• 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.

• 디지털융복합연구
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• 제13권10호
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• pp.549-559
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• 2015

이 연구는 국내 한의학 분야에서 발표된 체계적 문헌고찰 논문의 질을 AMSTAR 도구를 이용하여 평가해 봄으로써 최근 한의학계에서도 그 중요성이 강조되고 있는 근거중심대체의학(ECAM; Evidence-Based Complementary and Alternative Medicine) 연구의 문제점을 확인하고 향후 발전 방향을 모색해 보고자 하였다. DBPIA, OASIS, KISS 데이터베이스를 통해 검색한 한의학 분야의 체계적 문헌고찰 논문(26편)을 두 명의 연구자가 AMSTAR 평가기준에 따라 평가하여 분석하였다. 국내 한의학 관련 체계적 문헌고찰 논문의 질 평가 결과 평균 6.0점이었으며, 전체 26편의 논문 중 높은 수준의 체계적 문헌고찰 논문은 2편(7.7%), 보통수준 21편(80.8%), 낮은 수준은 3편(11.5%)인 것으로 나타났다. 또한 체계적 문헌고찰 연구의 질 평가 점수는 출판연도와의 관련성이 없는 것으로 나타났다. 이러한 결과를 근거로 향후 한의학 분야의 체계적 문헌고찰 논문의 질적 수준이 꾸준히 개선되어야 할 것으로 사료된다. 나아가, 한의학분야의 근거기반실무를 활성화하기 위한 꾸준한 노력은 보건의료분야의 융복합적 접근을 위한 발판 마련에 도움이 될 것이다.

• 임상간호연구
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• 제29권1호
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• pp.12-23
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• 2023

Purpose: This study was conducted to update the previous evidence-based nursing clinical practice guidelines for pressure injury. Methods: The guideline was revised in 22 steps based on the international standards. Results: The updated nursing practice guideline for pressure injury consisted of four domains and 494 recommendations. The numbers of recommendations in each domain was: 31 hospital policy, 64 assessment, 386 prevention and management, and 13 education. The recommended grade was 10.3% for A, 13.8% for B, and 75.9% for C. Of these, the major revision was done in 40 recommendations (8.1%). A total of 55 recommendations (11.0%) were newly added. 25 recommendations had minor revisions such as changes or additions for some words, and only one recommendation was deleted. Conclusion: The revised nursing practice guidelines for pressure injury are expected to serve as an evidence-based practice guideline for pressure injury in Korea. This guideline will provide healthcare providers, patients, and caregivers with information to help prevent and manage pressure injuries, leading to improving patient outcomes.

• 한국의료질향상학회지
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• 제24권2호
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• pp.41-61
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• 2018

Purpose: Falls are one of the most frequent health events in medical institutions, however, they can be predicted and prevented. The Quality Improvement Nurse Society clinical practice guideline Steering Committee developed the Clinical Practice Guideline for the assessment and prevention of falls in adult people. The purpose of this study was to assess the risk factors for falls in adults aged 19 years and older, to present an evidence for preventing falls, formulate a recommendations, and indicators for applying the recommendations. Methods: This clinical practice guideline was developed using a 23-step adaptation method according to the Handbook for clinical practice guideline developer (version 1.0) by National Evidence-based Healthcare Collaborating Agency. Evidence levels and recommendation ratings were established in accordance to SIGN 2011 (The Scottish Intercollegiate Guidelines Network). Results: The final 15 recommendations from four domains were derived from experts' advice; 1) assessment of risk factor for falls in adult 2) preventing falls and reducing the risks of falls or falls-related injury 3) management and reassessment after a person falls 4) leadership and culture. Conclusion: This clinical practice guideline can be used as a basis for evaluation and prevention of fall risk factors for adults, to formulate recommendations for fall risk assessment and fall prevention, and to present monitoring indicators for applying the recommendations.

• 사상체질의학회지
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• 제34권2호
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• pp.48-64
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• 2022

Objectives The purpose of this study was to review and evaluate the clinical evidence of the efficacy and safety of treatment based on Sasang constitutional medicine (SCM) for post-stroke patients by systematic review and meta-analysis. Methods Randomized controlled trials (RCTs), published in 10 electronic databases up to December 2020, were searched. For the included studies, Cochrane's risk of bias assessment was performed to analyze the methodological quality. The strength of evidence was evaluated using the grading of recommendations assessment, development, and evaluation system based on the results of analyses. All review processes were performed by two independent researchers. Results Five RCTs were finally included. All included RCTs were conducted for one month on post-stroke patients in 60-80s, four studies on Tae-Eum patients and one study on So-Yang patients. Four types of constitution-specific herbal medicine (Chungpyesagan-tang, Cheongsimsanyak-tang, Yeoldahanso-tang, and Yangkyuksanhwa-tang) and constitution-specific acupuncture therapy were identified as interventions. More than half of the included studies were evaluated as low quality due to the high-risk of bias in selection, performance, and detection. The combination of constitution-specific herbal medicine, acupuncture, and conventional treatment was more effective in improving the patients' motor impairment, dysphagia, aphasia, and depression than conventional treatment alone. No serious adverse events by SCM treatment were reported. Conclusions SCM treatment may improve the sequelae of post-stroke patients safely in combination with conventional treatment. Since the quality of clinical evidence included in this study was low, higher quality clinical evidence obtained in well-designed clinical studies will be needed.

