• 대한물리의학회지
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• 제13권3호
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• pp.49-60
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• 2018

PURPOSE: This study was conducted to investigate the intervention effect obtained by applying an ICF tool to improve the dressing in a patient with rotator cuff syndrome to schematize the problems and approaching with PNF to solve the problems. METHODS: The subject of this study was a 44-year-old patient who underwent surgery after complete right rotator cuff tear. To treat his symptoms, the processes of clinical practice were implemented in the order of examination, assessment, diagnosis, prognosis, intervention, and outcome. During examination, patient information was collected using the ICF core set. In the assessment, the problems were schematized, and an ICF assessment sheet was used to identify the interaction of the problems. The diagnosis was made by clearly describing the causal relationship derived from the assessment in ICF terms. To solve the problems, the intervention was given in the order of indirect, direct, and task based on the philosophy of PNF. To evaluate the outcome, the differences before and after the intervention were compared. Additionally, the comparison for the ICF qualifier is presented with the ICF evaluation display. RESULTS: The results of the study showed clinical advantages in shoulder strength, eccentric control, range of motion, scapular stability, and shoulder pain. Overall, our patient with rotator cuff syndrome showed improvement in dressing and undressing activity in response to the PNF strategy. CONCLUSION: Application of the PNF intervention strategy after complete rotator cuff tear would have a positive effect on patient upper extremity function.

• 한국의료질향상학회지
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• 제2권2호
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• pp.46-54
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• 1996

Background : The medical record is a compilation of pertinent facts of a patient's life and health history, including past and present illness and treatment. It is written by the health professionals contributing to that patient's care. And the medical record is the permanent, legal document which must contain sufficient information to identify the patient, justify the diagnosis and treatment, and record the results. As such, it must be accurate and complete. So we try to analyze the medical record especially a kind of incomplete record, loose laboratory reports. Methods: During the one-year period(from January to December 1988), a medical record practitioner examine and analyze the record of laboratory reports at K Hospital in Seoul. A total of 320 loose laboratory reports for 3,818 admitted laboratory reports. And a medical record practitioner and a physician review and analyze the influencing factors for the various reasons of clinical and laboratory aspects. Result: The loose percentage by department is the highest in obstetrics(40.4%) but the highest loose rate is in pediatrics(25.0%). The most of omission is occurred in operation room(80.3%) than OPD(19.7%). The change of diagnosis is according to duration of laboratory and more changable in cancer patient. Conclusion : Regular analysis of the documentation in the medical record so it fulfills its purposes of communicating patient care information. So it serves as evidence of the patient's course of illness and treatment for various legal, reimbursement, and peer evaluation review. And it is very important aspect of quality assurance in medical activities.

• 한국임상약학회지
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• 제19권2호
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• pp.131-145
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• 2009

Background: Medication counseling is important to improve qualify of pharmaceutical care, but there are lack of studies to investigate satisfied counseling practice in community pharmacies. Purpose: This study was to investigate current medication counseling provided by community pharmacists. Method: Questionnaires to assess medication counseling practices were mailed to nationwide 1,269 community pharmacists who were Sookmyung Women's University alumni. Result: One hundred sixty five pharmacists were responded to the questionnaires (response rate 13.63%). 16.8% of them all respondents had counseling room in their pharmacies. 75% and 29.9% of respondents provided patient counseling always for new and refilled prescriptions, respectively. Counseling was provided primarily by verbal, but especially for drug name, usage and storage, it was provided in written concurrently. 31.1% of respondents was satisfied with counseling practices by themselves, and a major barrier of unsatisfied counseling was lack of time in 64.6% of respondents. Majorities of respondents (66.3% and 76.3%) spent 1-3 minutes and <1 minute, for new prescription and refilled prescription, respectively. Approximate 99% of respondents presented necessity of standardized patient counseling information for drugs and 97.6% responded that quality of patient counseling would be improved by using software containing counseling information. Old respondent group had higher accumulative patient counseling practice scores and pharmacy owner group took much time for counseling, resulting in higher scores too. Conclusion: This study showed that qualified patient counseling practice has not been reached in community pharmacies. Much more discussion to seek ways to improve the quality would be necessary.

