• Title/Summary/Keyword: Clinical implication

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The Influences of Perceived Locus of Control to Patients with Pain (지각된 통제소재 (Locus of Control)가 통증환자의 심리상태에 미치는 영향)

  • Cho, Sun-Mi;Chin, Bum-Su;Song, Ho-Jeong;Kim, Chan;Han, Gyung-Lim
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.2
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    • pp.101-109
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    • 2002
  • Objectives: Cognitive-behavioral scientists have long been interested in how a pain patient's cognition such as locus of control relates to coping and adjustment. The present study examined the relationship of locus of control orientation to pain coping strategies, psychological distress and perceived pain intensity of patients with pain. Methods : Subjects were 96 patients with pain who visited pain clinic. All patients were administered the Multidimensional Health Locus of Control Scales, the Minnesota Multiphasic Personality Inventory, the Coping Strategies Questionnaire, and rating for perceived pain intensity, distress, and duration. Results : Correlational analysis revealed that patients who viewed outcomes as controlled by internality tended to have better ability to control and decrease pain. Also they tended to be less depressed and anxious. Regression analysis indicated that patients having a internal locus of control were more likely to use coping self-statement and reinterpreting pain sensation. Powerful others and chance locus of control orientation were predicted reliance on catastrophizing. Conclusion : The clinical implication of the present study is that cognitive factors of patients with pain such as locus of control influence emotional distress and coping. this study show that these factors should be applied to cognitive behavioral therapeutic intervention.

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The Effects of Low Intensity Resisted and Aerobic Exercise Training on Blood Lipid in Chronic Stroke Patients (저강도의 저항운동과 유산소 운동 훈련이 만성 뇌졸중 환자의 혈중지질에 미치는 효과)

  • Lee, Dong-Yeop;Cho, Nam-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.2
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    • pp.753-758
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    • 2011
  • The purpose of this study was to investigate effect of low intensity resistance exercise and aerobic exercise on serum lipid level in chronic stroke patients. A total of 37 chronic stroke patients were enrolled in this study. The participants were allocated randomly to 2 groups: the low intensity resistance exercise group(n=19) and aerobic exercise group(n=18). Low intensity resistance exercise group took exercise with low intensity resistance for 50minutes, 5 times per week over a 8 week period. Aerobic exercise group received only aerobic exercise. We measured serum lipid level to compare of effectiveness both exercises. Paired t test was executed to determine differences between pre and post exercise. For all analyses, a significant level set at p<.05. The low intensity resistance exercise group showed significant increase in TG, TC HDL-C and LDL-C(p<.05). The aerobic exercise group had significantly higher TC and LDL-C (p<.05). Theses results suggest that low intensity resistance exercise and aerobic exercise are feasible for stroke patients by improving motivation and interest. Further studies is necessary to clinical implication classified by onset time and disability level.

Does Process Quality of Inpatient Care Serve as a Guide to Reduce Potentially Preventable Readmission (PPR)? (의료서비스의 과정적 질과 잠재적으로 예방 가능한 재입원율과의 관계)

  • Choi, Jae-Young
    • Korea Journal of Hospital Management
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    • v.23 no.1
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    • pp.87-106
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    • 2018
  • Objective: The objective of this study is to examine the association between process quality of inpatient care and risk-adjusted, thirty-day potentially preventable hospital readmission (PPR) rates. Data Sources/Study Setting: This was an observational cross-sectional study of nonfederal acute-care hospitals located in two states California and Florida, discharging Medicare patients with a principal discharge diagnosis of heart failure, acute myocardial infarction, or pneumonia January through December 31, 2007. Data were obtained from the Healthcare Cost and Utilization Project State Inpatient Database of the Agency for Healthcare Research and Quality, Centers for Medicare and Medicaid Services Hospital Compare database, and the American Hospital Association Annual Survey of Hospitals. Study Design: The dependent variable of this study is condition-specific, risk-adjusted, thirty-day potentially preventable hospital readmission (PPR). 3M's PPR software was utilized to determine whether a readmission was potentially preventable. The independent variable of this study is hospital performance for process quality of inpatient care, measured by hospital adherence to recommended processes of care. We used multivariate hierarchical logistic models, clustered by hospitals, to examine the relationship between condition-specific, risk-adjusted, thirty-day PPR rates and process quality of inpatient care, after taking clinical and socio-demographic characteristics of patients and structural and operational characteristics of hospitals into account. Findings: Better performance on the process quality metrics was associated with better patient outcome (i.e., low thirty-day PPR rates) in pneumonia, but not generally in two cardiovascular conditions (i.e., heart failure and acute myocardial infarction). Practical Implication: Adherence to the process quality metrics currently in use by CMS is associated with risk-adjusted, thirty-day PPR rates for patients with pneumonia, but not with cardiovascular conditions. More evidence-based process quality metrics closely linked to 30-day PPR rates, particularly for cardiovascular conditions, need to be developed to serve as a guideline to reduce potentially preventable readmissions.

