• 제목/요약/키워드: Patient reported outcome

검색결과 228건 처리시간 0.025초

Endoscopic Spinal Surgery for Herniated Lumbar Discs

  • Shim, Young-Bo;Lee, Nok-Young;Huh, Seung-Ho;Ha, Sang-Soo;Yoon, Kang-Joan
    • Journal of Korean Neurosurgical Society
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    • 제41권4호
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    • pp.241-245
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    • 2007
  • Objective : So called "minimally invasive procedures" have evolved from chemonucleolysis, automated percutaneous discectomy, arthroscopic microdiscectomy that are mainly working within the confines of intradiscal space to transforaminal endoscopic technique to remove herniated epidural disc materials directly. The purpose of this study is to assess the result of endoscopic spinal surgery and favorable indication in the thoracolumbar spine. Methods : The records of 71 patients, 73 endoscopic procedures, were retrospectively analysed. Yeung Endoscopic Spine Surgery system with 7 mm working sleeve and $25^{\circ}$ viewing angle was used. The mean follow up period was 6 months [range, 3-9]. Results : Operated levels were from T12-L1 disc down to L5-L6 of S1 disc. Of 71 cases, 2 patients underwent transforaminal endoscopic surgery twice due to recurrence after initial operation. MacNab's criteria was used to assess the outcome. Favorable outcome, excellent of good, was seen in 78% [57 procedures] of the patients. Among 11 fair outcomes, only 1 procedure was followed by secondary open procedure, laminectomy with discectomy. Two of 5 poor outcomes were operated again by same procedure which resulted in fair outcomes. One patient with aggravated cauda equina syndrome remained poor and a lumbar fusion procedure was performed in other patient with poor outcome. There were 2 postoperative discitis that were treated with conservative care in one and anterior lumbar interbody fusion in the other. Conclusion : Evolving technology of mechanical, visual instrument enables minimal invasive procedure possible and effective. The transforaminal endoscopic spinal surgery can reach as high as T12-L1 disc level. The rate of favorable outcome is mid-range among reported endoscopic lumbar surgery series. Authors believe that the outcome will be better as cases accumulate and will be able to reach the fate of standard open microsurgery.

요통 및 좌골신경통 환자의 치료결과 : 수면장애 및 피로감과 자각적 통증 및 장애정도의 관계 (Outcome of Low-Back Pain and Sciatica : Relationship among Self-reported Pain Intensity, Disability, Sleep Disturbance and Fatigue)

  • 이경석;윤석만;도재원;배학근;윤일규
    • Journal of Korean Neurosurgical Society
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    • 제29권3호
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    • pp.324-329
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    • 2000
  • Objective : Psychological factors may have a major influence on the outcome of treatment for back pain. We investigated the relationship between the outcome and some psychological factors, such as self-reported pain intensity, disability, sleep disturbance and fatigue. Method : The study was conducted as a survey using a questionnaire and telephone interviews. The survey included consecutive 294 patients who visited the neurosurgical out-patient department complaining of low back pain and contacted by telephone on average seven months after the first visit. Pain intensity was measured by visual analog scale, and disability was assessed by Waddell's chronic disability index. Results : The outcome of treatment for back pain was recovered in 36.7%, improved in 30.6%, almost same in 28.6%, and aggravated in 4.1%. Overall rate of improvement was 67.3%. The rate of improvement was related to the duration, patterns and intensity of the symptom, and Waddell index. It was not influenced by the doctors, special studies, and methods of treatment. When the duration was more than 6 months, there were the symptoms of both back and legs, and the self-reported Waddell index was 1-3, the rate of improvement was relatively low. Although the intensity of the pain and disability was closely related to the degree of sleep disturbance, fatigue, appetite, or indigestion, the outcome of treatment for back pain was not always bad in patients with high psychological stress. Actually the outcome of the patients who complained severe pain and disability was better than the outcome of the others. Conclusion : The outcome of the back pain can be predicted by the duration, patterns and intensity of the symptom, and Waddell index. The multidisciplinary treatment will be necessary for the patients whose expected outcome is not good to reduce not only the physical symptoms but also the psychological stress.

