• 제목/요약/키워드: Medical consultation

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화병변증도구 개발 연구 (Study to Develop the Instrument of Pattern Identification for Hwa-byung)

  • 임현주;김석환;이상룡;정인철
    • 동의생리병리학회지
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    • 제22권5호
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    • pp.1071-1077
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    • 2008
  • Hwa-byung is a form of psychogenic illness among people in Korea and is listed as a culture-bound syndrome of Korea in the DSM-IV. Despite increased clinical researches for Hwa-byung in the oriental medicine of Korea, there has been no agreement of pattern identification for Hwa-byung. The purpose of this study is to develop a standard instrument of pattern identification for Hwa-byung which will be applied to clinical research. The items and structure of the instrument were based on review of published literature. The advisor committee on this study was organized by 15 neuropsychiatry professors of 11 oriental medical colleges nationwide. The experts attended 2 consultation meetings and discussed developing the instrument. and we also took professional advices by e-mail. The results were as follows; First, we divided the symptoms and signs of Hwa-byung into five pattern identification - stagnation of liver Qi, flare-up of the liver fire, disharmony between heart and kidney, deficiency of both Qi and blood, malfunction of gallbladder due to phlegm stagnation. Second, we got the mean weights to each symptom of five pattern identification which had been scored on a 5-point scale - ranging from 0 to 4 by the 15 experts. Third, we made out the Korean instrument of the pattern identification for Hwa-byung. It was composed of 34 questions and decided on question-and-answer form. Though there are some limits in this study, the instrument of pattern identification for Hwa-byung is meaningful and expected to be applied to the subsequent research. And also, we hope to improve the instrument and make up for this study through various research and discussion.

치위생과와 비치위생과 학생의 치아미백에 대한 인식도 및 실태조사 (A servey on the actual conditions & recognition of tooth bleaching in female college students)

  • 신민우;지민경;한명숙
    • 한국치위생학회지
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    • 제8권4호
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    • pp.43-53
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    • 2008
  • Some female college students have to recognize and understand the actual conditions of the tooth bleaching, and effective consultation and training to provide basic data for the purpose of investigation. this study made a survey about recognize and understand the actual conditions of the tooth bleaching and oral health knowledge and generalization methods for 649 female college student in Daejeon and Jeonbuk areas during the period between March. 15 and April. 10,2008. The results were as follows: 1. Tooth Status was found low, self-discontent respondents Status 44.2% and average 31.1%, self-contentment were 14.8%. Tooth color was average respondents were 69.8%, yellow 29.0%, White 1.7% (p=0.001, p=0.030). 2. Tooth bleaching experience has not experienced the most the military was 86.4%, to the desired Tooth bleaching for the external beauty 44.2%, confidence of smile time 37.5%. self-discontent 10.7%(p=0.000, p=0.000). 3. Tooth health status satisfaction was dental hygiene students higher than non dental hygiene, and scaling knowledge of the Tooth bleaching effect was non dental hygiene higher than non dental hygiene(p=0.039, p=0.000). 4. General knowledge for Tooth bleaching was found high 96.1%, as for the recognition route, 55.6% were through broadcast medium(p=0.025, p=0.000). 5. Medical institution chosen for Tooth bleaching treatment method appears the most preferred by 79.9% to the dental hospital dental clinic. 6. Important to consider that the choice of Tooth bleaching was Tooth bleaching duration of 37.1% cost 33%, And when Tooth bleaching hoped to be long-lasting. In this research the high recognized of Tooth bleaching treatment, but very low Tooth bleaching experience female college students for the Tooth bleaching had the wrong information. Therefore, Tooth bleaching treatment and counseling that can be used to development and education were required to provide the correct information.

