• Title/Summary/Keyword: Patient's data

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Development of Dementia Care Model in a Community (지역사회 치매관리 모형 개발 : 광명시의 경우)

  • 배상수;김동현;우영국;오진주;민경복;이수현;이미라;이상숙;표옥정
    • Health Policy and Management
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    • v.9 no.1
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    • pp.30-71
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    • 1999
  • There has been a dramatic increase in public awareness regarding dementia during recent years. However, dementia remains a family affair and patients do not receive adequate care in Korea. This study aims to assist patients and their caregivers by establishing Home and Community based Long-Term Care in a city. The data collected for analysis include five main categories: dementia prevalence, limitations of daily activities of patients, burden of caregivers, the services that patient's family want to utilize, the resources that handle dementia in the community. Major findings can be summarized as follows: 1)The prevalence rate of dementia for elderly people is 13.1 per 100 persons. Alzheimer's disease amount to 38.9% of dementia patients and vascular dementia account for 36.7% of them 2)Eight out of ten patients have mild dementia. Almost all patients have normal ADL. IADL, however, shows different picture. In every items of IADL, about 60% of patients reveals some limitations. 3)The proportion of patients who had medical diagnosis is as low as 20%. Families of patients think dementia as normal aging process and medical doctors in the community do not give special concern to dementia patients. 4)Caregivers does not have proper social support. They suffer from long care time, experience large obstacles in respect of health, daily living, and social activity. 5)Health center and Community welfare center have launched some programs-consultation, home-visiting nursing, day care center, voluntary force mobilization and so on-for dementia patients. But they do not perform expected roles and functions because of lack of skilled personnels and inadequate coordination of relevant organizations for dementia care. 6)Families of dementia patients prefer home helper and home-visiting nurse to hospitalization. For the future, however, demand for institution-based long-term services will increase. We develope community dementia care model based on above findings as follows: 1)Health center execute community cardiovascular control program for the prevention of vascular dementia. 2)Refer to epidemiologic characteristics of patients and preference of family, the most urgent task for dementia care in this city is to expand and organize Home and Community based Long-Term Care. 3)For the continuous and comprehensive care, care plan for a patient must be prepared. Case management team should be builded to prepare this plan and coordinate relevant resources. 4)Special long-term care unit for dementia will be needed in a near future. This unit should have multiple functions, such as day-care center, short stay facility, training center for relevant personnels, besides long-term nursing home considering effective care of dementia and efficient operation of the facility. 5)Voluntary workers deserve their due efforts. Incentive mechanisms must be developed to activate voluntary activities.

A Comparison of Quality of Life between the Families of Hospital Hospice Patients and Those of Home-Based Hospice Patients (입원 및 가정 호스피스환자 가족의 삶의 질 비교 연구)

  • 노유자;김춘길
    • Journal of Korean Academy of Nursing
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    • v.28 no.3
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    • pp.773-785
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    • 1998
  • This study aims at providing more qualitative care in family nursing practice. It is designed to analyze the degree of quality of life(QL) among families of the patients. The subjects consisted of 79 families of hospital hospice patients and 74 families of home-based hospice patients. The ages of the subjects were 17-74 years, at five university hospitals in Seoul, Inchon, and Kyung Gi Province, and one clinic in Chunchon. The data were collected from September, 1996 to August, 1997. The instrument used for the study was the Quality of Life Scale (QLS), which was composed of six factors, developed by Ro, You Ja. The analysis was done using t-test, ANOVA Scheff test, and Stepwise multiple regression. The results were as follows : 1. There were no statistically significant differences between the families of hospital hospice patients and the families of home-based hospice patients ; however, the mean score of the families of hospital hospice patients was higher than that of the families of home-based hospice patients. The scores on QLS ranged from 75 to 224 with a mean score of 140.58 in the families of hospital hospice patients. In the families of home-based hospice patients, the scores ranged from 79 to 214, showing a mean score of 135.25. Among six factors of QLS, family relationships showed the highest score in both groups, but economic life showed the lowest score in the families of hospital hospice patients, and emotional state showed the lowest score in those of home-based hospital patients. Self-esteem and relationship with the neighborhood were significantly higher in the families of hospital hospice patients than the families of home-based hospice patients (t=2.69, P= 0.008 ; 1=2.04, p=0.043). 2. In the families of hospital hospice patients, QL had significant relationship with family member's age(F=2.52, p =0.029), marital status (F=3.57, P=0.018), economic state(F=6.07, P=0.004), and education level(F=3.77, P=0.014). In the families of home-based hospice patients, QL had significant relationship with marital status (F=2.53, P=0.049), education level(F=4.35, P=0.007), occupation(F=3.93, P=0.002), and patient's age(F=2.73, P=0.020) 3. Economic status accounted for 17% of QL, and diagnosis accounted for an additional 7% of QL in the families of hospital hospice patients by means of stepwise multiple regression analysis. In the families of home-based hospice patients, relationships with patient accounted for 12% of QL. The findings showed that self-esteem and relationship with the neighborhood were significantly higher in the families of hospital hospice patients than the families of homed-based hospice patients and family relationships showed the highest value in QL. These findings should be considered in nursing practice.

