• Title/Summary/Keyword: Patient's data

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Collective Experience: A Database-Fuelled, Inter-Disciplinary Team-Led Learning System

  • Celi, Leo A.;Mark, Roger G.;Lee, Joon;Scott, Daniel J.;Panch, Trishan
    • Journal of Computing Science and Engineering
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    • v.6 no.1
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    • pp.51-59
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    • 2012
  • We describe the framework of a data-fuelled, interdisciplinary team-led learning system. The idea is to build models using patients from one's own institution whose features are similar to an index patient as regards an outcome of interest, in order to predict the utility of diagnostic tests and interventions, as well as inform prognosis. The Laboratory of Computational Physiology at the Massachusetts Institute of Technology developed and maintains MIMIC-II, a public deidentified high- resolution database of patients admitted to Beth Israel Deaconess Medical Center. It hosts teams of clinicians (nurses, doctors, pharmacists) and scientists (database engineers, modelers, epidemiologists) who translate the day-to-day questions during rounds that have no clear answers in the current medical literature into study designs, perform the modeling and the analysis and publish their findings. The studies fall into the following broad categories: identification and interrogation of practice variation, predictive modeling of clinical outcomes within patient subsets and comparative effectiveness research on diagnostic tests and therapeutic interventions. Clinical databases such as MIMIC-II, where recorded health care transactions - clinical decisions linked with patient outcomes - are constantly uploaded, become the centerpiece of a learning system.

Content Analysis with Counseling Cancer Patients and Their Relatives in Outpatient Hospice Office (일 호스피스실 이용 환자와 가족의 상담내용 분석)

  • Choi, Eun-Sook;Kim, Keum-Soon
    • The Korean Journal of Rehabilitation Nursing
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    • v.8 no.1
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    • pp.50-58
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    • 2005
  • Purpose: The purpose of this study was to increase our understanding of the terminal cancer patients and their families concerns. I analyzed the counseling contents of terminal cancer patients and their relatives who referred to hospice office. Method: Data was collected from January 2004 to November 2004. During the counseling, I took notes the key points and contents. 109 patients and/or their families's counseling records were analyzed with the descriptive statistics and content analysis. Result: 73.4% of patients knew their current terminally ill status. The mobility of 86.2% of the patients was worse than ECOG 3 level. Patients have uncontrolled pain(28.4%), emotional distress(55.0%), and physical distress(49.5%). Caregivers of the patients were spouse(46.8%), sons and daughters(24.8%). Family members had problems to tell the bad news to their family cancer patient. 95.4% of the patient and family members was informed about the hospice and palliative care services, and 35.8% of them was referred to the hospice and palliative organizations. Frequently asked questions were 'what is hospice?', 'how much is the cost of hospice services?' etc. Conclusion: Care planning for terminal cancer patients must include patient. Also, professionals should consider and offer accessible, effective and empathetic counseling services to patients and families.

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Reirradiation of head and neck cancer in the era of intensity-modulated radiotherapy: patient selection, practical aspects, and current evidence

  • Kim, Yeon Sil
    • Radiation Oncology Journal
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    • v.35 no.1
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    • pp.1-15
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    • 2017
  • Locoregional failure is the most frequent pattern of failure in locally advanced head and neck cancer patients and it leads to death in most of the patients. Second primary tumors occurring in the other head and neck region reach up to almost 40% of long-term survivors. Recommended and preferred retreatment option in operable patients is salvage surgical resection, reporting a 5-year overall survival of up to 40%. However, because of tumor location, extent, and underlying comorbidities, salvage surgery is often limited and compromised by incomplete resection. Reirradiation with or without combined chemotherapy is an appropriate option for unresectable recurrence. Reirradiation is carefully considered with a case-by-case basis. Reirradiation protocol enrollment is highly encouraged prior to committing patient to an aggressive therapy. Radiation doses greater than 60 Gy are usually recommended for successful salvage. Despite recent technical improvement in intensity-modulated radiotherapy (IMRT), the use of concurrent chemotherapy, and the emergence of molecularly targeted agents, careful patient selection remain as the most paramount factor in reirradiation. Tumors that recur or persist despite aggressive prior chemoradiation therapy imply the presence of chemoradio-resistant clonogens. Treatment protocols that combine novel targeted radiosensitizing agents with conformal high precision radiation are required to overcome the resistance while minimizing toxicity. Recent large number of data showed that IMRT may provide better locoregional control with acceptable acute or chronic morbidities. However, additional prospective studies are required before a definitive conclusion can be drawn on safety and effectiveness of IMRT.