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The Impact of Implementing Critical Care Team on Open General Intensive Care Unit

  • Kim, Ick Hee;Park, Seung Bae;Kim, Seonguk;Han, Sang-Don;Ki, Seung Seok;Chon, Gyu Rak
    • Tuberculosis and Respiratory Diseases
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    • 제73권2호
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    • pp.100-106
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    • 2012
  • Background: There are a plethora of literatures showing that high-intensity intensive care unit (ICU) physician staffing is associated with reduced ICU mortality. However, it is not widely used in ICUs because of limited budgets and resources. We created a critical care team (CCT) to improve outcomes in an open general ICU and evaluated its effectiveness based on patients' outcomes. Methods: We conducted this prospective, observational study in an open, general ICU setting, during a period ranging from March of 2009 to February of 2010. The CCT consisted of five teaching staffs. It provided rapid medical services within three hours after calls or consultation. Results: We analyzed the data of 830 patients (157 patients of the CCT group and 673 patients of the non-CCT one). Patients of the CCT group presented more serious conditions than those of the non-CCT group (acute physiologic and chronic health evaluation II [APACHE II] 20.2 vs. 15.8, p<0.001; sequential organ failure assessment [SOFA] 5.5 vs. 4.6, p=0.003). The CCT group also had significantly more patients on mechanical ventilation than those in the non-CCT group (45.9% vs. 23.9%, p<0.001). Success rate of weaning was significantly higher in the CCT group than that of the non-CCT group (61.1% vs. 44.7%, p=0.021). On a multivariate logistic regression analysis, the increased ICU mortality was associated with the older age, non-CCT, higher APACHE II score, higher SOFA score and mechanical ventilation (p<0.05). Conclusion: Although the CCT did not provide full-time services in an open general ICU setting, it might be associated with a reduced ICU mortality. This is particularly the case with patients on mechanical ventilation.

한국판 사전의료의향서(K-AD)의 가용성 평가 (Feasibility Evaluation of Korean Advance Directives (K-AD))

  • 김신미;홍선우;김진실;김기숙
    • 한국간호교육학회지
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    • 제20권4호
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    • pp.639-649
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    • 2014
  • Purpose: This study evaluates the feasibility of Korean Advance Directives (K-AD) developed earlier. Method: From January 1 to February 28, 2013, data were collected from 330 adults through a self-reported questionnaire established by the authors based on literature review and expert consultation. The feasibility of K-AD was multi-dimensionally evaluated through four criteria: cognitive, psychological, document making and socially expecting aspects. Data were analyzed using t tests, one-way ANOVA, and Scheffe post hoc tests via the SAS 9.1.3 program. Results: The feasibility of K-AD differed significantly by gender (p=.003), educational level (p<.001), religion (p=.002), and self-reported health status (p=.039). Differences in the level of easiness with K-AD by gender (p=.008) and education (p=.047) were significant. Perceived simplicity of AD differed significantly by religion (p=.005), and the necessity of AD differed significantly by gender (p=.025) and religion (p=.005). Conclusion: K-AD are sufficiently feasible to be tentatively utilized in practice. This is the first study to explore the feasibility of K-AD on the basis of multiple aspects. However, further studies involving diverse populations and methodologies to validate the usefulness of K-AD are warranted.

언택트 기술 환경에서의 지능형 헬스 어드바이저 모델 접근 방안 (An Approach of Cognitive Health Advisor Model for Untact Technology Environment)

  • 황태호;이강윤
    • 한국빅데이터학회지
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    • 제5권1호
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    • pp.139-145
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    • 2020
  • 4차산업혁명 시대에 인공지능 API에 기반한 정보의 활용은 산업과 생활에 많은 영향을 주고 있다. 특히, 의료분야에서 인공지능을 이용한 데이터 활용은 사회에 많은 변화와 영향을 미칠 것이다. 이 논문은 "Cognitive Health Advisor model(CHA model)"을 구현하기 위하여 필요한 구성요소를 연구하고, 이를 기반으로 "chatbot 이용한 CHA model"을 구현하는데 있다. 개방형 Cognitive 챗봇을 이용하여 일상 생활에서 변화되는 사용자의 건강상태를 파악하고 분석하고 생체센서와 챗봇 상담으로 분석한 사용자의 건강정보는 챗봇을 통하여 사용자에게 정보를 전달하여 사용자의 건강증진을 위한 교육정보를 제공하는 지능형 헬스 어드바이저 모델을 구현한다. 이 구현을 통하여 향후 활용 가능성을 확인하고 연구방향을 제시하고자 한다.

