• 제목/요약/키워드: Patient-based

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가치통합 의사결정모델을 이용한 간호학생 대상 웹기반 환자권리교육 시뮬레이션 프로그램 개발 및 평가 (Development and Evaluation of a Web-based Simulation Program on Patient Rights Education using Integrated Decision Making Model for Nurse Students)

  • 김기경
    • 간호행정학회지
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    • 제20권2호
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    • pp.227-236
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    • 2014
  • Purpose: This study was designed to develop and evaluate the a web-based simulation program on patient rights education using integrated decision making model into values clarification for nurse students. Methods: The program was designed based on the Aless & Trollip model and Ford, Trygstad-Durland & Nelms's decision model. Focus groups interviews, surveys on learning needs for patient rights, and specialist interviews were used to develop for simulation scenarios and decision making modules. The simulation program was evaluated between May, 2011 and April, 2012 by 30 student nurses using an application of the web-based program evaluation tools by Chung. Results: Simulation content was composed of two scenarios on patient rights: the rights of patients with HIV and the rights of psychiatric patients. It was composed of two decision making modules which were established for value clarifications, behavioral objective formations, problems identifications, option generations, alternatives analysis, and decision evaluations. The simulation program was composed of screens for teacher and learner. The program was positively evaluated with a mean score of $3.14{\pm}0.33$. Conclusion: These study results make an important contribution to the application of educational simulation programs for nurse students' behavior and their decision making ability in protecting the patient rights.

『상한론(傷寒論)』 변병진단체계(辨病診斷體系)에 근거하여 죽엽석고탕(竹葉石膏湯) 투여 후 호전된 공황장애 1례 (A Case Report of Panic disorder treated by Jukyeopseokgo Tang based on Shanghanlun Provisions)

  • 김대담
    • 대한상한금궤의학회지
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    • 제8권1호
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    • pp.155-164
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    • 2016
  • Objective : The purpose of this paper is to report the improvement of patient with panic disorder treated by herb medication based on Shanghanlun disease pattern identification diagnostic system. Methods :, The patient with panic disorder was diagnosed according to 'Disease Pattern Identification Diagnostic System based on Shanghanlun Provisions'. The changing symptom of panic disorder was estimated by BAI(Beck Anxiety Inventory). Results : The patient was diagnosed with yin-yang-yi-cha-hou-lao-fu bing, number 397 provision, and took Jukyeopseokgo-tang herb medication about 113 days. The BAI score changed 37 to 12. Conclusions : The therapeutic intervention and herb medication showed a therapeutical effect on the patient. The anxiety and helplessness of the patient was improved. This patient's panic disorder was associated with poor sleep patterns and sensitivity to minor things and controled by Jukyeopseokgo-tang. The relationships between poor sleep patterns and 陰陽易差後勞復病, shortness of breath when sensitive to minor things and 少氣 need further study.

구음장애, 필기장애를 중심으로 한 중풍후유증에 소함흉탕(少陷胸湯)을 투여하여 호전된 1례 보고 (A Case Report of a Patient Who Has Dysgraphia and Articulation After a Stroke Treated by Sohamhyung-Tang)

  • 김창식;윤효중;이숭인
    • 대한상한금궤의학회지
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    • 제10권1호
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    • pp.115-124
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    • 2018
  • Objective : The purpose of this paper is to report the improvements of a patient who has suffered from aftereffects following stroke such as dysgraphia and articulation disorder, which is treated by herbal medication based on Shanghanlun disease pattern identification diagnostic system. Methods : According to 'Disease Pattern Identification Diagnostic System based on Shanghanlun Provisions', the patient was diagnosed as Taeyang-byung Gyeolhyung and number 138 provision, and was administered Sohamhyung-tang for 90 days. We recorded the progress of improvements based on the patient's statement and documented the patient's writing Results : The patient can write the letters such as U, 2, ㄹ,ㅇ more clearly and become confident on both writing and speaking. Conclusions : This case shows the effects of Sohamhyung-tang on aftereffects following stroke such as dysgraphia and articulation disorder. It was induced according to the 'Disease Pattern Identification Diagnostic System based on Shanghanlun Provisions' so that it suggest a potential interpretation, which is different with it of the text books Herbal Formula Science and Sanghallonjeonghae, on the provision no. 138. Also the usage of Sohamhyung-tang in this case may support the way far from the diagnosis of oriental neurological medicine, which explain the pathology of stroke as fire-heat(火熱), dampness-phlegm(濕痰), static blood(瘀血) and dual deficiency of qi and blood(氣血兩虛).

