• Title/Summary/Keyword: Patient blood management

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Meta-Analysis on Effectiveness of Intervention to Improve Patient Compliance in Korean (한국인 치료순응도 향상을 위한 개입 효과에 대한 메타분석)

  • 김춘배;조희숙;현숙정;박애화
    • Health Policy and Management
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    • v.12 no.2
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    • pp.23-42
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    • 2002
  • The purpose of this study was to analyze the results of 133 studies related to patient compliance published between 1980 and 2001 and to assess the effectiveness of intervention on compliance by using meta-analysis. We collected the existing literatures by using web and manual search 'patient compliance', 'sick role behavior', 'major clinical disease', and 'intervention' as key words and by reviewing content of journals related to medicine, nursing and public health. The compliance interventions were classified by theoretical focus into educational, behavioral, and affective categories within which specific intervention strategies were further distinguished. The compliance indicators broadly represent five classes of compliance-related assessments: (1) health outcomes (eg, blood pressure and hospitalization), (2) direct indicators (eg, urine and blood tracers and weight change), (3) indirect indicators (eg, pill count and refill records), (4) subjective report (eg, patients' or others' reports), (5) utilization (appointment making and keeping, use of preventive services). Quantitative meta-analysis was performed by MetaKorea program which was developed for meta-analysis in Korea. Among the 133 articles, 10 studies were selected through the qualitative meta-analysis process, and then only 6 studies were selected for the quantitative meta-analysis finally. The interventions produced significant effects for all the compliance indicators with the magnitude of common effect size (4.1192) than the non-intervention group in a random effect model. The largest effects were each study for patient of hypertension using health outcome such as blood pressure (0.4679) and diabetes mellitus using direct indicator such as glucose level in blood and urine (0.7753). These results suggest that strategic interventions showed clear advantage for improvement of patient compliance compared with non-intervention group.

A New Scale(NS) Score System to Predict Outcome of Intracranial Aneurysm Using TCD (TCD를 이용한 두개강내 동맥류의 예후 예측 가능한 New Scale(NS) Score System)

  • Park, Sang Hoon;Park, Chong Oon;Park, Hyeon Seon;Hyun, Dong Keun;Ha, Young Soo
    • Journal of Korean Neurosurgical Society
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    • v.30 no.8
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    • pp.970-975
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    • 2001
  • Objective : By conducing a review of clinical outcomes for patients with aneurysm treated using current microneurosurgical techniques and intensive care unit management, we speculated that grading systems based only on clinical condition or CT finding after admission failed to provide a significant stratification of outcome between individual grades of patients, because these systems did not include the factor for postoperative vasospasm. We hypothesized that postoperative blood flow velocity could have a significant impact on outcome prediction for patients surgically treated for intracranial aneurysms. Methods : We conducted a analysis on patient- and lesion-specific factors that might have been associated with outcome in a series of 55 aneurysm operations performed with measurements of blood-flow velocity with transcranial Doppler ultrasonography(TCD). In the new scale(NS) score system, 1 point is assigned additionally for the case with Hunt and Hess(H-H)/World Federation of Neurological Surgeons(WFNS) Grade IV or V, Fisher Scale(FS) score 3 or 4, aneurysm size greater than 10mm, patient age older than 60 years, blood-flow velocity higher than 120cm/sec, and posterior circulation lesion. By adding the total points, a 6-point scale score(score 0-6) is obtained. Results : Age of patient, size of aneurysm, clinical condition(H-H grade and WFNS), FS score, and blood flow velocity(TCD 1day after operation) were independently and strongly associated with long-term outcome. When NS scores were applied to 55 patients with at least 6 months follow-up, the correlation of individual scores with outcome was strongly validated the retrospective findings. Conclusion : It was speculated that TCD could be used to assess postoperative vasospasm and to monitor noninvasively the patients with aneurysmal SAH. This NS score system is easy to apply, divide patients into groups with different outcome, and is comprehensive, allowing for more accurate prediction of surgical outcome.

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An unstable patient with a large sucking chest wound managed with gauze packing for preventing tension and bleeding control before surgery in Korea: a case report

  • Chang-Sin Lee;Min-Jeong Cho;Tae-Wook Noh;Nak-Jun Choi;Jun-Min Cho
    • Journal of Trauma and Injury
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    • v.37 no.2
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    • pp.147-150
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    • 2024
  • This case report describes the management of a 51-year-old female patient who arrived at the emergency room with a stab wound to the upper right chest. Immediate medical interventions were undertaken, including blood transfusions and endotracheal intubation. To prevent tension and control bleeding, gauze packing was applied directly through the large open wound. Further surgical exploration identified a laceration in the lung, necessitating a right upper lobe resection. Postoperatively, the patient's vital signs stabilized, and she was subsequently discharged without complications. This case highlights the decision-making process in selecting between an emergency department thoracotomy and an operating room thoracotomy for patients with penetrating chest trauma. It also illustrates the role of gauze packing in managing tension and hemorrhage. In summary, gauze packing can be an effective interim measure for stabilizing patients with traumatic injuries, unstable vital signs, and large open chest wounds, particularly when a chest tube is already in place, to prevent tension and facilitate bleeding control prior to surgical intervention.