Pre-diagnosis Management in WSN based Portable Healthcare Monitoring System (무선센서네트워크 기반 휴대용 헬스케어 모니터링 시스템을 위한 휴대폰 자체 간이진단 관리)

  • Hii, Pei-Cheng;Lee, Seung-Chul;Chung, Wan-Young
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2009.10a
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    • pp.538-541
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    • 2009
  • Increasing of number of people who suffered from long term chronic diseases which required frequent daily health monitoring and body check up in conjunction with the trendy uses of mobile phones and Personal Digital Assistants (PDAs) in various ubiquitous computing had make portable healthcare system a well known application today. A mobile phone based portable healthcare monitoring system with multiple vital signals monitoring ability at real time in WSN and CDMA network is developed. This system carries out real time monitoring and local data analysis process in the mobile phone. Any detection of abnormal health condition and diagnosis at earlier stage will reduce the risk of patient's life. As an extension to the existing model, a pre-diagnosis management system (PDMS) is designed to minimize the time consuming in pre-diagnosis process in the hospital or healthcare center. An alert is sent to the web server at the healthcare center when the patient detects his health is at critical state where the immediate diagnosis is needed. Preparation of diagnosis equipments and arrangement of doctor and nurses at the hospital side can be done earlier before the arrival of patient at the hospital with the help of PDMS. An efficient pre-diagnosis management increases the chances of diseases recovery rate as well.

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Factors Affecting the Quality of Life of Family Caregivers of Patients with Parkinson Disease (파킨슨병 환자 가족의 삶의 질에 미치는 영향요인)

  • Kim, Gyuri;Kim, Minju
    • Journal of muscle and joint health
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    • v.26 no.2
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    • pp.102-110
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    • 2019
  • Purpose: The purpose of this study was to investigate the factors affecting the quality of life of family caregivers of patients with Parkinson disease in Korea. Methods: A total of 162 family caregivers of patients with Parkinson disease who were visiting the D hospital in B city completed questionnaires, including general and disease-specific characteristics, family burden, patient-caregiver relationship satisfaction, family support and quality of life. Data were analyzed with t-test, ANOVA with $Scheff{\acute{e}}$ test, Pearson's correlation coefficient, and multiple regression analysis using SPSS 23.0. Results: The average score of the quality of life was $85.54{\pm}17.74$ (range: 26~130) among family caregivers of patients with Parkinson disease. Stepwise multiple regression analysis revealed that fifty percent of the quality of life was explained by family support, family burden, and patient-caregiver relationship satisfaction. Conclusion: Family support, family burden, and patient-caregiver relationship satisfaction were identified as factors affecting the quality of life of family caregivers of patients with Parkinson disease. Therefore, it is necessary to develop a program to enhance family support and reduce family burden to improve the quality of life of family members caring for patients with Parkinson disease.

The Relationship Between Educational Needs and the Caregiving Burden in Stroke Patients' Primary Caregivers (뇌졸중 환자를 돌보는 주 보호자의 교육 요구도와 돌봄부담과의 관계)

  • Kim, Un-Kyeung;Yu, Hye-Yon
    • Quality Improvement in Health Care
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    • v.25 no.1
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    • pp.29-42
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    • 2019
  • Purpose: The aim of the present study was to identify the relationship between educational needs and the caregiving burden of primary caregivers with stroke patient. Methods: This cross-sectional and descriptive study was conducted in 2016 with 115 primary caregivers for stroke patients at a university hospital. The caregiving burden and educational needs were investigated using structured questionnaires via interviews. Data were analyzed with descriptive statistics, the t-test or ANOVA, and Pearson's correlation analysis using IBM SPSS Statistics version 23.0. Results: The scores of caregiving burden and educational needs of primary caregiver with stroke patient were $77.65{\pm}1.66$ and $123.33{\pm}2.37$, respectively. The caregiving burden was associated with health status in primary caregivers' general characteristics. The caregiving burden and educational needs of primary caregivers have a significant correlation (r = .44, p <.001). Conclusions: Educational needs of primary caregivers with stroke patient are associated with their caregiving burden. Therefore, it is necessary to develop a primary caregiver centered intervention program considering educational needs to improve their caregiving burden. Also, to promote quality of nursing, there is the need to increase the educating competency of nurse and nursing professionalism of clinical nurse using various educational training program.

