• 제목/요약/키워드: Korean medicine clinical practice guideline

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국내 근거기반 임상간호실무지침의 주제 선정 (Topics for Evidence-Based Clinical Nursing Practice Guidelines in Korea)

  • 구미옥;조명숙;조용애;정재심;정인숙;박정숙;김혜정;은영
    • 임상간호연구
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    • 제17권3호
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    • pp.307-318
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    • 2011
  • Purpose: This study was to identify topics for evidence-based clinical nursing practice guidelines in Korea. Methods: Data were collected from 330 staff nurses from 10 general hospitals and 53 nurses in charge of nursing education in 110 hospitals with over 500 beds. Using open questions, the nurses identified activities which could not be verified, which lacked consistency among nurses, clinical units and/or hospitals, which were not based on the up-to-date knowledge and which needed reform. The data were analysed by content analysis using a qualitative methodology. Results: Collected data consisted of 1882 clinical topics, which were classified into 50 topics, 207 mid-categories, and 456 sub-categories. The most frequent topics in order of frequency were medications, central line management, intravenous injections, urinary catheterization, perioperative nursing care, skin tests, pressure ulcer care, blood transfusions, laboratory examination-culture, respiratory care which were performed routinely in clinical setting by staff nurses. Conclusion: The research findings indicate the urgent need to develop evidence-based clinical nursing practice guidelines related to these research findings. Further research is needed to identify topics related to health promotion, and symptom/management of health problem.

만성요통의 적정 치료를 둘러싼 논란: 중재적 치료 대 보존적 치료 (The Controversy Regarding the Optimal Management of Chronic Low Back Pain: Interventional vs. Medical Treatment)

  • 권오현
    • Annals of Clinical Neurophysiology
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    • 제12권1호
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    • pp.1-2
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    • 2010
  • Chronic non-specific low back pain (CLBP) is one of the major health problems casting substantial amount of economic expenses and negative impact on quality of life onto an individual as well as society. On contrary to public familiarity, the ways of management of CLBP are diverse and there is yet no general consensus about which approach is better than others or to whom the specific management should be applied. Some hold the negative point of view on the efficacy of the invasive maneuver such as epidural injection because there is no controlled clinical trial (RCT) yielding better long term outcome of those invasive managements over conservative ones. But the experts of interventional or surgical treatment stress the methodological difficulty in performing RCT and assert that those invasive treatments can bring the prompt and complete resolution of low back pain and restoration of function in appropriately selected cases. These seemingly opposite views on the invasive management on CLBP are rather complimentary each other than to be contradictory.

턱관절 질환의 한의진료 임상현황조사를 위한 웹기반 설문조사 (A Web-based Survey for Assessment of Korean Medical Treatment Clinical Practice Patterns for Temporomandibular Disorders)

  • 김창은;도호정;송현섭;신재권;이원준;김종호;이근재;윤영석;김노현;서창용;이윤재;김미령;조재흥;권미정;하인혁
    • 한방재활의학과학회지
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    • 제28권1호
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    • pp.73-84
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    • 2018
  • Objectives While Temporomandibular disorders (TMD) is highly prevalent in Korea, studies examining its Korean medical treatment are currently lacking. The aim of this study was to assess current Korean medical treatment practice patterns for TMD. Methods A preliminary questionnaire was developed to investigate current practice patterns of TMD treatment and underwent further revision through external review. The final questionnaire was distributed as a web-based survey to 18,289 potential respondents by email. Results The response rate was 2.23%. Most participants replied that they received multiple Korean medicine interventions for TMD treatment consisting of such methods as acupuncture, chuna manipulation, electroacupuncture. The percentage of treatment services among uncovered services, which need to be covered by national health insurance was high in the order of pharmacopuncture, chuna manipulation, and herbal medicine. The most commonly used diagnostic examination tools for TMD was Physical examination and next was Imaging diagnosis. The frequency of TMD treatment was the highest at 2~3 times per week (76%) and the period was from 4 to 12 weeks (63%). Conclusions This survey study helps determine current practice patterns of TMD, and recognizes the need for use of diagnostic devices in TMD treatment. These results are further anticipated to provide basic data for clinical practice guide lines (CPGs).

ERRATUM: 퇴행성 요추 척추관 협착증의 한의표준임상진료지침 핵심질문 설정에 대한 환자 인식 설문 조사: 단면 설문 연구 (ERRATUM: Patient's Perception for Developing Research Questions of a Clinical Practice Guideline of Korean Medicine for Degenerative Lumbar Spinal Stenosis: A Descriptive Cross-Sectional Survey)

Pediatric Severe Traumatic Brain Injury : Updated Management

  • Ha, Eun Jin
    • Journal of Korean Neurosurgical Society
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    • 제65권3호
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    • pp.354-360
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    • 2022
  • Traumatic brain injury (TBI) is the leading cause of death and disability in children. Survivors of severe TBI are more susceptible to functional deficits, resulting in disability, poor quality of life, cognitive decline, and mental health problems. Despite this, little is known about the pathophysiology of TBI in children and how to manage it most effectively. Internationally, efforts are being made to expand knowledge of pathophysiology and develop practical clinical treatment recommendations to improve outcomes. Here we discuss recently updated evidence and management of severe pediatric TBI.