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Quality Assessment for Elbow CT scan by positioning and respiratory control (팔꿈치관절 CT검사에서 환자 자세 및 호흡에 따른 화질평가)

  • Lim, Jong-Chun;Park, Sang-Hyun;Lee, In-Jae
    • Journal of the Institute of Electronics and Information Engineers
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    • v.54 no.7
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    • pp.110-114
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    • 2017
  • Because the arm can't be sutured due to fracture during a elbow CT scan, a CT scan is proceeded in a state of abdomen and L-spire are overlapped which beam hardening artifact is done many times, and it often lowers the quality of elbow CT images. So there are many difficulties in reading and due to increase in radiation dose from it, the number of patient's exposure keeps increasing. In this research, it plans to improve the quality of the images by avoiding overlap with abdomen, and increasing the number of photon overlapped with lung field which the line attenuation is relatively small. The way of experiment is based on patient's right elbow and place him as head first position, then place his elbow at L2-3 level in supine position, turn about 30 degrees to the left in non-control breathing and in supine position, and compared with full inspiration after overlapping with lung. After figuring out the average value and standard deviation data using Image J program 5 times each for 16, 128 channels, the evaluation is proceeded by measuring each of CNR, MSR are statistically analyzed using SPSS program. Therefore, through positioning and inspiration during elbow CT scan, the way of inspection minimized the exposure radiation dose, and seems to be meaningful in a way to improve the quality of the images.

The Effects of a Cardiac Rehabilitation Program on Health Behavior Compliance, Cardiovascular Function, and Quality of Life for the Patients with Ischemic Heart Disease (심장재활 프로그램이 허혈성 심장환자의 건강행위 이행, 심혈관 기능 및 삶의 질에 미치는 효과)

  • 조현숙;김광주
    • Journal of Korean Academy of Nursing
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    • v.30 no.3
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    • pp.560-570
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    • 2000
  • This study is aimed at developing a cardiac rehabilitation program and enlightening the effects of the program on patient's health behavior compliance, cardiovascular functional capacity, and quality of life. Using a quasi-experimental approach the nonequivalent control group pretest - posttest design was accepted for this study. The subjects of this study consisted of 55 patients with ischemic heart disease at the Cardiac Center of 'G' Hospital located in Inchon from May 1, 1998 to April 30, 1999. The patients were divided into two groups: the experimental group, which participated in the cardiac program with 30 patients and 25 patients of a control group were not involved in the program. There were two phases in the cardiac rehabilitation program: the first phase was a team approach education. It focused on reducing the risk of ischemic heart problems. The second phase was individual training by using a home based exercise program, which was comprised of 8 weeks, three sessions per week, 40-60 minutes per session, and followed by consultation. Every session involved 20-40 minutes of aerobic exercise at 40-60% of heart rate reserve, 11∼13 RPE and 10 minutes of warm-up and 10 minutes of cool-down exercises. The experimental tools for the study were the health behavior compliance scale developed by Lee, Yoon-hee (1992), and quality of life scale developed by McGirr et al.(1990). RPPsubmax were measured by the treadmill. The collected data was processed by SPSS and analyzed by χ²test and t-test. The results of this study were as follows: 1. The health behavior compliance in experimental group was significantly increased (t=5.091, p=.000) when compared to the control group. 2. RPPsubmax also decreased significantly in the experimental group when compared to the control group(t=-2.109, p=.040). 3. The quality of life significantly improved in the experimental group (t=3.853, p=.000) as compared to the control group. As the above results of this study revealed, the effectiveness of the cardiac rehabilitation program of the study was confirmed. It increased the health behavior compliance for reducing the risk of further coronary events, enhanced the cardiovascular functional capacity, and eventually improved the patient's quality of life.

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Factors Influencing Post-Traumatic Growth in Traffic Accident Patient (교통사고 환자의 외상후 성장 영향요인)

  • Cha, Hye Ji;Bang, Sul Yeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.12
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    • pp.254-264
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    • 2019
  • This study is a descriptive correlation study investigating the effects of stress disorder symptoms, resilience, and social network on post-traumatic growth in traffic accident patients. The participants were 158 traffic accident cases enrolled from five 100-bed hospitals situated in city C. Data were collected from July 1 to August 31, 2018, and analyzed by t-test, ANOVA, Pearson's correlation coefficients, and multiple regression using SPSS / Win23. The explanatory power of post-traumatic growth was determined to be 36.9%, and the factors affecting post-traumatic growth were social network and post-traumatic stress disorder. In addition, social networks completely established the relationship between resilience and post-traumatic growth. Our results confirmed that a wider social network and increased symptoms of post-traumatic stress disorder of the traffic accident patient are associated with higher post-traumatic growth. Therefore, it is necessary to explore approaches that improve the social networks and resilience to help post-traumatic growth of traffic accident patients. Additional research is required through repetitive and long-term observation of the accident victims.

