• Title/Summary/Keyword: Patient's Situation

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Simulation training applying SBAR for the improvement of nursing undergraduate students' interdisciplinary communication skills (SBAR 적용 시뮬레이션 교육이 간호학생의 의료팀간 의사소통능력 향상에 미치는 효과)

  • Ha, Yikyung;Lee, Yoonju;Lee, Yeon Hee
    • Journal of the Korean Data and Information Science Society
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    • v.28 no.2
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    • pp.407-419
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    • 2017
  • In this paper, we aim to evaluate the effect of simulation training with a focus on the application of SBAR for the improvement of communication skills of nursing students with physician. The results of the analysis of 25 videos recorded pre/post-simulation were as follows: In terms of the SBAR score, "the most recently measured vital signs" in stage B increased significantly (Z = -2.448, p =.014); the frequency of step-by-step progress in SBAR did not advance to the SBA or SBAR stage in the pre-simulation stage, but increased to 48% post-simulation. The frequencies of SBAR evaluation items mentioned in the post-simulation were the following order: the name of the patient (96%), nurse's name (80%), most recently measured oxygen saturation (76%), and main symptoms (60%). The results of the nurse's judgment (A), request for additional prescription or request for the doctor's direct patient visit (R) were not mentioned. Therefore, it is necessary to consider the application of SBAR in simulation training, which requires problem solving through cooperation with physicians, because it has a positive effect on education in nurse-physician communication.

The propriety of Spatial Arrangement Condition of 119 Emergency Medical Service - Mainly Around H Town Area, Countrysid of Y city - (119지역대의 공간적 배치 현황의 적절성 -Y시 H면 지역을 중심으로-)

  • Yun, Jong-Geun;Choi, Kyu-Chul
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.11
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    • pp.374-380
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    • 2017
  • In this study, we analyzed the situation of the 119 emergency medical service zone of H town, countryside of Y city from January 1st, 2015 to December 31st, 2016 and then, on the basis of this analysis, we investigated the present condition of the patient-transportation service of the 119 emergency medical service to provide the basic data in order for patients to use the emergency medical service more efficiently. We analyzed the data with SPSS 21.0 using frequency analysis and, after positioning the virtual 119 emergency medical service, we analyzed the data of the transportation time and transportation distance by using GIS. The results of this study show that the use of the 119 emergency medical service for people over 65 years old represents approximately 57% of the total number of patients transported, The average distance and time of the real moving reaction are 6.41 km and 11.86 min, respectively. The distance and time from the pick-up location to the hospital are 18.24 km and 21.52 min, respectively. Given the present position of the 119 emergency medical service, the results of this analysis using GPS show that the (average) distance and time from the 119 emergency medical service to Jang * Ri town are 9.12 km and 12 min, and the (average) total distance and time to arrive at the hospital after the emergency medical service picks up the patient are 36.83 km and 62 min, respectively. In the case of the virtual emergency medical service, the total distance and time required to arrive at the hospital after the emergency medical service picks up the patient are 27.71km and 50min, respectively. The results of this study showed that the present position of the 119 emergency service does not provide the optimum distance and time from the patient's location to the hospital. Therefore, we consider that the repositioning of the 119 emergency medical center is necessary, in order to reduce the time required for the emergency medical service to move to the patient's location and then bring the patient to the hospital.

A Case of Isolated Gonadotropin Deficiency with Negative KALIG-1 Gene (KALIG-1유전자 음성을 보인 격리성 성선자극호르몬 부족증 1례)

  • Nam, Y.S.;Lee, S.H.;Kwak, I.P.;Yoon, T.K.;Cha, K.Y.
    • Clinical and Experimental Reproductive Medicine
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    • v.25 no.3
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    • pp.293-297
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    • 1998
  • Hypogonadotropic hypogonadism, or the lack of function of the testis or ovary secondary to the lack of pituitary and or hypothalamic trophic hormones, is also sometimes generally termed Kallmann's syndrome. Whether such deficiencies arise from an inborn error of hypothalamic organization and pituitary connection or damage to the hypothalamic pituitary system in prepubertal life, the manifestations of a eunuchoid or apubertal individual with potentially competent pituitary and gonadal function will result. Beyond the achievement of puberty, a similar situation can be recreated by the administration of a long-acting GnRH analog or by conditions of secondary hypothalamic dysfunction such as anorexia nervosa where shutdown of GnRH and its resultant effects cause cessation of gonadal function and even a regression of secondary sexual characteristics. Technically, these conditions are not Kallmann's syndrome but one must recognize the similarities. We have experienced a case of isolated gonadotropin deficiency which showed a negative KALIG-1 gene in infertile patient with primary amenorrhea. So we report this case with a brief review of literatures.