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환자기반 치과의료 환자안전에 대한 연구 (Development of patient-based patient safety questionnaire in dentistry)

  • 김보라;신호성
    • 대한치과의료관리학회지
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    • 제10권1호
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    • pp.53-65
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    • 2022
  • The Primary Care Patient Measure of Safety (PC-PMOS) is a measure of safety that allows patients to evaluate contributing factors related to patient safety in primary care. This study aimed to examine which questionnaire items of the PC-PMOS could be used in Korean dental institutions. A survey of the Korean translation of the PC-PMOS, a self-reported questionnaire, was conducted in August 2022 by 400 adults who had used dental-care services within the last three years. Of the 77 items, 34 were selected using principal component analysis and two experts' evaluations based on face validity. Five domains were identified from factor analysis: patient centeredness, patient information update, complaint processing, communication, and information about the complaint process. The Cronbach's alpha of the data was 0.913, indicating high reliability. As a result of the generalized multiple regression analysis, regression coefficients were not statistically significant, except for household income. This indicated that there was no bias in the patient safety scores of dental institutions evaluated by patients within the range of independent variables used in this study. The five domains with 34 items identified in this study suggested the factors that contribute to the safety of patients who used dental care services in Korea. However, validation of this study result is still important to refine questionnaires suitable for dental institutions in Korea so as to further improve the quality of dental care.

재활전문병원 간호사의 환자안전문화에 대한 인식과 안전간호활동 수행의 관계 (Relationship between Perception of Patient Safety Culture and Performance for Safety Care Activity in Rehabilitation Hospital Nurse)

  • 강정미;박정숙
    • 재활간호학회지
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    • 제19권1호
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    • pp.12-19
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    • 2016
  • Purpose: This study was to examine the relationships between nurse's perception of patient safety culture and performance for safety nursing activities at rehabilitation hospitals. Methods: This study applied a descriptive research design. Participants were 194 nurses who have provided nursing services for more than 6 months at 4 rehabilitation hospitals located in B metropolitan city. Data were analyzed using descriptive statistics, t-test, ANOVA, $Scheff{\acute{e}}$ test, Pearson's correlation coefficients and multiple regression. Results: There was a positive correlation between the awareness of patient safety culture and safety nursing activity. Multivariate analysis showed that hospital work environment, experience of education, hospital climate, frequency of reported events, and marital status were significantly associated with the safety nursing activity. Overall, approximately 23.1% of total variability in the safety nursing activity could be explained by the 5 variables ($R^2=0.231$, p<.005). Conclusion: Nurses at rehabilitation hospitals are relatively positive about patient safety culture. Therefore, we need to develop safety education programs at the level of organization in order to improve patient safety through performing effective safety nursing activities in addition to increase awareness of patient safety culture among nurses. Furthermore, we need hospital's strategies at the system level for open communication and outcome reports regarding patient safety.

Clinical Outcome of Surgery for Unruptured Intracranial Aneurysms

  • Rhee, Deok-Joo;Hong, Seung-Chyul;Kim, Jong-Hyun;Kim, Jong-Soo
    • Journal of Korean Neurosurgical Society
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    • 제40권4호
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    • pp.227-233
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    • 2006
  • Objective : To determine the rationale for treating pure unruptured intracranial aneurysms[UIAs]. it is mandatory to know the risk of each treatment modality. The purpose of this study is to evaluate the surgical risk for treating UIAs. Methods : Between December 1994 and May 2005, 147 unruptured aneurysms in 135 patients were treated. The majority of these cases [94.6%] were treated with aneurysmal neck clipping. The remainder received aneurysmal wrapping [2.7%], trapping with bypass [20%], or proximal occlusion [0.7%]. The clinical outcomes were evaluated in each patient by the Glasgow Outcome Scale at one month post-surgery. Results : The patient pool consisted of 41 males and 94 females. The mean age was 55.9 years [range : $16{\sim}82$]. The aneurysms were located at middle cerebral artery in 63 [42.9%]. anterior communicating artery 30 [20.4%], posterior communicating artery in 26 [177%]. internal carotid artery[ICA] in 14 [95%], anterior choroidal artery in 4 [2.7%] and others in 10[6.9%]. One hundred fifteen [78.2%] of aneurysms were small [<10mm]. Others were large [10 to 25mm] and giant [>25mm]; 29 [19.7%] and 3 [21%] respectively. More than ninety percent [91.1%] of all patients recovered well. Mild to severe disability was seen in 8.7% of the patients. One patient succumbed to complications following injury to the ICA. Conclusion : The mortality and morbidity associated with UIA surgery at our hospital compared very favorably to the previous reported literature and with the previously established natural history of this disease.