Effects of immediate and delayed light activation on the polymerization shrinkage-strain of dual-cure resin cements (즉시 광중합과 지연 광중합이 이원 중합 레진시멘트의 중합 수축량에 미치는 영향)

  • Lee, So-Yeoun;Kim, Sung-Hun;Ha, Seung-Ryong;Choi, Yu-Sung;Kim, Hee-Kyung
    • The Journal of Korean Academy of Prosthodontics
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    • v.52 no.3
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    • pp.195-201
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    • 2014
  • Purpose: This study was designed to compare the amount of polymerization shrinkage of dual-cure resin cements according to different polymerization modes and to determine the effect of light activation on the degree of polymerization. Materials and methods: Four kinds of dual-cure resin cements were investigated: Smartcem 2, Panavia F 2.0, Clearfil SA Luting and Zirconite. Each material was tested in three different polymerization modes: self-polymerization only, immediate light polymerization and 5 minutes-delayed light polymerization. The time-dependent polymerization shrinkage-strain was evaluated for 30 minutes by Bonded-disk method at $37^{\circ}C$. Five recordings of each material with three different modes were taken. Data were analyzed using one-way ANOVA and multiple comparison Scheffe′test (${\alpha}$=.05). Results: All materials, except Panavia F 2.0, exhibited the highest polymerization shrinkage-strain through delayed light-activated polymerization. No significant difference between light activation modes was found with Panavia F 2.0. All materials exhibited more than 90% of polymerization rate in the immediate or delayed light activated group within 10 minutes. Conclusion: As a clinical implication of this study, the application of delayed light activation mode to dual-cure resin cements is advantageous in terms of degree of polymerization.

Influence of the Alveolar Cleft Type on Preoperative Estimation Using 3D CT Assessment for Alveolar Cleft

  • Choi, Hang Suk;Choi, Hyun Gon;Kim, Soon Heum;Park, Hyung Jun;Shin, Dong Hyeok;Jo, Dong In;Kim, Cheol Keun;Uhm, Ki Il
    • Archives of Plastic Surgery
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    • v.39 no.5
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    • pp.477-482
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    • 2012
  • Background The bone graft for the alveolar cleft has been accepted as one of the essential treatments for cleft lip patients. Precise preoperative measurement of the architecture and size of the bone defect in alveolar cleft has been considered helpful for increasing the success rate of bone grafting because those features may vary with the cleft type. Recently, some studies have reported on the usefulness of three-dimensional (3D) computed tomography (CT) assessment of alveolar bone defect; however, no study on the possible implication of the cleft type on the difference between the presumed and actual value has been conducted yet. We aimed to evaluate the clinical predictability of such measurement using 3D CT assessment according to the cleft type. Methods The study consisted of 47 pediatric patients. The subjects were divided according to the cleft type. CT was performed before the graft operation and assessed using image analysis software. The statistical significance of the difference between the preoperative estimation and intraoperative measurement was analyzed. Results The difference between the preoperative and intraoperative values were $-0.1{\pm}0.3cm^3$ (P=0.084). There was no significant intergroup difference, but the groups with a cleft palate showed a significant difference of $-0.2{\pm}0.3cm^3$ (P<0.05). Conclusions Assessment of the alveolar cleft volume using 3D CT scan data and image analysis software can help in selecting the optimal graft procedure and extracting the correct volume of cancellous bone for grafting. Considering the cleft type, it would be helpful to extract an additional volume of $0.2cm^3$ in the presence of a cleft palate.

