• 제목/요약/키워드: Clinical evidence

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국내 근거기반간호의 현황과 발전 방향 (Current Status and Direction for Future Development of Evidence-based Nursing in Korea)

  • 최명애;방경숙;박연환;강현주
    • Perspectives in Nursing Science
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    • 제8권2호
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    • pp.129-138
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    • 2011
  • Purpose: The purpose of this study was to identify the current status of evidence-based research, education, and practice, and to suggest a directions for the future development of evidence-based nursing. Methods: To examine the current status of evidence-based nursing research, experimental research among studies published in the Journal of Korean Academy of Nursing from 2008 to 2010 were analyzed. We suggested a direction for the future development of evidence-based research based on the analysis and literature reviews. We also suggested a direction for the future development of evidence-based education and practice based on literature reviews. Results: The results showed that designs and methods of studies were insufficient to use evidences derived from the studies in terms of evidence-based research, and experimental studies consistent with themes were found to be deficient. In the future, the methods and rationale for the design of experimental studies need to be clearer In addition, a test for intervention effects through repetitive studies and a connection between the intervention effects and a protocol for clinical practice will be required. In terms of evidence-based education, curriculum revision and development of teaching methods including contents related to evidence-based practice and research methodology in undergraduate and graduate programs will be required. Evidence-based practice in Korea was less actively done than with that of foreign countries. Some large hospitals have recently attempted systemic activities to promote evidence-based nursing practice in clinical settings. To activate evidence-based practice, the perception of nurses for evidence-based practice needs to be changed and support for education and administration of the program is required. Also, evidence-based practice guidelines, protocols, and assessment tools need to be developed. Conclusion: Evidence-based nursing in Korea is in the process of evolving. To realize evidence-based nursing, we need to develop nursing science based on evidences of closer communication and cooperation in terms of nursing research, education, and practice.

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Conservative surgical approach to aggressive benign odontogenic neoplasm: a report of three cases

  • Kumar, Vijay
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제41권1호
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    • pp.37-42
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    • 2015
  • Aggressive benign odontogenic neoplasms have substantial potential to grow to an enormous size with resulting bone deformities, and they often invade adjacent tissues and spread beyond their normal clinical and radiographic margins; as such, they have a high rate of recurrence. Historically, management (conservative versus aggressive) on the basis of clinical, radiographic and/or histopathologic characteristics has been controversial. However, recent advances in the understanding of the biological features of these lesions may provide greater evidence of the benefits of conservative management. Three patients with different complaints and final histopathologic diagnoses were enrolled in the study. All three cases were treated by a single operator with similar conservative surgical procedures. During follow-up, the patients had uneventful secondary healing and bone regeneration, less packing time than previously reported, no clinical or radiographic evidence of recurrence and no apparent deformity. The aggressive behavior of these lesions requires long clinical and radiographic follow-up. Conservative surgical management may be an option to reduce recurrence and morbidity and increase the probability of uneventful secondary healing and bone regeneration.

CT Assessment of Myocardial Perfusion and Fractional Flow Reserve in Coronary Artery Disease: A Review of Current Clinical Evidence and Recent Developments

  • Chun-Ho Yun;Chung-Lieh Hung;Ming-Shien Wen;Yung-Liang Wan;Aaron So
    • Korean Journal of Radiology
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    • 제22권11호
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    • pp.1749-1763
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    • 2021
  • Coronary computed tomography angiography (CCTA) is routinely used for anatomical assessment of coronary artery disease (CAD). However, invasive measurement of fractional flow reserve (FFR) is the current gold standard for the diagnosis of hemodynamically significant CAD. CT-derived FFRCT and CT perfusion are two emerging techniques that can provide a functional assessment of CAD for risk stratification and clinical decision making. Several clinical studies have shown that the diagnostic performance of concomitant CCTA and functional CT assessment for detecting hemodynamically significant CAD is at least non-inferior to that of other routinely used imaging modalities. This article aims to review the current clinical evidence and recent developments in functional CT techniques.