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Clinical Implementation of Precision Medicine in Gastric Cancer

  • Jeon, Jaewook;Cheong, Jae-Ho
    • Journal of Gastric Cancer
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    • 제19권3호
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    • pp.235-253
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    • 2019
  • Gastric cancer (GC) is one of the deadliest malignancies in the world. Currently, clinical treatment decisions are mostly made based on the extent of the tumor and its anatomy, such as tumor-node-metastasis staging. Recent advances in genome-wide molecular technology have enabled delineation of the molecular characteristics of GC. Based on this, efforts have been made to classify GC into molecular subtypes with distinct prognosis and therapeutic response. Simplified algorithms based on protein and RNA expressions have been proposed to reproduce the GC classification in the clinical field. Furthermore, a recent study established a single patient classifier (SPC) predicting the prognosis and chemotherapy response of resectable GC patients based on a 4-gene real-time polymerase chain reaction assay. GC patient stratification according to SPC will enable personalized therapeutic strategies in adjuvant settings. At the same time, patient-derived xenografts and patient-derived organoids are now emerging as novel preclinical models for the treatment of GC. These models recapitulate the complex features of the primary tumor, which is expected to facilitate both drug development and clinical therapeutic decision making. An integrated approach applying molecular patient stratification and patient-derived models in the clinical realm is considered a turning point in precision medicine in GC.

Design and Implementation of a Personal Health Record Platform Based on Patient-consent Blockchain Technology

  • Kim, Heongkyun;Lee, Sangmin;Kwon, Hyunwoo;Kim, Eunmin
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • 제15권12호
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    • pp.4400-4419
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    • 2021
  • In the 4th Industrial Revolution, the healthcare industry is undergoing a paradigm shift from post-care and management systems based on diagnosis and treatment to disease prevention and management based on personal precision medicine. To optimize medical services for individual patients, an open ecosystem for the healthcare industry that allows the exchange and utilization of personal health records (PHRs) is required. However, under the current system of hospital-centered data management, it is difficult to implement the linking and sharing of PHRs in practice. To address this problem, in this study, we present the design and implementation of a patient-centered PHR platform using blockchain technology. This platform achieved transparency and reliability in information management by eliminating the risk of leakage and tampering/altering personal information, which could occur when using a PHR. In addition, the patient-consent system was applied to a PHR; thus, the patient acted as the user with ownership. The proposed blockchain-based PHR platform enables the integration of personal medical information with scattered distribution across multiple hospitals, and allows patients to freely use their health records in their daily lives and emergencies. The proposed platform is expected to serve as a stepping stone for patient-centered healthcare data management and utilization.

Extended Kepler Grid-based System for Diabetes Study Workspace

  • Hazemi, Fawaz Al;Youn, Chan-Hyun
    • 한국정보처리학회:학술대회논문집
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    • 한국정보처리학회 2011년도 춘계학술발표대회
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    • pp.230-233
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    • 2011
  • Chronic disease is linked to patient's' lifestyle. Therefore, doctor has to monitor his/her patient over time. This may involve reviewing many reports, finding any changes, and modifying several treatments. One solution to optimize the burden is using a visualizing tool over time such as a timeline-based visualization tool where all reports and medicine are integrated in a problem centric and time-based style to enable the doctor to predict and adjust the treatment plan. This solution was proposed by Bui et. al. [2] to observe the medical history of a patient. However, there was limitation of studying the diabetes patient's history to find out what was the cause of the current development in patient's condition; moreover what would be the prediction of current implication in one of the diabetes' related factors (such as fat, cholesterol, or potassium). In this paper, we propose a Grid-based Interactive Diabetes System (GIDS) to support bioinformatics analysis application for diabetes diseases. GIDS used an agglomerative clustering algorithm as clustering correlation algorithm as primary algorithm to focus medical researcher in the findings to predict the implication of the undertaken diabetes patient. The algorithm was Chronological Clustering proposed by P. Legendre [11] [12].

