• Title/Summary/Keyword: Patient evaluation

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A Study on the Effectiveness of Care of Patients with Alzheimer s Disease According to Residence Arrangement and Types of Services (치매노인의 거주형태 및 서비스유형에 따른 간호관리의 효과분석)

  • 홍여신;박현애;조남옥
    • Journal of Korean Academy of Nursing
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    • v.26 no.4
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    • pp.768-781
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    • 1996
  • The problem of care of patients and families with Alzheimer's disease has become a conscious raising social policy issue in Korea. The government of the Republic of Korea has become cognizant of the situation and has begun searching for ways to remedy it. Thus, there is a need for a comprehensive under-standing of the situation in which patients and their families are struggling and the enormous problems of care. With a realization of the urgent need, this study was done to investigate the situation and the care needs of families with patients with Alzheimer's Disease, and to compare the effectiveness of services utilized by the families in terms of cost and effects on patient's conditions and on family live. The Subjects for the study were 29 families with hospitalized patients, 25 families utilizing hospital outpatient clinics, 14 families utilizing day care facilities, and 16 families with homebound patients. A total of 84 families were interviewed by four trained interviewers using structured and semistructured questionnaires. The data produced from these interviews included : the patient's stage of Alzheimer's disease, patient's bizarre behavior, hours spent on patient care per day, family burden and quality of life, direct and indirect costs encountered in the care of patients, and the families' evaluation of the effectiveness of the services received. The data were analyzed to determine the relationships between family charactersistics, patient's conditions and services utilization. The effectiveness of each of the service entities was assessed through families evaluation and hoped for service and comparisons were made between services in terms of the cost-effectiveness ratios. After initial comparison of cost-effectiveness ratios, further analysis was done to compare between groups for incremental effectiveness for each incremental unit of cost to determine the most cost-effective service entities. The findings of the study are as fellows : 1. The choice of living arrangement and the types of services are a function of the stage of Alzheimer's condition and the economic status of the family. 2. Comparision of the cost of care showed that most expenses were encountered in by families with hospitalization, families using outpatient services, and families using day care services in that order. The least expense was involved in the care of homebound patients. The economic burden felt by families was in the same order as expenses. 3. The average number of hours spent on daily patient care was 9.9 hours for the outpatient clinic users, 9.7 hours for homebound patients, and 5.4 hours for day care users. 4. There were significant differences in the patient's conditions (CDRL), bizarre behaviors and the families's burden by living arrangement and /or types of service. However, no significant difference was found between groups in the family's quality of life. 5. The families rated the services of day care center as most effective for the care of the patients and families, except for a few families who had experienced some improvement in the patient's conditions. The outpatient clinic users expressed psychological comforts mainly in that the patient was being taken care of. For those hospitalized patients, families expressed the comfort of being relieved of the burden of care and that the patient is being professionally cared for. Form the analysis of the costs, hours of patient care, patient's bizarre behaviors, family's quality of life and burdens, and family's evaluation of services, it is concluded that up to the mid stage of Alzheimer's condition, the utilization of day care center services is found to be the most cost-effective, and toward the end stage of the Alzheimer's disease, it is hoped that there will be a establishment of long term or short term in-patient facilities for the protection of patients and preservation of the integrity of families for less cost. Thus. it was concluded that the family centered system of care is the most effective for Korea with systematic support systems developed for the care of patients and their families according to the needs of families as the patient's condition deteriorates.

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A Study on Establishment of Essential Performance Evaluation Criteria for C-arm Computed Tomography (C-arm CT의 필수 성능평가 기준 마련을 위한 연구)

  • Kim, Eun-Hye;Park, Hye-Min;Kim, Jung-Min
    • Journal of radiological science and technology
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    • v.45 no.2
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    • pp.127-134
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    • 2022
  • In order to overcome the image quality limitations of the conventional C-arm, a flat panel detector (FPD) is used to enhance spatial resolution, detective quantum efficiency, frame rate, and dynamic range. Three-dimensional (3D) visualized information can be obtained from C-arm computed tomography (CT) equipped with an FPD, which can reduce patient discomfort and provide various medical information to health care providers by conducting procedures in the interventional procedure room without moving the patient to the CT scan room. Unlike a conventional C-arm device, a C-arm CT requires different basic safety and essential performance evaluation criteria; therefore, in this study, basic safety and essential performance evaluation criteria to protect patients, medical staff, and radiologists were derived based on International Electrotechnical Commission (IEC) standards, the Ministry of Food and Drug Safety (MFDS) standards in Korea, and the rules on the installation and operation of special medical equipment in Korea. As a result of the study, six basic safety evaluation criteria related to electrical and mechanical radiation safety (leakage current, collision protection, emergency stopping device, overheating, recovery management, and ingress of water or particulate matter into medical electrical (ME) equipment and ME systems: footswitches) and 14 essential performance evaluation criteria (accuracy of tube voltage, accuracy of tube current, accuracy of loading time, accuracy of current time product, reproducibility of radiation output, linearity and consistency in radiography, half layer value in X-ray equipment, focal size and collimator, relationship between X-ray field and image reception area, consistency of light irradiation versus X-ray irradiation, performance of the mechanical device, focal spot to skin distance accuracy, image quality evaluation, and technical characteristic of cone-beam computed tomography) were selected for a total of 20 criteria.

