9
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• pp.65-72
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• 2020

This study conducted to investigate the core competency of dental hygiene based on learning outcomes for establishing an educational evaluation and certification system for dental hygiene. The sub-categories of core competencies, the overall score of professional behavior and ethical decision-making ability (category 1) and the ability to apply scientific and professional clinical hygiene and knowledge and skills of clinical dental work (category 2) was highest. and the level of communication skills (category 3) was 4.48 points, and the level of evidence-based integrated thinking and problem solving skills (category 5) was 4.35 points. Furthermore, there was a strong correlation between the core competency sub-categories, and it is necessary to identify the core competency between health care service occupations and to qualitatively study the core competency of dental hygienists working in clinical practice.

• Journal of Pharmacopuncture
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• v.22 no.3
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• pp.131-139
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• 2019

Introduction: Mastalgia is the most common benign breast disorder during the fertility period of women. So far a wide range of natural or complementary medicines is used to cure mastalgia. Sanitary organizations need complete and suitable details to help women, for making the proper decision for alternative treatment based on the evidence. The aim of the present study is to introduce medicinal plant-based treatments about mastalgia and summarizes clinical trials about this disorder. Method: The articles were provided using mixture of keywords including cyclic pain, breast, treatment, therapeutics, therapy, clinical trial, herbal, drug, mastalgia and all the probable terms, in national and international databases SID, Iran Medex, Magiran, PubMed, Scopus, Medline, Science direct and Cochrane library, in both Persian and English languages. All cross-sectional and review articles about herbal treatment of mastalgia until 2018 November were studied. Results: Nineteen articles from all of the available articles (45 cases) and a sample size about of (1987 cases) were included in our study. The articles were clinical trials. The results revealed that mastalgia could be healed by Nigella sativa, Vitex agnus-castus, curcumin, Hypericum perforatum, Citrus sinensis, wheat germ, and Ginkgo biloba. Conclusion: Most of the evaluated medicinal plants possessing antioxidant compounds with anti-inflammatory and analgesic properties, exhibited healing effects in the treatment of mastalgia. Thus, medicinal plants can be considered in the treatment of mastalgia; however, further investigations are needed to obtain more details about their probable side effects.

• Journal of Korean Academy of Nursing Administration
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• v.4 no.2
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• pp.475-487
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• 1998

This is a study to search for the ethical basis for valid informed consent of organ donors. It is an admirable action that a person give his own body part or organ as a gift to another person. The organ for transplantation can be removed only when the donor consents voluntarily to donation. It is recently proposed as the need for organ transplantation is increased that organs can be harvested although the consent of deceased cannot be obtained. This may raise many moral issues because human beings all have an unalienable right to control their own bodies. The principle of autonomy is usually regarded as an ethical basis for informed consent. However, some people criticize that the principle of autonomy requires a person and his decision to be autonomous (but there are many patients who aren't autonomous due to their confusion or unconscious condition in a clinical situation). or this principle can foster indifference to patients needing help: thus respect for principles of care and beneficence is necessary. When we consider the complexity of making a decision about organ donation. the principle of autonomy should be replaced by the principle of respect for individual autonomy. as expressed by Childress (1990). This principle requires the care givers to respect the client's individual decisions. The elements of informed consent are threshold elements: competence to understand and decide. voluntariness in deciding: information elements: disclosure of material information. recommendation of a plan. understanding of disclosure and recommendation: and consent elements: decision in favor of a plan. authorization of the chosen plan. In cases of living donors. the elements of competence and voluntariness are more important than the others. So only an adult can give a recipient his own body part. but it should be forbidden to harvest from minors or protected adults (i.e. developmentally disabled person However. when organs are removed from a cadaver donor. we ought to respect the donor's decision. So we ought to try to seek donor cards or any documents expressing the donor's opinion about organ transplant. All health care givers ought to disclose donor information about organ transplantation clearly enough for the donor to understand it and to be able to weigh the harms and benefits. We are going to propose 'the subjective standard' as the ethical standard of disclosure. This standard will assure that patients have enough information to be able to decide autonomously from their own position. Care givers have to consider the method of disclosure because donors can be influenced by it positively or negatively, Establishment of the Hospital Committee is recommended. because medical professionals will have a chance to discuss the procedure of decision and the validity of harvesting a organ from a person.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.4
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• pp.304-310
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• 2017

This study is a methodological research study that tests the validity and reliability of the NCRC (Nurse Clinical Reasoning Competence scale), an instrument developed by Liou and his colleagues as the basic data for enhancing the clinical reasoning competence of nurses, by translating it into Korean and checking the similarity of the sentence structure and meaning (between the two versions?). This study verified its validity and reliability by examining 166 nurses working in four tertiary hospitals located in Seoul and Busan. An analysis of the content validity by experts showed that all of the items have a content validity higher than CVI 0.8. From the exploratory and confirmatory factor analysis, it was found that the instrument includes a total of 15 items consisting of one factor. In addition, the correlation with the Korean version of the Nurse Clinical Reasoning Competence scale is confirmed to test the concurrent validity, by using a measurement tool of nurses' critical thinking dispositions and clinical decision-making abilities (correlation coefficient =.55-.64(p<.001) and Cronbach's ${\alpha}=.93$). Thus, the Korean version of the NCRC may be a useful instrument for evaluating the clinical reasoning competence of Korean nurses and providing the basic data for assessing their clinical reasoning competence and developing their promotion strategies.