Management of Osteoporosis Medication after Osteoporotic Fracture

  • Young Kwang Oh;Nam Hoon Moon;Won Chul Shin
    • Hip & pelvis
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    • 제34권4호
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    • pp.191-202
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    • 2022
  • The aim of this study was to provide helpful information for use in selection of an appropriate medication after osteoporotic fractures through conduct of a literature review. In addition, a review of the recommendations of several societies for prevention of subsequent fractures was performed and the appropriate choice of medication for treatment of atypical femur fractures was examined. Clinical perspective was obtained and an updated search of literature was conducted across PubMed and MEDLINE and relevant articles were selected. The articles were selected manually according to relevance, and the references for identified articles and reviews were also evaluated for relevance. The following areas are reviewed: Commonly prescribed osteoporosis medications: BPs (bisphosphonates), denosumab, and SERMs (selective estrogen receptor modulators) in antiresorptive medications and recombinant human parathyroid hormone teriparatide, recently approved Romosuzumab in anabolic agents, clinical practice guidelines for the management of osteoporosis, osteoporotic fracture, and atypical femur fracture. Most medications for treatment of osteoporosis do not delay fracture healing and the positive effect of teriparatide on fracture healing has been confirmed. In cases where an osteoporotic fracture is diagnosed, risk assessment should be performed for selection of very high-risk patients in order to prevent subsequent fractures, and administration of anabolic agents is recommended.

중풍 입원 환자 관리를 위한 임상경로 개발 (Development of a Critical Pathway for a Korean Medicine Hospital Inpatient with Stroke)

  • 김미경;한창호
    • 대한한의학회지
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    • 제42권2호
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    • pp.62-71
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    • 2021
  • Objectives: This study was aimed to share the development process of the critical pathway (CP) for the treatment and management of stroke patients admitted to a Korean medicine hospital. Methods: A draft CP was prepared based on a review of relevant literature and medical records in the hospital, and its validity was reviewed by the in-hospital CP review committee. Each member evaluated all items in the CP on a 5-point Likert scale. Items with an average score of 3.5 or higher or an agreement rate of more than 80% were considered valid. In addition, free described opinions to improve the CP were also received from the review committee. Results: The horizontal axis of the CP was composed of a time domain, including 7 time points from hospitalization to discharge. The vertical axis was composed of 9 domains of medical practice. All items in the CP satisfied the validity criteria. The CP was revised, supplemented, and completed by reflecting the opinions of the committee. Conclusions: This CP will be taught to in-hospital users and will continue to be used with regular monitoring and a feedback plan. This study is expected to serve as a useful reference for standardizing the treatment process and delivering measures to improve the adequacy of Korean medicine treatment for stroke patients.

간호사의 경과관찰업무에 대한 판례분석 및 관리지침 개발 (Legal Analysis and Development of managerial guideline to nursing activities related to observation)

  • 김인숙;김기경;김대란
    • 간호행정학회지
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    • 제8권2호
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    • pp.273-281
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    • 2002
  • Purpose. The study was done to develop nursing guidelines to prevent nursing negligence in the clinical setting that would lead to malpractice. Method. A comprehensive review of the literature and focus groups interviews were used to search for malpractice cases related to "observation", one of the most basic nursing activities. The cases were analyzed with respect to nursing practice and a legal expert was consulted on the content. Results. 4 malpractice cases related to observation negligence were selected for this study; 1) a case of failing to observe dyspnea after a thyroidectomy, 2) a case of failing to observe a depressed patient for suicide attempts, 3) a case of failing to observe a VP shunt obstruction, 4) a case of failing to observe a cardiac ischemia after a bronchoscopy. 11 guidelines were developed for clinical nurses and 13 guidelines for nursing managers. Conclusion. These guidelines are useful in preventing malpractice due to nursing negligence. Therefore nurses need to apply them to their practices and continue to make an effort to develop guidelines for other malpractice situations.

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Clinical application of prenatal chromosomal microarray

  • Chang Ahn Seol
    • Journal of Genetic Medicine
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    • 제19권2호
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    • pp.43-48
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    • 2022
  • A prenatal chromosomal microarray (CMA) is generally recommended when a major anomaly is suspected on prenatal ultrasonography. As it can overcome the limitations of conventional karyotyping, it is expected that the number of prenatal CMA test requests will gradually increase. However, given the specificity of prenatal diagnosis, there are practical considerations compared to postnatal testing, such as the validation of prenatal specimens, maternal cell contamination, precautions when reporting variants of uncertain significance, and the need for comprehensive genetic counseling considering secondary findings. The purpose of this article is to provide necessary information to health care providers in consideration of these issues and to provide appropriate genetic counseling to patients.

유방암 환자의 이차성 림프부종에 대한 침 치료 임상 연구 고찰 (A Review on Clinical Studies of Acupuncture Treatment for Breast Cancer-Related Lymphedema)

  • 박경덕;황수인;박장경;윤영진
    • 대한한방부인과학회지
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    • 제32권3호
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    • pp.102-115
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    • 2019
  • Objectives: The purpose of this study is to confirm the effectiveness and safety of acupuncture for treating breast cancer-related lymphedema (BCRL), thus providing a clinical basis for acupuncture treatment and helping to develop clinical practice guideline through consideration of used meridians and acupoints. Methods: Clinical studies applying acupuncture on breast cancer-related lymphedema were searched through 7 databases such as The Cochrane Library Central, Embase, Pubmed and CAJ. Interventions and results of the selected clinical studies were analyzed. Results: 8 Clinical studies were finally included according to inclusion and exclusion criteria. There were 6 randomized controlled studies and 2 single-arm pilot studies. All of those studies were searched in The Cochrane Library Central, Embase, Pubmed and CAJ and written in English and Chinese. Treatment group applied acupuncture as a Korean medicine intervention. Interventions of control group were made with non-treatment, upper limb exercise, and oral administration of capillary stabilizer or diuretics. Outcome measurements varied from paper to paper but every study measured reduction in arm circumference. Among 8 studies, 6 studies reported statistically significant reduction in arm circumference in treatment group and there were no serious adverse effects. Conclusions: This study suggested that acupuncture has few side effects as well as statistically significant effects on many aspects in treating breast cancer-related lymphedema. However the results should be taken cautiously as more clinical studies are needed.