• Title/Summary/Keyword: Multidisciplinary care

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A Study on Relationship between the Practice of Aerobic Exercise and the Prevalence and Risk of Arthritis with Comorbid Chronic Diseases (유산소운동의 실천과 만성질환이 동반된 관절염의 유병률 및 위험도에 대한 관계 연구)

  • Yoon, In-Sang;Lee, Hye-Lim;Lee, Jongseok;Jung, Deuk
    • Journal of Digital Convergence
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    • v.19 no.8
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    • pp.351-359
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    • 2021
  • This study was conducted to analyze the relationship between the practice of aerobic exercise and the prevalence and risk of arthritis with comorbid chronic diseases. For this study, the National Health and Nutrition Examination Survey 2017-2019 data were used and 17,356 people were selected as subjects. The relationship between the practice of aerobic exercise and the prevalence and risk of arthritis according to demographic characteristics and chronic diseases was analyzed by the chi-square independence test and Breslow-Day test. While the rate of aerobic exercise was low among women, the elderly, the low-income group, the low-education group, and people living in rural areas, the prevalence and risk of arthritis were relatively high. And in the chronic disease-positive group, those who practiced aerobic exercise had a relatively lower prevalence and risk of arthritis than those who did not. In particular, the practice of aerobic exercise was an effective complement in reducing the prevalence and risk of arthritis in people with high blood pressure, diabetes, and dyslipidemia. Therefore, the practice of aerobic exercise such as walking, slow running, and aerobic dance should be recommended in terms of the preventive medicine and health care to people who are in the group with a high prevalence of arthritis in demographic characteristics and people who have comorbid chronic diseases.

Hospice and Palliative Care in Chronic Obstructive Pulmonary Disease (만성 폐쇄성 폐질환의 호스피스 완화의료)

  • Shin, Jinyoung;Park, Hye Yun;Lee, Jungkwon
    • Journal of Hospice and Palliative Care
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    • v.20 no.2
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    • pp.81-92
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    • 2017
  • Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation that is usually progressive. It is a major cause of morbidity and mortality worldwide, leading to substantial and increasing economic and social burden. Palliative care for COPD patients aims to reduce symptoms and exacerbations and improve exercise tolerance and quality of life. It is difficult to make a prognosis for COPD patients due to the variable illness trajectory and advanced care of patients. However, severity of breathlessness, assessment of lung function impairment, and frequency of exacerbations can help to identify palliative care needs and determine effective methods to mitigate symptoms, which is discussed in this paper. In these patients, it is recommended to provide individualized palliative care along with curative/restorative care at the onset of COPD symptoms. Before launching a palliative care system in Korea, it is necessary to prepare pulmonary rehabilitation resources, patient-centered communication, timely palliative responsiveness, and a program for effective advanced care planning. A multidisciplinary approach involving collaboration with not only the respiratory and palliative care teams but also primary care offers a new model of care for these patients and should be considered with a priority.

Needs for Hospice Care among Families of Children with Cancer for Outpatients (외래통원 암 환아 가족의 아동호스피스요구)

  • Chung, Young-Soon;Park, Sang-Youn
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.4
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    • pp.1706-1713
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    • 2012
  • The purpose of this study was to analyze the need for child hospice care in families of children with cancer for outpatient. The participants were 83 parents of children with cancer. This survey was conducted from January 2011 to March 2011 at four hospitals in Daegu. Data were collected through self-report questionnaires and analyzed by descriptive statistics, t-test and ANOVA using the SPSS/WIN Program. Needs for hospice care for the participants were high. The need for "emotional care of children" showed the highest, "control of secondary physical problems", "acceptance of the family's difficulty", "management for terminal physical symptoms", "spiritual care for preparing for death". With respect on the demographic characteristics of the participants, there were statistically significant differences in hospice care needs, among to the religion, sibling, relatives, whether of the cancer. The above findings indicate that needs for hospice care for the participants were high about emotional care, especially as it is related to children's anxiety. Therefore hospice care, based on emotional part, should be provided systematic hospice care with specialized multidisciplinary child hospice care team, child hospice center.

