• Journal of Korean Neurosurgical Society
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• 제65권2호
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• pp.255-268
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• 2022

Objective : Chronic subdural hematoma (CSDH) is a common disease in neurosurgical departments, but optimal perioperative management guidelines have not yet been established. We aimed to assess the current clinical management and outcomes for CSDH patients and identify prognostic factors for CSDH recurrence. Methods : We enrolled a total of 293 consecutive patients with CSDH who underwent burr hole craniostomy at seven institutions in 2018. Clinical and surgery-related characteristics and surgical outcomes were analyzed. The cohort included 208 men and 85 women. Results : The median patient age was 75 years. Antithrombotic agents were prescribed to 105 patients. History of head trauma was identified in 59% of patients. Two hundred twenty-seven of 293 patients (77.5%) had unilateral hematoma and 46.1% had a homogenous hematoma type. About 70% of patients underwent surgery under general anesthesia, and 74.7% underwent a single burr hole craniostomy surgery. Recurrence requiring surgery was observed in 17 of 293 patients (5.8%), with a median of 32 days to recurrence. The postoperative complication rate was 4.1%. In multivariate analysis, factors associated with CSDH recurrence were separated hematoma type (odds ratio, 3.906; p=0.017) and patient who underwent surgery under general anesthesia had less recurrence (odds ratio, 0.277; p=0.017). Conclusion : This is the first retrospective multicenter generalized cohort pilot study in the Republic of Korea as a first step towards the development of Korean clinical practice guidelines for CSDH. The type of hematoma and anesthesia was associated with CSDH recurrence. Although the detailed surgical method differs depending on the institution, the surgical treatment of CSDH was effective. Further studies may establish appropriate management guidelines to minimize CSDH recurrence.

• 기본간호학회지
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• 제9권2호
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• pp.226-236
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• 2002

Purpose: The purpose of this study was to investigate the effects of aromatherapy on the level of anxiety and fatigue in student nurses who were undergoing their first clinical practice. Method: A non-equivalent. control group. pretest-posttest design was used. A convenience sample of 42 student nurses were selected. They were assigned to experimental and control groups. The aromatherapy using lavender, geranium and camomile was given to the experimental group for four consecutive days while the control group only rested. Result: 1. Anxiety scores for the experimental group were significantly lower than those of the control group on the $2^{nd},\;3^{rd}$ and $4^{th}$ days of clinical practice. 2. Fatigue scores for the experimental group were significantly lower than those of the control group on the $2^{nd},\;3^{rd}$ and $4^{th}$ day of clinical practice. Conclusion: The results support the conclusion that aromatherapy using selected essential oils is an effective intervention for relieving anxiety and fatigue in student nurses experiencing their first clinical practice. However differences between aromatherapy and massage were not clear. Further investigation needs to be done.

• 보건행정학회지
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• 제20권2호
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• pp.1-16
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• 2010

Background : Clinical practice guidelines are an increasingly familiar part of clinical practice. Moreover, rigorously developed evidence based guidelines has been widely used. However, in Korea, some of published documents as clinical practice guidelines have shown considerable disparity in structure, contents and quality. This is mainly because there is no consensus on the definition and quality standard of clinical practice guidelines. The purpose of this study was to draw consensus on the definition and the quality standard about clinical practice guidelines. Method : We developed a questionnaire about the definition of clinical practice guidelines with inclusion criteria(23 items) and the quality standard(30 items). We selected 9 experts who had prior experience in developing and implementing guidelines. Rating methods for appropriateness of items were adopted from the RAND method. Consensus was drawn in three rounds. Results : Of the 47 items agreed, 40 items were determined to be appropriate. Clinical practice guidelines were defined as "scientifically and systematically developed statements to assist practitioners and patients on making decisions about appropriate health care for specific clinical circumstances." Narrative reviews, systematic reviews or health technology assessment without recommendations, translation of foreign guidelines, guidelines for patients only and training manuals were not considered as clinical practice guidelines. For the quality standard of clinical practice guidelines, 27 items were deemed necessary. Conclusions : The consensus on the definition with inclusion criteria and the quality standard of clinical practice guidelines carries an important meaning as the first attempt to draw a general agreement in our society. The unique achievement of the consensus reflects the current status of clinical practice guidelines that there has been a high tendency to adapt foreign guidelines. We hope efforts of this kind will continue to bring improvement in clinical practice guidelines.

