• 대한간호학회지
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• 제23권4호
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• pp.569-584
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• 1993

This study was done to verify validity of nursing diagnoses related to difficulty in respiratory function. First, content validity was examined by an expert group considering the etiology and the signs / symptoms of three nursing diagnoses - ineffective airway clearance, ineffective breathing pattern, impaired gas exchange. Second, clinical validity was examined by comparing the frequencies of the etiologies and signs / symptoms of the three nursing diagnoses in clinical case studies with the results of the content validity. This study was a descriptive study. The sample consisted of 23 experts (professors, head nurses and clinical instructors) who had had a variety of experiences using nursing diagnoses in clinical practice, and 102 case reports done by senior student nurses of the college of nursing of Y-university. These reports were part of their clinical practice in the ICU. The instrument used for this study was a checklist for etiologies and signs and symptoms based on the literature, Doenges and Moorhouse (1988), Kim, McFarland, McLane (1991), Lee Won Hee et al. (1987), Kim Cho Ja et at. (1988). The data was collected over four month period from May 1992 to Aug. 1992. Data were analyzed using frequencies done with the SPSS / PC＋ package. The results of this study are summarized as follows : 1. General Characteristics of the Expert Group A bachelor degree was held by 43.5% and a master or doctoral degree by 56.5% of the expert group. The average age of the expert group was 35.3 years. Their average clinical experience was 9.3 years and their average experience in clinical practice was 5.9 years. The general characteristics of the patients showed that there were more women than men, that the age range was from 1 to over 80. Most of their medical diagnoses were diagnoses related to the respiratory. system, circulation or neurologic system, and 50% or more of them had a ventilator with intubation or a tracheostomy. The number of cases for each nursing diagnoses was : · Ineffective airway clearance, 92 cases. · Ineffective breathing pattern, 18 cases. · Impaired gas exchange, 22 cases. 2. The opinion of the expert group as to the classification of the etiology, and signs and symptoms of the three nursing diagnoses was as follows : · In 31.8% of the cases the classification of etiology was clear. · In 22.7%, the classification of signs and symptoms was clear. · In 17.4%, the classification of nursing interventions was clear. 3. In the expert group 80% or mere agreed to ‘dysp-nea’as a common sign and symptom of the three nursing diagnoses. The distinguishing signs and symptoms of (Ineffective airway clearance) were ‘sputum’, ‘cough’, ‘abnormal respiratory sounds : rales’. The distinguishing sings and symptoms of (Ineffective breathing pattern) were ‘tachypnea’, ‘use of accessory muscle of respiration’, ‘orthopnea’ and for (Impaired gas exchange) it was ‘abnormal arterial blood gas’, 4. The distribution of etiology, and signs and symptoms of the three nursing diagnoses was as follows : · There was a high frequency of ‘increased secretion from the bronchus and trachea’ in both the expert group and the case reports as the etiology of ineffective airway clearance. · For the etiologies for ineffective breathing pat-tern, ‘rain’, ‘anxiety’, ‘fear’, ‘obstructions of the tract, ca and bronchus’ had a high ratio in the ex-pert group and ‘decreased expansion of lung’ in the case reports. · For the etiologies for impaired gas exchanges, ‘altered oxygen -carrying capacity of the blood’ and ‘excess accumulation of interstitial fluid in lung’ had a high ratio in the expert group and ‘altered oxygen supply’ in the case reports. · For signs and symptoms for ineffective airway clearance, ‘dyspnea’, ‘altered amount and character of sputum’ were included by 100% of the expert group. ‘Abnormal respiratory. sound(rate, rhonchi)’ were included by a high ratio of the expert group. · For the signs and symptoms for ineffective breathing pattern. ‘dyspnea’, ‘shortness of breath’ were included by 100% of the expert group. In the case reports, ‘dyspnea’ and ‘tachypnea’ were reported as signs and symptoms. · For the sign and symptoms for impaired gas exchange, ‘hypoxia’ and ‘cyanosis’ had a high ratio in the expert group. In the case report, ‘hypercapnia’, ‘hypoxia’ and ‘inability to remove secretions’ were reported as signs and symptoms. In summary, the similarity of the etiologies and signs and symptoms of the three nursing diagnoses related to difficulty in respiratory function makes it difficult to distinguish among them But the clinical validity of three nursing diagnoses was established through this study, and at last one sign and symp-tom was defined for each diagnosis.