Fertility preservation during cancer treatment: The Korean Society for Fertility Preservation clinical guidelines

  • Kim, Jayeon;Kim, Seul Ki;Hwang, Kyung Joo;Kim, Seok Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.44 no.4
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    • pp.171-174
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    • 2017
  • While many fertility preservation (FP) options now exist for reproductive-aged cancer patients, access to these services continues to be limited. A comprehensive FP program should be organized to serve oncofertility patients effectively. Also, much effort is needed from various individuals-patients, specialists from various fields, and consultants-to facilitate FP in a timely manner. Various challenges still exist in improving access to FP programs. To improve access to FP treatment, it is important to educate oncologists and patients via electronic tools and to actively navigate patients through the system. Reproductive endocrinology practices that receive oncofertility referrals must be equipped to provide a full range of options on short notice. A multidisciplinary team approach is required, involving physicians, nurses, mental health professionals, office staff, and laboratory personnel. The bottom line of FP patient care is to understand the true nature of each patient's specific situation and to develop a patient flow system that will help build a successful FP program. Expanding the patient flow system to all comprehensive cancer centers will ensure that all patients are provided with adequate information regarding their fertility, regardless of geography.

Recent Advances in Diagnosis and Treatment of Alzheimer's Disease (알츠하이머병의 최신지견)

  • Lee, Jung Jae;Lee, Seok Bum
    • Korean Journal of Biological Psychiatry
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    • v.23 no.2
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    • pp.48-56
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    • 2016
  • Alzheimer's disease (AD) is a neurodegenerative disorder in which neuronal loss causes cognitive decline and other neuropsychiatric problems. It can be diagnosed based on history, examination, and appropriate objective assessments, using standard criteria such as the Diagnostic and Statistical Manual of Mental Disorders or the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA). Brain imaging and biomarkers are making progress in the differential diagnoses among the different disorders. The cholinesterase inhibitors, donepezil, rivastigmine and galantamine and N-methyl-D-aspartate receptors antagonist memantine are approved by the US Food and Drug Administration for AD. Recently some acetylcholinesterase inhibitors gained approval for the treatment of severe AD and became available in a higher dose formulation or a patch formulation. Optimal care in AD is multifactorial and it should include early diagnosis and multidisciplinary care with pharmacological and nonpharmacological interventions including exercise interventions, cognitive interventions and maintenance of social networks.

An Evolutionary Concept Analysis of Forensic Nursing Competency (법의간호 역량에 대한 진화론적 개념분석)

  • Jo, Na Young;Lee, Yun Mi;Son, Youn-Jung
    • Journal of Korean Critical Care Nursing
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    • v.11 no.2
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    • pp.34-50
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    • 2018
  • Purpose : This study aimed to clarify attributes, antecedents, and consequences of forensic nursing competency. Method : Rodgers' evolutionary concept analysis was used to analyze twenty nine articles on forensic nursing based on a systematic review of theology, medicine, psychology, and nursing literature. Results : Forensic nursing competency consists of the following seven attributes: awareness of the medico-legal problem, multidisciplinary integrated knowledge, education and training in forensic science, professional career development, evidence based practice in forensic nursing, collaborative forensic nursing with community partner, safety and security effective communication, and supportive relationships. Finally, we could explain the consequences of forensic nursing competency on knowledge construction in nursing, enhancing professional nursing, and establishing a human rights and social justice based approach. The antecedents of forensic nursing competency were forensic science interest, forensic science experience, and nurses' view of person in forensic-works. Conclusion : Based on these results, we recommend the development of a Korean version of a scale to assess forensic nursing competency.

A CASE OF MULTIPLE FACIAL GUNSHOT WOUNDS (다발성 안면부 총상환자의 증례보고)

  • Kim, Jong-Ryoul;Hwang, Dae-Seok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.1
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    • pp.60-63
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    • 2003
  • Gunshot injuries can range from the most minor to the life-threatening. Multidisciplinary care is required for successful management of patients, In the acute phase, care may involve emergency surgeons, anaesthesists, neurosurgeons, ophthalmic surgeons, vascular surgeons, ENT specialist in addition to the oral and maxillofacial surgeons. Afterwards, definitive treatment of facial gunshot injuries depends ultimately on the abilities and skills of the oral and maxillofacial surgeons, and their appreciation of such injuries. The timing and sequence of the surgical procedures used for reconstruction and rehabilitation of maxillofacial gunshot injuries are crucial to a successful outcome and aesthetic result. If incorrect, they may lead indefinitely to infection, graft rejection, wound dehiscence with consequent multiple revisional operations and complication which will prolong hospital stay and increase treatment costs and morbidity on those patients. We present a gunshot case of a 46-year-old man who tried to commit sucide, and have avulsive and penerating wounds on the face and the neck. We removed the scattered bullets and fragments successfully and the wounds were closed primarily.