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CLINICAL SUBTYPING AND TREATMENT STRATEGY OF COLLEGE ENTERANCE EXAMINATION STRESS SYNDROME (입시병의 아형과 대처방안)

  • Lee, Young-Sik;Ku, Young-Jin;Lee, Kil-Hong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.2 no.1
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    • pp.43-48
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    • 1991
  • The College entrance examination stress syndrome is a kind of anxiety disorder. The underlying cause of this disorder is not a test anxiety itself. One's hidden inner and familial conflicts are more likely attributed to this disorder. Patient's the most common complaints are various psychosomatic symptoms but in severe cases underlying psychopathology may be activated and progress to major psychosis. In a broad sense adolescent's delinguent behavior, drug abuse, school drop-out and sucide are closely related to this syndrome. In clinical management of these patients, considering the special situation of impending examination, the therapist must access to central conflict theme in a short time without severe resistance. The authors classified this syndrome into 5 clinical subtypes ; 'the anxious group', 'the exhaustion group', 'the despair group', 'the emptyness group' and 'the boredome group'. Typical case of each subtype and it's management methods were presented briefly.

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Efficient QRS Detection and PVC(Premature Ventricular Contraction) Classification based on Profiling Method (효율적인 QRS 검출과 프로파일링 기법을 통한 심실조기수축(PVC) 분류)

  • Cho, Ik-Sung;Kwon, Hyeog-Soong
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.17 no.3
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    • pp.705-711
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    • 2013
  • QRS detection of ECG is the most popular and easy way to detect cardiac-disease. But it is difficult to analyze the ECG signal because of various noise types. Also in the healthcare system that must continuously monitor people's situation, it is necessary to process ECG signal in realtime. In other words, the design of algorithm that exactly detects QRS wave using minimal computation and classifies PVC by analyzing the persons's physical condition and/or environment is needed. Thus, efficient QRS detection and PVC classification based on profiling method is presented in this paper. For this purpose, we detected QRS through the preprocessing method using morphological filter, adaptive threshold, and window. Also, we applied profiling method to classify each patient's normal cardiac behavior through hash function. The performance of R wave detection, normal beat and PVC classification is evaluated by using MIT-BIH arrhythmia database. The achieved scores indicate the average of 99.77% in R wave detection and the rate of 0.65% in normal beat classification error and 93.29% in PVC classification.

A Study of Medical Abstraction on 'The Theory of Byeongin' (病因論) of Kim Goo Young (김구영(金久永)의 『병인론(病因論)』에 나타난 의학사상 연구)

  • Kim, Chong-Won;Kim, Namil;Cha, Wung-Seok
    • The Journal of Korean Medical History
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    • v.30 no.1
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    • pp.11-22
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    • 2017
  • This paper is a study on the life and clinical reasoning of Kim Goo Young (1958-2014). Offering a new perspective through his interpretation of Donguibogam (東醫寶鑑), Kim introduced his unique theory of Korean medicine, 'The Theory of Byeongin (病因論)'. Kim recognized the confusing situation of communication between people studying Korean medicine and tried to make a new standard based on the principle that many people can share. 'The Theory of Byeongin' offers a newly constituted "Donguibogam" focusing on 'Byeongin' (病因, pathologic origin) which can be translated as the cause of a disease. In so doing Kim recognized 'Byeongin' as the most important factor in 'Byeonjeung' (辨證, classifying the origin), or the classification method of symptoms. In addition, Kim recognized how 'Byeongin' was considered to be a diseased lifestyle, and tried interpreting. The patient's lifestyle to treat diseases. As a result, 'The Theory of Byeongin' is a theory consisting of an intuitive structure, reducing notable elements like Yin Yang Five Movement theory. The theory's significant characteristic is its easy application in clinical settings due the established core principles which are based on Kim's insight and clinical experience. This study contributes to the understanding of the theoretical and clinical development of Korean medicine through deeper studies on 'The Theory of Byeongin' and Kim's medical theory.

A Bibliographical Study on Dementia (치매(痴?)에 대한 문헌적(文獻的) 고찰(考察))