Validity and Reliability of the Korean Version of the Ethical Sensitivity Questionnaire for Nursing Students (간호대학생의 한국어판 윤리적 민감성 측정도구 타당도와 신뢰도)

  • Min, Hye Young;Kim, Yoon Jung;Lee, Jung Min
    • Research in Community and Public Health Nursing
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    • v.31 no.4
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    • pp.503-513
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    • 2020
  • Purpose: The purpose of this study was to evaluate the validity and reliability of the Korean version of the Ethical Sensitivity Questionnaire for Nursing Students (KESQ-NS). Methods: The participants were 138 nursing students who have experience in clinical practice. The Korean version of ESQ-NS (KESQ-NS) was examined using content validity, construct validity, criterion-related validity, and testing of internal consistency reliability. Data were collected from November to December of 2019 through an online-survey. Results: The KESQ-NS that was composed of 13 items was divided into three dimensions: Critical understanding of the patient, patient holistic care, patient privacy, and confidentiality. The instrument explained 67.9% of the total variance for ethical sensitivity. Cronbach's α was .88. Conclusion: The KESQ-NS showed good validity and reliability. This instrument can be used to evaluate ethical sensitivity in nursing students in Korea.

The Effect of Perceived Patient- and Family-Centered Care on Nurses' Caring Behavior in Intensive Care Units (중환자실 간호사의 환자-가족 중심 간호에 대한 인식이 돌봄 행위 수행에 미치는 영향)

  • Kim, Na-Yeon;Choi, Hye-Ran
    • Journal of Korean Biological Nursing Science
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    • v.23 no.3
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    • pp.208-216
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    • 2021
  • Purpose: The purpose of this study was to identify the factors influencing nurses' caring behavior. Methods: The descriptive study included 178 intensive care unit (ICU) nurses who completed a self-report structured questionnaire. The data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, and Pearson's correlation and multiple regression analysis using the IBM SPSS/WIN 23.0 program. Results: Significant correlation existed between perception of Patient- and Family-Centered Care (PFCC) and nurses' caring behaviors (r=.36, p<.001). Multiple regression analysis showed that perception of support (β=.36, p<.001), total career length (β=.33, p<.001), and familiarity with PFCC (β=.15, p=.018) affected the caring behavior of ICU nurses. These variables explained 30.0% of the variance in caring behavior. Conclusion: Effective strategies are needed to improve perceptions of support as well as to promote PFCC for increasig the frequency of caring behavior among ICU nurses.

Development of the Upper Wear Fixation Device for Chest AP X-ray Imaging on the Emergency Stretcher Bed (응급실 침대 위 흉부전후방향 엑스선 검사를 위한 상의고정장치 개발)

  • Lim, Woo-Taek;Hong, Dong-Hee
    • Journal of radiological science and technology
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    • v.45 no.3
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    • pp.205-211
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    • 2022
  • This study aimed to provide basic data for 3D printing in the medical health field by developing upper wear fixation device (UWFD), an auxiliary device for shortening chest AP examination time on emergency room beds and non-contact with patients. The standard of hooks was modeled according to the bed frame using the Autodesk Fusion 360. It was printed with Form2 (Formlabs, Somerville, MA, USA), as SLA (stereo lithography apparatus) method, and was washed and hardened using Form Wash and Form Cure. The completed UWFD conducted an online survey on 4 items of stability, convenience, availability, preference and general characteristics. The total stability average was 3.93±0.80, the total convenience average was 3.93±0.68, the total availability average was 4.01±0.89, and the total preference average was 3.80±1.08. This study was significant in suggesting improvements in the general X-ray examination process in the emergency room by designing and making aids to easily fixing the patient's top to the frame of the emergency bed while meeting promptness and non-contact with the patient.

Behavioral Strategies for Weight Loss Maintenance (체중감량 이후 장기적인 유지를 위한 다양한 행동전략)

  • Young Hye Cho
    • Archives of Obesity and Metabolism
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    • v.2 no.1
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    • pp.6-10
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    • 2023
  • Compensatory changes in energy consumption and neuro-hormonal changes following weight loss make it difficult to maintain the reduced weight and may cause weight regain. Therefore, establishing a long-term weight control plan and strategy starting from the initial weight loss period is necessary. Both the patient and doctor should know that weight loss cannot occur continuously, and that maintaining weight after the weight loss period is the basic course of obesity treatment. No single dietary pattern is effective for weight maintenance, and a variety of dietary control methods - such as calorie restriction and healthy proportions of carbohydrates, proteins, fats, and meal replacements - should be used to target an integrated and healthy dietary habit. An increase in physical activity is needed for weight loss and maintenance; however, rather than recommending an excessive amount of exercise, it is better to set realistic and long-term achievable goals. It is necessary to reset the goal according to the patient's weight maintenance stage and continuously apply behavioral therapies, such as self-monitoring and stress management. In previous studies, since the degree of weight loss and changes in behavioral patterns over the course of one year were important factors in maintaining long-term weight loss, obesity therapists should closely examine patient data and behavioral patterns across a period of one year and actively intervene when needed.