국내 임상진료지침의 개발 현황 (An Investigation of Current Status of the Clinical Practice Guidelines in Korea)

  • 천부순;이영숙
    • 한국임상약학회지
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    • 제25권3호
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    • pp.178-186
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    • 2015
  • Objective: Clinical practice guidelines (CPGs) are systematically developed statements aimed at helping optimal care of the patient in a given clinical circumstance. Because of the increasing evidence that active implementation of CPGs improve health outcomes, there is a growing awareness of the importance of guideline development and dissemination. The objective of this study was to investigate the status of CPG development and availability of the CPGs in Korea. Method: We searched in the Web sites of 180 organizations to identify CPGs which were developed and/or published in Korea until 1 July 2014. The data of titles, published year, publisher, distributer, and accessibility at the internet web of all CPGs were collected and analyzed. Results: A total of 172 CPGs were developed and 80% had been released since 2009. Most (51.2%) were developed for management of 4 diseases: 28 for digestive system disease; 27 for infectious disease; 18 for endocrine and metabolic diseases; and 15 for neoplasms. Of the 172 CPGs, 150 CPGs were publicly available. Among the 150 CPGs, 78.7% (118/150) were developed by only one organization. Conclusion: To ensure the production of high-quality CPGs, it is necessary to collaborate with other relevant professional societies in guideline development process. In addition, stronger efforts on wider dissemination of CPGs must be employed at the country levels to promote implementation of CPGs in clinical settings.

간호사의 근거중심실무역량에 대한 영향요인 (Factors Influencing Competency in Evidence-based Practice among Clinical Nurses)

  • 김연숙;김지미;박미미
    • 간호행정학회지
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    • 제21권2호
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    • pp.143-153
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    • 2015
  • Purpose: The aim of this study was to describe competency in evidence-based practice (EBP) among clinical nurses and to explore critical thinking disposition (CTD) and organizational culture (OC) as possible predictors for competency in EBP. Also this study was conducted to identify baseline data for purpose of developing evidence-based OC to ensure safety of patients and to improve quality of nursing services in clinical setting. Methods: With a descriptive correlation study design, a competency in EBP questionnaire was administered to a convenience sample of nurses (N=393) from a single general hospital in Gyeonggi Province. Results: The overall mean score for competency in EBP was $3.03{\pm}0.53$. Factors influencing competency in EBP were education (${\beta}=0.23$, p<.001), attendance at lectures on EBP (${\beta}=0.18$, p<.001), intellectual eagerness & healthy skepticism (${\beta}=0.27$, p<.001) among CTD, and hierarchy-oriented OC (${\beta}=0.14$, p=.005), which explained about 35% of the total variance. Conclusion: Critical thinking and competency in EBP should be part of nursing education especially for undergraduate students as well as strengthening clinical practice by activation of EBP. The results of this study that hierarchy-oriented OC, is a significant predictor for competency in EBP is difficult to accept. Its seemed to require further exploration.

수용개작방법을 활용한 당뇨인의 발관리 실무지침 개발 (Development of Clinical Practice Guideline by Adaptation: Diabetic Foot Care)

  • 정인숙;박경희;송복례;심강희;한은진;홍은영;정영선;이선희;박동아;정재심
    • 임상간호연구
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    • 제21권2호
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    • pp.196-206
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    • 2015
  • Purpose: This study was done to use a guideline adaptation process to develop a Korean evidence-based diabetic foot care clinical practice guideline for diabetic foot prevention and management. Methods: The guideline adaptation process was conducted according to the guideline adaptation manual developed by the National Evidence-Based Healthcare Collaborating Agency. The process consists of three main phases, with 9 modules including a total of 23 steps. Results: The newly developed diabetic foot care clinical practice guideline consisted of an introduction, description of diabetic foot, summary of recommendations, recommendations, references, appendices, and glossary. There were 165 recommendations in 4 sections (risk assessment for diabetic foot ulcers, prevention of diabetic foot ulcers, wound assessment of diabetic foot ulcers, and management of the diabetic foot). In grading by recommendations, for A there were 30 (18.2%), B, 8 (4.8%), C, 30 (18.2%) D, 97 (58.8%). Conclusion: This guideline can be used as educational material for healthcare workers and diabetic patients. It can also be utilized as a practice guideline for healthcare workers in the hospital and community setting.