  • Kim, Yeong-Gyun;Gwon, Jeong-Nam;Choi, Ran-Suk
    • The Journal of Internal Korean Medicine
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    • v.18 no.2
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    • pp.177-194
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    • 1997
  • This thesis, deduced from studying eastern and western medical records, deals with geriatric demedtia in modern society. The result were obtained as follows : 1. Dementia is a kind of chronic, progressive, degenerative disease. The chief expression and pathogenic change of the disease is organic: e.g., extensive change such as cerebrum - atrophy, and denaturalization result. in such a situation intellectual capacities and the ability to enjoy daily life deteriorate trenendously. 2. A basic internal cause of the disease is Defficiencies of the heart, liver and kidneys. An exterior cause is an Excessiveness of the 'Dam'(痰), 'Blood Stasis', 'Fung'(風) and 'Fire'. In a Western Medical view, the reason for dementia is due to the onset of Alzheimer's disease and Brain anemia resulting from Multi - infarction or some other reason. If the white - matter of the brain is injured, then dementia easily to results. 3. Disease symptoms result in troubles in intellectual functions : e.g., memory, orientation, intelligence, judgement, common sence and calculating abilities. 4. The proper therapeutic treatment depends on the causes. When the Deficiency is serious, Fortification (heart, liver. and kidney deficiency) is applied and Decrease is follow. When Excessiveness of wrong is serious, the Decrease is tried before the supplement measure is used depending on the deficiency, which generally is used together with 'Fortify Right - Decreace Wrong'. 5. If the disease wasn't caused by some mental reason, it's difficult to be cured of the disease. When the degree of the disease is light and it doesn't continue for a long time, the therapeutic treatment can block the disease's progress and improve the patient's symptoms.

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Analysis of symptom pattern through comprehensive diagnosis of Qui Xui Shui in patients with functional dyspepsia (기혈수변증(氣血水辨證)에 의한 기능성 소화불량 환자의 변증유형 분석)

  • Lim, Jung-Hwa;Ryu, Jong-Min;Jang, Sung-Young;Kim, Hyun-Kyung;Lee, Joon-Suk;Yoon, Sang-Hyub;Kim, Jin-Sung;Ryu, Bong-Ha;Ryu, Ki-Won;Han, Sook-Young
    • The Journal of Internal Korean Medicine
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    • v.25 no.2
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    • pp.224-237
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    • 2004
  • Background & Object : It is well known that functional dyspepsia is one of the most common diseases. While many dyspepsia patients have been helped with oriental medical therapy, there has not been a study based on the concepts of oriental medicine. The aim of this study was to perform a fundamental epidemiological survey and to analyse the symptom pattern of functional dyspepsia. Methods : 86 patients(27 males, 59 females) diagnosed with functional dyspepsia in Kyunghee Oriental Medical Center from May to December 2002 were involved in this investigation. The disease characteristics of functional dyspepsia(based on Rome criteria II) and the Qui Xue Shui diagnostic procedure were investigated by questionnaire and physical examination. The total score and composition ratio of each comprehensive diagnosis were calculated from the symptom score described in the questionnaire. Results : The total score from the Qui Xue Shui diagnostic procedure was found to be influenced by the number of functional dyspepsia symptoms(p=0.026) and the patient's own cognition of their current dyspeptic situation(p=0.006), in addition to digestive ability and general congnition(p=0.006), and was not associated with sex, duration of dyspeptic symptoms in one year, or the total illness period, In the composition ratio of the Qui Xue Shui diagnostic procedure, only Qui-yu(p=0.048) diagnosis was accurate regarding the number of symptoms in one year, total illness period, or the patients' own congnition of their current dyspeptic situation, But the value of the composition ratio among the total factors involved was most similar to that of sex. Conclusions : Thus, it is shown here that the total score of using the Qui Xue Shui diagnostic procedure is mainly dependent on dyspeptic symptoms and the patinets' own cognition of their current dyspeptic situation, and that regular symptom patterns in the Qui Xue Shui diagnostic procedure exist in dyspeptic patients.

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Measurement of the Nursing Workload by Patient Classification System in a Secondary Hospital;As a Preliminary Step for Computerization of Nursing Staffing and Scheduling (환자분류에 의한 일개 2차 의료기관의 간호업무량 조사;전산화를 위한 기초작업으로서)