• 대한간호학회지
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• 제29권3호
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• pp.605-613
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• 1999

The main purposes of this study were to determine the time interval between the onset of symptoms of myocardial infarction and treatment-seeking time and to identify the factors related to the interval time. This study used a retrospective design. The sample consisted of 45 patients aged over 30 who were diagnosed with an acute myocardial infarction at two large university affiliated medical center from September 1, 1997 to June 30, 1998. Data was collected by using questionnaries, which included demographic data, permonitory clinical signs and symtoms of myocardial infarction, and a measure of the severity of the signs and symptoms. Also semi-structured interviews and chart reviews were used to obtain information related to treatment-seeking time. The results of this study are summarized as follows ; 1. The most frequent premonitory clinical symptom was chest pain(92.9%), the second, was perspiration(81.0%), and the next were nausea(40.5%) and dyspnea(38.1%). Thirty two patients reported having more than four premonitory signs and symtoms. Patients described the characteristics of chest pain as “somethings very heavy pressing down”(26.2%), “felt like my chest would burst”(24.4%), or “sharp pain”(16.7%), Over 95% of the sample reported having chest pain. 2. Twenty two (52.4%) patients reported to have “very severe” premonitory pain. 3. The mean time interval between the onset of signs and symptoms and the arrival at the medical center was 6.39$\pm$10.80 hours in 42 samples, the mean time from the onset to arrival at a local hospital was 3.27$\pm$5.39 hours and for transfer from a local hospital to the medical center was 4.75$\pm$9.87 hours in patients who had arrived at medical center via local hospital. 4. The severity of premonitory signs and symptoms did not differ significantly according to existence of premonitory signs and symptoms. 5. There was no significant relationship between treatment-seeking time and age, gender, marital status, economic status, occupation, or residence. But education had significant relationship(r＝－0.51, p＝0.01). Analysis of difference of the time interval according to the premonitory signs and symptoms showed that the time was shorter in patients who experienced nausea or dyspnea(U＝115.50, p＝0.01, U＝132.00, p＝0.04), however the severity of premonitory signs and symptoms did not have statistical significance.

• 생물정신의학
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• 제2권1호
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• pp.115-122
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• 1995

This study was performed to know the relationship between neurologic soft signs (NSS) and clinical variables such as psychopathology. history of illness, and premorbid social adjustment in patients with schizophrenia. The authors evaluated NSS in 31 patients with schizophrenia using the structured tool for measuring neurologic abnormalities, Neurological Evaluation Scale- Korean Version(NES-K). Relationships between NSS and clinical variables such as duration of illness, intensity of precipitating stressors, duration of outpatient treatment, schooling, peer relationship, total duration of unemployment, total days of psychiatric admission, age, total days of being medicated, age at the first psychiatric admission, frequency of admissions, content of treatment, social adjustment, and severity of symptoms were analyzed. Differences between paranoid and non-paranoid schizophrenics were examined. In addition, Differences between patients with schizophrenia who have predominant positive symptoms and who have predominant negative symptoms were examined too. Total scores of NES-K were correlated with lower schooling (${\gamma}$=0.44, p<0.01). Scores of motor coordination subcategory were correlated with poor peer relationship(${\gamma}$=0.67, p<0.001). Other clinical variables were not correlated with any scores of NES-K. Paranoid and non-paranoid schizophrenics were not different in scores of NES-K. Also positive and negative schizophrenics were not different in scores of NES-K. Most clinical variables except schooling and peer relationship were not related with NSS. This results indicated that the meaning of these signs was not fully be understood. Introduction of the new classification concepts such as deficit or non-deficit syndrome will be helpful to elucidate the meaning of NSS in patients with schizophrenia.

