• 제목/요약/키워드: Patient management system

검색결과 927건 처리시간 0.054초

여성 성의학의 새로운 지평(地平) (New Spectra in Female Sexology in Korea)

  • 고민환
    • Journal of Yeungnam Medical Science
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    • 제16권1호
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    • pp.10-14
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    • 1999
  • The World Association for Sexology (WAS) will adopt a Declaration of Sexual Rights as basic and fundamental human rights August this year in Hong Kong. Two years ago WAS has been developing a Declaration of Sexual Rights in order to further promote sexual health and protect the sexual rights of everyone. Undoubtedly sexuality is one of the most intriguing subjects in the area of human behavior and psychology, and has been so since antiquity. The influence of sexual factors of human on all aspects of the society has been immense. The varieties of marriage, from traditional to the open marriage model are presented in front of our sight. The influences of women's movement in Korea, which has produced sexual, psychological, economic, political, familial and social changes look so small and the changes are not that much in America. But the profound effects of the women's movement affect on Korean society being realized as man's view of woman and woman's view of herself undergo constant change and reevaluation. With increased sexual awareness on the part of the public owing to mass media, for example AH-U-SEONG aired in TV and with increased emphasis on sexual matters in daily life, more and more physicians are being asked to deal with and manage sex-related problems in their daily practice. Yet, despite the obvious need for informed sexual counseling, doctors are often uncomfortable about sexual matters and many physicians have no special expertise in this area. So physicians concerned in sexology especially such as gynecologists, urologists, psychiatrists and endocrinologists must realize well about sex-related knowledge which is needed for counseling the patient as medical consumer and gap between reality and ideality in sexual diagnosis and treatment. Establishment of management system for the people who have sexual problems is strongly needed to promote sexual health and protect the sexual rights of everyone and for the Sexual Rights as basic and fundamental human rights.

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거골 골절 탈구 후 무혈성 괴사의 장기 추시: 5예 (Long Term Follow-up of Avascular Necrosis after Talar Fracture and Dislocation: 5 Cases)

  • 김병철;최성종;김휘택;류총일;정성원;은일수;구정모;김종균
    • 대한족부족관절학회지
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    • 제9권1호
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    • pp.31-37
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    • 2005
  • Purpose: To report our opinions of management about avascular necrosis following operative treatment of talar fracture and dislocation. Materials and Methods: We followed up 5 patients who were diagnosed as talar avascular necrosis after operation of talar fracture and dislocation. Clinical and radiological analysis were performed. The mean age of patients was 36 years. There were 4 males and 1 females. The average follow up was 51 months. Hawkins scoring system was used as clinical evaluation. Results: Regardless of radiological sclerotic finding, all patients showed satisfactory clinical result. Despite arthritic change in one patient, there were no further radiological and clinical deterioration to require salvage procedure. Conclusion: Most avascular necrosis after operative treatment of talar fracture and dislocation showed satisfactory result with conservative treatment. Thus, salvage operation such as talectomy or ankle fusion should be reserved in cases of intractable ankle pain and claudication.

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간호진단중심의 퇴원계획과 가정간호적용의 효과 -만성질환자를 중심으로- (The Effects of Hospital Home Nursing Interventions based on the Nursing Diagnosis)

  • 서문자;김금순;김명애;김인자;손행미
    • 기본간호학회지
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    • 제3권1호
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    • pp.50-67
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    • 1996
  • Home nursing interventions based on nursing diagnosis were implemented to the patient who are discharged from one hospital often the treatment for chronic neuromuscular system problem, and its effects were studied. The purpose of this study was to find out the effectiveness of hospital bouned home nursing provided by hospital nurses and to categorize home nursing diagnosis and its interventions. Data from experimental group patients were collected at three different time ; at the time of discharge, two weeks after discharge and our weeks after discharge. Data from controll group patients were collected twice ; the first one at the time of discharge, and the other one four weeks after discharge. For this study nursing assessment and intervention booklet developed by the research team. There were no significant decrease of the number of nursing problems and life satis-faction. But daily activity level of patients showed the signs of significant improvement at the time of four weeks after discharge. Results of this study indicates that home nursing intervention based on nursing diagnosis provided the patients with noticeable difference in health maintanance, impairment of physical mobility, potential for infection, impaired home marntenance management, health seeking behavior, chronic pain, disuse syndrome, impaired skin integrity.

