• 제목/요약/키워드: Clinical judgment

검색결과 119건 처리시간 0.023초

Diagnosis of diseases in livestock: Do's and not do's

  • Yoon, Kyoung-jin;Acvm, Diplomate
    • 한국수의병리학회:학술대회논문집
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    • 한국수의병리학회 2002년도 추계학술대회초록집
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    • pp.21-37
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    • 2002
  • Successful diagnosis of a disease in food-producing animals depends in many times on proper collection and handling of specimens, as well as careful clinical observation and evaluation of the diseased animals. During the period required to complete the appropriate laboratory tests, an awareness of the potential problems of disease spread to animals at risk and the available palliative treatments is essential. Because most microbial-induced diseases in herds or flocks cannot be effectively treated once the problem is established, management through prevention and control of the disease must be instituted to offer the maximum protection to animals at risk. Thus, the course of disease management for infectious diseases is oftentimes a difficult judgment decision. This paper presents a brief general guide to specimen collection and laboratory methods used for diagnosis of diseases in production animals. (omitted)

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Effects of integrated simulation education among nursing students during the COVID-19 pandemic in Korea

  • Shon, Soonyoung;Moon, Kyoung Ja
    • International Journal of Contents
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    • 제17권3호
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    • pp.38-47
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    • 2021
  • The purpose of this study was to analyze the effectiveness of integrated simulations conducted by virtual simulation and in situ simulation among nursing college students during COVID-19. This study was conducted from July 7 to 9, 2020 and the participants included 126 fourth-year nursing college students. Integrated simulation consisted of virtual simulation, teledebriefing, pre-briefing, in situ simulation, and debriefing. The results showed that after the use of various simulation modules and the training of integrated simulations incorporating virtual and in situ simulation training, critical thinking (t=5.20, p=<0.001), clinical judgment (t=6.71, p=<0.001), and simulation effectiveness (t=3.53, p=0.001). These findings could help establish the direction for more diverse forms of simulation-based education and it should be conducted in future nursing simulation during this COVID-19 pandemic era.

시뮬레이션 실습 교육에서 나타난 간호대학생의 임상수행능력에 대한 개념분석 (Conceptual analysis of nursing students' clinical competency in simulation-based practical training)

  • 이초원;김은영
    • 한국응용과학기술학회지
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    • 제40권5호
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    • pp.1176-1190
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    • 2023
  • 본 연구의 목적은 시뮬레이션 실습 교육에서 임상수행능력에 대한 명확한 개념의 속성을 규명하고 이를 조직화하여 임상수행능력에 대한 이론적 근거를 마련하기 위해 시도되었다. 연구 방법으로는 Walker And Avant의 개념분석 방법을 사용하였다. KISS, KMbase, DBpia, RISS, PubMed, CINAHL, Medline의 데이터베이스에서 보건의료인 교육을 위한 시뮬레이션 교육이 권고된 시점인 2000년부터 2023년 4월까지 보고된 논문을 수집하였다. 연구 결과 임상수행능력의 속성은 (1) 지식, 판단, 기술의 종합적인 능력, (2) 의료 환경 변화에 능숙히 대처하는 능력, (3) 간호 대상자의 요구에 적절하게 대응하여 간호 역할을 수행하는 능력이다. 본 연구는 시뮬레이션 실습 교육에서 임상수행능력에 대한 연구가 활발한 상황에서 간호학적 관점의 중요성을 인식하고, 개념분석을 한 연구로서 의의가 있다. 본 연구에서 나타난 시뮬레이션 실습 교육에서 임상수행능력 속성을 포함한 훈련 프로그램 및 도구를 개발하고 이를 활용하여 프로그램의 효과를 측정하는 것이 필요할 것으로 사료된다.

책임능력판단에 관한 범죄심리학적 이론과 정신장애 항변 연구 (A Study on the Responsibility Judgment and Mental Disorder of Criminal Psychology)

  • 임상곤
    • 시큐리티연구
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    • 제10호
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    • pp.293-322
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    • 2005
  • 본 연구는 형사책임과 관련성이 있다고 생각되는 일치추론이론과 외부귀인이론 등을 통해 도의적 책임판단에 관한 범죄심리학적 이론을 연구하여 미국에서 배심원이 유무죄의 평결을 도출해 내는 판단과정에 관한 이론적 관점들을 접근하고자 한다. 정신장애(insanity)는 형사책임능력에 관한 법적인 개념이며 임상적인 혹은 정신의학적인 개념이 아니다. 따라서 법체계가 다르면 정신장애의 정의도 달라지게 마련이다. 우리나 라 법과 미국의 법은 서로 매우 다른 체계를 가지고 있어서 미국법의 개념들이 한국법의 개념들과 불일치하는 경우가 매우 많은데, 형사책임능력에 관한 법이론적 개념들이 그 대표적인 예라고 할 수 있다. 우리나라의 형법은 심신상실(형사책임무능력)과 심신미약(한정책임능력)을 구분함으로 미국이나 영국에서 이용되는 정신장애의 개념이 직접 적용되지 않는다. 그럼에도 불구하고 최근에 들어 한국에서도 미국의 법에서 사용되는 정신장애의 개념에 대한 관심이 높아지고 있고, 형사책임의 법적판단에 임상적인 자료 및 전문가 의견이 큰 비중으로 고려되고 있으므로 법학과 심리과학(학문적 글로벌 개념)과 사이에 상호간 진지한 논의와 협력이 요구된다. 한국에서의 정신장애에 대한 정의와 구체적 기준들은 한국 형법의 전반적인 이론적 맥락에서 구축되어야 함은 분명한 것으로 사료된다. 그러나 그러한 조작정의가 객관적 진실을 전혀 도외시한 것이어서는 안된다고 사료되며, 따라서 이 문제에 관하여 실증적인 경험학문을 지향하는 심리학이나 정신의학 등의 행동과학과의 적극적인 협력이 절실히 요구된다.

