• 중환자간호학회지
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• 제12권2호
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• pp.61-72
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• 2019

Purpose : The aim of this study was to explore the attributes, antecedents, and consequences of patient-centered care (PCC) for older adults with multimorbidity in acute care hospitals. Methods : The concept analysis performed by Walker and Avant was used to analyze PCC. Fifteen studies from the literature related to PCC appear in systematic literature reviews in the fields of theology, medicine, psychology, and nursing. Results : PCC in acute care hospitals was defined according to the five attributes of 'maintaining patient autonomy', 'empowering self-care', 'individualized and relationship-based care', 'shared decision-making', and 'creating a homelike environment'. Antecedents of PCC were found to be a respect for patients' preferences, qualifications of the nursing staff, care coordination and integration, and organizational support. Consequences of effective PCC were a functional status; health-related quality of life; satisfaction with care, mortality, and medical costs from the perspective of the patient and family; and quality of care and therapeutic relationships from nurses' viewpoints. Conclusion : PCC as defined by the results of this study will contribute to the foundation of institutionalization and the creation of a safe and healthy acute care hospital culture focused on patients' preferences and values.

• 한국임상약학회지
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• 제28권1호
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• pp.57-64
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• 2018

Background: Patients experience significant differences in aspects of mortality, quality of life, and costs between during the year of receiving liver transplant (LT) and the subsequent years (post-LT). This study aimed to estimate the medical utilization and cost of LT for patients compared to post-LT patients by using a recent National Patient Sample (NPS) data provided by the Korean Health Insurance Review and Assessment Service (HIRA). Methods: This study used a subset of the 2015 HIRA-NPS. Patient claims data that included Z944 (Korean Standard Classification of Diseases code for LT status) were selected. Within the selected data, LT patients were identified based on whether the national health insurance number code of Q80 (procedure code for LT surgery) was included, and they were compared to post-LT patients. Results: In the analysis, 330 patients were included. The average cost per patient was $90,066{\pm}36,959$ thousand KRW and $10,557{\pm}9,668$ thousand KRW for LT and post-LT patients, respectively. Especially, LT patients' costs for injection/procedure, surgery/treatment, and examination were higher than other costs, being $35,983{\pm}18,115$ thousand KRW, $28,246{\pm}9,408$ thousand KRW, and $12,131{\pm}6,604$ thousand KRW, respectively. For inpatients, the average number of hospitalized days was $63.5{\pm}66.0$ days for LT patients and $22.3{\pm}35.1$ days for post-LT patients. Conclusion: Compared to post-LT patients, LT patients had higher costs, especially for injection/procedure, surgery/treatment, and examination. Additionally, the LT group had longer hospitalization duration and higher costs for their hospital admission, whereas they did not show a significant difference in number of visits and medical costs for outpatient-care.

• 대한한방내과학회지
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• 제44권2호
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• pp.158-166
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• 2023

Background: Adductor spasmodic dysphonia (ASD) is caused by the involuntary contraction of laryngeal muscles due to dystonia localized to the larynx. In the case of ASD, conventional treatment is mainly performed with a botulinum toxin injection. However, the botulinum toxin injection has a short-lasting effect and requires repeated injections. Alternatives are needed due to concerns over adverse effects, such as general weakness and airway aspiration caused by the botulinum toxin injection. Case report: A 46-year-old female patient with ASD complained of voice tremor and hoarseness. The combined Korean medical treatments-Ukgan-san-gami, Jakyakgamcho-tang, acupuncture, and transcutaneous electrical nerve stimulation (TENS)-were administered on the first day the patient was hospitalized. The Voice Handicap Index (VHI) was evaluated during the treatment. The VHI taken on the second day totaled 92 points. On the ninth day, 81 points were recorded. Total score gradually improved, and on the 16th day, 62 points were recorded. Combined Korean medical treatment lasted 19 days. Conclusion: The present case report suggests that a combined Korean medical treatment approach with Ukgan-san-gami, Jakyakgamcho-tang, acupuncture, and TENS might be effective for symptoms such as voice tremors and hoarseness. Combined Korean medical treatment can be a therapeutic option for patients with ASD.

• 대한간호학회지
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• 제29권5호
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• pp.1113-1122
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• 1999

The author investigated pain experiences of 90 cancer patients and the adequacy of pain treatment they have received during their stay at a large medical center in T city between October 1994 and August 1995. Pain was assessed by the Shortened BPQ and results are summarized as follows: As for ratings of “worst pain” during the 24 hour period, 70% of the patients reported they had “severe” pain. As for ratings on “pain now,” 43% of the cancer patients reported “moderate to severe” pain. Over 46% of the patients reported a pain relief score of 0(not at all) or 1(somewhat) even after receiving pain medication. Adequacy of analgesic treatment was evaluated by comparing the patient's reported level of pain and the analgesic use, namely, the pain management index(PMI). The PMI indicated that 58% of the patients were undertreated for the pain control. In review of nurse's notes. systematic pain assessment was scarcely recorded, although pain documentation appeared in 70% of the notes; and the contents were mostly simple description. In conclusion, the results of patient's pain ratings, the PMI and poor pain documentation in the nurse's notes implied poor pain assessment and management.