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만성질환자 대상 맞춤형 투약상담 중재 프로그램 시범사업에 대한 평가 (Participants' Evaluation on the Payer-driven Medication Counseling Intervention for Individuals with Chronic Disease)

  • 손현순;장선미;이주연;한은아
    • 한국임상약학회지
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    • 제26권3호
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    • pp.245-253
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    • 2016
  • Objective: This study was conducted to evaluate payer-driven medication adherence intervention program from the patient's and counselor's perspectives. Methods: Target patients for intervention were selected by retrospective adherence measures based on national health insurance claims data for hypertension, diabetes and hyperlipidemia. As a serial intervention for higher risk groups of medication non-adherence, initial direct mailing, the first direct telephone call and the second direct call or a home visit were followed. Interview approach to qualitative inquiry was used to evaluate intervention results. Results: Participants including 4 patients received telephone calls, and 4 National Health Insurance Service staff and 4 pharmacists participated as counselors were interviewed regarding their impression of the intervention program. Three major themes arose: overall perception; necessities; and suggestions for success, of the intervention. Despite short period of intervention, educational intervention by telephone counseling involving pharmacists shows potential to improve self-management of chronic disease, and pharmacist-involvement. But more sophisticated selection of target patients requiring the intervention and complementation of electronic database system would be necessary. In addition, personal disposition of counselor was revealed to be an important factor for achieving successful outcome of intervention. Conclusion: The findings suggest that the individualized counseling intervention would be an efficient option for improved medication adherence. Further researches should include longer periods of interventions, a quantitative analysis using adherence measures based on claims data and consideration of clinical benefits associated with the intervention.

웰니스를 위한 빅데이터 분석과 의료 질 관리 (The Big Data Analysis and Medical Quality Management for Wellness)

  • 조영복;우성희;이상호
    • 한국컴퓨터정보학회논문지
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    • 제19권12호
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    • pp.101-109
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    • 2014
  • 의학기술의 발전과 소득수준의 증가로 "건강하게 오래살기"에 관심이 높아지면서 적극적으로 건강을 증진하고 유지하는 웰니스가 확대되고 있다. 또한 맞춤형 의료서비스에 대한 수요가 증가하고 방대한 의료 빅 데이터를 이용한 질병 예방의 움직임도 나타나고 있다. 이 논문에서는, 의료 시장에서 주요 관심분야로 부각되고 있는 웰니스를 지원하기위해 빅 데이터 기반의 의료 질 향상을 통한 환자중심의 의료서비스를 목적으로 한다. 환자를 약물에 의존적으로 치료만 하는 것이 아니라 식생활 개선을 기반으로 질병예방과 치료를 위해 빅데이터를 분석한다. 개인 트윗터를 분석해서 일상생활정보를 획득하고 웰니스 사전을 기반으로 질병예방과 치료를 목적으로 한다. 효율적인 빅데이터 분석을 위해 하둡노드를 증가하면서 데이터 처리시간을 실험하였다. 실험결과 저장시간의 경우 63%, 데이터 통합의 경우 18%, 전체 테스트 시간을 기준으로 26%로 하나의 노드로 처리하는 경우보다 세 개의 노드로 처리하는 것이 효율적임을 실험을 통해 확인하였다.