Research Trend on Diabetes Mobile Applications: Text Network Analysis and Topic Modeling (당뇨병 모바일 앱 관련 연구동향: 텍스트 네트워크 분석 및 토픽 모델링)

  • Park, Seungmi;Kwak, Eunju;Kim, Youngji
    • Journal of Korean Biological Nursing Science
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    • v.23 no.3
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    • pp.170-179
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    • 2021
  • Purpose: The aim of this study was to identify core keywords and topic groups in the 'Diabetes mellitus and mobile applications' field of research for better understanding research trends in the past 20 years. Methods: This study was a text-mining and topic modeling study including four steps such as 'collecting abstracts', 'extracting and cleaning semantic morphemes', 'building a co-occurrence matrix', and 'analyzing network features and clustering topic groups'. Results: A total of 789 papers published between 2002 and 2021 were found in databases (Springer). Among them, 435 words were extracted from 118 articles selected according to the conditions: 'analyzed by text network analysis and topic modeling'. The core keywords were 'self-management', 'intervention', 'health', 'support', 'technique' and 'system'. Through the topic modeling analysis, four themes were derived: 'intervention', 'blood glucose level control', 'self-management' and 'mobile health'. The main topic of this study was 'self-management'. Conclusion: While more recent work has investigated mobile applications, the highest feature was related to self-management in the diabetes care and prevention. Nursing interventions utilizing mobile application are expected to not only effective and powerful glycemic control and self-management tools, but can be also used for patient-driven lifestyle modification.

Healthcare Application based on Radio Frequency (무선 통신 기반의 헬스케어 어플리케이션)

  • Seo, Jung-hee;Park, Hung-bog
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2009.05a
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    • pp.899-902
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    • 2009
  • As computer network and wireless technology continue to grow rapidly, a wide range of remote application has been applied to medical field such as remote medical consulting and remote patient monitoring. This research aims to design RF telecommunication-based healthcare application to collect and manage patient's physiological data, and describe the overall procedure of experiment. MySQL database is designed to record patient's physiological data including temperature, blood pressure and heart rate and save information about medical behaviors such as doctor's prescription for patients. Therefore, users approved by healthcare application can query patient's data and collected data can be used to reorganize data for clinical test. As a result, temperature and humidity of patient's room which must be checked frequently can be processed automatically through ubiquitous sensor network. The information entered from mobile phones or web is saved in database, ensuring systematical management through computer. Moreover, patient's family members can easily access hospital data, improving their experience with medical service.

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Postoperative Rehabilitation of Lumbar Spine (요추 수술 후 환자의 재활)

  • Kim, Ho-Jun;Lee, Jong-Soo
    • The Journal of Korea CHUNA Manual Medicine
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    • v.2 no.1
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    • pp.111-120
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    • 2001
  • We reviewed literatures of western and oriental medicine about postoperative management of spine. Traditionally, with orthoses and bed rest, many physicians restricted activity of daily life and back exercises of patients who had taken spine surgery. More aggressive early mobilization, however, such as strengthening exercise and stretching after 4 weeks of surgery gets grounds nowadays. Physical therapies including manipulation, TENS, MENS, ultrasound and cryotherapy are being used as helpful treatment modalities of postoperative pain and swelling. Failed back surgery syndrome occurs due to wrong patient, diagnosis and surgery and is managed with conservative treatment or reoperation. In oriental medicine, treatments of musculoskeletal injuries including surgical wound are based on the balance of chi(氣) and blood(血).

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Diagnosis and Management of Post-Partum Hemorrhage Caused by Acquired Hemophilia A: A Case Report

  • Rashid, Nawshirwan G.;Amin, Shaema Salih;Abdulqader, Aveen M. Raouf
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.2
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    • pp.163-166
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    • 2022
  • Acquired hemophilia A (AHA) is an uncommon autoimmune bleeding disorder in which autoantibodies that affect the functions of factor VIII (FVIII) are present in the blood. The initial diagnosis of AHA is difficult as the presentations of AHA differ from those of congenital hemophilia A. Moreover, the treatment of AHA is more complex due to the presence of autoantibodies against FVIII. Here, we present a case report of postpartum AHA, to increase the perception and knowledge regarding the recognition and management of such cases. We present a young female with the chief complaint of vaginal bleeding and upper arm ecchymosis. Laboratory results exhibited isolated prolonged activated partial thromboplastin time (APTT) and FVIII inhibitors. The patient was treated with corticosteroids, FVIII concentrates, and a bypassing agent. In conclusion, unexplained postpartum bleeding, unmanageable with basic hemostatic measures, should lead to clinical suspicion of an acquired bleeding disease.

