• 한국보건간호학회지
• /
• 제15권2호
• /
• pp.376-386
• /
• 2001

I. Background The problem of discharging patients from hospital have been well documented in the literature over the last 20 years. They included poor communication between hospital and community, inadequate notice of discharge, over-reliance on informal support and lack of statutory support, inattention to patients needs before leaving hospital, and wasted or duplicated visits by community nurses. Most patients discharged from hospital are able to return home with little or no support, while others will require a 'package of care' to support them back to good health. Patient with complex care needs, including the frail elderly and those with mental health problems, may require continuing care in special housing, residential, or nursing homes. With this population,effective discharge arrangement is needed and the study on this problem is urgent in Korea because the Medical Reform Project is on suspension of success. II. Results of the Study: 1. Discharge service needs assessed on 360 elderly patients who were hospitalized during the survey period at four university hospitals. Patients want to know the information on disease management after discharge. Follow-up telephone service is the most frequently checked service. 2. Multidisciplinary Discharge Planning is recommended at the hospital level to reduce the readmission and decrease the length of stay. 3. Further research is needed to validate and test the assumption of the solution which is developed in this research.

• 한국전문물리치료학회지
• /
• 제3권2호
• /
• pp.55-76
• /
• 1996

The objective of this study was to identify the immediate effects of the short leg brace on the weight bearing distribution and gait patterns of hemiplegic patients. The subjects of this study were 18 hemiplegic patients who had been hospitalized or visited out-patient department of Rehabilitation Hospital, Yonsei University College of Medicine, from January 5, 1996 through March 23, 1996. PLS(Posterior Leaf Spring) on and off changes in gait patterns were measured using ink foot print as well as by recording weight bearing distribution using a limb load monitor. The data were analyzed by the correlation and paired t-test. The findings were as follows: 1. Eighteen subjects were more weighted on the affected leg when PLS was put off(42.74%) than on(40.08%). 2. The defference in gait patterns between PLS on and off was statistically significant, with an increase in step length by 1.7cm on the involved side; a decrease in foot angle by 4.41 degree on the involved side; and a narrowing of base of support by 1.46cm when PLS were off. In conclusion, this study showed that PLS did not affect the weight bearing distribution and gait patterns of hemiplegic patients. Since, the evaluation method used in this study has limitations in regard to temporal distance gait values. Further studies are required to numerous experiments for subject and extensive study.

• 기본간호학회지
• /
• 제8권2호
• /
• pp.172-188
• /
• 2001

Purpose: The purpose of this research was to test the effectiveness of the nursing intervention, mutual goal setting, for patients who have had a mastectomy. Special reference was given to King's goal attainment theory and a theoretical framework for establishing an effective nursing strategy to enhance patient recovery is suggested. Method: This research employed a quasi-experimental design which consisted of pretest-posttest non-equivalent control and experimental groups. Data were collected from 37 patients who had a mastectomy and were hospitalized in the Department of Surgery of Y Medical Center from January 2001 to May 2001. The experimental group received the nursing intervention, mutual goal setting four times from the day before the operation to the fifth day after the operation while the control group received only routine nursing care. As postoperative recovery indicators, ROM of arm joints, arm circumference, pain, physical symptoms, oxygen saturation stress, anxiety and body image were measured. Result: The test results are as follows : 1) there were statistically significant differences between the experimental and control groups in extension and internal rotation of the shoulder Joint and flexion of the wrist joint. 2) there was no significant difference between the two groups in arm circumference. 3) there were no significant differences between the two groups in pain, physical symptoms, or oxygen saturation. 4) there were no significant differences between the two groups in stress, anxiety, or body Image. On the basis of research results, the following are recommended : 1) The effectiveness of nursing intervention in the acute recovery period as well as long term effects need to be investigated. 2) There is a need to develop an instrument to measure perception which facilitates goal attainment in the interactive setting between patients and nurses.

• 척추신경추나의학회지
• /
• 제9권2호
• /
• pp.125-132
• /
• 2014

Objectives : The Purpose of this study is to investigate the clinical application of conservative Korean treatment including hip joint MST for Bilateral Sacroillitis with Synovitis in Rt. Hip Joint Caused by Ankylosing Spondylitis. Methods : Patient is hospitalized at Dept. of Korean Internal Medicine, Jaseng Korean Medicine Hospital, diagnosed as Bilateral Sacroilitis with Synovitis in Rt. Hip Joint Caused by Ankylosing Spondylitis, and treated by herbal medicine, acupuncture, moxibustion, and hip joint MST. This study was measured by NRS(Numeric Rating Scale), SLRT(Straight leg raising test), Patrick test, and Blood test(ESR, CRP). Result : After conservative treatment, the patient's pain was controlled and NRS score was decreased. SLRT score also improved. Patrick test unchanged. ESR, CRP score was decreased. Conclusion : As seen in this one case, conservative Korean treatment including hip joint MST has a positive effect to control pain with Bilateral Sacroillitis with Synovitis in Rt. Hip Joint Caused by Ankylosing Spondylitis.