국내 근거기반 임상간호실무지침 주제의 우선순위 결정 (A Prioritizing for the Evidence-Based Nursing Practice Guidelines Development)

  • 구미옥;조명숙;조용애;정재심;은영;정인숙;박정숙;김혜정
    • 임상간호연구
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    • 제18권1호
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    • pp.39-51
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    • 2012
  • Purpose: Thisstudy was conducted with an aim to get a kind of prioritiesin developing the evidence-based nursing practice guidelines in fields. Methods: This study utilized a two-round Delphi surveys from November to December, 2010 with self-administered questionnaires which had a scale ranged from 0 to 9. A total of 95 head nurses working at the forty different general hospitals was asked to evaluate the priorities in four criteria; patient coverage, certainty, improvement in patient outcome and in nursing practice (first round) and 65 head nurses were asked to decide the importance of the criteria afterwards (second round). Results: The relative importance of 4 criteria was 22.3% in patient coverage, 26.5% in certainty, 23.5% in improvement of patient outcome, and 27.7% in improvement of nursing practice as the results of the 1st round and 20.6%, 26.6%, 24.8%, and 28.0% for the 2nd round, respectively. Top five nursing practices showed high scores after considering the relative importances of the 4 criteria were medication, intravenous therapy, checking vital sign, pain management, and diagnostic test or procedures care. Conclusion: It is recommended to take into account of the priorities that were found in this study when someone intends to develop a evidence-based nursing practice guideline.

Transcranial direct current stimulation for spinal cord injury-associated neuropathic pain

  • Li, Caixia;Jirachaipitak, Sukunya;Wrigley, Paul;Xu, Hua;Euasobhon, Pramote
    • The Korean Journal of Pain
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    • 제34권2호
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    • pp.156-164
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    • 2021
  • Several types of pain occur following spinal cord injury (SCI); however, neuropathic pain (NP) is one of the most intractable. Invasive and non-invasive brain stimulation techniques have been studied in clinical trials to treat chronic NP following SCI. The evidence for invasive stimulation including motor cortex and deep brain stimulation via the use of implanted electrodes to reduce SCI-related NP remains limited, due to the small scale of existing studies. The lower risk of complications associated with non-invasive stimulation, including transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS), provide potentially attractive alternative central neuromodulation techniques. Compared to rTMS, tDCS is technically easier to apply, more affordable, available, and potentially feasible for home use. Accordingly, several new studies have investigated the efficacy of tDCS to treat NP after SCI. In this review, articles relating to the mechanisms, clinical efficacy and safety of tDCS on SCI-related NP were searched from inception to December 2019. Six clinical trials, including five randomized placebo-controlled trials and one prospective controlled trial, were included for evidence specific to the efficacy of tDCS for treating SCI-related NP. The mechanisms of action of tDCS are complex and not fully understood. Several factors including stimulation parameters and individual patient characteristics may affect the efficacy of tDCS intervention. Current evidence to support the efficacy of utilizing tDCS for relieving chronic NP after SCI remains limited. Further strong evidence is needed to confirm the efficacy of tDCS intervention for treating SCI-related NP.

Probiotics in Children: What Is the Evidence?

  • Hojsak, Iva
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제20권3호
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    • pp.139-146
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    • 2017
  • The number of papers discussing probiotics increases tremendously that limits the possibility for primary care physicians and clinicians to stay updated. Therefore, the aim of this paper will be to summarize available evidence of probiotic use in well-defined clinical indications of importance for pediatricians. Based on currently available evidence certain probiotic strains (Lactobacillus rhamnosus GG [LGG] and Saccharomyces boulardii) have proven effect in the treatment of acute gastroenteritis and prevention of antibiotic associated diarrhea. Furthermore, LGG was proven to be effective in prevention of nosocomial diarrhea and respiratory tract infection in day care centers. In conclusion, not all probiotic strains have same efficacy for all clinical indications, therefore, only strains with proven efficacy and safety should be recommended.

A Study on the Evidence-Based Herbal Medicine

  • Park, Jin-Han;Cho, Young-Mook;Choi, Sun-Kyung;Kim, Na-Hyun;Lee, Ki-Taeg;Hong, Seung-Heon
    • Journal of Evidence-Based Herbal Medicine
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    • 제3권1호
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    • pp.9-18
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    • 2010
  • The use of complementary and alternative medicine (CAM) is currently widespread and appears to be growing. As an increasing proportion of the population turns to CAM therapies, whether singly or in combination with allopathic medicine, the need for quality research in this area is reinforced. Much of this research consists of clinical studies aim ed primarily at clinicians, yet challenges arising from poor methodological quality will occur w hen interpreting study findings and their implications. For clinicians to be effective consumers of the scientific literature, familiarization with the principles of evidence based medicine (EBM) is essential. The goal of this review is to introduce clinicians to the concept of critical appraisal of clinical studies and foster critical thinking when reading research articles in order to best evaluate and incorporate study findings into their daily practice.

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