Impact Factors and Validity of Blood Variables on Death in COVID-19 patient: Using Data of Korea Disease Control and Prevention Agency

  • Kim, Yu-Rin;Nam, Seoul-Hee;Kim, Seon-Rye
    • Journal of the Korea Society of Computer and Information
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    • v.25 no.11
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    • pp.179-185
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    • 2020
  • In this paper, we propose impact factors and validity of blood variables on death of COVID-19 patients. The clinical-epidemiological data of 5628 COVID-19 patients, provided from Korea Disease Control and Prevention Agency as day of 30th April 2020, were used. As results, impact factors of death were dementia, older age, high lymphocyte, cancer, dyspnea, COPD, change of consciousness, heart disease, high platelets, abnormal diastolic pressure and fever. The validities of blood variables for death were high in the order of lymphocyte, hemoglobin, hematocrit, platelet and WBC. Therefore, risk factors such as initial clinical characteristics, underlying disease and blood test results, could be regarded for efficient management of COVID-19 patients.

A single injection of saphenous nerve block reduces postoperative bleeding after total knee arthroplasty (무릎전치환술 환자에서 일회성 복재신경차단술이 수술 후 출혈량 감소에 미치는 영향)

  • Choi, Yun Suk;Yun, So Hui;Cho, Seung Yeon;Song, Seung Eun;Kim, Sang Rim
    • Journal of Medicine and Life Science
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    • v.18 no.1
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    • pp.11-15
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    • 2021
  • In elderly patients, the vital parameters tend to fluctuate based on the blood volume status, which may cause sudden hypovolemic shock if the postoperative bleeding continues. Particularly, those who undergo surgery for arthritis needs to pay extra attention because the bleeding may persist over the joints after the surgery. Therefore, appropriate pain control is required to reduce the postoperative blood loss. This retrospective chart review study was conducted to assess the postoperative pain control and reduction of blood loss with a single injection of saphenous nerve block (SNB) in elderly patients with osteoarthritis. We reviewed the electronic medical records of patients who underwent knee total arthroplasty with spinal anesthesia between January and May 2016. A total of 51 patients participated in this study. All patients were treated with intravenous patient-controlled analgesia for the postoperative pain control, and additional analgesic agents were administered at a visual analogue scale above a score of 6. In 25 patients, SNB was performed using ultrasound with the administration of 0.75% ropivacaine (15 mL) after the surgery. Patients who received additional analgesics were significantly low in the nerve block group (P=0.009). Additionally, the volume of blood loss from catheter drainage was significantly low at 2 and 3 days postoperatively (P=0.013 and P=0.041, respectively) in the nerve block group. In patients who underwent total knee arthroplasty with osteoarthritis, only a single injection of saphenous nerve block was sufficient for the postoperative pain control and reduced bleeding.

Survey of Point-of-Care Testing Devices for Pre-hospital EMS Equipment of Glucometer on Local Area (지역 EMS의 현장검사 혈당측정기 사용에 대한 실태조사)

  • Byeong-Hyun, Kim;Dai-Hai, Choi;Gyoung-Yim, Ha
    • Journal of agricultural medicine and community health
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    • v.47 no.4
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    • pp.220-228
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    • 2022
  • Objective: glucometer is one of POCT(point-of-care testing) devices used by EMS. Accurate measurement value is important for patient decision making. Quality control is necessary for this, but most EMS are still using glucometer without quality control it. Therefore, management status and quality control status of glucometers used by 119 paramedics waswere investigated. Methods: 6 and 8 of glucometers and blood glucose test strips were submitted from 4 safety centers in 2010 and 8 safety centers in 2012, respectively. Glucometers submitted by local safety centers were analyzed in 2010 and 2012. The control glucometer, which was well managed at A University Hospital, was assumed to be accurate for at blood glucose measurement. Glucose values of various quality control materials control solutions were measured and analyzed using linear regression and Pearson's correlation test. Error rates were obtained via error tolerance range required by the 2011 ISO(International Organization for Standardization) guideline. For statistics, Excel and MedCalC programs were used. Results: mong 14 safety centers in the region, 4 centers(28.5%) in 2010 and 8 centers(57.1%) in 2012 submitted 6 and 8 glucometers. In the first evaluation in 2010, 2 out of 6(33.3%) glucometers were untestable due to error, and 45 out of 6(66.683.3%) blood glucose test strips' validity were expired. In the second evaluation in 2012, 1 out of 8(13.5%) glucometers were untestable due to lack of battery, and 2 out of 8(25%) blood glucose test strips' validity were expired. All correlation coefficients were above 0.989 in 2010 and above 0.997 in 2012. Error rates were generally high when using expired blood glucose test strips. Conclusion: Among 119 paramedics' guideline, quantity and operation status of POCT devices are well managed, but quality control is not. Therefore, it is necessary to add management status and quality control status of POCT devices to the EMS' field work guideline.