Head motion during cone-beam computed tomography: Analysis of frequency and influence on image quality

  • Moratin, Julius;Berger, Moritz;Ruckschloss, Thomas;Metzger, Karl;Berger, Hannah;Gottsauner, Maximilian;Engel, Michael;Hoffmann, Jurgen;Freudlsperger, Christian;Ristow, Oliver
    • Imaging Science in Dentistry
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    • v.50 no.3
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    • pp.227-236
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    • 2020
  • Purpose: Image artifacts caused by patient motion cause problems in cone-beam computed tomography (CBCT) because they lead to distortion of the 3-dimensional reconstruction. This prospective study was performed to quantify patient movement during CBCT acquisition and its influence on image quality. Materials and Methods: In total, 412 patients receiving CBCT imaging were equipped with a wireless head sensor system that detected inertial, gyroscopic, and magnetometric movements with 6 dimensions of freedom. The type and amplitude of movements during CBCT acquisition were evaluated and image quality was rated in 7 different anatomical regions of interest. For continuous variables, significance was calculated using the Student t-test. A linear regression model was applied to identify associations of the type and extent of motion with image quality scores. Kappa statistics were used to assess intra- and inter-rater agreement. Chi-square testing was used to analyze the impact of age and sex on head movement. Results: All CBCT images were acquired in a 10-month period. In 24% of the investigations, movement was recorded (acceleration: >0.10 [m/s2]; angular velocity: >0.018 [°/s]). In all examined regions of interest, head motion during CBCT acquisition resulted in significant impairment of image quality (P<0.001). Movement in the horizontal and vertical axes was most relevant for image quality (R2>0.7). Conclusion: Relevant head motions during CBCT imaging were frequently detected, leading to image quality loss and potentially impairing diagnosis and therapy planning. The presented data illustrate the need for digital correction algorithms and hardware to minimize motion artefacts in CBCT imaging.

The Study For Clinical Measurement of Pain (통증(痛症)의 임상적평가법(臨床的評價法)에 관한 고찰(考察))

  • Shin, Seung-Uoo;Chung, Seok-Hee;Lee, Jong-Soo;Shin, Hyun-Dae;Kim, Sung-Soo
    • The Journal of Dong Guk Oriental Medicine
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    • v.8 no.2
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    • pp.25-46
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    • 2000
  • Pain can be evaluated by experimental methods and clinical methods, but due to subjective characteristics of pain, clinical methods are generally used. The clinical pain measurement tools are divided into unidimensional and multidimensional assessment tools. The former include Visual Analogue Scale, Verbal Rating Scale, Numerical Rating Scale, Pain Faces Scale, and Poker Chip Tool and the latter include McGill Pain Questionnaire, MMPI, Pain Behavior Scale, Pain disability index, and Pain Rating Scale. Unidimensional pain scales mainly measure the intensity of pain on the basis of the patient's self report and their simple construction and ease of use enable the invesgator to assess acute pain. Multidimensional pain scales are used to evaluate subjective, psychological and behavioral aspects of pain and because of its comprehensive and confidential properties they are applied to chronic pain. Patient's linguistic and cognitive abilities are major factors to restrain accurate assessment of pain. Although behavioral patterns and vital sign are inferior to self-report in the measurement of pain, they can be useful indexes in those situations. When deciding on a pain-assessment tool, the investigator must determine which aspect of pain he or she wishes to evaluate on the characteristics of the group of patients, their backgrounds, and their communication skills. Making the proper choice will facilitate the acquisition of meaningful data and the formulation of valid conclusions.