• 영어어문교육
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• 제8권2호
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• pp.177-196
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• 2003

The purpose of this study is to help teachers and program developers develop comprehensive and authentic assessment models with appropriate ways of using various kinds of assessment tools in college English instruction and assessment. Assessing by traditional discrete tests based on grammar and vocabulary cannot measure the authentic ability for language use in meaningful context in the real world. Currently, the trend in language assessment is changing to performance assessment. Increased use of performance assessments that involve language students in selecting and reflecting on their learning means that language teachers will have a wider range of evidence on which to judge whether students are becoming purposeful and are able to communicate as English users. Also, language programs focused on performance assessment are likely to instil in students authentic skills related to communication in the global world and enable them to evaluate what they learn from their English classes. In this study, the author investigated the theoretical background, the need of change, and several types of performance assessment.

• Asian Pacific Journal of Cancer Prevention
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• 제14권6호
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• pp.3785-3792
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• 2013

This study aimed to discover to what extent ethical issues are considered in the reimbursement decision process based on health technology assessment (HTA) in Korea, especially for oncology medications. Public summary documents (PSDs) published by the Health Insurance Review and Assessment Service (HIRA) were analyzed for empirical and normative factors. For external comparison, PSDs presented by corresponding institutions of Australia and the United Kingdom were employed. Furthermore, the opinions of eight expert oncologists were obtained regarding the accountability of the evidence in PSDs. Among 7 oncology drugs, there were differences in the final decisions and empirical factors considered, such as selected comparators and interpretation of evidence between the PSDs from the three institutions. From an ethical viewpoint, the following matters were deficient in the HTA decision-making process for oncology drugs: clear and reasonable standards; identifying and evaluating ethical values; and public accountability for reasonableness about decisions and due process.

• Nuclear Engineering and Technology
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• 제54권3호
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• pp.948-958
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• 2022

Since reliability and security of man-machine system increasingly depend on reliability of human, human reliability analysis (HRA) has attracted a lot of attention in many fields especially in nuclear engineering. Dependence assessment among human tasks is a important part in HRA which contributes to an appropriate evaluation result. Most of methods in HRA are based on experts' opinions which are subjective and uncertain. Also, the dependence influencing factors are usually considered to be constant, which is unrealistic. In this paper, a new model based on Dempster-Shafer evidence theory (DSET) and fuzzy number is proposed to handle the dependence between two tasks in HRA under uncertain and dynamic situations. First, the dependence influencing factors are identified and the judgments on the factors are represented as basic belief assignments (BBAs). Second, the BBAs of the factors that varying with time are reconstructed based on the correction BBA derived from time value. Then, BBAs of all factors are combined to gain the fused BBA. Finally, conditional human error probability (CHEP) is derived based on the fused BBA. The proposed method can deal with uncertainties in the judgments and dynamics of the dependence influencing factors. A case study is illustrated to show the effectiveness and the flexibility of the proposed method.

• 대한치과의사협회지
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• 제52권8호
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• pp.464-471
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• 2014

This article reviewed theological background and historicak development in dental caries management by risk assessment. Dental caries prevention and treatment according to CAMBRA model is patient-centered, risk-based, evidence-based practice. Team approach is necessary and clinician need to integrate science, practice and product. Dental hygienist take a important role in implementing CAMBRA. CAMBRA model could be incorporated into dental and dental hygiene education. Dentist and dental hygienist able to provide scientific and ethical care managing dental caries by risk assessment.

• 임상간호연구
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• 제18권1호
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• pp.159-170
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• 2012

Purpose: This study was designed to examine the validity of the evidence-based guideline on pain developed by Registered Nurses Association of Ontario(RNAO) translated into Korean based on the experts' opinions. Methods: The panel consisted of experts of 60 registered nurses in surgical units, medical doctors and nursing managers who were experts in pain assessment and management. The validity of translated RNAO guideline was evaluated in terms of appropriateness, applicability, and utilization in current practice. Appropriateness and applicability of each recommendation were measured with 9 point scale, whereas utilization was measured by yes/no question. Data were analyzed by mean, standard deviation, and percent. The experts' opinions were analyzed by content analysis method. Results: In general, most of the recommendations in the guideline received above 7 point in appropriateness and applicability. However, above 20% of recommendations showed less than 50% of utilization rates in current practice. Conclusion: The reasons for low utilization of recommendations in current practice are in need for investigation. This study can be used for the development of guideline more acceptable in Korean health care settings and improve the quality of care for the abdominal surgery patients suffering from pain in Korea.