Factors Affecting Nurses' Performance of Cancer Pain Management in a Tertiary Hospital

  • Kang, Minhwa;Seo, Minjeong
    • Journal of Hospice and Palliative Care
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    • v.25 no.3
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    • pp.99-109
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    • 2022
  • Purpose: More than 60% of patients with advanced cancer experience pain, and uncontrolled pain reduces the quality of life. Nurses are the closest healthcare providers to the patient and are suitable for managing cancer pain using pharmacological and non-pharmacological interventions. This study aimed to identify factors affecting the performance of cancer pain management among nurses. Methods: This study was conducted among 155 participating nurses working at a tertiary hospital who had experience with cancer pain management. Data collection was performed between October 18, 2021 and October 25, 2021. Data analysis was conducted using descriptive statistics, the independent-sample t-test, one-way analysis of variance, and hierarchical regression analysis. Results: There were 110 subjects (71.0%) who had no experience of cancer pain management education. The results of regression analysis indicated that barriers included medical staff, patients, and the hospital system for cancer pain management (𝛽=0.28, P<0.001). The performance of cancer pain management was also affected by experience of cancer pain management training (𝛽=0.22, P=0.007), and cancer pain management knowledge (𝛽=0.21, P=0.006). The explanatory power of the variable was 16.6%. Conclusion: It is crucial to assess system-related obstacles, as well as patients and medical staff, in order to improve nurses' cancer pain management performance. A systematic approach incorporating multidisciplinary interventions from interprofessional teams is required for effective pain management. Furthermore, pain management education is required both for cancer ward nurses and nurses in other wards.

Diagnostic Approaches for Idiopathic Pulmonary Fibrosis

  • Jae Ha Lee;Jin Woo Song
    • Tuberculosis and Respiratory Diseases
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    • v.87 no.1
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    • pp.40-51
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    • 2024
  • Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fibrosing interstitial pneumonia with a very poor prognosis. Accurate diagnosis of IPF is essential for good outcomes but remains a major medical challenge due to variability in clinical presentation and the shortcomings of existing diagnostic tests. Medical history collection is the first and most important step in the IPF diagnosis process; the clinical probability of IPF is high if the suspected patient is 60 years or older, male, and has a history of cigarette smoking. Systemic assessment for connective tissue disease is essential in the initial evaluation of patients with suspected IPF to identify potential causes of interstitial lung disease (ILD). Radiologic examination using high-resolution computed tomography plays a pivotal role in the evaluation of patients with ILD, and prone and expiratory computed tomography images can be considered. If additional tests such as surgical lung biopsy or transbronchial lung cryobiopsy are needed, transbronchial lung cryobiopsy should be considered as an alternative to surgical lung biopsy in medical centers with experience performing this procedure. Diagnosis through multidisciplinary discussion (MDD) is strongly recommended as MDD has become the cornerstone for diagnosis of IPF, and the scope of MDD has expanded to monitoring of disease progression and suggestion of appropriate treatment options.

Clinical Characteristics and Treatment of Immune-Related Adverse Events of Immune Checkpoint Inhibitors

  • Juwhan Choi;Sung Yong Lee
    • IMMUNE NETWORK
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    • v.20 no.1
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    • pp.9.1-9.21
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    • 2020
  • Immune checkpoint inhibitors (ICIs) have been changing the paradigm of cancer treatment. However, immune-related adverse effects (irAEs) have also increased with the exponential increase in the use of ICIs. ICIs can break up the immunologic homeostasis and reduce T-cell tolerance. Therefore, inhibition of immune checkpoint can lead to the activation of autoreactive T-cells, resulting in various irAEs similar to autoimmune diseases. Gastrointestinal toxicity, endocrine toxicity, and dermatologic toxicity are common side effects. Neurotoxicity, cardiotoxicity, and pulmonary toxicity are relatively rare but can be fatal. ICI-related gastrointestinal toxicity, dermatologic toxicity, and hypophysitis are more common with anti- CTLA-4 agents. ICI-related pulmonary toxicity, thyroid dysfunction, and myasthenia gravis are more common with PD-1/PD-L1 inhibitors. Treatment with systemic steroids is the principal strategy against irAEs. The use of immune-modulatory agents should be considered in case of no response to the steroid therapy. Treatment under the supervision of multidisciplinary specialists is also essential, because the symptoms and treatments of irAEs could involve many organs. Thus, this review focuses on the mechanism, clinical presentation, incidence, and treatment of various irAEs.