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고위험 신생아 무호흡 응급관리 시뮬레이션 시나리오 평가 (Evaluation of Algorithm-Based Simulation Scenario for Emergency Measures with High-Risk Newborns Presenting with Apnea)

  • 신현숙;이유나;임다해
    • Child Health Nursing Research
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    • 제21권2호
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    • pp.98-106
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    • 2015
  • Purpose: This study was done to develop and evaluate an algorithm-based simulation scenario for emergency measures for high-risk newborns presenting with apnea. Methods: A one shot case study design was used to evaluate the algorithm-based simulation scenario. Effects of the developed simulation scenario were evaluated using the Simulation Effectiveness Tool (SET) and the Lasater Clinical Judgement Rubric (LCJR). From March to November 137 senior nursing students completed the simulation using this scenario. Results: The eight-frame simulation scenario was developed based on the Neonatal Resuscitation Program (NRP) and the nursing clinical judgment process. After use of the scenario, overall scores for SET and LCJR were 21.0 out of 26.0 and 32.4 out of 44.0 respectively. There were no significant differences in scores according to general characteristics. Positive correlation coefficients were identified among overall and subcategories of SET and LCJR. In addition, students provided positive feedback on the simulation experience. Conclusion: Considering that nursing students have limited access to high-risk newborns during their clinical experience and that newborns presenting apnea are common in the neonatal intensive care unit, the simulation scenario developed in this study is expected to provide nursing students with more opportunities to practice emergency measures for high-risk newborns.

근골격계질환 수술후 추나 기법 임상적용 현황분석 (Clinical Application Status Analysis of Chuna Manual Therapy after Musculoskeletal Disorder Surgery)

  • 이상진;이강준;박정식;송윤경
    • 척추신경추나의학회지
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    • 제14권2호
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    • pp.123-134
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    • 2019
  • Objectives : The purpose of this study was to analyze the clinical application status in papers related to Chuna Manual Therapy after musculoskeletal disorder surgery. Methods : We searched 6 electronic databases(RISS, DBpia, KISS, NDSL, OASIS, Pubmed) and 2 associated journals (Korea CHUNA Manual Medicine for Spine & Nerves, Korean Medicine Rehabilitation). We classified the papers by related musculoskeletal region and analyzed them in detail. Results : 1. Of the 24 papers included in the final analysis list, 13 were carried out for fascia and 18 for joints. 2. There were positive effects on the improvement of symptoms, including the relief of pain in patients, and there were no cases of severe side effects and adverse events. 3. Thus, CMT can be used as a safe and effective treatment if a skilled practitioner makes proper use of the follow-up procedure based on accurate judgment of the patient's postoperative condition. Conclusions : Through this paper, we expect that there will be active research on the clinical applications of Chuna Manual Therapy in Korean rehabilitation treatment after musculoskeletal disorder surgery.

태음인 소증 진단평가도구 개발 연구 (Study on the Development of Diagnosis and Assessment Instrument for the Original Symptom of Taeeumin)

  • 권진혁;이준희
    • 사상체질의학회지
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    • 제33권1호
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    • pp.57-89
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    • 2021
  • Objectives This study is aimed to develop a standard instrument of diagnosis and assessment for the original symptom of Taeeumin. Methods 1. Based on the clinical practice guidelines, the works of Dong-mu, and the expert clinical judgment of the research team, the items to be used in the instrument of diagnosis and assessment for the original symptom of Taeeumin were extracted, and translation was proceeded in plain Korean for easy application and feasible use in daily clinical practice. As a result, candidate items for the diagnosis and assessment tool were derived. 2. An online questionnaire survey was conducted on the candidate items derived through the above process to the expert advisory group for (1) inclusion/exclusion as diagnosis and assessment index (2) evaluation of importance and (3) the validity of translation. Results & Conclusions Through survey of expert advisory group, the number of candidate items were reduced and the preliminary weights were assigned. And based on this, was developed. There were a total of 9 items for Exterior Cold[Wiwanhan] original symptom diagnosis and assessment tool, 21 items for Interior Heat[Ganyeol] original symptom, 15 items for Exterior Disease Unfavorable Patterns[Wiwanhan-paejo] original symptom, and 17 items for Interior Disease Unfavorable Patterns[Ganyeol-paejo] original symptom, and the weights were reflected in each response score so that the final total score could be calculated.