Psychological Characteristics of Infant Outpatients and their Parents in Korean Traditional Clinic (한의원 내원 환아 및 보호자의 정신건강 특성 연구)

  • Lee, Soo-Jin;Byun, Soon-Im;Kim, Kyung-Seon;Kim, Hye-Jin;Yang, You-Jin;Gang, Ki-Rim;Kim, Myoung-Geun;Choi, Hyeon;Chae, Han
    • The Journal of Korean Medicine
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    • v.30 no.5
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    • pp.88-101
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    • 2009
  • Objectives: Since Korean traditional medicine has an integrative perspective by its nature, the patients' psychological and physical problems in a Korean traditional clinic may be resolved through a more integrative approach. The purpose of this study was to describe the latent characteristics of psychological health of child outpatients and their parents visiting Korean traditional clinic with physical complaints and was to propose an alternative curriculum to meet their needs based on their psychological and physical aspects. Methods: Subjects studied consisted of 100 outpatients (59 boys, 41 girls, mean age 55 months, age range 18 to 83 months) and their parents. Behavior characteristics for children were measured by Korean version of Child Behavior Checklist for Ages 1.5-5 (CBCL1.5-5) while parenting stress, depression, and anxiety for parent were measured by Korean-Parenting Stress Index-Short Form (K-PSI-SF), Center for Epidemiologic Studies Depression Scale (CES-D) and State-Trait Anxiety Inventory (STAI), respectively. The data of subjects were compared to those of standardized groups and then were compared according to child's gender within sample. Results: Child participants were reported to have significantly higher scores of all CBCL 1.5-5 subscales than the standardized group. When compared, no differences of K-PSI-SF, CES-D, and STAI was found between parents of participants and the standardized groups. However, parents of child participants with at-risk psychological problems showed significantly higher scores of all parenting stress subscales than those of all child participants. In addition, the mothers of boy participants demonstrated significantly higher anxiety, depression and parenting stress than those of girl participants irrespective of psychological severity. Conclusions: We discussed the implication of these results in clinical situation and make recommendations for curriculum of psychiatry and pediatrics with the aim of improving proper diagnosis, consulting and treatment.

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Tooth size and arch parameters of normal occlusion in a Iarge Korean sample (한국인 정상교합자의 치아크키와 치열궁 계측치에 관한 연구)

  • Lee, Shin-Jae;Moon, Seong-Cheol;Kim, Tae-Woo;Nahm, Dong-Seok;Chang, Young-Il
    • The korean journal of orthodontics
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    • v.34 no.6 s.107
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    • pp.473-480
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    • 2004
  • The aim of this study was to establish normative data on the tooth size and arch parameters of Koreans with normal occlusion, This study employed the dental casts of 296 (male: 179; female 117) normal occlusion samples, who were selected from 15,836 adults through a community dental health survey. The mesiodistal diameters of teeth, arch width, and arch length were measured by digital electronic calipers(accurate to 0.01 mm) and Bolton's indices as well as intermaxillary arch width ratios were calculated. In order to ensure reliability, intra- and inter-examiner error were evaluated. Although our dimensional data showed overt differences between genders, the indices and intermaxillary ratios evaluated were the same. The resultant data obtained were compared with the previous data to reveal whether any changes have occurred over the time. The clinical implication of the present findings was also discussed. This biometric study seemed to provide a clinically applicable diagnostic criteria for an individual malocclusion patient.