• 기본간호학회지
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• 제13권1호
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• pp.6-14
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• 2006

Purpose: The purpose of this study was to investigate autonomy, teaching effectiveness, and clinical practice satisfaction for fundamentals nursing clinical practice in student nurses. Method: The participants were 244 sophomores, who had done the practice for 8 weeks from June 17 ${\sim}.33$ August 23, 2005. Autonomy the Caring Perspective(ACP) devised by Boughn(1995) was used to measure autonomy, Instrument to Measure Effectiveness of Clinical Instructor(IMECL) by Reeve(1994) for measuring teaching effectiveness, and an instrument by Moon(2002) for measuring satisfaction. Results: After practice, the role model was seen as rich in knowledge and experience(48.77%). Desirable categories for instructor were full-time professors with a practice background and head nurses(31.97%). Average score for autonomy was 3.71(${\pm}.33$), for teaching effectiveness, 3.67(${\pm}.48$) and for satisfaction 3.51(${\pm}.38$). Autonomy scores were high for students satisfied with their major(F=5.23, p=.006), and interested In practice(F=4.38, p=.014). Teaching effectiveness scores were high for students satisfied with practice (F=2.57, p=.038). Clinical practice satisfaction scores were high for students interested in practice(F=5.01, p=.007). Relationships between autonomy and teaching effectiveness (r=.174, p=.006), and between leaching effectiveness and satisfaction showed a positive correlation(r=.632, p=.000). Conclusion: Interest in clinical practice courses in first year affect autonomy, teaching effectiveness and satisfaction.

• 대한암한의학회지
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• 제20권1호
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• pp.55-79
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• 2015

Hepatocellular carcinoma(HCC) is the fifth most common cancer worldwide (fifth in male, seventh in female) and the third most common cause of cancer mortality. Since 2001, the various research group in the United States, Europe and Asia have published clinical practice guidelines for HCC. In Korea, a clinical practice guideline for HCC have been published by The Korean Liver Cancer Study Group in 2003, revised in 2009 and 2014. In China, oriental medicine clinical practice guideline have been published for the first time in 2014, and in the oriental medical profession of Korea, there is growing need for the guideline. This study will introduce the methods of diagnosis and the medical therapeutics which is commonly utilized for HCC in Korea, and existing korean medicine clinical practice guideline for Disease Analysis and Treatment(辨證論治) and herbal therapy of HCC. Further clinical research about various herbal medicines are needed to develop more advanced guideline of HCC.

• 대한통합의학회지
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• 제12권3호
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• pp.93-100
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• 2024

Purpose : This study aims to review the physical therapy training programs in the United States, Canada, Taiwan, and Japan, and propose standardization plan for clinical practice in physical therapy education to advance the development of physical therapy education in South Korea. Methods : This study investigates the clinical practice standards in advanced countries such as the United States and Canada, and refers to the clinical practice standards in Taiwan and Japan, which are members of the association of world phyisotherapy and have economic, cultural, educational, and healthcare delivery systems, as well as legal systems, similar to those of South Korea. Results : In the United States, physical therapy education programs allocate an average of 22 weeks and 880 hours for clinical practice. Foreign-trained physical therapists who wish to take the licensure exam in the United States must have their educational programs reviewed and recognized as having completed at least 1,000 hours of clinical practice. In Canada, physical therapy education programs allocate an average of 31 weeks and 1,240 hours for clinical practice. Taiwan allocates over 1,440 hours of clinical practice in its educational programs, while Japan requires 800 hours of clinical practice as a legal prerequisite for the licensure exam. Conclusion : Based on the results of this study, the following standardization plan for clinical practice of the physical therapy education in South Korea are proposed. First, a minimum of 16 weeks and 640 hours of clinical practice is necessary to produce competent physical therapists. Second, university-based basic practical training should be at least 440 hours, with the introduction of a standardized accreditation system and unification of the four-year academic system. Third, the qualifications of physical therapists who supervise clinical practice in medical institutions should be clearly defined in the curriculum, and the standards for clinical practice instructors need to be expanded.