간호대학생의 Virtual 시뮬레이션 실습 및 High fidelity 시뮬레이션 실습교육 경험 분석: 혼합연구방법 적용 (Analysis of the virtual simulation practice and high fidelity simulation practice training experience of nursing students: A mixed-methods study)

  • 이은혜;류소영
    • 한국간호교육학회지
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    • 제27권3호
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    • pp.227-239
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    • 2021
  • Purpose: This study used an exploratory sequential approach (mixed methods) design to explore essential meaning through comparing and analyzing the experiences of nursing students in virtual simulation practice and high fidelity simulation practice education in parallel. Methods: The study participants were 20 nursing students, and data were collected through focus group meetings from July 17 to August 5, 2020, and via online quantitative data from November 10 to November 15, 2020. The qualitative data were analyzed using Giorgi's phenomenological method, and the quantitative data were analyzed using descriptive statistics, the Mann-Whitney U test, Kruskal-Wallis H test analysis of variance and Spearman's ρ correlation. Results: The comparison between the two simulation training experiences was shown in five contextual structures, as follows: (1) reflection of the clinical field, (2) thinking theorem vs. thinking expansion, (3) individual-centered learning vs. team-centered learning, (4) attitudes toward participating in practical training, (5) metacognition of personal competency as a prospective nurse, and (6) revisiting the method of practice training. There was a positive correlation between satisfaction with the practice and the clinical judgment ability of high fidelity simulation, which was statistically significant (r=.47, p=.036). Conclusion: Comparing the experiences between virtual simulation practice training and high fidelity simulation practice training, which has increased in demand due to the Coronavirus Disease-2019 pandemic, is meaningful as it provides practical data for introspection and reflection on in-campus clinical education.

Problems Related to the Act on Decisions on Life-Sustaining Treatment and Directions for Improvement

  • Heo, Dae Seog;Yoo, Shin Hye;Keam, Bhumsuk;Yoo, Sang Ho;Koh, Younsuck
    • Journal of Hospice and Palliative Care
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    • 제25권1호
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    • pp.1-11
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    • 2022
  • The Act on Decisions on Life-Sustaining Treatment has been in effect since 2018 for end-of-life patients. However, only 20~25% of deaths of terminally ill patients comply with the law, while the remaining 75~80% do not. There is significant confusion in how the law distinguishes between those in the terminal stage and those in the dying process. These 2 stages can be hard to distinguish, and they should be understood as a single unified "terminal stage." The number of medical institutions eligible for life-sustaining treatment decisions should be legally expanded to properly reflect patients' wishes. To prevent unnecessary suffering resulting from futile life-sustaining treatment, life-sustaining treatment decisions for terminal patients without the needed familial relationships should be permitted and made by hospital ethics committees. Adult patients should be permitted to assign a legal representative appointed in advance to represent them. Medical records can be substituted for a patient's judgment letter (No. 9) and an implementation letter (No. 13) for the decision to suspend life-sustaining treatment. Forms 1, 10, 11, and 12 should be combined into a single form. The purpose of the Life-sustaining Medical Decisions Act is to respect patients' right to self-determination and protect their best interests. Issues related to the act that have emerged in the 3 years since its implementation must be analyzed, and a plan should be devised to improve upon its shortcomings.

병원 간호사의 자기효능감에 대한 개념분석 (Concept Analysis of Clinical Nurse's Self-Efficacy)

  • 김수진;윤소연;이보람;홍진하;황도연;유슬기;신나연
    • 디지털정책학회지
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    • 제2권3호
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    • pp.25-32
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    • 2023
  • 본 연구는 병원 간호사의 자기효능감에 대한 개념과 속성을 분석하는 것으로 간호학에서의 병원 간호사의 자기효능감 개념과 관련된 이론적 기초를 마련하는 것이다. Walker 와 Avant의 개념분석 방법을 적용하여 병원 간호사의 자기효능감에 대한 개념 분석을 하였다. 간호사로 하여금 스스로 임상 환경에서 오는 스트레스와 역경, 그로부터 수반되는 부정적 감정을 이겨낼 수 있다는 믿음과 기대를 갖게 하는 것, 간호사 자신에게 간호업무 수행 능력이 있다고 믿게 하여 명확한 방향성을 가질 수 있게 하는 것, 임상에서 일어나는 여러 상황을 통제할 적합한 판단력이 있다고 믿게 하여 업무를 속행 할 수 있게 하는 것, 간호 업무에 대한 적극적 참여를 통해 도전적인 목표 의식을 갖게 하고 미래를 위한 동기를 부여하는 것, 간호사 개인적 측면에서부터 환자나 병원 조직까지 다방면에 연쇄적으로 영향을 끼치는 것의 다섯 가지 속성으로 규명되었다. 본 연구를 통하여 자기 효능감 개념이 간호사 개인의 발전에서 끝나는 것이 아니라 직무 성과와 조직 몰입을 이끌어 내 병원이라는 조직에 영향을 미친다는 점, 임상에서 가장 중요한 환자 안전에 영향을 미치는 요인을 공고히 하기 위한 추가적인 연구가 필요할 것으로 생각된다.