• 대한한의학회지
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• 제33권2호
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• pp.73-77
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• 2012

Objectives: This report reports a clinical case of a patient with recurrent aphthous stomatitis (RAS) for 10 years who was completely cured using Korean medicine. Methods: A male patient with terribly severe RAS was hospitalized, and then treated with Jibaekpalmi-hwon, indirect moxibustion (KI 1 and CV 4) and acupuncture. The clinical outcome was observed by self-reported VAS measurement and macroscopy. Results: The severity of stomatitis became improved gradually and completely recovered during 17 hospital days, and RAS has not recurred for three months as an outpatient. The blood test including complement activity was in the normal range. Conclusions: This case report provides information about a therapeutic effect of Jibaekpalmi-hwon and Korean medicine on RAS.

• Imaging Science in Dentistry
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• 제52권4호
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• pp.421-427
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• 2022

McCune-Albright syndrome (MAS) is a rare multisystem disorder characterized by a clinical triad of polyostotic fibrous dysplasia (FD), skin pigmentation, and hyperfunctioning endocrinopathies. A 42-year-old man visited our medical hospital for the treatment of intermittent headaches and was diagnosed with MAS with acromegaly. This patient showed various clinical features of MAS, including pituitary adenoma, polyostotic FD, and hypogonadotropic hypogonadism. The FD lesions showed characteristic radiographic features, such as widespread, sclerotic bony lesions in the cranial bones, mixed radiolucent-radiopaque multilocular lesions in the mandible, and radiolucent lesions in the axial and appendicular skeleton. Over the years, the patient had been hospitalized multiple times due to accidental bony fractures associated with the fragile bony state of FD. This report presents a retrospective description of a case of MAS, with a review of the relevant literature.

• 동의생리병리학회지
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• 제17권1호
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• pp.258-262
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• 2003

Background and Purpose : In the acute stage of stroke, many medical and neurological problems complicate and affect the clinical course of patients. according to previous reports. Although some of them may be predicted, few data exist about them. So we were to investigate the characteristics of complications in hospitalized patients due to stroke. Methods : We retrospectively examined the clinical notes of patients admitted in Won Kwang oriental medical hospital after stroke. Two observers inspected the clinical notes using predefined diagnostic criteria and recorded the type, timing, and frequency of complications that occurred during hospitalization. Results: Total 78 subjects were included in this study. Medical complications(88%) were more frequently complicated than neurological ones(65%). The most common medical complication was constipation(29%) followed by fever(28.2%) and overflow incontinence associated with dysuria(28%). The most common neurological complication was dysphagia(23.7%) and the second was agitation or Insomnia(36%) and the third was headache(21%). Conclusion : Complications after acute stroke were commonly observed. And There were more frequent medical complications than neurological ones. So we should have much knowledge about medical complications and treat them actively. The differences between our study and previous studies are attributable to the different methods including patient selection and diagnostic criteria.

• 대한한방내과학회지
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• 제24권2_4호
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• pp.1023-1029
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• 2003

Objective: The purpose of this study is to inspect recovery state of patients suffering from nausea and vomiting, who received auricular acupuncture. On the other hand, we are going to examine effects of auricular acupuncture through the study of treatises on nausea and vomiting. Nausea and vomiting are ordinary symptoms of dispositional or functional disease. The symptoms often appear without obvious disorders that can be detected on various inspection. Methods: Auricular acupuncture needling was given to the patients who had reported the symptoms of nausea and vomiting. They were hospitalized at the korean oriental internal medicine of National Medical Center from Dec. 2002 to Aug. 2003. Result: Relatively quick response of treatment was acquired after auricular acupuncture on nausea and vomiting. Conclusion: This study shows that auricular acupuncture is effective in reducing nausea and vomiting without regard to causal disease.

• 대한한의학회지
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• 제21권4호
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• pp.227-235
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• 2000

Background and Purpose : Medical and Neurological complications in patients with acute stroke may affect their prognosis including death rate, function and admission period. Some of these complications may be preventable. But few data exist regarding complications occurring in the first weeks. So we sought to observe the type, timing, and frequency of complications in hospitalized patients after stroke. Methods : We retrospectively examined the case notes of patients admitted in Won Kwang Oriental Medical Hospital after stroke. Two observers inspected the case notes using predifined diagnostic criteria and recorded the type, timing, and frequency of complications that occurred during the inpatient period. Results : Complications were recorded in 43 patients(82.7%). The most common medical complications were constipation(25.0%) and shoulder pain(21.2%). The most frequent serious medical problems were pulmonary infection(9.6%) and UTI(7.7%). The most common neurological complications were insomnia(34.6%) and dysphagia(23.7%). The most frequent serious medical problem was mental deterioration(7.7%). Conclusion : Complications after acute stroke are common. There were more medical complications than neurological complications. So we should compile much knowledge about medical complications and treat them actively. The differences between our study and previous studies are attributable to the different methods including patient selection and diagnostic criteria.

• Journal of Yeungnam Medical Science
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• 제30권1호
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• pp.51-54
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• 2013

Synovial sarcoma is a rare malignancy in the thoracic cavity, especially in the mediastinum. In this paper, a case of primary mediastinal synovial sarcoma is reported. A 34-year-old woman was hospitalized with dyspnea. Her chest X-ray and computed tomography (CT) showed a $16{\times}13{\times}11$ cm mass in her anterior mediastinal space. Surgical resection was performed but was incomplete. The pathological and immunohistochemical analysis confirmed the diagnosis of monophasic spindle cell synovial sarcoma. The patient underwent adjuvant radiotherapy for two months, but local recurrence and metastasis occurred in her pleural cavity. She eventually underwent chemotherapy for one year and died 18 months after her operation.