• 대한물리치료과학회지
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• 제17권3_4호
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• pp.11-21
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• 2010

Purpose: To Provide 3 main principles that needs to be changed for clinical practice and suggest the frame of clinical practice in accordance with the change of generation. Methods: We reviewed literatures related with Clinical Practice. Results: The purpose of physical therapy is to maintain the client's motor and functional ability and enhance the quality of lifestyle. To carry out the principles of clinical practice effectively all the physical therapist must be able to comprehend as follows. First, physical therapy can be different generation by generation. Second, technical terminology must be used when communicate. Third, There are certain ways of process in physical therapy. Conclusion: Physical therapist that is heath care professional occupation in health related, is in need of constant endeavor. Also physical therapist must train oneself self-directed learning.

• Korean Circulation Journal
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• 제52권6호
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• pp.401-413
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• 2022

Pragmatic clinical studies, an emerging clinical research discipline, include a wide range of studies that are largely embedded with routine clinical practice and aim to evaluate the comparative effectiveness and safety of different clinical intervention strategies. Increased availability and quality of electronic medical/health records drives the development of pragmatic clinical studies. In this review, we describe evolution of the conceptual framework of pragmatic clinical studies and share perspectives on the importance of pragmatic clinical studies in evidence-based practice for cardiovascular diseases, as a complement to conventional randomized controlled trials. We also highlight specific needs of pragmatic clinical studies in improving evidence-based practice for cardiovascular disease in Asian countries. The main challenges of pragmatic clinical studies are discussed briefly in this review.

• 대한물리의학회지
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• 제17권3호
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• pp.41-50
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• 2022

PURPOSE: This study sought to investigate the change in the satisfaction levels of healthcare students regarding clinical practice before and after the coronavirus disease 19 (COVID-19) outbreak. METHODS: This was a longitudinal survey using a structured questionnaire. The first survey was conducted before the COVID-19 outbreak in April 2018, and the second survey was conducted after the outbreak from May to June 2022. The questionnaire used before and after COVID-19 had the same content and was categorized into the following six factors to determine clinical practice satisfaction: practice guidance, practice environment, practice time, practice evaluation, interpersonal relationships, and effectiveness of practice. Before the COVID-19 pandemic, a total of 153 healthcare students (average age: 22.43 ± 1.47 years old), participated from 4 departments: nursing, physical therapy, occupational therapy, and dental hygiene. After COVID-19, 84 students (average age: 22.75 ± 2.87 years old), from the physical therapy, occupational therapy, nursing, and dental hygiene departments participated in the survey. RESULTS: Clinical practice satisfaction was evaluated considering the factors of practical guidance, practice environment, practice time, interpersonal relationships, and practical effects. It was observed that the satisfaction with clinical practice increased in nursing, physical therapy, occupational therapy, and dental hygiene students after COVID-19 compared to the situation before the outbreak. There was no difference seen in the practice time and practice evaluation factors in the occupational therapy department and in the practice time factor in the dental hygiene department before and after COVID. CONCLUSION: In clinical practice under the extremely constrained circumstances imposed by the COVID-19 pandemic, it seems that the emotional internal response is greater, and the satisfaction with clinical practice appears to be relatively higher than before the outbreak.

• 기본간호학회지
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• 제11권1호
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• pp.21-30
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• 2004

Purpose: The purpose of this study was to explore perception of clinical experience between the initial and final practice and to explore changes in the perception of clinical experience. Method: The study used a Q-method to measure perception of clinical practice. Thirty-six statements made up the finalized Q-sample. The P sample used thirty three nursing college students from K university. The initial collection was done in the first semester of their junior year and second collection was done in the last semester of their senior year. The Q-sorts by each student were coded and analysed with the Quanl PC program. Result: Many students classified as having the perception type 'alienation of ideal and reality' or 'perception of limitation of ability' in the initial clinical practice changed to the type, 'active participation' by the final clinical practice. Further, in the initial clinical practice, part of 'active participation' and 'perception of limitation of ability' changed to 'alienation of ideal and reality'. Conclusion: This study shows that perception of their clinical practice by student nurses changed in a positive direction through clinical experience and that this fact was related to the level of satisfaction with nursing. The knowledge and understanding obtained in this research provide insights for nursing faculty and students involved in nursing education.