  • Park, Jung-Ho;Joe, Hyon;Park, Hyeoun-Ae;Han, Hye-Rah
    • Journal of Korean Academy of Nursing Administration
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    • v.1 no.1
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    • pp.132-146
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    • 1995
  • Even though Korean medical law stipulates that number of patients attended by a nurse is 2.5 for hospitalization and 30 for ambulatory care, the number of patients cared by a nurse per day is much greater than the standard prescribed by the medical law. Current productivity of nurses is not desirable unless the quality of care is considered. And nursing manpower staffing based on neither current nurses' productivity nor standard of medical law cannot respond properly to dynamic situation of the medical services. Under this background, the necessity of more efficient management of nursing manpower occupying 1/3 of total hospital workers has been recognized by many nursing administrators. Many nursing researchers have studied to foretell the nursing manpower objectively on the basis of measured nursing workload according to patient classification as well. Most of These researches, however, have been conducted in the tertiary hospitals, so it is imperative to conduct other researches to predict necessary nursing manpower in the secondary and the primary hospitals. The study was performed to measure nursing workload and predict pertinent nursing manpower to a secondary hospital with 400beds. Nursing workload was surveyed using measuring tool for direct and indirect care hours in a surgical unit and a medical unit. Survey was conducted from Sep.10 to Sep.16 and from Oct.5 to Oct.11, 1994 respectively by two skilled nurses, Subjects were patients, patients' family members and nursing personnels. Results are follows : 1. Patient classification distributed as 22% of class I (mildly ill patient), 57% of class II (moderately ill patient), and 21% of class III (acutely ill patient) in the medical nursing unit, while 23% of class I, 29% of class II, 12% of class III, and 36% of classIV (critically ill patient) in the surgical nursing unit. There was no difference of inpatient number between weekday and weekend. Bed circulation rate was 89% in both units and average patients number per day was 37.4 (total 42beds) in the medical nursing unit, 32.9 (total 37beds) in the medical nursing unit. 2. Direct care hours per day measured as 2.8hrs for class I, 3.3hrs for class II, and 3.5hrs for class III in the medical nursing unit, while 3.1hrs for class I, 3hrs for class II, 2.7hrs for class III, and 2.2hrs for classIV in the surgical nursing unit. Meanwhile, hours for nursing assistant activities per patient by patients' family members were 11mins and 200mins respectively. Direct care hour rate by shift was day 36%, evening 25%, and night 39% in the medical nursing unit, while 40%, 29%, and and 31% respectively in the surgical nursing unit. 3. Measurement and observation activity held 44.2% of direct care activities of nurses and medication 36.7%, communication 11.7%, exercise 1.8%, treatment 1.3%, hygiene 1.3%, elimination and irrigation 1.1%, suction 1%, nutrition 0.5%, thermotherapy 0.3%, oxygen therapy 0.1% in order. 4. Indirect care hours per day were 294.2mins in the medical nursing unit, and 273.9mins in the surgical nursing unit. By shift, evening was the highest in both units. Indirect care hours for each patient were 44.5mins in the medical nursing unit and 46mins in the surgical nursing unit. 5. checking activities including doctor's order, medication, and delivering patients to the next shift occupied 39.7% of indirect care activities, and preparation 26%, recording 23.8%, communication and conference 6.7%, managing equipments 2.1%, messenger activity 1.7% in order. 6. On the ground of these results, nursing manpower needed in a secondary hospital was estimated ; 27 nursing personnels for the medical nursing unit of 37beds, and 20 nursing personnels for the surgical nursing unit of 33beds.

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Doctor's and Nurses' Perception and Experiences of DNR (DNR(Do-Not-Resuscitate)에 대한 의사와 간호사의 경험 및 인지도)

  • Han, Sung-Suk
    • Journal of Korean Academy of Nursing Administration
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    • v.11 no.3
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    • pp.255-264
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    • 2005
  • This study is a descriptive research in investigating the perception of doctors and nurses with regard to DNR, and data were collected through survey questionnaires. The period of collecting data was between July 15 and October 30, 2004, distributing 128 questionnaires to 128 participants, and a total of 110 questionnaires from 55 doctors and 55 nurses were collected (86%)among 70 different hospitals. The collected data were analyzed using SAS program to get real number and percentage, and were also analyzed with $X^2$-test. The Study Results are as follows: 1. Respondents who agreed with the necessity of DNR was 97.27%, the reasons of DNR necessity were 59.20% of 'impossibility of recovery in spite of lots of efforts,' and 35.20% of 'for the purpose of choosing a comfortable and dignified death,' and 97.2% of respondents answered that it was necessary to give explanation of DNR to serious case patients, terminal patients and their family. 2. Problems derived from DNR decisions were 44.44% of 'lack of treatment and nursing,' 21.11% of 'guilty conscience about failing to do best efforts,' and 71.57% of CPR implementation right after DNR decision. 3. Reasons of implementing CRP for patients with DNR decision were 50.94% of 'for the presence of family and relatives at the point of patient's death,' 20.76% of 'guardian's change of DNR decision,' and 16.98% of 'no communication for the consent after DNR decision.' 4. With regard to who was to make DNR decision? there was a difference in the opinion between doctors' and nurses' group while the group of doctors chose 'by the consent of the family and the doctor in charge,' and the group of nurses chose 'patient's intension,' and with regard to Have you received DNR related education? and Will people who want DNR increase if there is explanation given? there was a difference between the two groups. 5. In the catholic institutions, respondents of 71.7% said that it was necessary to take DNR depending upon the situation, and 73% said that they had performed DNR before. 6. In the institutions with over 500 beds, 91.92% of respondents said that there should be an establishment of guideline book as a written format to implement DNR. From the results of this study, it was found that DNR was implemented and executed broadly in clinical fields in the absence of necessary instructions and/or guideline, and that DNR order was placed to the group of doctors who got less opportunity for proper education than did that of nurses.

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