The Impact of Trauma Center Establishment on Laparotomy Patterns and Outcomes in Severe Hemoperitoneum Patients

  • Lee, Min A;Lee, Jungnam;Chung, Min;Lee, Giljae;Park, Jaejeong;Choi, Kangkook;Yoo, Byung Chul
    • Journal of Trauma and Injury
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    • 제30권1호
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    • pp.6-11
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    • 2017
  • Purpose: The establishment of the trauma system has changed the quality of trauma care in many countries. As one of the first designated level I trauma centers in Korea, we hypothesized that there were changes in laparotomy patterns and subsequent survival rates after the center was established. Methods: This was a 5-year retrospective study of all severe hemoperitoneum patients who were transfused with more than 10 units of packed red blood cells (RBCs) within 24 h of hospitalization. Variables related to trauma were collected throughout the study period, and the patients admitted before (period 1) and after (period 2) the establishment of a trauma center were compared. Results: Forty-five patients were managed from January 2009 to March 2015. The baseline patient characteristics of the two groups, including age, Injury Severity Score, blood pressure, and hemoglobin levels, were similar. The time to the operating room (OR) was $144.3{\pm}51.5$ min (period 1) and $79.9{\pm}44.1$ min (period 2) (p<0.0001). Damage control surgery (DCS) was performed in 17% of patients during period 1 and in 73% during period 2. The number of actual survivors (n=10) was higher than expected (n=8) in period 2. Conclusion: This is the first study analyzing the impact of a trauma center on the management of specific injuries, such as severe hemoperitoneum, in patients in Korea. During the study, the time to OR was shortened and DCS was used to a greater extent as a surgical procedure.

치과용 임플란트 보철물적용환자의 만족요인 (A Study on Satisfaction Factors with Dental Implant Patients)

  • 이성욱;김지환
    • 대한치과기공학회지
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    • 제28권1호
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    • pp.67-81
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    • 2006
  • This research has been attempt to examine closely factors that high cost and value to overall satisfaction state for dental implant prosthesis, re-utilization intention, inducement intention of the general hospital dental service user and provide basis data necessary to establish competitive general hospital dentistry management strategy. Collected data using own recording way questionnaire from April 17, 2004 to May 15, 2004 choosing 142 people that agree on this research and question of 361 people that dental implant prosthetic treatment finished from March 1, 1999 to March 1, 2004 for this. Major analyzation consequences are as follows : First, general satisfaction, re-utilization intention, inducement intention for implant prosthesis that highly correlation variables are kindness, explanation, medical treatment level and appreciation of the aesthetic. Second, correlation is high relatively between re-utilization intention, inducement intention in the 3 variables such as general satisfaction re-utilization intention, inducement intention. Third, the result of multiple regression analysis showed that most significant effective factors are satisfaction with explanation of dental implant prosthesis between the 3 dependant variables such as general satisfaction, re-utilization intention, inducement intention. In looking into these consequence, how to improve that raise satisfaction about dental implant prosthetic treatment and to establish patient focused care service system for dental implant prosthesis, it is consider that explain enough about implant prosthesis and raise quality of medical examination and treatment level, including satisfied with fabrication of good esthetic dental implant prosthesis.

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Cancer Registration in Basrah-Southern Iraq: Validation by Household Survey

  • Hussain, Riyadh Abdul-Ameer;Habib, Omran S
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권sup3호
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    • pp.197-200
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    • 2016
  • On an international scale, the burden of cancer in absolute numbers continues to increase, mainly due to aging of population in many countries, the overall growth of the world population, changing lifestyle with increasing cancer-causing behavior, like cigarette smoking, changing dietary habits and sedentary life. Cancer is the second-leading cause of death and disability in the world, after only heart disease. Recently, increasing incidence and mortality of cancer have also become evident in the developing world. In Iraq and particularly in Basrah in the southern part of the country, the burden has definitely increased and deserves extensive research. The present paper is part of an extensive household survey carried out in Basrah in 2013. Among the objectives was to validate official cancer registration in the governorate. The cross-sectional survey had a retrospective component to inquire about the incidence of cancer and cancer-related deaths during the three years preceding the date of inquiry (2010-2012). A convenient sample of 6,999 households with 40,688 inhabitants using multistage cluster sampling was surveyed involving all urban and rural areas of Basrah. The official cancer registration activities in Basrah seemed to have attained a high level of registration coverage (70-80%) but the gap, represented by missed cases, is still high enough to criticize the system. Most of the missing cases were either not notified by treating facilities or they were diagnosed and treated outside Basrah. Using a set of parameters, the pattern of cancer was consistent based on data of the household survey and data of the cancer registry but a gap still existed in the coverage of incident cancer and mortality by cancer registration. Integrated serious steps are required to contain the risk of cancer and its burden on the patient through improving the registration process, improving early detection, diagnostic and management capabilities and encouraging scientific research to explore the hidden risk factors and possible causes of low registration coverage. Periodic household surveys seemed feasible and essential to support routine registration.