• 한방안이비인후피부과학회지
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• 제33권2호
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• pp.112-129
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• 2020

Objectives : The aim of this study is to explore the types of pattern identification (PI, 辨證) and the differential points of PI used for the treatment of psoriasis in Traditional Chinese Medicine (TCM) based on the Chinese references and to provide the evidences applying PI for the treatment of psoriasis in clinical practice. Methods : This study extracted patterns of psoriasis through database CNKI (China National Knowledge Infrastructure) and analysis the patterns and classification criteria of the patterns. Those examined in the study are dermal symptoms, general symptoms, formula and herbs which are different depending on the patterns. Results : Total 60 studies were selected and 44 pattern types were extracted from them. We categorized the main pattern types on psoriasis used in TCM as 'blood-heat syndrome(BHS, 血熱證)', blood-stasis syndrome(BSS, 血瘀證), and 'blood-dryness syndrome(BDS, 血燥證)', 'dampness-heat syndrome(DHS, 濕熱證)' and 'yang-deficiency syndrome(YDS, 陽虛證)'. Among these patterns, BHS was the most common. In TCM, the pattern of BHS tended to have skin symptoms and signs related to inflammatory erythema and heat. Both BSS and BDS were characterized by long disease duration and poor healing. In addition, DHS tended to have the skin symptoms and signs such as oozing and severe itching. The symptoms and signs related to coldness mainly showed in YDS. For PI criteria, 'qi-blood-essence criteria(氣血津液辨證)' and 'eight-doctrine criteria(八鋼辨證) are commonly used. Conclusions : Our findings show that each PI on psoriasis in TCM has different characteristics related to dermal and general symptoms or signs. Further studies are needed to develop the diagnostic tool of PI on psoriasis reflecting on clinical practices in Korean Medicine by referring to the findings of this study about PI on psoriasis in TCM.

• 동의생리병리학회지
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• 제20권6호
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• pp.1789-1792
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• 2006

To develop the Korean Standard Differentiation of the symptoms and signs for the Stroke(KSDS), the committee on Stroke Diagnosis Standardization of Korean Traditional Medicine was organized by nineteen experts in College of Korean Medicine, The Consensus of the second Consultation Meeting was as follows : First is the definition of the stroke on the Korean Traditional Medicine. Second is the five categories to the Differentiation of the symptoms and signs for the Stroke - fire and heat, dampness and phlegm, blood stasis, qi deficiency, yin deficiency. Third is the indices of the Differentiation of the symptoms and signs for the Stroke respectively. KSDS-1 will be applied to the clinical practice and revised. The Consensus of the third Consultation Meeting had agreed 81 symptoms indexes of KSDS.

• 대한중풍순환신경학회지
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• 제12권1호
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• pp.41-49
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• 2011

Objective : Stroke is the most common disabling neurological disease of adult life. And some part of the clinical symptoms and signs are correlated to the post stroke complication. This study was to analyze the therapeutic effect of the East-West collaborative treatment, especially on the motor power and the clinical symptoms and signs improvement of ischemic stroke patients. Method : For 2 weeks as possible, we observed the patients with acute ischemic stroke receiving East-West collaborative treatment. We assessed the patients using Motricity Index (MI) and the changes of clinical symptoms and signs three times at seven-day intervals. At the end of the study, we compared the results. Result : Motricity Index of patients changed from 71.55 to 76.03 (upper limb) and 73.05 to 79.42 (lower limb), respectively. Some items of clinical symptoms and signs showed the statistically significant result. Especially, the urination and defecation symptoms improved obviously. Conclusion : The East-West collaborative treatment has an effect on motor power and clinical symptoms and signs improvement of acute ischemic stroke patients.