Outcome of complete acellular dermal matrix wrap with polyurethane implant in immediate prepectoral breast reconstruction

  • Naemonitou, Foteini;Mylvaganam, Senthurun;Salem, Fathi;Vidya, Raghavan
    • Archives of Plastic Surgery
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    • 제47권6호
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    • pp.567-573
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    • 2020
  • Background Polyurethane implants have been used on and off in breast reconstruction since 1991 while prepectoral breast reconstruction has gained popularity in recent times. In this study, we present our outcomes from the use of acellular dermal matrix (ADM) complete wrap with polyurethane implants in prepectoral breast reconstruction. Methods This is a retrospective review of prospectively maintained database from 41 patients receiving complete ADM wrap with prepectoral polyurethane implants over a 3-year period. Selection criteria were adapted from a previous study (4135 Trust Clinical Audit Database) evaluating prepectoral reconstruction with Braxon matrices. Patient demographics, operative data, surgical complications, and outcomes were collected and analyzed. Results A total of 52 implant reconstructions were performed in 41 patients with a mean follow-up of 14.3 months (range, 6-36 months). The overall reported complication rates including early (less than 6 weeks) and late complications. Early complications included two patients (4.9%) with wound dehiscence. One of which had an implant loss that was salvageable. Another patient (2%) developed red-breast syndrome and two women (4.9%) developed with seroma treated conservatively. Late complications included one patient (2%) with grade II capsular contraction, 12 patients with grade I-II rippling and two patients (4.9%) with grade III rippling. Conclusions We present our experience of prepectoral polyurethane implant using complete ADM wrap. This is one of the few papers to report on the outcome of the prepectoral use of polyurethane in immediate implant-based breast reconstruction. Our early observational series show satisfactory outcome and long-term results are warranted by a large multicenter study.

Percutaneous Sacroplasty : Effectiveness and Long-Term Outcome Predictors

  • Lee, Jaehyung;Lee, Eugene;Lee, Joon Woo;Kang, Yusuhn;Ahn, Joong Mo;Kang, Heung Sik
    • Journal of Korean Neurosurgical Society
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    • 제63권6호
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    • pp.747-756
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    • 2020
  • Objective : To evaluate the effectiveness and long-term outcome predictors of percutaneous sacroplasty (PSP). Methods : This single-center study assessed 40 patients with sacral insufficiency fractures using the short-axis technique under C-arm flat-panel detector computed tomography (CT). Two radiologists reviewed the patients' magnetic resonance and CT images to obtain imaging findings before PSP and determine technical success, respectively. The short-term outcomes were visual analog scale score changes and opioid usage reductions. Long-term outcomes were determined using telephone interviews and the North American Spine Society (NASS) patient-satisfaction index at least one year after PSP. Results : Technical success was achieved without any significant complications in 39 patients (97.5%). Telephone interviews were possible with 12 patients and failed in 10 patients; death was confirmed in 18 patients. Fifteen patients (50%) re-visited the hospital and received conservative treatment, including spinal injections. Nine patients reported positive satisfaction (NASS patient-satisfaction index 1 or 2), while the negative satisfaction group (NASS patient-satisfaction index 3 or 4, n=3) showed a higher incidence of compression fractures at the thoracolumbar spine level (66.7% vs. 22.2%) and previous spinal injection history (66.7% vs. 33.3%). The poor response group also showed higher incidences of facet joint arthrosis (100% vs. 55.6%), central canal stenosis (100% vs. 22.2%), neural foraminal stenosis (33.3% vs. 22.2%), scoliosis (100% vs. 33.3%), and sagittal malalignment (100% vs. 44.4%). Conclusion : PSP was effective for sacral insufficiency fractures and showed good long-term outcomes. Combined compression fractures in the thoracolumbar spine and degenerative lumbar pathologies could be possible poor outcome predictors.