Effects of Oketani Breast Massage on Breast Discomfort, Breast Milk Amount, and Breast Milk Total Protein (오케타니 유방마사지가 유방불편감, 모유량 및 모유 Total Protein에 미치는 효과)

  • Kim, Su-Mi;Jeon, Soon-Ie;Song, Seon-mi
    • The Journal of the Korea Contents Association
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    • v.18 no.1
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    • pp.493-503
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    • 2018
  • The purpose of this study was to measure the effects of Oketani breast massage on breast discomfort, The amount of the breast milk, and the total protein of the breast milk in early postpartum mothers. The design was a non-equivalent control group Quasi-experiment. In the nursing intervention, The Oketani breast massage was given to the experimental group twice after giving birth, and Self Mamma Care (SMC) training was given to the control group. The collected data were analyzed by $x^2-test$ and t-test. The results of the study showed that the Oketani breast massage was more effective than the SMC-treated control group because of decreasing breast discomfort and increasing the amount of breast milk and total milk protein. Therefore, the Oketani breast massage will help early postpartum mothers more easily breastfeed. For the implication for practice, this study suggests that Oketani breast massage can be used as the effective nursing intervention that facilitates breastfeeding of early postpartum mothers in clinical practice.

THE DEGREE OF EGO IMPAIRMENT IN ADOLESCENT PSYCHIATRIC PATIENT GROUPS (청소년 정신과 환자군을 대상으로 한 자아기능의 장애정도 비교 - Rorschach검사의 자아손상지표를 중심으로 -)

  • Oh, Youn-Hee;Kim, Zoung-Soul;Shin, Min-Sup
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.2
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    • pp.178-185
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    • 1999
  • Objective:This study was designed to examine the validity of the Ego Impairment Index(EII) in adolescent psychiatric patients(depression, depressive-conduct disorder, schizophrenia), and to explore the validity of the depressive-conduct disorder as a diagnostic entity. Method:19 depressives, 13 depressive-conduct disordered, and 10 schizophrenics with the age from 12 to 18 were selected based on DSM-IV and ICD-10 criteria, and their responses of the Rorschach and MMPI were analyzed. The EII was empirically developed by Perry and Viglione(1991) in order to assess the degree of ego impairment, and was derived from the Rorschach test. Results:It was founded that a single factor, ego impairment, was derived from the principal component analysis and explained 57.18% of total variances. The degree of ego impairment was grater in schizophrenics than in the other two groups, but there were no difference between depressives and depressive-conducts. Conclusions:These results offered support for the use EII as an empirical means of assessing the degree of ego impairment in adolescent patients. And these results suggest that depressive-conduct disorder group is more similar to the depressive group, implying that depressive-conduct disorder might correspond to so called masked depression. The clinical implication and limitation of present study were discussed.

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A Study of the Influence of 'the Separation of Prescribing and Dispensing Roles' Policy on Medical Institutions (의약분업실시에 따른 의료기관의 건강보험외래부문 순이익변화 추계)

  • Chung, Woo-Jin;Shin, Seung-Ho;Lee, Sun-Mi;Jung, Sang-Hyuk;Koh, Kwang-Wook;Park, Si-Woon;Shin, Eui-Chul;Lee, Sun-Hee;Hwang, Jin-Mee
    • Korea Journal of Hospital Management
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    • v.7 no.4
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    • pp.1-23
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    • 2002
  • This study examined the influence of the separation of prescribing and dispensing roles(SPD) policy implemented in Korea in July 2000, especially on the change in the net profit of medical institutions. Using the data set from the Korea's National Health Insurance and the previous research, this study elicited the following main results. First, tertiary care institutions was estimated to lose about 631 billion won after the SPD policy. Second, general hospitals and hospitals gained about 557 billion and 564 billion won, respectively. Third, it is shown that clinics also gained 389-659 billion won. Finally, however, the change in net profit of medical institutions after the SPD policy largely depends on different estimation models. Moreover, it also varies from the assumptions on the price differential of a reimbursable drug which worked as cross-subsidy to insufficient physician's fee before the SPD policy. Despite such limitations as lack of data outside of the National Health Insurance's coverage, this study differs from others. This is the first research to explore the effect of the SPD policy on different types of medical institutions and to attempt to purely focus on the SPD policy. In this study, we can draw the policy implication that preparing for a policy change, the government should set up the policy evaluation system to collect the concerned data and develop the methodologies in advance to the policy implementation.

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