• Therapeutic Science for Rehabilitation
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• v.1 no.2
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• pp.41-53
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• 2012

Objective : The purpose of the research is to investigate Korean occupational therapists' awareness of Evidence-Based Practice(EBP), basis of clinical decision making, barrier factors of EBP execution. Methods : Form December 2009 to March 2010, 500 questionnaires were sent out to clinical occupational therapists and 160 questionnaire which are returned by the therapists were analyzed through descriptive statistics. Results : There are more female respondents than male. More than 90% of them had less than 5 years experience. Most of respondents hadn't experienced education concerning EBP(76%), and the education is not periodically conducted(55%). Moreover, treatment was being tailored based on subjective judgement. On the other hand, the degree of recognition showed that the professionalism of occupational therapists can be improved through EBP(96%), and be helpful to make clinical decision(88%). Most of the therapists answered that guaranteeing enough time to search the basis of treatment(90%) and participating in the education course(92%) is needed to make EBP applicable. This result shows that while the application rate of EBP is low, the recognition rate of EBP is high, which means it is necessary to revitalize EBP education program. Conclusions : In order to provide quality service, education course and instructor training program is needed. We should also make a great effort to offer evidence-based education to occupational therapy students. Furthermore, EBP has to be carried out to improve the professionalism of occupational therapists, and the research about education program and its effect has to be executed.

• Journal of Physiology & Pathology in Korean Medicine
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• v.20 no.1
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• pp.202-208
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• 2006

The goal of this study is to develop knowledge representation method for the construction and evaluation of ontology for diagnosis in oriental medicine. To develop the expert system for decision making on diagnosis and treatment, the systematic and structural knowledge which can be processible in EMR(Electronic Medical Record) must be precedent, and the Computational Process which control the system as well. This study set up an ontology as a trial model to represent the oriental medical knowledge into the machine processible one. Protege 2.1 has been used to build the ontology, and the serialization format of our ontology is the XML document based on OWL. The components of oriental medical diagnosis was arranged with the combination of symptoms which belong to the certain symptom patterns. Then natural language which expresses the oriental medical diagnosis components were converted into the logical sentence, and individual characteristic symptoms into each values of specific properties. In addition to the study, the diagnosis software for oriental medicine was developed and it used the ontology which we developed. Sequently, we tested the software to confirm the appropriateness of ontology. The result of the test shows that diagnostic questions are automatically formulated according to the diagnosis components of this ontology and that as such diagnostic results are induced. Therefore, the ontology system in this study will be efficient to develop the diagnosis program and useful as a tool for doctors to make decision. But, it is not recommendable to apply the system to the clinical environment until the clear diagnosis standards are introduced, and the more reliable diagnosis program can be developed based on the more appropriate ontology mentioned above.

• The Journal of Korean Medicine
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• v.40 no.1
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• pp.46-62
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• 2019

Objectives: This study was made by Chung Yeon Korean Medicine Hospital in order to perform appropriate East-West integrative medicine. The purpose of this manual is to support decision-making and communication in the implementation of the East-West cooperative treatment of vascular dementia. Methods: In order to carry out this study, it is based on search terms such as 'vascular dementia', 'acupuncture', 'herbal medicine', 'integrative medicine', 'chinese traditional medicine', and 'cognitive function' in databases such as MEDLINE, EMBASE, OASIS and CNKI We collected references. The drafting proceeded with the collaboration of two specialists of the Korean medicine, and the disagreement on the basis of the quotation was determined through a two person agreement. After, The draft was reviewed by a western medical doctor(rehabilitation specialist). Then, The opinions of the entire medical staff of the committee were reflected in the draft and finalized the agreement. Results: Through this study, manuals for diagnosis, treatment, and other considerations in the process of applying East-West integrative medicine to vascular dementia were derived. Conclusions: This study has significance in that it provides manual information about the decision structure, treatment contents, role distribution, etc. of East-West integrative medicine within the medical institution that conducts the vascular dementia consultation. In order for this study to function as a generalized medical guideline, it is necessary to improve the research methodology and carry out professional consensus procedures.