• 한국방사선학회논문지
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• 제10권1호
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• pp.39-44
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• 2016

본 연구는 전립선암의 치료방법 중 근접치료 시 환자 주변의 공간에 대한 선량을 평가한 것으로 환자, 시술자 그리고 보호자에 대한 선량을 예측함으로서 피폭을 최소한으로 예방하고자 수행하였다. 실험방법은 몬테칼로법을 기반으로 한 MCNPX를 사용하여 가상의 공간에서 모의피폭체를 만들어 실험하였으며, 선원은 $^{192}Ir$, $^{125}I$, $^{103}Pd$를 seed 형태로 이식하였다. 환자를 중심으로 전방 30, 50, 100, 200 cm 거리에 관심영역을 설정하여 공간 선량을 평가하였다. 그 결과 거리에 관계없이 $^{192}Ir$에서 가장 높은 선량을 나타내었다.

• 한국임상약학회지
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• 제26권1호
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• pp.33-39
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• 2016

Background: Elements of informed consent including capacity, disclosure, understanding, voluntariness, and permission of the participant, are all crucial for clinical trials to be legally and ethically valid. During the informed consent process, the patient information leaflet is an important information source which prospective research subjects can utilize in their decision-making. In the adequate provision of information, KGCP guideline necessitate 20 specific items, as well as the use language that individuals can understand. This study measures the vocabulary level of patient information leaflets in an effort to provide an objective evaluation on the readability of such material. Methods: The word difficulty of 13 leaflets was quantitatively evaluated using Kim kwang Hae's vocabulary grading framework, which was compared to the difficulty level of words found in the $6^{th}$ grade Korean textbook. The quantitative outcomes were statistically analyzed using chi-squared tests and linear by linear association for ordinal data. Results: There was a statistically significant difference between the vocabulary level and frequency of words in leaflets and the 6th Korean textbook. The leaflets were on average 260 sentences and about roughly 15 pages long, including lay language (easier or equal to language used in primary school) of around 12% less; technical language of around 4.5% more. As the vocabulary grades increase, there was a distinct difference in vocabulary level between Korean textbook and each information leaflet (p < 0.001). Conclusion: Patient information leaflets may fail to provide appropriate information for self-determination by clinical trial subject through the difficulty level of its wording. Improvements in the degree of patients' understanding and appropriate use of information leaflets are collaboratively equipped to strengthen patient's autonomy and therefore guaranteeing participant's rights.

• 대한족부족관절학회지
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• 제13권1호
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• pp.80-84
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• 2009

Purpose: The purpose of this article is to assess the efficacy of a bioabsorbable polylactide (PLA) plate and screw for treating injuries of ankle fractures. Materials and Methods: 24 patients who underwent an open reduction and internal fixation operation for ankle fractures from July 2005 to March 2007 were enrolled into the study. There were 15 men and 9 women. The average age of the patients was 44 years and the average follow-up period was 16 years and two months (16.2 months). All cases were divided into low grade fracture patient (11) who belongs in type A and B of Danis-Weber classification and high grade fracture patient (13) who belongs in type C1, C2 of Danis-Weber classification, and each groups were analyzed by clinical (Meyer score) and radiological finding at the time of their last follow-up evaluation. Results: The clinical results according to Meyer scoring system, showed that all patient with low grade fracture had good to excellent result, but only 54% of patient with high grade fracture had good to excellent result. According to Cedell's radiologic finding, there were 91% cases above fair in low grade fracture. But there were 62% of patient above fair result in high grade fracture, the reduction losses were seen in 38% of patient with high grade fracture. Conclusion: Bioabsorbable PLA plate and screw is good internal fixation device which doesn't have additional operation for removal of implant because of slow absorption within the human body. It showed sufficient strength for acquisition and maintenance of reduction in low grade fracture, but need attention to use because of many cases of reduction loss in high grade fracture. So, it seems to be safe and effective when used in heeling of low grade fracture under considering about type of fracture sufficiently.