폐포충낭종의 수술치험 2 (Surgical treatment of pulmonary hydatid cysts: two cases report)

  • 정경영
    • Journal of Chest Surgery
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    • 제16권4호
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    • pp.518-525
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    • 1983
  • Hydatid cystic disease of the lung is rare in Korea. Recently, the authors encountered 2 patients with this disease who were treated surgically with a successful outcome in both. The first patient, a 27 year old housewife never traveled outside Korea and the second, 25 year old man had a history of spending a year in Kuwait. These 2 cases are the first documented cases of pulmonary hydatoidosis among Koreans reported in the literature.

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Attachment systems for mandibular implant overdentures: a systematic review

  • Kim, Ha-Young;Lee, Jeong-Yol;Shin, Sang-Wan;Bryant, S. Ross
    • The Journal of Advanced Prosthodontics
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    • 제4권4호
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    • pp.197-203
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    • 2012
  • PURPOSE. The aim of this systematic review was to address treatment outcome according to attachment systems for mandibular implant overdentures in terms of implant survival rate, prosthetic maintenance and complications, and patient satisfaction. MATERIALS AND METHODS. A systematic literature search was conducted using PubMed and hand searching of relevant journals considering inclusion and exclusion criteria. Clinical trial studies on mandibular implant overdentures until August, 2010 were selected if more than one type of overdenture attachment was reported. Twenty four studies from 1098 studies were finally included and the data on implant survival rate, prosthetic maintenance and complications, patient satisfaction were analyzed relative to attachment systems. RESULTS. Four studies presented implant survival rates (95.8 - 97.5% for bar, 96.2 - 100% for ball, 91.7% for magnet) according to attachment system. Ten other studies presented an implant survival rate ranging from 93.3% to 100% without respect to the attachment groups. Common prosthetic maintenance and complications were replacement of an assay for magnet attachments, and activation of a matrix or clip for ball or bar attachments. Prosthetic maintenance and complications most commonly occurred in the magnet groups. Conflicting findings were found on the rate of prosthetic maintenance and complications comparing ball and bar attachments. Most studies showed no significant differences in patient satisfaction depending upon attachment systems. CONCLUSION. The implant survival rate of mandibular overdentures seemed to be high regardless attachment systems. The prosthetic maintenance and complications may be influenced by attachment systems. However patient satisfaction may be independent of the attachment system.

Foot Function Index와 Foot and Ankle Outcome Score의 기입방법 연구: 종이와 연필을 이용한 기입 방법과 전자기기를 이용한 두 가지 측정방법에 대한 일치도 비교 (The Methods for Foot Function Index and Foot and Ankle Outcome Score Measurement: A Comparison between Paper-and-Pencil Method and Electronic Method)

  • 김지범;권민수;김정곤;이영;이우천;하정구;장석환
    • 대한족부족관절학회지
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    • 제21권1호
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    • pp.33-38
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    • 2017
  • Purpose: The patient-reported outcome measure (PROM) is used to quantify the subjective state of patients before and after the treatment. The electronic method was recently developed and used for the completion of PROM, in addition to the conventional paper and pencil method. This study identified whether the results of Foot Function Index (FFI) and Foot and Ankle Outcome Score (FAOS) using the paper and pencil method was different from those using the electronic method. Materials and Methods: Between May 2016 and August 2016, 42 patients who were admitted to the Seoul Foot and Ankle Center two days before surgery were included for evaluation. The mean age was 46 years (range, 21~72 years). There were 29 males and 13 females. To use the electronic method, the PADAS software (PADAS, Seoul, Korea) was implemented using a touch pad. The primary trial of FFI and FAOS was performed using either the paper-and-pencil method or the electronic method. At 24 hours after the primary test, a secondary trial of FFI and FAOS was performed using the other method. Then, we identified the reliability of FFI and FAOS between the two methods by calculating the intraclass coefficient. Results: Twenty-two patients underwent the first trial using the paper-and-pencil method, and 20 patients underwent the first trial using the electronic method. Of the 42 patients, 8 patients were excluded from this study and only 34 patients were included in this study. The reliability of FFI was excellent with an intraclass coefficient of 0.957, and the reliability of FAOS was also excellent with an intraclass coefficient of 0.840. Conclusion: The paper-and-pencil method and the electronic method have the same result for the completion of FFI and FAOS in this study. Therefore, it is commonly considered that the completion of FFI and FAOS using the electronic method can be applied in practice.