• 동의신경정신과학회지
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• 제24권4호
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• pp.435-450
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• 2013

Objectives: The purpose of this study is to develop a standard tool for pattern identifications in Korean Medicine for depression. Methods: The advisor committee for this study was organized by 15 Korean Medicine neuropsychiatry professors from 11 Colleges of Korean Medicine. The items and structure of the tools were based on reviews of published literature. In order to develop the tool, we took the consultation from discussions with the advisor committee twice and also incorporated additional advices from e-mail correspondences. Results: 1) We divided the symptoms and signs of depression into 11 pattern identifications. 2) We obtained the mean weights which reflected the standard deviations from each symptoms of the 11 pattern identifications which were scored on a 100-point scale by 15 experts. 3) We designed the Korean medicine pattern identification tool for depression. It was composed of 66 questions in the question- and-answer format. Conclusions: There are some points which should be considered in this study. First, we couldn't reach a complete agreement on the concept of 11 patterns. Second, each pattern identification has a different number of symptoms and signs. In addition, the items of symptoms and signs of each pattern identification are unequal. Third, as we did not set any clinical trials when using this tool, it was not possible to test its validity and reliability. Although there are some limits in this study, the development of pattern identification tools for depression through discussions with the advisor committee is meaningful. If the validity and reliability of the Korean Medicine pattern identification tools for depression are confirmed through clinical trial,s this tool is expected to be applied to the subsequent researches in the future.

• 간호행정학회지
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• 제17권3호
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• pp.336-348
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• 2011

Purpose: This methodological study was done to develop a telephone consultation algorithms and practice guidelines for patient discharged with ophthalmic diseases. Methods: The ophthalmic problems of the patients were identified and expert knowledge on managing the problems was acquired. Algorithms and practice guidelines were developed based on the expert knowledge. The content validity of algorithms and practice guidelines was evaluated by the experts. Results: The preliminary algorithms and practice guidelines were developed from 60 detailed signs and symptoms and 45 nursing interventions. The experts agreed that 57 detailed signs and symptoms linked with nursing interventions were valid, with the content validity index over 80%. Meeting with nurse experts and ophthalmologists was convened to review the rest of the 3 detailed signs and symptoms linked with nursing interventions. Finally, 60 detailed signs and symptoms and 46 nursing interventions were confirmed. Conclusion: This study suggests that the algorithms and practice guidelines are effective decision-making tools and utilization of these algorithms and practice guidelines is expected to improve the quality of clinical nursing and patient satisfaction.

• Journal of Oral Medicine and Pain
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• 제21권1호
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• pp.103-113
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• 1996

The author examined the clinical signs and symptoms , routine radiographs, laboratory test and bone scan in 73 subjects with TMJ disorders and studied the responses of clinical test on patients, the distribution of signs and symptoms of joints, the simple uptake rate(SUR) of affected joints , the SUR of subclassified groups of TMJ disorders, active joints of subclassified groups of TMJ disorders and the SUR of joints with noises. The obtained results were as follows : 1. The percentage of joint pain on palpation, joint noises joint pain on function, mandibular dysfunction and active finding of bone scan in aptients with TMJ disorders were higher 2. The SUR was higher in joints affected by joint pain on function, joint pain on palpation, mandibular dysfunction and creptius. 3. The SUR of osteoarthrosis was the lowest. 4. The percentage of active joints were the highest in joints with discdisplacement without reduction, and followed by osteoarthritis, and disc displacement with reduction. 5. The SUR of TMJ showing joint noises only was lower.

• Journal of Yeungnam Medical Science
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• 제22권2호
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• pp.131-140
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• 2005

Heart failure is a clinical syndrome comprised of a number of symptoms and signs associated with congestion and/or hypoperfusion. Specific pharmacologic therapies have been developed to slow disease progression from early to more advanced stages. Once symptoms have developed, aggressive multimodality interventions are instituted to alleviate symptoms and improve clinical status and quality of life; especially in those patients that present symptoms. Recently, an evolving adjunctive therapeutic modality, that involves using implanted electrical devices: cardiac resynchronization with or without implantable cardioverter defibrillators (ICD). has been used for management. Cardiac resynchronization therapy (CRT) is a proven treatment for selected patients with heart failure-induced conduction disturbances and ventricular dyssynchrony. When used in combination with stable, optimal medical therapy, CRT is designed to reduce symptoms and improve cardiac function by restoring the mechanical sequence of ventricular activation and contraction. This review summarizes the rationale, procedure, clinical trials, and clinical indications for CRT.