• 대한영상의학회지
• /
• 제83권2호
• /
• pp.265-283
• /
• 2022

흉부영상의 적절한 활용을 위해 한국형 코로나바이러스 감염증(이하 COVID-19) 흉부영상진단 시행 가이드라인을 개발하였다. 8가지 문장형 핵심 질문을 선정하고, 근거기반 임상영상 가이드라인 수용개작 방법론에 의거하여 권고안을 작성하였다. 권고 내용은 다음과 같다. COVID-19 확진자와 접촉한 증상이 없는 사람에 대하여 COVID-19의 진단을 위하여 흉부영상검사(흉부X선검사 또는 CT)를 사용하지 않는 것이 적절하다. COVID-19가 의심되는 증상이 있으나 reverse transcription polymerase chain reaction 검사를 이용할 수 없는 경우 흉부영상검사 사용을 고려할 수 있다. COVID-19가 확인된 환자에게 병원 입원을 결정하기 위하여 임상 평가 및 검사실 검사와 함께 흉부영상검사를 고려할 수 있다. COVID-19 입원환자의 증상 경중 및 위험요인의 유무에 따라 흉부영상검사를 고려할 수 있으며, 치료 방법을 결정하거나 수정하는데 이용할 수 있다. COVID-19 환자에서 객혈 또는 폐색전증이 의심되는 경우 CT 혈관조영술을 시행할 수 있다. 증상이 호전된 COVID-19 환자의 퇴원 결정을 하는데 흉부영상검사를 사용하지 않는 것이 적절하다. COVID-19에서 회복된 환자를 추적검사할 때 폐 기능 장애가 있는 환자에서 치료 가능한 폐질환과 구별하기 위해 흉부영상검사를 고려할 수 있다.

• 의료법학
• /
• 제20권1호
• /
• pp.243-279
• /
• 2019

2018년 주요 판결 중에는 법리적으로 새로운 판결을 발견하기 어려운데, 이는 어느 정도 법리가 확립되었고, 손해배상이라는 틀 안에서 주로 사실관계에 대한 다툼에 집중하기 때문인 것으로 이해된다. 과실판단이 심급끼리 상반된 사례들은 그 사유와 법리를 이해하는데 도움이 되었으며 갈수록 의료소송에서 다툼이 치열해짐을 확인할 수 있었다. 책임제한을 하지 않은 판결들과 의무기록기재 관련 판결 등도 눈에 띄었는데, 특히 의무기록 기재 관련 판결들이 상당히 증가한 것으로 보인다. 이는 당사자들이 의무기록 관련 의문을 제기하는 사건들이 늘어나는 현상의 일환으로 생각되고 이번 기회에 몇 개판례를 분류하여 소개하였다. 장기입원환자의 퇴거 및 진료비 청구 사례는 의료과실로 인한 후유증 치료에 소요된 진료비는 환자에게 청구할 수 없다는 취지의 대법원의 판결 이후 퇴원 거부와 장기입원을 하는 환자들이 늘어가는 현실에서 법리적으로 관심이 가는 판결이어서 소개하였다.

• 척추신경추나의학회지
• /
• 제9권2호
• /
• pp.81-92
• /
• 2014

Objectives : The Purpose of this study is to investigate the clinical application of Bee venom pharmacopuncture and conservative treatment for lumbar HIVD(Herniated Intervertebral Disc) and Femoroacetabular Impingement. Methods : Patient is hospitalized at Dept. of Oriental Internal Medicine, Jaseng Oriental Medicine Hospital, diagnosed as lumbar HIVD(Herniated Intervertebral Disc) and Femoroacetabular Impingement and treated by Bee venom pharmacopuncture, herbal medicine, acupuncture and moxibustion. This study was measured by NRS(Numerical Rating Scale), ODI and EQ-5D. Results : After Bee venom pharmacopuncture and conservative oriental medical treatment, the patient's pain was controlled and NRS score was decreased. ODI and EQ-5D also were improved. Conclusions : As seen in this one case, Oriental conservative treatment and Bee venom pharmacopuncture have a positive effect to control pain with lumbar HIVD(Herniated Intervertebral Disc) and Femoroacetabular Impingement.