애성환자에 대한 임상적 고찰 (A Clinical Study of Patients with Hoarseness)

  • 문영일
    • 대한후두음성언어의학회지
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    • 제3권1호
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    • pp.13-21
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    • 1989
  • A clinico-statistical analysis was performed on 1373 cases who complained of hoarseness at the Dept. of Otolaryngology of Ewha Womans University hopital during the past 10 years from fan 1975 to Dec 1984 and the following results were obtained. 1) Among total of 44,912 who visited the Dept. of Otolaryngology. the patients with hoarseness were 1373 cases(3.1%). 2) Among total of 1373 cases, male were 586 and female were 787, the ratio being 1:1.3. 3) The underlying diseases causing hoarseness in order of frequency were acute laryngitis 374 cases(27.2%), chronic laryngitis 325 cases(23.7%), vocal nodule 248 cases(18.1%), vocal polyp 130 cases(9.5%), vocal cord paralysis 101 cases(7.4%), laryngeal cancer 24 cases(1.7%). 4) The highest incidence of age causing hoarseness in order of frequency were 3rd decade 368 cases(26.8%) 2nd decade 312 cases(22.7%) 4th decade 297 cases(21.6%), 5) The highest incidence of age for underlying diseases in order of frequency were as that follows: acute laryngitis in 2nd decade 114 cases(30.5%), chronic laryngitis in 3rd decade 92 cases(28.3%), vocal nodule in 3rd decade 81 cases(32.7%), vocal polyp in 4th decade 38 cases(29.2%), vocal cord paralysis in 5th decade 19 cases(18.8%), laryngeal cancer in 5th decade 13 cases(54.2%). 6) Number of the patients who came the hospital within 10 days after the onset of hoarseness were 272 cases(19.8%), 15 cases(1.1%) had medical attention for first time 10 years after hoarseness. 7) The highest incidence of the duration from the onset to consultation for the underlying diseases were as that follows: acute larynsitis within 10 days 205 cases(54.8%), chronic laryngitis 3M-6M 76 cases(23.4%), vocal nodule 3M-6M 55 cases(22.2%) vocal polyp 6M-lYr 32 cases(24.6%), vocal cord paralysis 3M-6M 20 cases(19.8%)

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뇌종양 환자의 보완대체요법 이용에 영향을 미치는 요인 (Investigation into the Use of Complementary and Alternative Medicine and Factors Affecting Use in Korean Patients with Brain Tumors)

  • 신용순;이정아;배소현;이수연;장민경
    • 기본간호학회지
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    • 제20권2호
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    • pp.147-156
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    • 2013
  • Purpose: The study was done to define complementary and alternative medicine (CAM) use among primary brain tumor patients and factors influencing use. Methods: The study was conducted with convenience sampling in 5 neuro-oncology centers in Seoul and Gyeonggi Province. Data were collected using a 25-item questionnaire developed by the researchers. Results: Of 250 patients approached, 231 (92.4%) agreed to participate. Overall, 26.8% of the respondents used CAM and the average cost for CAM use was 300,000 KRW. More than 72% of CAM users did not disclose CAM use to their health care professionals. The most frequently used therapy was natural products including mushrooms. Logistic regression analysis revealed that an education level of university or higher (OR=2.92, 95% CI=1.56-5.44, p=.001), unemployment (OR=1.99, 95% CI=1.04-3.80, p=.037), and WHO grade III & IV tumors (OR=2.18, 95% CI=1.07-4.72, p=.048) were significant factors influencing CAM use. Conclusion: Three out of ten brain tumor patients spend substantial sum of money for CAM. In these situations, health care professionals should be aware of this phenomenon and provide adequate information and consultation to the patients.

치과병원에 내원한 삼차신경통환자의 치험예 (34예 분석) (The Analysis of Dental Hospital Patients with Trigeminal Neuralgia)