Psychodynamic Psychotherapy of PTSD (외상 후 스트레스 장애의 역동정신치료)

  • Kim, Jung-Young;Park, Jong-Il;Yang, Jong-Chul
    • Anxiety and mood
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    • v.11 no.2
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    • pp.106-113
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    • 2015
  • In psychodynamic therapy, trauma related symptoms are considered as an attempt to overcome the traumatic experiences. Therefore, psychodynamic psychotherapy regards the symptom not as a patient's defect but as an adaptive reaction. In contrast to other therapies, psychodynamic theory places heavy emphasis on the understanding and resolution of the patient's symptoms. In addition, transference is a distinctive feature of this theory, which plays a significant role of reflecting the realistic evaluation on the therapist's characteristics, and in guaranteeing the therapeutic alliance. The psychodynamic therapist inducts meaning from the patient's unconscious mind. The therapist's task is to help the patient to better understand defense mechanisms guide their management of experiences and reactions, and facilitate a better understanding of their personal experiences.

A Case Study of a Vertigo Patient Treated with Korean Medical Treatment (한방치료로 호전된 현훈 환자 1례)

  • Kim, Gang-san;Kim, Koang-lok;Park, Dong-ill;Lee, Jun-su
    • The Journal of Internal Korean Medicine
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    • v.37 no.5
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    • pp.903-909
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    • 2016
  • Objective: To evaluate the effect of Korean Medicine on a patient having vertigo disease. Methods: The patient was treated with Korean medicine, including Bongnyeongbanha-tang (茯苓半夏湯) and acupuncture, from October 3, 2015 to October 8, 2015. The Vertigo Score Scale and Numeric Rating Scale were assessed for evaluation. Results: After the treatment, the intensity of vertigo and nausea were decreased and the patient's walking and visual difficulties were improved. Conclusions: Korean Medicine treatment can relieve vertigo symptoms.

Hematoma in Neck after Stellate Ganglion Block (성상신경절 차단후에 발생한 경부혈종)

  • Han, Young-Jin;Choi, Huhn
    • The Korean Journal of Pain
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    • v.7 no.2
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    • pp.270-272
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    • 1994
  • A 43 year old male patient injured in a traffic accident was admitted to the department of general surgery for the treatment of spleen rupture and multiple rib fractures. After subphrenic abscess occurred after splenectomy was treated. After 50 days of admission, left facial palsy occurred with sensory neural hearing loss, and tinnitus by longitudinal fracture of left temporal bone. The patients was consulted to pain clinic for further evaluation and treatment. The patient was treated with stellate ganglion block with 1% lidocaine 6ml one time daily. On 19th day, stellate ganglion block was given as usual, and the patient complained of pain in the neck and headache the next day. Two days later, mild fever elevation and hematoma in the neck were found. Hematoma was drained with hemovac. Ruptured muscular branch of vertebral artery was ligated surgically but the ligation was released in the next day and the hematoma was removed and the artery religated. Five units of packed RBC were transfused during the period and the patient was discharged without any sequelae.

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A Clinical Evaluation of Spontaneous Pneumothorax; A Review of 612 Cases (자연기흉의 임상적 고찰)

  • 황석하
    • Journal of Chest Surgery
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    • v.26 no.11
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    • pp.866-870
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    • 1993
  • Possible enhancement of myocardial protection with oxygenated crystalloid cardioplegia and blood cardioplegia were evaluated in a cardiac enzyme study. The bicarbonate-containing solution equilibrated with 100% oxygen becomes highly alkaline as carbon dioxide is released. 95% oxygen and 5% carbon dioxide was added to the crystalloid cardioplegic solution [St. Thomas` Hospital No. 2 Solution] for prevention of severe alkalinity of oxygenated crystalloid cardioplegia. Heart was arrested and reinfused every 20 minutes throughtout the ischemic period with crystalloid cardioplegia or oxygenated crystalloid cardioplegia or blood cardioplegia. Group I was a patient with crystalloid cardioplegia in 11 patients. Group II was a patient with oxygenated crystalloid cardioplegia in 9 patients. Group III was a patient with blood cardioplegia in 15 patients. The value of CK-MB was evaluated from the patient`s serum at 6 hours, 24 hours, and 48 hours postoperatively. In Group I and II, there was no significant change of CK-MB. In Group I and III, the value of CK-MB at postoperative 6 hours was 114$\pm$83 ng/ml and 56$\pm$22 ng/ml [P < 0.05]. In conclusion, blood cardioplegia was superior to crystalloid cardioplegia.