『상한론(傷寒論)』 육경(六經) 진단체계에 근거하여 오수유탕(吳茱萸湯)을 투여한 양명병(陽明病) 아토피 피부염 1례 (A Case Report of Atopic Dematitis treated by Osuyu-tang (Wuzhuyu-tang) based on Shanghanlun provisions)

  • 윤수민;임은교
    • 대한상한금궤의학회지
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    • 제5권1호
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    • pp.85-92
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    • 2013
  • Objective : This case report aims to show the effect of Osuyu-tang on an atopic dermatitis. The patient was diagnosed with Yangmyung-byung based on Shanghanlun provisions. Methods : According to Diagnostic system based on Shanghanlun provisions, the patient was diagnosed with Yanamyung-byung and has been unusual dietary habits. So she took Osuyu-tang decoction for 2 weeks. We evaluated the results of treatment by SCORAD Index and before and after treatment photos. Results : After taking Osuyu-tang decoction for 2weeks, the patient's SCORAD INDEX and symptoms was decreased from 49.5(severe) to 3.5(mile). Also, the patient's chronic diagestive disorder improved. Conclusions : This case report showed an effectiveness of using Osuyu-tang according to Diagnostic system based on Shanghanlun provisions on atopic dermatitis.

Evidence-Based Medicine에 대한 소개 (Introduction to Evidence-based Medicine (EBM))

  • 최재걸
    • 대한핵의학회지
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    • 제35권4호
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    • pp.224-230
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    • 2001
  • EBM is "the conscientious, explicit and judicious use of current best evidence in mating decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research." EBM is the integration of clinical expertise, patient values, and the best evidence into the decision making process for patient care. The practice of EBM is usually triggered by patient encounters which generate questions about the effects of therapy, the utility of diagnostic tests, the prognosis of diseases, or the etiology of disorders. The best evidence is usually found in clinically relevant research that has been conducted using sound methodology. Evidence-based medicine requires new skills of the clinician, including efficient literature-searching, and the application of formal rules of evidence in evaluating the clinical literature. Evidence-based medicine converts the abstract exercise of reading and appraising the literature into the pragmatic process of using the literature to benefit individual patients while simultaneously expanding the clinician's knowledge base. This review will briefly discuss about concepts of evidence medicine and method of critical appraisal of literatures.

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전원 관련 안전간호수행에 영향을 미치는 요인 (Predicting Patient Safety Behaviors of Nurses in Inter-Hospital Transfer)

  • 박선희;이태화
    • 간호행정학회지
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    • 제22권3호
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    • pp.230-238
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    • 2016
  • Purpose: The purpose of this study was to investigate predictors of nurses' patient safety behavior during inter-hospital transfer. The study was based on the Theory of Planned Behavior (TPB). Methods: A descriptive survey design was used. Data were collected with a self-administrated 39-item questionnaire completed by 111 nurses from a university hospital in Seoul, South Korea. The questionnaire was developed based on the Theory of Planned Behavior (TPB) guideline and included measure of self-reported past patient safety behaviors, intentions, attitudes, subjective norms and perceived behavioral controls. Ethical approval was granted by the hospital review board. Hierarchical regression analyses were carried out. Results: The average score of patient safety behavior was $4.21{\pm}0.63$ (5 point scale). The TPB variables explained 49.9%of the variance in patient safety behavior. Intention and subjective norm were the most significant predictors of nurses' patient safety behavior. Attitude was related to nurses' patient safety behavior. Conclusion: TPB variables predicted the nurses' patient safety behavior during inter-hospital transfer of patients except for perceived behavioral controls. The results of this study suggest that better strategies for subjective norms and intentions related to patient safety behavior will be helpful in safety culture reform.

안전과학 패러다임의 전환과 환자안전의 개선 (What Will We Learn from the Paradigm Shift in Safety Science for Improving Patient Safety?)

  • 이상일
    • 한국의료질향상학회지
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    • 제27권1호
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    • pp.2-9
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    • 2021
  • Patient safety remains one of the most important health care issues in Korea. To improve patient safety, we have introduced concepts from the field of safety science such as the Swiss cheese model, and adopted several methodologies previously used in other industries, including incident reporting systems, root cause analysis, and failure mode and effects analysis. This approach has enabled substantial progress in patient safety to be made through undertaking patient safety improvement activities in hospitals that are systems-based, rather than individual-based. However, these methods have the shared limitation of focusing on negative consequences of patient safety. Therefore, the paradigm shift from Safety I to Safety-II in safety science becomes the focus of our discussion. We believe that Safety-II will complement, rather than replace, Safety-I in the discipline of patient safety. In order to continuously advance patient safety practices in Korea, it is necessary that Korea keeps abreast of the recent global trends and development in safety science. In addition, more focus should be placed on testing the feasibility of new patient safety approaches in real-world situations.