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A Randomized Controlled Trial about the Levels of Radiation Exposure Depends on the Use of Collimation C-arm Fluoroscopic-guided Medial Branch Block

  • Baek, Seung Woo;Ryu, Jae Sung;Jung, Cheol Hee;Lee, Joo Han;Kwon, Won Kyoung;Woo, Nam Sik;Kim, Hae Kyoung;Kim, Jae Hun
    • The Korean Journal of Pain
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    • v.26 no.2
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    • pp.148-153
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    • 2013
  • Background: C-arm fluoroscope has been widely used to promote more effective pain management; however, unwanted radiation exposure for operators is inevitable. We prospectively investigated the differences in radiation exposure related to collimation in Medial Branch Block (MBB). Methods: This study was a randomized controlled trial of 62 MBBs at L3, 4 and 5. After the patient was laid in the prone position on the operating table, MBB was conducted and only AP projections of the fluoroscope were used. Based on a concealed random number table, MBB was performed with (collimation group) and without (control group) collimation. The data on the patient's age, height, gender, laterality (right/left), radiation absorbed dose (RAD), exposure time, distance from the center of the field to the operator, and effective dose (ED) at the side of the table and at the operator's chest were collected. The brightness of the fluoroscopic image was evaluated with histogram in Photoshop. Results: There were no significant differences in age, height, weight, male to female ratio, laterality, time, distance and brightness of fluoroscopic image. The area of the fluoroscopic image with collimation was 67% of the conventional image. The RAD ($29.9{\pm}13.0$, P = 0.001) and the ED at the left chest of the operators ($0.53{\pm}0.71$, P = 0.042) and beside the table ($5.69{\pm}4.6$, P = 0.025) in collimation group were lower than that of the control group ($44.6{\pm}19.0$, $0.97{\pm}0.92$, and $9.53{\pm}8.16$), resepectively. Conclusions: Collimation reduced radiation exposure and maintained the image quality. Therefore, the proper use of collimation will be beneficial to both patients and operators.

Correlation between Sasang Constitution and Eight Principle Pattern Identification, Qi-Blood Pattern Identification, Bing-Xie Pattern Identification by using Oriental Diagnosis System (전문가시스템을 활용한 사상체질과 팔강변증, 기혈변증, 병사변증간의 상관관계)

  • Hwang, Kyo Seong;Park, Jun Gwan;Choi, Seong Un;Noh, Yun Hwan;Cho, Young Seuk;Shin, Dong Ha;Kwon, Young Kyu
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.32 no.6
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    • pp.370-374
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    • 2018
  • Oriental Diagnosis System(ODS) is an artificial intelligence program that utilize entered diagnosis knowledge, determine patient's disease and decide right medicine. The purpose of this study is to find a correlation between pattern Identification in Korean medicine and each sasang types(Tae-Eum and So-Yang) by analyzing ODS diagnosis result. Eventually our study secure availability of using ODS program at clinical training or developing diagnosis program. Subject of this study is 50 patients who was performed Sasang constitution diagnosis (28 patients were Tae-Eum and 22 patients were So-Yang). We analyize patient's diagnosis records by using ODS program and obtained result about pattern Identification. We used SPSS statistics 23 in analyzing the differences of the scores of Eight Principle Pattern Identification, Qi-Blood Pattern Identification, and Bing-xie Pattern Identification in each Sasang types (Tae-Eum, So-Yang). The Heat and Heat-moisture scores were significantly different(p<0.05) and Qi-Blood Pattern Identification scores were not different in each Sasang types(p>0.05). And Weight was significantly different in each Sasang types(p<0.05). It is hard to generalize the result because subject of this study was not enough and had sample speciality(tinnitus patients). However, we explained correlation between pattern Identification in korean medicine and each sasang types based on quantifiable and objective evidence system. it can be used at education of korean medicine and evidence of practice diagnosis. Futhermore, there have been no studies about anaylizing correlation between pattern Identification in Korean medicine and each sasang types using ODS program. So it is worthy of being utilized at clinical evidence data of ODS program.

Work Engagement and Associated Factors among General Hospital Nurses (종합병원 간호사의 업무몰입 관련요인)

  • Park, Jin-Hwa;Lee, Eun-Kyung;Kim, Sun-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.12
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    • pp.462-470
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    • 2018
  • This descriptive survey was conducted to explore the effects of work engagement and its associated factors among general hospital nurses. Nurses working in general hospitals were recruited in D city and K region. Data were analyzed by descriptive statistics, t-test, one-way ANOVA, Pearson's correlations, and stepwise multiple regression using IBM SPSS 25. The mean score of work engagement of the subjects was 3.08. The mean scores of emotional modulation effects in profession, patient focused emotional suppression, and emotional pretense by norms which are subgroups of emotional labor by norms were 3.82, 3.28, and 3.22, respectively, while that of the nursing work environment was 2.59. Work engagement was significantly positively correlated with emotional modulation effects in profession (r=0.30, p=0.001), patient-focused emotional suppression (r=0.20, p=0.030), and nursing work environment (r=0.21, p=0.024). The results showed that the factors that affect the work engagement were age, current position, and emotional modulation effects in profession, which explained 20% of the variance in work engagement (F=10.37, p<0.001). Therefore, to establish strategies for improving the level of work engagement, it is necessary to consider age and current positions of nurses and to develop a nursing intervention program to strengthen emotional modulation effects among general hospital nurses.