• 보건행정학회지
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• 제26권4호
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• pp.289-304
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• 2016

Background: Rehabilitations in subacute phase are different from acute treatments regarding the characteristics and required resource consumption of the treatments. Lack of accuracy and validity of the Korean Diagnosis Related Group and Korean Out-Patient Group for the acute patients as the case-mix and payment tool for rehabilitation inpatients have been problematic issues. The objective of the study was to develop the Korean Rehabilitation Patient Group (KRPG) reflecting the characteristics of rehabilitation inpatients. Methods: As a retrospective medical record survey regarding rehabilitation inpatients, 4,207 episodes were collected through 42 hospitals. Considering the opinions of clinical experts and the decision-tree analysis, the variables for the KRPG system demonstrating the characteristics of rehabilitation inpatients were derived, and the splitting standards of the relevant variables were also set. Using the derived variables, we have drawn the rehabilitation inpatient classification model reflecting the clinical situation of Korea. The performance evaluation was conducted on the KRPG system. Results: The KRPG was targeted at the inpatients with brain or spinal cord injury. The etiologic disease, functional status (cognitive function, activity of daily living, muscle strength, spasticity, level and grade of spinal cord injury), and the patient's age were the variables in the rehabilitation patients. The algorithm of KRPG system after applying the derived variables and total 204 rehabilitation patient groups were developed. The KRPG explained 11.8% of variance in charge for rehabilitation inpatients. It also explained 13.8% of variance in length of stay for them. Conclusion: The KRPG version 1.0 reflecting the clinical characteristics of rehabilitation inpatients was classified as 204 groups.

• 대한물리치료과학회지
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• 제11권2호
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• pp.18-26
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• 2004

The purpose of this study was to compare difference of the static and dynamic balance in normal subject and LBP subject and recognizes about postural sway. The subjects of this study included 30 normal subjects and 30 LBP subjects. By using Active balance system, the static balance was measured by unit path length, circumference area, weight bearing, stabilometry length, while the dynamic balance was measured by step evaluation. Statistically analyzed using independent t-test to search static balance and dynamic balance difference in two groups. Postural sway appeared greatly in patient group than normal group in analysis result of static balance and postural sway was big in patient group of when closed eye and normal group and patient group did show statistical significance in unit path length, circumference area. Weight support of normal group was shared equally in weight bearing rate, but weight support of patient group stewed less to pain side. Anterior step time and Task achieve time of dynamic balance were spent more in patient group than normal group. Desire to be used to useful information to lay treatment policy about set-up and action of when quantification result of valued postural balance treats low back pain patient by objective tool, in the fixture, more researches in postural estimation desire that is enforced abuzz.

• 사상체질의학회지
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• 제27권3호
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• pp.326-332
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• 2015

Objectives The quality of life in cancer patients is important. The aim of this study is to report a case which showed symptoms improvement after treatment with modified Galgeunhaegi-tang. Methods We retrospectively reviewed the medical records. The patient's body weight and the circumference of lower extremity were measured and the subjective symptoms such as chest pain were evaluated by the NRS(Numeric Rating Scale). And the frequency of defecation was checked daily. Results The patient had received chemotherapy from March to November 2014 for 8th times. During the chemotherapy, the patient developed symptoms such as weight gain, edema of lower extremity, chest pain, headache, low back pain, and constipation. But additional evaluation and management with western medicine couldn't solve the problem. So he started to take Korean medicine. And he was transferred to our cancer center to keep continuing the treatment. After the treatment, the body weight, the lower extremity circumference and the subjective severity of chest pain, headache, low back pain were all decreased. During hospitalization at our center, the patient didn't suffer from constipation. Conclusions An elderly non-small cell lung cancer patient showed the improvement of symptoms that were continued during chemotherapy. As we can see in this case, Korean medicine can be a solution of the symptoms induced by chemotherapy, if there is no symptom improvement with western medicine.

• 가정∙방문간호학회지
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• 제23권2호
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• pp.186-194
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• 2016

Purpose: The purpose of this study was to evaluate the effects of standardized patient simulation on nursing students' communication skills, problem-solving skills, critical thinking dispositions, and clinical competency. Methods: A one-group pretest-posttest design was used. Data were collected from a convenient sample of 47 junior nursing students at W University. Scenarios to train SP and checklists to evaluate the students''competence were developed by our research team. The collected data were analyzed with descriptive analysis t-test, Pearson's Correlation Coefficient and Cronbach's ${\alpha}$ using SPSS WIN 21.0 Program. Results: The simulation practicum using a standardized patient was conducted based on four steps, namely, selections of scenario modules, standard patient training, implementation, and evaluation. The differences between the pre and post-test scores of problem-solving skills(t=-2.94, p=.005) and clinical competency(t=-2.84, p=.007) were statistically significant. But communication skill(t=-.32, p=.747) and critical thinking(t=-.68, p=.498) was not different in group. Conclusion: Standardized patient simulation in nursing education may be useful the improvement of problem-solving skills and clinical competency.