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The Influence of Inpatient's Experience on Hospital Recommendation Intention - Focusing on the Moderating Effects of Health Condition - (입원 환자경험이 병원 추천의도에 미치는 영향 - 건강상태의 조절 효과를 중심으로 -)

  • Lee, Kyoungsook;Kim, Jeoungae;Lee, WangJun
    • Korea Journal of Hospital Management
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    • v.22 no.3
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    • pp.133-143
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    • 2017
  • Purpose : This study is to analyze the inpatients's experience of medical services provided by hospital including medications, treatments, and environment. Based on the results of surveys conducted as part of the inpatient experience evaluation in A hospital in Goyang, Gyeonggi province. Methodology : A sample of 300 adults aged 19 years or older who had more than one day of hospitalization was selected. The questionnaire was conducted from April 3rd to June 21st, 2017 by telephone. Findings : It is found that recommendation intention influenced by medical services, hospital environment, medication treatment process. but it turns out that there is no moderate effects of health condition between patient's experience and recommendation. Practical Implication : In order to improve the inpatient experience, there should be a way to improve experience in providing patient-centered services in the hospital s environment, medication and treatment.

Infection of Thyroid Cyst Occurring 1 Month after Fine-Needle Aspiration in an Immunocompetent Patient

  • Park, Jung Kyu;Jeon, Eon Ju
    • International journal of thyroidology
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    • v.11 no.2
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    • pp.182-188
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    • 2018
  • Fine-needle aspiration (FNA) with ultrasonography is considered a minimally invasive and safe procedure. Complications of it are infrequent and occur immediately or within a few days after FNA. Such complications may occur mainly in patients with underlying problems. We here report a rare case of thyroid cystic nodule infection occurring 1 month after FNA in an immunocompetent patient and serial sonographic findings in this patient. A 33-year-old woman with a cystic nodule including partially isoechoic solid areas on the right thyroid gland complained of difficulty swallowing and painful sensations in the right neck 1 month after FNA. On follow-up examination, the cystic nodule and perithyroidal soft tissue were suspicious of infection. The possibility of infection after FNA should be considered even if the patient is immunocompetent in order to prompt evaluation and immediate management with empirical antibiotic therapy to avoid life-threatening complications.

A Case-Report of a Taeeumin Patient with Diabetes Mellitus Treated by Mangeummunmu-tang gagambang (당뇨병으로 진단받은 태음인 만금문무탕가감방(萬金文武湯加減方) 치험 1례)

  • Cho, Young;Lee, Jun-Hee
    • Journal of Sasang Constitutional Medicine
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    • v.32 no.4
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    • pp.118-128
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    • 2020
  • We report 1 case about Mangeummunmu-tang gagambang that was used for a Taeeumin patient with diabetes mellitus. We treated a Taeeumin patient who was diagnosed with diabetes at another hospital two months ago. We considered his Sasang constitution as Taeeumin and prescribed Mangeummunmu-tang gagambang. The improvement of his diabetes was evaluated by improvement of his symptoms, results of blood sugar test, bone muscle mass, body fat, body fat rate of inbody test and the results of Blood test & urine test. The evaluation index of the patient's disease has all improved since treatment after Mangeummunmu-tang gagambang medication.

Pathway of Medical Care Seeking of Insured Patients (보험환자의 의료이용 추구경로)

  • 한달선;김병익;이영조;권순호
    • Health Policy and Management
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    • v.2 no.1
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    • pp.115-147
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    • 1992
  • The purposes of this paper are twofold : to identify what pathway insured patients are seeking medical care services through, and then, to provide the basis for the prediction and evaluation of the effects of a new policy intervention. To change the patient flow across different types of medical care facilities, this intervention has been enforced since July 1, 1989. It is mainly aimed at discouraging the use of the tertiary hospitals by imposing some restrictions on the patient's choice. The data for analysis were obtained from the claims to the insurance for govermment and school employees. The sample was drawn from the claims for about 1% of the enrollees using medical care facilities during 2 years since January 1, 1985. The sample included 91, 483 for 1985 and 81,914 for 1986, among them the number of patients to initiate the use of medical care service were 66,757 and 59,498 respectively. This paper analysed what types of and how many medical care facilities the patient with same disease had used.

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