• Journal of Periodontal and Implant Science
• /
• 제45권2호
• /
• pp.76-80
• /
• 2015

Purpose: Methimazole is an anti-thyroid drug that can cause life-threatening neutropenia in rare situations. The aim of this case report is to describe a set of oral complications associated with methimazole-induced neutropenia and the healing of the gingiva after proper treatment. Methods: A 31-year-old female patient hospitalized for systemic symptoms of sore throat and fever and showing extensive gingival necrosis with pain was referred to the Department of Periodontics from the Department of Endocrinology. Methimazole-induced neutropenia was diagnosed based on blood test results and her medical history. Methimazole was discontinued and a range of treatments was administered, including the injection of granulocyte colony stimulating factor. Results: After systemic treatment, the gingiva began to heal as the neutrophil count increased. Approximately one year later, the gingiva had returned to a normal appearance. Twenty-one months after treatment, sequestra of the alveolar bone that had broken through the gingiva were removed. Periodic supportive periodontal treatment has been continued uneventfully. Conclusions: The oral manifestations of gingival necrosis and ulcerations, in combination with systemic symptoms such as fever and sore throat, are the critical signs presented in the early stages of drug-induced neutropenia. Therefore, dentists need to be aware of these oral complications in order to make an accurate diagnosis and to ensure that prompt medical intervention is provided.

• 대한간호학회지
• /
• 제4권1호
• /
• pp.135-150
• /
• 1974

A study on the importance of fifty selected nursing activities that classified into four categories of patient care (physical care. psychological aspects of care, observing, reporting and implementing medical care, care for admission and discharge) was carried out from september 25 to October 10, 1973 toward 300 hospitalized patients and 300 professional nurses in four university hospitals in Seoul. The results were obtained as follows The importance score in order on four categories of nursing activities were seen as follows : 1. in physical care activities patients noted; moderately important 35.0% extremely important 20.5% very important 19.3% slightly important 18.6% not at all important 6.6% nurses noted: moderately important 41.5% very important 29.4% extremely important 23.5% slightly important 6.2% not at all important 3.4% 2. in activities involving psychological aspects of care patients noted: moderately important 33.4% very important 25.2% extremely important 23.2% slightly important 14.3% not at all important 3.9% nurses noted: moderately important 42.3% very important 34.8% extremely important 16.0% slightly important 6.2% not at all important 0.7% 3. in activities involving observing, reporting, and implementing medical care patients noted ; extremely important 35.9% moderately important 28.0% very important 26.0% slightly important 8.4% not at all important 1.7% nurses noted : extremely important 38.1% very important 31.8% moderately important 26.1% slightly important 3.6% not at all important 0.4% 4. in activities preparing for admission and discharge patients noted: moderately important 35.8% extremely important 24.5% very important 23.5% extremely important 12.5% not at all important 3.7% nurses noted: moderately important 47.6% very important 33.1% extremely important 12.5% slightly important 6.0% not at all important 0.8%

• 대한의생명과학회지
• /
• 제26권3호
• /
• pp.210-216
• /
• 2020

The purpose of this study was to evaluate GDH & Toxin (GDT) tests for the identification of the presence of Clostridioides difficile (C. difficile) as well as to detect whether any toxin was present in the feces of patients suspected of diarrhea associated with C. difficile. Data related to the results of toxin and culture (TC) tests and GDT tests conducted on patients with diarrhea and suspected CDI between January 2017 and august 2018, positive test rates, patient ages and sexes, whether the patients were hospitalized, and turnaround time (TAT) were analyzed retrospectively. Of the 7,554 total tests conducted for CDI diagnosis, 1,010 TC tests (14.9%) were positive, while 92 GDT tests (12.0%) were positive. Of these positive cases, 815 (80.7%) identified through TC test and 80 (87%) identified through GDT test were inpatients. also, among the patients with positive test results, 497 (49.2%) diagnosed through TC test and 45 (48.9%) diagnosed through GDT test were aged 61 years or older. The total time required to complete a TC test was 83.6 hours, while the time required for a GDT test was 11.2 hours, equating to an approximately three-day difference between the two tests. The detection of toxin-producing C. difficile is important in CDI diagnosis, but the commonly used Enzymeimmunoassay (EIA) toxin tests with low sensitivity result in delayed CDI diagnosis time. Therefore, primary screening tests for CDI diagnosis using the GDT method and secondary tests using additional methods are considered most effective.