  • 김인정;최종훈;김종열
    • Journal of Oral Medicine and Pain
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    • 제25권2호
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    • pp.235-240
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    • 2000
  • This study was carried out among 34 patients who visited Yonsei Dental Hospital from 1996. 1. to 1999. 5 for trigeminal neuralgia. By studying the patient's treatment prior to visiting our hospital, features of trigeminal neuralgia, treatment process of trigeminal neuralgia, prognosis of treatment, consultation with other professions and involvement of surgery, etc., the results are as follows: 1. 67.7% of onset age range from 40s to 60s, and average age is 50.2. 2. Ratio of right to left involvement is 1:2.1, male to female ratio is 1:1.9. 3. Occurrence rate of each branch is V3(44.1%), V2(11.8%), V1+V2+V3(11.8), V1+V2(8.8%). 4. Treatments prior to admission to our hospital are extraction(5.9%), endodontic treatment(5.9%), medication(11.8%), Oriental Medicine treatment(5.9%). 5. Routes of admittance to our hospital are by their preference(55.9%), local clinic referral(32.4%), E.N.T referral(5.9%), Neurology referral(5.9%). 6. 70.6% of patients treated at our hospital who were relieved of symptoms, were referred to Neurology(66.7%) and Pain Clinic(33.3%) for the reason of relapse, side effects of the drug itself, incomplete relief of pain. 7. 2 patients who were referred to medical part showed brain vessels contacting trigeminal nerve root on Brain MRangiography. But pain is being controlled by medication and no specific surgical procedure was carried out. The results show that 17.7% of patients admitted received inappropriate early treatment. In order to relieve tooth loss and patient's psychologic stress due to inappropriate treatment, precise differential diagnosis must be made among local teeth disease and idiopathic facial pain. Medication may show side effects of the drug itself, incomplete relief of pain or relapse of symptoms. Therefore, to treat trigeminal neuralgia appropriately by drug injection, surgery or radiation therapy, consultations among dentists, neurologists and anesthesiologists are required.

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청소년 위험행동과 흡연과의 상관성 (The Association between Adolescents Risk Behavior and Smoking)

  • 이준범;함명일;김동준;조하현;민인순
    • 한국병원경영학회지
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    • 제24권2호
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    • pp.12-22
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    • 2019
  • Purposes: The purpose of this study was to examine the association between risk behaviors and smoking in Korean adolescents. Methods: This study used data from online survey of youth health behavior in 2017. Data from a total of 54,411 people (27,139 male, 27,272 female) were included in the analysis. chi-square test, simple logistic regression, multiple logistic regression were performed using SAS 9.4. Findings: Multiple logistic regression analysis showed that risk behaviors such as drinking alcohol experience, sexual experience, drug use experience and high caffeine energy drinks intake experience had a significant effect on smoking. Adolescents with drinking experience were more likely to smoking than those who had no experience(OR=8.58, 95% CI: 7.67~9.60). Adolescents with sexual experience were more likely to smoking than those who had no experience(OR=4.47, 95% CI: 3.91~5.11). Adolescents with drug use experience were more likely to smoking than those who had no experience(OR=2.32, 95% CI: 1.63~3.32). Also, adolescents with high-caffeine energy drinks intake experience were more likely to smoking than those who had no experience(OR=1.37, 95% CI: 1.23~1.53). Practical Implications: All the risk behaviors were significantly associated with smoking rates. Results of this study suggest that physicians and health workers in medical institutions and health centers should simultaneously serve education and consultation for the smoking cessation as well as for the prevention of risk behaviors.

치과대학병원 치과보존과로 전달된 진료 의뢰서의 충실도 분석 (Fidelity analysis of Patient's Referral Letters delivered to the Department of Conservative Dentistry in a Dental University Hospital)

  • 전수진;황수정;서민석
    • 대한치과의사협회지
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    • 제57권8호
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    • pp.428-436
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    • 2019
  • In cases of a patient referral, the general dentist should communicate the patient's dental information as clearly as possible to the specialist to whom he/she is referring his/her patient. For this reason, it is necessary to write a referral letter in an accurate and complete manner. The purpose of this study is to analyze the referral letters of patients who are referred to the department of conservative dentistry in a dental university hospital. From January, 2017 to December, 2018, we gathered the information of the patients who were referred to the department of conservative dentistry in a dental university hospital with referral letter. We evaluated the fidelity of a total of 750 referral letters and recorded the information of the referral dentist and the dental clinic. The relationship between each item and fidelity was analyzed using SPSS 18.0 program. The analysis of the contents of the referral letters yielded the following results: The fidelity of the referral letter was higher when the patient was referred during the root canal treatment, or when there was a root canal filling or when there was pain during chewing. The fidelity of referral letter was low in cases where the referring clinic is close to and has cooperative relationship with dental university hospital. Among the factors affecting the fidelity, the year of graduation of the referral dentist was the most influential. This study confirmed the fact that the clinical practice of writing patient referral letters still leaves much to be desired. In order to solve this problem, it is necessary to create more clear and standardized guidelines for writing referral letters.

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