폐출혈을 동반한 현미경적 다발혈관염 1예 (A Case of Microscopic Polyangiitis with Diffuse Alveolar Hemorrhage)

  • 이상진;이재웅;김혜진;신경철;정진홍;이관호;박혜정
    • Journal of Yeungnam Medical Science
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    • 제21권1호
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    • pp.101-107
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    • 2004
  • Diffuse alveolar hemorrhage is a rare but serious and frequently life-threatening complication of a variety of conditions. The first goal in the management of patients with diffuse alveolar hemorrhage is to achieve or preserve stability of the respiratory status. Subsequently, the differential diagnosis is aimed at the identification of a remediable cause of the alveolar hemorrhage. The most common causes of diffuse alveolar hemorrhage with glomerulonephritis are microscopic polyangiitis and Wegener's granulomatosis, followed by Goodpasture syndrome and systemic lupus erythematosus. Microscopic polyangiitis (MPA) is a distinct systemic small vessle vasculitis affecting small sized vessels with few or no immune deposits and with no granulomatosus inflammation. The disease may involve multiple organs such as kidney, lung, skin, joint, muscle, gastrointestinal tract, eye, and nervous system. MPA is strongly associated with antineutrophil cytoplasmic autoantibody (ANCA) that is a useful serological diagnostic marker for the most common form of necrotizing vasculitis. Our report concerns a case of microscopic polyangiitis with diffuse alveolar hemorrhage in a 54-year-old man. He was admitted to our hospital due to dyspnea upon exertion and recurrent hemoptysis. Laboratory findings showed hematuria, proteinuria and deterioration of renal function. In the chest CT scan, diffuse ground glass appearance was seen in both lower lungs. A lung biopsy revealed small vessel vasculitis with intraalveolar hemorrhage and showed a positive reaction to against perinuclear ANCA. The patient was treated with prednisolone and cyclophosphamide. Chest infiltration decreased and hemoptysis and hypoxia improved. He is still being followed up in our hospital with a low dose of prednisolone.

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수술 중 발생한 다량의 급성 폐동맥 색전증에 의한 심장 정지의 경피적 심폐 보조를 사용한 성공적 소생 - 1예 보고 - (Successful Resuscitation of Cardiac Arrest with Acute Massive Pulmonary Embolism during Operation Using Percutaneous Cardiopulmonary Support (PCPS) - A case report -)

  • 박경택;김연수;장우익;김창영;류지윤;권성욱
    • Journal of Chest Surgery
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    • 제41권2호
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    • pp.273-276
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    • 2008
  • 심장 정지에 있어서 체외 심폐 보조가 1983년도에 도입된 이래로 심장 정지의 치료에 응급 경피적 심폐 보조가 사용되어 왔다. 다량의 급성 폐동맥 색전증은 사망률이 높고, 특히 수술 중 발생한 경우는 외과의와 마취의에게 힘든 문제를 제기한다. 본 증례는 수술 도중에 발생한 다량의 폐동맥 색전증으로 인한 심장 정지에 대하여 효과적인 치료수단으로써 응급 체외 순환기를 사용한 56세의 여자 환자에 대하여 기술하였다. 환자는 와파린을 복용하면서 퇴원하였고, 패동맥 색전증의 재발없이 외래추적 중이다.